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the services you render, and the law will hold you respon- sible in case mischief results from your interference. Theobject of the Act is to cliscourage practice without regis- :tration, and it seeks to do so by excluding from legal recogni-tion those not registered, and rendering liable to all civil

obligations men so practising. These proposed amendmentsdo more than this-they seek to go further than any measurewhich has ever heretofore been proposed, and to preventpractice altogether unless licensed by Act of Parliament, eventhough the person practising be of competent skill and possessqualifications which elsewhere entitle him to treat disease. Itis well to recall the dictum of Mr. Justice Hullock in VanButchell’s case: ’’ It is my opinion that it makes no differencewhether the party be a regular or an irregular surgeon; indeed,in remote parts of the country many would be left to die if

irregular surgeons were not allowed to practise. It is quiteclear that you may recover damages against a medical prac-titioner for want of skill ; but, as my Lord Hale says, ’Godforbicl that any mischance of this kind should make a personguilty of manslaughter.’

" Hitherto the law, though notrecognising, has not declared to be illegal, the undertaking ofmedical or surgical treatment by unqualified practitioners. Thefalse assumption of titles brought offenders under the ban ofcorporations, and ignorance or rashness rendered them open toproceedings, either of a civil or of a criminal nature, as thecase might be. The spirit of the law has heretofore been toleave it free for everyone with special knowledge to exercisethat knowledge for the good of his fellwv-man provided he did Iso honestly and without false pretence. The medical professionnow claim that none shall do so unless they be registered.The proposition is as broad as it is bold, and one whichdemands the most serious consideration. It is scarcely re-quisite to refer to the contemptible blunders and almosthumorous differences that have characterized decisions on this

question. Judges of minor tribunals, with too frequentlyrusty notions of law, have certainly contributed their aid toembarrass this question. This is scarcely to be wondered atwhen we find the highest common law authority in the king-dom, the Lord Chief Justice, declaring, in the case of Ladd v.Gould, he did not think it any false pretence for the defendantto use the name of "surgeon," when practising as a dentistwithout any qualification; an opinion approved by Mr. JusticeCrompton, who observed it was like the ease of " surgeon-chiropoaists, "—opinions neither recognised nor acted upon inthe minor courts; Samuel Nunn having been lined 40s. for asimilar offence, and, notwithstanding the dictum of the LordChief Baron in Ellis v. Kelly, Joseph Chamberlain, registeredas a Licentiate of the Apothecaries’ Company, having beenfined £5 for as;umiug the title of surgeon. We propose toreturn to the consideration of this section and of its defects.

CORONERS’ INQUESTS IN EAST LONDON.

A MEETING of the medical practitioners of the East-end ofLondon was held at the Beaumont Institute, Beaumont-square,-Alile-end, on Thursday, the 2nd inst., to consider the follow-ing subjects :-

1. The subject of medical evidence at coroners’ inquestsand the appointment of medical coroners.

2. The necessity of establishing a fund available fur disbursing the expenses of legal assistance in defending proceedings arising out of their profession.3 To receive the sense of the meeting upon the alteration;

necessary to render the present Medical Act more effectual iisuppressing illegal practice, &c.

Dr. RohE, who was unanimously called to the chair, saidthat he anticipated the objects of the meeting would bunanimously approved, and ii only mode of estlb- lishinproper esprit de amonget the profession was by combined

action, and the adoption of rules by which they should beactuated with respect to the courtesies which every memberwas entitled to receive from his brethren. He then referredto recent instances of coroners’ inquests, in which he con-sidered there had been much unfair play. In an instance thatlately occurred in the immediate neighbourhood, and in whichhe felt a special interest, he explained that the questions put tothe witnesses were of a leading character, all having a specialreference to the condemnation of the medical practitioner inattendance. He trusted that the meeting would adopt suchresolutions as would prevent a repetition of this wrong, andsecure to the profession more courteous treatment for thefuture. There might arise cases in which errors of judgmentwould be likely to occur, and in which differences of opinionwould arise, but in every case where competent skill wasbrought to bear and anxious attention was devoted to it,the proper course was to shield a professional brother fromthe attacks to which he might be exposed. In reference toadvertisements, which frequently appeared, requiring assist-ants who were "unqualified," he thought that, for the pro-tection of the profession, this practice should be avoided.Mr. SWYER proposed the first resolution,-" That the

present mode of taking evidence at coroners’ inquests is highlyobjectionable, and that, as a rule, the medical attendant atthe time of death should be communicated with by anygentleman who may be appointed by the coroner to make anexamination." Mr. Swyer, after supporting the principle ofthis resolution, related the circumstance of a case in which hehad been engaged, and which is fully detailed in the letterat page 162.The resolution was seconded by Mr. THOMPSON.Dr. HELSHAM thought that an additional protection should

be afforded to medical attendants in certain fatal cases by theemployment of a legal adviser at the inquest to watch theproceedings.

