Owzxo to a pressure of work at the Customs Press, the Medical Reports for the six months ended in September, 1873, have only just been issued. We are, however, shortly promised the succeeding volume, that we shall be the better able to compare the winter and summer reports. The volume under review contains reports from Dr, Dudgeon on the health of Peking, from March, 1872, to September, 1873, extending thus over eighteen months, and on the ports of Amoy, Hankow, Taiwan, Canton, Tientsin, and' Shanghai, for the half-year ending Sept., 1873. The reports concitr in the assertion that the summer of 1873 was a healthy one, and in general cooler than the average. Heavy rains occurred at the two extremities, at Canton and Peking, the effect'at the former being to cool the atmosphere and to reduce the amount of illness till September, when, with the return of dry weather, an unusual prevalence of fevers was notice and at the Intter to lead to an unusually large amount of fever during the entire period. While heavy rains characterised the extreme north and south, the intermediate porta seem to have received rather less than the usual amount, Asa general rule, rainy weather in summer seems to be conducive to the health of both foreign atives, while hot, dry summers, which cause extensive evaporation of the impure-surface water, seem to be conducive to many forms of disease, The present volume possesses more than usual value and interest, from the special reports which accompany it, notably, from the Drs, Manson at Amoy, on the Sequele of Malurial Diseas Dr. Wong, at Canton, on the leprosy prevalent at that port, gives interesting details of cases of sunstroke and hepatic disease at Hankow; Dr, Dudgeon treats specially of ague and opium poisoning at Peking; and Dr. Tamieson of that form of eczema vulgarly known as washerman's itch. Dr. Dudgeon has not met with any of the antagonism between opium and ague, supposed by Sir Rutherford Alcock and Consul Winchester to afford a reason for the prevalent use of opium in China, On the contrary, he is rather of opinion that the debilitating influence of the drug has a tendency predispose the system towai ill generally, fever not excluded. The principal disease at Peking met with among the natives during the Inst four years, has boon ague. Formerly comparatively rare, the heavy rains and consequent floods which have for years prevailed in the metropolitan province, have rendered the disease a constant resident. It seems year after year to assume a more chronic form. In the earlier years of the floods, the apronch of the cool weather put an end to ita attacks, but in 1873 it prevailed up till December, It seemed generally to yield readily to quinine, but in some cases where that medicine seemed inefficacious, arsenite of potash was administered with good effect. Carbazotato of ammonia was likewise tried with a successful issue; its faction is stated as similar to that of quinine. Besides ague, diphtheria was prevalent at Peking during the winter of 1872-73. With regard to the important subject of opium poisoning, and its treatment by subcutaneous injection of atropine, which has been highly spoken of by Dr. Johnston from experience at the Chinese Hospital here, Dr. Dudgeon seems rather to differ in his opinions. Dr. Dudgeon, however, acknowledges that he has not, in Peking, had the experience necessary to form a sound judgment, and bases his conceptions ona reply to Dr. Jobuston's conclusions in the Medical Times and Gazette, mainly based on the secondary authority of Dr. Harley, and not from actual experiment. Dr. Dudgeon quoted the experience of Dr. Hardey, of Hankow, under whose care two patients, out of three treated by injection of atropine, died, as arguing against Dr. Johnston's conclusion, He unwisely, we think, in the absence of any cases at Peking, recommended an unqualified American Missionary at U-chow, to try the effect of atropine. The result shews how great care should be exercised as to the class of men sent to practice as Medical Missionaries. Dr. Hardey's dose of grain seems to have been excessive, but Mr. Pierson's (the Missionary alluded to) of 2 grains, would in itself have been sufficient to account for the death of the patients. Mr, Williamson, lent medical officer at the Ventnor Hospital for Consumption, proves that any quantity of sulphate of atropia, exceeding 1/50th part of a grain, administered by the mouth to check sweating, provokes symptoms of poisoning,* and Dr, Johnston's dose in Shanghai' never. exceeded j grain. Taken in excess, sommolency, narcotism, and coma are marked features of belladonna poisoning, so that there is danger of the effects of opium, as undoubtedly happened in_the U-chow cases, being actually inten-sifed by the incautious exhibition of so powerfal " remedy. The report of the rs, Manson on the health of Amoy, contains what might be called a monograph sequela of malarious fever. They describe two forms of anemia, "which as indirect causes of death in this part of China (Fohkien), are second to no other pathological condition, and as direct causes yield only to smallpox." The two forms are the result respectively of antecedent disease and deficient and improper food. The paper is too long to give a resume in full. With foreigners, the Drs, Manson think that quinine is often administered too soon, and that the stage of convalescence is thereby prolonged. Many agues come and go without leaving bad effects, especially with the well-to-do, who have no immediate necessity for daily Inbour. If the patient be a poor man, obliged to work when he is not able, or fo starve in default, anaemia or other sequel are sure to make their appearance. Dropay, enlargement of the spleen, ulceration of the lower extreme disease of the liver and kidneys, and bad forms of dyspepsia, are amongst the most usual. On the second form of anglia the remarks are worth quoting, as bearing on the general subject of the development of the Chinese race.
