101ANSWERS TO CORRESPONDENT

TO CORRESPONDENTS.DEEPLY do we regret that we are compelled, week after week, to

withhold from our readers a great number of papers, the perusal of whichwould afford them much gratification ; but notwithstanding the frequentaddition of sixteen columns to the ordinary size of our journal, to thatdisagreeable necessity we are exposed. It is exceedingly perplex-ing to be obliged to postpone communications which exhibit all the

indications of great mental power and zea’.ous scientific research. If

we could only succeed in convincing our esteemed contributors thatit is not the longest communications that are always the best, and that those papers which contain the greatest number of useful facts clothedin the smallest number of words are the most highly appreciated by theprofession, much of the anxiety to which we are now subjected wouldbe abated.

CORRESPONDENTS who may courteously forward newspapers and otherprinted documents for reference are earnestly requested to attach someslight mark to the passages to which they wish to direct our attention.

C. T.-All regular medical practitioners who wish to settle in France,must be authorized to do so by the local authorities. The chemist-and-

druggist business does not exist in France; none but licensed apothe-caries can vend and prepare medicines. The dealer in mere drugs is asort of grocer.

MEDICAL FEES AT INSURANCE OFFICES.To the Editor 0/’THE LANCET.

SIR,—The question of medical fees at insurance offices has ever been aquestion of much importance to the medical profession, and one which hasbeen universally admitted as a most just and honourable claim; but thefollowing will, I think, open a new field for inquiry, and give fresh ener-gies to the able remarks on this subject by Messrs. Stookes, Self, Brox-holme, Stewart, Finer, and others, as well as by the worthy editor him-self. Should we "as a body" refuse the certificate of "death" to an in-surance office, where the insurance has been effected by an individual tocover some claim he might hold upon our patient, and for his own benefit,and not by the patients themselves, for the benefit of their families, with.out the fee of £1 Is.; in short, should we refuse certificates of "Death"(the certificate of health being admitted as a just claim) to an insuranceoffice without being filst paid for them by the office whose queries weanswer ? If we are to fill the pockets of the various insurance companiesby a species of free labour, or advice gratis, I would at once exclaim-

Then away with examiners and referees,Away with old fashions, excepting the fees;Away with the Hall, and away with the College,Away with insurance-medical knowledge ’.

If not, let us strenuously maintain our rights.I am, Sir, your obedient servant,

London, July, 1850. W.

Dr. F. D. Jones will perceive that a portion of his communication is insertedin the present number of THE LANCET.

Mr. Leonard.-The subject is noticed in another page. We can only give avery qualified recommendation of such a remedy.

lfr. A. Sewell did not send any report of the case. The circumstances justi-fied an unusual plan of treatment. We cannot discover that blameattached to any party connected with the transaction. Taken in any

aspect, it was a very unfortunate affair.Justus.—Yes.

W. T. should address his application to the rector of the university which hehas named. By that mode of proceeding it is likely that he will succeedin his object much more advantageously than by pursuing any othermethod. Although this notice is inserted here, the promise of a privatenote will be duly remembered.

A " LIST OF COVTRIBUTORS."To the Editor of THE LANCET.

SIR,—I, and many others, after the most pressing importunity, allowed myname to be used as a person who would contribute " something," at some timeor an other,to the weekly journal published by Mr. John Churchill,butat thattime I had no conception of the deceptive project that was in contemplation.I now look upon that work as a disgrace to the shop where it is sold, andnot one line of any article from me shall ever be printed therein. I holdthe opinion, that every honourable man who has promised to contribute toit is now completely absolved from his engagement. The dishonourablemay take what course they think fit. The voluntary supporters of theattempt at imposition which has been practised must not be surprised ifthey are stigmatised as " the piratical gang."

AN ADMIRER OF THE LANCET.

Antiquary.—Mr. Wadd died in Ireland, in 1829. He was on a tour in that

country, accompanied by Dqr. Tegart, of Pall-mall. They were in apostchaise, when the horses becoming frightened, the driver lost all con-trol over them, and Mr. Wadd, becoming alarmed, opened the door ofthe vehicle, jumped out, and was killed on the spot. He was the authorof several interesting works.

