ticable, such temporary establishments are conducted on the same plan as the permanent hospitals. The selection of buildings for the purpose, the distribution of beds, the means of ventilation and necessary conveniences, the arrangements for conducting professional details, for obtaining and preparing food, have all to be considered, and for the most part can be speedily arranged. Some buildings are evidently better suited than others for the purpose, but it may be stated, as a rule, judging from the experience of the late war, that the more imposing the appearance of the building, the more luxurious its interior fitting up, the less adapted it is for the accommodation of wounded. Public buildings in which large assemblies had congregated should be absolutely avoided-as churches, chapels, ball-rooms, &c.

Much has of late years been written on the subject of huts and tents for the accommodation of sick and wounded. Army medical officers-at first from necessity, afterwards from choicehave had recourse to both these means of temporary shelter before the subject attracted the notice of hygienists and others in civil life. Drs. Bell and Henner, of the British army, made use of tents during the Peninsular War; in 1830 they were used by the French in Algeria; in 1854-5 in the Crimea ; in 1861 M. Levy read a report on the subject before the Académie de Médecine, pointing out their advantages, and some of the defects which needed to be remedied. The following year the Americans perfected and extended their use; but as regards priority in their adoption, they have only the credit, but it is a great one, of having brought them to a condition hitherto unknown. In 1864 tents were used in Berlin as supplementary to the permanent hospitals; and in 1868, on the urgent representation of M. Le Fort, a tent constructed according to a plan of his own was erected near the Hôtel Cochin. The same tent was subsequently used for the accommodation of wounded during both sieges of Paris, and with more favorable results than usually occurred during normal years in the standing hospitals. Similar results were obtained by the Germans during the siege of Metz. Nevertheless, it has been shown beyond question that neither tents nor huts are, under all circumstances, "proof" against the outbreak in them of hospital diseases.

In comparing the relative advantages of huts and tents, it is observed that huts, from their nature, form a hospital more or less fixed; tents, from the readiness with which they admit of removal, are suited for mobile and temporary hospitals. They supply the means of making emergent provision for wounded, and afford shelter even, if necessary, upon the field of battle.

On the other hand, tents are permeable to the great heat of summer and cold of winter; and although capable of being readily and effectually heated by means of a stove and flue led under the floor, as adopted in the American ambulance in the Avenue de l'Impératrice in Paris, yet the establishment of such means of heating requires more time than is consistent with a completely moveable hospital.

M. Le Fort describes some of the hut hospitals used during the late war. He points out that they were elevated upon pillars from the ground to such a degree that the cold winter wind, being thus permitted to circulate completely around them, produced a temperature within so low as to be severely felt by the patients, and a similar observation is made by others. He also alludes to the existing tendency there is to abandon regularly built hospitals, and use in their stead huts such as those constructed in America and Germany, pointing out, at the same time, certain obvious difficulties in regard to them, such as that of regulating the interior temperature in extreme winter and summer climates, the continual danger of fire, the difficulty of obtaining, in or near cities of importance, ground of sufficient extent for their erection, and in the event of their being urgently required, as in the case of war, the difficulty of erecting them sufficiently rapidly to meet the emergency.

After what has already been said we are in a measure prepared to learn that no distinct pattern of tent for hospital or ambulance purposes existed with the French Intendance during the late war. MM. Legouest and Le Fort observe that conical tents, such as are usually issued for the use of effective troops, were alone available for ambulances at Metz, but that so illadapted were they for the purpose that they ought to be abolished. The latter-named author contrasts the defects in this respect of his own army administration as compared to the excellent models used in America in 1862 to 1864, and that adopted in Prussia since 1869. Towards the latter end of the siege of Paris a committee was formed, under the presidency of M. Husson, for the purpose of determining upon a form of hospital hut calculated to fulfil, as far as may be possible, all the requirements of hygiene.

Whatever be the nature of accommodation afforded to sick or wounded soldiers, it must be obvious that attendants are, perhaps, in only one degree less necessary for their well-being than medical men. Unfortunately the requirements of ambulances and hospitals during 1870-71 very far exceeded the means in this respect available, the result being that of the soldiers employed as such many were utterly untrained for the duties, others in no way suited for their performance. What

was wanting under the "administration" was to a great extent supplied by philanthropy, and undoubtedly in the great majority of instances were supplied; yet M. Le Fort does not hesitate to express himself very freely in regard to some of the "infirmiers et infirmières volontaires."

VIII. Mind and Body.'

WORKS with the title and scope of those before us are very liable to be regarded as sensational, as magazines of the marvellous, and to be read by those who prefer truth when clothed in mystery, and by the dyspeptic and hypochondriacal, who seek a resemblance or identification of their own sensations and symptoms with those of other and more notorious sufferers. All this may be entirely in opposition to the designs and desire of the authors; yet it is, perhaps, natural and legitimate that such treatises should find a ready acceptance with the class of subjective invalids, as a very large proportion of the illustrations of the influence of mind in its various manifestations over the structures and functions of the body are drawn from the histories of individuals affected with nervous diseases, real or imaginary, with proteiform constitutional conditions, with states of excitability, irritability, and departures from robust health, which, although they cannot be classed nosologically as diseases, are its prodromata or preliminary stages, or who were placed in circumstances calculated to act strikingly and prejudicially upon hereditary or innate predisposition and whatever feeble organs or morbid tendencies might exist. If we examine the 430 cases narrated or alluded to by Dr. H. Tuke in his volume, we cannot fail to be impressed by the large number which belong to one or other of the two categories enumerated; in other words, we perceive that the most prolific source of psycho-pathology is within the domain of disease itself, and disease not necessarily connected with the more obvious relations of mind to body. To Dr. H. Tuke belongs the merit, however, of having attempted, not merely to adapt his speculations to scientific inquiries, but to confine them within the regular and rigid limits of professional and philosophical investi

11. Illustrations of the Influence of the Mind upon the Body in Health and Disease. By DANIEL HACK TUKE, M.D., M.R.C.P. 1872.

