neighbourhood. The various forms of mental aberration appear to have been a favourite study with this novelist. Mr. Dick stands out clearly with his simplicity, his childishness, his times of being lifted out of himself, his hopeless confusion and entanglement with his memorial and the head of Charles I. Mr. F.'s aunt is another instance, with her malevolent gaze, her strange antipathies, her extraordinary, startling, disjointed ejaculations; Barnaby Rudge, with his love for his raven, for flowers, for wandering from place to place, and with the innocence with which he gets drawn into the Gordon riots; Harold Skimpole, with his inability and craftiness; Miss Flite, with her birds and flowers; Mrs. Nickleby's lover, with his shower of cucumbers-these and many more show the strange fascination of the grotesque aspect of mental derangement, and in this particular line our author is inimitable, though Stockton's amiable lunatics in Rudder Grange are, perhaps, the nearest approach to these familiar creations. 6 Dickens is not so easy to follow at all times, even when the symptoms appear to be given in full detail. In the Old Curiosity Shop we have a fair example of difficulty. These are the facts connected with the illness of Dick Swiveller. First the predisposing cause,' the spiritual excitement of the last fortnight working upon a system affected in no slight degree by the spirituous excitement of some years, proved a little too much for him.' This might serve as a prelude for an attack of delirium tremens, but the symptoms of this disease will not harmonise with what follows: That very night Mr. Richard was seized with an alarming illness, and in twenty-four hours was stricken with a raging fever.' Then come tossing to and fro,' fierce thirst,' rambling,' dull eternal weariness,' 'weary wanderings of his mind,'' wasting and consuming inch by inch,' 'a deep sleep, and he awoke with a sensation of most blissful rest.' Then we learn from the Marchioness that he has been ill three weeks to-morrow,' that his hands and forehead are now quite cool, and he is fed with a great basin of weak tea and some toast. The next day Dick was perfectly ravenous,' but is still kept on toast and tea, and later in the morning he takes 'two oranges and a little jelly.' Some pages further on we are told of Mr. Swiveller recovering very slowly from his illness. Now for summing up. Clearly not delirium tremens, not pneumonia-the illness is too long-not any of the commoner eruptive fevers, for the same reason; but either typhus or typhoid, or both hopelessly jumbled together. The onset belongs to typhus, the duration to typhoid; the wanderings would do for either, so would wasting, delirium, and protracted convalescence. The two oranges were injudicious, to say the least, for typhoid, but they were given, as is commonly the case, by a well-meaning friend. Yet we hear of no relapse, no return of the fever, and the conclusion to be arrived at is that Dickens, perhaps unconsciously, had mixed up the two diseases, merely intent on producing a quaint, humorous picture, in which he has undoubtedly succeeded. Of all the victims of this novelist, perhaps the most puzzling cases occur amongst the legion of children destroyed by him. The schoolmaster's little pupil, in the Old Curiosity Shop, would, in a modern novel, have died from tubercular meningitis, caused by educational pressure. He is allowed to be delirious at one time; but, instead of expiring in a state of coma and collapse, he enjoys the privilege accorded to most of Dickens's pets, the power of reviving to a strange brightness, to make touching and improving death-bed utterances, separated by the briefest possible interval from the final termination. Little Nell, we presume, dies of consumption, hastened by exposure, and the same ending is probably a safe guess for Little Dombey, as well as for the poor chivied outcast Jo, who had recently had smallpox; but in all these cases we cannot help thinking that the author was not in the least disposed to be hampered by any scientific accuracy; the time had come for the slaughter of the innocents, and accordingly he snuffed them out without troubling himself about certificates of death. They died for sentimental purposes, and it seems almost like sacrilege to inquire into their symptoms too closely. Anthony Trollope, as Mr. Henry James has said, did not believe sufficiently in the vitality of his characters even for art; hence it is not surprising to find disease conspicuous by its absence in most of his novels. His men and women were too genteel to suffer from illness; they had not reached the stage when it is right to have some fashionable complaint. Charles Reade does not make medicine play an important part, generally contenting himself with mere passing references, not entering into the symptoms in any detail; thus, when he kills with spinal injury, he just mentions the paralysis of motion and sensation, and