Dr. M'William's Account of the Niger Expedition.

421

at liberty, were not unfrequently made only to be broken whenever an opportunity offered for the exercise of the cunning so characteristic of this stage of the disease.

With regard to the nature of the poison, or even the progress of the disorder, the Doctor's views are not conclusive; his opinion seems to be that miasmata has impregnated the air, and that the particles being inhaled, they mingle with the blood, which thus becomes the first seat of the disease. Still he confesses his entire ignorance with respect to the noxious particles themselves. He says,—

But the nature of the poison to be combated was unknown, therefore it was impossible to predict what the effect of various materials might be. Such materials, therefore, were provided as were known to be most powerful in acting upon those poisonous bodies that have been found in the air, more particularly acids, lime, and chlorine; and to these were added substances capable of influencing the hygrometrical condition of the atmosphere. I do entertain the opinion that had we been fortunate enough to discover the precise nature of the poison, and had it been confined to no very extended district, that by keeping the white men below as much as possible, and steaming rapidly through that situation, the medicator might have been brought into much more efficient operation than was possible when, with every attention to experiment that circumstances permitted, no clue as to the constitution of the virus was obtained.

But if there be a virus at all as assumed, and something positively poisonous independently of the peculiarity of climate, how comes it that the blacks were not affected? The doctrine from this striking fact would naturally be this, that the different results were accountable only on constitutional principles, and such as arose from a greater or less susceptibility in respect of absorbing and generating heat.

Of the blacks attached to the expedition, consisting of natives of various parts of Africa, including Kroomen, Americans, West Indians of African origin, and East Indians, to the number of 158, eleven only were affected by the fever of the river; and these eleven had all been in England, and for some years absent from their respective countries. The disease in them, it is worthy of remark, assumed a comparatively mild form; and in no case did it become fatal; proving, we think, that it requires a process of acclimatizing, whether it be to fit or unfit the person for enduring the air of the Niger and of the coasts of Africa. But not to tarry longer amid pure conjectures, we go forward to mark two important questions respecting the fever, viz., whether it leaves the seeds of disorder behind it, and whether it be contagious. Let the Doctor make the answer in his own words :

The question as to whether contagion contributed to the spread of the disease on board of the ships may, in my opinion, be briefly disposed of.

All were exposed to the same influences, and nearly all were attacked with fever. Two only of the four medical officers who died had been in attendance on fever patients. Dr. Pritchett, Mr. Thompson, Mr. Stirling, and Dr. Stranger were among the few who escaped being seized with fever, although they were in constant intercourse with the sick; and I was the last person in the Albert laid down with fever. The nurses on board the Albert were among the latest taken ill, and one escaped altogether. No fact came under my observation affording the slightest evidence that the disease was communicable from one person to another. Does one attack of river fever afford any protection against a second? My own experience, added to information obtained from many of my brother officers, and from Mr. King, the surgeon of the Ethiope, who has been more in the Niger than any other medical man, is wholly unfavourable to the opinion that one attack of river fever affords any immunity from a second. On the contrary, those who have once suffered from this treacherous disease seem particularly predisposed to it, if they again venture within malarious influence. Of those who had the Niger remittent, on board the Wilberforce in 1841, many were again attacked with fever, on the return of the vessel to the coast the following year, while surveying the Cameroon river and Amboises islands; and when that vessel proceeded up the Niger the second time, in July 1842, six out of seven who had already passed through river fever, were again seized with it, from the effects of which two died. In many cases the character of the second attack may not be exactly like that of the first, but Mr. Stirling, who saw the patients on the return of the vessel to Fernando Po, considered the fever as in no way differing from that which had come under his observation when in the river during the previous year.

