the screw clamp invented by Mr. Lister for compressing the aorta, Mr. Syme dissected the parts so as to bring the coats of the artery distinctly into view, and passed a ligature on each side of the opening by which the artery communicated with the sac. The patient went on favourably, and on the nineteenth day after the operation, all the ligatures came away together, and then the wound gradually contracted. But some months afterwards, the man caught cold and died of pleurisy, and on examining the part operated upon, it was found that the external iliac had been torn completely across, and its open mouth had caused some misapprehension as to its real nature at the time of the operation.

XXI. Contribution to the Statistics of Cancer. By W. M. BAKER, M.R.C.S.-This paper is founded upon the notes of 500 of the cases of cancer, taken by Mr. Paget between the years 1843 and 1861, the original record of the cases having been made as they occurred, and without any reference to the particular kind of cancer, its seat, or its influence on the duration of life. In the 500 cases selected by Mr. Baker, only such cancers are included as are external, or may be called surgical, the so-called medical cases being omitted. It is shown that females are far more liable to cancer than males, but this is due to the cases of cancer of the breast, which are very numerous; and the proportion of females affected would be much larger if cancer of the uterus were included in Mr. Baker's tables. It appears, however, that on subtracting the cases in the reproductive organs and breast in both sexes, as well as those in internal organs, the proportion remaining is considerably higher in males than in females. As to the age most liable to cancer, it may almost be regarded as a rule that, for the external organs, medullary and melanotic are the cancers of youth and early adult age, scirrhous, that of middle life, and epithelial, that of middle and old age. Married women seem to be more liable to cancer of the breast than single women. The interesting question of the recurrence of cancer after operation cannot be accurately determined among the poor patients who attend at an hospital, because they are often lost sight of, unless the rapid return of the complaint obliges them to come back. Mr. Baker's paper also includes the influence of age on the recurrence of cancer, the influence of early and late operation, the influence of operation upon the duration of life, and many other important questions, but the results are not sufficiently definite to admit of their being included in an abstract.

XXII. Report upon Syphilis, with reference to the more Mixed and Unusual Forms of the Primary Symptoms. By JEFFERY A. MARSTON, M.D. The author of this paper is an army medical officer, and he treats of syphilis with especial reference to its more unusual, mixed, and anomalous forms. From Dr. Marston's experience, he is led to believe that the etiology and pathology of the disease are by no means so well-defined as the authors of the French school maintain. In model cases it is true that the distinctions between an infecting

and a non-infecting sore can be easily drawn; but mixed cases frequently occur, offering great difficulty in their diagnosis. Dr. Marston arranges his materials under six heads: viz., 1. The varieties of infecting sore. 2. The results of auto-inoculation. 3. The occurrence of syphilitic infection after suppurating bubo. 4. The occurrence of constitutional symptoms following an urethral discharge clinically identical with gonorrhoea. 5. The bubon d'emblée. 6. The periods of incubation preceding the appearance of the two kinds of venereal sores, and the absence of any proof that we can guarantee against constitutional infection by any abortive treatment applied to the primary syphilitic lesion. In reference to the latter point, Dr. Marston relates three cases in which syphilitic sores were treated at the earliest possible period by the application of nitric acid, but in which, nevertheless, secondary symptoms supervened.

XXIII. Case of Aneurysm of the External Iliac and Common Femoral Arteries, treated by Digital Pressure, with Observations. By HENRY LEE, F.R.C.S., Assistant-Surgeon to St. George's Hospital.Mr. Lee's patient was a man, aged thirty-one, who, after a slight accident, experienced some pain in the left groin, which afterwards became swollen and painful. On his admission into the hospital, the whole of the thigh was considerably swollen, and some patches of livid discoloration existed on the outside of the limb. In the left groin was a tumour, four inches in diameter from side to side and from above downwards, pulsating strongly; and on the application of the stethoscope the aneurysmal bruit was distinctly heard, while a very distinct thrill could be felt in every part of the tumour. All pulsation in the part could be arrested by pressure upon the external iliac artery. At Mr. Lee's request, twelve of the students of the hospital undertook in turns to keep up digital pressure upon this artery, so far as it could be borne without inconvenience; and on the day following the adoption of this treatment, the pulsation in the swelling was decidedly diminished. It was determined, in consultation, to continue the treatment by pressure, under which the case partially improved, but the amendment was only temporary, and death ensued in about four months. On a post-mortem examination, it was found that the common femoral artery was completely divided, the greater part of the walls of the aneurysmal cavity being formed by the surrounding structures. Mr. Lee remarks that the digital pressure used in this case appears to have had the effect of causing the formation of a very complete and firm coagulum, and so far the treatment may be said to have been successful, but this coagulum gradually gave way, being unsupported by the coats of the artery.