gives a fatal prognosis; when a character dies with plague she is filled with forebodings of the possibility of ghastly changes in her appearance after death. With his omnivorous reading he amassed in his commonplace book curiosities of any striking nature; we are not startled, then, at finding him giving a careful description of the mode of applying the wet-pack; but it is startling to find it used for a case of jaundice. Some of the modern novelists bestow care on medical detail. Clark Russell's Sea Queen treats a broken leg with skill sufficient to avoid shortening or other deformity, but we are not told quite enough about the accident to make us certain that the case was not what is termed technically an impacted fracture, which would considerably diminish the marvel. Yellow fever is drawn into the same book to account for a vessel in sound condition wandering on the ocean without a crew. In Christie Murray's Val Strange occurs a good picture of paralysis following severe anxiety and overwork; the premonitory symptoms and the slow restoration, with enfeeblement of intellect, being well pourtrayed. Henry James makes use of Roman fever to kill his wayward heroine Daisy Miller; and in the Madonna of the Future brain fever is just indicated with similar skilful touches. Other writers slip along carelessly in a vague way, appearing to mean something or nothing, medically, according to the knowledge of the reader. The illness and death of Mr. Dimmesdale, in the Scarlet Letter, would be very difficult to explain on a scientific basis. Robbed of all its glamour of sorrow, and looked at seriously, we feel the need of a new nomenclature, a new classification of disease to include a group which might be headed 'Killed by an acute attack of conscience.' Hawthorne has failed scientifically, but we cannot help admitting that he has exquisitely failed.' The ending is evidently intended to be dramatic rather than truthful; it is almost impossible not to feel that the man could get up and die again, every gesture, every word, every gasp being so studied, and the full stop coming with such admirable precision at the right time. Howells gives us an instance of loose writing in the fever of Don Ippolito in the Foregone Conclusion. It is impossible to be certain of its nature— typhus, typhoid, meningitis, pneumonia, or acute rheumatism-we feel it is all one to the author; he does not wish to give us a clinical record of the case any more than he does of the illness of the Pythoness of the Undiscovered Country. This last might well be acute rheumatism, especially when taken in conjunction with the illness of her father, attributed to an obscure affection of the heart; but he leaves it an open question, not filling in the picture with the same firm touch which he uses with the weakness and fainting fits, the general sleepiness and apathy of Mrs. Vervain of the Foregone Conclusion. This is an accurate study of disease; the others are but vague sketches with blurred outlines. When all scientific men chafe and beat against that dead wall which separates the known from the unknown, and are ever striving to break down the boundary, or, by changing its position, to annex part of the realm beyond, it is hardly to be wondered at that the novelist, who regards science as material for copy, should refuse to be bound by the same limits of knowledge, that he should occasionally make his characters a new order of beings, governed by laws untaught by medicine, and capable of recovering from diseases commonly regarded as incurable; or even that he should evolve from his inner consciousness new diseases or new mysterious combinations of nervous symptoms. Frequently we find that, starting from the boundary line, the novelist goes on to explain phenomena incapable of explanation, allowing his fancy free play, taking up the thread where science has left it for the present, and endeavouring to assume the part of a prophet, foretelling the cures, the marvels which may perhaps be looming in a nebulous form in the distance. To enjoy books of this nature we must be content to accept them as true, to set aside our knowledge and understanding for a while, and allow ourselves to be carried away from the landmarks of prosaic fact by the current of plausible reasoning and assertion in which we are involved. Such books are beyond the reach of serious medical criticism, which would lead us to apply to them a rude, unpleasant monosyllabic term. which has already caused mischief enough in the world. Provided however that we do not inquire too closely into probabilities, they may be read with the same keen interest which is excited by books of travel over virgin soils, or descriptions of the habits of newly-discovered races or animals-an interest akin to that with which we have devoured the Arabian Nights or Gulliver's Travels. It must be granted that we are not seeking facts by which to guide our lives, that we do not wish to