Jurist.—The Right Hon. George Tierney was "found dead" seated in thechair of his library. A friend having called to see him, was shown intothe library by a servant, and the discovery of the fatal event was made.There was an inquest held on the body by Mr. Gell, the coroner for West-minster. Not the slightest suspicion existed that the deceased gentlemanhad taken anything of a deleterious nature, with a view to the destructionof his life. Yet three medical practitioners were examined at the inquest,two of whom were Dr. James Johnson and Mr. Pettigrew. An enlargedbeart was found, which was stated to have been the cause of death ; butit is a curious fact, that although three medical practitioners were presentat the post-mortem examination, the stomach of the deceased gentlemanwas not examined.

A Subscriber. -The examinations at the College of Surgeons are discon-tinued from August to October.

DISEASES OF THE OS UTERI.

To the Editor H/’TnE LANCET.SIR,—In the last number of THE LAXCET, there is the following passage

in Dr. H. Bennet’s " Remarks on the Diagnosis of Inflammatory and Ulce-rative Affections of the Os Uteri,,-" An open state of the os is a proof of decrease of the cervical canal, in-

flammatory or ulcerative." In the natural healthy state, the os uteri isnot open either to the touch or the eye; merely admitting a moderatesized sound, as the male urethra would. Indeed, an open state of the osuteri, as detected by the finger, is to me the criterion of the necessity of aspeculum cxaminatJOn, as it indicates disease in a region (the os andcervical canal) where no injections can leach. and where disease can onlybe treated by instrumental means. This is a most important fact, which hasnot been pointed out, to my knowledge, by any foieign writer, which wasmost unquestionably unknown to the profession here, until I demonstratedit, and of which only a few practitioners are even now cognisant."

In Pauly’s work, published in Paris in 1836, and with which I have sincethat time been conversant, we read, at page 1 g-" Ordinairement quelquesjours avant et pendant les règles, l’ouverture d’1 col est assez dilatéepour admettre la phalange unguale du doigt explorateur. Dans l’etatsain on sent alors un tissu lisse, poli comme le tissu de la plèvre. L’in-terieur du col est il au contraire un peu rugueux, fait Il pereevikir la memesensation que donnerait la muqueuse de 1’estomac, on peut-etre presqueassure qu’ill’aglt d’un cas pathologique.

Si a d’autres epoques le col uterin offre encore cette dilatation, Hippo-crate 1’a dit, cet organe n’est pas dans une condition physiologique ; il estdejh sous le poids d’une affection grave, on bien la maladie est imminente.Le col est egalement dilate lors d’une hemorrhagie, et quand il existeune polype ; mais ces affections ont leurs signes particuliers qui fournirontplus de lumire au praticien. I am, Sir, your obedient servant,London, July 9, 1850. FAIR PLAY.

A Betired Officer.—We might mislead by giving a direct answer to such aquestion. The kind of rupture is not stated, and it frequently happensthat an instrument which answers admirably well when it is applied toone person, is not equally effectual to another individual whose form andoccupation are different. We therefore strongly recommend our corre-spondent to apply to an experienced surgeon, from whose advice andassistance we are fully confident he would derive the best scientific aid,as well as much mental consolation.

Mr. FINNEY presents his compliments to the Editor of THE LANCET, andbegs leave to submit for insertion, at the first convenient opportunity, someparticulars of the St. Marylebone Bank for Savings, which may prove in-teresting to the public.

Welbeck-street, July, 1850.ST. MARYLEBONE BANK FOR SAVINGS,

76, Welbeck-street.—Established July 5, 1830.Coi)2parative Statement of Progress at Specified-Periods During the Last

Seven Yeurs.

Medical Jurist.-The fatal accident happened to Mr. Hasnisson at the open-ing of the Manchester and Liverpool Railway, in Sept. 1830. The acci-

dent was witnessed by a great number of persons. At the time that it

occurred, Mr. Huskisson was holding fast by the door of the caniage inwhich the Duke of Wellington was seated. He was standing betweenthe two lines of rails; an engine approached; the carriage door wasstruck; he was thrown down, and having fallen across the rail, the wheelsof the engine passed over one of his legs, and frightfully lacerated themuscles of his thigh, the femur of the same extremity being also fracturedin two or three places. He survived the accident only a short time ; aninquest was held on his body, and a verdict of accidental:death was re-turned. The coroner for Westminster did not receive an application foran inquest in the case of the late Sir Robert Peel.

