wonderfully and mysteriously precise than the general fact as thus stated would prove it to be. I need only add, that the lands producing this Malaria are situated generally at about a mile distant, on the left hand, being as well known as the road itself."

The above fact rests on such unquestionable authority, and on so many eye-witnesses, that it cannot be doubted. Indeed, it is not much more remarkable than the confinement of malaria to one side of a street. The late terrible epidemic cholera of India, presented innumerable instances still more inexplicable than the above. The cholera would travel for days and weeks along one bank of a small river or even of a nullah, leaving the opposite bank free-and then deserting its favourite track, it would suddenly migrate to the bank that had so long escaped its ravages. For our own parts, we would be more inclined to account for the phenomenon, on the principle of malaria generated on the spot, than transported to it from a distance. The cause of the epidemic cholera at length reached Cape Comorin, and, from thence, after a certain lapse of time, it travelled to the Mauritius, over a great tract of ocean, and without the aid of a favouring monsoon-nay, against the atmospheric currents. How could this be transportation? It must have been generation.

The caprices of malaria, in respect to level, are often very difficult of solution. In Italy, where it was first remarked, as a general rule, that the malaria lay near the ground, and was transmitted in the direction of a stratum near its level, in preference to a higher one, the solution was sufficiently obvious. Thus, it was found safe to sleep in the second or upper story of a house, while the fever seized on those below-hence certain popular practices relative to the closing and opening of windows. This fact was also well ascertained in other and distant regions, both in the eastern and western hemisphere.

"The solution here seems easy, and perhaps it is also the true one. It is, that the Malaria is especially united with that transferable substance which forms the foggy stratum; or that the lowest portion of the atmosphere in the act of depositing water, is its vehicle and its residence."

It is not a little curious that, in some places on the coast of Norfolk, where malaria prevails, the second or upper story of a house becomes its favorite point of attack, while the ground floor invariably escapes. It is probable that, were the circumstances narrowly investigated, there would be found an explanation in the direction of some prevailing winds, or other local incidents, that have hitherto escaped observation.

The poisonous gas constituting malaria, or the vehicle in which it resides, is capable of lodgment and retention in places where it has not been produced. Valetta offers a striking example, in the cases of the Floriana Guard, which suffered so severely, while other portions of the garrison escaped. Here the ditch was very deep and narrow, but so perfectly dry, that it could not be suspected of producing the malaria to which the effects in question were owing. Nor could this be explained, except by supposing that this ditch lodged and protected from dissipation, a current of noxious

air, produced from the salt marsh, which seems to be the source of the malaria in Valetta, and which the sea-breeze directed on this point,

"Nor is this explanation improbable, either for this case or other similar ones, when we know that carbonic acid, as well as watery vapour, or a moist atmosphere, can thus remain at rest on the ground, or in any other place where it is protected from the general circulation of the atmosphere, for a great length of time."

The idea of the attachment of malaria to solid substances is strongly countenanced by many facts. Thus, in the Campagna of Rome, it is remarked that, if the labourers cut down certain plants, (a bushy thistle,) a a fever, that otherwise would not have occurred, is the consequeuce. The malaria is supposed to be entangled within it, and to be let loose by this disturbance. Farther it is observed that, in many parts of Italy, the labourers are safe, so long as they keep to the erect posture; but if they sit or lie down, they are in danger.

"In such cases as this, from the far inferior virulence of the poison with us, the result might be a very slight fever, or at most an ordinary one; while, as such an event would most frequently occur during the time of harvest, it would naturally be attributed to heat or fatigue, or to the influence of the sun; and might thus, under peculiar symptoms, as it most unquestionably often has, be even considered a phrenitis."

In respect to the propagation of malaria, as dependent on certain chemical conditions of the atmosphere, our author has little to offer except analogy, and some detached facts. If not rigidly a gazeous matter, Dr. M. thinks it must be such, or nearly such, in its union with the air. If odoriferous substances be allowed to be analogous, the malarious gas should be most easily united with, and diffused through, a moist atmosphere-as seems to be tolerably well proved to be the case with the matters of contagion generally. A moist atmosphere, indeed, may not only give facilities to the propagation of malaria, but contribute to the production of those diseases which are of a malarious character. But, in how far a moist air is favourable to the primary formation or developement of the poison itself, is a question which cannot be solved in the present state of our knowledge. The propagation of it by air impregnated with moisture, is, he thinks, pretty well proved, not so much by definite facts, as by a great number and variety of probable circumstances. Thus, the popular opinion goes not only to the belief that malaria is conducted by common fogs, but that these fogs themselves are the poison, or, at least, the cause of the diseases. This is the opinion in Holland, in America, and even in this country. The intermixture of malaria appears to be the real cause of the pernicious nature of fogs, making allowance for the effects of cold and moisture at the same time.

