381

alteration of that object. He must then acknowledge, that he Isubscribed, not only for the benefit of the poor, but for thepromotion of medical science. To that he decidedly objected. I

Ultimately, a committee of inquiry upon the best means ofadvancing the interests of the charity was agreed to, but thepassage, to promote the ends of medical and surgical science,"was expunged from the resolution by a majority of twenty-twoto twenty.The Leicester JournaZ has the following comment on the

occasion :-" The question of throwing open the Infirmary to a larger

number of medical men, who should form the medical staff,has been before discussed and, both on the last occasion andthe present, the admirable temper and disposition with whichMr. Macaulay has brought the matter forward, are much to becommended. To cure disease and mitigate su-ffering are undoubt.edly primary objects. But we cannot help thinking that, asschools of study and arenas of practice, all such establishmentsare fully entitled to be considered objects of great importance.They are, we opine, established as much for the general goodas the individual; and surely there can be no better mode of pro-moting the general good than by extending medical knowledgethrough their instrumentality. Weholdthatourpublic hospitalsare the safeguards of the people. In no instance, we believe, hasit ever been found that a worthy object for the charity of amedical institution has declined to enter an hospital because Iof the number of students or practitioners who might have theopportunity of exercising their curiosity,’ or of increasingtheir means of usefulness to the community at large, (as we.hould term it,) by increasing their knowledge of those dis-eases which may afterwards present themselves for cure inpatients in the humblest, as well as in the most exalted ranksof life. Were such the case, what would become of Guy’sHospital, and St. Thomas’s, and other great metropolitantheatres for the promotion of medical and surgical science?"

HOSPITALS AND MEDICAL INSTITUTIONS INITALY.

DR. MoRLAND, in a letter to the Boston Medical and SurgicalJournal, makes the following observations:-

Italy certainly possesses many very noble institutions forthe poor and the sick-and was, during the middle ages, farin advance of the rest of Europe. At Naples, the " RoyalPoor House" should be mentioned as an institution of greatusefulness and merit. It was commenced in 1751, and now isan immense building; one side is allotted to females, and theother to males. At present, between 5000 and 6000 (accord-ing to the statements) are maintained and instructed by thisestablishment: among other things the inmates are taughtsurgery. The hospital for incurables is capable of contain-ing upwards of 1000 persons; the sick are received from allparts of the kingdom-and foreigners also. There are cli-niqnes also--medicine, surgery, midwifery, an anatomicaltheatre, &c.In Rome, the hospitals are not so well looking, internally,

nor, I should think, so well conducted, as in most of the otherItalian cities. The small hospital of Benfratelli, containingeighty beds, is much neater and better ventilated than SanSpirito, the principal one. The Benfratelli is in the hands ofthe monks, who perform the services and duties for the sick.The aspect of things was exceedingly dubious as to the com-fort of the patients. The immense wards of San Spirito aredisgustingly dirty and wretchedly ventilated-and, what isworse, they have the most unscientific, outrageous arrange-ment of " stowing away" the poor patients in double tiers-two tiers on each side of the ward; the heads of patients intier No. 2, lying at the feet of those in tier No. 1. I havenever seen so bad an arrangement in any hospital-nor one socalculated to produce bad effects. More is the shame, too,for this hospital is very richly endowed. The FoundlingHospital and the Lunatic Asylum are also in this building,which, as you may imagine, is immensely large. In the lunaticdepartment the old restraint system is still in use. There areseveral other hospitals in Rome ; indeed, it is the boast there,"that no city in the world devotes so large a sum to institu-tions of charity, in proportion to the population. But somemaster’s hand is wanted to direct and apply the abundantmeans." La Consolazione, near the capitol, is the hospitalallotted to surgical cases-a good number of these are stabbingcases. It is stated that the average number of patients isabout 800 annually.

