410 and perspiration. It appears that the spontaneous vomiting of incipient cholera does not disgorge that which is needful to be thrown off, and that an irritant calls into action such auxiliary powers, exceeding in effect all that can be possibly induced spontaneously, howsoever protracted the efforts. The steady employment of opiates keeps the disorder for the most part under control, (say ten drops of the tincture every hour,) to which, in collapse, may be added one table- spoonful of brandy.with each dose. Thus have I been enabled ’’ to maintain a reputation, of which I am in no way ashamed; and to set at defiance every other remedy boasting of supe- riority. The same constitutes a line of practice to be adopted in my own house, and I believe sincerely, its -timely adoption in every other house, with free ventilation, would secure a success hitherto unknown. If one more sentiment I might be allowed to add, let me urge that it be publicly placarded— Open your windows a little both by day and by night; the word ventilation is not generally known in its practical application. The atmosphere is not generally regarded the great diluent of every noxious element, although the germs of the disorder were possibly to float therein. Whither shalt thou flee to breathe an element more pure ? 2 I am. Sir. vour obedient servant. WILLIAM HENDRY, M.R.C.S., &C. PROPHYLACTIC AGAINST CHOLERA IN INDIA. To the Editor of THE LANCET. SIR,—Should you deem the accompanying extract from my Annual Report for 1848 to the Medical Board at Madras worthy of a place in your journal,you will oblige me by in- serting it. I purposely avoid making any addition to the remarks then made, and should not have forwarded them for publication, but from having recently (a few weeks since) read some extracts from Dr. Billing’s book on cholera, in which the ’, same views are taken as to the cause of the disease.-I am, F. GODFREY, Superintending Surgeon. "Epidemic Cholera.—With regard to this subject, I may briefly remark that for some years past, I have, during the prevalence of the disease, been in the habit of recommending the use of quinine (three or five grains) daily, as a prophy- lactic ; and have never known a person, whilst thus under its influence, attacked by the disease. My experience, I may observe, has been too limited to form conclusive evidences as to its preventive influence, but offer the result of my observa- tions with deference for the consideration of the Medical Board. On the breaking out of the disease in a regiment, the plan might be put to the test, with some degree of fairness, by having one or two companies subjected to the treatment, and noting, not only the proportion attacked, but also the proportion of recoveries under such circumstances. At all events, a trial would not be followed by any injurious effects to the persons experimented on. " I was led to this practice from considering the poison of cholera as being analogous, if not having an affinity to, the miasmata productive of fevers, and am inclined to believe, that even if the disease occurred to individuals whilst u-,der the influence of quinine, it would be in a mitigated form. " With regard to the treatment of epidemic cholera itself, I have nothing here to remark-the drugs recommended have been so dissimilar, and the fatal results so nearly uniform." ’ THE DISCOVERY OF CELLS IN CHOLERA EVACUATIONS. To the Editor of THE LANCET. SIR,—In a notice in the last number of THE LANCET, re- specting the discovery of certain cells in the evacuations of cholera, I observed some strictures upon my colleague, Mr. Brittan, for anticipating his fellow-labourers in the publica- tion of that discovery. In fairness to him, I ought to state, that he published with the concurrence both of Dr. W. Budd and myself. It would have been, perhaps, better, had the first discovery been brought forward in the shape of a report from us to the society of which we formed a sub-committee ; but circum- stances occurred which rendered Mr. Brittan anxious for im- mediate publication, and we therefore conceded to him the priority in this respect, as we considered that he was the most entitled to it, on account of his subsequent discovery of cells in the atmosphere. I have had much reason to complain of the manner in which the first discovery was announced in the newspapers, especially the Morning Chronicle, but I am happy to say, that Mr. Brit- tan’s paper, in the Medical Gazette, from its fairness, has done much to cancel the injustice which was thus inflicted by other parties upon myself and the other members of the sub-com- mittee. T am. Sir. vour obedient servant. J. G. SWAYNE. THE MEDICAL ASSISTANT. To the Editor of THE LANCET. SIR,—About a fortnight ago, a gentlemanly person called at my house in the evening, and introduced himself tome as a medical assistant, then engaged to a general practitioner in the country, and bound to go to his situation in a few-days. He asked for pecuniary accommodation to a small extent, to enable him to pay the expenses of the journey, and get his clothes from his lodgings, where he was in debt. Without troubling you with all the