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menstrual fluid was considerably diminished, and she sufferedmuch pain. In the September of the fourth year after theoperation, the catamenia did not appear; but symptoms ofperitonitis, with an inflammatory swelling of the right iliacregion, took place. These symptoms abated, under the influ-ence of an energetic antiphlogistic treatment, and the patient Ipassed the months of November and December in tolerablehealth; but the menstrual flow continued absent, in spite of aconstant recurrence of the symptoms at each menstrual period,and of the means by which its appearance were solicited. Inthe following January, the peritonæal symptoms increased;a..manifest swelling appeared in the right iliac region; andthe patient suffered from dyspepsia. She remained in thisstate all February, when the swelling became more painful.Diarrhoea continued, and fever carried her off in the followingJune. The post-mortem examination was, made In presenceof Drs. Carron du Villars, Duperlet, and Pauly.The vaginal canal,, on being opened, was found to end in a

eul de sac, formed by .the solid fibrous tissue of a cicatrix.,The uterine orifice was completely obliterated; the iliac fossawas filled by a tumour, containing on its centre a substanceresembling tuberculous matter, though no tubercles were efound in the lungs or in any other organ. It is to be regretted,that no sort of information is given respecting the uterus, theoviducts, or the ovaries, but the last case gives us the meansof understanding the one we have just detailed. Notwith-standing the obliteration of the uterus, by the operation, men-truation, -though in a diminished quantity, took place for twoyears afterwards from the vagina. Its diminution was accom-panied by dysmennorrhagio pains,- and its suppression, andeffusion in the vicinity of the abdominal opening of the ovi-duct, by a painful swelling in the iliac region. At every re-currence of the menstrual period, an additional, quantity ofblood was extravasated, causing the aggravation of the localperitonitis.

After carefully perusing these cases, the question naturallyarises-Do not similar phenomena often occur, though to aless extent ? Admitting even the infallibility of that speciesof instinctive motion, by which the oviduct (when free)always applies its fimbriated extremity to that portion of theovary where its services are required, we know that both ovi-ducts are often bound down so as not to be able to performthis office, that the nmbriae are often destroyed, and the abdo-minal opening of the. tube is frequently obliterated. In thesecases the ovum and the fluids which accompany it must fall-into the peritonooal cavity. Will not this partly explain someof the symptoms by which menstruation is sometimes attended- symptoms similar to those of local peritonitis ? Can we notis this way account for those serous cysts, or sanguineous tu-mours, which we sometimes find in the pelvic cavity, andwhose origin we cannot otherwise account for ?

II. Puerperal peritonitis has, no doubt, sometimes itsstarting-point in the inflammation of the ovary, and of thosetissues which are together called the broad ligaments. Itssymptoms; prognosis, and consequences, are so well known thatwe will not stop to recal them to the reader’s memory.We will merely allude to one of the probable causes nf the

frequency of this disease, which has not sufficiently attractedthe attention of the profession. The extreme frequency withwhich pus is found in the oviducts of those who die of puer-peral peritonitis has been noticed by Cruveilhier and otheranatomo-pathologists. Whether this pus is developed in situ,or pumped up from the uterine cavity by the same capillaryattraction which raises the seminal fluid to the ovaries, wewill not at present stop to inquire; but is it not likely that itseffusion into the peritonæal cavity is sometimes the cause ofpuerperal peritonitis ?Among the less frequent terminations of ovaritis, we may

mention inflammation of the fossa iliaca, although it is consi-dered by Velpeau as frequent. Dr. Lever has several timesseen pelvic inflammation produce plilegmasia dolens, and Dr.Melier has sometimes seen phlebitis, and consecutive infiltra-tion of the limb, as consequences of puerperal ovaritis.Having thus treated of the extrinsic terminations of acute

ovaritis, or of the consequences of ovarian inflammation to theneighbouring viscera, we should now proceed to study the in-trinsic terminations of acute ovaritis, or those pathologicaltransformations of the ovarian tissues which constitute thevarious forms of ovarian encysted tumours; but as we shall beobliged in another chapter to reconsider these morbid growths,we shall immediately proceed to investigate the best treat-ment of acute ovaritis, and of pelvic inflammatory tumours.

Gloucester-road, Hyde-park, 1849.

(To be continued.)

A DESCRIPTION OF

A NEW KNAPSACK AND GIRDLE FORINFANTRY SOLDIERS;

WITH A NARRATIVE OF THE STEPS HITHERTO TAKEN TO PROMOTETHEIR ADOPTION IN THE BRITISH ARMY.

BY JAMES BERINGTON, ESQ., late Veterinary-Surgeonin the Army.

I Ant enabled, by the kind permission of the editor of thisjournal, and the interest which Mr. Wakley has personally_taken in promoting the success of my endeavours, to lay be-fore the medical profession, in the pages of THE LANCET, thefollowing description of some inventions which have for theirobject the relief of the infantry soldier from the great incon-veniences attending the use of his present equipment-an ob.ject which I think I can clearly point out, from the testimonyof competent witnesses, has been fully attained by the newequipment which I proceed to describe, and of which.the armyauthorities have it in their power to avail themselves.

