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ceed. I therefore separated them still more, and repeated thefomentations and friction to the abdomen.-Seven P.M.: Thepains are now more forcing and regular; the waters not yetruptured. To hasten matters, therefore, I introduced a pairof polypus forceps, and gently seizing the membranes, torethem. This soon brought on more powerful pains, which con-tinued for some hours, during which the head slightly de-scended, and came more within reach. As she was muchfatigued with pains which had now lasted for nearly threedays, and knowing that the extraction would occupy a con- z,siderable time, I gave her a full opiate, and left her for thenight, with the intention of returning the next morning, anddelivering as soon as possible.23rd.-Half-past nine A.M.: Has had but little rest; there is

no perceptible advance of the head; the vagina cool and moist;therefore, after introducing the catheter, I proceeded, with theable assistance of Mr. Stone, to perforate. Owing to the impos-sibility of making a sufficient opening in the direction of theconjugate diameter, I was obliged to be satisfied with a singleopening in the posterior fontanelle, in the direction of thelateral diameter. The brain was carefully broken down, andin order to evacuate the head as completely as possible, andcause it to collapse, a long elastic tube, attached to an enemaapparatus, was introduced into the opening in the cranium,and through this warm water was forcibly injected. By thismeans, the brain was immediately evacuated, and the bonescollapsed, by slow and steady traction, partly with the fingerand crotchet; and by keeping the head as much as possible tothe sides of the pelvis, it at length passed the brim, but wasdelayed for some time at the outlet, in consequence of the con-traction caused by the coccyx. It was from the passage of theshoulders, however, that the greatest difficulty was expe-rienced, for they were long delayed at the brim, and afterpassing that, when they approached the outlet, in spite ofpowerful uterine contraction, and being turned in the mostfavourable position, they were so firmly retained, that I wason the point of endeavouring to empty the contents of thechest, when one hand was seized during the absence of a pain,and being passed over the head, the arm was extracted. Thisenabled me to deliver the other, and now by turning the bodyobliquely, it was soon delivered also. The placenta wasthrown off in a few minutes, and the uterus contracted well.The whole operation occupied a little more than two hours.-Eight P.3i.: Has had no rest since the morning; pulse 90, rathersharp; tongue moist; some pain on pressure over the abdomen;has not been able to pass water; lochia natural; the catheterwas therefore introduced, and several ounces of urine eva-cuated, which gave great relief. She was also prescribed,sedative solution of opium, twenty minims; camphor mixture,one ounce and a half. To be taken immediately.24th.-Has passed a very quiet night, and is going on well

in every respect; the catheter was again passed, as all at-tempts to relieve herself caused pain.-Eight 1’.111.: Some painin the back and loins; lochia scanty; is rather thirsty; tonguemoist; pulse 86; some headach. A hot bran poultice was di-rected to the abdomen; saline mixture, with small doses ofantimonial wine, every four hours; and a powder composed ofcompound ipecacuanha, eight grains; James’s powder, fourgrains, to be taken directly.25th.-Ten A.M.: Pain much relieved; pulse 84; skin moist;

uterus hard, and tender on pressure, but not to any great ex-tent ; lochia scanty; can now relieve the bladder without thecatheter, and without pain.26th.-Has passed a good night; no fever; pulse 80; tongue e

moist; less pain over the uterus; lochia abundant; bowels notopen; suffers from distention of the breasts, which are hardand knotty; cold lotion to the breasts, and castor oil imme-diately.

2Tth.—Going on well in every respect, except sufferingfrom the breasts, which are full, and painful; bowels open;lochia quite natural; the breasts were relieved by drawing;cold lotion kept applied; and a mixture of carbonate and sul-phate of magnesia, with antimonial wine, given every fourhours.

I need not continue the daily progress of the case, forafter this time she went on as favourably as possible. Underthe use of antimony and magnesia the milk soon left her,without causing any more trouble. She had perfect commandru-er the bladder, and in about three weexs was about, and ingood health. Still further to satisfy myself with regard tothe measurement of the pelvis, I was fortunate enough to getmy friend Dr. H. Bennet to examine the patient, and wasmuch gratified to have my own opinion again completely con-firmed.Aion-street, Hyde-park, August, !847.

SPONTANEOUS EVOLUTION.BY J. JONES, Esq., Llanfair, Montgomeryshire.

