881BROKEN RIBS AGAIN.

not passed the Examining Board appointed under this Act.The universities were ireful at such a limitation of their

power to confer degrees. Their opposition to it prevailed,and Lord DE GREY agreed to the omission of the clause.Clause 3 standing part of the Bill, the licence of the Con-

joint Board still constitutes the only title to registration.But, Clause 18 being removed, the medical authorities maydispense their qualifications freely and easily to anybody.As we said last week, there will be twenty-two portals tothe profession.The College of Surgeons has acted creditably and disin-

terestedly in asking for the reinsertion of Clause 18-inother words, for the assertion in the Bill of the one-facultyprinciple, for which we have contended for forty years. TheBill without this would be utterly forceless. The Collegeof Surgeons, we say, has acted disinterestedly in this course.Clause 18 being omitted, it might do " a thriving trade"

by the easy sale of memberships and fellowships, and enterinto practical competition with the new Examining Board.But it has preferred testifying at an important juncture tothe principle that all men must pass through one speciallyguarded gate into the profession.

Medical Annotations."1’e quid nimis."

THE ROYAL MEDICAL AND CHIRURCICALSOCIETY.

THE meeting on Tuesday night was occupied by twopapers, one by Mr. Henry Lee, on a new method of remov-ing tumours, without haemorrhage or loss of skin, and theother by Dr. Meryon, on the functions of the sympatheticnervous system. Neither paper provoked discussion-theformer because it was a description of a method of operat-ing that has as yet been only practised by the inventor;the latter because the questions it raised were far too largeand intricate to be dealt with iinproviptu, or so near theclose of the meeting. Afterwards Mr. Spencer Watsonexhibited to the Fellows a modification of Beale’s ophthal-moscope, and Mr. Brudenell Carter exhibited Dr Wecker’s

prismatic object-glass, an account of which is given in

another place.Mr. Henry Lee’s method of removing tumours is especially

applicable to subcutaneous naevi ; and rests upon the appli-cation of elastic pressure. Taking as an example the caseof a circular subcutaneous nsevus, he would, in the first

instance, pass two needles under the skin only, from baseto base of the tumour, and crossing at its centre at rightangles. On each needle he would wind over the skin n,

ligature of india-rubber thread; .and, in the course of

forty-eight hours, the threads would produce a cross-shapedlinear slough, the separation of which would divide theskin covering the tumour into four flaps. He then insertsa needle under the apex of each flap, and brings it out inthe centre of the base; and next winds a strained india-rubberthread from needle to needle all round, making it pass alter-nately under the apex of a flap, with the head of one of thefour last needles, and under one of the projecting extremitiesof one of the original needles. The steady pressure of the con-tracting india-rubber gradually dissects back the four flaps,and a similar ligature is then applied round the base of theexposed tumour. When this has sloughed away the flapscan be replaced, and healing permitted to occur.

In brief replies to one or two questions that were addressedto him on points of detail, Mr. Lee mentioned that he hadused the india-rubber thread for other surgical purposes,and that its constant maintenance of tension rendered it

very useful in many cases.

BROKEN RIBS ACAIN.

ANOTHER lunatic has been so perverse as to break sevenof his own ribs, and to die from the effects of the injurythus inflicted. Such, at least, is the theory put forth bythe authorities at the Rochdale workhouse, where, and notin an asylum, it seems likely that the harm was done.James Doran, an attorney’s clerk, became insane, and wasremoved on the 2nd of June to the workhouse. He wasthere given into the charge of an "inmate," one Pilking-ton, who had orders to give him a bath, and he was nextplaced in the epileptic ward, and put to bed. On June 7thhe was taken to Prestwich Lunatic Asylum in a dying con-dition. The assistant medical officer who admitted himfound that his ribs were broken, and he actually died in twohours after his arrival. A coroner’s jury has returned anopen verdict.We trust that the matter will not be allowed to rest here;

and that the history of the five days in the workhouse willbe thoroughly investigated. In this case there is no sug-gestion of unusual fragility of the ribs; and the insanitywas of quite recent date. We should like to know howDoran came to be detained five days in a workhouse; orwhy, indeed, he was ever taken to a workhouse at all. Heseems to have been in a respectable position in life, and tohave money in a bank. The law places upon relievingofficers the duty of conveying lunatics to asylums ; but wemuch doubt whether there is any authority for conveyingthem to workhouses, or for keeping them there for five days.The practice was invented, we believe, by a former boardof guardians for Nottingham, and was regarded by themas a master-stroke of financial policy. The district medicalofficers were entitled to a fee of half-a-guinea for a certifi-cate of lunacy for an out-door pauper; but the workhousemedical officer had no such claim in the case of a pauperinmate. It occurred to the brains of Bumbledom that, ifall the out-door pauper lunatics were made to pass throughthe workhouse on their way to the asylum, so many half-guineas would be saved from the clutches of the extrava-gantly-paid and lazy officials-the out-door parish doctors.The brilliant thought was acted upon, more than once withtragic results; and we suppose that, by a curious coin-

cidence between great minds, it has also broken forth atRochdale, or that it was communicated to the Poor-law

authorities there as a discovery. However this may be, thefact remains that an attorney’s clerk, suffering, we suppose,from acute mania, was taken to a workhouse, stripped andbathed by an 11 inmate," dressed in workhouse clothing, putinto an epileptic ward with no proper attendance or super-vision, confined in a strait-waistcoat when he became

troublesome, detained for five days, and then taken, withinjured head and seven broken ribs, to an asylum that hebarely lived to reach. We should like to know how, and bywhom, he was fed during the five days; and what amountof attention he received from the workhouse doctor.