"<'The anemia from bad, imperfect, and insufficient food, has a class of symptoms as characteristic of those of malarial anomia, though, unlike the latter, its symptoms are seldom complicated by local organic disease. Usually they are only those of functional derangement or incapacity; the. red blood corpuscles are not formed in sufficient quantity, and the patient is pale; the imperfectly nourished heart cannot. pump the watery blood to the brain, the eyes, and the ears, and he is giddy, cannot comprehend or think, has aberrations of sight and hearing; there la nothing in his blood wherewith to renew wasted muscular tissue, and he is easily fatigued, and feels wearied after slight exertion, the muscles of his stai sympathise with the general exhaustion, there is no nitrogenous element in his bland and food wherewith to construct the highly nitrogenous gastric juices, and he is dyspeptic. As long as he keeps in the groove his life has ran in since he was a child, he may live comfortably enough, and his anemia not trouble him. There Lancet IL of 1874, page 116, is just enough nourishment in his daily food to enable him to do this,;: He may flit over a mudbank with a creel in his hand, looking for shell-fish year after year, and the amount of sustenance derived from sweet potatoes and periwinkles may be sufficient to nourish the sot of muscles and Jimited quantity of brains required for his work. He. may till the same field in the same manner, carry the same sort of burden the same way and over the same road, work at the same trade, think and scheme in the same way, be model fisherman, peasant, coolie, tradesman, or pedlar, year after year; but let him try anything, new, let him be forced to unusu exertion in an unusual direction, and it is soon apparent that there is not sufficient nourishment in the system for the old and the new; it may be supplied at the expense of some particular part for a time, ut very soon this breaks down, organ or function gives way, and the man become: invalid. This want of adaptability and power to answer'unwonted calls for exertion, is strikingly characteristic of this form of anaemia,"
On page30, the authors continue: "Herein we think is indicated one key to a part at least of the Chinese national character. The strong conservative pro-pens ities, the superstitious reverence for precedent, the patience under oppression, ye character of their art: these, we think, are but ox-pressions of incapacity for change, for adaptation, for originality, not the deliberate elections of philosophic experienc The authors indulge in a somewhat superfluous attack on Buckle's theory that external influences are solely concerned with the progress of nations, a theory we presume hardly accepted now, even by the most zealous disciple of the school of "thinkers." That external circumstances are greatly influential in developing peculiarities, physical and mental, of races no anthropologist can or will deny, and th Dre. Manson show how this can be explained by the process of natural selection, which causes the individuals least suited to the circumstances of the locality to die off in successive generations. It is thus certain that the inhabitants of a malarious country will be less liable to the attacks
race newly arrived from a well drained of gue than stronger and more healthy and temperate climate, It by no meani however, follows that the inhabitants the more malarious country should: have degenerated from a more healthy stock. If recent researches in anthropology turn out to be true, the history of the human race is rather one from the lower to the higher type. The original seats of the race, if it be true that they were situated on a submerged continent now represented by the Indian Ocean, must have been far, more subject to malarious influences than any country with which we are now acquainted and the nearest approach now existing amongst men tothe aboriginal inhabitant, the negroes. and the New Hollanders, are the most exempt from malarious attacks, lity of the Chinese to these perhaps, a proof that immigrant blood still more or less prevails amongst 'a nation apparently homogeneous.
Text read from the printed page and cleaned; old type leaves the occasional error.