which are constructed on the heights surrounding the city, is on one side of a quadrangle, a series of buildings, comprising chapel, directors', and servants' apartments. On the other side is a salle de veille, or watch-room. In the whole length of this chamber is a series of glazed sashes, each corresponding to a separate cell, and above each window a loud bell, termed the alarm-bell. This ominous alarm-bell is struck by a hammer which communicates with the interior of the cell by a simple mechanism in contact with the body placed therein as one of reputed apparent death-and only under these circum

stances.

Each of these mortuary cells is so built as to insure ventilation and temperature at the will of the director. In each is placed a stand, upon which is laid the bier conveying the body. The limbs of the body are so arranged and brought into connexion with the mechanism belonging to the alarm-bell, that it is impossible that the slightest movement can take place in the body without an alarm being given, and an attendant summoned. A medical officer, with competently educated assistants, are constantly upon the premises, furnished with all the means and appliances for fostering any indication of returning life.

A body deposited in these institutions is detained until decomposition has commenced its operations, when the friends are informed thereof, and interment takes place in the cemetery in as quiet a manner as possible.

Dr. Josat detects several objections to various parts of the arrangements he has described. The most serious of these is that in certain cases of syncope and hysterical trance the first indications of life are to be traced in a slight change of complexion, or a scarcely perceptible movements of the eyelids, of the thoracic muscles, or of the heart, to all of which the apparatus would be unavailable.

In Mayence, Dr. Josat states that all bodies are exposed, until decomposition takes place, in large chambers constructed for the purpose. There bodies are often left so long that these places become charnel-houses, distributing far greater danger than the risk of premature burial. In Berlin also, and many other Prussian towns, bodies are exposed until decomposition occurs--but the bodies are here carefully watched and attended with the greatest care, by skilful officers, and interment takes place on the earliest appearance of putrefaction. We learn from a recent return that in Berlin, out of a population of 430,000, only 48 corpses were brought to dead-houses. Not a single instance has occurred of resuscitation.

In Austria, bodies are received into dead-houses on the request of the friends. In any case interment does not take place until sixty-two hours after death, as certified by a medical man.

Restoration

In France, twenty-four hours is the term fixed by law for interment. from apparent death has frequently taken place later than twenty-four hours; consequently the law favours premature interment, and offers opportunities for the concealment of crime. An official medical attestation of death is required within the twentyfour hours, but it is obvious that this offers no protection or assistance to cases of apparent death lasting shorter periods, before the arrival of the attesting medical officer.

As a remedy for these dangers, the author proposes that no corpse should be interred until it presents signs of decomposition, which, he observes, will usually be apparent within seventy-two hours; that chambers should be attached to every cemetery for watching every reputed death, without regard to rank or condition of the individual; that a circular arrangement of cells constructed for the purpose would afford sufficient accommodation, according to the population or average mortality of each place. The author describes minutely the arrangements he suggests for the recognition of signs of life in the bodies thus exposed; these are modifications or improvements upon those of Frankfort.

As a sanitary measure, the separation of the dead from the living, especially from among the crowded poor, would be, apart from the not less important point of the verification of death, an incalculable benefit to France-to Paris: also to England-to London.

The histories of premature interments are in all cases to be received with hesitation. During epidemic visitations the most alarming accounts are greedily believed and mag

nified, all the while being totally devoid of truth. It is, however, not to be denied that such things have happened, and may therefore happen again. It has been urged that, even admitting the possibility of a person being buried alive, it is not possible that he could wake to consciousness in so small a quantity of air as is enclosed in a coffin under ground; that there being little more than enough to fill the chest, it would become so quickly vitiated that real death by asphyxia would be almost instantaneous. The statement is plausible, but we fear is not enough to divest of its unutterable horror the very thought of such a predicament. The truth is, that facts are stubborn things, and will not do obeisance to all theories. It behoves us in this matter to learn another lesson from our neighbours, and to take measures to prevent the occurrence of catastrophes too fearfully horrible to contemplate in thought-too dreadful for the most vivid or the most morbid imaginations to realize. Science can hold out no token by which to recognise the certainty of death. Sanitary police, at least in England, is indifferent about the risk of a few burials alive, and thinks it superfluous to prevent their occurrence.

W. B. Kesteven.

REVIEW VII.