Dr. EDMUNDS moved, as an amendment, ’’ That a medicalpractitioner who may be entrusted to make a post-mortemexamination in case where another practitioner had attendedat the time of death should always do the best he can to give

. such practitioner an opportunity of being present." In pro-’ posing this amendment Dr. Edmunds entered into a lengthenedstatement respecting the part he had taken in reference to

’ post-mortem examinations made by order of the coroner. Ile; had always endeavoured to do his duty fairly between the_ public and the profession.

Mr. HANKS having seconded the amendment, it was carried. unanimously.

Dr. MILLER having referred to a case in which Dr. Edmunds,t in his opinion, had acted most discourteously to the other prac-e titioners engaged,Dr. EDMUNDS disclaimed any intention of discourteous

treatment of the professional gentlemen who had been engagedin the case, and expressed his full intention in all future cases

a to act more in accordance with the feelings of the meeting.This determination was received with much satisfaction.

d The amendment was carried.The second resolution,-" That in consequence of the

numerous unjust actions against medical men, this meet-

ing considers it necessary that a Defence Fund be raised to

defray the legal expenses incurred, and that a committee beformed to draw up rules embodying the above resolutions,"was proposed by Mr. RILEY, and seconded by Mr. LYEL.,

Dr. EDMUNDM thought that the prosecution of medicalpractitioners had a beneficial effect even upon themselves, andin many cases eventually advanced their interests ; but withrespect to the proposed Fund he thought that before establish-ing it the meeting should affiliate itself to the Medical Asso-ciation, which was already established, and could be madeavailable for the purpose.Mr. THOMPSON, on the contrary, thought that the Asso-

ciation was unequal to the task, and that there were manycases in which a General Defence Fund was highly necessary.

In reply to a question by Mr. Wahony, the CHAIRMAN saidthat if this fund were established locally it would, of course,benefit the local members only ; he thought, however, that a

national association would be of far more service, and sug-gested the formation of a committee, whose duty it should beto correspond with other associations which were formedthroughout the country for the purpose of effecting a union ofthem all in one general body, and that London should bemade the starting point of this movement. A small annual

contribution would be amply sufficient for the purpose.I The principle of the second resolution was adopted by themeeting, and the establishment of n. fuud decided on ; and we

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believe that some subscriptions were received, headed by acheque for two guineas sent by Dr. Herbert Davies, who wasunable to attend the meeting.On the proposal of Dr. LYEL, the following gentlemen were

appointed as an acting committee :-Drs. Edmunds, Miller,Stephenson, Messrs. Riley, Thompson, Rose, Swyer, D’Olier,and Hawker.The attention of the meeting was not called to the amend-

ment of the Medical Act, as at first proposed ; this matter,with all others affecting the interests of the profession beingleft to the consideration of the committee, and for discussionat future meetings.After a vote of thanks to the chairman the meeting se-

parated.

Correspondence.

ON THE UNITY OF THE SYPHILITIC VIRUS.

" Audi alteram partem."

To the Editor of THE LANCET.

SIR,—My thanks are due to Mr. Gascoyen for the pains he Ihas taken in his letter of the 28th inst. to clear away the mis- Iapprehensions I was under concerning some of the statementscontained in his valuable paper " On the Unity of the SyphiliticVirus." But, through my not making my meaning quite clear,Mr. Gascoyen has failed to comprehend exactly what I in-tended to convey. In defending the dualists from the imputationof pretending to be able on first seeing a chancre to announcein all cases whether the patient has escaped contagion of the con-stitutional disease or not, I meant that they demand that theperiod of incubation possessed by real syphilis be passed overbefore they give a decided opinion as to the absence or pre-sence of that disease. This delay they think necessary because,according to their belief, until the incubation period be con-cluded syphilis does not reveal its presence in any way

appreciable to our senses. But I grant, and Mr. Gascoyen isquite correct, if he chooses to say so, that the holders of thedouble virus theory pretend to be able to state at once if thenon-infecting sore be present ; though whether it is alone oraccompanied by syphilis, they wait until the incubation periodhas elapsed before deciding. Mr. Gascoyen denies that thereis an incubation period between the inoculation of syphilis andthe manifestation of its symptoms; yet he must have seen somecases where such delay has taken place, and if not, he willfind in those cases of artificial inocul&tion where the constitu-tional disease was inflicted the incubation was clearly observed;in both of V. Baerenspriing’s cases it was so, for instance.With respect to the chancre mixte, Mr. Gascoyen holds up

