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just as if she had not lost her foot. She wears a sort of bucketshoe or boot, with a little cotton wool at the bottom, and saysshe never suffers any pain or inconvenience in the part. Theamount of shortening is much less than would be imagined-in fact, quite inconsiderable. I have had a cast taken of theieg, and as 1 am able to see the child at any time now at herschool, if there should be any point on which you would likefurther information, I shall be happy to obtain it for you.

I am, Sir, your obedient servant,ATHOL A. JOHNSON,

James Syme, Esq. Surgeon to the Hospital for Sick Children.ATHOL A. JOHNSON,

Surgeon to the Hospital for Sick Children.

THE

ROYAL MEDICAL BENEVOLENT COLLEGE.To the Editor of THE LANCET.

SIR,—Happening to go into my husband’s consulting-room,my eyes accidentally fell upon the words Royal Medical Bene-volent College, at page 507 of your number for November l4th,and as I have always taken a lively interest in that institution,I could not refrain from perusing the letters of your severalcorrespondents.The one signed W. Dalton seems to me to evince more zeal

than judgment, and to have been written under such a totalmisapprehension or perversion of facts, that I have no doubtyou will have many others most anxious and more competentto point out its glaring inaccuracies, both of argument andgrammatical construction.Having attentively read the pamphlet alluded to, published

by the sub-committee, I cannot resist, with your permission,making one or two remarks. Mr. Dalton states " anotherattempt" is being made " to misapply the funds of the institu-tion," and protests against such misapplication to " any otherpurpose than that of pure charity for the aged and theorphans. "

From my reading of the pamphlet, I infer that it is againstthe misapplication of the funds, and the failure of the councilto carry out the intentions of the subscribers as promised tothem in the original prospectus, that the committee are acting.As one illustration of the former, I take the building of the

College. The estimate was .618,000, whereas £31,000 and up-wards have been expended, and the building is yet unfinished.As regards the latter, a leading feature in that original pro-spectus was the education of the children of the medical pro-fession at a fixed and remunerative charge. Although this wasclearly set forth from the first, Mr. Dalton now indignantlyprotests against it, and threatens that if carried out, he andhis friends will withdraw their" annual guinea," which, Imust confess, I think could not very materially affect the fundsof the College.Now, I and many others subscribed principally with this

latter object in view; for in my opinion there is as much sym-pathy needed for those who from necessity are compelled tomake an appearance beyond what their incomes justify as forthe orphan. Indeed, if facilities were afforded for a moreeconomical education of our children, there would assuredly befewer orphans requiring the aid of charity. There is no povertymore keenly felt than genteel poverty. But the pamphlet seemsto me to show that this original intention can, so far as the ex-hibitioners are concerned, and with a less reckless expenditure,be made self-supporting; so that if objectionable, neither Mr.Dalton nor any one else need contribute anything towards theeducation of these the children of our less affluent professionalbrethren. I

I am quite disinterested in this matter, having no child atthe school; but I do think the terms "short-sighted andselfish," as applied by Mr. Dalton to those gentlemen who formthe sub-committee, both harsh and uncharitable, as it can onlybe under extreme circumstances that any one would willinglywage war with authority.

I remain, Sir, your obedient servant,November, 1857.

____

A LIFE GOVERNOR.

To t7te Editor of THE LANCET.SIR,-As a local secretary and as a governor, willing to exert

myself on behalf of all the benevolent objects of our institution,I am anxious to deny M. toto the statement of Mr. Dalton inTHE LANCET of the 14th inst., " that another attempt is beingmade to misapply the funds of that institution," when alludingto the movement now being made on the exhibitioners question.For the benevolent objects of the Royal Medical College, I

would first refer Mr. Dalton to the original prospectus issuedby our much respected treasurer, Mr. Propert, headed as a

! proposal " to Erect and Endow a College for the Reception ofDistressed Members of the Medical Profession, or their Widows,and a School for the Education and Maintenance of their Sons."This heading was followed by the outline of a scheme, theprinciples of which were, I may say, guaranteed to the profes-sion by the names of Dr. J. A. Wilson, Dr. Robert Lee, W.Fergusson, Esq., J. Bacot, Esq., and B. Phillips, Esq., beingappended.

