regarding which Dr. Jackson justly observes," the duty imposed in this case is not to select what is in every way good, but to reject what is absolutely unfit." The second part consists of a sketch of the military character of the nations which are, or have been, most eminent in war. Part third gives an outline of tactic, or rudiment of military training. Part fourth treats of the intellectual and moral motives of military action. These contain much interesting and instructive matter, but as they relate more to military than medical subjects, we pass on to part fifth, on discipline and economy for the field and quarters," under which are considered the important subjects of diet, clothing, exercise, barracks, camps, and transport-ships." On these points the health of our troops materially depends, and they consequently deserve the attention both of the military and medical officer. "The medical history of armies," says our author, "holds out a dismal picture of human misery. Armies were crippled, almost annihilated, by artificial diseases in the late war, that is, by contagious fevers, proceeding from corrupted sources of recruiting, and gaining strength from ignorance of the principles which conduce to the preservation of health, or from indifference and negligence in applying them to the occasion. Such losses are melancholy, because they proceed from error. The errors are not always reprehensible, for they proceed from ignorance and misapplied care, as often perhaps as from indifference and neglect. Soldiers are selected from the healthy part of the community. Reason says they ought to be more healthy than the mass of the people; it is not so in fact. The cause of sickness does not consist in actual hardship, for that is rarely to a great extent, or where it does occur it rarely affects the health." Dr. Hunter has justly remarked, that "in military physick, the great improvements to be made are not so much in the cure as in the prevention of diseases." (Diseases of the Army in Jamaica in 1766.)

Dr. Jackson's remarks on the various topics treated in this Part are in general very judicious, and evince a thorough knowledge of his subjecta knowledge acquired under the diversified circumstances of service in the field, and in garrison, at home, and abroad, in tropical and in temperate colonies. On one or two points we differ in opinion from him, but his observations are all well calculated to suggest useful hints, and afford materials for reflection. Under the head of diet he discusses a point worthy of the consideration of the military authorities, recommending that " care should be taken, in laying the basis of primary education, that every one be competent to dress in a suitable manner the raw provisions of which the ration consists. If the principle according to which the application of heat acts on raw provisions, for the improvement of their taste and nutritive qualities, be explained to the young soldier, and rightly comprehended by him, he will know to vary the mode according to his means, and not complain that his meal is unsavory when his ration is good in kind and abundant in quantity; a case which often happens with those who are young and uneducated, and which happens with almost all British soldiers in their first campaign." It is well known that in the last war the French troops much excelled the British in this respect. On service this is not a matter of such small account as some may suppose, for by

enabling the men to have their food in a palatable form they are induced to eat their rations, when from great fatigue they might otherwise reject it if in an uninviting shape. "It may be said without offence that if the art of cookery be understood by the English nation, it is not generally practised by the English soldiery."

Our space will not permit us to review in detail the opinions of our author on the various circumstances likely to affect the health of soldiers, and the best means of maintaining them in a state of efficiency-nor is it necessary. The work before us deserves the careful perusal of every medical officer in the army, and might be advantageously studied by every commanding officer. As the success of any military operation must depend in a great measure on the health and vigour of the troops employed to carry it into execution, there can be no subject more deserving the attention of officers than the best means of warding off disease from them, and of keeping them healthy and efficient.

We have already observed that Dr. Jackson was remarkable for the practical character of his suggestions, and for his zealous endeavours to promote the comfort and welfare of the soldier. We cannot illustrate this better, or point out more forcibly the great credit due to him, than by enumerating briefly some of the suggestions he made in the first edition of his work in 1804, and showing how these have been gradually adopted in the army. As regards diet, he recommended the introduction of a breakfast mess, which is now the rule of the service; he wrote strongly against the issue of a spirit ration as destructive of health and morals, and injurious to discipline: this was finally abolished by Sir H. Hardinge in 1830. In dress and equipment, he recommended the reduction of the weight of the kit, which has been partially effected, but is still capable of improvement; the use of trousers instead of breeches and leggins; the abolition of the custom of dressing the hair with grease and flour, a custom now unknown, and of the use of pipeclay to clean the clothing. On one point connected with soldiers' clothing, there yet remains great room for improvement. "The common manufacturer," says Jackson, exerts his genius to produce a commodity of the flimsiest interior texture with the best exterior surface. The contractor for soldiers' clothing exerts himself to go beyond the manufacturer for the common market, and he generally succeeds; for soldiers' clothing is inspected and approved by less competent judges than those who purchase for themselves. It thus happens, from the bad quality of contract clothing and contract shoes, English soldiers are sometimes ill clothed on actual service, and almost always ill shod .... a circumstance which, exclusive of better primary education for war, gives foreign soldiers great advantages over English, in protracted campaigns and harassing services carried on at a distance from the depôt of stores."

