In I: i in overcomin.u' i ad also with us. F SUKGERY OF THE CRIMEAN WAR. There are various traces of the occurrence of this affection during the Peninsular war; but it does not appear to have attracted much notice from surgeons there. The disease known as beriberi has, in some of its slighter forms, a resemblance to it, but has many symptoms of which we had no experience. In all these affections a depressed vitality and nervous excitement seemed to have been the chief causes of disease. Dr. Tholozan says he observed on dissection a peculiar " specific alteration " in the deep fatty tissues of the hands, feet, and legs, especially in the borders of the feet, the pulps of the toes, and the thenar and antithenar cushions, which, he thinks, has not been as yet explained, and which he does not connect either with scurvy, fever, he believes to be the cause of the peculiar affection to which I have made reference " Le tissu graisseux de la plante des pieds, de la paume des mains, ou bien celui qui forme le coussinet sur lequel repose le ligament rotulien, ou bien les vesicules graisseuses situces centre le femur, au-dessus de 1'articulation fdmoro-tibiale, ont presente 27 fois, dans les 79 autopsies, des alte'rations curieuses.
Avec un c-tat normal du denne et de 1'aponevrose, on trouve les vesicules graisseuses sous-cutanees fortcmeut injectees depuis le rouge clair jusqu'au rouge noir. La couleur jaunatre de la graisse a disparu derriere la forte injection, et meme 1'dtat ecchymotique de 1'enveloppe celluleuse des vesicules. Ce n'est point une ecchymose sous-cutande: c'est un etat anatomique particulier fort peu connu du tissu graisseux. Le tissu cellulo-fibreux intervesiculaire cst normal et plutot pale, les cellules graisseuses sont treshyperdmie'es, et ces vdsicules prdsentent quelquefois a leur surface un piquetc ecchymotique noiratre. La graisse contenuo dans les vesicules ne parait pas alt''ree. "Cette Idsion existe dans quelques cas en meme temps dans les rdgions indiqudes; souvent ou ne la rencontre qu'u la plante des picds ou au voisinage de 1'articulation du genou; toujours elle est plus la plante des pieds qu'a la paume des mains.
Le tissu graisseux le plus CONCLUSIONI candidly confess, I was one of those who looked forward with foreboding to the dinners of the plague appe our hospitals; but, providentially, we were spared this tearful invasion. Circumstances were certainly favourable to its outbreak; and, at one time. scurvy and malignant t'ever attained such a MX many of the features of plague, both in hospitals at Constantinople, and among the Russians at Odessa; but with us, the rapid amelioration which took place as the war proceeded, made us nervous al.oiit any development of it in our army. A review, however superficial, of the medical annals ot' the war; of the hygienic causes, and local circums which led to the appearance and development of disease in our army; reiterates in trumpet-tones tinsame lesson confirms and enforces the same conclusion that the barometer of health rose and fell, as external eireum-t ivouralile or injurious to health, were ided to or neglected.
These circumstances were, in a great degree, under our own control, as will always be the case, whether in the camp or the city. This si II ne ra'a e"t<i possible de saisir de relation. ntn,,-t dtat et le la typhoa, on la dyasenterie, on lea congelations II a'agit il'une alteration speciflquc non dferite, dont la valeur pathologique I bcsoin, poordtre d'un plus grand nombre d'observationa." MT hi ifaladiet <T Orient /IM a CAcad. de ML, Sept.
30, 1856, par X. U Dr. Tholoian, so. it is surely the first duty of a government, as well as of a commander, to adopt every possible precaution which can guarantee the health and life of the army to which the honour, and even the safety, of the state are intrusted. By the adoption of judicious and enlightened means, disease, if it cannot be wholly banished from our camps, may yet be stripped of the deadly power which it now so destructively wields. Even wounds would become comparatively harmless, if all the vital powers (the vis medicatrix naturce) possessed in full vigour and activity, were to put forth their mighty strength to sustain and restore the constitution. The soldier would have no enemy to fear but one he could see face to face one whom the British soldier never fears and thus the effectiveness of our army would be increased tenfold.
Any one who saw the two armies at Sebastopol; the ragged, gaunt, spectral-like figures guarding their fated trenches in the dreary winter of 1854-5, while the majority of their comrades lay in misery and pain in the wretched; and again witnessed the British army in the spring of 1856; every man in health and vigour literally " full of lusty life," and actually " rejoicing in his strength;" he who beheld that great contrast, and reflected how oversight and neglect were the causes of the one sad picture, and care, directed by knowledge and supported by energy, produced the other truly glorious one, would, whether actuated by principles of economy, humanity, or patriotism, ever urge his country to guard and preserve the health of the armies that defend it.
" Conserver les soldats," says Baudens, " transported a grand peine, est le premier interet d'une nation qui CONCLUSIONS. t'ait line LTIUTIV lointaine; c'est aussi le meilleur gage d'un succes definitit'. Lrs maladies tuent plus d'homincs que le fer et la poudre, et il est souvent facile de les pre*venir par de simples precautions hygieniques."