I wAs summoned to a woman in labour of her fifth child. Iwas informed the membranes had broken three days pre-viously. The patient had always had an expeditious and safedelivery, without assistance. Some hours before my visit anarm had presented itself. On my arrival, I found the shoulderso firmly impacted within the brim of the pelvis, that the im-practicability of turning was palpably evident. There was nohaemorrhage; slight, continuous, uterine action, but no symp-tom of exhausted strength. I at once determined to resort tothe method recommended, and first extensively and success-fully practised, by the elder Ramsbotham; and, as far as myexperience goes, it is the safest and most available practicein such untoward circumstances-that of perforating, and sub-sequently eviscerating, the chest and abdomen. I accordinglyintroduced a large perforator between the ribs. Scarcely hadthe instrument entered the thorax, than a severe expulsivepain came on. In the meantime,-it was the work of a second,-the body of the child receded, the arm followed, and I hadbarely time to withdraw the instrument before the breechpresented. A few minutes afterwards the labour was over,and the woman recovered without an unfavourable symptom.

Llanfair, Montgomeryshire, Aug. 1847.

Reviews.

Report on the Climate and Principal Diseases of the African.StatÚJn; compiled from Documents in the Office of the Directorgeneral of the Medical Department, and from other sources, incompliance with the directions of the Right Hon01lrable the.Lords Commissioners of the Admiralty. Under the immediatedirection of Sir William Burnett, M.D., K.6H., F.R.S. ByALEXANDER BRYSON, M.D., Surgeon R.N. London: 1847.pp. 260.

Report on the Fever at Boa Vista. By Dr. M’WILLIAM. Pre-sented to the House of Commons, in pursuance of theirAddress of the 16th of March, 1847. London: 1847. pp.112.

Letter addressed by Sir William Pym to the Lords of the Council,relative to a Report on the Fever at Boa Vista, by Dr.M’WILLIAM. Presented to the House of Commons, in pur-suance of their Address of May 14th, 1847. London: 1847.pp. 15.

(SECOND NOTICE.)A FOUL state of the hold in vessels employed on the AfricanStation appears to be a principal and efficient cause of re-mittent fever, and we may even judge, from some of the facts.mentioned by Dr. Bryson, that the persistent character of the-disease, and the malignancy it occasionally displays, may betraced, in a great degree, to the emanations from the decom-posing accumulation of filth in the hold, and under thelimber-boards.

"The ’Conflict’ arrived upon the station in July, 1830.The crew suffered but little from the common diseases of thecountry until the following July, the whole of that month andpart of the preceding one having been spent in the river ofSierra Leone. The greater part of the crew were on shoreduring the heavy rains, where they committed the usualexcesses, and frequently slept in the open air. Thirty casesof fever, of which eight terminated fatally on board, and fivewere sent to the hospital, were the result of these impru-dences. The disease appears to have been of a most malig-nant character. It was remittent, but varied in its symptomsin different cases. In the worst it was attended with greatexcitement, and, as it advanced, the skin assumed a yellowcolour, interspersed with livid spots. Towards dissolution, inthe fatal cases, a quantity of dark matter was vomited, whilea disagreeable cadaverous smell exhaled from the body somehours before life became extinct. The dejections were alsofrequently dark and foetid. In one instance, in the course ofhalf an hour after death, the whole surface of the body pre-sented a dark-blue colour, and the cuticle separated. Therecan be but little doubt that all these cases were what isusually termed yellow fever in its worst form. Still, althoughevery circumstance is very minutely detailed, contagion isnot alluded to.

C,

" This vessel sailed from Sierra Leone on the 5th of August,and arrived at Ascension on the 29th, where, in consequence

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of a representation which was made to the CommodorErelative to the state of the vessel below, it was directed thaishe should be thoroughly cleared out. On the removal of thEtanks and the limber-boards, the hold presented a very filthappearance, blackish mud with vegetable matter being broughinto view, the effluvium from which was at first insufferableThe passages to the pump-well were found to be completelyblocked up. This filth having been removed, the holds wenwhitewashed, well ventilated, and dried ; the tanks werEthen re-stowed, and her stores embarked, after which sh<again sailed for the coast, where she arrived on the lltlof October, and resumed her duties in the bights." - pp95-97.

