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The more formidable, and apparently hopelessly incurable,types of mental derangement admit, if not of cure, at least ofconsiderable alleviation and mitigation. We should never sayof a case of insanity that it is incurable, or that it baffles ourskill. We undoubtedly possess the power of materially modify-ing, if we cannot entirely re-establish, the mental equilibrium,the most unfavourable and distressing forms of insanity, ren-dering the violent, the turbulent, tractable and amenable todiscipline-the dangerous, harmless-the noisy, quiet-thedirty, cleanly in their habits--the melancholy, cheerful-by acareful study of the bodily or mental condition of each indi-vidual case, and by an unremitting attention to dietetic andhygienic regimen, as well as by a persevering, unflagging, andassiduous administration of physical and moral remedies fortheir relief.The spirit of love, tender sympathy, Christian benevolence,

unwearying kindness, and warm affection, should influence ourevery thought, look, and action, when engaged in the treat-ment of the sad and distressing cases entrusted to our care.We should never forget that, to use the felicitous and truthfullanguage of the bard of Avon, it is the special province of thepsychological physician to

" Fetter strong madness m a silken thread,Charm ache with air, and agony with words."

Oh, what a holy, honourable, and sacred occupation is that inwhich we all have the privilege to be engaged ! The godsmight well envy us the ennobling and exalted pleasures inci- ’,,dental to our mission of love and charity.

Correspondence.

HOSPITAL PHYSICIANS AND SURGEONS.

"Audi alteram partem."

To the Editor of THE LANCET.

SIR,-I appeal to you, the father of Medical Reforms, foryour powerful advocacy in the cause of the rising generation ofhospital physicians and surgeons. We are the victims of apolity which is daily becoming more burdensome and oppres-sive, and must, in candour admit, that the difficulties of ourposition leave us little hope of redress. AVe are much in-debted to THE LANCET for the publicity and discussion whichhave been freely afforded us, and much has been done in con-sequence ; but it seems of late the subject has either exhaustedthe zeal of its friends, or, in sheer hopelessness, they haveabandoned it. Am I presuming too much in this attempt tofan the expiring embers? If not, may I ask to be allowed toraise our ensign, and rally our ranks in THE LANCET? Idesire, then, to recall public attention to the case of the hos-pital physicians and surgeons; and though my remarks willmore immediately apply to that of the London hospitals, theywill not be inapposite to that of our brethren in the provinces.In the first place, let us take a glance at the qualifications,

&c., of those occupying hospital appointments. The physicianor assistant-physician to a metropolitan hospital must be amember of a college of physicians of Great Britain or Ireland,(generally London;) the surgeon or ass’stant-surgeon, a fellowof a college of surgeons, or, in the case of the assistant, amember. As a consequence, the medical officers are at leasttwenty-six years of age, and have generally graduated in artsand medicine in a British university, and have subsequentlyearned their promotion by filling the chair of physics, botany,or morbid anatomy, or by acting as registrar or curator of themuseum, or in some other capacity equally unprofitable in thehospital or college attached. The surgeons, though seldomgraduates, are equally men of standing, accomplished ana-

tomists, or have won their title to nomination by long years ofweary and unproductive labour. Now, suppose a vacancy, uprise half a dozen candidates, a tedious personal canvass (equalto that of a county member at least) ends in winning or losingat a cost of several hundred pounds. The unsuccessful candi-dates await the next turn-" still out of reach, but never outof view:" mine have grown gray on hope. The elect thenenters on his duties, and he fondly persuades himself that afterall his anxiety, toil, suspense, and outlay, he will soon beginto reap some tangible fruits of his labours. The terms of hisappointment require that he shall practise as a physician, or sur-