FIG. I.-The Knapsack: a, a, the rest over the shoulders, awayfrom the joint and armpits; b, the pack, to be sufficiently filled ac-cording to the hollow of the wearer’s back, to give the head of thepack, which contains the great coat, an inclination forward, inorder to place the pack in a position to balance upon the rest a, a;c, c, the arms, from the pivots d, d, continued up to the head of thepack, to steady the latter in quick motions of the body in any direc.tion. Their length is regulated at.the head of the pack, to corre--spond with the breadth of the upper part of the man’s body, overthe shoulders; and the rest under the projecting head thus length-ened or shortened, according to the breadth of the wearer -fromfront to back; d, d, the slides, with raised breast-straps, bucklingin front, and pivots to receive the ends of the side-straps comingfrom the bottom of the pack, bringing the weight they receive frombehind the man on to the pivots in front; and thus effecting a.balance over and upon the shoulders at the rest.

FiG. 2.-The Girdle and Pouch: a, the fixed loop to the pouch,that allows the latter to traverse from back round to front. Thecircle formed by the lower margin of the girdle is larger than thatof its upper margin, causing the girdle and pouch to rest firmlyupon the buttock and pelvic boiaes-. (See the letters of Drs. Fosterand Ramadge.)

I had been more than twenty-seven years a veterinary sur- geon in the army, and was placed upon the retired list bymedical report in 1828, when my attention was drawn by anofficer of infantry to the oppressive mode of the carriage ofthe linapsack, from the manner in which it is slung to theshoulders. The weight of the pack resting against the arm-pits and shoulder-joints pinions the wearer, and the strapsacross the breast, or main front, become so oppressive whenbuckled, that many privates have told me they could notadmit of any pressure at all from them, and they buckledthem merely for the sake of uniformity. The more inquiriesI made among old soldiers and Peninsular officers, the greaterconfirmation of their statement followed; so much so, that Ifound the conviction to be pretty general amongst them, thatthe equipment (knapsack and cross-belts for pouch andbayonet) had annihilated more men than powder and ball !From this it appeared very obvious to me, that no good couldaccrue from any modification of the equipment at present inuse. The thing had to be remodelled from its foundation.The weight must be removed altogether from interfering withvital actions; from pressing on blood vessels, nerves, and respi-

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ratory organs, for I found all were oppressed. Having ascer-tained what I proved to be the true position for the weight,and discovered the principle of keeping the same in its place,I applied to a friend to obtain from the adjutant-general atrial of my knapsack in one of the regiments of guards, ob-serving that, although confident of its advantages, I wished tohave the opinion of the non-commissioned officers and men, asit-was of no use founding hopes upon principles that the work-men did not feel to be correct. My friend succeeded for me,and in the year 1840 I saw Sir John Gardiner, deputy adjutant-general, from whose department he informed me the knap-sacks were supplied. The deputy adjutant-general was byno means freely disposed to give me a trial, but turning to

’ Major Meade, deputy assistant, the latter remarked, "Itlooked so like doing it, that it ought to have a fair trial." Afew days after this interview I saw Colonel Aitchison, of theScots Fusilier Guards, in the orderly-room at the HorseGuards, and to this day I believe he at the time felt a livelyinterest in the subject. After going well into the matter ofthe knapsack itself, (one made solely to prove the principle,)he-observed, " Your object appears to be, to place all the weightyou can upon the shoulders, close to the neck, away from thearms, and you have done so; but, pray, how do you keep itthere?" This I explained;* when he replied, 111 see clearly,Sir, and all I can say to it is, that if it does it, you have accom-plished what we have all been trying at for years." He thengave the sergeant-major directions to have it used by the menat punishment-drill to begin, saying, " By-the-by, give it over,to Quarter-master Sergeant Miller; he is a knapsack man; itwill be just the thing he will like, and he has more time to attendto it than you have, Serjeant-major; and-do you attend, Sir, (tome,) and put them in the way of it, as it is all new to them.".The work commenced in a few days, and continued for nearly-four months, and I attended at Portman-street Barracks inorder to explain the principles I had adopted, and to get allthe information I could from the non-commissioned officersand men relative to the effects of their own ordinary eqnip-.ment. These still confirmed the previous statements I hadreceived.of the baneful effects of the knapsack at present inuse. The non-commissioned officers made several trials of itafter their duties were over in the parks and on the roads, andfrom all speaking so favourably of its ease to the wearers,some of the officers-to their praise be it said-made trials of.both knapsacks alternately, and on marches from Windsor toLondon; they were fully satisfied with the superiority of myequipment. This trial closed as follows:-The knapsack wasplaced upon Corporal Eales, who had carried it, and knew itsprinciples,which he explained to Colonel Aitcheson, when thelatter observed, " The principles are correct; look you where hehas placed the weight close to the neck, over the shoulders, andit is kept there too, it.appears; so let the reports be made,,out." When informed of this order, I inquired if the colonelhad made any inquiries of any of the men who had carried myknapsack, and on being informed that all he had asked on thesubject was of Corporal Eales, I requested the serjeant-majorand Miller to call the men in one at a time, and to put downjust what each had to say. This was- done, and laid beforeme the next morning, to know if it was in the form I pro-posed, and it being perfectly so, Corporal Eales offered togive me a copy. I declined taking one from him, but I wroteto Captain Seymour, then adjutant, for one, which was refusedby the colonel, who stated that it was gone into the HorseGuards, with his report. On the 29th of February, 1840, Ireceived an official letter, signed by the adjutant-general, con-taining the following:-" Judging from the report of theofficer commanding the regiment in question, and from hisown observation, Lord Hill is satisfied that both the form ofand the mode of carrying the knapsack are objectionable," &c.On this I wrote, soliciting copies of the reports, and got foranswer, " That they were confidential." I then wrote a letterso full of facts, that I received a note from Colonel Cockrane,assistant adjutant-general, to call upon him. He took meto Sir John Gardiner, then deputy adjutant-general, whomet me with, " I thought, Sir, you had been long enough inthe service to know that it is extremely improper to writehere for copies of papers." I replied I could not conceivethat such reports contained any official secrets. The wordsecret I saw completely took him aback, and at once confirmedme in my impression that there was something unfair at work.Finding that I had no prospect of success, under existing cir-cumstances, I made efforts to get further proofs of the-advan-

