As it is impossible, without the interference of the legislature, to render compulsory the above regulations, the carrying them into effect must be left entirely to the good sense and humanity of the public. These, if duly exerted, will be found fully adequate to the purpose, as every individual, however indifferent or careless, cannot but be aware, that the neglect of any of these conditions, must subject him to the reproach of his fellow-citizens, for having violated, not only his obligations to society, but also the sacred duties of humanity.

With a general feeling of this kind on the public mind, the competency and success of the plan I have proposed, would soon cease to be doubtful. One advantage, I presume, it will be allowed to possess. It may be adopted with equal facility by all ranks and descriptions of people; for it involves neither expense nor inconvenience.

I appeal, therefore, with confidence, to parents, guardians, and all who possess influence, and who are interested in the fate of the rising generation, to give it their support, and to promote its favourable reception, by their example.

My expectations may perhaps be deemed visionary; but I am, notwithstanding, strongly impressed with the belief, that, by a strict adherence to the above plan, there are rational grounds for indulging the hope, so consolatory to every feeling mind, that the hooping-cough shall be divested of many of its dangers, and instead of being anticipated with terror and alarm, it shall at last come to be viewed with indifference.

If the preceding observations shall prove in any respect instrumental in promoting so beneficial an object, the design with which they have been written will have been fully and happily accomplished.

Sept. 1810.

October 2.- Since writing the above, I have been much gratified on seeing, in some extracts, published in the 24th Number of the Edinburgh Medical and Surgical Journal, from Jackson's Account of Marocco, the following facts mentioned.

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Leprosy being considered epidemical, those who are affected with it, are obliged to wear a badge of distinction whenever they leave their habitations; so that a straw hat, with a very wide brim, tied on in a very particular manner, is the signal for persons not to approach the wearer.” If such a precaution be considered necessary for the prevention of leprosy, which at least discovers itself by the "total want of eyebrows" in those who are, or have been affected with it, how much more necessary is it in hoopingcough, which is so much more destructive to life, and in which

there is no appearance to indicate its presence? Indeed, some such contrivance might be beneficially applied to all contagious diseases, each disease being distinguished by its peculiar device; and although we could scarcely expect to limit, in any very material degree, the aggregate dissemination of any disease, we might, at all events, be able to render it less indiscriminate in its operation: besides, the certainty of exposure having taken place, would, by preparing us for the attack, put it in our power to counteract its effects.

The range of action of this, and of every other contagion, is perhaps more limited than is generally imagined. The author formerly quoted, in his account of Marocco, says, "My daily observation convinced me, that the epidemy (a highly malignant species of plague) was not caught by approach, unless that approach was accompanied by an inhaling of the breath, or touching the infected person."-Med. & Surg. Journal, Vol. VI. p. 464.

V.

Inquiry into the Exactness of some Statements, made by Messrs Nagle and Wilson, Naval Surgeons, respecting their extraordinary success in the Treatment of Yellow-Fever. By a Naval Surgeon.

IN the 2d Vol. of Currie's Medical Reports, is a letter from Mr Nagle, surgeon in the Royal Navy, giving an account of his employment of the affusion of cold water in a fever that occurred on board the Ganges, in the West Indies. Mr N. gives it as his opinion, that the fever was that which has commonly been described under the title of yellow-fever. One hundred and twenty cases of this fever occurred on board the Ganges, and, under the treatment of Mr N., only two died. Now, in comparing this very great success of Mr N. (very great in any species of continued fever) with the experience of other authors who have written on the yellow-fever, and with what we have experienced in our own practice, and in that of others, it is impossible not to entertain a doubt that there has been some deception in the case. The disease in the hands of Mr N. proved so mild, so manageable- to all others it has proved so fatal and untractable, that we cannot conceive for a moment, that the difference of his practice only, from that of others, could have made such a wonderful difference in the

result; particularly, as we know, that the practice he says he followed, has been employed times out of number in the yellowfever without success. Before Mr N., we believe that the cold affusion, as directed by Dr Currie, was not so properly or so pointedly employed as it was by him; but since he wrote, it has had ample trials, unhappily with a result far different from that which it had in the fever on board the Ganges; and although it is undoubtedly one of the most powerful remedies we possess in yellow-fever, yet it falls far short of what its powers in the contagious fever of Europe had led medical men generally to expect. From all this, (I repeat it), we can hardly refrain from suspecting that Mr Nagle did not treat cases of yellow-fever, of the fever described by Dr Moseley and Dr Jackson, and other good authors, of the fever which still continues to carry off so many of our soldiers and sailors in the West Indies.

From what has been said, it may be inferred with safety, that Mr Nagle's discrimination, or his veracity, will hardly fail to be impeached by all those who have treated, and who still continue to treat, this fever with a degree of success so vastly inferior to that mentioned by him. The only way, as appears to me, that Mr Nagle can remove the imputation, is by publishing some cases of the fever at length. The full detail of symptoms in the early stage, † (if the disease did not proceed beyond this), will enable the experienced to judge of the nature of the disease. And I think an account of the two cases that proved fatal, would be decisive of the question of the identity of the fever of the Ganges with the endemic of the West Indies. It is mentioned that yellowness did not occur. But although yellowness of the surface is not a universal symptom of the disease, it seldom or never proves fatal, without exhibiting, in the combination of its phenomena, signs characteristic of itself.

