494

is manifest from the following consideration. If the pul-monary segment were contracted to a degree which wouldrender it capable of holding only one-twentieth its averagequantity of blood, the right heart, though having muchless than the normal quantity of blood in front of it, wouldhave very much more than the normal amount of work todo. Every time a ventricleful of blood passes throughthe systemic circuit the same quantity must on an averagetraverse the pulmonary circuit (Dr. Morison rightly observesthat I did not express myself clearly on this point in thearticle to which he refers), and such a diminution in the

capacity of the pulmonary circuit would lead to an enormousaugmentation in the rate of the pulmonary flow and to acorresponding increase in pulmonary resistance. 3. Dr.Morison further contends that "the aid afforded to thedextro-cardiac circulation by thoracic aspiration is one ofthe causes of the less powerful development of the right ascompared with the left ventricle." Is it certain that thoracic

.aspiration affords greater help to the pulmonary than to thesystemic circulation ? I have doubts on this point. In anycase Dr. Morison will allow that such a factor must be a

subsidiary one.It will thus be seen, Sirs, that Dr. Morison has not offered

.any valid objections to my conclusion. If I am wrong thereshould be little difficulty in proving it, for the problem which’I have sought to solve is one which can be stated and arguedout with almost mathematical accuracy.

I am, Sirs, faithfully yours,Devonshire-street, W., Aug. 8th, 1896.

y

HARRY CAMPBELL.

ELECTION OF DIRECT REPRESENTATIVESTO THE GENERAL MEDICAL COUNCIL.

To the Editors of THE LANCET. ISiRS,—I wish to bring before medical practitioners a very

.grave ruling of the General Medical Council whereby a

dumber of persons who should be entitled to vote are now.disfranchised.

In July last I wrote to the Registrar of the General Medical’Council asking if practitioners resident in the Isle of Manwere entitled to vote at the coming election of direct repre-sentatives, and on July 27th I was surprised to hear fromthe Registrar that such practitioners had no vote whatsoever.I next wrote to the Registrar to inquire whether prac-titioners resident in the Channel Islands, Isle of Wight,Scottish Isles, &c., had a right to vote, when the Registrarreferred me to Sections 7 and 27 of the Medical Act, 1886.If reference be made to Section 7 it will be found that itis enacted that three direct representatives shall be electedby registered practitioners resident in "England," one bythose in "Scotland "and one by those resident in " I Ireland " I-and if reference b made to Section 27, which is the definingsection, it will be found that the expression "part of the’United Kingdom" means, "according to circumstances,England, Scotland, or Ireland." Now it will be seen by the-words of these sections that, strictly speaking, all practi-tioners resident outside of "England," "Scotland," and" Ireland" can be disfranchised. It, however, is a puzzle tome to find that practitioners resident in the Isle of Man aredisfranchised by the action of the General Medical Council-this body of dry bones-while practitioners resident in Walesare not disfranchised, especially as the word Wales is notmentioned in the Act. I regret the Registrar of the Council’has refused to tell me if practitioners resident in the Isle ofWight and other contiguous islands are disfranchised, butthis act of the Registrar to me is only upon a par with thatdiscourtesy which I have received from the General MedicalCouncil since I began to take a practical interest in medico-political questions.

I ask that the Council of the British Medical Associationand the Councils of the various Medico-Ethical Societies and- practitioners in the Isle of Man, &c., should at once take thisquestion up, and that they petition the Privy Council toinstruct the General Medical Council not to disfranchise

registered practitioners, but to send voting papers to all resi-dent in the Isle of Man and other neighbouring islands.

I hope this question of disfranchisement will receive properattention when the amending of the Medical Act is taken inhand. The loose construction of many sections of theMedical Acts and the deplorable results accruing therefrom-should act as a severe lesson to practitioners and make them

understand the real and actual meaning of words in an Actof Parliament or elsewhere.

I am, Sirs, yours faithfully.Hverpaot, Aug. 12th, 1816. ROBERT R. RENTOUL.

P.S.-I intend calling the attention of the Privy Counciland of Members of Parliament to the replies of the Registiarof the General Medical Council.

To the Editors of THE LANCET.

SJRS,—At a meeting of the Council of the London andCounties Medical Protection Society, Limited, held on tLe4th inst., the following resolution was unanimously passed,viz.: "The Council, having considered the letters sent tothem by two members of the society in reference to thecoming election of representatives of the profession to theGeneral Medical Council, is strongly of opinion that, as thesociety not infrequently appears before tbe General Medi0!Council as prosecutor in cases affecting the interests ofmedical men, it is in the highest degree undesirable that thesociety should take any active part in furthering the electionof any candidate for a seat on the General Medical Council."

I am, Sirs, your obedient servant,

Aug. 7th, 1896.

HUGH WOODS,Hon. Secretary London and Counties Medical

Protection Society, Limited.

MANCHESTER.

(FROM OUR OWN CORRESPONDENT.)