* The explanation will be found in letters-testimonial at p. 504-6.t The adjutant-general’s reply, refusing copies of the men’s report,and

Colonel Aitcheson’s, is dated March tOth, 1840.

tages of my knapsack, by additional trials, and I was at lengthsuccessful with Colonel Love, of the 73rd regiment, early in1842. The regiment was at Woolwich; the colonel had aknapsack on trial at this time, belonging to Colonel Wood,and his men quickly satisfied him of the merits of mine; andMajor-General Brown, deputy adjutant-general, being in-formed by Colonel Love that he had two knapsacks on trial,sent his down against us; and on his visiting the regiment, ona tour of inspection, the men of the 73rd stated, " that theycould feel no. advantage in the ride of Colonel Wood’s, butthat mine was the best they had ever tried, and the major-general’s was the worst they had ever met with."* I hear,however, that since this condemnation of the major-general’sknapsack, the same has been issued to several regiments.Here we have official persons issuing knapsacks to the men,

which their comrades have condemned. What admirablecare for the sufferings of those whose meritorious conduct inthe field has so frequently received the thanks of both housesof Parliament! Surely they deserve more considerate pro-tectors. Colonel Love, who, as his men stated to me, is everygood soldier’s friend, kindly took my knapsack with him onleaving Woolwich for the north. I heard no more of himuntil he reached Newport, in Monmouthshire, where I visitedhim in May, 1843, and found he had been working the knap-sack on escort duties. He sent me his men’s reports, and atthe foot of this document is the following:—" I certify thateach individual named in the above return -has declared tome the comfort Mr. Berington’s knapsack has afforded, bythe relief it gives to the chest, and the trifling weight theyfeel by the manner in which it is placed on the shoulders.-*-JoiaN FOSTER, M.D., Surgeon 73rd Regiment." The numberof men in the above return is about forty, and day’s escorts179. Surely this, with the reports from the 2nd battalion ofScots Fusilier Guards, ought to command attention.On Colonel Love reporting to the Horse Guards, I had an

interview there with Sir John Macdonald, adjutant-general,when he informed me that Colonel Love had written to him,to Major-General Brown, and even to Lord Fitzroy, in favourof my, knapsack; and that he considered Colonel Love’sopinion of soldiers’ equipment one of the first opinions intheservice.

I should weary readers with a detail of all that passed atthis and succeeding interviews; but I may remark, that whenSir John Macdonald expressed doubts whether I could patentmy invention, and I told him I had .already done so, he ex-claimed, " I am -- glad of it." On a subsequent occasion,Sir John remarked, that the principle was not new, and that hewould convince me of this,-producing, at the same time, aknapsack, which I found and stated to be my own, at whichhe manifested surprise. At this interview an unsuccessfulsearch was made for the reports from the Scots FusilierGuards,-except Colonel Aitcheson’s, they were nowhere to befound.At the time of my second interview with Sir John Macdonald,

to which I have last referred, Quartermaster-serjeant Miller,of the Scots Fusilier Guards, who had had charge of numeroustrials of my knapsack in that regiment, was sent for, at myrequest,-and I then left, in order that my presence should notbe any restraint upon what he might wish to say. SerjeantMiller afterwards informed me that he had been taken by SirJohn to Colonel Cochrane’s office, and asked if he knew any-thingof his men’s reports,as they could not be found. He stated Here I will state that Sir James Macgrigor, Director general of the