1. Cure and Prevention of Scarlet Fever. By SAMUEL HAHNEMANN. (Lesser Writings of the Author, collected and translated by R. E. DUDGEON, M.D.)

2. Travaux Thérapeutiques sur la Belladone. Publiée par A. L. J. BAYLE. (Tome Seconde de Bibliothèque de Thérapeutique.')-Paris, 1830.

เ

3. Homœopathy: its Tenets and Tendencies. By Professor SIMPSON.-Edinburgh,

1853.

4. Homeopathy fairly represented. By Professor HENDERSON.-Edinburgh, 1853. SINCE the immortal discovery of Jenner, whereby one of the most frightful and most fatal diseases from which the human race has ever suffered was deprived alike of its terrors and its victims, the cultivators of medicine have been justly animated by the hope that their science might be caused to yield other services of a kindred nature to mankind. Nor has there been any want of real and earnest activity in a work which, since the introduction of vaccination, all must have had more or less at heart. For whether or not we concede to belladonna the prophylactic virtues in scarlatina which not a few have claimed for it, we are at all events called upon to acknowledge, that from very many the subject has, at various times during the five-and-fifty years it has been under discussion, received all that attention and patient investigation which every rightthinking man will readily and heartily admit to be its due. That a disbelief in the alleged power of belladonna should have taken possession of the mind of the profession generally, and more particularly in this country, was scarcely to be wondered at, when we consider the quarter from which the recommendation of its vaunted virtues proceeded, and the manner in which the test of its efficacy was required to be determined. But though apologizing for the feeling at first entertained by the bulk of medical men in regard to the announcement of the prophylactic action of belladonna, we are not to be held as thereby approving it, far less defending the course of procedure which it in some

"I believe," says Dr. Simpson, "medicine will yet most probably discover prophylactic measures against scarletfever, measles, &c." Homœopathy, p. 230, note at foot of page.

We may remind our readers that very many other prophylactics have been recommended and actually employed in scarlatina besides the exhibition of belladonna. In regard to such we find Joseph Frank writing, " Ad scarlatinam præpediendam commendata fuere: errhina et collutoria ex ammonia cum sufficiente quantitate aque; acida mineralia diluta tum interne, tum externe sub forma gargarismatis: subfumigia vel ope acidi muriatici sive simplicis sive oxygenati, vel ope acidi nitrici; minima doses succi inspissati herbæ atropa belladonnæ; et ipsa scarlatina insertio, de quarum autem rerum effectibus, cum non quivis homo necessario scarlatinæ subjici debeat, arduum est judicare.”— Praxeos Medica Universæ Præcepta, vol. ii. par. i. p. 221. Leipzig, 1815.

"Si l'action de la belladone est encore douteuse, malgré le grand nombre de ses partisans, celle des autres préservatifs est ancore bien plus hypothétique. Ainsi on a prôné une combinaison de soufre doré et de calomel. La dose, pour les enfants de deux à quatre ans, est d'un sixième ou d'un huitième de grain de calomel uni à autant de soufre doré d'antemoine, et mêlé à un peu de sucre ou de magnésie; on répète cette dose trois ou quatre fois par jour. Cette méthode a été conseillée par un médicin hollandais (E. J. Thomassen, à Thuessink), qui affirme que dans toutes les familles ou l'on fit l'usage du préservatif, la scarlatine ne sévit pas. Il cite l'observation d'un enfant qui sous son influence n'eut ni mal de gorge ni éruption, mais la desquamation consécutive."-Traité Clinique et Pratique des Maladies des Enfants, par MM. Barthez et Rilliet, deuxième édition, tom. iii. p. 208.

cases engendered; for, on the contrary, when regard is had to the frequency as well as to the extremely fatal nature of many epidemics of scarlet fever, whose ravages it was upheld both to mitigate and repress, we do feel that the mere circumstance of Hahnemann being its originator and strongest advocate formed no excuse for belladonna being either neglected or passed by. Some there were who entered at once upon the examination and investigation; and during the lengthened period that has since elapsed, abundant opportunities have been seized and turned to the best account.

