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n cases where they ought not to have been is very likely,just as chloral was used when it ought not to have been,and just as every new advance is misused by indiscri-minate and incompetent experimenters. In America, andperhaps here to a less extent, this has no doubt been thecase, because too many operators are rushing into the field ;but in London the fault is in the other direction. There arehundreds, if not thousands, of women who ought to be, andwho could be, cured by removal of their appendages, butthe high mortality of the operation in the metropolis, so faras we know it, hinders progress.

I am, Sir, yours faithfully,Birmingham, Aug. 16th, 1886. LAWSON TAIT.

P.S.-I have not referred in this letter in detail to errorsin the report from which you quote, and which very mate-rially misrepresents what i did say, because such details arehardly pertinent to the broader questions now discussed.

LAWSON TAIT.

DISCUSSION ON SUPRA-PUBIC LITHOTOMY ATTHE BRIGHTON MEETING OF THE BRITISH

MEDICAL ASSOCIATION.To the Editor of THE LANCET.

SIR,—I very much regret I was unable to take part in thediscussion upon supra-pubic lithotomy which took placelast week in the Section of Surgery during the meeting ofthe British Medical Association at Brighton. Business ofan important character detained me in another section, con-sequently I could not complete my engagement to speak.The operation of supra-pubic lithotomy, as now practised,is not the operation which Cheselden performed. Themanner of its performance is different, and so is the pre-liminary and after-treatment; and I cannot help thinkingthat, if Cheselden could only have known our presentmethod, he would never have forsaken the high operation.I feel convinced that in the future supra-pubic lithotomywill become a strong competitor of lithotrity. I take itthat the significance of the revival of this operation lies inthe fact that lithotritists have learned that there is a limitto the successful performance of lithrotity. We thus seethat surgeons are again directing their attention to litho-tomy as the better means, under certain circumstances, forthe removal of vesical calculi; and remembering the mor-tality which followed lateral lithotomy for large stones, theyare again invoking the aid of the operation we are dis-cussing.Speaking generally, my own opinion is that for stone in the

bladder of male infants and boys perineal lithotomy is thebest; for male adults with stone of a moderate size and withuncomplicated bladder conditions lithotrity is preferable;but for large or very large-sized calculi supra-pubiclithotomy will prove to be safer for the patient as well aseasier for the operator. I was much surprised to read thatMr. Jessop, excellent surgeon as he is, should speak of laterallithotomy in a small child as a difficult operation. I haveoperated upon numerous children, and I have never foundany difficulty. Several times I have operated upon twochildren, one after another, and upon two occasions threechildren, on an operating day, and no mishap has ever beenencountered, the operation generally being completed inthirty-five seconds. Mr. Cadge, in his recent lectures at theRoyal College of Surgeons, speaks of the possible difficultyof getting the forefinger into the bladder of a small child,and advises that a pair of dressing forceps should be usedinstead. With the utmost respect for Mr. Cadge’s opinion,I do not consider his recommendation a good one. The bladesof a pair of dressing forceps, if the stone is not

caught immediately, being opened and closed withinthe bladder, seem to me very likely to inflict con-

siderable injury upon the mucous membrane. A betterprocedure would be, if the difficulty above referred to wereencountered, at once to desist from all efforts to enter thebladder with the finger and to run a director along thegroove of the staff into the bladder, and after the staff hasbeen withdrawn upon the director, the forefinger or finelithotomy forceps can easily be conducted into the vesicalorgan. I have long had in my possession an instrumentintended to be used in the manner I have described ; it is adirector made of steel, measuring in length six inches, thehondle of which is broad and 0flat, and bent to an angle

midway between the straight position and a right angle, andtwo inches and a quarter long.

Mr. Jacobson says he should very much like to knowsomething of the personal history of those who had beencut for stone while young. What was the real fact as regardsthe emasculation which was asserted to follow in a propor-tion of the cases ?" As a surgeon who has operated by laterallithotomy upon nearly one hundred male children, some ofthese not more than twelve months old, I can only say Iknow of no instance; no case of the kind has ever beenreported to me; and as many of my patients were sent tomy care by medical men, I cannot but think that if any caseof sexual incompetency had been observed it would havecome to my notice.

I remain, Sir, yours faithfully,Wolverhampton, Aug. 17th, 1886. VINCENT JACKSON.VINCENT JACKSON.

THE HOSPITALS WEEK.

, To the Editor of THE LANCET.