In discussing the influence of exercise on the health, he advises the encouragement of dancing, running, football, cricket, quoits, and those other manly and athletic games, the introduction of which into the army has since been strongly recommended by the Military Punishment Commission, and partially carried into effect. But while he thus desired to find employment for the body, he also inculcated the necessity of attend

ing to the mental culture of the soldier, a subject which has been slowly but steadily making progress, and now receives the sanction of the highest military authorities.

We shall only notice one more suggestion, that of quartering the troops in the West Indies in the mountains, and employing the soldiers to erect hut barracks for themselves in these situations. This he strongly advocated on the plea of humanity, economy, and increased military efficiency. Upwards of a third of a century afterwards we find these views adopted by Government, and carried out in Jamaica by the very means he suggested, not however until the policy of the measure had been demonstrated by statistical investigation, and enforced by the loss of upwards of 12,000 soldiers, of whom it is probable two thirds at least might have been saved had the measure been adopted when he first proposed it. Although he did not live to see this or the abolition of the spirit ration, we can conceive the satisfaction he must have experienced at the steady progress the principles he had laid down were gradually making in the army, -a satisfaction in a great measure arising from the conviction that they were promoting that which had ever been the chief object of his exertions, the melioration of the condition of the soldier. We cannot conclude this article better than with the following quotation from the preface to the second edition:

"The subject of the present work has been under the author's consideration for upwards of twenty years. He has looked at it without prepossession, as desirous to ascertain the truth. He believes that many of the hints which have occurred to him would tend, if properly understood, to diminish the miseries which are common in military life; and in that belief he has put them together, and now presents them to the public, gratified if they do good; at any rate satisfied with himself, as acquitted of a duty which he conceives to belong to the station in which he has acted."

ART. XIV.

A practical Treatise on Inflammation, Ulceration, and Induration of the Neck of the Uterus: with Remarks on the value of Leucorrhoea and Prolapsus Uteri as Symptoms of Uterine Disease. By J. H. BENNET, M.D. &c. London, 1845. 8vo. pp. 212.

In the study of uterine diseases we in England labour under disadvantages, which the French accoucheurs, particularly in hospital practice, are exempt from. He would be, indeed, a hardy pioneer, who would undertake to face the storm of outraged feelings which the full adoption of the French system of exploration of the os uteri, in either public or private practice in England, would excite. Even to the mind of an English surgeon there is something revolting in the nonchalant manner of exposing females in the Parisian wards. This feeling, if it is found among the members of the medical profession in this country, is of course reciprocated a hundredfold by the public. It may be that it is a weakness, a want of philosophy; whatever it may spring from, so it is, and, in consequence, our neighbours enter this path of inquiry with advantages which we possess not; and, as

long as this is the case, we must yield to them, in some degree, the palm of practical acquaintance with those facts which the use of the speculum alone can reveal.

Not that the facts so discoverable have, in our estimation, the weight which some attach to them. The use of the speculum in French practice is so universal that the practitioners of that country are apt to despise all other means of investigation except as subsidiary to this; and therefore naturally give the most prominent and constant place to that which really might often be dispensed with. But we are happy to find that the use of this important means of investigation is increasingly adopted in England; and though we cannot hope or desire to see our national character so modified, as to find forty females at a séance submitting to a procedure, which must outrage all feelings of delicacy or decorum, yet, with proper precautions, and with all possible regard to decency, we do fully believe that this most valuable means of diagnosis may be practised both in public hospitals and in private practice.