DR. UVNCSTONE.

SIR RODERICK lIu,cz3zsorr, at the final fortnightly meet-ing of the session 1869-70 of the Geographical Society, tookoccasion to assure his audience of the safety of Dr. Living-stone. The Doctor has been, and still is, at Ujiji, unableto move forwards or backwards for want of carriers and

supplies. The =81000 vouchsafed him by the Government

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will go out with the Consul of Zanzibar, who happens tobe in this country, and starts immediately. That gentle-man will instruct Dr. Kirk, the vice-consul, to refit the

same expedition which was dispatched before, but was im-peded by the outbreak of cholera. The epidemic havingpassed away, the country is now free to Zanzibar; and theonly difficulty that remains is the getting to Ujiji with thesupplies-a journey from the seaboard which will take twomonths or more to accomplish. In seven or eight months atmost, says Sir Roderick, we may expect to hear good newsof the Doctor; and, very soon thereafter, to greet his pre-sence here. Sir Roderick was thus explicit as to the Doctor’smovements because a rumour had got afloat that we weregoing to start an expedition to Ujiji ; and at least a dozenadmirable young volunteers, who had not the least idea ofwhat they were about, had written to Sir Roderick express-ing their eagerness to join. No such expedition had everbeen contemplated; and, even if it had, Sir Roderick wouldhave felt it his duty to discourage it, as its inevitable re-sult would have been to " encumber the Doctor with its

help," if not to throw a number of patients on his hands.

CHARLES DICKENS.

cc I THINK of these past writers," said Mr. Thackeray inhis English Humorists," °6 and of one who lives amongus now, and am grateful for the innocent laughter and thesweet and unsullied page which the author of David

Copperfield’ gives to my children." In the universal sor-row at the extinction of so bright and benignant a geniusas Charles Dickens, our own profession has not been with-out its peculiar share. The organs of literature and politicshave already paid their tribute to the rare intellectual andmoral gifts of the novelist; they have dwelt on his etherealhumour, which played around and transfigured the lowliestand unloveliest objects of life; on his genial warmth ofheart, which fused down the divisions of class, and meltedthe most diverse conditions of men in a common humanityon the silent but salutary revolution which it was his toeffect in a social system hardened by tradition, and fraughtwith privation and all its attendant miseries for the poor.They have shown that he was to the humbler households in"populous city pent" what Sir Walter Scott was to themediseval world-the interpreter of their thoughts, theiremotions, and their aspirations, enabling one half of thecommunity to know how the other half lives and dies.

They have anticipated the judgment of posterity in num-bering him with

"The great of old,Those dead but sceptred sovrans who still ruleOur spirits from their urns ";

and in claiming for him the family resting-place of his

brother humorists and "weekda preachers," whose func-tion it was to soften the sentiment while enlivening theleisure of mankind. For all this high testimony to thegifted and genial man of letters who has been called awayat the flood-tide of popular favour, we have nothing butthe heartiest approval, believing as we do that as his figurerecedes in the advance of time it will stand out the clearerfrom the subsidence of contemporary mediocrity. It re-

mains for us only to make special acknowledgment of theobligations he has indirectly imposed on every practitionerof the healing art.

Medical science, particularly in its bearings on the com-munity as distinct from the individual, requires organisa-tion-the establishment and maintenance of centres of

relief, such as dispensaries, hospitals, and convalescenthomes. Depending as these do on voluntary support, theyflourish or languish in sympathy with the liberality or theselfishness of the public. To soften this selfishness, to

quicken this liberality, was the task to which Charles Dickensdevoted himself,-not after the mode of a licensed incul-cator, but in obedience to the love of mankind withwhich his warm heart and genial imagination glowed.There is not a page which bears the impress of his mindbut literally beams with this philanthropic spirit. Thereis hardly a work which he has written but has left theworld the more tolerant, the kindlier for its perusal. Itis to " Pickwick" " that we mainly owe the less bar-