Medical Department of the Army, and Dr. Gordon, of that department, atthis time inspected my knapsack and its principles. The former desired meto apply to the adj utant-general, Sir John Macdonald, for an order for themto report, and that, too, in the presence of Lieut.-General Sir Lewis Grant,who highly approved of my invention. Dr. Gordon, being at the- office ofthe major-general, told him that Veterinary-Surgeon Berington’s knapsackwas " the only one he had ever seen fit to go to a man’s back." The major-general asked, "Then why don’t you report?" The doctor replied, "Doyou send’us the order, and you shall quickly have a repott."t A portion of the conversation that occurred may be interesting, and

show that some sinister influence had been at work. Sir John remarkedto Colonel Cochrane, " Why, colonel, Mr; Berington says that this is hisknapsack, the reports of which you are looking for; I did not see it at thetime." The colonel replied, " You did not, Sir; Sir John Gardiner had it."" Then did Lord Hill ever see it?" I asked Sir John to take the opinion ofa medical board as to the constitutional relief given by my principle ofcarriage ; to which he replied, " What do we want with their opinion? aman must be blind that cannot see what it is."Some misapprehension existed then as to the probable cost of my knap-

sack, (and was at a subsequent period entertained by Mr. Fox Maule, andexpressed by him in the House of Commons.) Major-general Brown,deputy adjutant-general in 1842, estimated the price at thirty-six shillings !Quartermaster-serjeant Miller, who had had charge of numerous trials ofmy knapsack, told Sir John Macdonald, at the time of the second interviewabove alluded to, that from a pound to a guinea would be the cost, and.. that one of mine was worth two of the present knapsacks, as an articleof service to the men." I never sent in any estimate of the cost.

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to the colonel that lie did, for he wrote them out, and if hehad time to reflect, he thought he could recollect very nearlywhat each man said, in his own words. He then gave thecolonel what he could call to mind at the moment, whenColonel Aitcheson’s report was handed to him. Having readthis, he remarked to Colonel Cochrane, " Oh, Sir, the colonel(Aitcheson) has made a mistake, for I fitted the knapsack toevery man of them, and no man ever said it hurt him over theshoulders; and as to there being no provision for a mess-tin,Mr. Berington told me he drew the colonel’s attention to theomission at his first interview." Colonel Cochrane then said,I Serjeant Miller, if your memory serves you correctly, I can-not conceive any colonel in the service making out such a re-port, with the men’s report staring him in the face." Thereport certainly required the " confidential" mantle. A cer-tain captain of the Rifles was present, and found fault with mygear, saying it would come in the way of the men’s arms; whenMiller told him he was finding fault with a leading feature ofthe principle, and that so far from it, Corporal Bartlette swamthe Serpentine with it to prove the liberty of arms. Sir Johnhaving said they must show the knapsack to the Duke ofWellington, I waited patiently for twelve months withouttroubling them with another line of application on the subject.

Major-general Brown had remarked to Colonel Cockburn,in 1842, "We shall not be right until we have done away withthe cross belts; they are so oppressive to the men." I there-fore now gave my attention to this; and having constructed agirdle and pouch, with that view, I wrote to Sir John Mac-donald, in the year 1843, for an interview to show them, whenI got for answer "that competent judges had decided thediagonal belts(cross belts) far preferable to anything round theman’s body." Then how did these wise men intend to carrythe pouch and bayonet, if the cross belts were removed ? Butmark! they had put a straight belt round the body of the rifle-men, to carry the bayonet at the time; and Sir John told mein December last, that in the Duke of York’s time, a straightbelt was used round the body to steady the pouch, but discon-tinued from a Medical Report. Then why put a belt to carrythe bayonet ?-I must perforce conclude, therefore, that the"competent judges" were the medical officers; why,then,refuseme and the brave men their opinions of a medical boardrespecting the principles of my knapsack ? I have given thereply to my solicitation for an interview, but, strange to say, atthis very time an officer of the 73rd had a girdle and pouchfrom me, and on taking, them to the regiment, he got Dr.Foster, and several of the non-commissioned officers and mento try them. The following is the official report of Dr.Foster :-

Douglas, Isle of Man, June 28, 1845.

SIR,—I beg here to recal to your mind the circumstance ofthe statement I made to you while quartered at Newport,South Wales, relative to an improved knapsack, invented bya. Mr. Berington, which I still hold (physiologically and medi-cally speaking) is not to be equalled.

I again humbly bring under your notice an improved pouchand waist-belt, invented by the same gentleman. About thesecond of last month, when stationed at Kilkenny, the pouch &c.were shown to me by a Lieutenant Houghton, 73rd Regiment,and this officer placed it round my waist, and on several of themen also. We all found it very light, and not the slightestinconvenience to carry, after which I found it containedtwelve pounds of lead. On examining more minutely into theprinciple it was made on, I very readily saw the many greatadvantages it had over every other pouch, differing widelyfrom the Spanish and Portuguese-namely, in Mr. Berington’sbelt, it is made to rest on the brim of the pelvis, thereby avoid-ing all stricture on the abdomen and lumbar muscles, whichis the great objection to waist-belts, as they most necessarilyimpede action in the lower extremities, and consequentlyI’atlgue the soldier sooner, which is of course a great object tobe avoided. Mr. Berington’s belt fits exactly on the edge orbrim of the hip-bones, by a particular manner in which thebelt is made; but for a soldier to derive all its advantages thebelt must fit well. The sergeants and privates who carriedthe pouch at Kilkenny, guessed its weight to be from five toseven pounds, although it contained twelve.I trust, Sir, with your usual kindness, you will pardon the

liberty I take, in intruding my humble opinion on your timeand attention; but when I reflect on the great solicitude you:have at all times taken for the benefit and comfort of thesoldier under your command, I do with confidence hope youwill take this invention of Mr. Berington under your conside-ration, and have it, if possible, brought under the notice of His-Grace the Commander-in-Chief; and so persuaded am I of thebenefit it would afford to the health of the soldier, that if it

was referred to a medical board it must stand upon its ownmp.rit,q.___.._____

(Signed)To Colonel Love, C.B. & K.H.,Commanding". South Wales.*

JOHN FOSTER, M.D.,Surgeon to the 73rd Regt.