With respect to prescriptions and medical treatment, Dr. M'William's facts as well as opinions seem to guide to this conclusion,that change of air is the most certain means of cure, and that nothing which can reduce the patient ought to be attempted. In fact the recoveries appear to have resulted from the powers of the constitution to resist the poision, or whatever may be the nature of the noxious influence. However, had the expedition continued much longer in the river, there are grounds for thinking that few or none would have returned to tell the dismal tale that is now before us. Of the three vessels, the Soudan was only exposed for forty days, and the Wilberforce for five more; and yet of all the white men, only fifteen escaped the fever. These are facts which teach that it is a fearful thing to encounter the marsh miasmata or poison of the Niger, and that had there been fewer precautions used, and a longer stay made by the expedition, its fate must have been still more disastrous than it actually turned out to be.

ART. II.-Numerous Cases of Surgical Operations without Pain, in the Mesmeric State. By JOHN ELLIOTSON, M.D. Baillière. MESMERISM bids fair to distract the attention of people of fervid temperament away from some of the more exciting political as well as ecclesiastical topics of the day. In Paris we learn there are persons who make a profession as mesmerisers, and others as mesmeric patients, and who frequent private parties in order to entertain and astonish people; these exhibitions having become so fashionable that rank and grandeur do not disdain to countenance them. In London too the subject is creating considerable sensation; and even the Maids of Honour to the Queen Dowager, it is reported, have been converted to the mesmeric creed. But what shall be said to the canny citizens of Glasgow, where seven-and-thirty mesmeric patients have been exhibited at once in the largest hall of the town, and to a crowded audience?

Mesmerism, however, as a subject, is not to be disposed of by sneers; for if the physical phenomena spoken to by medical gentlemen and creditable witnesses really occur, enough has been witnessed to entitle these symptoms to the earnest investigation of physiologists.

Dr. Elliotson is one of the most able and ardent preachers of the creed; and his acknowledged eminence in medical science should secure for him a patient hearing while explaining and defending himself in the present pamphlet. Of course, it is not for us to offer an opinion on the point at issue; but this we have a right to say, that it is not by abusive personal epithets, nor by merely charging him with quackery, or any species of hollow pretension, that his views and statements are to be set aside. He may be in error on the subject in question; but it cannot be denied that his personal character is unimpeachable and his learning extensive; any more than that his contributions to the science of his profession have been rich, his actual discoveries important, and his standing as a physician high.

The Doctor has been called a reckless speculator and pernicious projector. His answer to this charge is couched in the following terms; and the reader cannot but admire the manly sincerity, and the simple force with which he expresses himself in vindication. "I have never," he declares, "speculated, but have always devoted myself to the observation of facts; so that whatever I have advanced, I have seen ultimately established. I appeal to my writings on Quinine, Hydrocyanic Acid, Iron, Creosote, Glanders, the Use of the Ear in ascertaining the state of the Heart, my Human Physiology, and my Lectures on the Practice of Medicine, and my Clinical Lectures. I came into practice solely from the devotion to facts evinced in my Clinical Lectures."

Dr. Elliotson is not less candid and earnest in his defence of his

mesmeric patients, the "Sisters Okey." He may be called an enthusiast on his favourite theme, but his honesty cannot be impeached. He declares that both sisters were genuine throughout: that they were perfectly virtuous but afflicted female children. He adds,

The display of disreputable unacquaintance with this kind of case, and the composition of vulgar tirades by so many professional men pretending to medical knowledge, was precisely the conduct which we witness in the streets when a deranged or imbecile person is pursued and hooted by boys and rabble, as though he were master of his own condition and conduct, and not the subject of an affliction profoundly interesting to the philosopher and to the man who can feel for others. Everything stated or ever printed to their disadvantage was an absolute falsehood; I repeat these words emphatically, an absolute falsehood.