2. The Power of the Soul over the Body, considered in relation to Health and Morals. By GEORGE MOORE, M.D. 1846.

3. Theory of the Influence exerted by the Mind over the Body in the Production and Removal of Morbid and Anomalous Conditions of the Animal Economy. By JOHN GLEN, M.A.

1855.

gations. Although his work be a repertory of very curious and interesting illustrations, it is not addressed, although it may be acceptable, to the general reader, but is couched in scientific language, is arranged in accordance with certain psychological principles, many of which, although current and popular, are not recognised, and it has evidently for its grand object the solution of the difficulties which surround the subject upon known physiological and pathological laws. We do not absolutely demur to the incessant effort to explain every problem by reference to recent supposed discoveries; but although the last to receive a dogma or a fact because it was inexplicable or impossible, we would prefer to admit a doubt or a difficulty to the reception of a solution which itself requires solution or is founded upon mere hypothesis. Dr. Tuke appears to be conscious of the habit, if not the vice, now prevalent, of over or strained elucidation, enters a gentle caveat as to the admissibility of antagonistic doctrines, as where he endeavours to reconcile the hyperæmia of Kussmaul with the anæmia of Van der Kolk, as observed in epilepsy, knowing that what the actual condition of the blood-vessels was prior to or at the time of the convulsion, or even subsequently, cannot be inferred from that seen after death, by the supposition of the latter being the result of malnutrition and degeneration, and by the theory of vascular centres or areas (p. 174); but, occasionally, rushes courageously into discrepancies where different results are attributed to the same cause, or different causes are assigned for the same result. When quoting the words in order to satisfy "our craving for explanations," and describing Brown-Séquard's opinions, he very opportunely remarks that "the influence of one portion of the brain itself free from disease may affect another portion and produce paralysis, and that the irritation is in these cases transmitted through nerve-fibres to some cells at the base of the brain, and from them reflected upon the neighbouring blood-vessels by means of other nerve-fibres." (P. 217.)

The apparent confusion-we shall not venture to call it contradiction-in tracing out the causation of various phenomena may in part depend upon the minute subdivision of mental factors, and the endeavour to connect them specially with structural or functional changes. Thus, the mind is represented in its operation upon the body as consisting of (1) intellect, (2) emotions, (3) will. Intellect is secondly held to act in the form of (1) excess of study or mental strain; (2) voluntary attention and contemplation; (3) involuntary attention, dominant ideas; (4) recollection and memory, association of ideas; (5) imagination and expectation; (6) imitation and sympathy.

Then, under each of these genera or species of mental influence, sometimes constructive or reparative, sometimes degenerative and destructive, are grouped the multiform diseases, abnormal sensations and phenomena which they have been supposed to produce, cure, alleviate, or modify. Again, the emotional powers are enumerated, as (1) joy and its various forms; (2) grief and its various forms; (3) hope and faith; (4) despair; (5) self-esteem; (6) humility; (7) fear, fright, terror, anxiety, &c.; (8) calmness; (9) anger; (10) love and benevolence; (11) hate and malevolence; (12) general emotional excitement. Then follow, under each of these sentiments or passions, long catalogues of very heterogeneous effects, which have been attributed to their interference with the established laws of the economy by various authorities of different degrees of trustworthiness. When we discover among these that joy is adduced as the cause of death in Irish convicts on the announcement of their liberation (p. 317), in the Roman mothers whose sons returned after the battle of Thrasymenus (p. 118), although we have no evidence as to the state of the heart or large vessels in these individuals, and that fright is regarded as leading to a similar result, the force of an observation made above may be appreciated; and, lastly, under volitions there are placed numerous affections, such as hallucinations, trance, simulated hemiplegia, and tetanus, and cure of epilepsy, with which the will is conceived to be in some way associated. We are prepared to expect that in a more advanced stage of knowledge such an exhaustive classification as we have now epitomised may prove a useful, even a necessary guide in judging or dealing with the modus operandi of the nervous system, and that it should be regarded even now as an important contribution in guiding our inquiries in the right direction; but, examined from a practical point of view, we are inclined to prefer the course pursued by Dr. Moore, who, in a much more general and simpler fashion, confines his observations to the power of attention, abstraction, memory, will, passion, in affecting for good or for evil different corporal conditions. In fact, although presented under different aspects, all the mental manifestations arranged by Dr. Tuke under intellect are resolvable into acts of attention. His text or starting-point is the well-known saying of John Hunter, himself of a susceptible and sensitive nature:-" I am confident that I can fix my attention to any part until I have a sensation in that part" (p. 5). We have not the most remote notion of treating either John Hunter's little finger or anything connected with our celebrated countryman with disrespect when we recall the equally far-famed experience of Ben Jonson, who related to Drummond that he distinctly saw Turks, Tartars,