this doctrine to ridicule, because it is to him incomprehensiblefor a sore to be the site of two morbid actions, distinct in theirnature, and propagating two different viruses at one and thesame time ; ergo, as there is no doubt that from some chancresboth varieties of venereal ulcers proceed when their secretionis inoculated on others, the existence of such sores is a strongargument in favour of a single poison and not of two. But inhis reply to me, when I urge that in cases of vaccination andsyphilis the vaccine virus and syphilitic virus show no suchincompatibility, and therefore no such impossibility of twopoisons being in simultaneous action exists to disprove thepresence of two viruses in the mixed chancre, I am told that,as Mr. Gascoyen does not believe in the existence of twopoisons, he cannot allow the existence of the mixed chancre.This being so, the mixed chancre can hardly be made an argu-ment to negative the existence of the two viruses. At presentwe have Mr. Gascoyen’s belief that it is not charged with twopoisons-nothing more. Mr. Gascoyen compares the abortiveeffects sometimes seen in vaccination, when the lymph has notbeen secured at a right moment, to the soft chancre, and the iregular vaccine disease to the constitutional syphilis. I do inot allow this comparison to be a fair one, for it can hardly beasserted that these slight local inflammations of unsuccessfulvaccination can be propagated indefinitely from individual toindividual and produce specific inflammations in the neigh-bouring lymphatic glands-undoubted characteristics of thenon-infecting venereal sore.

Mr. Gascoyen says that syphilis, when introduced by vac-cination, is very different from the primary affection, andthat he is discussing primary affections only. I am glad indeedto read this, as it strengthens what has been advanced bydualists, that syphilis is a constitutional disease, and that itsearliest manifestations are as much constitutional as its laterones, but that it is often complicated or contemporary with alocal affection of distinct nature.

In speaking of idiosyncrasy I am accused of "taking forgranted that Mr. Gascoyen was about to invoke idiosyncrasyas a chief explanation of how one poison may produce differentresults." I did not mean to do so, nor do I think I have, ason referring to page 655 of your last volume (Dec. 17th) Iread, "They (the advocates for the unity of the virus) accountfor the varieties observed in the manifestation of the same

poison by the peculiar idiosyncrasy of the person, state of hishealth or constitution, susceptibility or non-susceptibility to thereception of the disease, condition of the tissues in which thevirus has been deposited, and source from which it has beenobtained." After reading this I think I shall be acquitted oftaking it for granted that diversity of idiosyncrasy is a chiefreason, in the opinion of Mr. Gascoyen, that the same poisonproduces such various effects in different individuals. But Iam perfectly willing to be so charged if my error has inducedhim to explain that he does not include idiosyncrasy in thecauses of the different actions of the venereal poisons.You, Sir, and Mr. Gascoyen will excuse my replying to his

letter of the 28th inst. at such length, as this question of thenature of venereal poisons is a most important one. I hold thepaper to be a valuable contribution to the elucidation of thatquestion. It contains some important principles which are notgenerally received : I allude especially to the statement thatthe changes and peculiarities in the ulcer accompanying theconstitutional disease are themselves in part, at least, if notall constitutional, and the result of the disease having alreadyimpregnated the system with its poison. If this principlewere generally accepted the question of the advantage ofabortive treatment would be greatly narrowed. Your spacewill not permit my passing on to the enumeration of otherweighty points in this paper " On the Unity of the SyphiliticVirus."

I am. Sir. vour obedient servant.M. BERKELEY HILL,

Assistant-Surgeon, University College Hospital.Weymouth-street, January 31st, 1865.

CASE OF PRYCE AND WIFE VERSUS BOWEN.To the Editor of THE LANCET.

I!i SIR,—Having now passed through my duScuIty and trouble,I must beg as an additional obligation from you, who have sopotently placed my case before the profession and the public-a small space for a word of sincere thanks for the great servicewhich has been rendered me.Allow me most gratefully to acknowledge the kind sym-

pathy, as well as the moral and practical support, which Ihave met with from the profession as a united brotherhood.To the powerful advocacy of the medical press I am, indeed,most deeply indebted, especially to its leading organs, whichalways have been, and I feel sure ever will be, the trust-worthy guardians of professional honour and the readychampions of professional grievance.The same consciousness of right with which I accepted the

gauntlet thrown down by this gross aspersion on my profes-sional ability, and by the aid of which I faced the inevitableslander and exposure of public trial, well assured me of theapproval of the profession, of the good word of the professionalpress, and of the sympathy of the rightly-judging public.

Grant me the opportunity of expressing the intense grati-fication which I, and, I am sure I may add, the whole profes-sion, have experienced from the dignified and righteous con-duct exhibited throughout this case by the medical professionof Liverpool and this neighbourhood, as well as of thus feeblyacknowledging the great service rendered me by those leadingmembers of it who were present upon the day of trial.

I must not omit to state that, with the exception of Mr. Eva.n Thomas, jun., the only surgeon in Liverpool who sawthe case at an early date was Mr. Martin, of Rodney-street ;and that Mr. Martin, as soon as he became informed of thethreatened action, very courteously called upon me and toldme of it.

I deeply regret the position occupied by Mr. Lund in this