512 LETTER ON THE STATE OF ANATOMY, FROM

cil now themselves admit, held out an’

" encouragement " to the commission of theworst of crimes. After violating all the

sacred obligations imposed by the charter,and the still more sacred obligation of theiroaths-after pertinaciously withhotding fromthe members of the College their legal rightsand privileges-after filching from the

pockets of the medical students the most ex-tortionate fees-after attempting to preventthe study of anatomy and surgery through- Iout every part of England except London-after refusing to examine those gentlemen I

who enjoyed the most advantageous oPP,9T-tunities of dissecting in Paris-this worth-less Jumo presume to address Lord MEL-

BOURNE as though they themselves were

the innocent victims of those very " Regu-lations" of which they are themselves theauthors-as though they were the virtuousabhorrers of those crimes which they havethe brazen effrontery to confess have, in

great measure, been encouraged by the

operation of by-laws framed solely with aview to the promotion of " sound chirur-

gical knowledge ! " When brass itself

shall exhibit the crimson blush of shame,then may we expect that these men,-

acknowledging their guiltiness-will not

omit to supplicate with contrite hearts forthe sins which they have committed againsttheir brethren, and also against the generalwelfare of society.

After the reader has bestowed some at-

tention upon this " confession," his mind

will be better prepared for those commentswhich, from want of space, we must deferuntil the publication of our ensuing Num-ber.

ANATOMY.

Copy of a Letter from the Council of the RoyalCollege of Surgeons in London, to ViscountMelbourne, dated the 16th of Dec. 1831.

Royal College of Surgeons in London,Dec. 10.

My Lord,—The undersigned, members ofthe Council of the Royal College of Sur-

geons in London, have the honour of ad-

dressing your Lordship on a subject of pain-ful interest to the whole communitv, butespecially to the members of the medicalprofession.The Royal College of Surgeons are em-

powered by their charter to examine cer-tain individuals as to their knowledge ofsurgerv, and they are especially requiredto institute such examination respectingthose who are candidates for the situationof surgeons in the army or navy.

It is not possible that any one should beproperly qualified to practise in this depart-ment of the healing art who has not ob.tained a due knowledge of human anatomy,and explored, with his own hand, thestructure of the dead body; proofs oftheir having done so have therefore been

always required of candidates who have

presented themselves for examination.The Council believed that they could not

properly perform their duty to their Sove-

reign, from whom the College received itscharter, nor to the public, for whose benefitit was granted, without insisting on the

study of anatomy by dissectien, as the mostimDortant nart of surff ical education.They have, however, been aware that

some serious objections might be urged tothe course which they thus ventured totake.

In the present state of the common law,as it is construed by the law authorities,the individual who dissects a human body,or even has it in his possession for any otherpurpose than that of burial, is guilty of amisdemeanour, unless it be the body of amalefactor hanged for murder.

Bodies used for dissection in the anato-micalschools have necessarily been procur-ed by illegal means,-by the invasion ofconsecrated ground, and the disturbance of

graves, in a way disgusting to society atlarge, and especially offensive to the fticndsand relatives of the deceased. The regulations of the Council havetherefore had a tendency to encourage bothteachers and students to a direct violationof the law, and to establish, in the procur-ers of dead bodies, a set of men living bypractices which are revolting to the feelingsof society, exposed to the hatred and con.tempt of those around them, and likely, bythe joint operation of these causes, to becometrained and gradually habituated to the com-mission of still greater crimes..,The Council felt that thev could onlv do

what was, on the who’e, for the best, in thedilemma in which they were placed. Thecircumstances which have just been enume.rated did not escape their attention, andhave continually excited their most deepregret. But, on the other hand, they werecalled upon to regard the obligations of

513

their charter. They were aware that the’

want of pro perl y-educated surgeons wouldprove a serious evil to the public. How-ever much they might be inclined to en-courage the use of preserved parts and mo-dels as subsidiary means of teaching ana-tomy, they were convinced that these are ofthemselves quite inadequate to afford thatminute, complete, and accurate knowledgewhich is necessary in surgical practice, andwhich the student only requires by dissec-tion.The Council further submit that they

have laboured under much embarrassmentfrom the inconsistencies and contradictionsof the law itself, which at the same timethat it declares the student to be guilty ofa misdemeanour if he attempt to obtain ana-tomical knowledge, renders him also, whenafterwards engaged in practice, liable to a

civil action on account of any mistakewhich his ignorance of anatomy may leadhim to commit.