SI/191w Prevention in Manchester and Salford,FoR about six years a committee has been engaged in

testing various smoke-preventing appliances, and on the15th inst. a deputation waited on the Lord Mayor of Man-chester and the Mayor of Salford to present to each a copyof the report embodying the results of work carefullycarried on during this long period. Mr. Herbert Philips(vice chairman of the committee and chairman of the Man-chester and Salford Noxious Vapours Abatement Association)said the " Committee for Testing Smoke-preventing Appli-ances " was started by Mr. A. E. Fletcher, the late chiefinspector of alkali works, and Mr. Carpenter, the presentchief inspector, while Mr. F. Scott, who has so long been thesecretary of the Manchester and Salford Sanitary Associa-tion, has been very energetic as secretary of the committee.The inaugural meeting was held in Manchester in 1889,Lord Egerton of Tatton being in the chair, and meetingshave been held in London, Glasgow, Sheffield, Leeds, andBirmingham, and committees formed in nearly all of them.The inquiry has been limited to smoke from factories andmanufacturing works. Dealing with house smoke is a dif-ferent and a difficult problem still remaining to be solved.The Public Health Act has long given the power to theauthorities to deal with the smoke from factories, but it has

I not been used with regularity as there was doubt as towhether manufacturers were able, at a reasonable cost, to

comply with the requirements of the law. The result of longand practical investigation is given in the report as follows:

. " In presenting this report the committee would express their

, conviction that in the great majority of cases the black smoke- thrown into the air during the combustion of coal is pre-, ventible, either by hand or mechanical firing, and without; great cost to the consumer. Often the prevention of smoke; is accompanied by a saving of expense in that an increase- of heat is developed by a more perfect combustion of the- fuel, and where live hre-bars are adopted-i.e., where the

bars have an automatic reciprocating motion-an inferior and, cheaper quality of coal can be used, and thus a further. saving of expense is effected. To sum up in one sentence the

; conclusion of the committee as to smoke produced inI raising steam : a manufacturing district may be free from: manufacturing smoke-at least from the steam boilers, with- which alone the committee have concerned themselves; and

as to the means by which it may be so freed this report. contains ample information." The Lord Mayor thanked tb’’l deputation, and said "he could not promise when he wou](I: be able to peruse the report," but he would take anl early opportunity of doing what he could tol familiarise himself with its salient points. Though

495

not altogether unfriendly, his lordship does not (

seem consumed with zeal for the cause of smoke prevention. 1From the Manchester town hall the deputation went toSalford and was received by the chairman of the SanitaryCommittee, in the absence of the Mayor. Mr. Philips said ithey had not come to discuss the case of Salford, as there wasnothing local about the work of the committee, but he couldnot help fearing that the condition of the Salford atmosphet ewas about to be considerably deteriorated through the loss ofthe great open space represented by Trafford Park. " Cir-cumstances connected with the sale of the park led one tosuppose that a great volcano of smoke would be set up onthat side of the river which westerly winds would carry toSalford." Mr. Lavington E. Fletcher said the Steam Users’Association had quite independently arrived at results whichquite corroborated those of the committee. " All that wasneeded was that boiler owners should take a personalinterest in the matter." This report, though not lightreading, is really of immense value in showing, not theoieti-cally but practically, how much may easily be done to abatethe nuisance and the serious evil of excessive smoke pro-duction ; and the community at large owes a debt of

gratitude to the committee for the patient carrying out ofthis somewhat costly investigation. It is to be regrettedthat iron-works, which are even more offensive than thefactories, did not come within the scope of inquiries. Thisis a familiar fact, but the neighbouring town of Warringtonrny be taken as one illustrati’ n out of many of the way inwhich the neighbourhood is befouled by the dense volumesof black smoke sent forth in utter disregard of the comfortand well-being of the patient and long-suffering inhabitants.

Deathfrom a Steam Bath.The city coroner held an inquest the other day on a child

seven months old, and though the verdict was "Accidentaldeath" it seems to have been due to carelessness or stupidityso gross as to have been almost criminal. While undermedical treatment for bronchitis and convulsions the motherwas advised by a sister to give the child a steam bath. These

women, therefore, put a shawl about the head of the cradle,fixed a piece of rubber tubing to the kettle spout, put theother end of the tube in the cradle-head, and proceeded toget up steam by setting the kettle to boil. No wonder thata cry was heard and the baby found scalded about the face.The infant was taken to the infirmary, and died the day butone after, the innocent victim of that dangerous weapon, "alittle knowledge."

Fatal L6a_p at Hope Hospital.Mr. Holmes, the Salford coroner, held an inquest a fort-

night since respecting the death of Elizabeth Kelsey, a

patient at the workhouse hospital, which is under the controlof the Salfo:d guardians. During the temporary absence ofthe nurse she jumped out of the ward window on the thirdstory and was killed. It came out in evidence that thenurse had to attend to three wards on three different floors.The jury, in returning a verdict of "Accidental death,"made some judicious recommendations, the first was thaithere should be a nurse for each floor ; the second observa.tion was that, in their opinion, the hours during which th(nurse was on duty were excessive ; and the third that thEwindows ought to be made more secure. In this case i1was the patient, not the nurse, that committed suicide, alat Pendlebury, but the nurse, as in too many cases, hac

clearly more to supervise than she was able to do. In man]other callings the treatment nurses often receive would b4considered an approach to " sweating."

