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forthe conveyance of the poison into the human economy.But, in relation to this latter point, Dr. Ewart briefly iiar-

rated an incident which happened to him when civil surgeonof Ajmeer. A complaint having been submitted concerningthe quality of the milk provided for the consumption of theprisoners ; it was iound that it had a most offensive tasteand smell. His native doctor suggested that this arose fromits being mixed with impure water. They visited thevillage from which the milk was supplied. Some freshdrawn milk was then mixed with water obtained from aneighbouring stagnant pool, which was used for ablution andbathing by men, women, and children, and around whichwere the evidences of fsemi pollution. The mixture thm

procured corresponded in its offensiveness of taste and smellto that which had been objected to as unfit for use, andcondemned. On urging these facts in the proper quarter,the contractor was changed, and no more milk adulteratedwith stinking water was supplied during the remainder oihis residence at Ajmeer.When, at this station, he met with cases of enteric fevei

among the population of the city. But confirmation of thediagnosis in fatal cases was not practicable owing to theobjections of the natives to post-mortems. This unavoid.able defect is all the more to be regretted, because, as hasalready been pointed out, it too often happens that in thevery dark skin, the lenticular rose-coloured eruption comingout in successive crops, and in all their phases, disappear.ing on pressure, and quickly returning on the withdrawal ojthe same-such a valuable indication in the fair-skinnedEuropean-cannot always be distinguished. Here, again,there was no difficulty in discovering abundance of animalfilth. In almost every house in the town there was a privy,and in many a cesspool in addition ; the evil odours ema.nating therefrom in close, still, and warm weather taintedthe atmosphere within ; whilst the drains in the streets,receiving liquid sewage from overflowing privies and cess.pools, polluted it without.Dr. Ewart recorded similar experiences at Kherwarrab,

among the Bheels of his regiment and the community:and at Calcutta, during his connexion with the MedicalCollege and General Hospitals. The disease was mostabundant in the autumn, then in the cold season, nextin the hot weather, and least so during the monsoon.The modifying power of malaria was most apparent in theautumn and first half of the cold season, becoming less so inthe middle and end of this, and scarcely perceptible in theremainder of the winter and during the hot months.Strangers of the dark and fair races below the age of thirtywere most exposed to attack. It prevailed in the palace.of the rich and well-to-do, and in the huts and hovels of thepoorer classes. It spared neither sex. His impression,derived from unremitting attention to this subject, was thatenteric fever was domesticated in Calcutta.Looking around for the reason of this, a little attention

will show that the same insanitary conditions as are gene.rally considered to lie at the foundation of the disease, intemperate regions, exist, to a very marked extent, in themetropolis of British India. After giving in detail a de-scription of the utterly indescribable filthiness of the backslums of many parts of the European, and most parts of thenative quarter ; the difficulty does not consist in not findingplenty of animal filth to account for any amount of entericfever; but in understanding how or why it is not still moreprevalent than it is in such an unsavoury city. It is explainedthat "the reason why this form of fever is not more fre-quently met with amid such an abundance of fsecal matterin a state of putrescent fermentation, is probably to be dis-covered in the fact that fortunately most of it is not pent upin ill-ventilated sewers, but exposed daily to the powerfulantiseptic influences of the atmosphere and sunlight in opendrains, open privies and latrines, and in comparatively opencesspools. The impression which has been gaining groundof late years, that as the sewering of the town has been ad-vanced, so has enteric fever been more frequently observed,lends countenance in support of this view. The augmentedprevalence, however, may, in some measure, be owing simplyto greater recognition of the fever, although it must not beforgotten that attention has been directed to the endemicexistence of the disease during the past fifteen or twentyyears."

"

As regards the assertion that such insanitary conditionsare not to be found in military stations, barracks, and hos-pitals, Dr. Ewart is not satisfied with "the condition of theprivies used by natives in the service of officers, and of the

latrines employed by the numerous followers of native andBritish regiments. Even if the sanitary excellency of theseis unimpeachable, there is still overwhelming evidence, inthe reports of the Sanitary Commissioners, to prove that theneighbouring bazaars, frequented more especially by theyounger soldiers, present, in unmitigated intensity, all theinsanitary blemishes summarised in the foregoing narrative.It is here, it may be far away from their barracks, wherethey are not only liable to breathe air impregnated withemanations from decomposing animal filth, but to obtainfood, milk, drink, and water of questionable quality andpurity."On a full review of the subject, there is nothing, in the