geon, " pure," as the case may be. The etiquette of the pro-

fession compels him to place himself on a par with Sir James

or Sir Benjamin as to fees. He of course resides in such ahouse as a man of his dignity may be expected to occupy,endeavours to sustain the appearance of a gentleman, continuesto consume " the midnight oil," and by all means to renderhimself worthy of his office. As an assistant, he takes chargeof 100 to 200 out-patients, whom he passes in review twice aweek; and, in addition, performs such duties as may devolveon him by the absence of his senior colleague. Should thatdignitary be the victim of old age, indolence, or other in-firmity, which causes him to bear his burden lightly, the

junior, at a moment’s notice, may be called on (regardless ofhis own interests) to take vicarious duty. His conduct as anofficer is strictly scrutinized by a lay committee, sometimesmore exacting than courteous; he is at all times, and under allcircumstances, bound to strict punctuality in the discharge ofhis duties, failing which he receives a smart philippic, and isreminded that public duties claim his first attention. Again:in undertaking this important charge, he finds he has verymuch restricted the sphere of his movements; for the governorshave decreed that the only terms on which he may absenthimself are by providing the services of a colleague conse-quently, when weary of the hum and toil of this " modernBabylon," he seeks repose, and to recruit his exhausted frame,(for he is but a mortal, and even steam-engines wear out,) heincurs a debt which can only be remitted in kind, on hisreturn, by doing double duty.The facts that all this responsibility and restriction, which

impose on the officer such devotion, and exact so large a partof the available working hours of his life, are absolutely unpaid,and that when exhausted, weary, and depressed, as a man mustbe who has done his best for a hundred poor sufferers, withwhom he has been incarcerated for some hours, breathing anatmosphere at all times polluted in such an assemblage, andoften pestilential, he returns to his home empty as hc left it, toseek some profitable employment, are known to comparativelyfew. Doubtless a man has thus many opportunities of gainingthe confidence and gratitude of his patients, and of thus build-ing a fame which may ultimately raise him into private andprofitable practice; but ill health or other unforeseen circum-stances may deprive him of those dearly-won fruits of his labours.Few, I am sure, of the munificent benefactors of these enduringmonuments of the charity which animates our countrymen areaware that these great blessings to the desolate sick thus de-pend on the unrewarded labours of the medical staff, and fewerstill, I hope and believe, would decline to render us a less pre-carious consideration for our services. But years roll on; theseniors win their way to fame, gather their laurels, or are

gathered to their fathers, and the juniors take their places;"by turns we catch the vital breath and die;" their gray hairsreplace their once luxuriant locks, (unless time has been toorelentless;) they then begin to reap some of the fruits of office,such as the fees of pupils at the hospital, and obtain such prac-tice as years of accumulative labours and standing bring them.This, and this only, has been the junior’s hope. The publicconsiders that the title of assistant does not convey much; andas some seniors retain their honours with doubtful advantageto the hospital and themselves, long deferring the promotion oftheir colleagues, (which with few honourable exceptions can-not be gained by a limited service, though clearly so reasonableand advantageous to the institution and the staff,) thus eventhis adventitious advantage may be indefinitely postponed.When these appointments were originally instituted, the

profession, as a mass, was infinitely worse informed, and there-fore in a less degree possessed public confidence; but as thesystem of hospital relief extended, the great body of practi-tioners has become more enlightened, and thus the want ofconsulting physicians and surgeons has diminished. Competi-tion is now so great, that the junior has but little chance ofprivate practice; consequently, unless he be a man of property,he cannot afford to wait his turn. The public may be, andoften is, deprived of "the right man in the right place ;" or ifa young man of talent, but not of money, attempt the hospitalcareer, his distraction in the struggle of life robs the public ofthat developed talent of which only the young and plastic mindis susceptible.Under the enlightened policy of the continental regime, the

young medical officer possesses, by virtue of his appointment,a certain adequate consideration, which enables him to devotehis early life to the cultivation of his profession, and producesthe fruit of an early harvest. As all real advancement ofmedical science benefits the public rather than the profession,(for few men discriminate between the unsuccessful though de-serving, and the successful and plausible,) therefore it is for thepublic good that these great schools of Nature should be made

71

available instruments of science to the really worthy. The

public would thus gain by a liberal consideration of the servicesof the medical and surgical officers of hospitals, and at thesame time render an act of justice to a class.