This example, perhaps, may hardly be considered con

clusive, as to the danger resulting from a foul state of a ship’:hold, inasmuch as the crew were also exposed to the feverexciting agencies of the shore, and of those resulting fronintoxication, and, probably, also of other acts of imprudenceIt is not impossible, however, that the malignant character o:the disease, which is especially alluded to in the report, ma3have been, at all events, partly owing to the emanations fron:vegetable decomposition within the ship. There are, how.

ever, other instances of fever occurring on board ship, whictcan be clearly traced to the agency of this cause. " ThE’Heroine’ was employed on the Benguela division of the

station, during the early part of the year 1844, when thereoccurred fifteen cases of fever, of which four, contracted whilepumping out the hold of an old leaky slaver in the harbour oiSt. Paul de Loando, were the worst; three of the men wereseized with the disease while at work, and upon examination;it was ascertained that they complained of headach, sicknessof stomach, and prostration of strength, the tongue beingtremulous, and the pulse full and rapid; one of these ulti-

mately died; two recovered in the course of ten or twelvedays; while the fourth, who also died, did not present thesame symptoms until eight days afterwards, and they werethen apparently less severe."The crew of the unfortunate steamer, "Eclair," suffered

doubly from the emanations from foul holds. In the first

instance, from being employed in clearing out the hold of the"Albert," which had not been done since that vessel leftEngland on the Niger expedition; and in the second, fromthe accumulation of decomposing filth under her own limber-boards, which existed to such an extent, that although thehold, which was reported to be perfectly clean, was

thoroughly cleaned out at Boa Vista, and also well ventilatedand whitewashed, yet when the vessel was re-commissioned, alarge collection of mud was found, fully three inches in depth,upon that part of her bottom occupied by the boilers andmachinery, which apparently had not been disturbed for along time. When the hold of the " Growler" was openedat Woolwich, after her return from the coast of Africa, twomen, who slept directly over the hatchway, were seized withfever possessing all the characteristics of yellow fever; and inthe course of a few days, they both had black vomit, and diedin the Marine Infirmary, where they were taken on the com-mencement of the attack.

Sir W. Burnett, in his official report on the fever which cc-curred in the " Bann," quotes a report from Mr. Comrieassistant-surgeon to the Pyramus," to the following effect:&mdash;Mr. Comrie states, " that having, on four occasions, in his ma-jesty’s ships, been an eyewitness of attacks of this fever, he isof opinion, that in the Pyramus’ it arose from the particular iperiod of her arrival in the West Indies (July), the foul stateof the hold, and from the coal-tar mixing with the bilge-water,choking up the passage to the wells, and the bilge-water,together with the vegetable matter it contained, becomingstagnant, and thence emitting miasma.

" From the reports of Mr. Comrie, and the medical officersof the army, it appears that upon removing the limber-boards Ia most offensive smell issued from the parts beneath; indeed, Iof so powerful and deleterious a nature was it, as to produce Ifijumediate fining in some, and ssycral of the onicers of the i

ship who attended this examination were seized with th<

prevailing disease. The state of the hold under the limberboards is compared by Staff-Surgeon Hartle to a bog of th(most pestiferous nature on shore; and Mr. Comrie mentionsthat three or four of the slaves employed in cleaning the shilwere attacked with the fever. I may here observe," add!Sir W. Burnett, " that previous to the sailing of the’ Pyra.mus’ from England, she had had her magazine fitted on a neplan, and that the shavings and chips resulting therefrominstead of being removed from the ship, were unfortunatelsuffered to remain in the lower part of the hold, and thmmixed with the bilge-water under the limber-boards.

" Dr. Fitzgerald states, that some time previous to the appearance of the fever, (in the ’ Pyramus,’) the foul state of thEhold was sufficiently indicated by smells of a very disagreeable nature issuing therefrom, and diffusing themselves ove]the ship, and that a candle, when placed at the mouth oithe hold,’ was immediately extinguished. I was also informec

by an officer of the ship I formerly knew, and whom I latei3saw in the royal hospital at Haslar, that all the captains oi

the hold had lost their lives."Six large mud-boats of filth were taken out of this frigate

although she had been only six months from England, andnot long out of dock. It was entirely out of sight under thElimber-boards; in other respects the ship was in the cleaneststate possible.