But while we readily allow the same privilege to Hahnemann and his followers as we claim for the disciples of our own School, in so far as the propriety of investigating the peculiar virtue claimed for belladonna by the former was incumbent upon both, we at the same time do conscientiously believe, that had it owed its suggestion and enforcement to such a physician as Laennec, or even to Bayle,* the question of the prophylactic action of belladonna would have long ere this been settled, in the one way or in the other. Once propounded, the claim advanced would have been rigidly examined, and not accepted as correct by some upon what we shall presently show to have been most insufficient grounds, nor rejected in several instances, as we believe, upon grounds certainly not more reliable. For ourselves, we are clearly of opinion that the time and occasion have now arrived when the question of the prophylaxis of belladonna can readily and satisfactorily be answered-and, as we think, in the negative. But, desirous as we are of doing our opponents-we have now declared our own view-every justice, and the subject itself being full of interest, we shall devote this article to a reconsideration of the whole matter.

Although the discovery of the supposed prophylactic action of belladonna in scarlatina has been attributed to Castelliz, of Vienna,† there appears little doubt that the idea originally occurred to the mind of Hahnemann, and no doubt that by him the subject · was first introduced to the notice of the profession. The former happened when he was resident at Königslutter, in 1799. Two years thereafter he published a pamphlet, entitled Heilung und Verhütung des Scharlachfiebers,' from the translation of which, in Dr. Dudgeon's edition of the lesser works of Hahnemann, we extract his own account of the manner in which his discovery was made.

"The mother of a large family, at the commencement of July, 1799,§ when the scarlet fever was most prevalent and fatal, had got a new counterpane made up by a sempstress, who (without the knowledge of the former) had in her small chamber a boy just recovering of scarlet fever. The first-mentioned woman on receiving it examined it, and smelt it, in order to ascertain whether it might not have a bad smell that would make it necessary to hang it in the open air; but as she could detect nothing of the sort, she laid it beside her on the pillow of the sofa, on which some hours later she lay down for her afternoon's nap. She had unconsciously, in this way only (for the family had no other near or remote connexion with scarlatina patients), imbibed this miasm. A week subsequently she suddenly fell ill of a bad quinsy, with the characteristic shooting pains in the throat, which could only be subdued after four days of threatening symptoms. Several days thereafter her daughter, ten years of age, infected most probably by the morbific exhalations of the mother, or by the emanations from the counterpane, was attacked in the evening by severe pressive pain in the abdomen, with biting itching on the body and head, and rigour over the head and arms, and with paralytic stiffness of the joints. She slept very restlessly during the night, with frightful dreams, and perspiration all over the body excepting the head. I found her in the morning with pressive headache, dimness of vision, slimy tongue, some ptyalism, the submaxillary glands hard, swollen, painful to the touch, shooting pains in the throat on swallowing and at other times. She had not the slightest thirst, her pulse was quick and small, breathing hurried and anxious; though she was very pale she felt hot to the touch, yet complained of horripilation over the face and hairy scalp; she sat leaning somewhat forwards, in order to avoid the shooting in the abdomen, which she felt most acutely when stretching or bending back the body; she complained of a paralytic stiffness of the limbs with an air of the most dejected pusillanimity, and shunned all conversation. She felt,' she said, 'as if she could

Bayle manifestly gave it his support, but to a certain extent, and in a certain sense, the theory whose associated facts Bayle has done much service in recording, was tarnished in its propounder.

† See Lectures on Materia Medica and Therapeutics, by G. G. Sigmond, M.D. Lecture xiii. Lancet, vol. ii. 1836, 37. Originally published at Gotha, in 1801.

5 The 14th of May, 1796, was, as Dr. Watson happily terms it, "the birthday of vaccination;" it is not unlikely that during the period from May, 1796, to July, 1799, the mind of Hahnemann had been strongly directed to the subject of the prevention of contagious diseases.

only speak in a whisper.' Her look was dull and yet staring, the eyelids inordinately wide open, the face pale, features sunk.

"Now I knew only too well that the ordinary favourite remedies, as in many other cases, so also in scarlatina, in the most favourable cases leave everything unchanged; and, therefore, I resolved in this case of scarlet fever just in the act of breaking out, not to act as usual in reference to individual symptons, but if possible (in accordance with my new synthetical principle) to obtain a remedy whose peculiar mode of action was calculated to produce in the healthy body most of the morbid symptoms which I observed combined in this disease. My memory and my written collection of the peculiar effects of some medicines, furnished me with no remedy so capable of producing a counterpart of the symptoms here present as belladonna.