’

But, whatever may have been the extentof the difficulties which have heretofore ob-structed the Council in the execution oftheir duty, they may well be regarded asinsignificant when compared to those whichthey have to encounter at the present mo-ment.The large prices which have of late been

given for anatomical subjects have operatedas a premium for murder. If the Councilof the College continue to require thatthose who present themselves for examina-tion shall have studied practical anatomy,who can venture to say that crimes similarto those which have just now filled the pub-lic with dismay will not be again committed ?More criminals will undoubtedly arise;new victims will be added to the list; andthe medical profession will be necessarilydegraded from the high situation which itought to hold, as having in its relations to

society no object but that of conferring be-nefit on others.The Council have no expectation, while

the law remains as it is at present, and sur-gical students continue to cultivate thescience of anatomy, that any means can becontrived which will prevent a repetitionof the horrible offences to which they havejust alluded. Attention and constant sus-picion on the part of the teachers may effectmuch, but not all that is requisite.

It is v ai,n to imagine it always possibleto distinguish the body of a person who hasbeen murdered from that of one who hasdied a natural death.The very individuals who have lately

suffered on the scaffold would probably haveescaped detection if they had been morecircumspect and wary in their conduct: no]can all the precautions with which it isdesirable the study of anatomy should be

conducted, be adopted under the existinglaws.

In the other countries of Europe anatomyis taught only under a license, and in cer-tain places appointed by the Government,and an exact register is preserved of all thebodies consigned for dissection. But it isa contradiction to suppose that any suchlicense can be granted, or such registerpreserved in this country, where the studyof anatomy is barely tolerated, and wherenot only the procurers of dead bodies, butthe anatomical teachers and students, are

alike engaged in illegal pursuits.In offering this representation to his Ma-

jesty’s Government, the Council are notwithout hopes that some plan may be devisedby the legislature calculated to remove theserious evil of which they now complain.At the same time they beg leave to declareon their own part, and on that of all theother members of their profession who arenow in practice, with the exceptioh of thevery few who devote themselves to thelaborious and often unprofitable task of

teaching anatomy, that the question is onein which they have no direct or personalinterest. Whether anatomy be taught le-gally or illegally, or not at all, does notconcern the existing race of practitioners inmedicine or surgery, who have completedthe period of their education ; but it deeplyconcerns the public : and it is under a

strong’ sense of the evils which society mayultimately experience, and from a desire

conscientiously to perform their duties,that the Council of the College have venturedto make this demand on your Lordship’s

patieiiee and attention, at a moment which,on an occasion of less importance, theyshould have deemed unseasonable.

(Signed)’

Robert Keate, President.

John P. Vincent, Vice Presidents.G. J. Guthrie, .

William Blizard, Thomas Copeland,Astley Cooper, John Howship,William Lynn, James Briggs,J. A. Hawkins, Wm. Lawrence,

t Anthony Carlisle, B. C. Brodie,

H. Leigh Thomas, Benjamin Travers,s Anthony White, Henry Earle,J. G. Andrews, Charles Bell,

Samuel Cooper, Joseph Swan.P

514

The Edinburgh Medical and Surgical Journal.January, 1832.

1’N the current Number of our Edinburghcontemporary, there occur some originalarticles well deserving an extensive cir-culation. Of these we may particularise,in the order of their location rather than oftheir merit, Dr. Stedman’s Contributionsto Operative Surgery," a history of thescarlet fever of St. Bartholomew, by Dr.Cock, tending to show that the Dandy is buta modification of that disease; a continua-tion of Dr. James C. Gregorv’s excellent

article on the pathology of diseased kidney,conneoted with an albuminous state of

urine ; amedico-legal examination, by Mr.Alexander Watson, of two cases of deathfrom injuries of the head; and, lastly, animportant article on the effects of opium-eating on health and longevity, by theEdinburgh Professor of Forensic Medicine.Of the articles now named, we proceed tooffer a sufficient analysis; the remainingpapers shall receive a passing notice.

