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to Cairo. By following precisely this plan, the patient enjoysthe advantage of some months of settled weather and a warm,equable temperature. It is true that the nights are cold, butthis evil is easily avoided by not going out after sunset. Cairoand Lower Egypt are subject to heavy rains in winter, withoccasionally considerable cold. In spring, when Upper Egyptbecomes too hot, they answer very well for the patient toretreat to for six or eight weeks, not longer. Cairo is not ad-visable after March; the heat becomes very great, and thesiroccos (or "khamsin") set in, and the patient should nowbetake himself to some cooler country.

This, then, is what Egypt is worth for consumptive patients:to arrive in October, go up the country for three months,return leisurely, and leave Egypt by the end of March orbeginning of April, but not to be there at any other season.If managed in this way, it secures for the phthisical patientfive or six months of a mild, warm, equable climate, with theadvantage of an easy mode of travelling amid objects of ex-ceeding interest; but by resorting thither unadvisedly, andbeing in the different latitudes of that extensive country at awrong season, mischief is done, or at any rate inconvenience issuffered, and then blame is attributed to the climate, which israther due either to mismanagement or to the particular casebeing unsuitable to that country.At the same time, the value of the climate of Egypt has its

limits; it must not be overrated; for to expect of it more thanit can do will only cause it to be condemned unjustly. More-over, there are risks to be guarded against, and precautions tobe taken; nor will a residence there do any good to thephthisical patient, unless the diet, clothing, and generalmanagement ani mode of living are properly regulated accord-to the peculiarities of the climate and of the individual case. ,

Twenty miles south of Cairo, and from thence up the Nile,the climate is rainless. The air is excessively dry, so much soas to render sore and uncomfortable the exposed mucous mem-branes of the lips and nostrils, and to aggravate the tendencyto eruptive disease for which Egypt is noted. These are stillthe plagues of that country. Even in the cool season, pimplesand boils are apt to break out, and accidental sores to betroublesome in healing; and in July, August, and September,whenever the north wind does not blow so steadily as totemper the heat, a painful eruptive complaint, called boutondu Nil prevails. Dust and vermin are both troublesome, andthe prevalent ophthalmia is another drawback.

It is much to be wished that means existed of collecting thestatistics of the cases of invalids resorting in each season toEgypt, and every other place where patients are sent for thesake of climate. Numerous European invalids were up theNile the winter I was there, but they had their own medicalattendants, and in a few instances only did I come to knowa/nvthTno’ of themOne gentleman, extremely emaciated, (apparently a case of

extensive tubercular deposits, with great tendency to secondaryinflammation,) informed me, that the disease appeared to bearrested by his residence in Egypt, that he felt better andstronger, and more capable of exertion, and had gained flesh.I cannot doubt that the fatal termination of his case was con-siderably retarded by his stay in Egypt. He died in thefollowing November, I believe in Spain.

Another gentleman, of florid complexion, who had beenattacked in England with repeated hæmoptysis, became quitefree from it in Egypt, and to all appearance perfectly well.He afterwards died of coup-de-soleil, brought on by neglectedbowels and over-exertion in the heat of the sun. Both these,gentlemen came to Egypt in October, went straight to theupper country, and remained south of Thebes till after

February. Then, as the weather got warmer, they descendedthe Nile and came northwards, intending to quit Egypt for acooler climate during the summer. They had spent theprevious winter in Andalusia, they said with much advantageto their health.

Among the native population of Egypt, Mr. Davidson, ofAlexandria, says that consumption is only known along thenorthern sea-board, and is supposed to arise from the extremehumidity of the atmosphere in that region. It does not, how-ever, prevail extensively, and is scarcely met with any otherpart of Egypt.

