atmosphere which is supposed favourable to persons predisposed to that disease. In Malta, on the average of 20 years, about 6 per thousand of the troops have been attacked annually by consumption, and in Gibraltar and the United Kingdom, nearly the same ratio, while in the Ionian Islands only 5 per thousand have been attacked, and the deaths have been fewer in the same proportion. This slight exception may, however, in some measure, be attributable to a smaller proportion of force being at that period of life when persons are supposed most liable to this disease; for instance, on reference to the abstract of ages, No. XVI. of Appendix, it will be seen, that in Malta and Gibraltar, one-third of the troops are under twenty-five, whereas, in the Ionian Islands, about a fifth only are under that age; a circumstance which may exert considerable influence on the results, particularly as regards consumption.

It is stated in many of the Medical Reports that, owing to the sudden and frequent atmospherical vicissitudes in this climate, inflammation of the lungs is extremely frequent and fatal. The result of these investigations, however, establishes, that it is not more so than in other stations which are less liable to such vicissitudes; in Malta, for instance, out of an aggregate strength of 40,826, there were 1370 attacked, and 44 died by this disease in the course of twenty years; whereas in the Ionian Islands, out of an aggregate strength of 70,293, there were only 2186 attacks, and 81 deaths during the same period, being about an equal proportion. This disease is more prevalent in Corfu, and more generally fatal in Cephalonia, than in any other of the Ionian Islands.

SECTION VII-Deductions from the preceding Report.-As the preceding results tend to render questionable many of the theories regarding the influence of certain climates and localities in inducing some diseases, and modifying the operation of others, it may be necessary here to take a brief review of the information which has been obtained on that subject in the course of this investigation.

The mild climate of the Mediterranean, for instance, has generally been considered favourable to the cure or prevention of consumption and other pulmonary affections. To ascertain whether this supposition is well founded, or the reverse, is manifestly an object of much importance to medical science, and can only be determined by investigations extending over a long series of years, and including large masses of individuals. The experience of civil practitioners, however carefully recorded, is on too limited a scale to warrant general conclusions on a subject of such magnitude; yet, hitherto, no other source of information has been available for that purpose, and it is not surprising, therefore, if their conclusions, when submitted to the test of numerical calculation, are, in many instances, found to be erroneous.

In no way can the relative influence of climate in inducing any particular disease in different countries be more accurately estimated than by a comparison of the proportion attacked annually out of a given number of individuals resident in each. If we apply this test to

the Mediterranean stations, by investigating the relative prevalence of consumption among the troops there and in the United Kingdom we obtain the following results:

We have already alluded to this subject in a more general way, in the course of our observations on diseases of the lungs in each of the Mediterranean commands, but we can now speak with more certainty from results extending in each instance over the same seven years, and embracing a large number of individuals of the same profession, the same age, the same habits, and having, except at Gibraltar, the same diet. This affords so accurate a standard of comparison as to place beyond a doubt the interesting fact, that, except in the Ionian Islands, the liability of troops to consumption in the Mediterranean stations is even greater than in the United Kingdom. We have not compared the deaths by consumption for a similar period, because conclusions could not have been drawn in regard to the relative mortality with the same accuracy, so many labouring under that disease having died on their passage home or after their arrival in this country; but from all the information we have been able to obtain there can be no doubt that if due allowance is made for these casualties, the proportion of deaths also, among those attacked by consumption, will be found fully as high in the Mediterranean as in the United Kingdom.

We might have carried this comparison further, and shewn how little influence temperature has on this disease by the fact, that it is still more prevalent and fatal in the Mediterranean than in North America, where the soldier has frequently in the course of his duty to be exposed to the night air, when the thermometer is several degrees below zero; but we defer entering on any more extensive comparison of this kind till we have an opportunity of adducing evidence on that subject in a more detailed form.

These facts offer a striking contradiction to the popular idea regarding the influence of sudden atmospherical vicissitudes, and rapid alternations of temperature, in inducing this disease; but it is even more remarkable that similar results should be obtained in regard to the relative prevalence and mortality by pleurisy and inflammation of the lungs, which are supposed to be still more influenced by these agencies.

A table is given, which we omit, shewing that inflammatory affections of the lungs are nearly twice as prevalent in the Mediterranean as among the same number of troops in the United Kingdom, and that in the mild climate of Malta they are also twice as fatal.

These facts, combined with a careful examination of the Abstracts in the Appendix, lead to the inference that residence in the Mediterranean, though so often recommended to patients labouring under pulmonary affections, is by no means likely to be attended with beneficial results: in some cases, no doubt, change of air, change of scene, and the sea voyage, may have benefited a patient, and led to a partial recovery, but the same would in all probability have taken place wherever he had been sent, it being by no means likely that any beneficial influence can be exerted by the climate itself, when a body of selected soldiers, subject to no severe duty and exposed to no hardship, lose annually a larger proportion of their number by consumption than in the United Kingdom. This inference, however adverse to generally received opinions, is strikingly corroborated by the prevalence of consumption and other pulmonary affections among the civil inhabitants of Malta, as shewn in Appendix No. III. of this Report.

The average number of pulmonary affections during the last seven years is certainly not too favourable a standard of comparison for the climate of the United Kingdom, as they have been more frequent than usual, owing to the influenza having twice prevailed to a great extent among the troops. The results for the same period may be supposed, however, to afford a fairer average for the Mediterranean, where that epidemic was not so prevalent.