Additional evidence might be readily brought forward Ieprove the direct agency of the emanations from a foul state

of the hold &c. in the production of African remittent and dyellow fever; but it would be a task of supererogation, and asheer waste of time and space, seeing that the facts alreadyadduced are such as must carry full conviction of the dele-terious agency of these emanations.

" A clean state of the hold of a ship of war, in a sicklyclimate, is a matter of greater importance, however, than asimilar condition of the decks. The latter, when foul, offendthe eye, and attract immediate attention, although it is hardlypossible, exposed as they are to the external air, and withthe rage for white decks which now prevails in the service,that they can ever be permitted to remain a day in such astate as to prove injurious to health. In the hold it isdifferent; the cause of offence is hidden, difficult to be got at,and can only be removed by disturbing the whole internaleconomy of the ship, at the expense of considerable labour,and what is frequently considered of more importance on thecoast of Africa, loss of time. It therefore not unfrequentlyhappens that a foul state of the hold proves detrimental tohealth before it is suspected, or, at all events, before a con-venient opportunity occurs for clearing it out. It is notalways possible to account for the dirt and rubbish whichmay be found in the bottom of a ship: fragments of wood,vegetable substances, and dirt of all kinds, however, gravitateby the form and motion of the vessel towards the kelson orlimbers, where, by the heat of the climate, and the action ofthe salt water, they rapidly decay, and form a blackish mud,not dissimilar to that observed amongst the roots of mangrovethickets on the banks of rivers within the influence of thetide; it sometimes even acquires a consistence sufficient toblock up the passage of the limbers. In small vessels witha flying-deck, there is less difficulty in accounting for the pre-sence of foreign matters in the hold: dust, fluids of variouskinds, the sweepings and scrapings of the decks, and a thou-sand other things, will find their way there, notwithstandingthe greatest care both on the part of the officers and men;although the latter, nevertheless, are frequently wilfully care-less in this respect. In steam vessels it is much more difficultstill to keep the hold clean, while it is impossible on a foreignstation to clear it out so thoroughly as in a sailing vessel,the boilers and engine occupying a large portion of the floorof the hold, which cannot be got at; it might therefore be ad-visable, in the event of the bilge water being very offensive,to admit frequently a sufficiently large quantity of waterthoroughly to wash out the bilge-limbers and pump-well. This,indeed, has been practised, it is said, with advantage. Thehold of the Eclair,’ it was supposed, had been made perfectlyclean, while her. crew were disembarked at Bona Vista; butthere was afterwards found, when she was recommissioned, alarge collection of mud fully three inches in depth, upon that

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portion of her bottom occupied by the boilers and machinery, The character of the fever principally affecting the crewswhich apparently had not been disturbed for a long time. An of shipping on the African station, is remittent, terminatingidea. therefore, naturally suggests itself, that were it possible not unfrequently, either in protracted convalescence, or a trueto leave space enough somewhere on each side of the kelson,for a boy to crawl along under the platform on which the or irregular intermittent. Epidemic diarrhoea is an occasionalboilers and engines rest, this might in a great measure be precursor of the disease.

obviated."-pp. 222, 223. From the surgeon’s report of the disease in the " Bedford,"Of the "Bonetta" it is reported, that the commander, published in Sir W. Burnett’s official report of the "Bann,"

master, assistant-surgeon, purser, and twenty-eight seamen we gather, that "the general symptoms were, a cold and hotand marines, were all lying about the deck in a most helpless paroxysm, quickness of pulse, headach, nausea, general andand melancholy state, three with black vomit, and to all ap- great debility, and, in two-thirds of the cases, local pains in

pearance beyond the aid of medicine. The vessel was in a some parts of the chest. The debility, (query, nervous shock,)very filthy condition, the stench from the holds being almost in many cases, was so great, that sentinels at their posts, andinsupportable, and totally incompatible with health. It may sailors in the common duty of the ship, fell down as if struckalso be added, that on subsequently clearing out, the corn and by lightning, without any previous complaint whatever, and,yams with which she was freighted were found to be in a as far as I was able to remark, the danger was in proportionstate of decomposition. to the degree of this symptom. On the second and third dayA means of preventing these mischiefs is pointed out by of the disease, all their skins acquired more or less of a yellow