SIR,-It cannot but be gratifying for you to know that,apart from the benefit which the hospitals have receivedfrom the increased contributions on Hospital Sunday, as aresult of the establishment of the Hospitals Week, withwhich the Special Supplements will ever be associated andremembered with gratitude, the appeal which the autho-rities of this hospital have made during the past two monthshas produced a monetary return greater than that of anysimilar appeal to the public on behalf of any of the Londonhospitals with the financial management and secretariat ofwhich I have been personally associated during the lasteight years.

I am induced to trouble you with this communicationbecause I was present at the meeting of the representativesof the London hospitals which the Lord Mayor convened atthe Mansion House, when the committee of the HospitalSunday Fund decided to institute the Hospitals Week. Atthis meeting the representatives of St. George’s and Univer-sity College Hospitals, with others, strongly opposed thisnew departure on the part of the Hospital Sunday Council,on the ground that it would interfere with the proper workof individual hospitals and tend to lessen the amount ofdirect pecuniary support which they already receive fromthe general public. Mr. Burdett vigorously combated thisview, and maintained that the greatest benefit to individualhospitals would prove to be the result. It is indeed gratify-ing to know, by actual experience, that not only were thoseobjections based upon unsound premisses, but that theexact opposite to the contention of the objectors has re-sulted to an important hospital like St. Mary’s.Thanking you on behalf of my governors for what you

have done, and with gratitude for the increased interestthat has this year been awakened for the London hospitalsby independent efforts on the part of both clergy and laity,

I am, Sir, your obedient servant,PIETRO MICHELLI, Secretary.

St. Mary’s Hospital, Aug. 12th, 1886.PIETRO MICHELLI, Secretary.

LIVERPOOL.

(From our own Correspondent.)

THE GREEK GIPSIES.

THE Greek gipsies alluded to in a previous letter still con-tinue at the Zoological Gardens, Walton, and constitute adanger against which it may be well to warn other localauthorities. It is said that they were brought over by somepublic entertainer and then abandoned. The managers ofall the American steamers decline to receive them, partly onaccount of their filthy state and refusal to conform tosanitary requirements, and partly from a belief that theauthorities in America will refuse to allow them to land inthat country. It is feared that there will be some troublein getting rid of them.

ACCIDENTAL DEATH OR MANSLAUGHTER?An inquest was held by the borough coroner, on the 18th

instant, which adds one more to the melancholy list offatalities from firearms. The deceased, a youth of eighteen,was shot by his brother, aged fourteen, and died the same

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evening in the Royal Infirmary. The evidence was some-what conflicting, the owner of the gun declaring on oaththat he left it unloaded; the boy. whose handling of itcaused his brother’s death, declaring with equal emphasisthat he never loaded it. It is, however, much more pro-bable that the former was mistaken, and left it loaded. Theboys-had no business in the room where the guns were, butthe history of this and similar fatalities shows that firearmsought to be kept under lock and key, or at least out of thereach of young people.

DEATHS FROM DROWNING.

Within the last month there have been many cases ofdeath from drowning in the river Mersey, and in the Leedsand Liverpool Canal. In most of them there was an absenceof any evidence of foul play or self-murder. The circum-stances pointed rather to accident, combined with total in-ability to swim sufficiently to keep afloat for a few minutes.Liverpool abounds with swimming baths, where youths maybathe for a very small charge, and also learn swimming onterms within reach of all, except the very poorest. A moregeneral knowledge of the art of swimming would save manyvaluable lives, and it is greatly to be desired that SchoolBoards and other public school authorities should take thematter up. A few prizes for boys under ten, who can swimround a public bath, would be a most popular as well aslaudable movement,

A HEALTHY wAT3’RI1VG-PLACE.

Llandudno presents an admirable illustration of how aplace may rise when promoted with due regard to sanitationand other public requirements. Thirty years ago it was asmall village giving but faint prospects of ever attaining toits present proportions. It is now one of the most popularseaside resorts in the kingdom, combining all the advantagesof easy access by rail and boat, excellent sea-bathing, ampleaccommodation, and, what is most important of all in amedical aspect, the low death-rate of 14’1 per 1000. Dr.James Nicol, formerly medical officer of health, who haspaid great attention to the climate and other advantagesof the locality, declares that the range of temperatureis 1° less than the average of the united seaside places,and 35° less than the average of inland places. Healso shows that there is an almost entire absenceof smoke or fog, that the temperature is by the sea

raised in winter and lowered in summer, and that therainfall is some inches below the average. But-and this ismost important of all-the system of sewerage, which cost.636,000 ten years ago, is not to be surpassed anywhere, thewater-supply being abundant, exceptionally soft, and per-fectly free from organic impurity. There is an excellentswimming bath, renewed with every tide, and altogethe!Llandudno possesses great attractions to the inhabitants olthis city, who are frequent visitors to it.