EXTIRPATION OF A SCIRRHOUS TUMOUR.

To begin with Dr. Stedman’s contribu-tions to operative surgery, we find the nar-rator describing three rather remarkable

operations performed by him at St. Thomas’sin the West Indies. The first was the ex-

tirpation of a large scirrhous tumour in thesituation of the right parotid gland, pre-ceded by the ligature of the carotid arteryat the same side. The patient was a freeblack, a boatman in the harbour. Thetumour extended from behind the conchaof the external ear, to one inch below the

angle of the jaw-bone. Upon the upperpart of the tip of the ear, and part of thecartilage of the concha were embedded inthe swelling, which extended on the fore-part from a little below the malar bone tothe upper portion of the thyroid cartilage.It dipped under the jaw-bone to the depthof nearly two inches. Its dimensions were

4½ inches in length from its attachment tothe jaw, 16½ inches in its largest circum-ference, 9 inches from the base of the earto the bottom of the tumour, 10½ inchesacross its middle from the posterior to theanterior boundary. The greater part was

exceedingly hard, but on the top of the

swelling there were two lobe-like, parts,

softened and covered by thin reddish skin,which soon ulcerated and discharged a

sanious fluid. The disease was of twelve

years’ duration, and commenced at the angleof the jaw with an induration the size of awalnut. Within the year preceding the

time now described, the swelling increasedrapidly, and was accompanied by cousider.able pain ;-

" Operation.- The operation may be di-vided into two parts. The first consistedin tying the common carotid artery, thesecond in extirpating the tumour.

" The man being laid on his back on afirm cot, and his chin turned to the leftside, an incision was made along the inter-nal margin of the sterno-cleido mastoideus,commencing from a point on a line withthe middle of the thyroid cartilage, and

extending to near the sternal extremity ofthe clavicle. The fibres of the platysmamyoides were next cut through, and I pro-

’ ceeded cautiously to dissect through the. cellular substance to find the sheath of the, artery. This part of the operation was ren.dered very embarrassing by the quantity of’ blood, both venous and arterial, that flowed

at each touch of the knife, for as fast as itwas sponged, the wound was filled up againwith blood. As the bleeding continued,

notwithstanding five small arteries had been- tied, by the advice of Dr. Hornbeck, 1 en.e larged the incision backwards towards thes tumour. This was a circumstance of little

moment, as this incision would have beennecessary, at all events, in the subsequent

e operation. This gave me more room; and

- by waiting patiently for a short time, thev wound was so far cleared of blood, as to

allow me to distinguish the sheath of thecarotid artery, with the descendensnoni onits anterior part. The artery lay very deep,so that after repeated attempts to cut openthe sheath, I was obliged to make the mansit up. On turning his chin to the leftside, the artery now became much moresuperficial ; and 1 was easily enabled to

open the sheath, by pinching up a part ofit with the forceps, and dividing it, by cut-ting with the knife laid flat. Having passedthe common aneurismal needle, armed withone stout well-waxed silk thread, closelvround the artery, and having satisfied theround the artery, and having satisfied thegentlemen in attendance that there was

nothing but the artery included, I drew theligature firmly and strongly. The pulsationimmediately ceased in the upper purtion ofthe artery, which I could distinctly feel

through its sheath for at least a third of aninch above the piace where it was tied.The internal jugular vein gave me not theleast embarrassment, nor did I even see it

! during the operation. The artery was tied

515

at a point about a line opposite to the mid- Idle of the thyroid cartilage. This first

operation lasted fifty-five minutes, andwould probably have been concluded in halfthe time, but for the embarrassment caused

by the superabundant flow of blood."

