KEYIEWS. 
409 
tinction, but should be familiar with the means of preventing the develop- 
ment of such maladies. To educate the people on these points has been 
Dr. Anstie’s aim, and we must say that he has discharged his task with 
-clearness and ability. Such diseases as typhus and typhoid fever, epidemic 
diarrhoea, scarlet fever, measles, diphtheria, small-pox, whooping-cough, and 
influenza, are unhappily too well known to dwellers in cities, as Dr. Anstie’s 
statistics fully prove. Let us take London alone as a sad example of the 
ravages of epidemic disease. In the thirteen years, from 1852 to 1864 in- 
clusive, the deaths from zymotic (epidemic) diseases numbered 218,998 — 
nearly quarter of a million — of these 41,664 were caused by scarlet fever 
and diphtheria, 18,256 by measles, 26,892 by whooping-cough, 13,160 by 
cholera, 29,995 by diarrhoea, 31,937 by typhus, and only 1,168 by influenza.” 
There is a bill of mortality which we paid for our neglect of hygiene, our 
parsimony in water and our disregard of cleanliness. Let those who would 
banish these terrible records from our Degistrar-General’s returns read Dr. 
Anstie’s book, and see how, by the adoption of the rules of preventive 
medicine, this black list may be erased from our public statistics. The 
author of the work does not address himself to the subject of domestic 
medicine” or domestic druggery ” as it should be styled. He tells his 
readers how they may detect the affection, and then he cautions them to 
lose no time in placing the patient in the care of his medical attendant. 
There is one point to which Dr. Anstie calls attention, and which has much 
scientific interest attaching to it. It is the application of the thermometer 
to the detection of the febrile diseases (maladies which include nearly all 
the epidemics). It is a most remarkable fact, that as a fever settles itself 
upon the system, and while the patient is complaining of cold and shivering, 
the blood is absolutely many degrees higher than the ordinary standard of 
93^ Faht. The thermometer may therefore prove an invaluable instrument 
in the hands of an anxious and careful mother who fancies her child ^^has 
caught a mere cold,” but feels much anxiety as to the possibility of febrile 
symptoms setting in. Of course other general indications of disease must 
not be neglected. Nor does it follow that high temperature necessarily in- 
dicates fever. But for all practical purposes the thermometer may be 
readily emploj^ed by a nurse or mother, and cannot fail to give warning of 
the very utmost import. The healthy temperature may be reckoned at 
from 98° to 99° Faht., and any elevation above this indicates serious mis- 
chief. If the thermometer, for instance, rises as high as 101°, the degree 
cf fever may be known to be severe. When the temperature exceeds 105° 
the complaint is dangerous to life On the contrary, if during 
the first two or three da3^s of illness the temperature never rises above 100^ 
the complaint is probably a trivial one, whatever its exact nature may be.” 
As to the instrument and the mode of using it, the following intelligible 
instructions are given : — The self-registering maximum thermometer is the 
most convenient for the use of non-professional persons who are not accus- 
tomed to the daily employment of the instrument. No observation should 
be made till the patient has been resting quietly in bed for at least an hour. 
The bulb of the thermometer should then be placed deeply in the arm-pit, 
the arm being folded across the chest, and the bed-clothes so arranged to 
cover the projecting stem as high as the marking 90° or thereabouts. The 
YOL. YII. NO. XXIX. F F 