It is to be hoped that Mr N. will not withhold the information required. His honour and his humanity are both interested; for surely, if he had such great success in the treatment of the yellow-fever, he must have employed means as yet untried by other practitioners.

In the same volume is given the result of the practice of Mr Wilson, surgeon of the Hussar, in this fever also (as is said), extracted from Dr Trotter's Medicina Nautica. Out of eighty-three cases of fever Mr Wilson did not lose one. This is still greater

† A general statement of the first symptoms, in these cases, is indeed given; but these, although certainly generally present in yellow fever, are more or less found in all fevers.

success than Mr Nagle's. But the judgment of Mr Wilson lies under still greater imputations of inaccuracy than does that of Mr Nagle; because, in the account itself of the disease by the former, we have, as it were, intrinsic proof that it was not the yellow-fever; whereas, in the report of the latter, 'tis the success alone that staggers our belief." Mr W. says the fever was contagious; now, we know that the yellow-fever is not contagious. And if it be said that Mr W. might have been deceived with regard to its contagious nature, as so many others have been, we reply, that the fact of its spreading among the crew of the Hussar, in the manner it did, and the circumstance of its having been carried from Guadaloupe to North America, prove the contagious nature of the fever. Consequently this was not the yellow-fever; for, however medical men in England, who have never seen this disease, or who, having seen it, have had their judgment warped by theory and prejudice, may maintain the contrary, we now certainly know, that the yellow-fever is not contagious. Besides, the comparison of his practice and success, with the practice and success (or we rather fear, it ought to be stated want of success) now witnessed in the West Indies, must inevitably lead us to the same conclusion. Mr W.'s practice was to bleed early, employ the cold affusion, and give emetic tartar. Now, the two former modes of cure are those actually employed at present, with a very different effect from what Mr W. experienced, while the third is universally abandoned, from experience of its ill effects. From these considerations, I think we are warranted to conclude, that Mr Wilson did not treat patients labouring under yellow-fever. This question of the real nature of the fever which Mr W. treated, on board the Hussar, excites a livelier interest, as it is adduced by Dr Blane in his letter to Baron Kloëst, (Ed. Med. & Surg. Jour. Vol. III. p. 385.), as a conclusive proof of the contagious nature of yellow-fever. Fortunately, however, we did not want this confutation of Mr Wilson's opinion, to disprove the contagion of this fever.

I consider the present inquiry as of some importance, inasmuch as the successes related by these authors, are apt to give rise, in those unacquainted with the discase, to suspicions unfavourable to the character and abilities of other surgeons, who, at present, treat the fever in question unhappily with very different event. I have, therefore, upon returning from the scene of this disease, thrown together the above observations, trusting you will give them a place in your widely circulated Journal; a medium through which they are most likely to fulfil the intention with which they were written.

VI.

Description of a very singular and complicated Case of Malconformation of the Genital Organs, Rectum, &c. By J. T. CONQUEST, Assistant-Surgeon to the Royal Marine Forces, and Member of the Royal College of Surgeons.

E. F. was a few months since delivered of an infant, of the natural size of a small nine months foetus, which presented the following curious deviations from Nature's usual course. It survived the birth three days. The whole body of the child was emaciated, and great deficiency of vigour was very perceptible; the muscles were of a loose flabby texture; the lower extremities were considerably distorted, the feet being turned completely inwards. On the second and third lumbar vertebræ, there was spina bifida situated, of the size of a common orange.

The umbilicus was lower than usual, and on the right side; it did not appear to perforate the linea alba in its natural place, but came out nearer the edge of the rectus muscle; there was a considerable elevation, both on the upper and lower part of its perforation.

The anus, in its natural situation, was imperforate, nor was any appearance of the termination of the rectum perceptible, when exertions were made, by crying or voiding the urine. About midway between the umbilicus and symphysis pubis, the rectum protruded about three inches from the abdomen, and was covered by the common integuments, which were regularly continued on from the abdomen, and reflected over its whole length. The peristaltic motion was constantly going on, and the_meconium were voided through it. It was much thicker than the rectum of an adult, supposing it to have the addition of a cuticular covering. It appeared to be surrounded with a strong muscle, which, when the internal or villous coat suffered the least attrition, contracted with an unusual degree of force, amounting to a temporary obliteration of its canal. The sphincter was perfect at its termination, where it was for a small distance inverted. The inversion of its lower part rendered the internal coat so distinct, as to admit of its being minutely examined. The villous coat was extremely red, vascular, and tinged with blood of a florid hue. It was so extremely sensible, that when slightly irritated with a probe, a determination of blood took place to the