The patient was now allowed to rest fora quarter of an hour, and some refreshmentwas given him. At the expiration of thisperiod the operation was again resumed." An incision was made from behind the

cùnclw of the ear to the termination of thetumour in the neck. I next dissected theskin from the tumour until I had arrivednear its base. An oval incision was thenmade on the front part of the tumour, ex-tending from the front of the ear to the ter-mination of the first incision. I was unableto save so much skin as I had wished, flOmits being tuberculated, and of a suspiciousappearance. The tumour was dissected out

cautiously on this side also. Notwithstanding the ligature of the common carotid

artery, several arteries sprung’ in the courseof the dissection, <o that I had altogetherto tie seven in this part of the operation.The tip of the ear, and the cartilage above,were now dissected out of the tumour, Iwhich was dissected alternately on eachside, until it hung by a portion not thickerthan the middle finger, deep under the

angle of the jaw. Upon attempting to cutthis, a considerable artery jetted out itsblood. Drs. Hornbeck and R.aven havingthrown two ligatures round this part, 1

bolclly cut it away, and had the satisfactionto find that no haemorrhage followed. Asmall lymphatic gland, about the size of abean, being’ a little hard, was seized withthe hook aud extirpated. The whole ofthe space that had been occupied by thetumour was now carefullv searched bv theattendant physicians and myself, and nodiseased portion could be detected. In thecourse of the dissection, I was obliged tocut away a part of the head of the sterno-mastoid muscle, as it was impossible to

separate them.The wound that was exhibited after

the removal of the tumour, including theone made for tying the carotid artery, eg-tended from the mastoid process of the tem-poral bone to near the sternal extremity ofthe clavicle, and from the front part of theears to deep under the jaw, near the angleof the mouth. The lips of the wound fromthe sternal extremity, to the angle wherethe two incisions round the tumour metbelow the jaw, were brought together bythe interrupted suture." The upper wound, where the tumour

was situate, could not be closed by the skin,as a large portion had been cut off for its

unsoundness. This space was thereforecovered with adhesive strap, and allowedto granulate."

The second operation lasted about forty-eight minutes. The loss of blood was in-

considerable, and the patient showed nosigns of weakness. The cure proceeded mostfavourabiy ; the ligature came away on th e24th day, and on the 27th he was dismissedquite well. Dr. Stedman’s remarks on thiscase are so brief and pithy, that withoutbeing prodigal of our space, we may allowhim to suppiy his own commentary, withwhich we entirely coincide." Remarks.&mdash;The two sketches prefixed

represent the patient with the tumour, andwhen cured. It will be observed that thereis a slight contraction of the mouth to theleft side. There was something of this be-fore the tumour was removed, but it hassomewhat increased since ; probably owingto the labial branch of the ves anserinusbeing cut in the operation.

" There hae been some dispute amongauthors whether the common carotid arteryshould be tied in operations similar to thisone. I think this case clearly demonstratesthe propriety of the measure, not only from.its saving a useless and even dangerouseffusion of blood, but also as tending to di-minish the local inflammation. 1 quite agree with that eminent sur-

geon, Mr. Colles of Dublin, in thinkingthat it is impossible to extirpate the parotidgland, and that those cases in which theparotid gland was said to be extirpated,were nothing more than cases of diseasedenlargement of lymphatic glands, whose in-

. creased volume had occupied the positionof the parotid on the cheek, causing the pa-rotid absorption of that gland." That such was the case in this in-

stance, I am convinced bv the oval andwell-defined base of the tumour, so differentfrom the ragged and multitudinous adhesionof the parotid gland." I have only to add in conclusion, that

it is now nearly a year since the operation,and that John Sensire has continued to en-joy uninterrupted health ever since ; thathis shirt collar covers the scar of the woundon the neck, and his whisker the greater partof that on his cheek. He still continues hisold occupation of boatman.SCARLET FEVER AT ST. BARTHOLOMEW’S.