Dr. Bryson, in the use of the solution of the chloride of zinc, tinge; and in the worst cases, (at the hospital,) were of as deepwhich, according to the reports made by naval captains and a dye as anything I have ever seen, the yellow fever of themedical officers, is exceedingly effective in correcting and West Indies not excepted." The fever in this case, accordingdestroying the injurious consequences resulting from bilge to Sir W. Burnett’s report, arose solely from the foul state ofwater. In the squadron employed on the African coast it the holds. With respect to those cases in which it is men-

must be eminently beneficial. tioned that the men fell down as if struck by lightning, it doesNumerous proofs are scattered throughout this work, of the not follow that there were not any premonitory indications of

dangers of insolation, intemperance, and night exposure. They disease, as sailors are unwilling to complain of ill-health untilafford convincing proof of the truth of Dr. Bryson’s assertion, totally unfitted for duty, and thus, in many cases, the diseasethat most of the principal causes of fever on the African coast gains such a hold on the constitution that Nature is unable to

might be avoided by the adoption of proper and adequate pre- resist, the case terminating fatally, or else in permanently im-

cautionary measures. It is not, however, by the employment pai’ed health, so that the sufferer must be invalided.of one or two modes of proceeding that so desirable an end The symptoms of the fever on board the "Action" arecan be obtained. The means of preventing the influence of all thus described in the work under notice:-

the causes which exert a direct action in the production of " First, there were several hours of shivering, succeeded byfever, must be carried out, or else comparatively little benefit severe headach, with occasional retching and vomiting; thewill result, as experience has shown that any one of the causes state of the bowels was irregular, but more frequently there

was a tendency to diarrhoea than to constipation. Therepreviously enumerated is fully competent to induce disease, was a tendency to diarrh&oelig;a than to the eyes, and Therewere great heat of skin, suffusion of the eyes, and much:and that when so induced on a large scale, and in a certain thirst; the tongue was always furred, and in some of thedegree of malignancy, it has a great tendency to become con- worst cases flabby and enlarged; it retained the impressiontagious, thus constituting that variety of contagion known by of the teeth upon the sides. There were deep-seated pains inthe name of contingent contagion. On this point, however, we the Iimbs, joints, and back, with great weakness of the lowerdo not purpose dwelling at present.

extremities, and inability to retain the upright position.The pulse varied, but never indicated great force ; it

The following circumstance is singular, and clearly enough was most frequently small and tremulous, and seldom ex-points out the greater danger attending exposure by night ceeded ninety; delirium soon appeared during the exacerba-than by day to the exciting causes of fever in this climate. tion, which, with the great heat of the skin, were decidedly"The crew of the ‘Thetis’ assisted in the defence the prominent features of the disease, and sure indications ofthe severity of the attack: biliary (yellow) suffusion of the skinCape Coast Castle, when it was attacked by the Ashantees and eyes took place in most of the cases, as the disease ad-in July, 1824, and several cases of fever occurred in persons vanced. In all, more particularly in the early stages, thewho were employed on shore. Of a party, consisting of paroxysms were well marked, and the remissions perfect. The

one midshipman and seven men, who for two days and physical suffering did not appear to be commensurate withone night held a tower (Phipps’) half a mile to the left of the severity of the disease,"-p. 171.the town, near which there is a small brackish lagoon,six were attacked with fever from the 10th to the 17th The remittent character of the disease was frequently wellday after exposure, and three died. In one case there marked, but in some instances it was hardly perceptible. Inwas deep-yellow suffusion of the skin and eyes. The ini- the endemic fever on board the " Buzzard," each case wasmediate cause of the disease in these cases, is supposed to marked by two distinct daily exacerbations, one in the morn-have been exposure during the night to marsh, jungle, anddead animal effluvia; in proof of which it is stated, that ing and the other in the evening, the latter the more severe,the carpenter and ten of his crew, who had been employed and lasting until midnight. The remissions were attendedat the same tower for four successive days, did not contract with considerable alleviation of the more urgent symptoms.the disease; they had their breakfast before they landed Indications of local congestion, affecting one or other of the

in the morning, and always returned on board by sunset."- principal organs, principally of the brain, generally at-