WE have not space for the letter of Mr. T. D. Hawker relative to the ques-tion of establishing self-supporting dispensaries on a large scale in thismetropolis ; besides, it should be recollected that the subject is to befully discussed at a public meeting which is to be held in London in thecourse of the present month. Mr. Hawker, who is Secretary of the Lon-don Society, informs us, that " Mr. Smith’s plan for the founding of theseSocieties has been successfully tried at Derby, Northampton, Burton-on-Trent, Coventry, and many other places." We consider that it will be

very advantageous if the members of the profession who practise in thetowns thus named would make known to the profession such facts asthey have been enabled to collect concerning the working of self-sup-porting dispensaries which are thus announced to be in successful

operation. Whatever maybe the opinions which the profession may formà priori on the subject, it is highly desirable that the truth, and thewhole truth connected with the scheme in which are involved the

sanitary interests of a large portion of the public, as well as the profes-sional interests of a great number of medical practitioners, should be ex-tensively and thoroughly known.

102

"CHLORIDE OF SODIUM IN CORXEIT!S."To the Editor of THE LANCET.

SIR,-Having observed in THE LANCET of the i3th inst., that chloride ofsodium has been sllccessfu!1y used in diseases of the eye, by Dr. Tavignot,of Paris, and Dr. Benoit, of Montpeliier, I can bear testimony to the efficacyof that remedy in inflammation of the eyes.

I had an opportunity, when a boy at school, of seeing common salt usedas an application to cattle on a certain pasture, which were affected with akind of catarrhal ophthalmia. The mode of application was the follow-ing:-The salt was finely pulverized, and placed in a hollow tube, and held at a

distance from the eye, which was kept open by an assistant, and the saltblown into it. From this application, several times repeated, I witnessedthe most satisfactory results. Many years afterwaros, when I became apractitioner in medicine, and had brought under my care cases of inflam-mation of the eye, and bearing in my recollection the hint which I had re-Ceived from the old cow 11 leech," I applied the common salt in the mannerabove indicated, in a very obstinate case of conjunctivitis, and the resultwas most satisfactory. Since that time I have applied the salt frequently,both as a collyrium and in powder. I must observe, however, that I havenever used this remedy when ulceration had taken place, before I had anopportunity of seeing the case narrated in THE LANCET, (last number, p. 54;)but, having the authority of the above-named medical gentlemen, I shouldhave no hesitation in using it even in ulceration, the general state of theconstitution being, of course, attended to. Should you think the above re-marks worthy of a corner in your widely circulated journal I shall feelobliged, and remain your obedient servant, OBSERVER.

July 16, 1850.THE note of A Publislta (Paternoster-row) shall be inserted in an earlynumber of our journal, together with several selections from numerousletters on the same subject. We are rejoiced to find that the mean anddishonest act which has been perpetrated is condemned as strongly by pub-lishers as by the members of our profession. At the establishment of

Messrs. Longman and Co.-the first house of the kind in Europe—we areinformed that the piracy in question has been denounced in the strongestterms, and that it is regarded as a desperate effort to maintain the existenceof a journal which has always had the peculiar merit of bringing into dis-repute all who have been connected with it. But this last net of its ownersis at once of so flagrant and suicidal a character, that "THE PIRATE"is not likely to require much further notice in the columns of THELANCET.

THE SURGICAL TREATMENT OF THE LATE SIR ROBERT PEEL.

To the Editor of THE LANCET.

SIR,—In your columns of the 13th last past-viz., July 13th, 1850—I reada letter addressed to you by a Mr. Langley. As a very old subscriber toTHE LANCET, it is with pain I read such illiberal remarks in such a liberaljournal. I beg to make the following comments :-What does Mr. Langley know of the condition of Sir Robert Peel at the

moment of his accident Who told him of his inflammatory or, what he calls ubsurdlJ termed,

gouty diathesis ?What does he know of Sir Robert’s habits?What acquaintance has he of .surgery when demanding such rigorous and

copious depletion in such a habit (if admitted) upon concussion ?What has the report in the Times to do with forming a synopsis of the

medical treatment?I could add much more. When men of acknowledged talent in our pro-

fession-viz., Sir B. Brodie, C. Hawkins Mr. Hodgson, and other names inattendance, (though not perhaps known generally to the profession,) atleast form a shield, or ought to do, to the publishing of remarks alike unfairto such medical attendants, and reflecting upon the pages of THE LANCETa discredit unworthy of its general usage.