The second and third cases are of com-

paratively minor interest, so we pass to

Dr. Cock’s History of the Scarlet Fever, as

it appeared in the island of St. Bartholo.mew in the years 1829 and 30. The authorsupplies us with an account of the meteoro-

516

logical phenomena preceding the epidemic.The appearance of the disease and its treat-ment next receive attention. Of the formerDr. Cock speaks in these terms :-’&deg; The first case of scarlet fever which Isaw on the 2d of December, 1829. This Ibelieve to have been the earliest instance ofthat disease, as I am not aware of any otherhaving previously come under the notice ofthe medical men of this place. It occurredin a little girl from six to seven years ofage, was exceedingly mild, and attendedwith little, if any, soreness of throat. Seve-ral members of the same family were at-

tacked, but in a much more violent manner.The disease in them assumed the anginosecharacter. Thence it soon extended to a

neighbouring family, whose friendly atten-tions were repaid by one of its severestvisitations.The mother of four children having

visited a young lady who was labouringunder the disease, was speedily affectedherself, and waf the means of communicat-ing it to the members of her family. Hercase was mild; that of her family verysevere ; and three of her children exhibitedspecimens of the disease in its most malig-nant form, and one fell a victim to it. Itnever became epidemic, but continued iiii-

til the end of June, creeping gradually fromone familv to another. It seldom existed

in more than one house at a time, and itssource could always be traced to a commu-nication with the infected. The fever wasbelieved to be imported from America by alady who arrived here with her children,who were attacked on board with it; and itappeared first in the family in which she

lodged during her stay in this island. Sheleft this for Montserrat, where I under-stand the disease broke out soon after herarrival.

‘&deg; The greatest proportion of cases were ofthe anginose and malignant species; butboth forms were distinguished by beingaccompanied with, or complicated by, rheumatic pains of such singular severity as to

make some approach to the fever formerlydescribed under the name of Dandy."The author next describes the semeiology

of the anginose and malignant varieties ofthe epidemic, and under the first he particu-larly dwells on the occurrence of violentand long-continued pains of the head, back,wrists, elbows, and knees, and of the jointsof the toes and fingers, aggravated much atnight, and remittent in their visitations.

Grounding his observations principally onthese symptoms, Dr. Cock traces a close

parallel between them and the Dandy

fever of 1827’, and establishes, entirely to

our satisfaction, a complete identity be-tween the diseases. He dwells with much

judgment on the impropriety of applyingnew nosological terms, and of constitutingnew genera of diseases, on the strength ofthe accidental complications to which all

epidemic maladies are exposed.Of the treatment of the disease, Dr.

Cock speaks at some length. As his gene.ral observations can only be interesting toWest Indian practitioners, we pass themover, and extract his interesting remarks onthe reputed power of belladonna as a pto.phylactic against the contagion of this

malady." Bellladonna.&mdash;Having read some time

ago in the Edinburgh Medical and SurgicalJournal (vol. xxvi. p. 222) the observa.tions of Dr Randhahn on the efficacy ofbelladonna as a preventive against scarletfever, I felt anxious to ascertain the valueof his remarks ; but the difficulty of obtain.ing any fresh preparation of this medicineprevented me from making any experimentson this subject until the 12th of April. Thescarlet fever having attacked an individualof a family consisting of seven or eight per.sons liable to the disease, I embraced thatopportunity of trying what power it pos-sessed in guarding the rest of the familyfrom the contagion. I accordingly gave toeach of those who had not yet sufferedfrom the disease a pill of the extract of bel.ladonna every night and every morning.The effects which were produced by thepills were similar in all ; they slept well,perspired more freely than usual, and had asoft and full pulse. Only one of the seven,however, escaped an attack of the disease,and 1 cannot say thathis exemption was dueto the belladonna, or to a constitutional im-munity. The disease, however, in theothers, was not severe, and appeared cer-tainly to have been modified by the useof that drug. It appeared to me, that,if it was useful as a preventive, it mustbe by keeping up a state of action ofthe system incompatible with the existenceof scarlet fever, and that this action con-sisted in preserving a full and soft pulse,and a tendency to perspiration in the cuta-neous vessels, and that, if such be the case,it ought to he not only useful in warding ot1’an attack, but in subduing the disease whenit already existed. I accordingly used it inseveral cases of scarlet fever, and in all withadvantage ; it induced sleep, rendered thepulse slower, and produced a perspirablecondition of the surface, which is very de.sirable in this disease. I employed it in

517

six cases, some of which threatened to be

vety violent; but they all terminated well,and in a short period. In some it actedlikewise as a purgative. Its value as a

preventive or a remedy, should the diseaseoccur in public schools, or any other publicestablishment where there are a number ofindividuals susceptible of its contagion,might easily be ascertained. In privatepractice, opportunities for making such ex-periments do not often occur. 1 think,however, that it will be found more valu-able as a remedy than as a prophylactic."