Being on the subject of climate, I will add a case showingthe effects of the tropical part of the Atlantic. A friend ofmine, being threatened with phthisis consequent on pleurisy,took a voyage or two in a vessel sailing between Sierra Leoneand the West Indies. He found the most marked benefit fromthis proceeding, so much so, that I believe if he had remainedn that latitude his life might have been spared, for he returned

bo England comparatively well. His residence in Englandwas in one of the most favourable climatic situations of thesouth coast; but, notwithstanding this, his complaints returnedunder our variable English sky, and at length he died. Itmay be said that the same result would have occurred had heremained between the tropics; but this is matter of opinion,and there are the facts that illness twice came while he livedin the climate of England, whereas a visit to the south wasattended with a restoration of health.Burwood-place, Hyde-park, Dec. 1853.

ANEURISM OF THE AORTA, BURSTING INTOTHE PERICARDIUM.

BY WILLIAM HENRY BELLOT, F.R.C.S.E.,SURGEON TO THE 1ST. REGT. CHESHIRE MILITIA.

ON the morning of September 22, 1851, I was requested togo up to the barracks, to see private C-, of the 50th(Queen’s Own.) I reached there in about a quarter of an hour;the man had fallen down in his barrack-room, and had justbeen carried over to the hospital; when I arrived I found himdead.

Before making a post-mortem examination, I was called

upon to give my evidence before the coroner; I stated that inmy opinion the man had not died from apoplexy, but mostprobably from some affection of the heart.On the morning of the man’s death he appeared in his usual

excellent health, not having been in the hospital for nearlytwo years, and then for some totally different and very triflingdisease; had never been subject to rheumatism. He was agedtwenty-four years; one of the most active men in his company;he had breakfasted as usual at eight A. M.; had been singing,jumping about, and walking upon his hands, &c.; he thenwashed, stooped down to brush his shoes, preparing for paradeat 10 A.M., fell to the floor, and never spoke again. He wasapparently so well, that he had that day requested a pass tovisit some friends. Had occasionally complained to hiscomrades of tightness of the chest, with some little difficultyin breathing when in heavy marching order; sometimes he hadslight cough, when he became very red in the face, but neverreported himself sick.

Post-mortent examination.—The house-surgeon to our infir-mary (Mr. Rigby) assisted me in the examination. On

opening the chest we found old adhesions of the pleura costalisand pulmonalis, the pericardium strongly adherent, on openingwhich we found the heart covered and surrounded to thedepth of half an inch with coagulated purple blood. Therewas a true aneurism of the aorta at its commencement of aboutthe size of a small orange, which had burst into the pericar-dium. The coagulated blood (which was dark-purple) con-tained in the pericardium, weighed thirteen ounces; the heartitself, and lungs, healthy. On examining the aneurismal sac,we found the internal coats partially destroyed, and theatheromatous matter (described by Mr. Gulliver) was clearlyto be seen.

Stockport. Jan. 1854.

POISONING BY TARTAR EMETIC.DEATH; AUTOPSY.

BY JOHN S. BEALE, ESQ., M.R.C.S.

E. S. S-, aged sixteen years, complained of feelingbilious, and was advised by a nurse to take a dose of tartaremetic; one penny-worth was therefore procured at a chemist’s

near her residence, on Sunday, Nov. 21st, and two-thirdstaken the same evening at six. Within a quarter of an hourafter, vomiting came on, very sharp; and a little while after,smart purging. These symptomscontinuedforaboutthree hours.The girl also complained of pain down the oesophagus, anddescribed it as "burning her." She then fell asleep. Thematter vomited was described as being very dark. On theMonday morning she had some tea, and did not appear to beso ill as to attract attention. Whilst her mother and fatherwere out, on the same afternocn (about four), a neighbourwas called in, as she said "she felt as if she was dying."Medical aid was summoned, brandy-and-water ordered, beef-tea clysters exhibited, and everything tried to rally her. Her

pulse was thin and cord-like. She kept continually throwingher head back, and screaming. Skin warm and moist; pupilsdilated; knees drawn up. She lingered till Tuesday morning,

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when death closed the scene. During the six or eight hoursprevious to her death she was quite delirious.

