jails, we subjoin a brief account of the method adopted at the Model Prison, Pentonville, in which the system of Separate confinement is adopted. The most important point in this and all similar prisons is, of course, the ventilation of the cells, the main objects of which are thus stated:

"1st. The withdrawal of a stated quantity of Foul air from each cell. "2nd. The supply of an equal quantity of Fresh air into each cell without subjecting the occupier to the prejudicial effect of a draught.

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3rd. The means of warming the fresh air when necessary, without injuring its qualities or affecting its hygrometrical condition.

"4th. That no additional facilities for the transmission of sound should be afforded by the air-channels or flues."-Report on the Construction, Ventilation, and Details of Pentonville Prison, p. 18.

The following is the mode of carrying out these objects. An apparatus for warming the air when required, consisting of a boiler, is placed in the centre of the basement story; from the top of this boiler a rising main communicates, in the usual way, with any number of pipes which may be required for the circulation of hot water, the return-pipes being introduced at the bottom. Around the boiler is an air-flue, into which the external air is admitted and is subsequently conveyed along tubes or flues placed under the floor of the corridors, and from thence passes upwards through small flues preserved in the corridor wall, which terminate respectively in a grating placed close under the arched ceiling of each cell. A grating is placed close to the floor of each cell diagonally opposite to the point where the fresh air is introduced; this grating covers a flue in the outer wall, opening into a horizontal foul-air flue in the roof of the cell, which communicates with a vertical shaft raised 20 or 25 feet above the external roof. The deteriorated air of each cell is withdrawn by the action of this shaft, the air of which is rarified, in the Winter by the fire of the boiler, and in the Summer by a small fire provided for the purpose at the bottom of the shaft: it is found that, if an average difference of 5° to 10° above the external temperature be maintained, the desired effect is produced. From a series of experiments performed by Dr. O. Rees, the principal medical officer of the establishment, the following facts have been determined.

"1st. That from 30 to 45 cubic feet of pure fresh air is made to pass into every cell in a minute; and that the ventilation is maintained with great regularity. "2nd. That this amount of ventilation, and a temperature ranging from 52° to 60° can be uniformly maintained in the cells during the coldest weather, at an expense of less than a farthing a cell for 24 hours.

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3rd. That the same degree of ventilation is effected during the summer months at less than half that expense."-L. c. p. 25.

The general results of this important experiment have doubtless been satisfactory, but we have been informed, by a high authority in these matters, that much still remains to be done to secure complete success. One fundamental error extending throughout the whole of the cells will not have escaped the notice of our readers-the insertion of the grating for the escape of the foul air in the floor, and the introduction of the fresh air at the ceiling. In all improvements of this kind it is essential to bear in mind, that the carbonic acid gas generated by respiration (notwithstanding its intrinsically superior specific gravity) being rarefied by the heat of the body in all warm-blooded animals, becomes lighter than common atmospheric

air, and so ascends towards the ceiling, from which, if no escape be provided, it begins to descend, partly by becoming cooler, but principally by diffusion. The same thing also happens in the case of gas-lights, lamps, &c., the heated carbonic acid ascends. In every instance, without exception, in which openings are made for the escape of the products of respiration and combustion, they should, for these reasons, be placed at the upper part of the apartment, or otherwise it is inevitable that the indwellers must breathe a contaminated atmosphere.

The removal of the noxious products of combustion forms an essential part of ventilation in all places where gas-lights and lamps are used; and this has become a point of increased importance in consequence of the general use of gas, not only in shops and public institutions, but in private houses. The simplest and most inexpensive plan is the one now often adopted, to affix, namely, a tube over each burner, carrying this either through the ceiling or roof, or, which is often much better, into the chimney, so as to form a draught of which advantage may be taken to ventilate the room itself. In all these cases, however, it is desirable to make the apparatus which removes the products of combustion, at the same time ventilate the apartment. This has been accomplished by some of the London lamp-makers, and in such a manner as to be ornamental, rather than otherwise; but, as cheapness is in all these matters of primary consequence, we are desirous of noticing a most economical contrivance, described in the report on the state of Exeter by Dr. Shapter. A copper tube, one inch in diameter, is suspended over the glass chimney of an argand gas-burner; the upper part of this tube enters for about one foot into a tube of similar shape but of double the diameter; this larger tube has a wide trumpet mouth, the lip of which is exactly on a level with the ceiling, and can thus receive the vitiated air of the apartment; finally, the upper end of this large tube is carried through the roof, and is protected at the top against the rain by a conical cap. The mode of action is as follows:-" The column of hot air discharged by the glass chimney passes through the smaller tube with great velocity into the larger tube, in which it occasions a rapidly ascending current; whilst, therefore, the smaller tube carries into the larger one all the air vitiated by combustion, the larger tube discharges through the roof, not only the air which is received from the smaller tube, but also the air vitiated by respiration or other causes, which it sucks up from the upper part of the room." This simple and effective apparatus, invented by P. C. De la Garde, Esq., has been in constant use at the Devon and Exeter Institution upwards of seven years, during which time "it has required no cleansing, reparation, or indeed attention of any kind whatever." -Octavo Report on Exeter, p. 23.