I would next refer Mr. Dalton to the printed form, by whichhe and other local secretaries appealed to the public to establish41 a Medical Benevolent College," to include " a School, inwhich a liberal education will be given to 100 boys, the sonsof duly qualified medical men, the majority of whom will pay£30 a year each for education, board, lodging, and washing,while the rest will be orphans, educated and maintainedentirely at the expense of the Society." These appeals weremost generously responded to, and Mr. Dalton will find hisprinted form of receipt headed " Medical Benevolent College,for the Reception of Distressed Members of the Profession, ortheir Widows, and to afford a first-class Education to theirSons or Orphans." The word " Benevolent" was, I believe,introduced into the name of the College after considerable dis-cussion, to express the true design of the institution.

I would now briefly remind Mr. Dalton of Law 30, adoptedand acted on for about twelve months, " that a certain numberof scholars should be exhibitioners, and should pay a sum notexceeding X30 a year." This, as all must allow, was an

immense boon to the profession generally, but was most un-fortunately and unexpectedly snatched from our more needybrethren by a resolution passed in August, 1856. By this, thescholars, still called exhibitioners, are required to pay the sumof X40 annually. The section of the Act forming the excusefor thus depriving many of so great a boon reads thus:—

" It shall be lawful for the College to educate at their school,with the foundation scholars to be elected by the governors,other children, either as boarders or as day scholars, and eitheras exhibitioners or otherwise; and such children shall be re-ceived upon such terms of payment, and other terms and con-ditions, as shall be fixed by the Council; so, nevertheless, thatthe funds of the College applicable to the charitable objects ofthe foundation shall not be diminished by the admission to theschool of such other children."Webster defines an exhibition to be " an allowance of meat

and drink; pension; benefaction settled for the maintenanceof scholars in the English universities, not depending upon thefoundation." And if this definition be correct, the four Surreyscholars are now the only exhibitioners at the Royal MedicalBenevolent College; and I can see nothing in the section of theAct above-quoted to justify the exclusion of exhibitioners fromour Benevolent College. The question to be solved by thegovernors appears to me to be, ought there to be exhibitionersat the College or not? But I cannot conceive how the advo-

cacy of the exhibitioners’ cause-the prominent feature of thebenevolent scheme from the first-can be considered an at-tempt to apply the funds to a wrong purpose.

Sincerely trusting that every medical man will not only be-come a governor of the College, but lend a helping hand to thecause of their more needy brethren, thus rendering the insti-tution a more lasting monument to Mr. Propert’s benevolentperseverance, and still more-worthy of the medical profession.

. I am, Sir, yours very truly,Dutwich, November, 1857.

’

, . EDNV-AP.D RAY, F.R.C.8.EDWARD RAY, F.R.C.S.

HOSPITAL REFORM.To, the Editor of THE LANCET.

SIR,—Being a "Constant Reader," I have noticed withmuch satisfaction some remarks in a ’past number of yourjournal, on the propriety of appointing senior resident-sur’geons in our large metropolitan hospitals. It is no flatteryto say you have contributed, in a marked degree, to intro.duce many improvements in the way of hospital reform,and I hope you will not leave this stone unturned. It is, in-deed, a stumbling-block and an offence that in the very insti’tutions set apart for the instant relief of every description ofcasualties, a patient may actually be carried in and die beforehe can receive the attention of an experienced surgeon.Now, Sir, we shall all be indebted to you, both profession,

patients, and public, if by your reformatory pen this evil canbe removed. As things stand at present, the unhappy wightwho may have severed his femoral artery, or sustained a com.