We do not hesitate to join fully in the assertion of the intelligent author of the little book before us, that we have never found insuperable obstacles to the use of the speculum, and we cannot but attribute the comparatively rare employment of it more to the want of will in the surgeon than in the patient. We would strongly impress upon our surgical brethren that the value of the speculum consists, not more in its facilities for diagnosis, than in the application of remedies, and we do not hesitate to say, that all local remedies must be much more readily and perfectly applied with the speculum than without it.

But we must go farther, and say, that if the use of the speculum should not be more general than it is, the practice of the touch, as being more ready of application, and less likely to excite a feeling of opposition in the patient, should in all doubtful cases be considered indispensable. We are well aware that this practice, particularly in the country, is lamentably neglected. Patients are allowed to go on, week after week, month after month, to sink into an ill-understood but confirmed state of disease, and to death, without the least proposal being made by the surgeon to examine locally the nature and character of the affection. The accuracy which may be attained by practice in the detection of shades of disease by the finger is quite inconceivable by those who have only rarely practised it; and we hold it to be the bounden duty of every practitioner; who is in the habit of treating the diseases of females, to neglect no opportunity of examination of the os uteri by the touch, in order that he may acquire and perfect that discriminating sense of which the finger is capable.

We have been led to preface our observations upon Dr. Bennet's treatise with these remarks upon the means of investigating the diseases of the os uteri, from the conviction that a stimulus is greatly needed to induce practitioners of one of the most important branches of the healing art, both to make the most use of that means of investigation which they possess, and to take every opportunity of completing its value by the use of the speculum.

The opportunities which our author possessed of investigating uterine disease in Paris were considerable, and he has certainly made the most of

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them with the results he makes us acquainted in his book; of which we feel it but fair to speak in terms of considerable praise, as the produce of much industry and accuracy of observation. But we could have dispensed with much unnecessary matter; and had the pruning and clipping been intrusted to our hands, before it was sent to the printers, we should have been inclined to have reduced its size to the really valuable portion of the matter. Notwithstanding, we augur well for the future success of the author, from the ability and industry shown in the present attempt, and wish him heartily well in the very important course of investigation which lies open to him.

The frequency of chronic inflammation of the neck of the uterus has often struck us as remarkable; and has in many instances been to us the clue to obscure diseases, the external manifestations of which are not at all to be trusted to. Cases of apparent spinal, lumbar, hypogastric, and even crural neuralgia, and a number of the anomalous cases of obstinate nervous diseases, may be traced, more or less directly, to a chronic state of inflammation of this part, with which the whole system most peculiarly sympathises.

We can further entirely sanction, by the result of our experience, the views of our author upon the frequency of the symptoms of prolapsus depending upon a chronic inflammation, and consequent hypertrophy of this portion of the female organ. We were long surprised at the amount of distress occasioned by symptoms of prolapsus uteri when on examination we have found but little descent, and the size of the entire uterus not much more than natural, though the cervix itself was hard and occasionally tender. We were at first so struck with this discovery, that we were inclined to doubt the reality of the relation. But observation has convinced us that the symptoms usually attributed to prolapsus are often produced simply by the engorgement and hypertrophy of this portion of the uterus; and that to relieve the symptoms they must be attacked through it, as the fons et origo mali. Nor do we consider that in these observations we are at all at variance with the authority of Dr. Ashwell, who, in his valuable work on the Diseases of Females, gives it as the result of his experience, that inflammation of the cervix is rare; as, from the statement of symptoms which he there gives, he is evidently speaking of acute inflammation of this part, whereas the cases which have fallen under our observation have all been of a chronic character, and probably never exhibited symptoms of an active nature. That the symptoms of prolapsus are by no means always proportionate in severity to the size attained by the uterus, as generally understood, or to the laxity of the vagina and round ligaments, we think few practitioners will maintain, who are in the habit of examining all their cases by the touch. That the existence of such a state of parts in women who have borne many children, and who have favoured the descent of the uterus by over exertion, will be productive of severe distress, we deny not; neither do we doubt that, in neglected cases of inflammation and hypertrophy of the cervix, the foundation of permanent enlargement and descent may be laid; but we do contend that there is a large number of cases which a superficial examination would set down as prolapsus, in which the sufferings are dependent upon other causes than those of prolapsus in general, and which