Liverpool. Aug. 18tb.

MANCHESTER,

(From our own Correspondent.)

VICTORIA UNIVERSITY.

AT the recent medical examinations of the Victoria Univer-

sity the numbers showed a steady increase. The totalnumber of successful candidates in the Pass,the Intermediate,and the Preliminary Scientific (Faculty of Medicine) wasthirty-seven, of which twenty-three were students of OwensCollege and fourteen from University College, Liverpool, theonly two colleges at present affiliated to the University.The new Hulme Hall of residence in connexion with OwensCollege will, in all probability, be ready for the reception ofstudents in October, and the Rev. E. L. Hicks, M.A., rector ofFenny Compton, has been appointed the Principal. He comeswith very high credentials both as a scholar and a teacher.

SIMPSON MEMORIAL COLLEGE.

On Saturday last Professor Ward laid the foundation stoneof this College, at Moston, one of our northern suburbs,which bids fair to become in the future an importantmedical institution. The late Mrs. Fay, née Simpson, be-queathed more than .620,000 for the purpose of foundingthat establishment in her native township. ProfessorWard enlarged upon the relation which the university wasdestined to hold in regard to all these higher educational

bodies, and also touched upon the same subject as Dr. Mooreat Brighton-namely, the higher education of women, pro-vision for which is one of the main features of the SimpsonMemorial scheme.

SIR H. ROSCOE. ,

An influential deputation waited upon a special committeeof the Council of Owens College recently in reference to theresignation by Sir Henry Roscoe of the chair of chemistry inthe College, urging that if possible his connexion should notbe entirely severed, but that some arrangement should bemade whereby his services and long experience in all thatrelates to the chemical department might be available whenrequired, and his advice and direction not entirely lost tothis important branch of study. At the recent festival ofthe founding of the University of Heidelberg, the honorarydegree of doctor of medicine was conferred upon Sir Henry.

THE MAYORALTY.

It was stated in these columns that Mr. Alderman Schofieldhad been selected as mayor for the coming year. Thisgentleman, who has so long presided over the health depart-ment of the corporation, has, however, declined the honour,and Mr. Alderman Curtis will be elected, this being thethird time he has filled the office. It bids fair to be animportant year, for the proposed exhibition is now a matterof certainty, more than 100,000 having been subscribed to aguarantee fund. The site chosen is the same as that onwhich was held the Art Treasures Exhibition some thirtyyears ago.

HOLIDAYS AND PLAYGROUNDS FOR TOWN CHILDREN.

The children’s holiday fund has not this year met withthe support that it deserves ; only some ae500 has been sub-scribed, with which 590 children have been sent into thecountry. It was hoped that at least 1000 would have beenat the disposal of the committee, who have had to refusenumerous applications from lack of funds. Under another

organisation a camp has been formed at Llandudno, wherefrom twenty to thirty boys are accommodated, taken fromthe poorest and lowest parts of the towns, and who areliterally gutter children. It is hoped that 300 of these maybe sent to the seaside for a short time during the season.The Local Board of Stretford has, with commendable publicspirit, been lately taking steps for the acquisition of openspaces for playgrounds in the more densely populated partof their township-an example which might well be fol-lowed by other local boards round the city, before the landhas reached such value as almost to make it prohibitive forthis purpose.

THE COLLIERY EXPLOSION.

Another disastrous colliery explosion occurred at Leighon Friday last, whereby nearly forty lives were lost. A

peculiarity of the present catastrophe is the fact that one ofthe survivors appears to have seen the actual ignition of thefire-damp from which the explosion arose, and this tookplace in a "safety" lamp carried by one of the workers.None of our safety lamps are really safe in a dangerousatmosphere; and a miner’s safety lamp, in the true sense, isstill a thing to be produced by the scientist of the future.Manchester, Aug.. 18th.

NORTHERN COUNTIES NOTES.

(From our own Correspondent.)

SUNDERLAND INFIRMARY.

AT the annual meeting of the Sunderland Infirmary, heldthis week, the report spoke favourably of the general work-ing of the institution during the past year, and added thatthe income had been well maintained, and, notwithstandingthe long-continued depression in trade, which had been

hanging over the town for the past two years, the work-men’s subscriptions had increased. Amongst the subscrip-tions to the new wing, as a memorial of the late Mr. JamesHartley, were promises of 1:500 from Mr. Laing, and £ I00from the new Lord-Lieutenant of Ireland.

YORK EYE INSTITUTION.

Dr. Tempest Anderson, in the annual report of the YorkEye Institution, says that the number of patients has been761, which compares not unfavourably with former years.