Our notice of the important matter contained in the Reports and Evidence of the Commissioners of Inquiry has occupied so much space, that we can merely cursorily refer to the remaining works of which the titles are inserted at the head of this article. "The Health of Towns Association" has published some useful tracts with the view of conveying to the public, a knowledge of the main facts elicited by the above-named Commission, and also of preparing the way for those sanitary measures which, as we have endeavoured to show, are so urgently demanded. These pamphlets are well adapted to secure the objects for which they are designed,

and we therefore recommend them to the perusal of our readers. Mr. Gir dlestone has also published a very useful Abstract of the Evidence, and his "Letters," illustrated by many wood-cuts, may be consulted with great advantage, as presenting a well-digested resumé of the whole question.

It has been our object, in the present article, to lay before our readers a comprehensive view of the bearings of the Sanitary question, which, at this time, engages so large a share of the public attention, and which must of necessity, from the momentous and varied interests concerned, occupy a prominent place in the proceedings of Parliament during the next Session. To our professional brethren more especially the matters we have considered are deeply interesting, and, as many of them will be hereafter called upon to take an important part in the introduction and suggestion of improvements, and as all of them are frequently consulted on the means of obviating the causes of unhealthiness in towns and other populous districts, it becomes no less their interest than their duty, to master the whole subject of which we have, in the present article, notwithstanding the large part of our space we have thought it right to devote for the purpose, only given an outline.

ON THE NATURE, CAUSES, PREVENTION AND TREATMENT OF ACUTE HYDROCEPHALUS, OR WATER-BRAIN FEVER. By Thomas Smith, M.D. 8vo. pp. 168. London, Longmans, 1845.

HYDROCEPHALUS is so frequent and so destructive a disease that a new publication concerning it is sure to challenge due attention. The present Essay, however, is unfortunately addressed to both the general and the professional reader, the inevitable consequence being, that it treats of topics which the former can neither comprehend, nor would benefit by comprehending, while it contains but little allusion to various points respecting which the latter is anxious for additional information. We hold that attempts at the instruction of the public in the "nature, causes, prevention, and treatment" of important diseases are not only useless, but fraught with danger. They beget an injudicious meddling and self-sufficiency in some minds, and needless and nervous apprehensions in others, by which the unfortunate little patient is often driven into the very evils sought to be averted. Before saying more upon the subject, it will be better to place the view Dr. Smith takes of it before our readers.

"If a popular treatise on any malady or class of maladies be desirable, it will surely be so on one which, when once established in its most decided form, is generally admitted to be unmanageable and without hope. It is because hydrocephalus is a desperate, and but too frequently, an incurable malady, that, so far as I am able to form an opinion, it is of the utmost importance that the medical attendant, the parent, and the nurse, should be on the alert to watch the threatening signs of its insidious approach, and by a seasonable interposition of diet, regimen, and remedy, to oppose the mischief at its onset. It may be stated, without hazarding any doubtful responsibility, that this fatal and rapidly growing disease ought not to be ranked with those whose progressive advance can neither

be seen nor prevented. It very seldom sets in but as the result of a previous and gradual change in the condition of the child's system, tolerably manifest to the observation of an attentive parent or nurse; yet, how frequently little or nothing is done to arrest its further progress, until the active form presents itself; and then the family medical attendant has barely to announce the name of the disease, and every mother at once recognizes the knell of death in the sound.

"To the most severe and uncompromising critic, who may ask to what good end this, my effort, may lead, my answer is, I have found medical and popular literature equally deficient in suitable admonitions to parents and nurses. I have found statistics telling us that one-eighth of infantile deaths in crowded towns have occurred from water-brain-fever. I have found my own profession, with regard to the disease in its least equivocal form, confessing the impotence of medicine, and physicians pursuing, as the result of habit, the same uniform, authorized, but unsuccessful treatment of the disease, as on a mere routine without hope, without encouragement, without comfort, and without consolation; meeting in consultation in such cases merely to reflect reciprocal humiliation, and to indulge in reciprocal confessions of incompetency. I have found them persisting in a plan of treatment in which generation has servilely imitated generation, and under which an occasional recovery has been more a matter of wonder, and occurring more from the intervention of some unexpected constitutional effort in the patient, than from any well directed aim of science.