I subscribe myself, with every feeling of respect,Yours faithfuly,

Oxford-road, St. Peter’s, Manchester. ROBT. H. M’KEAND.

To the Editor of THE LANCET.

SIR,—In this city the greatest su7-p?-ise is felt at the apparently absurd andnugatory treatment employed in the case of the late Sir Robert Peel. Theuniversal exclamation is, " Why was he not bled from the arm ,"Had he been a patient brought, under precisely the same circumstances,

into any metropolitan hospital or dispensary, I for one feel convinced thathe would have been bled the moment reaction set in. Why not ? The onlypossible hope was through venesectionto a large amount. Leeching was nosubstitute, and could afford no relief to the labouring system. As for SirRobert’s nervous temperament, it was no objection, as bleeding would haveacted as a sedative, soothing and tranquillizing. Sir Robert’s good sensewould not have objected to such a slight infliction of pain. I assure you,the general impression amongst Irish surgeons is, that a valuable life hasbeen trifled with, if not permitted to pass away without an effort at rescue.Dublin, July 15, 1850. AN IRISH SURGEON.

,* The above notes have been selected by us for publication from severalothers which have been addressed to us to the same effect. It cannot,however, we think, be necessary to offer any further observations on thesubject, in addition to the remarks which appeared in the two pre-ceding numbers of THE LANCET. It should always be recollected, thatthe sufferer had the advantage of the best surgical skill which the worldcould afford. His medical attendants had an opportunity of noticing allthe symptoms, and of becoming thoroughly acquainted with the condition,of the patient. Surgeons who had not the same opportunities for obser-vation are not likely to form so correct a judgment as the highly-giftedand able men upon whom devolved the great responsibility of wielding allthe powers of our science and art, with a view to affording the greatestpossible amount of relief to the extraordinary and beloved man who wasthe object of their professional and friendly solicitude. Never, in our

opinion, was a patient placed in safer hands; and we firmly believe, that,from the nature of the injuries, they were inevitably followed by a fatalresult.

B. P. G.-An apprenticeship is not necessary for the purpose of qualifyinga candidate for examination at the Royal College of Surgeons. A fully-qualified general practitioner holds the diploma of a college of surgeons,and the licence of the Apothecaries’ Society of London.

Lector ab initio.—Yes.

WE have not been enabled to find room for the report of the South-EasternBranch of the Provincial Medical Association, and of the able amendmentproposed by Mr, Bottomley. As the votes of the profession are nowbeing recorded in detail on the question of establishing a separate incor.poration of general practitioners, we cannot see the advantage of pub-lishing the opinions of small collective bodies of the profession.

A rnivATE note, with the information required, has been forwarded to Mr.Russell.

Aledicus.-Dr. Currie was a lecturer on the Theory and Practice of Medicineat Guy’s Hospital. He was an eloquent man, but unhappily was muchtroubled by a very kantankerous disposition.

ANOTHER SUCCESSOR OF HEROD.

°° For I can raise no money by vile means :By heaven, I had rather coin my heart,And drop my blood for drachmas * * *."

To the Editor of THE LANCET.

SIR,—The chivalrous antagonism of THE LANCET to sins and knavery inthe profession, the able, unninching, and spirited manner in which its abusesare frequently exposed, and its honour and dignity defended, in yourcolumns, induce me to forward you the following little story. It tells of therenowned deeds of a legally quaried practitioner, to account for which itrequires not the ingenuity of a Gall or Spurzheim ; for the cupidity of man-kind, from the days of prostration to the solden calf to the present era, fur-nishes a key to the motives of such actions. The close relationship, too, ofa medical marauder to a knight of the pea and thimble is obvious; diffe-rence of craft constituting no difference in mind-the real distinction beingthat of accident in birth and social position ; the one is a member of theCollege of Surgeons, the other of the college of prigs.Some years ago there lived (and I believe still lives) in Norton Folgate a

