in making him a lodger in district 24, "between the two houses first attacked." The man was not married, and had no permission to lodge or sleep out of the barracks. It has been stated, indeed, that this man kept a woman in the above district-and if so, Mr. F. does not wonder at his imbibing the febrific fumes of that foul locality during his visits to his paramour. Mr. Amiel, however, surgeon to the regiment, in his examination before the Board, at its 17th sitting, (7th March,) observes that Oldroyd "was found drunk and disorderly under the bridge of the Naval Hospital, two days before he was taken to the hospital, i. e. 31st of August," a place which afterwards proved a hot-bed of fever, and where he thinks the serjeant was just as likely to have contracted his fever as in district No. 24.

"POSTULATE 8.-This disease left upwards of 5000 persons untouched, who had passed it before. There is not a single authenticated case of second attack in Gibraltar.

Of 164 military orderlies in the regimental hospital 141 caught the disease. Of 61 civil attendants who voluntered to attend the military sick (being largely paid) two only were attacked, and these were the only persons of the 61, who had not passed the disease in some former epidemic. This fact is taken from the official returns of regimental surgeons."

The doctrine of ‘non-liability to a second attack,' as it now obtains in Gibraltar, is an imposing argument, more specious however than real; it is obviously one open to much fallacy; for the proposition is more or less assumed. Have the 6000 persons alluded to been all interrogated, as to the nature of their first attack? Have none of them left the garrison for other countries and returned? has it been ascertained that all these people lived within the circle of epidemic influence in 1828, and if so, is it certain that none of them sickened to a greater or lesser degree? did none pass through a sub-acute form of the malady? Knowing that none of these interrogations can be answered in the affirmative, I hold it to be ridiculous to argue further; for no conclusions could be drawn that would not be open to most serious objections. The experience of another epidemic, or more, will be hardly sufficient to place this question on such a basis as to be useful to the profession. It must, however, be acknowledged to be a belief, at present held by the natives of Gibraltar and of Spain, paramount to all others, except their conviction in the truth of the importation of the disease; but it does not follow they are correct. The history of man, in every age, shows him prone to embrace notions, however false, which pamper his hopes, and allay his fears; and to tell any of these natives, that a first attack of yellow fever was not to exempt them from a second, would be received with the same repugnance, as the telling an old and pious lady on her death bed, that men of erudition had doubted the existence of her soul, That a belief so rivetted, has the most salutary effect in resisting a second attack, no one can deny; for it renders the system impregnable to the impression of fear, which all who have witnessed an epidemic of yellow fever, will admit to have a powerful influence in keeping up and extending the disease. But, as the object of this paper is not the discussion of speculative points, I shall proceed to the examination of the proofs on which the immunity of these 5000 people is said to rest.

At the time that the Board of Commission sat here, a Board of Medical Officers was ordered to investigate this subject. It was composed of the French commission, Drs. Chervin, Louis, and Trousseau—Dr. Barry and myself—besides some half-dozen Spanish doctors; but the principles on which it was conducted, were, to me, as well as to Dr. Chervin, so objectionable that I addressed a letter to His Excellency the Governor, expressive of my sentiments on the subject, and refusing to sign its proceedings. The letter is as follows;-and shows, in a tolerably clear manner, the spirit which influenced this board.*

* I regret not being able to give a copy of the letter of Dr. Chervin refusing to sign the proceedings, and containing his dissentient opinions, which he also addressed to His Excellency the Governor on this occasion.

Gibraltar, 1st April, 1829.

Sir, In reference to the Board of Medical Officers assembled at your Excellency's order, in the chronicle of the 24th January last, to examine into the liability or non-liability of a second attack of the epidemic yellow fever which prevailed here last year, and of which Dr. Pym did me the honor to be associated a member, I beg to remark to your Excellency, that, at a meeting held yesterday, for the purpose of concluding and signing the report to be made to Your Excellency on this most important question, I felt myself reluctantly obliged to dissent from the conclusion therein given; and, it is with much concern, I have to state to Your Excellency, that when this report shall be laid before Your Excellency, my signature will be found to be wanting. I entreated the Board to sign'dissentient;' but this was refused. I am therefore most anxious to make known to Your Excellency the reasons which have induced me to adopt such a measure, and with this view, I beg to enclose a copy of what I wished to accompany my signature.