One other cause of fever, which had nearly escaped notice, tended the invasion of the disease. The term " congestion"remains to be mentioned. Green firewood, it is stated, is is, however, probably ill applied, as it would appear that

favourable to the production of disease on board when closely nervous excitement and irritation was the concomitant of the

stowed; it becomes heated, and emits an effluvium strongly fever, rather than absolute congestion, although cases did

perceptible to at least one of the senses. The "Vestal," in the occur in which the latter condition was well marked.

year 1839, had a quantity of green wood on board, from which With respect to the epidemic fever in the " Eden,"there arose so disagreeable a smell as to annoy the men who "Its symptoms are described as being divisible into twowere at work in the hold; when it was got upon deck, to be classes-the first indicating increased excitability and inor-stripped of its bark, the fever then prevalent on board seemed dinate vascular action; the second, diminished excitability,to become more virulent and fatal, while the -men who were

with congestion of the brain, and of the organs of the abdo-

employed stripping off the bark were all, within two or, at minal cavity. In some cases, the symptoms in the stage ofemployed stripping off the bark were all, within two or, at invasion were rapidly developed; in others, more e slowly, andmost, three days, seized with the disease in an aggravated in an insidious manner. In the course of twelve or fourteenform. hours, there was generally a remission of the symptoms, fol-

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lowed, sooner or later, by the next and last stage, charac-terized by prostration of strength, remission of pain, the skinbeing covered with a clammy moisture, or dry, and below thenatural temperature ; pulse natural or flagging, or quick,small, and weak; irritability of stomach, hiccough, yellow-ness of the eyes, frequent but ineffectual calls to stool, andmental anxiety. As the disease advanced, the debility in-creased ; the eyes became more yellow, bloodshot, and glassy;the skin also became of a yellow tinge, and covered with acold perspiration, with sordes on the teeth, chapped lips, andhurried respiration, vomiting of black matter, (black vomit,)sometimes delirium and convulsions; at others, coma and in-sensibility to surrounding objects closed the scene. All thedeaths occurred between the third and ninth day of the dis-ease, but the majority on the fourth or fifth.

" Venesection in some cases procured a remission, whichwas seldom followed by exacerbation, but generally by a trainof unfavourable symptoms in the second stage. When bleed-ing was not had recourse to, there was usually an exacer-bation on the third day. Black vomit, though a common,was not an universal symptom: sometimes it appeared early,at others late; and was occasionally attended with a burn-ing pain in the region of the stomach, and a desire forfood. The brain seemed to be the organ primarily affected;then in succession the alimentary canal, the liver, andstomach."The treatment consisted in bleeding in the early stage,

purging, and the free exhibition of mercury, both externallyand internally, in order to produce salivation as quickly aspossible. Blisters were also used when indicated. In somecases which proved fatal, the mouth was sore from the in-fluence of mercury, showing the danger of depending uponthe supposed specific effect of that mineral. Althoughbleeding produced a temporary remission and relief for atime, it was soon followed by collapse, from which thepatient seldom recovered; while those patients who were notbled appear to have survived fully as long as those whowere."-pp. 66, 67.The epidemic at Fernando Po was distinctly remittent in

its character, and accompanied by yellow suffusion of the skinand eyes, and black vomit.

"The appearances on dissection were engorgement of thevessels of the brain, with slight serous effusion into the ven-tricles, and between the membranes. Lymphy deposit was.only observed in one case. The peritoneal surface of the sto-mach was healthy; the villous membrane of a dark-brown andred appearance; both these conditions existing sometimes indifferent parts of the same stomach; dark spots the size of apin’s head; the membrane not abraded in any instance; blackvomit was generally found in the organ. The liver was in-flamed in two instances towards its acute margin; in all theothers it was much enlarged, and of a dark colour. In noinstance was an abscess detected in this organ by incision.The bile was viscid, and invariably dark. The spleen gene-rally enlarged. The intestines also frequently contained thematter of black vomit, and were sometimes inflamed on theirmucous surface-the small intestines more frequently thanthe large.