"If it were not so, the same diseases which the pernicious fogs, of fenny countries produce, should occur in elevated or mountainous situations subject to be involved in clouds, since the cloud is, in every other respect, a fog. If it were not so, the fogs of dry countries should produce the same diseases as those of moist ones, which they do not; and if it were not so, the westerly fogs that so often arrive in our island from the Atlantic, should generate the diseases of Malaria, like the easterly ones arriving from Holland or formed on our own fenny coasts, which they are never

known to do. And to confirm this, it is remarked, that while, in Flanders, (in Artois,) it is the south-westerly and southerly winds which bring and spread disease, in consequence, obviously, of the lands which they traverse, as well as of their own conduc ting qualities, it disappears as soon as the sea wind from the northern quarters sets in, although this is accompanied by dense and durable fogs. And the same rule w I be found to hold good in many parts of the Mediterranean, as well as in France, in nu

merous cases."

The next fact is analogous, though somewhat different. It is equally a matter of popular belief and medical evidence. It is the pernicious nature of the morning and evening mists formed on low grounds. In the hotter climates, the effects of such mists in generating fever are very notorious— and this fact certainly strengthens the doctrine that the watery or moist atmosphere is the active conductor or repository of malaria-and that when the former is dissipated, as by the sun in the day, the latter is checked in its progress-possibly in its production. The poisonous qualities that have been attributed to dews in hot climates are doubtless owing to their holding miasmata in solution.

"Thus also is it especially remarked, that if a hot day is succeeded by a cold and damp night, the effects of Malaria are much augmented; and the same analogy holds as to similar changes in seasons, or as to incidental ones occurring in any manner. Hence if cold and wet weather should unexpectedly take place in the midst of a hot summer, an augmentation of severity, or a state of disease before not in existence, will occur; and hence also severe epidemics occur particularly, if, to such a hot summer there should succeed a cold and rainy autumn; the production of the poison, as I formerly remarked, being apparently augmented in this manner, while the atmosphere is also rendered a better conductor."

The effects of rains in hot climates are accounted for in the same way by our author, who disagrees with Park and Lind as to the power of rain or rainy seasons to produce intermittents by themselves. He here mentions a curious popular belief, grounded on popular experience, in Italy--namely, that there is no danger from malaria, however plentiful it may be, after nine o'clock at night-in other words, that its influence belongs to evening rather than to night.

"It is conceived, of course, here, that as it is entangled in the morning vapour, becoming dissipated or destroyed as the sun approaches the meridian, so when the condensation of the evening mists has been completed, it is precipitated and rendered inert or null."

This is the explanation which Dr. Johnson gave nearly 20 years ago, with the addition, that, as the earth, in hot climates, continued to be hotter than the air for some hours after sunset, so there continued to be an extrication of miasmata from the earth for some time after sunset, thus meeting with, and augmenting the miasmata falling with the dews. In this country, indeed, the night air is considered unhealthy—but this circumstance is generally attributed to the cold of the night. Dr. M. believes this explanation to be quite erroneous, and the following are his sentiments.

"It is thought unwholesome because it is cold, or because it is damp: these are the the reasons assigued; but the philosophy is false or confused, and thus the rule of avoidance becomes an inconvenience without being a precaution; while as an inconvenience, it is for ever broken. It is broken also when this air is not damp and not cold, because the philosophy is erroneous: and hence danger and disease which real VOL. VIII. No. 16. 49

knowledge would have prevented. No one fears a summer evening, even a mild sum mer night, unless indeed he shall find or fear a dew. Yet here lies the very danger; in a land of meadows and parks and ponds and rivers and woods, a thousand times more hazardous than all the nights of all the winters that ever were. This is the real night air to be feared, even though the grey mist should not rise, as it is called, or the dew not fall. To take a pleasant evening walk by the banks of the river or the lake, to watch the trout rise from the fish-pond or the canal as the evening flies, to attend the milking of the cows in the green meadow, to saunter among wet groves till the moon rises, listening to the nightingale, these, and more, of such rural amusements and delights, are the true night air, the Malaria, and the fever."