Your Excellency, I trust, will do me the justice to believe, that I am not actuated by a desire to be troublesome; or that an obstinate self-will, or any over-weening conceit to be singular, is my motive:-on the contrary, I solemnly declare to Your Excellency, that I am guided by no other feeling than a conscientious adherence to what I conceive to be the truth, and I cannot help observing to Your Excellency that had the enquiry in question been conducted on more enlarged and on more philosophical principles, I humbly think the results might have been different, and more in accordance with the principles of true reasoning. Your Excellency is well aware that the laws which govern pestilence are but little known; and that it is becoming to speak doubtingly, and to speak with modesty, on a subject so very obscure, and so very open to be darkened with fallacy. I therefore hope Your Excellency will approve of my not having attached my signature to a document which I am disposed to consider somewhat faulty.

I have the honor to be, &c.

His Excellency Gen. Sir George Don,

&c. &c.

(Signed)
&c.

HUGH FRASER, Surgeon.

Dissentient-1st. Because moral testimony has been refused-the only testimony which, to my view, possibly could have been accepted to confirm the question of the liability or non-liability of an individual to a second attack of the yellow fever. Upon such testimony rests the whole of the valuable facts collected by the Board of Commissioners and the Anglo-French Commission. Had this species of testimony been received, many instances of second attack during the late epidemic might have been adduced.

2dly. Because the numerous relapses which have occurred during the epidemic fever of 1828, negative, in my opinion, the supposition that the malady bears any analogy to the order of exanthematous diseases; besides many of the relapses are of such a nature as to induce me to consider them unequivocal examples of second attack.

3dly. Because the immunity which has been observed in Gibraltar, appears to be entirely dependant on the individuals seldom changing their place of residencevery seldom the latitude. Viewing this fever, therefore, to be of malaric origin, the immunity observed, is a matter of no surprize :-it is in perfect accordance with what has been recorded of the black vomit fever of the West Indies, and America; where second, and even third attacks have been known to take place, whenever the individual lost his climatic constitution by residing a certain time in a northern latitude."

That the doctrine of non-liability to second attacks has been "fairly" brought before the public, Mr. Fraser denies. A species of evidence, he observes, is admitted as proof, when it favours the doctrine; but is refused when it has a contrary tendency.

"For example, two men come before the Board, who had been ill (we suppose during some former epidemic) with exactly the same symptoms-namely, headach, pains in the loins, sickness, and nausea, with other marks of fever, and both

recover. Another epidemic takes place—one of these men escapes, the other is seized with the fever-the man who escaped, according to the mode in which this Board received evidence, would have been put down as a case of immunity; the other, as not having had the fever at any former period, and, of course, a case of first attack-only, forsooth, because the man must have been mistaken as to his first illness!! In short the slightest indisposition during any former epidemic, was put down as an attack of the fever, when the individual escaped during the last.”

Mr. Fraser, however, does not attempt to deny that the cases of immunity have been very numerous-but the rule of immunity is far, he says, from being absolute. In papers which he is preparing for the press," many well-authenticated cases of second attacks will be shewn."

"Without vouching for the accuracy of the 225 hospital attendants taken ill among the military, during the epidemic, according to Dr. Barry, the simple statement of facts is ;

1st. That, for the period of about one month from the commencement of the epidemic, no hospital servant was taken ill at all, though in the closest attendance on the sick.

2dly. That when the disease began to appear among them, it was not until it had begun amongst the inhabitants of the south district, in which the hospital for the military is situated.