XXIV. Report of the Committee appointed to investigate the Subject of Suspended Animation.-The Committee on Suspended Animation, appointed by the Royal Medical and Chirurgical Society, consisted of Dr. C. J. B. Williams, Dr. Brown-Séquard, Dr. Harley, Dr. Kirkes, Dr. Hyde Salter, Dr. J. B. Sanderson, Mr. W. S. Savory, and Dr.

Sieveking, and at the first meeting of this committee it was resolved to pursue their inquiries by means of experiments on living animals, and also by experiments on the dead human body. The Report accordingly consists of two parts, the first being devoted to the results of experiments on the lower animals, and the second to those obtained by experiments on the dead body. In the first series of experiments, dogs and other animals were asphyxiated (apnoea is the word used by the committee in preference to asphyxia), with a view of ascertaining the period which elapsed between the last respiration and the last pulsation of the heart; also to ascertain how long an animal might be in a state of apnoea without actually dying; and to determine the best treatment in cases of apnoea. The committee, in investigating this latter point, employed artificial respiration, the actual cautery, venesection, the cold splash and douche, the hot douche alternated with cold, galvanism, and puncture of the diaphragm, but none of these methods was of such unequivocal efficacy in a sufficient number of cases as to warrant the Committee in specially recommending the adoption of one in preference to the others. The second series of experiments were made upon the dead human subject, with the view of determining the value of the various methods which have been employed for alternately compressing and expanding the cavity of the chest in such a manner as to imitate the natural movements of the thoracic walls in breathing. The following methods were investigated-viz., 1. Pressure exerted by the hands on the anterior wall of the thorax, the body being in the prone posture; such pressure having for its object to expel a portion of the air contained in the chest; on relaxing the pressure the chest expands and air enters. 2. The postural, or so-called ready method, described by Dr. Marshall Hall, which consists essentially in "turning the body gently on the side and a little beyond, and then briskly on the face alternately;" and in making pressure along the back of the chest each time the body is brought into the prone position. 3. The method of Dr. Silvester, in which the action of the pectoral and other muscles passing from the shoulders to the parietes of the chest in deep inspiration, is imitated. An inspiratory effect is produced by extending the arms upwards by the sides of the head; on restoring them to their original position by the side of the body the expanded walls are allowed to resume their previous state, and expiration takes place, the quantity of air expelled being in proportion to that which had been previously inspired. The experiments were performed upon dead subjects in the metropolitan hospitals, and the results were obtained by an apparatus, devised for the purpose, and consisting of a kind of spirometer adjusted to a counterpoise. We regret that our limits preclude us from describing at length the series of interesting and valuable experiments instituted by the committee, but we may state generally that the conclusion at which they arrived was, that in the treatment of apnoea the method of Dr. Silvester was preferable to that of Dr. Marshall Hall, and that they recommend in such cases a modification of the former plan to be generally adopted.

REVIEW X.

Du Mexique au Point de Vue de son Influence sur la Vie de l'Homme. Par D. JOURDANET, Docteur en Médecine des Facultés de Paris et de Mexico.-Paris, 1861. pp. 400.

The Influence of Mexico on the Life of Man. By Dr. JOURDANET.