particulars of his account of himself, which induced me to give credit to his statement, I advanced him what he thought he wanted, and requested him to call again, which he did. In the meanwhile I took care to make such inquiries as satisfied me that his difficulties were of a kind which are inseparable from the vicissitudes of the life of a medical assistant, and proceeded from no faults of his own. The morning he was to join the gentleman who had engaged him, his agent in town received a letter, declining his services altogether, in consequence of information received from some one he had called on in the midst of his distress, before he came to me, erroneously representing his application as a form of begging, common amongst a set of impostors who infest the medical public. It is unnecessary to enter into the hardship of this new misfortune. His character was good; his distress real. The method he adopted to get assistance might be im- politic, but yet, surely, excusable; he had already passed two nights in the open streets. There is an institution established for the express purpose of securing for governesses of good character a cheap home when out of a situation. It provides in every way for their protection against the temptations which too often press heavily upon want. The system works admirably; and my ob- ject in writing this is, to inquire whether a similar place of refuge could not be provided for the medical assistant. For the present I leave the question to your well-known advocacy in favour of any plan likely to benefit the condition of a hard-working, useful,-nay, as the profession stands at present,-indispensable body of our fellow-creatures. The members of the profession at large are not likely to find any- thing better worth their attention for some time to come, and the publication of this communication in your widely-eircu- lating periodical, will, I trust, lead to the adoption of some plan similar to that of the Governesses’ Institution. It is far from creditable to us of the nineteenth century that even the meanest member of our profession should find himself, blame- less as he may be, a desolate wanderer in the open streets, his means of livelihood utterly exhausted for the time, and gone for ever the moment he confides his misfortunes to those whom he has spent his last days in serving; and in evidence that this is no more than the truth, I adduce the subject of this letter. I remain, Sir, your obedient servant, HENRY SAVAGE. APOTHECARIES AND SURGEONS. To the Editor of THE LANCET. SIR,—At the present time there are more than 1500 mem- bers of the College of Surgeons, who may be fairly classed under the head of general -practitioners, though not possessing any licence from the Apothecaries’ Company; more than sixty of whom are surgeons to some of the various Unions. Now it is quite evident that all these 1500 individuals, many of them of long standing in the profession, are liable to be convicted at the County Courts for illegally practising; such is the law. A M.R.C.S. may prescribe in any case, (in fact, the great majo- rity of the pure London surgeons exist principally by attend- ing families,) yet if he dispenses his prescriptions (an act which any man without the slightest qualification whatever can always do by putting Chemist and Druggist over a shop- door) he is liable to a prosecution ! It would be useless to enlarge upon the absurdity of this law. If the surgeon has no right to dispense medicine, he certainly has no right to prescribe. But there are a great many surgeons who would be willing to become licentiates of the Apothecaries’ Company, if they could be admitted to an examination, which, as the law now
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and perspiration. It appears that the spontaneous vomitingof incipient cholera does not disgorge that which is needful tobe thrown off, and that an irritant calls into action suchauxiliary powers, exceeding in effect all that can be possiblyinduced spontaneously, howsoever protracted the efforts.The steady employment of opiates keeps the disorder for
the most part under control, (say ten drops of the tinctureevery hour,) to which, in collapse, may be added one table-spoonful of brandy.with each dose. Thus have I been enabled ’’
to maintain a reputation, of which I am in no way ashamed;and to set at defiance every other remedy boasting of supe-riority. The same constitutes a line of practice to be adoptedin my own house, and I believe sincerely, its -timely adoptionin every other house, with free ventilation, would secure asuccess hitherto unknown. If one more sentiment I might beallowed to add, let me urge that it be publicly placarded—Open your windows a little both by day and by night; the wordventilation is not generally known in its practical application.The atmosphere is not generally regarded the great diluent ofevery noxious element, although the germs of the disorderwere possibly to float therein. Whither shalt thou flee tobreathe an element more pure ? 2
I am. Sir. vour obedient servant.WILLIAM HENDRY, M.R.C.S., &C.
PROPHYLACTIC AGAINST CHOLERA IN INDIA.To the Editor of THE LANCET.