3dly. That the first hospital servants taken ill, were the cooks and watermen, whose services did not bring them into the wards of the sick.

4thly. That, according to a nominal list (by Deputy Inspector Gillkrest, lately surgeon of the 43d Regiment) officially given in to the Board of Commissioners at their 45th sitting, it appears that of 69 men of the 43d Regiment, who, during the first month of the epidemic, were exposed in the wards day and night, in parties of from four to six each, for the space of 24 hours, the number of them attacked was found at the close of the epidemic, not to have exceeded the proportion of the general mass of the regiment attacked. Two thirds of them indeed were never attacked at all; and it was shown by that list (signed by the Adjutant of the Regiment) that those of the above 69 who were taken ill, had mounted guards in the town, and after they had been on duty in the hospital; and that the bulk of them were not taken ill till a period of from 15 days to two months, after performing the duty referred to.

5th. That it appears that in bospitals placed out of the influence of the infected atmosphere of the rock, no servant was attacked, though several were exposed, who were susceptible in the sense of not having had the disease before. This was shown to be the case, in the hospital establishments of the 73d and 94th, removed about the middle of the epidemic season to Wind Mill Hill Barracks and in the small hospitals of the 12th 42d and 43d Regiments, established near the close of the season, outside the walls, near the neutral ground.

We regret that we are unable to afford space for the table of cases, not febrile, admitted into the Regimental Hospital of the Royal Welsh Fusiliers, from the 1st of September till the 30th of October, shewing the number of men attacked there by the epidemic, and the length of time that must have elapsed after their exposure to the contagion (if it existed) and the coming forth of the fever.

"Taking the mean time of exposure in residence in hospital, and the interval from this mean to the date of attack, as the latent period of Bulam, the mean latent period in the eleven subjects attacked, will be, setting fractions aside, no less than 33 days! the duration of exposure of the eleven attacked, taking the mean and setting aside fractions, is 10 days, while the exposure of the 25 who escaped the contagion, is, setting aside fractions, 14 days."

The postulates 9, 10, and 11 remain to be noticed.

"Three modes of treatment-1st. Mercury with a view to salivate rapidly. Id.

Free bleeding. 3d. Oily and other mild aperients. The first was by far the least successful, the third the most so.

10th. Some cases (7) of icterus appeared in 1829, from May to September. Three of these had no fever-four had passed the disease in other years.

11tb. No atmospheric or other physical phenomena different from those of the five preceding years, were noticed in Gibraltar in 1828."

"Dr. Barry's opportunity of forming a correct estimate of the comparative merits of the different modes of treating yellow fever were so extremely limited, that any observations of his, on this head, must be received with caution. He arrived towards the decline of the disease, when it had assumed a milder type, and perhaps did not see twenty cases altogether;-nevertheless, he had the modesty to condemn the use of mercury' in toto, before he had seen a single case; and took no small pains to deprecate it as the most ruinous and pernicious of medicines.

A small detachment hospital on the glacis, on the north front, was given in charge to him, and it was very soon discovered that his success was not greater than that of his neighbours, with all his boasting; for I believe that even by the aid of his own energetic treatment of a cataplasm of port wine and bread to the pit of the stomach, and five leeches to the ankles, he lost every fever-patient under his care, who had the disease in a severe form. Of this latter description of patients, however, he had but very few. None of us, it is true, can boast of much success in the treatment of the disease; those, however, of the greatest experience, are inclined to give the preference to the medicine which was so much and so loudly condemned by Dr. Barry. I myself, indeed, believe that, in the more concentrated forms of this fever, it makes very little difference what mode of treatment is adopted. The disease will run on to a fatal termination. With regard to the anatomical characters of the disease, to which I promised to advert, the Doctor's opportunities were equally limited with those he had of treating it. On arriving here he put himself under canvas, on the Neutral Ground, beyond the reach of the epidemic influence, and only had charge, as I have stated, for a short time, of the Detachment-hospitals of the 12th, 42d, and 43d Regiments, where the mortality, I believe, did not exceed eight or ten; and, to the pathological knowledge that was to be gained elsewhere at the Military and Civil Hospitals, the Doctor was a stranger, for I can assert, without the fear of contradiction, that he very seldom visited either of these establishments, so that, in truth, any facts advanced by him on these two heads, can be only from hear-say; and I shall take no farther notice of them."