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pound fracture of the thigh, must remain comparatively un-treated-say for an hour-while messengers are dispatched forthe surgeon of the day, or week, or for his substitute, unlesssome other member of the staff thinks proper to interfere.Surely this ought not to be. The house-surgeons are, I believe, Iwithout exception, zealous and well informed men; but what ’,is zeal without experience, or information apart from practice. ’,I know they perform their harassing duties most manfully; butenergy and industry can avail little without skill, and skill canonly be acquired by practice, and practice only makes perfect.Their position is often most trying. They must not interfere,not even to the tying of a large artery, for it is contra leqes;they must wait for the arrival of the authorities. But I haveknown a house-surgeon tie, at midnight, the anterior tibialartery, and the patient died; and I have known a house-sur-geon, whose zeal exceeded his discretion, operate instanter ona patient who hobbled into the surgery one morning with aloose cartilage in his knee-joint; and I have seen two youngdressers, whose zeal exceeded both their knowledge and dis-cretion, seize on three or four poor wretches who laboured underphymosis, and proceed to circumcise them there and then, andthat too after the boldest fashion, and with much bloodshed.But not to multiply instances, I can say, from experience of alarge hospital, that a resident-surgeon, a man of experienceand skill, no new-fledged bantling of the college, but one whohas proved himself a man, is really required. He should notbe less than thirty years of age, and should be a 1).J01’kingman; not, indeed, to be summoned for every slight accident,but to be ready for emergencies; one to whom those around canlook up for guidance, and on whose authority they can im-plicitly depend. In those hospitals that possess the form of acollegiate residence-such, for instance, as St. Bartholomew’s-he could at the same time hold the responsible position ofwarden, but he should not fill any other appointment withinthe walls, nor, of course, take private practice.You know, Sir, the jobbery by which every good post is

secretly given to somebody who may be at the time ready forit. This is a disgrace to our London hospitals. Why are theynot advertised, and thus thrown open to the profession? Whyshould a demonstratorship, or the registrar’s office, or anyother ladder to promotion be covertly bestowed on the manwho can afford to live for two or three years idle ? Do strikeat the root of the system !

I am, Sir, your obedient servant,Devizes, Nov. 1857. AN ADMIRER OF A FREE CONSTITUTION.

DENTAL DISPENSARIES AND MEDICALCHARITIES.

To the Editor of THE LANCET.SIR,-I read with much interest in THE LANCET of Oct. 31st

of the opening of a Dental Dispensary. No doubt this institu-tion supplies a real want. The poor, who cannot pay a dentist,cannot expect the parish doctor to stop teeth or supply theplace of lost ones. They must therefore go without, sufferingthe loss of tooth after tooth, and the consequent dyspepsia andother maladies which come upon them, unfit them for work,and shorten their lives, without the means of obtaining relief,and often without knowing what is the cause of their sufferings.The extent of this evil amongst the poor is very great: probablyhalf the poor, both men and women, who have attained fortyyears of age, are unable, from loss of teeth, to masticate theirfood. Unless, therefore, they could establish amongst them-selves " tooth clubs," on the principle of benefit clubs, which isnot likely, they cannot obtain artificial teeth without the aid ofsome institution like this. Medical writers and medical practi-tioners should bear in mind the position they hold in the bodypolitic, and the whole duties they owe to it; and should wellconsider the effect and tendency of all their proceedings, notonly upon themselves, but also upon the nation. For example,it is the fashion of the day to found endless dispensaries, &c.,some general, others for special diseases. This may serve thepurpose of Mr. A. or Dr. B., who want to get into practice, orto become noted for some speciality, or to write after theirnames "surgeon to such and such a dispensary," (I have beenone myself); but what is its effect upon the community ?What benefit to the public is proposed by having so many dis-pensaries ? Who are they to help ?-those who cannot pay orthose who can ? For those who cannot there is the parishdoctor, and, in extraordinary cases and accidents, the greathospitals. For those who can pay there are but too manyprivate practitioners, quite ready to physic the lesser patientsat the cheapest rate; and for these, again, when they can pay