SIR,—Should you deem the accompanying extract from myAnnual Report for 1848 to the Medical Board at Madrasworthy of a place in your journal,you will oblige me by in-serting it. I purposely avoid making any addition to theremarks then made, and should not have forwarded them forpublication, but from having recently (a few weeks since) readsome extracts from Dr. Billing’s book on cholera, in which the ’,same views are taken as to the cause of the disease.-I am,
F. GODFREY,Superintending Surgeon.
"Epidemic Cholera.—With regard to this subject, I maybriefly remark that for some years past, I have, during theprevalence of the disease, been in the habit of recommendingthe use of quinine (three or five grains) daily, as a prophy-lactic ; and have never known a person, whilst thus under itsinfluence, attacked by the disease. My experience, I mayobserve, has been too limited to form conclusive evidences asto its preventive influence, but offer the result of my observa-tions with deference for the consideration of the MedicalBoard. On the breaking out of the disease in a regiment, theplan might be put to the test, with some degree of fairness, byhaving one or two companies subjected to the treatment, andnoting, not only the proportion attacked, but also the proportionof recoveries under such circumstances. At all events, a trialwould not be followed by any injurious effects to the personsexperimented on.
" I was led to this practice from considering the poison ofcholera as being analogous, if not having an affinity to, themiasmata productive of fevers, and am inclined to believe,that even if the disease occurred to individuals whilst u-,derthe influence of quinine, it would be in a mitigated form.
" With regard to the treatment of epidemic cholera itself,I have nothing here to remark-the drugs recommended havebeen so dissimilar, and the fatal results so nearly uniform." ’
THE DISCOVERY OF CELLS IN CHOLERAEVACUATIONS.
To the Editor of THE LANCET.SIR,—In a notice in the last number of THE LANCET, re-
specting the discovery of certain cells in the evacuations ofcholera, I observed some strictures upon my colleague, Mr.Brittan, for anticipating his fellow-labourers in the publica-tion of that discovery.In fairness to him, I ought to state, that he published
with the concurrence both of Dr. W. Budd and myself. Itwould have been, perhaps, better, had the first discovery beenbrought forward in the shape of a report from us to thesociety of which we formed a sub-committee ; but circum-stances occurred which rendered Mr. Brittan anxious for im-mediate publication, and we therefore conceded to him thepriority in this respect, as we considered that he was the mostentitled to it, on account of his subsequent discovery of cellsin the atmosphere.
I have had much reason to complain of the manner in which
the first discovery was announced in the newspapers, especiallythe Morning Chronicle, but I am happy to say, that Mr. Brit-
tan’s paper, in the Medical Gazette, from its fairness, has done
much to cancel the injustice which was thus inflicted by otherparties upon myself and the other members of the sub-com-mittee. T am. Sir. vour obedient servant.J. G. SWAYNE.
THE MEDICAL ASSISTANT.To the Editor of THE LANCET.
SIR,—About a fortnight ago, a gentlemanly person called atmy house in the evening, and introduced himself tome as amedical assistant, then engaged to a general practitioner in thecountry, and bound to go to his situation in a few-days. Heasked for pecuniary accommodation to a small extent, toenable him to pay the expenses of the journey, and get hisclothes from his lodgings, where he was in debt. Withouttroubling you with all the particulars of his account of himself,which induced me to give credit to his statement, I advancedhim what he thought he wanted, and requested him to callagain, which he did. In the meanwhile I took care to makesuch inquiries as satisfied me that his difficulties were of a kindwhich are inseparable from the vicissitudes of the life of amedical assistant, and proceeded from no faults of his own.The morning he was to join the gentleman who had engaged
him, his agent in town received a letter, declining his servicesaltogether, in consequence of information received from someone he had called on in the midst of his distress, before hecame to me, erroneously representing his application as a formof begging, common amongst a set of impostors who infest themedical public. It is unnecessary to enter into the hardshipof this new misfortune. His character was good; his distressreal. The method he adopted to get assistance might be im-politic, but yet, surely, excusable; he had already passed twonights in the open streets.There is an institution established for the express purpose
of securing for governesses of good character a cheap homewhen out of a situation. It provides in every way for theirprotection against the temptations which too often pressheavily upon want. The system works admirably; and my ob-ject in writing this is, to inquire whether a similar place ofrefuge could not be provided for the medical assistant.For the present I leave the question to your well-known
advocacy in favour of any plan likely to benefit the conditionof a hard-working, useful,-nay, as the profession stands atpresent,-indispensable body of our fellow-creatures. Themembers of the profession at large are not likely to find any-thing better worth their attention for some time to come, andthe publication of this communication in your widely-eircu-lating periodical, will, I trust, lead to the adoption of someplan similar to that of the Governesses’ Institution. It is farfrom creditable to us of the nineteenth century that even themeanest member of our profession should find himself, blame-less as he may be, a desolate wanderer in the open streets, hismeans of livelihood utterly exhausted for the time, and gonefor ever the moment he confides his misfortunes to those whomhe has spent his last days in serving; and in evidence that thisis no more than the truth, I adduce the subject of this letter.