occurrence of enteric fever in India, repugnant to theMurchisonian doctrine that, in its etiology, it is inti-mately connected with the presence of putrefying animaor faecal filth. " The reason why the origin of the dis-ease has not been more frequently traced to pythogeniccauses is probably due to the stage of incubation havingbeen too much excluded from consideration. The diffi-culty, especially in the case of those who dwell in cleanand well cared-for barracks, is greatly magnified by theperiod of latency or incubation. This varies from seven orten to fourteen or twenty days. So that to trace the originof any case, the investigation must be of a much moresearching and comprehensive character than any which hashitherto been conducted in India. It is manifest that thealleged freedom of the barracks and their immediate sur-roundings from filth is, in itself, scarcely sufficient. Theinquiry should embrace a calm and impartial review of thepatient’s history and habits, derived first from himself, andsecondly corrected by the collateral evidence of his friends,extending over a period of many days antecedent to theattack. As the disease is rarely spread by direct contagion,in the well-ventilated military hospitals in India, it followsthat, in almost every isolated case or series of cases, a simi-lar exhaustive investigation would have to be undertaken ifthe source of it, in all cases, is to be identified to the utmostextent attainable."

Dr. Ewart does not believe that the enteric fever latelyprevailing in the "Madras Command" has been merely"malarial or climaterial fever of the continued or remittenttype with intestinal complication." Even should the resultsof future investigation go against the filth theory of itsorigin, this conclusion, however well grounded, would notsuffice to justify us, with the evidence of so many inde-pendent clinical observers proving the contrary, in disputingthe domesticated existence of the fever in India. It wouldrather have the effect of causing inquiry on some other lineor lines with a view to discover the habitat and nature of thecause not only in that country, but in Europe and America."Whatever views may be held concerning the cause, so longas the thing-enteric fever-is present in India, it will, nowthat so much attention has been attached to it, continue tobe more and more generally recognised as a distinct entity,generated and diffused independently of malaria, though,like many other affections, being liable to be modified by it,perfectly irrespective of the views that may, from time totime, prevail about its precise etiology.

Reviews and Notices of Books.The S’lroectroscope in Medicine. By CHARLES A. MACMuNN,

B.A., M.D. Univ. Dub. With Chromo-lithographic Platesand other illustrations. London: J. & A. Churchill.1880.

A WORK of this kind has long been called for. The pro-gress of pathological and physiological research by means ofthe spectroscope has not attained its due development fromthe want of a simple treatise clearly defining the methodsof investigation and their application to this branch ofmedical study. Already, however, the spectroscope hasdone good service in physiology by correcting many erro-neous ideas regarding various animal pigments, and also byexplaining the difference in colour between arterial andvenous blood, and showing wherein the oxygen-holdingpower of the red corpuscle resides. In forensic medicine the

spectroscope, too, renders invaluable aid in affording the

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only reliable means for detecting the presence of bluodwhen present in almost unappreciable quantities. The pre-; e lce of poisonous metals, again, such as arsenic, antimony,mercury, copper, lead, &c., can readily be demonstrated bymeans of their respective spectra. The practical applica-tion of the spectroscope in clinical medicine is still, how-ever, extremely limited. Nor can much advance be ex-

pected in this direction till clinical observers are madefamiliar with the practical working of the instrument. Dr.MacMunn’s work appears to us admirably suited for thispurpose. It is simple in style, lucid in exposition, andmodest in tone. The first two chapters are devoted to aconsideration of the various kinds of spectra, with a

description of instruments and methods for using them.Chapter 3 deals with the application of the study of brightline spectra to medicine, particularly drawing atten-

tion to the late Dr. Bence Jones’s researches in de-

termining the time that salts take to reach varioustissues and organs. Chapters 4, 5, and 6 treat of the

absorption spectra of blood, and give easy methods of

preparing most of the important spectra which have beenhitherto described. Speaking of a simple process, by whichthe important spectra of hsematin and cruentin can be pro-cured, Dr. MacMunn states, that it was not till after he hadstudied Dr. Thudichum’s method that he was able to pro-cure the various decomposition products of haemoglobin bysimple and rapid means. Dr. MacMunn thinks that this

gentleman’s method ought to be more generally known, andtakes this opportunity of observing, " that he has not been

sufficiently thanked by the members of his own profession forthe great and valuable additions to our knowledge of pbysio-logicalandpathological chemistry which he has made." Aswehave lately been inconflict withDr. Thudichum with respect toanother matter, we have pleasure in giving prominence to thisjust tribute with regard to the value of his scientific researches.Chapter 7 gives an account of the absorption spectra of bile,urine, &e. Reference is made to the pathological importanceof Jaff6’s isolation of the pigment, which gives an absorptionband at F, for this pigment appears to be identical with theuro-bilin, which Dr. MacMunn has found in every specimenof healthy human urine. With regard to urine, there is

only one pigment which gives a well-marked absorptionband, and this is the pigment just named (uro-bilin). Dr.MacMunn remarks that this is the pigment which ought tohave the greatest attention paid it by clinical observers, for,although constantly present in healthy human urine, it issometimes absent in disease, though in what diseases it isabsent he is at present unable to say. Another bile pigment,according to the author, besides uro-bilin, which does not, how-ever, give the characteristic colouration with Gmelin’s test,occasionally appears in certain morbid conditions of the urine.It was found to occur in the following specimens of urine :-1. Taken from cases of rheumatic fever. 2. Pregnancy (sixthmonth). 3. Thoracic aneurism accompanied with albumi-nuria. 4. Cirrhosis of the liver. 5. Cancer of the pylorus.As a second absorption band has never been obtained in somehundreds of specimens of urine from patients suffering fromtrifling ailments, Dr. MacMunn infers that it only appearsin those cases where there is undoubted disease of a severecharacter.