I attempted to enter the Hospital of San Michele, which isvery large, twice, but was prevented each time : once, because

it was the " sleeping time ;" the other visit, on account of itsbeing fete day. The exclusion of visitors at the time whenpatients are asleep is certainly a good idea; and I have oftenthought that the visits in the Parisian hospitals, made at soearly an hour, are decidedly more for the advantage and con-venience of the physician and student, than that of the poorpatient, who is often roused from a slumber of great im-portance to him, to respond to the interrogatories of thevisitor. Certainly, on the score of comfort and likelihood ofbenefit to patient, the visiting hour as it is with us is far pre-ferable.San Michele is highly spoken of, and is doubtless worthy of

the praise. It contains a House of Industry and of Correction.It is to be trusted that it is cleaner than San Spirito.

Florence, whose admirable and very extensive collection ofanatomical models in wax is so well known to all medicaltravellers, and indeed universally visited, contains, I believe,only two or three hospitals. One of these, Santa Maria Nuova,is worthy of all praise for the remarkably excellent manage-ment exhibited. It is the medical school of Florence, andcontained, at the time I saw it, 600 patients, having accommo-dations for 400 more. The cabinet of pathological and ana-tomical specimens, although small, contained many very goodpieces; the skeleton of a child, with the bones of the skullpushed widely apart by hydrocephalic effusion, the head beingenormous--I believe larger than any one I have seen; manyspecimens of excessive distortion of the spinal column; somewax models of tumours, &c. &c. In a small cabinet are pre--served the pieces of the human body petrified by Segato.There were portions of the liver, the brain, the intestines;also the organs of animals. You doubtless have heard of thetable-top, inlaid with petrified pieces of this nature: it, also, iskept in this cabinet.The hospital is remarkably airy, neat, well arranged, and.

has an air of great comfort; the different attendants are ex-ceedingly polite, and every part of the hospital was shownwith great readiness, and pride, too, as I thought. In themidwifery department are many separate rooms, in which thebeds were very clean-the nurses neat and looking quite good-natured. There is a room for delivery, and others for thoseaffected with after troubles. In this department was shownto me a bed different in construction from any I happen tohave seen; it has, about one-third of the way from its head, aslight elevation (continued, of course, to the head) ; beneaththe pelvis an aperture sufficiently large for the issue of mattersfrom the genital organs; not large enough to interfere withthe proper support of the body. Besides these things there isa succession of cushions, to regulate, at pleasure, the positionof the woman, and two cranks or handles, (moveable or fixed,at pleasure,) by which the woman supports herself whileundergoing the contractile efforts of the womb. If I remem-ber aright, the elevated portion at the head of the bed did notadmit of graduation; I may be mistaken in this, however, asit would seem that it should, and might easily.The splendour of some of the buildings now devoted to hos-

pitals in Italy is quite striking. In point of architecture, and,often, internal decoration, there probably is nothing of thesame destination that equals them.At Venice, the building known as the Scuola di San Marco

is now a portion of an immense hospital, the remainder ofwhich is formed out of the adjoining convent of the Dominicanand the Franciscan friars. It is really a long walk throughthis enormous building, which contains a handsome churchand a smaller chapel also, within its walls. The arrangement

: and planning of the wards, beds, and appurtenances, is mostexcellent-plenty of air, and evidently great attention tocleanliness. The lunatic wards are in excellent condition-

. and so, as to comfort and attention, are the unfortunate in-, mates. This, I believe, was one of the first institutions toi abandon the restraint system. We entered the large room, which contains the greater number of lunatics. Very many; were working in one way or another; some came and gazed, upon us, with not an idiot, but a mischievous leer, (this was: the female ward;) only one was at all violent. She rushed: towards us from the farther extremity of the hall, uttering a, torrent of words in a loud tone, and brandishing her knitting-- work ! I looked sharp at the needles, but she, on arriving

where we stood, stopped a moment-and then darted to a seat,l where she continued scolding. But the physician of the esta-! blishment soon entered, and going to her, took her hands in

his, and saying a few words she was quiet, as if by magic.> Some two or three more were wild, but not violent; every partof this establishment seems admirably managed.> I In the sick wards there is suspended over the head of eachbed the name of the disease under which the individual is

382

labouring I noticed a goodly crop of bronchitis, many casesof pericarditis, several, also, of intermittent fever: in the sur-gical wards one case of spina bifida; abscess, fracture, &c.At the head of each bed also hangs a ticket, containing name,profession, age, dates, symptoms, internal and external reme-dies, &c.&c.

