[1] A plan established in the army proved so useful, that I will here mention it. The letters and reports of the medical gentlemen in the pest-houses, I constantly sewed together, made them up in monthly volumes, and kept them at my quarters, where every medical gentleman in the army was invited to come and daily peruse them. The disease became thus the subject of daily discussion; and, from these discussions, I was enabled daily to propose queries in my letters to the gentlemen in the pest-houses. Thus, the history of the disease, in most of its points, came to be investigated; and, previously to entering a pest-house, before his tour of duty came round, every gentleman had acquired some knowledge of the plague, and of the success of other practitioners.

[2] These circumstances I learned from a member of the French Institute, and from the Pharmacien en ChÉf to the French army, who often related to me the order which Bonaparte gave him to poison the wounded with opium.

[3] In Dr Duncan’s Annals of Medicine, for 1801, I have adduced a striking instance of this.

[4] Dr Buchan was on the staff of the British army, but twice nobly volunteered his services, and twice did duty in the lazaretto of Alexandria, at this period common both to the English and Indian armies.

[5] This remark we found to be particularly applicable to the last stages of the disease. In the beginning of the season, one case occurred that gave rise to much conversation in the army. From having come into contact with a case of plague, a Lascar, in the department of the commissary of cattle, was sent into the observation-room of the pest-house of Rosetta; he was brought there much against his will, and contrived to make his escape from it, on the evening of the day on which he was admitted, though fired at by the dragoon-centries placed round the establishment. Ineffectual search was made for him every where in the neighbourhood of Rosetta, and we could hear nothing of him for about five weeks, when he was discovered at Boulac. On being brought down to Rosetta, I examined him with Mr Guild, the surgeon of his corps. We found him then well; but certainly he had had the disease, for we saw an axillary bubo not quite healed. He told us, that he remained concealed for a great part of the time among the rushes by the side of the river. On mentioning this case to Dr Currie, of Liverpool, I think he said, he had heard of some similar cases.

[6] Since my arrival in England I see that the contagious nature of the Egyptian ophthalmia has been noticed by two gentlemen of the English army, Mr Edmonstone and Mr Powers.

[7] Though this practice is now followed by many gentlemen in India, yet I believe that it has been carried to a greater extent by Messrs Dean and Bellars, of the 86th regiment, than by any other practitioners. These gentlemen have recorded several hundreds of cases of dysentery treated solely by nitric mixture and bath.

[8] In Egypt we gave trial to a mode of treatment which was strongly recommended to me by Dr Whyte. It was the application of flannel bandages over the whole abdomen. In chronic cases, and in convalescents, it appeared to be of the greatest service; and, in recent cases, when the appropriate remedies were used at the same time, it appeared to shorten the cure. I have seen it tried alone but in a few cases of this disease. From the result of these, however, in cases of either the European or tropical dysentery, I would not venture to rely on it alone for a cure.

Before leaving the subject of dysentery I may mention, that, in India, I have met with some cases of a very violent dysentery which ran its course in three, four, or five days. In this disease the usual practice did not succeed. The best treatment appeared to be, after a dose of castor oil, to give opium liberally by the mouth, and by clyster; and to make the patient drink very freely of gum arabic at the same time. In some of these cases I have likewise given diluted nitric-acid. A constriction of the vessels discharging mucus was in this way effected; the incessant discharge was stopped, and time given for a secretion of mucus to cover the abraded gut. I have thus sometimes succeeded in checking a most violent disease. Thereafter, the mouth could be gradually and gently affected by mercury, or by nitric-acid.

On opening the bodies of those who died of the tropical dysentery, in Egypt as in India, we almost constantly found the liver diseased. In old cases, we likewise most commonly found ulceration of the great intestines, and very frequently within the reach of enemata. In the composition of these, a variety of articles were used: most frequently, I think, solutions of sugar of lead, or vitriolated zinc, gave greatest relief; and we sometimes found that gum arabic, milk, and broths, gave relief, when many other things had failed.

[9] It was soon afterwards introduced to India, by the exertions of the Medical Board at Bombay; and the world has had a full account of its introduction and success from my friend Dr Keir, who had the charge of the institution for disseminating the vaccine disease, from Bombay through India.

[10] Vide Appendix.