Post-naortena examination, thirty-six lzoecrs after deatli.-Thefeatures were placid; the throat appeared swollen; there wasalso green discoloration in each iliac region, but predominantin the right. The lungs were slightly congested; the hearthealthy, and contained about six drachms of fluid blood; theleft ventricle was so contracted as almost to close its cavity;liver pale; spleen healthy; gall-bladder half-full of very thick igreen bile; kidney healthy but congested; the stomach wasremoved for further examination; the duodenum, jejunum,and ilium were smeared with a thick grumous fluid and

quantities of mucus; there were no traces of inflammation; thebladder was half-full of urine; the hymen was quite perfect;uterus healthy, but right ovary contained four cysts, the largestable to contain a large horse-bean, the smallest a pea. Theywere filled with a glairy, straw-coloured fluid; the ovarywas twice its natural size, and had several coagula of blood in itssubstance; besides being generally congested, the Fallopian tubesand morsus diaboli were also much congested. The stomachcontained about sixteen ounces of thick grumous fluid; therewas a large patch of greenish discoloration on the posteriorpart of the great curve of the stomach, near the cesophagealopening, penetrating to the peritoneal covering, at which partthe structure was softened, and blood effused under the mucouscoat, as likewise in some eight or ten places near the greatcurve, but very slight traces of the poison were obtained bythe usual and appropriate tests.At the inquest, the nurse said she told the parents of the

girl to get a dose of tartar emetic, but she obtained a

pennyworth, and the quantity served was stated to have beenninety grains. The residue of the powder when weighed wastwenty-five grains, so that sixty grains, or at least forty, wereswallowed. The smallest dose on record producing death isfifteen grains ;* most of the poison had passed off in vomitingand by stool. Verdict, "Accidental Death, with caution tothe nurse and parents, &c.

I consider it as an interesting fact, that so much incipientdisease of the ovary should exist in one so young, and I think itserves also to prove that, immediately on the female attainingpuberty, and calling her ovaries into their functions, so soonare they prone to alteration in structure and increase of bulk,and must necessarily play a most important part in the femaleeconomy.Harrow-road, Jan. 1854.

SOME IMPORTANT FACTS REGARDINGCHOLERA.

BY JOHN FUKLONGE, M.D., Antigua.

THE following facts are so interesting that I hasten toforward them for insertion in your widely-circulated journal.The ship Glenmenna, from Liverpool, bound to New Orleans,with 500 emigrants, put into the Port of Charleston, Nevis,for medicines and provisions. She had lost between twentyand thirty emigrants from cholera since she left England, andhad then between twenty and thirty lying ill with the disease.The authorities at Nevis prohibited communication with theshore, and the President sent his secretary alongside, whoboarded her, to warn the captain to that effect. The ship wassupplied, however, with what she wanted, She lay at anchorvery near to the shore, and remained sixteen hours, and wasreported by the persons who went to her as very dirty, anddisgustingly and intolerably offensive. The ship arrived onthe 22nc1 of November, and on the 4th of December (twelve daysafter),malignant, and cholera of a terribly fatal nature broke outat Charleston. Amongst the first who suffered wasthe secretary,who went on board; he recovered. The first five cases, a

father and four children, all died, and in fourteen days it sweptoff upwards of 100, ten being the average daily mortality, On

Sunday last, the 18th instant, thirty are reported to have died,and on the next day twenty-eight. We here. at Antigua, arevery much alarmed, as Nevis is about fifty miles west, and thewind for sometime had prevailed from that quarter. The

profession here are almost to a man non-contagionists, but this"blow" has, in some degree, shaken our doctrine, and theBoard of Health has ordered strict quarantine between theislands. This outbreak at Nevis-one of the healthiest WestIndia islands, isolated, and which escaped yellow fever, so

lately prevalent in the neighbouring colonies-would almostseem to settle the question of contagion, aud to afford a kind

