4 JULY 1846, Page 17

DR. GEDDES'S CLINICAL ILLUSTRATIONS OF THE DISEASES OF INDIA.

DR. GEDDES was appointed, in May 1829, medical officer to what is now called the right wing of the Madras European Regiment, and re- mained in charge of it till May 1833. The number of men under his care varied from about five to seven hundred; and the regulations of the Company's service exhibited very complete particulars of their previous lives, not merely as to age and country, but as to the kind of district they had previously lived in—urban or rural, the character of the occu- pations they followed—as labourers in the open air, in the house, in a constrained position, in heat, and similar particulars. A corresponding exactness was required as to the medical statistics ; which Dr. Geddes not only pursued con amore, but enlarged them by plans and arrangements of his own. When to such facts are added an elaborate description of every locality where the regiment was stationed, and minute reports upon the weather at different seasons, it will be seen that materials exist for a very complete medico-statistical history of the regiment during the four years it was under Dr. Geddes's care.

- It is this species of historywhich is contained in the volume before us; generally embracing a period of five years from July 1828, but treating very fully and particularly of the period during which the regiment was under the direction of Dr. %rides. A more elaborate display o medical statistics has, indeed, rarely been given to the public ; the variety of Subjects which are included in the exhibition embracing all the conco- mitants as well as the diseases, and going into the biography of the patients so far as it can be classed and reduced to tabular display. To accomplish this effectually, the work is divided into two lead- ing sections; one of which exhibits the regiment in its composition of nations, ages, previous occupation, length of time in India, habits as en- gendered by the rules of the service, the quarters occupied, the weather experienced, and the annual state of the regiment's health. The other part deals with specific diseases ; taking in succession, fevers, affections of the head, inflammations of the chest, air-passages, liver, and stomach, and finally rheumatism. The general statistics of these cases are first ex- hibited; then the story of particular cases, with their treatment; and in the event of a fatal termination, a description of the post marten; exami- nation. The book is frequently interspersed with general remarks on the subject in hand ; though on the whole it is rather a storehouse of facts than a collection of deductions. The author presents his readers with his own experience, so far as it can be ground down into statistics or narrative, mostly leaving them to draw their own conclusions ; a thing that is not to be accomplished without a large amount of patient labour, the facts being necessarily stripped of the original life, whilst the student is deprived of that stimulus to attention which life itself imparts. As a vast amount of facts, the book is really, we believe, unrivalled ; but un- less the student has a fund of active exertion and original inquiry in him, he may be overwhelmed by the immense extent of his material. This is the general character of the book. Upon many subjects Dr. Geddes draws his own conclusions : one of which is, that the probability of life increases in proportion to the length of residence in a warm cli- mate; another is, that a continued state of great heat or great cold does not induce fever,—which as regards heat may perhaps be doubted. His facts, too, frequently contain obvious conclusions which the reader can hardly avoid drawing : one of these seems to be, that intelligence and stamina carry the day, struggling through difficulties under which the feeble-minded and the debauched or exhausted quickly sink : the same would seem to take place among the natives of India, from some cases that came under our author's observation ; though he ascribes it to per- haps a less influential cause than the strength arising from mental cha- racter and various food. The Mahometan's statement of his complaint is a mere consequence of his intelligence. "Another circumstance worthy of remark is, that while the regiment was com- posed of 244 Mussnlmans and 450 Hindoos of the South of India, with 153 natives of the Bengal provinces—and the number of cases of fever in each class was not greatly disproportionate—seventeen of the deaths took place in the Southern Hindoos, and three among the Bengalees, while in none of the Mahomedans was the disease fatal. This may be partly attributed to difference of food, and greater stren of constitution in the latter; but is in a great degree owing, it is be- Beved, to the Mahomedans reporting themselves more readily when sick; being less under the influence of superstitious feelings while in this state; and affording, in general, a more intelligible statement of their complaints than the Hindoos."

Abstracting such complaints as cholera, and the effects of very active service under unfavourable circumstances, the statistics would seem to argue that the heats of India are not necessarily so fatal as is generally assumed, and would be still less so if the soldier were taught to manage himself with more reference to hygiene. Dr. Geddes, like Doctors Jackson and Ferguson, has his facts about dram-drinking.

"The subject of drink forms an important one for consideration in the life of an Indian soldier. A system has been in force in that country, (the Madras Pre- sidency and the year 1833 are here particularly alluded to,) based, apparently, upon an idea of the necessity of the use of ardent spirits by the European troops, whereby. a certain portion is allotted daily to each recruit from the period of his arrival in India, the price of which is deducted from his pay. Many circum- stances lead to the recruits becoming thus accustomed to such a stimulus; and there are few individuals, accordingly, who omit during the remainder of .their service to swallow their daily allowance of arrack: a spirituous liquor, in strength as supplied to the troops, little inferior to brandy; and of this two measures, forty to the gallon, form the daily appropriation to each European soldier. • • • The whole averages about 10,000 gallons of smack in twelve months. In addi- tion to this allowance, the canteen is kept open for the sale of liquors to the men; and it has been ascertained that the average annual expenditure of arrack and European spirits, wine or beer, as sold in that place, amounted to 1,440 gallons of arrack, 56 dozen of brandy or gin, 18 dozen of wine, and 60 dozen of beer, during the period referred to in the above table. The average number of individuals pre- sent with the regiment, throughout this interval, was about five hundred."

Here is a sample of Dr. Geddes's descriptive style.

SIGNS OF DELIRIOUS FEVER.

The mental disorder is chiefly remarkable in the disposition of the patient to consider himself quite well. He is accordingly found sitting up or walking about, or disposed to leave the hospital; while the tenor of his srech indicates a similar delusion. In the remission or at the commencement of lirium, the pa- tient is most generally sensible when spoken to; requiring, however, at times a short period to comprehend what has been said to him; and he lapses into deli- rium, or a half-dozing state, when the call upon his attention has ceased to ope- rate. As the disease proceeds, if it is of a protracted nature, each exacerbation of fever adds to the intensity. of the mental disorder and the debility of the pa- tient; and, from the increasing weakness, the delirium becomes of a less active nature: the patient is more quiet, and, towards the termination of the case, is either found quite insensible, or muttering deliriously, with his eyes more or less shut, and sometimes passing his evacuations in his bed-clothes. In other cases, where the disease is more rapid and the strength of the patient less exhausted, he is occasionally found sitting up and looking about him, with a delirious stare, or walking through the hospital ward, within a few hours of his death.

The following intimation may furnish a useful hint in the transport of troops, where the necessity of the service does not imperatively require everything to give way to speed. Individuals of course will have their way, if they die for it. " It will be for future observers to ascertain whether the quick passage to In- dia by the overland route, now so generally adopted, has any influence in Fo- clueing peculiar diseases on the arrival of Europeans in that climate; and it may then become worthy of consideration, whether the lengthened voyage by the Cape of Good Hope does not possess advantages, in respect to the gradually accustoming strangers to a residence in a warm country, which may render this always the most eligible route for such individuals to proceed to that part of the world."

This is only one part of the contemplated.work :• the remainder will consist of a similar exposition of other disorders from data in the author's possession, should the reception of the present volume encourage him to persevere.