I remain, Sir, your obedient servant,HENRY SAVAGE.
APOTHECARIES AND SURGEONS.To the Editor of THE LANCET.
SIR,—At the present time there are more than 1500 mem-bers of the College of Surgeons, who may be fairly classedunder the head of general -practitioners, though not possessingany licence from the Apothecaries’ Company; more than sixtyof whom are surgeons to some of the various Unions. Now itis quite evident that all these 1500 individuals, many of themof long standing in the profession, are liable to be convictedat the County Courts for illegally practising; such is the law.A M.R.C.S. may prescribe in any case, (in fact, the great majo-rity of the pure London surgeons exist principally by attend-ing families,) yet if he dispenses his prescriptions (an actwhich any man without the slightest qualification whatevercan always do by putting Chemist and Druggist over a shop-door) he is liable to a prosecution ! It would be useless toenlarge upon the absurdity of this law. If the surgeon hasno right to dispense medicine, he certainly has no right toprescribe.But there are a great many surgeons who would be willing
to become licentiates of the Apothecaries’ Company, if theycould be admitted to an examination, which, as the law now
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stands, they cannot, Take my own case, for instance: I was,more than twenty-five years ago, articled to a pure surgeonfor six years, with the intention of practising -surgery alone;but, from circumstances, I became a general practitioner.Now I would willingly submit myself to a fair practical exa-mination from the Apothecaries’ Company, but of course, nothaving been apprenticed-to any member of their Society, itweuld be useless to offer myself. No doubt, there are manyother members of the College similarly situated. Let the
Apothecaries’ Company, therefore, imitate the College ofPhysicians, and throw open their doors, under certain regu-lations, to all M<R.C.S. of a certain standing, who are willingto enter them. Hundreds, no doubt, would avail themselvesof the opportunity; not that it would be attaching any addi-tional honours to their names, for who, at the present day,takes pride in calling himself an apothecary in being com-pelled, at all times and all hours, to make up the prescriptionsthat any member of the College of Physicians may choose todirect to him ? In conclusion, I cannot help observing, thatif,a member of the College of Surgeons has no right to dis-pense medicines, surely the mere apothecary has no right topractise surgery, or to style himself a surgeon; and if the oneis to be prosecuted, it does not appear like equal justice thatthe other should pass unscathed. The College of Surgeonshas received enormous sums from its members, and, in return,all its exertions have as yet been confined to degrading themajority for the purpose of exalting the few. It is now, how-ever, imperatively called upon to interfere on the behalf ofthose members situated as I have described; and surely it hassufficient influence to obtain the assent of the Apothecaries’Company to the proposed arrangement, though it would bemuch better that the College of Surgeons took upon itself thepower of granting full licence to practise all branches of theprofession-of course, under proper examinations.The general practitioner almost invariably designates him-
self surgeon, and by that title always gives his evidence inall courts of law; why not, therefore, do away with the objec-tionable term apothecary altogether, letting the professionbe known only as surgeons and physicians ?
I am, Sir, your velY obedient servant,A PRACTITIONER OF MANY YEARS’ STANDING.
COD-LIVER OIL.To the Editor qfTHE LANCET.
SIR,—I send you, at your request, the report of an analysiswhich has been made of Messrs. Langtons’ cod-liver oil.I may suggest that the chief points in favour of this oil are,first, its ascertained freedom from adulteration; secondly,its containing in due proportion all the known constituents ofcod-liver oil in general; and thirdly, its being, beyond com-parison, the most agreeable both in taste and odour, or rather,the only one that is agreeable at all. To find this last re-
commendation in that class of oil (the pale) which containsthe greatest quantity of iodine, would incline us at once togive it preference for trial in rheumatism, phthisis, and scro-fula ; for though the amount of iodine even in the pale oil isbut small, yet the peculiar combination in which it exists aspart of an animal product may well be thought capable ofgiving it an efficacy beyond what its mere quantity would in-dicate, as occurs in the case of chalybeate and other mineralwaters, which have a power over disease altogether dispro-portioned and superior to the amount of their medical con-stituents. And with the confession of even so intelligent anobserver as De Jongh, that the substances (as gaduine) pecu-liar to cod-liver oil are in all likelihood medicinally inert,there seems fair ground for assuming that the iodine mostabundant in the pale oil plays an important part in the nowfrequent cases of cure, more especially as iodine in its mineralforms has a well-proved influence over those very diseaseswhich most readily yield to the oleum aselli.The liberality and spirit of the Messrs. Langton, in sending
over to Newfoundland a first-rate extractor of the oil, so as toinsure its being obtained in the best manner, and from thefresh liver-and in their procuring a minute analysis of thearticle by such chemists as Mr. Aikin and Dr. Taylor, forman additional claim on their behalf to the support of the pro-fession.