The sergeants and pnvateswho earned thepouch at Kilkenny,guessed its weight to be from five to seven pounds, althoughit contained twelve pounds. My girdle pouch, with sixtyrounds of ball, is about seven pounds and a quarter, all restingon the pelvis, hip-bones, and buttock, the strongest part of thebody, and it exercises no interference with the motion ofthe loins, and no stricture on the belly, not being a straightwaist-belt. The weight of the cross belts, with sixty round ofball, with pouch, is about eleven pounds five ounces. Thesebelts come over the shoulders, and the bayonet and pouch,‘with its sixty rounds of balls, are at their extreme ends, downat the buttock, so that the weight is, in truth, lying deadagainst the projecting chest of the wearers. The cross beltsnow in use are, as Major-Gen. Brown admits, most oppressive.Sir Harry Smith has told me, that in India, after a long, hotmarch, he has wrung the perspiration out from that part ofthese belts that rest against the chest. By my arrangement,the shoulders and chest are relieved of all the weight of belts,pouch, and ammunition. Now, Dr. Foster forwarded a report,through Colonel Love, of what took place at Kilkenny, withhis professional opinion of the merits of this arrangement ofmine, soliciting that it might be forwarded to the Horse-Guards, for the information of his Grace, the Commander-in-Chief ; but, strange to relate, the same was sent back to Dr.Foster, with an official letter, to say-" The pouch to whichDr. Foster alludes has not been produced at this office." (Why,I was refused an interview to show it on the 6th of March,1845 !) My principles of carriage of knapsack, pouch, andbayonet, are considered by men of science to be ingenious,andby all medical men their perfect adaptation to the constructionof the body, and the care taken to avoid obstruction to vitalorgans, are regarded as complete: and the members of theadjutant-general’s confidential board report mine " inferiorto that in use." This is rich in the extreme ! Why, the menlaugh outright at the idea of anything worse than their ownto work in. I have frequently put the following question tomen who have worked my knapsack-" Suppose you hadalways had my knapsack, (it was, in fact, the one in use,) andthe authorities wished to have something more airy in appear..ance, and I brought you the present one for trial, what wouldyou say, after ten miles’ march ?" "Why, that you weremad, Sir; and I don’t think the men would be got to take it,nor would it be wished." ,

On the receipt of the reply to my request to show my girdleand pouch, I wrote to Sir John, on the 9th of March, 1845, onthe subject of the knapsack, there being no mention of it, al-though I had waited twelve months, requesting of him to takethe opinion of a medical board. Indeed, I stated I could notresign medical opinion, both on his account, as well as myown, understanding that he had said, that his deputy wasmy only opponent, which I believed at the time. I gotfor answer-" the knapsack which has been fixed upon forthe army (a pattern of which is lodged in the office of Mili-tary Board) is found to answer every purpose in view, &c.Your knapsack, although ingeniously constructed in some re-spects, there are objections to its principles, &c.—19th March,1845." Here we have it, that the regulation-pattern lodgedat the Military Board answers every purpose in view; thenwhat is the meaning of Major-Gen. Brown’s knapsack beingissued, when the men of the 73rd Regiment told the major-general, his was the worst they ever met with; and why wasa knapsack sent for trial to the Ist Royals, at Manchester,with a straight belt round the body, condemned in the Duke ofYork’s time by medical report ? And why have they been,as I hear, sending everywhere for all the new inventions theycan hear of? I also hear that they have a sneaking kindnessfor one, and all this since Major-General Sir De Lacy Evansbrought the subject of ’(nine before Parliament; when Mr.Fox Maule, as an officer, said, " the present had been com-plained of as long as he could remember." In the followingsession of Parliament, Mr. Fox Maule, in reply to a questionfrom Mr. Wakley, said, that "the authorities acknowledgedthe present equipment to be oppressive, but that strenuousefforts would be made to relieve them." What! the patternone, found to answer every purpose in view," oppressive! /Has Sir De Lacy Evans made it oppressive, or have I, or has

* This report was forwarded by Colonel Love to the adjutant-general,and in place of laying it before his Grace, sent it back through that officerto Dr. Foster, and the original is now before me. What parental care forthe brave!