Memorial to the late Mr. Thomas Hick, B.A.,B.Se. Lond., .8-c.

The Owens College has suffered a serious loss in the deat]of the assistant-lecturer on botany, who was esteemed alikfor his personal qualities and his scientific attainments. Iwas felt by many that there should be something to mar :his connexion with the College, and on Friday last a meetinwas held in the museum and the following resolutions werpassed :-(1) ’’ That it is desirable that some permanenmemorial be established of the late Mr. Thomas Hick, B.AB.Sc. Lond., A.L S., Assistant Lecturer on Botany in thOwens College." (2) " That a sum of money be raised wita view to purchasing Mr. Hick’s collection of mioroscopisections of coal plants and depositing them in the Maichester Museum, to be known as the Hick’ collection, anthat any surplus be devoted to the purchase of a portion <

his library, to be given to the Yorkshire Naturalists’ Unioi

or to perpetuating his memory in such other manner as mayhereafter be decided by the contributors." Mr. Hick foralong time assisted the late Professor Williamson, F.R.S., who,was famed for his kill in grinding down and preparingsections of coal measure plants, and thus acquired unusualaptitude of like kind. A large committee was appointed tocarry out the above resolutions, consisting of friends and’scientific men representing Lancashire, Yorkshire, and otherparts of the country. Professor Weiss was appointed,secretary.

I Aug. llth.

LIVERPOOL.

(FROM OUR OWN CORRESPONDENT.)

Flozcrishing Quacks and Public credulity.THE evidence adduced at the coroner’s court relating to’

the death of a, widow named Lee, who died in Liverpoolunder suspicious circumstances, affords another instance ofthe remarkable credulity of the public in the bonf&Icirc; fides ofquack advertisements. The evidence of Mr. Hanley, whowas called in to see the deceased, proved that she was

suffering from haemorrhage and a threatened miscarriage.He then formed the opinion that she had been tamperedwith, probably by some blunt instrument, and thought itvery improbable that the injuries could have been self--inilicted. He also found indications of dangerous drug&having been administered. The deceased eventually mis-carried and died on June 6th from peritonitis set

up by the injury. The evidence of other witnesses’

brought out the fact that the deceased went to a,

house in Erskine-street kept by a Mrs. M’Conville andasked for "their strongest remedy." An advertisementheaded A Boon to Ladies" was produced in court. A.clerk in the employ of Mrs. M ’Conville named Burgess saidthat he gave the deceased two bottles of medicine on

March 24m, one to be used in the morning and the other inthe evening, for which he charged 22s. On April 10th thedeceased applied for more medicine, when two more bottles-at the same price were forwarded to her. The coroner thenproceeded to inspect the witness’s entry book and remarkedthat it seemed a very profitable business. Burgess admittedthat they advertised in over 200 papers under the name ofDr. Collins and spent thereon .f.30 a week. Denis Collins.said he had been a surgeon since 1863. He was not nowon the Register, having been struck off about two years age-for advertising. It was a fact that he hired himself out toMrs. M’Conville at 9, Erskine-street. His duties wereto attend to the male patients. The females were attended,

by "Dr. Fitzgerald." Upon the coroner asking him whowas Mrs. M’Conville the interesting reply was elicited thather husband carried on the business before her, but that heis at present in Portland serving the Queen. Asked by the-coroner upon what charge, the reply came that " it was onaccount of an electric belt sold to a person in Ireland."(An account of M’Conville’s prosecution and con ,-

viction, with editorial comments on his offence, will be, found in THE LANCET of March 31st, 1894.) The-,

coroner read the report of the analytical chemist: concerning the contents of the bottles supplied to the-

deceased, which consisted of aloes. Used as a purgative it, might procure abortion, but the analyst did Lot think it. would produce any serious effects. The coroner, in addressing-

the jury, said it was a lamentable thing that advertisements-of the kind referred to were allowed to appear in the publicpress. They merely held out false hopes and caused endlessand untold misery to the poor creatures who were so far

1 deluded as to be guided by them. They saw the kind of3 people who carried on such a business. Whether justicet would come home to anyone he did not know. He sincerelyB: hoped it might. An open verdict was returned by the jury.y who also expressed their condemnation of the conduct oLe Collins and Fitzgerald.t The Assizes.

, Mr. Justice Cave, in his charge to the grand jury on the-e 27th ult., said that although the number of prisonersh (amounting to somewhat under sixty) was not very great,c he was sorry to say that the quality of the offences was of aL- very grave description, especially in the number of thosed offences directed against persons rather than against property.f There were no less than six cases of murder, five cases ofi, manslaughter, and nine cases of more or less serious injuries