"It alone could fulfil most of the indications of this disease, seeing that in its primary action it has, according to my observations, a tendency to excite even in healthy persons great dejected pusillanimity, dull staring (stupid) look, with inordinately opened eyelids, obscuration of vision, coldness and paleness of the face, want of thirst, excessively small rapid pulse, paralytic immobility of the limbs, obstructed swallowing, with shooting pains in the parotid gland, pressive headache, constrictive pains in the abdomen, which become intolerable in any other posture of the body besides bending forwards, rigour and heat of certain parts to the exclusion of others-e. g., of the head alone, of the arms alone, &c. If, thought I, this was a case of approaching scarlet fever, as I considered was most probable, the subsequent effects peculiar to this plant,-its power to produce synochus, with erysipelatous spots on the skin, sopor, swollen hot face, &c.,-could not fail to be extremely appropriate to the symptoms of fully developed scarlatina.

"I, therefore, gave this girl, ten years of age, who was already affected by the first symptoms of scarlet fever, a dose of this medicine (1-432,000th) part of a grain of the extract, (which, according to my subsequent experience, is rather too large a dose). She remained quietly seated all day, without lying down; the heat of her body became but little observable; she drank but little; none of her other symptoms increased that day, and no new ones occurred. She slept pretty quietly during the night, and the following morning, twenty hours after taking the medicine, most of the symptoms had disappeared without any crisis; the sore throat alone persisted, but with diminished severity, until evening, when it too went off. The following day she was lively, eat and played again, and complained of nothing. I now gave her another dose, and she remained perfectly well, whilst two other children of the family fell ill of bad scarlet fever without my knowledge, whom I could only treat according to my general plan detailed above. I gave my convalescent a smaller dose of belladonna every three or four days, and she remained in perfect health. I now earnestly desired to be able, if possible, to preserve the other five children of the family perfectly free from infection. Their removal was impossible, and would have been too late. I reasoned thus: a remedy that is capable of quickly checking a disease in its onset, must be its best preventive; and the following occurrence strengthened me in the correctness of this conclusion. Some weeks previously, three children of another family lay ill of a very bad scarlet fever; the eldest daughter alone, who, up to that period, had been taking belladonna internally for an external affection on the joints of her fingers, to my great astonishment, did not catch the fever, although during the prevalence of other epidemics she had always been the first to take them.

This circumstance completely confirmed my idea. I now hesitated not to administer to the other five children of this numerous family this divine remedy as a preservative, in very small doses, and as the peculiar action of this plant does not last above three days, I repeated the dose every seventy-two hours, and they all remained perfectly well, without the slightest symptoms throughout the whole course of the epidemic, and amid the most virulent scarlatina emanations from their sisters who lay ill with the disease. In the mean time I was called to attend another family, where the eldest son was ill of scarlet fever. I found him in the height of the fever, and with the eruption on the chest and arms. He was seriously ill, and the time was consequently past to give him the specific prophylactic treatment. But I wished to keep the other three children free from this malignant disease. One of them was nine months, another two years, and the third four years of age. The parents did what I ordered, gave each of the children the requisite quantity of belladonna every three days, and had the happiness to preserve these three children free from the pestilential disease, free from all its symptoms, although they had unrestricted intercourse with their sick brother. And a number of other opportunities presented themselves to me where this specific remedy never failed." (p. 434.)

Such is Hahnemann's account of the mode in which the efficacy of belladonna was first suggested to his own mind. We shall anon revert to the passage we have quoted at such length; meantime, let it be observed, that over and above the prophylactic

virtue in scarlatina which Hahnemann claims for belladonna, he also asserts its potency as a specific remedy in the disease itself, modifying its symptoms, removing its "after sufferings," or consequences, " often worse than the disease itself;" and capable, too, of suppressing the fever "in its first germs," when its invasion has already occurred. Further, that, so far as the prophylaxis of belladonna is concerned, Hahnemann makes no restriction of the cases of true scarlatina in which the drug may either be inadmissible, or may, in his own experience, have proved useless. On the contrary, we are led to suppose that, in his experience, no such cases occurred. And this view of his own opinion is rendered more than probably correct, when we find him speaking in his greater work thus :-" Et qu'en prenant une dose de belladone aussi faible que possible, on se garantit de la fièvre scarlatine."