Again:

To accuse the patients of imposition is very easy. But it is a very vulgar, as well as cruel habit, founded on ignorance, presumption, and heartlessness. We should never prefer such an accusation on light grounds: and, to be assured of the grounds, we should be well acquainted with the subject. He who is ignorant of a subject is surely not justified in giving an opinion: and yet, medical men and others, because they are ignorant of the phenomena of the more wonderful and uncommon diseases of the nervous system, and of mesmerism, preposterously pronounce the subjects of them impostors, and those, who know the truth, to be fools, or rogues, or in league with the devil. It was the same cause which made the people pronounce Democritus mad, when he looked for the source of insanity in the brain; to pronounce Roger Bacon a sorcerer, who knew physical facts of which they were ignorant; to ascribe epilepsy, St. Vitus's dance, and numerous other diseases, to demoniacal possession; to ascribe the phenomena of electrical and galvanic apparatus to the agency of spirits, as the savage supposed there must be a spirit inside the watch.

The pamphlet is intended to answer and expose the "Members of the Royal Medical and Chirurgical Society," who resisted a Report of" Surgical Operations without Pain," which had been read at a preceding meeting. In so far as manner and the allegation of facts are concerned, the thing is effectively done; especially where the Doctor charges the Members with inconsistency and with ungrateful conduct :

Though I had been above thirty years a member of the society,-had been its president when it obtained its charter, which has no other living name in it than my own,-had procured for it myself the epithet Royal, and for its members the title of Fellows,-had allowed the society to hold its general evening meetings and the afternoon meetings of the council at my house when it had no house of its own, and given the members numerous conversazioni during the two years of my presidency, and afforded not merely

my house but the proper trifling hospitality on all these three kinds of occasions, and had furnished many papers to the Society's Transactions ;—I' thought that I could not consent to continue a member of it.

There is eloquence in the concluding passages of the pamphlet, where he urges upon the medical profession three grounds why disaffection ought not to have been shown to him, or hostility to the report of " Operations without Pain." These grounds are science, liberality, and humanity. But take the Doctor's own words:

It is the character off a scientific man to acknowledge that he is only an observer of the universe, and of a minute fraction of it; that he comes into existence with his peculiar nature, and is placed here without his own interference, and has had no share in constructing the universe; that he must admit all that he finds, and could never have imagined what he does find; that he can explain nothing, and what he calls explanation is merely the placing of various facts under the same head. Medical men constantly refuse to admit facts, because they presumptuously suppose beforehand that such facts are not; thus creating the world according to their poor narrow conceptions, and forgetting that it is their duty to be "humble, teachable, and mild." It is the character of a liberal man to give others credit for sincerity, a love of truth, industry, and sense equal with his own; yet they are puffed up, thanking God that they are not such fools as some other men are,-even as this mesmeriser. "Plagiarist! liar! impostor! heretic ! were among the expressions of malignant hatred lavished upon Galileo," in 1609. It is the character of a humane mar to be anxious that all promises of benefit to his fellow-creatures may be fulfilled; that every alleged means of curing disease may turn out, not a fallacy, but a reality, to "hope all things." Medical men should be the humblest of all practitioners of art. Highly as I estimate the powers of my art, when carefully and earnestly employed, and invaluable as is a skilful, laborious, and conscientious medical man, we know in our hearts that we have yet but an insufficient insight into disease; that the investigation of cases is too difficult and too laborious to be carried on efficiently, in the greater number of them, by persons who see many in the day, whether in charities or in a profitable round; that well-established measures require more pains for their perfect administration that are generally given; that for a very large number of cases, our means are very inadequate, for many all but useless; and that medical men are receiving money every day for doing little or no good. Were not their art so imperfect, they would not have to complain, as they do everlastingly, of the prosperity of quacks and persons altogether, and not, like themselves, in part, pretenders. They should each feel it a duty strenuously to be looking out for improvements of their art; and, satisfied that it may be as greatly improved as any other art, they, instead of hugging themselves on their receipts and sneering lazily at the disinterestedly industrious, when a new fact or remedy is mentioned, should hopefully listen, and determine to ascertain what amount of good it contains, ashamed of the errors and vices of their predecessors, who violently opposed the truths of the circulationthe lacteals, and then of the lymphatics,-the physiology of the brain,-