Instead of presumptive, uncertain, and precarious advan-tages, with indefinitely postponed promotion, we solicit somesubstantial acknowledgment of our services, and a definiteprospect of improved status.

I am, Sir, your obedient servant,Julv. 1857. CHIRURGUS.

THE GLASGOW CASE.—THE MICROSCOPE.[NOTE FROM DR. HASSALL.]

To the Editor of THE LANCET.

SIR,-In the course of perusal of the daily papers for someyears past, it has repeatedly occurred to me to notice how oftenthe truth fails to be elicited, and the ends of justice are defeated,in consequence of the neglect to employ the microscope.The Glasgow poisoning case affords an instance in point.

Had the microscope been resorted to in this case, it is probablethat information of a most important character might havebeen obtained, as I will now proceed to explain.The cocoas sold in this country consist of mixtures of cocoa,

starch, and sugar. Different makers employ different kinds ofstarch or flour ; thus some use wheat flour ; others potato orsago starches, &c.; and others, again, employ a mixture of twoor more starches. By means of the microscope these starchesmay all be identified, and this even after the cocoa has beenprepared by the addition of boiling water. Had therefore theejecta and the contents of the stomach and intestines beensubjected to microscopical examination, it is very probablethat the starch corpuscles of the cocoa actually consumedmight have been discovered, and if these on comparison werefound either to differ from, or to correspond with, those con-tained in the cocoa used by Miss Smith, a highly importantpiece of information would have been procured, telling eitherin favour of or against the prisoner. Again, the microscope iscapable of affording valuable information in cases of poisoningby arsenic, as to whether the arsenic was coloured, and thenature of the colouring matter used.

I consider it my duty to make known the above particulars,in furtherance of the ends of justice in any future cases whichmay arise.

I remain, Sir, your obedient servant,ARTHUR HILL HASSALL, M.D.

Benuett-street, St. James’s-street, July, 1857.ARTHUR HILL HASSALL, M.D.

ON POISONING BY STRYCHNIA.To the Editor of THE LANCET.

SIR,- We have allowed three impressions of THE LANCET tobe issued since Mr. Wilkins’ letter, in the expectation that thequestion we put to Dr. Taylor would have received some reply,and we would not now trespass upon your valuable space, wereit not for the fact, that upon the detection of strychnine is in-volved the truth or fallacy of Dr. Taylor’s theory. This theory,as many of your readers may remember, first assumed a cha-racter of importance at the trial of William Palmer, and whichis, in suhstance, that the strychnine which occasions deathundergoes such changes in the destruction of life as to cease tobe strychnine; consequently, if a minimum dose, or a dose onlyjust sufficient to destroy life, were administered, it would beimpossible to find any chemical evidence of its having causeddeath. It is obvious that this mode of reasoning will applyequally well to many other organic basic poisons, and the veryexistence of the notion that this is fact is, as can readily beimagined, full of danger to the public.Many of your readers may not be aware of the fact, that Dr.

Taylor’s theory was not founded upon the results of analysesmade by the process of Staas, which, however, had been pub-lished and known in this country for several years previous tothe death of Cook, but upon the results of a mode of analysisof a most imperfect kind, and one which filled with astonish-ment the mind of every chemist who heard Dr. Taylor give hisevidence.We emphatically deny having any hostility towards any

toxicologist, but we confess our determination to expose theuntruth of such dangerous theories when founded on error.The matter stands simply thus: Dr. Taylor failed to detectstrychnine in the body of Cook-failed by the same process todetect strychnine in the bodies of three rabbits out of fourpoisoned by large doses of it. This process, as we have said,