no longer, or in case of extraordinary illness, there are thegreat hospitals. There is a class between, whose medical wantsare partly supplied by benefit clubs, partly by hospitals. Yetstill new dispensaries spring up, and the great hospitals, tokeep pace, admit out-patients without letters of recommenda-tion !What is the effect of all this upon the people ? Why, they

find that they never need make provision for the future asregards medical attendance, seeing they can always get it for

asking. What need, then, to subscribe to a benefit club ?What need to save a little money to pay a doctor ? Whatneed to be provident ? They may squander their cash at plea-sure, and, when ill, walk to the nearest hospital for advice andmedicine, and demand it as a right. Such numbers do this,that many who can well afford to pay become out-patients in-stead, thinking themselves unnoticed in the crowd. I haveseen them, and noted them by scores--aye, and prescribed forthem. And still, as the dispensaries multiply, the crowds ofapplicants increase; and so they will increase ad infinitum.The supply, forced upon the public, creates a correspondingdemand, which will grow to any extent without the least re-ference to the necessities of the community. Every hospitaland dispensary coasts of the increasing numbers of its applicants. Is this a healthy moral tone of the lower ranks ofsociety ? Are the tendencies thus imparted sound and salutaryones? Can we estimate their ultimate effects? or do the sub-scribers and benefactors to the charities ever inquire into thesepoints ?And for ourselves, as medical men, do we not see how un-

dignified it is thus to thrust our unasked-for services upon thepublic ? Can we not discern the signs of the times ? Do wenot note how everywhere the lower orders take as a right,without thanks, and as if they were doing us a favour, our gra-tuitous services? And, finally, is not the medical profession,which includes some worthy struggling members, wronged ofmany thousands annually by this and other methods of givingadvice gratis ?Do not let us lend ourselves, even for present self-benefit, to

this mischievous system. Let us exercise some self-control.And when a new institution is proposed, let us see whether thewant it is intended to relieve may not be amply, or if not so,partially provided for, by machinery already in existence. For

example, with regard to dentistry. Several of the large hos-pitals have surgeon-dentists on their staff, so the poor are notin this respect wholly unprovided for. Again, stopping teethis not more difficult than extraction. May not the teeth ofthe poor be stopped, as well as extracted, for small charges?And may they not be encouraged and advised to have thisdone, instead of waiting till toothache comes, and so losingtheir teeth ? A little foresight and trouble on the part of bothpatient and practitioner would thus prevent all this loss ofteeth and the consequent evils; and the inculcation, at allavailable opportunities, both by medical and dental practi-tioners, of proper care of the teeth, would render unnecessarya multiplication of dental dispensaries.

I am, Sir, your obedient servant,Eltham, November, 1857. A GOVERNOR OF A LONDON HOSPITAL..

’ To the Editor of THE LANCET.

SIR,—The subject of Dental Dispensaries is indeed one that-demands the attention and support both of the profession andof the public, and I am glad to see that you are amongst thefirst to recognise its importance and to advocate its claims. Itmay appear to some that the loss of a tooth or two to a poorman cannot be a matter of much consequence to himself, muchless to the public at large, and that we are indeed carrying ourcharitable operations a little too far / but the fact is that com-paratively few know the wholesale manner in which teeth areremoved at our metropolitan hospitals and dispensaries ; butthose who do will agree with me, that if we do not endeavourto check this merely as a means of improving the appearance ofthe lower classes, (and even this should have some weight withus,) still we ought to do it as a means of preventing disease ;for I am sure, from repeated observation, that the loss as wellas the unsound and unhealthy state of the teeth is a prolificand constant cause of disease, not only local, but of the variousforms of dyspepsia, and a whole host of other diseases, of whichdyspepsia is but the precursor. -

Toothdrawing, as carried on at our different medical cha-rities, is generally a most barbarous proceeding; it either fallsto the lot of an already overworked officer, or to any zealousstudents who may chance to have a taste for dental surgery,and who seem to have an idfa. that strength of arm (or nerve,