I should think that more medicine was given internally inthe Italian hospitals than in the French-a supposition whichmay have some slight confirmation in the different size of thespaces allotted to external and internal remedies in the ticketalluded to. A very formidable, but exceedingly good-looking,apothecary’s shop is located, sentinel-like, near the entranceto the wards. The remark above made in reference to thefinish and ornament of some of the Italian hospitals, appliesin its full extent in this case. An author, speaking of thebuilding, says—" The external architecture of its elevation is.singularly fanciful and elegant; Byzantine richness, blendingitself with the grace of classical architecture, combinationsdefying all rules, but productive of a most magical effect.The carved work of the ceilings is, in many of the rooms, pe-culiarly beautiful; the contrast and effect are singular andstriking in glancing from the rich and varied ornaments aboveand around, to the pallid countenances and paraphernalia of Ithe sufferers stretched beneath." ,

At Milan, the " Ospedale Maggiore" is a noble establish- ’ment; a donation of the site of an ancient palace by FrancescoSforza in 1456 was its commencement. The front i3 800 feetin length: the writer of Murray’s Guide Book speaks of theGothic portion of the building as "magnificent." Besidesthis fine institution, there are the Lazaretto and the OspizioTrivulzi, the latter styled by the same writer a "noble monu-ment of pious charity," containing 600 inmates, all over seventyyears of age, well fed and clothed, and permitted once aweek to visit their friends. The Lazaretto, now disused, ex-cept in some portions for small shops, is in the form of asquare cloister, one quarter of a mile on each side in length;in the central square is a chapel. A fine crop of hay had beenmade, and lay spread upon the turf; men and women in someparts of the square still turning it. The long cloistered arcadesare quite striking. The Trivulzi I have not visited.At Genoa, the great Poor House is well worth seeing; clean

and well administered; its church, Santa Maria, contains aninvaluable work of Michael Angelo. Beside this, are theOspedale del Pammatone, and the Deaf and Dumb Institution;the former again confirming the remark made in regard tothe ornate appearance of many of these institutions.

MEDICAL INSTITUTIONS IN CANADA.To the Editor of THE LANCET.

SiR,ŅIn your number for July 25th, I noticed an extractfrom a newspaper printed in this city, purporting to be a re-port of part of a speech delivered by Dr. Wolfred Nelson, inthe House of Assembly of Canada, on the occasion of the pro-posal of the usual grant to the Medical Faculty of M’GillCollege.The violence of temper and the recklessness of the asser-

tions of that individual are so well known in this city, as wellas the hatred he has long borne to M’Gill College, stimulatedlately by the establishment of a rival school in which his sonis a lecturer, that had his mis-statements been confined to hisplace in parliament, or even to a local print devoted to hisinterests, it would have been almost unnecessary to have no-ticed them: but as they have travelled (however forwarded)to your widely circulated periodical, it seems to me to be myduty, holding an official connexion with the maligned institu-tion, to furnish you proof that your prudent remark " unlessgreatly exaggerated" was very judiciously applied.

Dr. Nelson’s mis-statements, as quoted by you, refer chieflyto the condition of the library, and of the PathologicalMuseum of the Medical Faculty of M’Gill College. I shallnotice them both.