Mr. Fraser animadverts on Dr. Barry's assertion that there were no atmospherical or other physical phenomena in 1828, different from those of the five preceding years. The average heat of the last four months of 1828 was greater, Mr. F. avers, than of the preceding years; though he pretends not to attribute the fever to this source, nor to explain why epidemics are produced in one year more than in another.

We must now close our review of Mr. Fraser's paper, reiterating our regret that men who see the same facts should so materially differ in the relation of them, and still more in the inferences which they draw from those facts. For our own parts, we greatly distrust the evidence which has been so often brought forward, in various countries, for the support of the doctrine of imported contagions. It is a most unnatural, and unfeasible doctrine, and is every day losing ground in the opinions of those best qualified to form a correct as well as an unbiassed opinion on the subject. The fact, if it be one, that an attack of the Gibraltar fever confers an immunity from subsequent seizures, is a very curious one, but we apprehend it will turn out to be nothing more than that degree of security enjoyed by those who have undergone any severe fevers either in northern or southern countries. How few do we find encounter a second attack of typhus fever in London? It would probably be extremely difficult to collect a dozen of well authenti

cated cases of this kind. Fevers are very different from inflammations, in this respect. The latter predispose the individual to repetitions of the disease even from slight causes-whereas the former confer a considerable power of resistance to the common causes that produce the first attack.

'VII.

ON THE DISEASES AND INJURIES OF ARTERIES, with the OPERATIONS REQUIRED FOR THEIR CURE. By G. J. Guthrie, F.R.S. &c. &c. &c. Octavo, pp. 408, London, 1830.

[Second and concluding Article.]

In the last quarterly number of this Journal, we gave a pretty full analysis of the portion of Mr. Guthrie's work which comprises the injuries to which the arteries are exposed, and the most appropriate methods of treating them. It now remains for us to notice the first and more copious part, which is dedicated to the important subject of aneurism. It might be thought that the labours of the many eminent individuals, whose researches have thrown a halo of glory on the surgical annals of the close of the last, and commencement of the present century, would have rendered unnecessary any further investigations on the diseases of the arteries. Guattani, Lancisi,and Scarpa in Italy; Pelletan, Corvisart, Dessault and Laennec in France; and more than all the galaxy of genius which our native land can boast, Hunter, Abernethy, Allan Burns, Home, Cooper, the Bells, Hodgson, and Guthrie, have left, one would imagine, little more to desire on the subject that exercised their observation and their talents.

But such is the imperfection of the human mind, or the inherent difficulties of the sciences which it creates and which still perplex and baffle their creator, that the accidental or morbid lesions of the nervous system are yet in need of further elucidation. What physiology, anatomy, and the keenest observation could do, may be fairly said to have been done already, but our forefathers and predecessors were in want of a weapon that peculiarly distinguishes us, we mean the extensive employment of post-mortem investigations. It is like the invention of gunpowder in fiercer warfare than our own; and will simplify tactics, if it does not save lives. We have for some time been convinced that the connexion beween the diseases of the heart and the arteries is one that requires the most careful, close, and extended study. It must be the work of some years spent at the bed-side, in the hospital, and in the dead-house. If a man of moderate talents will devote his time to this investigation, and throw on it the lights which auscultation certainly affords, we prophecy, and we do it with a little knowledge of the subject, ~ that the result will be highly beneficial to his profession, his species, and himself. Such a plan as we have chalked out must require some years to be properly put into effect, but much may, and we doubt not will, be done by able and observant surgeons in the interim.

If some of our readers imagine that we already know as much as is likely