THE GREAT MILITARY HOSPITAL.

235

was proceeding when I arrived, and I am bound to say, that a cleaner, better regulated, and better conducted medical establishment I never visited. It is on the plan of most British hospitals -containing a long corridor with wards on one side; these, forty in number, are lofty and well ventilated, and are capable of containing 1200 patients. Besides these, there is a civil hospital in the city, which has accommodation for about three hundred persons.

The medical attendants were all Europeans, and consisted of the six professors of the school, and a distinguished German physician, Dr. Pruner, who had likewise the care of the civil hospital in the city. The number of patients labouring under diseases of the eye, and whom I was especially anxious to see, amounted to several hundreds, but the cases of acute ophthalmia in the hospital at that moment were but few. When this disease is prevalent in autumn, 700 cases are frequently in the house at once, and not less than 300 often present themselves in a morning.

Egyptian ophthalmia has attracted so much attention, and has become a subject of such general interest, that I may be excused a brief notice of what appeared to me to be some of the predisposing causes of this formidable malady. The affection appears to be decidedly epidemic, and occurs periodically during the season of the Khumáséen winds, and is particularly violent in autumn, after the fall of the Nile, and when many noxious exhalations rise, the effects of the late inundation. It varies in character every year, both as to violence and duration, and generally retains the type it commenced with throughout. This character the medical men study accurately, and on the greater or less intensity of the inflammation lies the line of treatment, such as general bleeding, leeching, &c.*

* As a predisposing cause, I conceive that a peculiarity of the natural formation of the eye in the lower orders, those who are most exposed, contributes in some measure to the susceptibility of this disease; the cilia, or eye-lashes, being poor, ill-set, and scanty, and the eye-brows very small, and particularly devoid of hair. Diseases of the lids and the other appendages of the organs of sight, such as trichiasis, or irregularity of the lashes; ectropium and entropium, a turning out or inwards of the hairs; and diseases of their roots, interfering with the natural secretion of the adjacent glands; together with tinea palpebrarum and psorophthalmia, ending in

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EGYPTIAN OPHTHALMIA.

By the Europeans in the country it is generally attributed to suppressed perspiration; but, why should not the inhabitants of other warm countries be subject to a similar disease, where the heat is much greater, and the same cause exists in equal force?

Bleeding is not generally resorted to, unless it assume a very inflammatory type. Locally, astringent lotions, such as nitrate of silver, styled by the natives "The Devil's Fire," sulphate of zinc, and the preparation of copper of the old pharmacopoeias, called the aqua sappharina, are applied.

The pharmaceutical department is under the care of the professor of that art, and the students of the college assist in turn to compound medicine, and become acquainted with the practical details of that most necessary branch of medical education. The pharmacy was on a scale of great magnificence; beautifully

lippitudo, is very frequent even among those who have never suffered from purulent or Egyptian ophthalmia-all these assist in keeping up a predisposition to inflammatory diseases of the eye; to which may be added, exposure to the rays of a powerful sun, without any kind of shade or defence, as the turboosh, or even the turban offers little or none; and the sand-drifts and hot winds at the season of the Khumáséen also act most deleteriously on the visual organs. We have also the undoubted epidemic nature of the disease, similar to that of the other mucous membranes; and lastly, extreme dirtiness. Little idea can be formed of this without seeing it; the eyes or the face are seldom washed; the natural discharge is allowed to accumulate, and often a number of flies will be found collected in the corners of the eyes, to remove which would be considered unlucky. I have invariably remarked, that in the Mooslim ablutions before prayer, although they wash the arms to the elbows, the feet, back of the neck, crown of the head, and behind the ears, they always avoid washing the eyes. I do not think that blackening the edges of the eye-lids at all contributes towards the production of ophthalmia; and females, who alone use it, are much less liable to it than men, even allowing for their comparative numbers, and the circumstances in which they are placed.

With regard to the exact nature or specific character of this disease, I must say, that at first it in no wise differed from severe conjunctivitis, or catarrhal ophthalmia, of Europe, or even this country, except in the exceeding violence of its attack, and the extreme rapidity of its course. As, however, the disease became purulent, the papillarkörper on the surface of the divesting membrane, so accurately described by Müller, Jäger, and Peringer, became developed almost in a few hours, and sudden destruction of the organ soon followed.

SCHOOL OF MEDICINE.

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clean, in comparison with such establishments in England, and had in it all the most valuable and approved medicines, many of which were prepared in the laboratory by native hands.

I was next transferred to the care of Dr. Sicher, who conducted me through the college and school of medicine, which, as I before stated, forms a part of the building of the hospital, so that the student has but to cross the court from his dormitory to the ward, and can proceed from thence in a few minutes to the dissecting theatre, or the lecture-room; become acquainted with materia medica under the same roof in which he sleeps, and enjoy his morning's walk in the botanic garden beneath his window. Besides this, the students are all required to become acquainted with practical operative chemistry, and for that purpose are sent for a certain time to work at the chloride of lime and saltpetre manufactories. This system, added to that of the general medical education here given, is one well worthy of imitation in Great Britain, and reflects no small credit on its founder, Clot Bey.