"In such a position, after duly weighing all authorities, and having had many opportunities of comparing my sentiments with those of my contemporaries, if I have determined to try to lay down a beacon or two, by means of which even a few lives may be saved, and much misery prevented, it ought rather to excite surprise that I have not long ago been anticipated in the performance of what may justly be called a duty of humanity, long neglected. And although others after me may perform the same duty more ably, and perhaps more successfully, I may at least claim to myself the credit of first pointing the way.” P. v.

After the perusal of the above rather grandiloquent introductory passage, we turned to the chapters on the Means of Prevention, naturally expecting to find some novel suggestions or improved prophylaxis; but great was our disappointment, since we found nothing there but has been more fully and better told by Dewees, Eberle, Evanson and Maunsell, Barlow, Combe, and numerous other writers, who have of late years treated upon the Physical Management of Children. What the author means by saying he is the first to lay down the beacons derivable from these instructions we know not. He may be the first who has engrafted them upon professional treatise on hydrocephalus intended for popular perusal, and thereby seems to us to be running far more risk of planting rocks than of raising beacons. Professional men are well engaged in endeavouring to impart to the public approved rules for the preservation of health-the principles of hygiene-insisting that recourse should be had to their assistance when any aberration from the healthy condition occurs. The author may tell us that his work is addressed to this end; but if so, why couple with his hygienic precepts, which are just as applicable to the prevention of any other diseased condition as this, an account of the symptoms, diagnosis, treatment, &c. of hydrocephalus. When we consider the difficulty that frequently exists in the detection of this disease, and the errors able and practical men not unfrequently fall into respecting it, the scheme of enabling nurses, parents, and the like, to compass this by furnishing them with an accurate account of its well-marked form, seems to us, to say the

least, a very foolish one. If Dr. Smith believes these personages will con. fine their attention to the portion of the work suited to their capacity, he can know little of the habits of the class whose instruction he is labouring for; for however inapplicable the maxim" that a little knowledge is a dangerous thing," may be in general, we have had too often to deplore their meddlings and thwartings to doubt its infallibility as regards the management and treatment of disease. The arguments for endeavouring to popularize the recognition and management of this disease are just the same fallacious ones the notorious Buchan-whose work has consigned thousands to their graves-employed long ago.

Although the term Hydrocephalus is a defective one, as only indicating one of the effects of the diseased condition, it is perhaps not very easy to substitute a better; and indeed, when employed in the sense which Heberden first attached to the term dropsy, suffices well enough—“ Hydrops non tam ipse morbus est quam alicujus morbi signum.” Dr. Hennis Green, and the writers of the French school who have succeeded him, term the disease Tubercular Meningitis, on account of the very great frequency with which tubercles, or lardaceous deposits are found in the inflamed pia mater. Of 60 cases observed at the Children's Hospital at Paris, Dr. Green found these appearances in 56. MM. Rilliet and Barthez found the same 29 times out of 33 cases, and M. Bouchut in six out of nine cases. This complication, however, does not by any means so frequently occur in this country as in France; and the exceptions even allowed by the above-named authors should suffice to prevent this term being accepted. However this may be, the intimate connection of the disease with the strumous diathesis has been long observed. The observations of English, German, and French writers, but especially the latter, all tend to show the rarity of the occurrence of hydrocephalus without tuberculization of some one or more organs of the economy. Still there can be no doubt that cases of this disease do occasionally occur in subjects unaffected with tubercle, it being then a simple inflammatory disease, which may come on primarily in an otherwise healthy subject, or secondarily as a consequence of scarlatina, &c. In the vast majority of cases it is the strumous and far less manageable form of inflammatory action which prevails. Dr. Smith considers the disease as analogous to the nervous fever of adults, and, but for the inconvenience of changing names, would term it infantile nervous fever, or, as he expresses it on the title-page of his work, "water-brain fever."

Symptoms and Stages." In 1768," MM. Rilliet and Barthez observe, "appeared Robert Whytt's remarkable dissertation, and as regards the symptomatology it is even now the best work that has ever yet appeared. We cannot too much admire the talent for description, and the eminent spirit of observation which shine through every page of this interesting monograph; nor praise too much the ideas, full of justice, by which the author seeks to explain the development of the different symptoms." Whytt divided this disease into three stages, the varying state of the pulse forming a principal indication; this being rapid in the first or precursory, and in the last or convulsive stage, and slow in the second stage, when stupor first commences. To this there are exceptions; and, although his arrangement has been generally followed, it would be preferable, M.