SECTION VII.-Deductions from the preceding Report.-Having, in the course of this Report, frequently adverted to the uniform degree of prevalence which, notwithstanding the dissimilarity of climate, has been found to exist in the proportion of pulmonary affections in Nova Scotia and Canada, compared with Malta and Gibraltar, it seems unnecessary here to recapitulate the evidence on that subject; but it may be proper to inquire whether there exists, in the moral or physical condition of the troops in the Mediterranean and American stations, any difference likely to have influenced the results on which that comparison has been founded.

In the last section of the West India Report we showed that these diseases, even under the high temperature of the tropics, prevailed to a greater extent than in the United Kingdom. But it may be argued that several circumstances, independent of climate, were there in operation to induce that peculiarity; for instance, the innutritive qualities of the diet, the limited and defective state of the barrack accommodation, and the general prevalence of intemperance, were all causes tending to affect the health of the troops in no inconsiderable degree. We are, therefore, led to inquire whether any deteriorating circumstances of a similar nature exist in the Mediterranean from which the troops in North America are exempt, and by which the tendency to these diseases may have been so far aggra VOL. XV. NO. 44. 2 x

vated as to counterbalance the advantages otherwise resulting from its mild and equable climate.

So far, however, from this being the case, every circumstance has been more favourable to the troops in the Mediterranean. The barrack and hospital accommodation, in Malta and Gibraltar at least, is not only of a more substantial nature thon in Canada and Nova Scotia, but nearly double the space is allotted to each soldier; the diet, with the exception of a greater issue of salt meat in Gibraltar during the winter months, is nearly the same, and the meals are regulated on similar principles. Intemperance, to which so much has been attributed as an exciting cause of these diseases, cannot be said to prevail to a greater extent in the Mediterranean than America, where the constant use of ardent spirits is likely to prove still more prejudicial than the low wines which form the principal medium of intoxication in the Mediterranean.

In all these respects, then, the troops in the Mediterranean have decidedly the advantage. We have yet to advert to another circumstance no less favourable to them: consumption, the most fatal of this class of diseases, is supposed to affect persons at an early period of life more than those of mature age. Now, owing to the frequency of desertion in North America, so many recruits have to be sent out from this country that nearly one-half of the force there is under 25 years of age, while in the Mediterranean, where no such necessity exists for large drafts from the depôts, the proportion under that period of life is only from a third to a fourth of the whole; consequently the composition of the force in the Mediterranean renders it much less subject to the influence of consumption, if not also of the other pulmonary diseases which frequently precede it.

When we find, notwithstanding all these circumstances apparently so favourable to the greater development of these diseases in Canada and Nova Scotia, that the troops there do not suffer from them to a greater extent than in the Mediterranean, it would manifestly be incorrect to attribute their prevalence in North America to the reduced temperature and sudden atmospherical vicissitudes incident to that quarter of the globe, seeing that the sufferings of the troops from these diseases are equally great in other climates where no such causes are in operation to induce them.

We have been thus particular on this head, because, in the Reports from the different medical officers in North America, we find a great portion of the sickness and mortality attributed to the severe and changeable nature of the climate inducing pulmonary affections of various kinds. It is true that many of the deaths arise from these diseases, but in this respect the troops there are by no means singular in their sufferings, for, throughout the wide extent of the British Colonies, few stations can be found where soldiers are not affected by them in an equal degree, though, perhaps, owing to the greater extent of mortality by other diseases, these are less a subject of observation or remark. In addition to the instances already adduced on that head it will be shown, in a future Report, that even in the mild climate of the Mauritius, more soldiers are attacked by con

sumption, and nearly as many by inflammation of the lungs, as in the most inclement regions of North America, though we do not find that the prevalence or fatal character of these diseases attracts so much attention.

Biographical Memoir of DR. JAMES JOHNSON, Senior Editor of the Medico-Chirurgical Review." Nec medici, nec imperatores, nec oratores, quamvis artis præcepta perceperint, quidquam magnæ laudis dignum sine usu, et exercitatione consequi possunt."-CICERO. A justly celebrated physiologist and physician has well observed, that "that man is a scientific physician, who is well acquainted with, and has appropriated to his own use the results of all the inquiries which has been made at different times by eminent observers upon the symptoms, course, and causes of diseases, and with the precepts of treatment which they have recommended and employed." And that, "to become a skilful practitioner, he must understand how to bring this knowledge into operation, and be ready to apply all its rules and deductions to each particular case." This is a talent only to be acquired by the most patient observation, the most diligent study, and the most extensive practice; and if any one member of the medical profession is to be regarded as having most zealously laboured to attain this summit of medical knowledge, it is the subject of the present memoir, who has now for many years given to us the fullest evidence of his erudition and practical knowledge by the judicious and able manner in which he has conducted the "MedicoChirurgical Review, and Journal of Practical Medicine," a work which must be admitted to hold the very first rank and importance in medical periodical literature.

The opinion thus directly given of the merits and qualifications of Dr. James Johnson is not simply a result derived from the perusal of the pages of his review; but has been formed from an acquaintance with his practice, and an association with him in professional matters at various times, and during several years. It is not to be regarded as the language of panegyric-it is truly the payment of a debt of gratitude to one who has so ably led the minds of the medical public to a consideration of what is due to themselves as practitioners, and to those individuals whose happiness and lives have been committed to their care. The importance of an able and just periodical literature of medical science must be admitted by all—it is too generally entrusted to inexperienced hands, and crude theory has but too often usurped the place of practical observation. The press of the present day teems with the productions of authors on medical subjects, and literary discrimination is more necessary than ever, to point out not only to the student, but also to the practitioner, the works of real value and necessary to be perused. This is a task of no little labour or difficulty-great information is necessary on the part of the guide, to accomplish this object in a satisfactory manner. Pope observed, that "the greater part of critics form a general character from the observation of particular errors, taken in their own oblique or imperfect views; which is as unjust, as to make