RENAL DISEASE.

Dr. Gregory’s paper next demands no-tice. It consists of the details of thirty-five cases of renal disease, accompanied bvalbuminous urine, and in which the reme-dial measures were attended, if not with

permanent, at least with lengthened, benefit.In a former number of this Journal, it willbe recollected that we gave a brief ana-

lysis of Dr. Gregory’s first paper on this

subject. We observed that he differed fromDrs. Elliotson and Graves, the latter ofwhom supposes that the low specific gra-vity, and coagulability, of the urine, werecharacteristic of chronic hepatitis, and un-certain in their indication regarding the

pathology of dropsy. Dr. Elliotson, again,contended, that the numerous examples ofrecovery from deceased conditions, accom-

panied by these phenomena, showed thatwe could not depend upon them as dias-nostic signs. We now find Dr. Gregorysumming up his excellent article by a gene-ral review of all the conclusions afforded

by the multitude of facts it contains.Dr. (Gregory first remarks, that of the

eighty cases described minutely in his

essay, none were below the age of puberty,while in a large proportion of the whole

number they were above forty years of age.They moreover pointedly illustrate the fre-quent complications of this disease with

affections of other organs ; symptoms of thelungs or heart, existing in twenty out ofthirty-five cases. Again; more or less

dropsical effusion existed in fifty eightcases, denoting that hydropic accumulation,though a frequent is by no means an essen-tial companion of this malady. The symp-toms next in point of frequency were

vomiting and diarrhoea, which occurredsooner or later in 46 out of the 80 cases.Lumbar pain is, another phenomenon on

which he places much reliance, as it existedin various grades of intensity in one-halfthe patients. The cases recorded, also il-lustrate, forcibly, the slow and insidious

progress of the symptoms, and their tend-ency to recur, often without any obvious

cause, and in a more aggravated form, and,occasionally, after long intervals of apparentgood health.With regard to the treatment, Dr. Gre-

gory considers venesection to be admissi-ble only in a very early period of the symp-toms. Of diuretics and mercury he speaksin these judicious terms :-

&deg;&deg; Diuretics generally acted well, and inmany cases very rapidly and powerfully.Those most commonly employed were digi-talis, squill, and supertartrate of potass;and they were generally found to act bestwhen combined, as, for example, digitalisand squill in the form of pill, or squill pillsand supertartrate of potass in doses of halfan ounce dailv continued for some time.In such doses, supertartrate of potass provedin these cases, as Dr. Bright aud Dr. Chris-tison found it to do in their practice, one ofthe most certain, and, at the same time,most powerful of the diuretics employed.The spirit of nitrous ether, acetate of potass,and mercury, appeared to act well as diure-tics in some cases. It is proper to remarkthat, in six out of eleven cases, includingthose in the former part of the paper, inwhich mercury was given, soreness of themouth and gums, with mercurial fetor, wasproduced by a small quantity in a veryshort time, and in three of these violentsalivation set in with great pain and swell-ing of the mouth and face, and in one, ofthe tongue and external fauces, requirin-active measures of depletion. These cases,therefore, would seem so far to confirm theobservation of Dr. Bright as to the tend-

ency to rapid and violent salivation evenfrom small doses of mercury, which existsin this disease, and as to the difficulty whichis frequently experienced in restraining itsefIects.

Diarrhoea was best cheeked bv solid opiumin full doses, when existing- either alone orin an urgent form ; the opium was advan-tageously combined with chalk or the ace>tate of lead.