Ir would be hardly possible to name a region of the earth which, within the same limited area, presents such a variety of physical conformation, or such a combination of the most favourable and the most prejudicial influences to which the human frame can be exposed, as the southern portion of the Republic of Mexico. From the littoral district by which it is bounded on the east to the elevated plateau on which the capital, Mexico, itself stands, the traveller will pass through scenes which are often made up of more vivid contrasts and more violent extremes than any which the tamer physiognomy of Europe can supply. In one part he will find, amidst the wildest fertility of vegetative growth, the haunts of some of the worst maladies to which flesh is heir; in another, a short ride will carry him from a soil so fertile and a climate so benign that the productions of tropical and temperate countries may alike be cultivated there with success, to a barren and desolate plain, almost entirely destitute of life; whilst in a third he may step, with a single stride, from the blazing effulgence of a vertical sun into a cold shadow that will chill him to the bone. Even before he sets his foot on a shore whose pestilence has become proverbial, the haggard and sallow countenance of the pilot by whom his vessel is conducted into Vera Cruz will warn him that he has arrived at a land where disease marches at a more rapid pace and leaves behind it a more permanent imprint of its attack upon the constitution than it does in the milder climates which he has quitted. So great, indeed, is the mortality of the eastern maritime districts of Mexico, and so heavy is the price, either in health or life, which the unacclimatized stranger is in most cases called upon to pay for his residence in them, that it would almost seem as if nature had surrounded the mineral treasures that lie hidden in its mountains with a barrier so repulsive that nothing but the most insatiable thirst for wealth would encounter the risk involved in their collection.

But, with all these drawbacks, Southern Mexico is by no means either uniformly unhealthy or unattractive. Within the limits of the tierras templadas there are districts in which all the advantages of the temperate are so admirably blended with all the charms of the tropical zone as to produce, by their combination, the nearest approach to perfection of physical existence with which we are acquainted. And even in Vera Cruz itself, where the dreaded vomito is an endemic scourge, its terrors are mainly confined to foreigners, the natives and those who are acclimatized enjoying a general immunity from disease which is fairly comparable with that of the average of European coun

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tries. So important, indeed, is it to take into consideration the element of acclimatization in all questions affecting the mortality of any locality, that it would be as unfair to estimate the sanitary character of the Gulf of Mexico by the ravages which yellow fever commits amongst the immigrant population there, as it would be to estimate that of London by the mortality which is exhibited by Lascars and other natives of the tropics who fall victims to the inclemency of our northern winters. However efficiently nature may have enabled man to withstand the prejudicial effects which a sudden change of external conditions-whether of climate, food, or habit-invariably produce upon him, such a change is always more or less attended with danger, and the period during which the process of adaptation is being carried out will be liable to disturbances of health against which it will require the greatest caution to guard. Hence the term "unhealthy," when applied to a locality, has within certain limits a relative significance, great mortality amongst strangers to it being often consistent with a reasonably healthy condition of the natives.

It is to this land of startling contrasts, upon which nature has apparently exhausted all the resources of her creative power, and whose unhappy destiny has made it the scene of political troubles which have at last culminated in open anarchy and a foreign intervention, that we propose for a brief period to transport our readers. Although our share as a nation in the late expedition is fortunately at an end, there is still sufficient interest left in the subject itself, and in the prospects of our brave allies who have continued the crusade on their own account, to excuse our devoting a larger portion of our space to the very interesting work which M. Jourdanet has given to the world on the climate of Mexico than we should probably feel justified in doing to a similar treatise on the climate of any other country. The conditions under which life must be maintained in the wide range of physical features which Mexico exhibits are in many respects so unique, and their operation has been so imperfectly studied, that we should gladly receive any contribution to our knowledge of the influences which they exert, from whatever source it might come. when a writer adds to the weight which a nineteen years' sojourn in that country gives to his statements the acuteness of observation and the clearness of description of which M. Jourdanet's book gives such abundant evidence, its claim upon our attention is proportionately increased. We shall, therefore, make no apology for presenting to our readers such an outline of it as will enable them to form some idea of the very interesting country to which it relates, and to appreciate some of the important conclusions as to its physiological effects to which the author's long residence in it has led him.

But

The physical features which characterize the coast of the Mexican Gulf have been rendered so familiar by the numerous travellers who have visited it as to render any description of them unnecessary here; but there is one which is of such importance in a medical point of view, and which has hitherto received so little attention from ordinary writers, as to justify our dwelling for a short time upon that portion