One of the earliest notices, if not the first mention of the alleged virtues of belladonna, which appeared after the publication of Hahnemann's own pamphlet, and corroborative of his views, was in Hufeland's Journal, for May, 1812, from the pen of Dr. Schenck, having reference to an epidemic which occurred in the department of Hilchenbach, in the grand duchy of Berg. It and the other testimonies which follow, both in favour of and against belladonna, are detailed, for the most part, with much precision in the learned work of Bayle.‡

In 1812, when Schenck witnessed the effects of belladonna at Hilchenbach, the epidemic had, before his arrival, lasted for three weeks. Eight persons had already died, two of whom were previously healthy and robust young men, and two young women in like condition. Twenty-two were then affected; almost all were children, or young persons below the age of twenty. Of 525 persons who used the belladonna, 522 were unattacked by the disease. The three persons who suffered were a mother and her two children, who were, it is said, peculiarly exposed to the contagion, and had only taken the drug four times. The manner of making and administering the preparation of bella'donna adopted by Schenck, to whom it was suggested by Hahnemann himself, is thus recorded, and as this is important, we shall quote the French of Bayle:

"M. Hahnemann eut la bonté de me faire parvenir trois grains d'extrait de belladone qu'il avait préparés lui-même, attendu qu'on le confectionne pas dans toutes les pharmacies avec assez de soin pour qu'on puisse compter sur son effets. Il m'envoya en même temps l'instruction suivante: On triture ces trois grains dans un petit mortier, avec une onçe d'eau distillée qu'on y ajoute peu-à-peu, de manière à ce qu'ils soients exactement dissous. On ajoute à cette solution un autre composé d'une once d'eau distillée et d'une once d'alcool purifiée; on agit le tout, et on laisse déposer. On met une seule goutte de cette liqueur bien claire, dans une bouteille contenant trois onces d'eau distillée et une once d'alcool rectifié: on agite bien le tout. C'est cette liqueur qui sert de préservatif. On en donne aux enfans au-dessous de neuf ans une seule goutte, et aux personnes au-dessus, deux gouttes sur du sucre, tous les quatre jours, de manière à ce qu'on reste deux jours pleins sans en donner. . . . . M. Hahnemann me conseilla en même temps de recommander qu'on préservât les enfans de toute commotion vive, ainsi que de lésions externes: mais de ne rien changer d'ailleurs à leur genre de vie. . . . Le 7 février l'on commença l'usage des gouttes, et on les continua pendant quatre semaines." (p. 391.)

In this experience of Schenck, let it be noticed that three individuals who had taken the belladonna four times were attacked, and let the possibility of the epidemic having approached its termination before his observation of it began, not be lost sight of. To M. Schenck, M. Rhodius writes as follows:

Indeed the only restriction made mention of is "in some particular cases, where the original disease has been very violent, and advice has been sought for the after sufferings too late, that belladonna is no longer of service," but in this restriction we recognise a very great amount of speciousness; what is it but to say that whenever and wherever the disease baffles the belladonna, it is not to be laid to its charge, but to the mistake of a too-late advice or consultation.

Organon: Nouvelle Traduction, par Jourdan, p. 85.

The title of Schenck's paper, as published in Hufeland's Journal, is "Versuche mit dem Hahnemann'schen Präservatif gegen das Scharlachtieber, von Hrn. Hofrath Schenck."-It is from no desire to find fault, but, on the contrary, with great reluctance, that we must, at the outset of our references to Bayle, express our extreme astonishment and disapprobation of the course Dr. Henderson has adopted. He writes at p. 112 of his work-"Before adverting to the experiments made in Edinburgh, I shall adduce from an article by M. Bayle," &c., &c. Now, it is quite clear that Dr. Henderson has never had recourse to Bayle, but only to Dr. Black's very inaccurate representation of what Bayle has written; for he even copies Black so literally as to transcribe his errors-one of which, miserable as it is, we must beg Dr Henderson to correct. He follows Dr. Black in referring to the Bibliothèque Thérapeutique, tom. ii. p. 583, et seq., being unaware that there are only 532 pages in the volume.