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symptoms was vague enough to escape all but acute obser- Ivation; the organ at fault was one the use of which physio-logists were perfectly ignorant of, and which was almost loverlooked by pathologists; the disease is rare ; and, whenit does occur, is frequently complicated with other grave dis-ease which might be thought sufficient to explain the symp-toms : all these circumstances made the discovery difficult,and now make it creditable.

Dr. Greenhow’s present work includes a tabular list andoutline of every authenticated and well-identified case of

supra-renal disease which has been published either by Englishor foreign observers, and must long continue to be the mostvaluable and complete reference on the subject. The numberof such cases in the list is 128. Dr. Greenhow greatly fortifiesthe argument for the reality of Addison’s disease by statingclearlv in two clinical lectures the combination of symptomswhich is to be considered diagnostic, and by closely examiningthe spurious cases which have been published, and showingconvincingly in what they differed from the true cases. Ten

cases are given in the Report-which, we may remark by theway, is reprinted from the Transactions of the PathologicalSociety,-in which there was bronzed skin without disease ofthe supra-renal capsules. In nine of these there was an absenceof the constitutional symptoms which are as characteristic,and were by Dr. Addison regarded as characteristic, as the dis-coloration itself. These symptoms, indeed, are so peculiarthat Dr. Greenhow has twice diagnosed the disease inde-

pendently of the discoloration, which was either absent or soslight as not to be seen till specially searched for, and afterdiagnosis.

Though we must accept Dr. Greenhow’s book as establish-ing-if it were not established before-the reality of Addison’sdisease, it is clear that we are still very ignorant of the supra-renal capsules and of their uses. It looked as if the destruc-tion of them in Addison’s disease was to teach us theirfunction. But we are about as ignorant as ever on this

point. Dr. Greenhow shows that they may be affected withcancerous disease in cases which do not present the charac-teristic discoloration and symptoms. This is probably due tothe circumstance that cancer and most other lesions which do ’,not produce Addison’s disease are not so destructive of thewhole tissue of both organs as is the tubercular or the quasi-tubercular lesion which is found in the best marked cases,Dr. Greenhow regards this as of the nature of inflammationextending from neighbouring parts, injured or diseased, inpersons of tubercular diathesis.

It only remains for us to commend this book as the mostexhaustive record of our present information on the subject.What remains now to be done is to come to some clearer

conceptions of the nature of the supra-renal capsules andof their uses. Dr. Greenhow and others have establishedthe fact of Addison’s disease. Who will give us the truetheory of it : "

THE VENEREAL COMMITTEE OF THEHARVEIAN SOCIETY.

THE Committee held its third meeting on Thursday, May9th; Dr. Pollock in the chair. Several returns of the num-ber of cases of disease daily under treatment were received.The most complete return showing the prevalence of venerealaffections is that furnished by Dr. Steele, of Guy’s Hospital,where about 60,000 out-patients are attended each year. Ofthese about 36,000 are surgical and 14,000 medical; of the

former, 24,000, or about two-thirds of the total cases, are ve-nereal ; the proportion amongst the latter is about five per cent.About 700 new cases of skin diseases are seen every year, andfour-fifths are stated to be venereal. About 43 per cent. of allcases treated are set down as venereal. In the FarringdonGeneral Dispensary the proportion is about one-eighth of the

surgical cases, and at the ’V olverhampton General Dispensaryabout one-sixth, where there are 10 out-patients and 1 in-

patient a day. At University College, where venereal cases arenot supposed to be admitted, their ratio to surgical cases is1 to 3 ; at St. Mary’s Hospital, 1 to 5, where the average dailyattendance consists of 8 syphilitic and 6 venereal patients (nobeds are set apart for venereal diseases.) The Chatham Hos-

pital report states that no male cases are admitted; 27 percent. of the out-patients have venereal diseases; the totalnumber of fresh entries for the quarter ending March, 1866,was, for all cases, 527, of which 133 were surgical and 35venereal ; forty beds are set apart for females to be treatedunder the Contagious Diseases Act. At the West LondonHospital there is a daily attendance of about 5 males and 3females affected with venereal diseases, which form about one-eighth of the total surgical cases. The secretaries reportedthat they had received communications from Southampton,Manchester, and Salisbury acknowledging the readiness of themedical societies in those towns to promote the objects of theCommittee, and to obtain statistical information relative to theprevalence of syphilitic disease in the places named. A com-mittee of the Medical Society of Suuthampton has already beenformed for the purpose. It seems to be a general impressionthat venereal diseases are treated to a very large extent bychemists throughout the country. A report was received fromthe Middlesex Hospital to the effect that the daily number ofcases in attendance there could not be ascertained without greatlabour, and that no information could be given to the Committee;there are eleven beds set apart for the treatment of venerealcases. As far as the reports go at present, it would seem that theprevalence of syphilis and gonorrhoea, is much more extensivethan one would have been inclined to believe.

Mr. Acton called in question the suggestions already made bythe Committee as to legislation. He was inclined to think thatthe so-called religious party was only looking out for a case inwhich interference with the liberty of the subject could be provedto raise an outcry against any forced procedures, and he pointedout certain objections that might arise from them.Mr. James Lane explained that the good results already

obtained by the operation of the Contagious Diseases Actformed the basis of the present suggestions, and no one hadas yet offered any objection to the regulations enforced in gar-rison towns; in fact, it was their success beyond all expecta-tion that had led the Committee to propose the same kind ofmeasure to the entire population, though he admitted that theresult would not be so marked, perhaps, as in the case of gar.rison towns.A good deal of discussion then took place as to the facilities

given to the admission of diseased women into hospitals ingeneral; Dr. Beigel and others arguing that every institutiondevoted to the treatment of disease should offer increased facilities for the admission of venereal cases. A resolution to this

effect was proposed by Dr. Drysdale and seconded by Mr.Teevan; but it was subsequently withdrawn, as the Commit-tee considered that a former resolution embraced this parti-cular question.Mr. Gascoyen suggested that the Committee would do well

to agitate, as there are to be changes in workhouse infirmaries,for some special provision for venereal cases.

During the criticism of the resolution referred to, Dr. Steelealluded to the prejudice of the public, who consider that theadmission of venereal cases is an encouragement of vice, andthat many persons might feel disposed to withhold their sup-port from hospitals should it be carried into effect. Dr. Sedg-wick pointed out that prostitutes, when diseased, often becamepaupers, and that it would be desirable that somespecial returnsshould be obtained from the workhouse infirmaries, &c., wherethe women were often neglected, and the guardians of whichmade every possible attempt at the exclusion of venereal dis-eases. One result of the studied non-admission of these casesin workhouses and hospitals, was a greater demand made uponother institutions that made no such exception.

It will be observed that the Committee wish to avoid thequestion of prostitution as much as possible, and are anxiousto deal with venereal disease from a strictly medical pointof view, to devise measures whereby it shall be speedily de-tected, its spread checked, and its cure effected. The firstobject is to ascertain the extent of the evil itself ; and as an es-sential feature in the preventive scheme is the provision of £increased hospital accommodation, the mode in which this isto be obtained will come under discussion probably at the nextmeeting.