*Vide Tailor, p. 192. This mak28 Hie third case on record,

of experimentum crucis on the subject. We are doing in An-tigua all we can to avert the pest from our shores, so far assanitary measures can be effectual. I may mention that it is

reported that several of the ship’s men got on shore at Nevis,and became very drunk; but this requires authentication.*The disease is reported to have attacked chiefly the poorerclasses, and the persons about butchers’ shambles are saidto have suffered much, and all filthy localities. The town is re-presented as in a very bad condition as regards sanitary require-ments, and the sea-shore (the town is close to it) is made thereceptacle for all the filth, domestic and otherwise, and isintolerably disgusting.

St. Jolm’s, Antigua, December, 1853.

REPORT OF A

CASE OF RUBEOLA IN AN ADULT, USHEREDIN BY SEVERE COLLAPSE.

BY H. C. HASTINGS, M.R.C.S.

I WAS summoned at four A.-M. to visit a Mr. C-, anassistant in a large grocery establishment, who had retired torest in his usual health, with the exception of slight colickypains in the body, for which he had taken two compoundrhubarb pills. At about three A.M. the noise and groans hemade, (as if from pain,) and his incoherent talking, awoke acompanion sleeping in the same apartment, and who, on

striking a light, discovered that Mr. C——— appeared to be in a, " fit;" that he was insensible or nearly so, and his face, lips,and fingers were much darker than natural.

I was soon after this at the bedside, and found, in additionto this partial loss of consciousness and livid hue of the surface,that the heart’s action had become extremely feeble, the pulsa-tion at the wrist being scarcely perceptible; that there was aclammy sweat to be both seen and felt; the extremities weregetting cold, and the respiration laboured. The symptomsseemed to depend on congestion of the brain from a "poison"of some kind, and the state of the pulse and the coldness of theextremities indicated the employment of stimulants and arti-ficial warmth with a view to bring on reaction; and brandywas administered, a teaspoonful at a time, as soon as the

patient could be made to swallow. The circulation ralliedunder this treatment, after a considerable interval, and con-sciousness being restored I left the house.In the course of the day there were several copious evacua-

tions from the bowels; much sickness; colicky and epigastricpain complained of, evidently depending on the morbid condi-tion of the blood, and its temporary stagnation in the capil-laries of the internal organs. The vomiting, diarrhoea, andpain continued all day, and in the evening, small, red, dingypapules began to show themselves on the forehead and face,convincing me at once that the severe stage of collapse I hadjust witnessed was merely a premonitory symptom of oneof the exanthemata, small-pox or measles. The next day thecharacteristic eruption of measles showed itself in a moremarked form all over the body, and subsequently the extre-mities, rendering the diagnosis, which was before obscure,perfectly easy, and with the exception of the pulse, whichaveraged for several days 120, nothing else occurred worthy ofremark.East Dercham, Norfolk. Dec. 1854.

Hospital Reports.ROYAL WESTMINSTER OPHTHALMIC HOSPITAL.

Mr. GUTHRIE desired to draw attention to the followingCASE OF MALIGNANT DISEASE WHICH REQUIRED REMOVAL OF

THE WHOLE EYE.

Wm. T-, aged nfty, a labourer, residing at Wantage,Berks, was admitted into the hospital on the 10th of October,1853, suffering from a growth extending from the inner canthusof the left eye to the centre of the cornea. This was intenselyred, and presented an irregularly ulcerated surface, with ele-vated and thickened edges, secreting an unhealthy discharge.The pain in the eye was not great, but he suffered much fromcircum-orbital pain, especially in the fruntal region, of a throb-

* I have since heard that this is true, and that five dead bodies were thrownoverboard in the roadstead, and it was at first believed that the illness arosefrom eating fish which had preyed on the bellies. T_.e people will not touch.fish.

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