Mr. -, holding the diploma of the College of Surgeons : he was appointeda vaccinator to the district in which he resides, being a distinctly circum-scribed one of seven, into which the union of Whitechapel is divided; thearrangements in respect of payment (1s. 6d. per case), allowing for cases doneupon application being made at any of the stations by parties resident inevery part of the union.Things were in this order, and harmony prevailed, until Mr. -, lured

from the right path, by casting his eyes upon the preserves of his neighbourvaccinators-saw and coveted-sighed-hesitated, and filched just one case.Oh, irresistible tempter, Mammon! thou hast overcome others: Judassuccumbed to thee for thirty pieces. Poor Mr. ---, he too fell-for what ? Oh heavens! 1 tell it not in Gath. From this time he is seen, at first onlystealthily, overstepping the border districts ; then, emboldened by success,and having procured lists of bilths from the registrars, he commenced aseries of forays, which gradually extended to a complete periodical scouringof the union. Some of the other vaccinators, finding their appointmentsconsequently but nominal, essayed to obtain their mite in their own dis-tricts, by pursuing Mr. -’s plan of visiting persons at home; but alas insulted by the emissaries of the invader, doors slammed ;n their faces,rumours of sudden descents upon defenceless mothers and children, accom-panied by threats or imprisonment in case of refusal, &c., met their ears,they despaired and retired from the disgraceful contest.This was borne for some years ; at length, finding their private patients

called upon, and induced by cautious misrepresentations of being agents ofthemselves, to submit their infants to the operation;—calumnious reportscirculated of unfavourable sequeise to it, when done by themselves, &c.,rouses their anger. The more petty, the more contemptible. The callingupon Mr. - to expostulate is replied to with threats of ejection from hisshop by police, and other abuse. As a last resort, in giving publicity tothe affair, it is hoped that shame may have its influence where there appearsto exist no sense of professional propriety.

I am, Sir, your obedient servant,W. B. HART,

one of the Vaccinators to the W. C. Union.Union-street East, Spitalfields, July 15, 1850.

WE are compelled to postpone replying to several of our correspondents untilnext week.

COMMUNICATIONS, LETTERS, &c., have been received from-A Publisher,(Paternoster-row;) Mr. M’Keand, (Manchester;) Mr. Young; Mr. St.John Lucas, (Alford, Lincolnshire;) Mr. Tidmas, (Langwith, Notts;) Mr.R. Watt; Mr. J. B. Mills; Mr. Ramsay, (Gloucester;) Mr. R. Leader,(Sheffield;) Mr. John Lizars, (Edinburgh;) Mr. Booth Eddison, (Notting-ham ;) Dr. Tilt; Miss Fanny Perkins. (Masham;) Mr. Toynbee, (withinciosure;) Dr. Rooke, (Dreadnought Hospital Ship;) Mr. Bodington,(Sutton Coldfield, with inclosure :) C. N., and A. C. of 1850, (with inclo-sure ;) Observer ; Dr. James Bird, (with inclosure ;) Dr. F. J. Brown,(with inclosure;) An Irish Surgeon; Bede, (Manchester;) Mr. Wilton;Guido; Mr. F. H. Hewitt; Mr. Higham; Mr. T. D. Hawker; C. K.;Mr. B. Hewitt, (Clapham;) Dr. Michael Healy, (Ennis, with inclosure;) Dr.James Miller ; Subscriber; Mr. J. A. Tucker, (Truro;) Dr. F. D. Jones,(Washington, Gateshead, with inciosure;) Mr. Hogarth; C.J., an OldSubscriber to THE LAXCET; Mr. Howard Johnson, (Alderley, Cheshire;)Mr. E. Russell, (Morpeth;) Mr. W. B. Start; Mr. Finney; Dr. Barnes;Dr. Garwood; Machaon ; a Hater of Imposture ; Mr. Anstice; One ofthe Cheated ; An Impartial Observer; Mr. Erichsen ; A Lash for thePirate; Mr. Edwin Newbolt; Mr. J. H. Tucker; Dr. Nevison; Mr. L.

Dean; Mr. Tucker; Timolean ; A Man about Town; Mr. C. Wakefield;Dr. Stevens; Medicos, (Leeds;) Medicus, (Clifton;) Medicus, (South-wark ;) Juvenis, M.R.C.S.E., &c.; Lector ab Initio; B. P. G.; Mr.Leonard; Justus; W. T.; Mr. A. Sewe’d; A Subscriber; W. B. Hart;Mr. Donkin, (York;) Howard S. Johnson, Esq.; Dr, Stopforth; Mr. S.Mault, (Fenny Stratford;) ;) Mr. Ballenden, (Dudley.)

THE Alton Adcertiser, July 13th, and Bath Herald, July 13th, have beenreceived.