At the date of my visit, there were three hundred students in the college, who were fed, clothed, educated, and paid by the Básha. The dormitories and other apartments of these young men were clean and airy, and they themselves appeared orderly and attentive. They all wore a uniform; were regularly drilled as soldiers; and rose in rank and pay according to proficiency. The pay varies from twenty to fifty piasters a month, and they are allowed to walk beyond the college once a week, on Friday, the Mohammadan sabbath. The nominal duration of study is five years; but the greater number of the pupils are drafted off into the army or navy after three years; some few remain as long as

seven.

The school of medicine consists of seven professorships, viz.— anatomy and physiology, surgery, pathology and internal clinique, medicine and chemistry, botany and materia medica, and pharmacy. Instruction is given by means of an Arab interpreter, or dragoman; the professor writes his lecture, and it is translated to the class in his presence by the interpreter. The majority of the professors are French, and their salary is somewhat more than £200 a year. They are all obliged to wear the Egyptian uniform, and shave the head, but no sacrifice of religion or principle is demanded; and, I need hardly remark, that

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ANATOMICAL MUSEUM.

all European Christians are under the protection of their respective flags, and should they be convicted of any misdemeanour, they must be handed over to their consuls.

The laboratory contained a good chemical apparatus, and the dissecting-room several subjects. This latter indispensable requisite to medical education, it would be scarcely worth mentioning, but that it occurred among a people whose strong religious prejudices prohibited even the touching of a dead body in some cases; and the introduction of the novel science of anatomy, was one of the most difficult things Mohammad Alee had to enforce for a long time. He in the first place referred it to the priesthood, who obstinately set their faces against it, declaring it utterly incompatible with the religion of the Prophet of Mekka. The Básha's answer, that it was his royal wish and pleasure that they should legalize the act, and that, if they did not speedily do so, it was more than probable they themselves should form material for the first experiment in this branch of the practical sciences, soon brought them to reconcile their prejudices with his unbending will.

Attached to the school is a museum, under the direction of the anatomical professor, Dr. Sicher, containing the usual anatomical preparations, besides a daily increasing zoological collection, and some good wax models-principally the work of an Arab boy. The progress of this collection is an object of much interest, and the most beneficial results may be expected from it by the lover of science, as well as the naturalist. As yet, the want of funds to support this museum has prevented its being as extensive as it might be in a country offering so wide a field; but the preparations are well done, and, like all such infant institutions, it wisely gives a place to every thing that is offered to it. I should hope, that as many of the animals in it have not yet been introduced into our museums, we might be able to procure some in return for a set of wax models, or some such articles, which could not be procured there.

There is a printing establishment connected with the hospital, where several of the most approved works on medical science are translated into, and printed in Arabic. The chemical laboratory is a handsome, spacious apartment, well furnished with apparatus, and all other necessaries; and I was informed by the professors that chemistry was a science in which the pupils took great

interest, and made considerable progress. Besides professional education, general literary and religious instruction is provided for these students. There is a mosque inside the walls, and two or three Ulemas, or Mohammadan priests, also reside in the establishment.

The Europeans connected with this, and indeed with most of the recent improvements in Egypt, complain that the pupils are removed from their care, and sent into active service too soon. In other departments of the state, they say, this might be passed over, and would eventually find its remedy; but in this case it is a serious error, for if it be true of other sciences, that a little knowledge is dangerous, how much more so is it in medicine, where the uneducated, or partly educated, are emboldened by that little knowledge to sins of commission in addition to those of omission. I have often heard it said of this, as well as of all the other colleges and places of instruction, "Oh, what could you possibly expect from a set of illiterate brutes, whom the Básha took but yesterday from the plough or the Nile bucket? Surely, you do not suppose that such persons, without any previous ideas, can be taught science." But what other native material had Mohammad Alee but this? And although this race are at present illiterate, and cannot be expected to have the same ideas as Europeans of that rank in society who would enter learned professions, will not the next generation be of a superior description? True it is, he keeps them too short a time, and many are removed after three years; but the demands of his large army have compelled him to do this; and the army must be without medical assistance entirely, or have such as three years' education afford, a period which was not required by countries more to the northwest of the meridian than Egypt not many years ago.* I confess I felt particularly disgusted at hearing the Europeans,

*Those who raised this outcry against the insufficiency of education in the Egyptian doctors, would do well to inquire what description of men it was that the lives of British soldiers, and more particularly British sailors, were entrusted to during the last war; and they will find, that it was to persons much inferior in medical education to those at present in Egypt. Nay, at the present moment they will find practitioners, patronised by the public, and permitted by the government and the colleges, in every town and village in Great Britain, who have no such claims to support.