I have the honour to be, Sir, your most obedient servant,F. A. B. BONNEY.
(COPY.)We hereby certify that we have examined a specimen of
cod-liver oil, transmitted to us for this purpose by Messrs.Langton Brothers and Scott.
The oil is of a pale yellow colour, with a slight but notoffensive fishy odour, and is free from any disagreeable taste.It is very fluid, and in consistency and general appearanceresembles good Florence oil. Its specific gravity at 6rPahr. is 0.924. At, the temperature of 14° Fahr. the steariiieis deposited, and the liquid oleine when poured off; thestearine becomes gelatinous at 10° Fahr: It contains no freeacid, and is perfectly neutral to re-agents. In ether it iswholly soluble, not leaving behind any deposit or sediment.Alcohol of 0.815 dissolves it in small quantity. This alcoholicsolution is quite colourless, and does not produce any bluecolour on starched paper immersed in it, thus proving thatno iodine had been added to the oil. Sulphuric acid producesin the oil a rich violet-pink colour, indicating the presence ofcholic acid, and therefore of biliary matter. A portion of theoil was saponified by a solution of pure soda, and the soapthus prepared was charred in a close vessel. This residue,when boiled in water, gave a colourless solution, which wasfound by appropriate tests to contain iodine. The quantityof iodine per cent., according to the nearest calculation whichcould be made, amounted to .027 or part by weight.This corresponds to the proportion assigned by other analysts.From these and other results we believe that the sample
sent to us is a genuine and unsophisticated specimen of cod-liver oil.We are likewise of opinion, from its purity, and the absence
of any unpleasant odour or flavour, that it is preferable formedicinal use to those samples of cod-liver oil which havehitherto come under our notice.
(Signed) ARTHUR AIKIN,ALFRED SWAYNE TAYLOR, M.D., F.R.S.,
Professors of Chemistry in Guy’s Hospital.Chemical Laboratory, Guy’s Hospital, Sept. 25, 1849.
THE LATE ASTON KEY, ESQ., F.R.S.To the Fditor of THE LANCET.
SIR,—The sorrow evinced by the death of Mr. Aston Keyis sufficient evidence to show in what light this eminent sur-geon was regarded both by the profession and the public; andmakes it too clear that a great loss has been sustained, ancithat his worth was duly estimated. Having seen much ofMr. Key for a few years past, I think it would not be uninter-esting to your readers if, in addition to the account of hispublic career, which you gave in a former number, I were tooffer a few remarks on his character, which might bring tolight any peculiar qualities with which his mind was endowed,and enable us to discover what gave him that power, whichplaced him in such an honourable eminence, and that strengthto retain it, until death, cloaked under a dire pestilence, cameand struck him down.
If a stranger for the first time had met Mr. Key, and ob-served his figure, tall, upright, and commanding, he wouldhave at once declared that he was looking upon no ordinaryman, but upon one accustomed to rule-upon one from whomhe must involuntary shrink back and feel himself inferior.Nor would this first impression,from external appearances alone,have deceived him; for let him but mark the first utterancesof his lips, and it would be incontestably proved that he wasone who habitually carried with him an air of superiority, aright to command, which tinctured all his words and actions,and which, in fact, as distinguished from others, formed themain feature of his character. However friendly you mightbecome, he ever made you feel your inferiority; and even if,from his elevated sphere, ho perchance descended to a moreconvivial mood, he was always ready to assert his superiority,and to retrace his steps to that height from which he had fora moment stepped. Thus was there always an unfathomablegulf between him and his admirers. The question naturallysuggests itself—how was this superiority acquired ? Howmuch of it was to be attributed to a natural force of character ?How much to a conscious knowledge of merit, and how muchto that praise lavished on him by his brethren, and acquiredby time ? We shall find that the truth is evolved from theconsideration of all these sources.There can be no doubt that knowledge is power; but it does
not necessarily follow that its possessor always has thissuperior influence so marked in him that it can be traced inall his footsteps, and cause him to be recognised by every oneas if by intuition.As regards the subject of these remarks, we may truly say
that Mr. Key’s knowledge of his profession was in the fullestsense profound. He had not studied surgical disease in alarge hospital in vain. Nothing worthy to be acquiredcould have escaped his quick and penetrating mind. Add to