It is further stated that-" The cases of intermittent generally assumed the quotidian

form at first ; but the paroxysms subsequently became soirregular, as to defy all nosological arrangement. Theygenerally, however, came on about five P.M., and lasted untiltwo or three A.M. The cold stage was slight and short;swelling at the praecordia from flatulence, with an uneasysensation in both hypochondria, in general accompanied it.The disease produced extreme languor, with both mental andphysical prostration. The Africans suffered much from re-mittent and intermittent fevers, ulcers, yaws, and diarrhoea."--pp. 72, 73.On board the "2Etna," and in some other instances also, the

remittent fever, in addition to the yellow suffusion of the skinand eyes, and black vomit, was characterized by haemorrhagefrom the gums and fauces. In the " Waterwitch," after theoccurrence of numerous cases of diarrhoea, a malignant feverbroke out, marked by remissions, yellowness of the skin,black vomit, black urine, haemorrhage from the nostrils, throat,and mouth, and vomiting of blood. There were several re-coveries after haemorrhage from the mouth, throat, and nos- Itrils, had taken place; but there were not any after black Ivomit had occurred. The crew consisted of fifty-two lo

Europeans and eighteen native Africans; only three of thewhite men escaped. Many of the Africans also suffered, buttheir attacks were comparatively mild, and not attended withdanger. As the vessel approached the coast, the number ofcases increased with such rapidity, that there were at onetime twenty-three fresh attacks within the space of threedays, leaving only five white men to do duty on deck, althoughfrom the 4th to the 6th of June there had been only three.The insidious and variable type of the disease is shown in

the following extract from the report of the surgeon of the" Gr owler:"-"At the period of invasion, the symptoms were exceed-

ingly variable and insidious. In young and vigorous con.

stitutions, when treated early by full doses of calomel, fol.lowed up by cathartic draughts, the disease disappearedunder the type of the ephemeral inflammatory fever. Somefew cases, in less vigorous constitutions, showed distinct re-missions ; passing, as convalescence advanced, into perfect in-termissions, and then subsiding under the influence of sulphateof quinine. But there were two cases which assumed themalignant remittent form, with vomiting of coffee-colouredfluid, both of which proved fatal on the fourth day of treat.ment. The men had been ill three days before they com-plained, and the attack in each succeeded intemperance andexposure to wet. One was an old quarter-master, who hadpreviously had an attack of hemiplegia; the other, a youngman of twenty-two, with a shattered constitution from re-peated excess."-p. 164.

’. From a table, which appears to have been carefully drawnup, we gather, that the total mean force for twenty-one yearswas 20,604; ratio of mortality from disease per 1000, 58.4; forall causes, 64’9.

" It would thus appear that the annual ratio of mortalityfrom disease alone on the African station, for a period oftwenty-one years, was 58’4 per 1000 of the mean force em-ployed. The fatal nature of the climate, however, becomesmore apparent when placed in juxtaposition with the mor-tality on other stations,-to wit:

" It is proper, nevertheless, to observe that nearly one-halfof this proportional amount resulted from epidemic feveralone, which was confined to a few vessels of the squadronduring the years 1828-9 and 30; again in 1837-8 and 39;and in the Eclair in 1845. Deducting the loss from epi-demic fevers, therefore, the ratio of mortality from all otherclasses of disease on the station will be about 20’0 per 1000of the mean force annually: this, however, can give noadequate idea of the permanent loss of health, which is as-sumed to be great. Still, from these and other data, it seemsfair to deduce that if boat service were in some degree re-stricted-if prize crews were not permitted to land at SierraLeone-and if all vessels contracting epidemic disease wereto leave the station, and proceed directly to a colder climate,- the ratio of mortality, and the permanent loss of health,one year with another, would be reduced at least nearly one-half."-pp. 177,178.

Foreign Department.FRENCH PERIODICALS.

Action of Sulphate of Quinine on the Genito- U2-inary Organs.M. AUGUSTE DuCHASSANG, of Guadaloupe, has observed the

administration of the sulphate of quinine to be sometimes fol-lowed by h&aelig;maturia and strangury, more or less severe; thatsuch effects are not produced in general, except in youngsubjects, and among those in whom the existence of ague hasbrought about some degree of cachexia. But whilst he has re-marked the occurrence of these accidents with sulphate of qui-nine, he has noticed that the quinquina produces no such effects:this he attributed to the presence of tannic acid in the latter,and believed that, by adding any acid to the sulphate of qui-nine, no hsematuria would occur. In this opinion he has beencountenanced by experiment.In one case, sixteen grains of sulphate of quinine were given