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Mr. Wakley ? I will answer for the latter. A coroner oughtscarcely wish to continue anything that destroys health andlife, and incur the moral guilt of manslaughter. Now, if thesufferers and medical men are right as to the baneful effectsof the present mode of applying the equipment, it would becurious to speculate to what amount the destruction of healthand life has been carried on within the nine years that theauthorities of the Adjutant-General’s Office have known ofthe true means of applying relief. Last session of Parliament,I presented a petition to the House of Commons, for a medicalboard to report on my equipment. I was fortunately intro-duced to Mr. Fox nlaule, who not only kindly inspected myequipment, but saw a sergeant go through that most laboriousprocess, the bayonet exercise," with each knapsack alter-nately ; and as a proof of his (Mr. F. Maule’s) conviction andanxiety to serve and relieve the brave men, he obtained apromise from the adjutant-general, that my knapsack, withothers, should be tried in three regiments, and desired me toget equipments for a dozen men, and to take one to the

adjutant-general at once. I did so, was received with greatcourtesy, and told, " You shall have fair play and justice doneyou" ! !-an exclamation plainly conveying to me that I hadnot hitherto received it. Whether I did receive it remains tobe told. ,

I shall close this portion of my narrative with the intro-duction of some amongst the testimonials which I have re-ceived from army and other medical practitioners in favourof my equipment: -

Langham-place, July 7, 1845.DEAR SIR,—I have examined the construction of your

knapsack with great care and satisfaction, and have no liesita-tion in assuring you, that I consider it is in every respectsuperior to that in common use. There can be no doubt,that when the weight is referred to the shoulders, and thepressure removed from the axillae, as is the object and effectof your invention, the soldier can not only carry a largerweight, but for a longer time, than when disposed as in theknapsack now employed. His arms,moreover, are unfetteredin quick evolutions, and especially in the motions inseparablefrom loading and firing his piece. The girdle is equally in-genious, and deserves notice.-I remain, dear sir, yours mostrespectfully, E. W. DUFFIN, M.D.

Woolwich, July Ig, 1842.

SIR,—In compliance with your directions some days since,to examine and report upon a knapsack invented by a Mr.Berington, I beg leave to inform you I have done, and withthe greatest satisfaction.

I also consulted three of the oldest medical officers of theOrdnance, named in the margin, (1-Ir. Thomas, Dr. Verling,and Mr. Chisholm,) with several others of junior rank, all ofwhom expressed their highest approbation of the invention,and in a medical point of view.From long experience of the diseases of soldiers, none are

so frequent or fatal as those of the chest, and I am fully per- I,suaded a great deal may be attributed to the manner in whichthe present knapsack is carried. ’

How often have I been obliged, in my medical capacity, to ’,relieve the soldier from this necessary evil, not from its

weight, but from the drag on the shoulders, and the strictureapplied across the ribs; add to this the weight of the crossbelts ! We frequently see it a cause for a permanent develop-ment, where the slightest disposition to disease of the heartand lungs exist in the constitution. I beg to recal to yourmind the number of men we lost at Montreal from chestaffections, when the excitement was passed, and the men gotquietly settled in quarters.

I do not mean to say that the knapsack &c. was the proxi:mate cause, but I do believe, in many instances, it was theremote and exciting one. I have seen the present knapsackmost injurious to men on home service, and doubly so onforeign and active service..... Now, Sir, the foregoing mostserious objections are, in my humble opinion, entirely re-moved by the new knapsack invented by Mr. Berington: withthis the soldier has the complete use of his arms, the lungsperfectly free, no unnecessary pressure on the ribs or breast-bone, and the whole weight of the pack falling on the per-pendicular axis of the body, bringing it immediately to bearon the arch of the foot, its proper place. The soldier is re-lieved from all the harassing inconvenience of the old knap-sack. Besides, Sir, your better judgment will at once see thegreat advantage accruing to the soldier and the service, fromthe great facility in which the man himself is able to removethe weight without any assistance, and replace it with thesame ease. ’

In conclusion, knowing your anxiety at all times to be afriend to the soldier in every way possible, I need hardlyurge you to use your influence for the adaptation of this newinvention, as I am thoroughly persuaded you cannot bestow agreater boon to the soldier under arms-only take his ownopinion, and he is by no means a bad judge.

I have the honour to be, Sir,Your obedient, humble servant.

JOHN FOSTER, M.D.,Surgeon 73rd regiment.

To Colonel Love, C.B. & K.H.,Commanding 73rd regiment.

E. W. DUFFIN, M.D.

J. T. CONQUEST, M.D. & F.L.S.

Finsbury-squa,e, London, July, 1345.Mr. Berington having shown me his improved knapsack

after a careful examination of the principles on which it isconstructed, I have no hesitation in certifying that it is ad-

mirably adapted to secure ease and comfort, and cannot f’ailto conduce to the prolongation of the life of the wearer, inas-much as it is free from all those objections which apply to the

injurious to the soldier.Hoxton, Sept. 15, 1846.

SIR,—I have carefully examined the knapsack and girdlewhich you have submitted for my inspection, and I was verymuch pleased to observe the manner in which you have placedthe weight,-as, upon your principle, you have relieved thechest, clavicle, and axillæ from that pressure which is so in-jurious to it, from the manner in which the weight of the oldknapsack is suspended, which must be acknowledged by allmedical men to be highly calculated to produce contraction ofthe chest, and tend to aggravate pulmonary diseases, shouldany exist in the individual carrying it.With reference to the girdle, I was much pleased at the

scientific manner of its construction, by which you have madethe weight to rest on the brim of the pelvis, consequentlyavoiding that pressure on the abdominal and lumbar muscleswhich is so objectionable in the. common waist-belt, as maybe seen in the usual policeman’s belt, as worn with the capeattached.Now, the superiority of your girdle over the cross belts at

present in use must be obvious, as from the bayonet and pouchattached to the cross belts having so long a bearing from theshoulders, the weight is necessarily very much increased, andby its position is thrown upon the chest, where it must be felta dead weight to the wearer.