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OUR LIBRARY TABLE.

1’epoot by Dr. Milne Robertson upon Certain PeculiarHabits and Customs of the Aborigines of TYestern Australia.By Dr. A. MILNE RoBERTSON, Surgeon, Convict Establish-ment, Western Australia.-This brief report has been pre-pared " for the information of gentlemen of the medical andother scientific professions, and to accompany the collectionof weapons, implements, &c. sent to the exhibition at

Sydney, N.S.W., 1879. It relates to the practice of cir-

cumcision at the age of puberty, and also to slitting the, urethra, also at puberty, among certain families of the

aborigines of Western Australia. The two practices arenot found to exist together in the same group of families,and the families slitting the urethra differ as to the extentto which the slit is carried. Dr. Robertson’s account is fullof interest to the anthropologi,,,t.A Brie A ccount of the .N ativcs of lf7estei,)t A llstralia,

their Character, Manners, and Customs. Prepared underinstructions from H.E. Major-Genaral Sir N. H. GEORGEORD, K.C.M.G., C.B., Governor jf the Colony.-An ex.cellent summary account, written to illustrate the collectionof weapons, implements, &c. sent to the exhibition at Sydney,New South Wales.A Systematic Course of Practical Qualitative Analysis.

By THOS. ELTOFT, P.C.S., P.I.C. London: Simpkin,Marshall, and Co. 1879.-We fail to perceive any real ad.vantage possessed by this little book beyond that of beingprinted in strong clear type. There are already too manysmall text-books of the kind.

INSTRUMENT FOR ILLUMINATING THE EYE.To the Editor of THE LANCET.

SIR,-A common difficulty in ophthalmic surgery is metby the suggestion made by Mr. James E. Adams in his re-marks on " an instrument for illuminating and magnifyingthe anterior parts of the eyeball." A small black foreignbody on the cornea near its centre, especially if the iris is

dark-coloured, is absolutely invisible to the naked eye, evenin a good light; but with the aid of a convex lens and focalillumination, by means of a second lens, is easily discovered.When discovered, however, its removal is extremely difficultwithout skilled assistance. Mr. Adams’s instrument over-comes this difficulty, though I venture to think that the useof a pair of spectacles (with biconvex glasses of, say, ten-inch focal length) worn by the surgeon is a simpler andbetter way of obtaining the magnified image, and obviatescertain disadvantages attending Mr. Adams’s method. Thelens fixed to the patient’s head must have a more or lesslimited range of motion, whereas the observer, with a pairof spectacles on his nose, can alter the line of observation toany required angle. The fixed lens, too, may puzzle theobserver by the reflected image of the surrounding objectsif not set carefully, and this is not the case with the use ofthe spectacles. If therefore Mr. Adams’s apparatus is em-ployed, I would suggest that the lens for magnifying theimage should be dispensed with altogether, and the spec-tacles be used by the operator. The focal illumination mayalso be dispensed with in good daylight, and even in theabsence of daylight the benzine lamp supplied by Messrs.Krohne and Sesemann answers every purpose in the majorityof cases. There will, however, still be exceptional occasionsin which Mr. Adams’s instrument, with the modifications ofform that I suggest, would be a valuable addition to our re-sources. The use of spectacles is not necessary for myopicsurgeons, but for the emmetropic, hypermetropic, or pres-byopic will be found of great value, and, when once tried,will not be easily laid aside for the merely fanciful objectionthat their use is, perhaps, regarded by the patient as a con-fession of inefficiency. The successful issue of an operationwill easily reconcile the patient to any such imaginary defectin the operator.Even focal illumination and a magnified image sometimes

fail to give the information required in the search for aforeign body. The illumination of the pupil by theophthalmoscope is then the most efficient method; andwhen the two methods are resorted to any doubts as to thedepth of the foreign body, as to its having penetrated deeplyinto the cornea, as to its having passed into the anteriorchamber, and whether it has penetrated or wounded thelens, will be much more satisfactorily solved than if onemethod only has been resorted to. The same reasoning willapply to traumatic lesions, or the result of disease in thesame regions without the presence of a foreign body.

I am, Sir, yours, &c.,Feb. 6th, 1880. W. SPENCER WATSON, F.R.C.S.W. SPENCER WATSON, F.R.C.S.