, The concluding twelve pages of Dr. G re-g’ory’s elaborate memoir are devoted to aminute inquiry into the specific gravity ofthe urine in health and disease ; into thetests by which albumen is detected in thatfluid ; and into the circumstances under whichit occurs, and the relation of the quantity of

518

urea present to the quantity of albumenand of urine. In fifty patients labouring’under this disease the urine was examined

as to its specific gravity with that accurateinstrument Twaddel’s hydrometer, and theaverage of 1011.88 obtained in the fatal

cases, and of 1014.48 in those which re-

covered, the maximum being 1023. 5 andthe minimum 1004.5. In all these cases

the specific weight was ascertained beforeany diuretics or other remedies were em-

ployed. Collecting the results of these

experiments with those previously obtainedby Drs. Bostock, Bright, and Chistison,the mean sp. gr. is found so nearly identical,that Dr. Gregory justly concludes lownessof sp. gr. of the urine to be a constant ac-

companiment of this disease.

The average specific weight of healthyurine next engages the author’s attention.He notices the great discrepancy betweenthe best authors on this subject, and thencommunicates the results of his investiga-tions on the urine of fifty young, or middle-aged, healthy men. Here also every pre-caution was observed in guarding againstany circumstances calculated to render theresults fallacious, and it was found that themaximum average sp. gr. attained 1026. 63,that of the lowest 1017.72. It will be re-marked that the minimum of the healthy ishigher than the maximum of the morbidsecretion. Dr. Gregory fiaally states thecurious and important fact, that the albu-

men of the blood is considerably diminishedin quantity, the sp. gr. of the serum beingso low occasionally as 1018. 25.

We have thus given our readers a con.densed notice of the most prominent pointsin Dr. Gregory’s instructive essay, but thepathologist will find it necessary to make

it the subject of much more detailed anddeliberate study. We esteem it as one ofthe most important contributions to thescience of semeiology which modern prac-titioners have afforded; and we are happyto compliment the author on the evidenceit affords of the industry and ability withwhich he cultivates the facilities suppliedhim by his situation of hospital physician.Did the drones of our huge asylums for thesick follow Dr. Gregory’s example but forfive short years, what progress might not

pathology effect-what therapeutic bless-

ings might there not be lavished on man.kind !

In our next we shall give a detailed

analysis of Dr. Christison’s excellent paper,and offer some remarks on the other essayswhich the present number contains.

PREVENTION OF CHOLERA.

APPEAL TO THE RICH ON BEHALF OF THE

POOR.

IN No. 433 of TilE LANCET, I read thevery important communication of your Sun-derland correspondent, and there is a pointinsisted on in that letter which appears tome of such superlative importance that Imust beg leave to intrude on your attentiona few observations respecting it. The sub-

ject I allude to is that of ameliorating thecondition of the poor. For some time pastI have felt an impression on my mind, thatthe attention of the British public was notsufficiently awakened to the necessity oftaking speedy and decided measures in orderto eflect the removal of all those states andcircumstances which might tend hereafterto invite, to accept, and to foster the threat-ened pestilence. It is true that somethinghas been done, that much exertion has beenused, that much valuable time has been em-ployed in removing filth and other nuisances,which, in ail probability, will soon collectagain ; but as far as regards the improvementof the condition of the poor, in mv opinionnothing- short of radical reform can avail usany-thmg. I hnow that it has been pro-posed, at meetings of the wealtherinhabit.unts of certain parts of London, to raise afund in order to provide clothing, food,and fuel, for the poor, in case of the ar-rival of the cholera; but this has been

opposed on the score of the impossibilityof raising a sum, by subscription, ot mauni-tude sufficient to meet the demands whichwould be-made upon it. Now when welook at the circumstances under which weare placed, a great and populous kingdomalready invaded, and threatened to be over-.run, by a pestilence which presents amost for-midable aspect to us individually, and collec-tivelv as a nation, shall we not under suchcircumstances make extraordinary exertions!Is this not a season tenfold more urgentthan ha. ever, during the lifetime of any ofthis benelation, presented itself for mal,mga pecuniary sacrifice for the public good ? Andif there be enormous poverty in this greatcity, is there not also unmeasurable wealth ?If appeals to our benevolence alone, havebrought forth a guinea from our purses, shallnot an appeal made simultaneously to our