T ramain Sir vniir Obedient servant

CHARLES PARKER, Surgeon.

I give the following as a further proof of the liberty of

arms to the wearer of my knapsack:-Rose and Bell Inn, Bankside, Southwark,January 27, 1841.

MR. BERINGTON : SIR,—In answer to your letter of the 25thinst., in which you ask whether I had any conversation withthe late S. Scott, the American diver, as regards the merit ofyour invention of the buoyant knapsack, I beg to state that Iaccompanied him upon the Thames, for the purpose of makinga trial of it, and that he plunged into the river with it on.The result was a firm conviction upon his mind, that a personhaving one of them on would certainly float upon the waterwith a kit in his knapsack of fifty pounds weight.He frequently expressed to me that he considered it a

clever, meritorious invention; and that he was quite convincedno person could sink with it on, even if he had never beenin the water before. I have pleasure in adding my testimonyto that belief: and am. Sir. vour most obedient servant.

Newport, Monmouth, June 18, 1843.In 1843, Colonel Love, 73rd Regiment, forwarded to me a

return of the number of men (nearly forty) of his regimentwho had carried my knapsack on escort, 179 days; and at thefoot of that return is the following:-

I certify that each individual named in the above returnhas declared to me the comfort Mr. Berington’s knapsack hasafforded to them, by the relief it gives to the chest, and thetriilinsr weight thev feel. bv the manner in which it is nlacedon the shoulders.

P.S.-Sergeant Thompson has the other knapsack still inpossession, and has had several long days’ marches, on thesame route, and an extra kit. He informs me he carried itwith great ease, and would not have attempted to carry thoseextras, if he had been using the regulation knapsack; in fact,

in avf?rv

WILLIAM SPARKS.

JOHN FOSTER, M.D.,Surgeon 73rd Regiment.

A. BROWN,Sergeant-Major 73rd Regt.

506

The whole of the foregoing, and more, was laid before theconfidential committee, by me, J. B.

I have had opportunities of practically examining the mili-tary knapsack and double circular angular girdle invented byMr. Berington.

It is strange, and here deserves particular remark, that theequipment hitherto furnished to the soldier for the carriage ofhis kit and ammunition has been invariably constructed onmost faulty and unscientific principles. The knapsack at pre-sent in use, instead of being borne by the shoulders, where itsweight would be less felt than elsewhere, is hung to the back,thus necessitating the wearer to assume a stooping posture,which greatly distresses his frame when prolonged throughouta day’s march. In addition, the straps, of which the ordinaryknapsack is fastened to the body, are brought in a very inju-dicious manner, around the front of the shoulder-joints, wherethey pinion the arms, and press upon important bloodvesselsand nerves. The cartouche-box, as at present placed, is eithersuspended with cross belts,-which by their weight and pres.sure on the chest greatly impede respiration and provokelung-disease,-or else it is attached to a belt which passesaround the loins and abdomen, above the hips, equally inter-fering with proper respiration, provoking (when the cartouche-box is loaded) an oppressive dragging to one side of the body,and certainly calculated to induce visceral disease.From all the above objections, my personal experience

enables me to state that Mr. Berington’s inventions are free.His knapsack rests fairly on the shoulders, immediately oveithe centre of gravity in the body, and supported by bony struc-tures, which bear its weight, when fitted, with so much easethat no pressure exerted by it can deflect the wearer from theerect position. The "arms" by which it is fixed on the chestpass over that part of the thorax which is the most archedand the best able to suffer their pressure; the cross straps infront, which keep these " arms" in their place are raised fromthe chest, so as to obviate any interference with respiration;and the side straps, which maintain the equilibrium of theweight, and make the whole firm on the body, pass directly-from the corners of the knapsack to their destination, leavingthe wearer free to perform unrestricted motions of the armsor trunk.The cross-belts are entirely discarded by Mr. Berington,

who supports the cartouche-box, with its ammunition &c., on

the sacrum and hip-bones,-the strongest bony structures inthe body,-by means of an angular girdle, devised with greatingenuity, and which, while it is incapable of acting injuriously,admits of the shifting of the cartouche-box to either side withgreat ease, and a support instead of a burden to the wearer.

That the soldier’s equipment exercises a material influenceon his health and efficiency does not admit of a doubt. M.Lebeau, physician to the King of the Belgians, and physician-in-chief to the Military Hospital of Brussels,in the preface tohis translation of my work on the Nature and Treatment ofPulmonary Consumption," makes the following statement :-"Placed, for more than the last five years, at the head of alarge military hospital, I have often felt surprised at thenumber of young soldiers who die of pulmonary consumption.I can affirm that seven-tenths of the deaths which take placein that establishment result from that disease..... An at-tentive examination of all the circumstances which precedeand accompany the disease, and the appearances observed atpost-mortem examination, have proved to me, incontestably,that the compression which the weight of the kit (baggage)and arms exercises on the upper part of the thorax, contributegreatly to the production of phthisis in young soldiers."