was not Staas’, but one of the crudest possible description, yetupon such results is this theory founded. On the other hand,Mr. Herapath, Drs. Wrightson, Letheby, Ogle, Garrod, andAyres, ourselves, and others, have found strychnine pass un-changed through the system, and have separated it unchangedfrom the tissues and blood of animals poisoned by it. Wetherefore repeat, that it was with surprise that we found Dr.Taylor adopting Staas’ process, which we had pointed out asincapable of separating strychnine from the tissues and fluids,and thus seizing an opportunity of repeating his dangeroustheoretical opinion, while he had at his disposal our mode ofanalysis, which, if carefully carried out, would have given hima different result, and would have convinced him of the errorof his own theory.

In conclusion, we would remark, that we should not havecommented so severely upon the word inadequate, had we notknown that Staas’ process is really inadequate to separatestrychnine from the tissues and fluids of the body, although inmany cases it is adequate to separate strychnine from thestomachs of animals. Its great defect even here is, that thereis no provision made for destroying foreign organic matter, andwe cannot too strongly impress on your readers the necessityof destroying all foreign organic matter by sulphuric acid, as.already published, before applying the tests, as, without this,precaution, failure will certainly be the result, even although.there be a large amount of strychnine present.

We are, Sir, your obedient servants,J. E. D. RODGEES,

Lecturer on Chemistry at St. George’s School of Medicine.G. P. GIRDWOOD,

Assistant-Surgeon Grenadier Guards.Laboratory, St. George’s School of Medicine,

July, 1857.

J. E. D. RODGERS.Lecturer on Chemistry at St. George’s School of Medicine.

G. P. GIRDWOOD,Assistant-Surgeon Grenadier Guards.

CHANGES IN THE UNIVERSITY OF LONDON.To the Editor of THE LANCET.

SIR,-A short time since I appended my name to a protestframed by a committee of the graduates of the University ofLondon, against the changes proposed by the senate relativeto the admission of candidates for degrees in arts. I did so fortwo reasons: the first, that I considered the degree of B. A.implied something more than the successfully passing a certainexamination,-namely, college training, and various advan-tages therefrom arising, not to be tested by an examination;the second, that I believed the two older universities were aboutto frame examinations equal in stringency to those at presentexisting for the degree of B. A., but to which candidates havinghad no college training were to be admitted, and who weretherefore to take an inferior title. I consequently reasonedthat if candidates for B.A. at London were to be admitted onthe same terms, they would only rank with the A.A.s at Ox-ford and Cambridge, and would also sink to their own level allprevious graduates, thus producing a manifest injustice.But subsequent revelations have convinced me that the col-

legiate training hitherto enjoyed by London arts graduatesexists in but little more than name, and that the B.A. degreemust be simply taken as implying that the candidate possessedan amount of knowledge enabling him to pass an examinationgiven under, I am happy to say, very stringent conditions; sothat my first reason against the proposed change is disposedof. My second reason has likewise been subverted since it hasbecome known that the two older universities intend their newexaminations to be of a very elementary character, and onlyadapted to youths under eighteen years of age. Therefore myfear of the A. A. of Oxford and Cambridge being held on a parwith the B.A. of London can no longer be entertained. Underthese circumstances I must in justice revoke my former decla-ration.

I am, Sir, yours, &c.,Scarborough, July, 1857. T. MORLEY llooKE, 11.D. Lond.

’ The change of opinion of our correspondent is the naturaleffect of deliberation on a candid and generous mind. Suchinstances of conversion from the absurd doctrine of exclusive-

ness, as regards the admission of candidates for the degrees ofthe University of London, are, we are assured, numerous.

The bulk of those graduates who signed the Memorial circu-lated by the graduates’ committee probably did so, influencedby unquestioning confidence in the committee, by esprit decorps, and prejudiced by the ex parte "Statement of Factsand Arguments" which bears the signatures of the two cbair-men, neither of whom believes in the truth of those facts, or in

T. MORLEY ROOKE, M.D. Lond.