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formation of an efficient hospital corps, our soldiers willhave the best chance that can be given them of recoverywhen prostrated by fever.

Dr. Marston calls attention to the " increased proclivity ofthe meat-eating and spirit-drinking races to enteric fever,"and gives some details respecting the diet of the soldier inIndia, and the want of sufficient exercise to counteract itseffects. He concludes that "it would be most undesirable,as well as wrong perhaps, to make him conform to the habitsof the native, or deprive him of meat and alcohol; but thatis no reason why some attempt in this direction should notbe made at the advent of the hot season by curtailing hispowers to eat and drink-especially drink-too much. Somemen are tempted to drink beer or rum to secure sound sleep-difficult enough in a barrack room in the hot weather,when tormented with flies, mosquitoes, and possibly bugs.At such seasons it is very questionable whether thesoldier’s health would not be improved, too, by hisremaining longer in bed in the morning, when sleep is morepracticable, than by attending unreasonably early parades."The paper is followed by carefully drawn up "remarks on

the diagnosis and treatment of enteric fever," which welldeserve the thoughtful study of the medical officer. Wecaùnot enter into any detail on these remarks, but we maybriefly notice one or two of Dr. Marston’s conclusions. And,first, as to the occurrence of enteric fever in India, he re-marks " whatever be the causes, there can be no doubt asto its nature. Enteric fever in India is, both in its clinicalphenomena, when taken as a whole, and in its post-mortemappearances, perfectly identical with what is elsewhere z,known as enteric fever.... In short, it conforms tothe description by which enteric fever is almost universallyrecognised." And again, he thus sums up his views on thesubject. "The point which it is desired to emphasise isthis-that one of the most common and fatal fevers in thiscountry is enteric fever; that it chiefly attacks soldiersduring their first years of Indian service; that it appears toprevail, though unequally, both in the plains and the hillsespecially during the hot and rainy season and that by itssymptoms during life, and by its pathological appearancesafter death, it can be recognised as genuine enteric or intes-tinal fever; and that where the period of observation issufficiently extended it can, in a large majority of cases, bediagnosed by the conformity of its symptoms as a whole tothe descriptions given of enteric fever elsewhere."The treatment of enteric fever is discussed under the

various heads of accommodation, nursing, diet, reduction oftemperature, regulation of the bowels, and the medicinesmost appropriate to the treatment of the various symptomswhich arise in the course of the disease. A caution is givenagainst the too early return to duty after an attack of entericfever, and the value of a sea voyage or hill climate in restor-ing the patient to excellent health is pointed out.We consider this paper to be a valuable addition to the

history of disease as it occurs among our fellow- countrymenin India. Although there are many points still to be clearedup with reference to enteric fever in that country, Dr.Marston has done good service in bringing to the notice ofthe Army Medical officers in a condensed form the informa-tion which already exists on the subject, and has thuscleared the way for further inquiry into the controvertedpoints connected with it. We trust that the example hehas thus set may not have been thrown away, and that inthe next annual report of the Surgeon-General we may havea continuation of these inquiries, conducted in the same spiritwhich has hitherto characterised his labours in this field.

THE BIRMINGHAM EYE HOSPITAL.

A SPECIAL meeting of the governors of this institution Iwas held on the 15th inst., for the purpose of considering thereport of the committee on the reconstruction of the hospital.The question at issue and the discussion to which it hasgiven rise are of more than local interest.Founded by the late Mr. Joseph Hodgson in 1823, and

celebrated as the field of the classic labours of Mr. RichardMiddlemore, the Birmingham Eye Hospital is only secondto Moorfields, for the extent of its beneficent operationsamongst similar institutions in the United Kingdom.Twenty years ago its patients (341 in, 3992 out) were somuch more numerous than could be accommodated in the

building then occupied, that the hospital was transferred toits present quarters, the old home of the Royal Hotel. Its981 square yards of freehold ground were purchased on veryadvantageous terms, through the instrumentality of thesenior surgeon, Mr. Edwin Chesshire; and it was found prac.ticable and profitable to devote 400 yards of the site to thepurposes of the hospital, and to let off the remainder, withgoodwill and licences, as a Royal Hotel within reduced limits.The reputation of the staff, the wise management of the

committee, and the rapid growth of Birmingham and itssurrounding district, concurred in producing the naturalresult. The patients steadily increased ; so much so thatthey have more than trebled since 1860. Structural altera.tions have been made from time to time to meet the growingrequirements ; but since old drains will leak and brick wallsare not elastic, the inevitable block has come at last. Themedical officer of health has pronounced against the hospitalbuilding in its present state, and no one seems bold enoughto defend it. On the necessity of a new hospital everyoneseems agreed, not so as to its site and size. If the 981 squareyards of freehold land belonging to the charity were de.voted to the purposes of a new hospital, the architects wouldhave an easy task ; all present requirements could be ful.filled, with reserve space for years to come. But thehotel licence is so valuable, that it has been proposedto reconstruct the hospital on the 400 yards whichit now covers, and gain additional cubic space bymaking the wards and corridors more lofty, and addingtwo new storeys. This plan has commended itself to Mr.Vose Solomon, whose position would have entitled hisopinions to greater consideration from the governors if notopposed by his three colleagues, who are substantially of onemind. Mr. Chesshire is against building a hospital on asite not large enough for a good private residence. Only theother day he ordered the application of half-a-dozen leechesto one of his hospital patients, and erysipelas followed. Mr,H. Eales states that erysipelas is in the hospital at thepresent time, two patients suffering from it; while anotherof the surgeons (Mr. Lloyd Owen) urged " that the area onwhich it is proposed to reconstruct the hospital is totallyinsufficient for the needs of the institution."Yet stronger were the statements of Mr. J. D. Goodman,

a magistrate and one of the leading merchants of Birming.ham, who filled the office of chairman of the Committee ofthe Eye Hospital during many of its most prosperous years.We gather from a report of his speech in the BirminghamDaily Post that " in the old building there was no accom.modation for infectious cases. From time to time they hadsuffered from erysipelas, and even scarlet fever, in theinstitution, and it was most important that there should besome special ward for such cases. There was no such pro-vision made in the new plans. In the old building therewas no dead-house, and the practice had been to put thebodies of those who died in the operating room. Wouldthey believe it, that there was no remedy for this in theproposed new building ?

" Such a state of things, attestedon such authority, could not fail to produce a deep andserious impression on the governors, and the meetingadopted the prudent course of referring the whole matterback to the committee for reconsideration.Birmingham should have an eye hospital worthy of its

old repute, and equal to the wants of the community,according to the present high standard of sanitary andophthalmological science. The recent census has provedhow rapidly the Midland metropolis is growing, and itsmunicipality and people are showing themselves alive totheir honourable responsibilities by planning new streetsand erecting colleges, libraries, art galleries, and museums,on a truly imperial scale. The public interest, the calls ofhumanity and science, and the honour of the medical pro.fession, require that hospitals should not lag behind insupplying legitimate wants. After all, the difficulty ofthe Committee of the Birmingham Eye Hospital is anhonourable one. It has been brought about by thesuccess of their operations, and the repute of theirstaff. If they have now an unhealthy hospital they possessa splendid freehold site with valuable rights, and a goodlyreserve at their bankers. To spend eight or ten thousandpounds in a reconstruction, which would scarcely be equalto the wants of the next ten years, could not be calledeconomy, and it is to be hoped that, when they report tothe governors, the committee will be prepared with reconi-mendations worthy of the institution, and of the town onwhich it has conferred such signal benefits.