I know also that a very large number of deaths occur in theBritish army from the same cause, and as I am equally coii-vinced, with M. Lebeau, that the compression on the chestexercised by the military equipment at present in use exertsa very fatal influence on the frame. I think that policy andeconomy, as well as humanity, ought to cause the generaladoption, in our armed force, of the improved knapsack andgirdle invented bv Mr. Berington.

FRANCIS-HOPKINS RAMADGE, M.D.Fellow of the College of Physicians, London,

and late Senior Physician to the RoyalInfirmary for Asthma, Consumption, andother Diseases of the Lungs.

(To be continued.)London, 1847.

MEDICAL APPOINTMENTS.—Royal South Battalion of Glou-cester Light Infantry Regiment of Militia, Assistant-SurgeonG. Tate to be surgeon, vice Witton, resigned. W. P. Brookes,M.D., to be lieutenant and assist.-surg., vice Tate, promoted.

ON THE NECK AS A MEDICAL REGION; ONSYNCOPAL SEIZURES ; ETC.

By MARSHALL HALL, M.D., F.R.S., &c.

(FOURTH SERIES.)I TRUST the time will arrive when a minute knowledge ofanatomy and physiology will be esteemed to be as essential tothe physician as to the surgeon, and that this view of the sub-ject will prevail, not in the profession only, but in the public.Then, and not till then, will the hydra-headed monster,quacliery, become extinct. And yet it does not appear to beexacting too much to require, that he who undertakes to repaira complicated machine should first become acquainted withits structure and springs of action, and the nature of its variedderangements.A useful work might be written on Medical Anatomy and

Physiology. I have ventured to offer specimens of such awork, in treating of the Neck as a medical region, and of thearrière circulation. In the present paper I propose to addanother topic to those already mentioned, in noticing brieflythe effect of conditions within the cranium and spinal canal ininducing shock of the medulla oblongata, and of this on theheart and stomach.

It will be observed, that all the kinds of seizure to which Ihave adverted, are spinal in their origin-emotion and causesof reflex action acting variously on this centre of the nervoussystem-whatever their forms, and whether these be cerebralor spinal, or, as I now proceed to describe them, cardiac or sto-machic.For the seizure is not always one affecting the intellect, or

the muscular system; sometimes, on the contrary, there arepallor and faintishness, if not actual syncope, and nausea, ifnot vomiting.

This form of seizure-I purposely avoid the term epilepsy-arises from the same causes as the others to which I have ad-verted. They belong to a Class of affections, which, how-ever various and varied in other respects, combine the symp-toms of faintness or sickishness. A fall, or blow on the head;an apoplectic seizure; hydrencephalus; loss of blood; disgust,fear, and other forms of emotion, and sea-sickness, are of thiskind.A fall or blow on the head may be regarded as likely to be

more or less serious in its ulterior effects, according as it is oris not followed by pallor and sickness. The apoplectic seizureis frequently marked by pallor and vomiting; a frequent,sometimes the only, symptom of incipient hydrencephalus, isvomiting. Every one knows the effect of certain emotions inblanching the cheeks, and inducing nausea; the effects of lossof blood and of posture during bloodletting or haemorrhage;the phenomena of sea-sickness: in all these cases it is proba-ble that the medulla oblongata is the precise part of the ner-vous centres specially affected. It is on this part that theblow, or contre-coup in the case of accident, that certain emo-tions, that the diminished pressure of the column of spinalblood in bloodletting in the erect position, and that the variedpressure of that column on the sea, have their chief influence.

I have suggested the anatomy of the veins and muscles ofthe neck as an important subject of inquiry to the physician.I would now suggest a careful examination of the veins withinthe spinal canal and cranium, as presenting another topic inmedical anatomy of great interest. Again, I would expressmy hope, that medicine, like surgery, will one day be basedon the sciences of anatomy and physiology, to the exclusionof ignorance and empiricism together. It was written on theportal of the school of PLATO: O&ngr;&dgr;∈&sfgr; &agr;&ggr;∈&ohgr;µ∈&tgr;&eegr;&tgr;o &sfgr; ∈&sgr;∈&tgr;&ohgr;.Is it too much to ask of the legislature to enact that no oneignorant of anatomy and physiology shall prescribe or ad-minister medicine,and cause the words O&ngr;&dgr;∈&sfgr; A&PHgr;&Ugr;&Sgr;IOO&Sgr;∈&sgr;&tgr;&ohgr; to be inscribed over our Medical Colleges ? Anatomy,physiology, DIAGNOSIS, pathology, (that is, living pathology,)therapeutics, (or the modus operandi of medicine,)-such are-the steps to be taken by the scientific physician in his visitsto his patients. In the absence of any part of this knowledge,he may descend to what is termed experience or experiment.He must descend low, indeed, if he would place himself ona level with public expectation and opinion. Men in generalhave no higher ideas of medicine than those of a remedy, orof a collection of remedies, for a disease or diseases. Ofpathology and of therapeutics, of the nature of morbid ac-tions and of the actions of remedies, and so of the Scienceand rational treatment of disease, no adequate idea existsin the public mind. But I proceed with my subject.

We do not find the most violent voluntary efforts to affect