The prevention of such malarious influences in the night season, hinges principally on exercise, and invigorating food and drink. How far smoking and stimulant liquors may be preventive of the operation of miasmata, it is difficult to say, though the general opinion is that they are salutary. To sleep in a miasmal situation, exposed to the night air, is, of course, most dangerous. In this place our author dwells a good deal on food, as rendering the body more liable to the impressions of malaria, especially in hot countries, when taken in immoderate quantities, at improper times and of too animalized nature. It is a fact, that the natives of hot climates almost always breakfast before sun-rise, and dine after sun-set. This is the case, at least, with the great tribes of the Asiatics. They eat but little in the heat of the day, and that chiefly vegetable food. They drink cooling beverages then, and repose as much as possible in the shade. The Europeans too often exercise, eat meat, and drink stimulating potations, throughout the fiery heat of the day, and we all know the rate of mortality among them. It is highly probable, that much of the sickness among Europeans is caused in this way.

It is a curious fact, in the history of malaria, and contrasts strongly with the properties of contagion, that the former is less readily propagated through dense population and dirty streets than along the most spacious terraces, or through the thinly inhabited suburbs. Thus the JUDAICUM at Rome (the Saffron Hill or St. Giles's, of London) escapes the malaria in a remarkable manner :-and so a great number of examples might be cited of the same kind. Perhaps the following explanation may be as good as any.

"The Malaria must be a chemical compound, and therefore decomposable: it is, experimentally, decomposed by fire and smoke, and it is therefore probable, that, amid the unknown mixture which forms the atmosphere of crowded streets or habitations, it is actually destroyed."

The last topic which we shall touch upon is, the real or supposed defence against malaria by means of a veil or canopeum surrounding the head. In Malta and some other places the belief in this measure is universal-hence the popular practice of covering the mouth and nose with a handkerchief, in the morning going out, or in other suspicious circumstances. If dependence can be placed in popular belief or assertions, there is some foundation for this practice.

Our limits have been outstripped, and we must bring our account of Dr. Macculloch's first volume to a close. We are now prepared for the promised

volumes on the diseases arising from malaria--and those must afford ample materials for interesting discussions. We shall not fail to give our readers due information of all practical matter brought forward by this industrious author. We are sorry to see some of our cotemporaries endeavouring to turn into ridicule all investigation of the nature, laws, and effects of malaria.* They would better exercise their "TALENTS," of which they have unfortunately TOO MUCH, upon the trickeries, the delinquencies, and the abuses of the profession. These are the legitimate objects of satire and criticism. -not the patient labours of those who are toiling to draw the veil from some of those obscurities that are perpetually entangling the medical practitioner in the labyrinths of error.

XI.

MEDICAL EDUCATION.

IN approaching this important subject, once more, we feel that, however, unequal we may be to the task, we shall bring to the investigation a freedom from prejudice, and complete independence of mind. We shall endeavour to discard from our thoughts (as far as possible) the impressions. made by the writings of others, in order that we may examine for ourselves, and draw those deductions that should naturally follow an unbiassed and unimpassioned inquiry. The two great points of examination, in our opinion, are, first, what is the actual state of medical education in this country, and what are its defects ?-secondly, what are the means most likely to remedy these defects, if they are found to exist?

We will suppose that a sovereign or a subject of this realm (for, on the bed of sickness, there is a sad levelling of ranks) is stricken down with any formidable disease-say gout in the stomach, and inflammation in the foot. The best aid that the healing art can afford is called in, and we will suppose Sir Henry Halford, Sir Astley Cooper-and Mr. Teggart, in consultation on the case. These gentlemen investigate the disease, and determine on the remedies. It would be consonant with reason and common sense that, were these gentlemen all educated and trained to the study of medical science in the best possible way, so they would bring to the treatment of the disease the greatest amount of professional information. But these three gentlemen, who may represent the three great institutions presiding over the profession, are educated in three different ways--and grow up with three very different views of the basis of medical knowledge. These three ways or views cannot all be the best-it is more than probable that not one of them is the best that could be devised. The representative of the COLLEGE OF PHYSICIANS is taught to consider a long and expensive study of Greek, Latin, Mathematics, and Philosophy, in two specific towns of England, as the sine qua non--the beau ideal of medical science--and laws are framed accordingly. The representative of the COLLEGE of SURGEONS has been trained in a very different way of thinking. His institution looks to anatomy, physiology, surgery and the clinical practice of hospitals, as the sure path to the summit of medical knowledge. But this institution, too, has its peculiar views (if not prejudices) of study. Anatomy can only be learnt when the sun is in six particular signs (out of twelve) of the Zodiac.

* Vide "Death in the Bottle," in the 4th number of the MEDICAL. GAZETTE,