First, as to the library. A good many years ago, when thelectures were first established, the four professors then con-ducting the school, deposited a considerable number of books,which were subsequently given to the institution, and becamea nucleus, which, being augmented yearly by the appropria-tion of the matriculation and graduation fees, has increased toupwards of 1100 volumes, now belonging to the institution. In

1845, when the Faculty obtained proper accommodation inthe college building, (having previously been obliged to use ahired house, ill adapted for their purpose,) the library was re-moved from the house of the professor of medicine to the

* This I have not noticed elsewhere in Italy."ŅDR. M.

college, and at that time most of the lecturers agreed to de-posit what books they could spare as an addition to thelibrary. About 500 volumes were thus added to those belon-ing to the Faculty, and ALL were freely opened without fee tothe use of the students.The assertion of Dr. Nelson is, therefore, either a wilful

mis-statement, or (if pretended to be based on a knowledge ofthe deposit) exhibits a culpable ignorance; culpable, becauseallowed to sanction a calumny. When there is a determina-tion to find fault, occasion is seldom absent. In 1844, whenthe library was in a private house, it was convenient to doubtits existence: in 1845, when publicly exhibited, it was, ac.

cording to Dr. Nelson, a temporary collection for show anddeception.

Secondly, of the museum. Here, also, according to the sameauthority, the preparations are private property, liable to beswept away, and the museum annihilated by individual caprice.The same character of unwarrantable, and if not dishonest,yet certainly of culpably ignorant assertion, attaches to thisimputation. One fact will prove the utter baselessness of theassertion-viz., that in 1845, nearly X35 were expended forglass preparations, jars alone; all of which have been employed,and an additional order is required.But as we do not see the impropriety of allowing the pro-

fessors to deposit preparations, (most of which will probablybe permitted to remain as the property of the museum,) weare glad to receive them, notwithstanding they may expose usto be accused of merely making a show. It is strange thatDr. Nelson, in his eagerness to depreciate our school, did notsee that by his own admission he fastens a more aggravatedguilt upon the rival one which he is so anxious to uphold.The very preparations which once adorned the shelves of theSchool of Medicine, now stand on those of the Medical Faculty;and why ? because the proprietors of the School of Medicine(perhaps not for the sake of show?) were willing to accept,not only the preparations which its own lecturers might fur-nish, but all those which they could induce their friends tolend them, even at the risk of sudden removal.Hence it appears, that though, in Dr. Nelson’s eyes, it was

highly indecorous for the one school to accept the preparationsof its own lecturer, it was quite proper for the other to use(for show or otherwise) the preparations of one in no way con-nected with it. I am, &c.,

A. F. HOLMES, M.D. & P., Secretary Med. Fac.

THE FICTITIOUS CHARLOTTE-STREET SCHOOLOF MEDICINE.

To t7te Editor of THE LANCET.

SiR,ŅI received this morningby post, a circular of the aboveschool, which had been previously sent to my former resi-dence, at Pimlico,and which, while it announced the "removal"of this school, at the same time advertised its continuanceat 15, Bloomsbury-street, (late Charlotte-street,) the placewhere it used to be situated. As no account of this schoolhad been given in the recent Students’ Number of THELANCET, and as I knew that, although a " Charlotte-streetSchool of Medicine" had been advertised, no such school ex-isted in that part of the thoroughfare to which the name ofCharlotte-street is now restricted, curiosity prompted me togo immediately to No. 15, Bloomsbury-street, and inquire ifthe said school were really in existence there, in order tosatisfy myself of what was actually the fact as to the dubious"local habitation" of the " name." On making inquiry atNo. 15 in Bloomsbury-street whether the Charlotte-streetSchool of Medicine was held there, I was referred to a paintedboard affixed to the outside of the house, on which I read," Charlotte-street School of Medicine, (removed,)"-withoutstating whither. On my further distinct inquiry, whethera school of medicine was about to be held there this autumn,I was as distinctly answered " No;" and one of the personswho replied to me, added that she thought the advertiser had"an object in view," in publishing the address of that housein connexion with his school.

I have, then, failed to penetrate the mystery, and am stillignorant where the late Charlotte-street School of Medicineis in future to be held, so destitute of even a hint on thepoint have been all the circulars recently issued concerningit. But of this I am certain-that, notwithstanding the adver-tisements and circulars which have appeared, there is noSchool of Medicine in Charlotte-street, nor at No. 15, Blooms-bury-street, where it heretofore existed, and where it is pub-licly announced still to exist.