trammel our author with historical precision, that we read his book only for the amusement or amazement it affords. Called Back probably largely owed its phenomenal popularity to the skill with which the impossible was demonstrated as fact. The author seized upon and made his own a large number of subjects of current controversy. He gave us what professed to be a truthful version of experiences akin to thought-reading, mental states of consciousness being declared to be interchangeable by the mere contact of the hands, and brain-waves passing from one individual to another; we get curious deductions concerning localisation and inhibition of nerve force, or, to speak less technically, we are asked to believe that, after a sudden shock, memory can be lost entirely until a recurrence of the shock brings it back again, calling to mind the man and the quickset hedge of our youth, a repetition of the same course of treatment producing diametrically opposite results, as in the last act of Martha and some other operas. Through the whole book the secret of success may be traced to a combination of causes, foremost among them being a judicious pandering to popular weaknesses, to credulity, to the love for the marvellous, and even to Russophobia. An author must believe his own story,' says Mr. Besant, but the author of Called Back was surely too clever for that. This mode of utilising current ideas, of touching upon strings which are already vibrating, determines to a large extent the success or failure of novels of this description. Paul Vargas, a sketch by the same hand, merely excited ridicule; the secret of perpetual life is too much out of date to interest; the illness of the hero of too mysterious a nature to delude into belief. It is curious to find that many novelists who, as a rule, are to be commended for the fidelity of their medical data, seem sometimes weary of this world which they know, and cross the boundary line into the unknown land of the imaginative or ignorant. They seek relaxation by change of style of workmanship, just as an artist occasionally draws caricatures; or perhaps they intend to point a moral from these airy flights, preaching contentment by awful examples. That weirdly unpleasant Lifted Veil of George Eliot's is a typical instance of this class, professing to be the autobiography of a man conscious of the precise date and hour of his doom, and of all the attendant circumstances, capable of reading the unspoken thoughts of those about him, showing in their full horror the result of the possession of powers for which many have longed in a vague way. It matters little that symptoms of a true disease, angina pectoris, should herald the death, when all those preceding are exaggerations and fictions. So too with the Ten Years' Tenant of Besant and Rice, the possible discomforts and shifts arising from the possession of immunity from death by disease form the mainspring of a story in which the leading character is supposed to live through over two and a half centuries. While medical men puzzle and theorise over the limits to be assigned to the influence of heredity, the novelist is not troubled by more doubts than those of the monthly nurse, whose confidence is so great in the matter of maternal impressions. The modes of thought, the vicious habits, the same likes and dislikes, have often been drawn, but the oddest of all developments of this subject is the curious background it affords Wendell Holmes in the fate of Elsie Venner, whose snakelike propensities are in this way accounted for by a doctor in this book. In like way it would be amusing, were it not for the grain of truth which lies hidden like a sting, to note how often novelists shift responsibility for strange statements to the shoulders of medical men. Ouida, in one of the Bimbi stories, makes a doctor speak of a case as meningitis, and after gloomy prognostications she cures it with the bark of a long-lost dog. Dickens also, having stumbled across. the notion of destruction by spontaneous combustion, proceeded to quote authorities without estimating their scientific value. A reference to Taylor's Medical Jurisprudence will at once set this matter in its true light. Further we find novelists gravely predicting the future of medicine. An American writer in Dr. Heidenhoff's Process recently started with three separate ideas-the doctrine of inhibition, the localisation of motor and sensory areas in the brain, the assumption of similar localisation of memory. With these materials he proceeded to development of an imaginative nature: in the form of a dream following closely after a talk on mental physiology, a dose of morphia, and a dry book on electricity-a dream occupying a large portion of the book-we are led to believe with the author that it will be possible in the future to 'Throw physic to the dogs,' and to answer in the affirmative Macbeth's questions:: Canst thou not minister to a mind diseased, |