barous relations between debtor and creditor which have

prevailed since the pulling down of that hot-bed of moraland physical disease the " Fleet-prison " ; and it is to thesame genial correction that we must attribute the gradualextinction of the Bob Sawyer type of medical student. In"Nicholas Nickleby" may be found the source of thatreform in the boarding-schools of the country which, havingconverted these establishments into habitable and, in themain, well administered households, bids fair to render eachof them what Carlyle called Dr. Arnold’s residence at Rugby—" a temple of industrious peace." The marvellous vivid-ness of the representations of workhouse life in " OliverTwist " gave an impulse to Poor-law legislation which isfelt to this hour ; and the significance of Christmas, with itsever-recurring lessons of charity and self-sacrifice, has foundits most genial and effective interpretation in the immortalCarol in prose." We might run through the whole

catalogue of his great works of fiction and find the same

gospel of humanity preached in a thousand subtle butirresistible forms-breaking out, withal, into occasional vehe-mence at the perversion of purpose which deflected charityinto unworthy channels, or lavished the outpourings of thephilanthropic spirit on insincere or undeserving objects.But among all the radical reforms of recent days, we maybe allowed to single out one in which we know him to havetaken special interest-one of which he may be consideredas the original promoter-the amelioration of workhouseinfirmaries, on which we started, five years ago, a Com-mission of Inquiry. We never failed to find him, amidmuch official irritation and obloquy, a most able andjudicious coadjutor, and in the columns of the weeklyjournal which will always be identified with his name wewere indebted for encouragement and support as power-ful as it was opportune. Towards the close of 1865, whenthe battle against purblind authority was at its height, weendeavoured, in an article on 11 Our Mutual Friend," tomake some acknowledgment of the debt we owed to ourgenerous and genial auxiliary. That acknowledgment wehere reiterate with all the greater emphasis now that thegifted philanthropist who inspired it is no more-consciousas we are that if our efforts for the removal of sanitaryand social abuses have been rewarded with some measureof success, it is due, in no inconsiderable degree, to themore favourable conditions prepared for us by the mightiestwielder of the emotions of his fellow-men that has beenvouchsafed to our times.

____

THE CLANDS OF THE STOMACH.

AT the last meeting (May 13th) of the Silesian ScientificSociety, Dr. Ebstein read a paper "On the Structure andFunction of the Mucous Glands of the Stomach," of whichan abstract has been forwarded to us, containing the follow-ing results of observations made upon the pig, cat, rabbit,and dog. The so-called mucous glands of the stomach arechiefly found in the pyloric region, except a zone having abreadth of about one-third or one-half of an inch, which ischiefly occupied with peptic glands. The alveoli of thestomach are lined with columnar epithelium, the cells of

which, at first closed, subsequently burst, dischargingtheir contents, and becoming replaced by others which

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were previously subjacent. The cells lining the mucous cal charge of the Naval Brigade during the expeditionglands are short, contain a granular protoplasm, with a against the rebels at Kahding, and for these services he wasnucleus at the lower end. The entire series of physical and gazetted and most favourably mentioned in the despatcheschemical characters of these cells show that they belong to (Gazette, Jan. 9th, 1863). He was also present at the attackthe typical cells (ha2cptzellen) of Heidenhain. Four or five on Kagosima and Simonoseki in Japan, and for his impor-hours after a meal the mucous glands appear cloudy and tant services on these occasions was twice gazetted-viz.,shrunken, whilst they absorb colouring matters, as aniline Oct. 30th, 1863, and Nov. 18th, 1864. He was promotedblue, with remarkable facility. The mucous glands secrete to the rank of Staff-surgeon on the 15th of October, 1866,a fluid which possesses digestive powers, converting albu- and served in the Royal Alfred, bearing the flag of themen into peptone. M. Ebstein, therefore, maintains that Commander in Chief, on the North America and West India,there is no essential difference between the mucous and station, and was on his return appointed principal medicalthe peptic glands, and recommends that the former should officer of the Naval Hospital at Haulbowline, from whichbe called simple, the latter compound, peptic glands. he has just been promoted.

- We may take this opportunity of mentioning thus earlyTHE COLLECE OF SURCEONS ELECTION. that there will be in all probability from twenty-five to

the ... , Council n i College of Surgeons thirty vacancies for assistant-surgeons in the Navy thrown

will take place to the Council of the College of Surgeons open to competition in August next. This large number iswill take place in three weeks time; and the necessary due to the diminution of the active list of naval medical 1

preliminary notices to the Fellows have already been for- officers consequent upon the recent scheme of retirementwarded from the College. Although no official announce- being carried into efE’ect.ment has yet been made of the names of the candidates, we being carried already been omcially announced that therebelieve we are correct in stating that their number has been WI ’II it has already candidates for the British or Indianincreased by the addition of the name of Mr. John Adams, Army be no entry of candidates for there will probably bewho proposes to offer himself for re-election on the present no difficulty in filling the vacancies in the Naval Medicaloccasion. We published a few weeks back (April 30th) a Service with men of first-rate abilities, and we recommendletter from that gentleman, in which he explained, quite th gentlemen who have been studying with a view tounnecessarily we think, the cause of his non-appearance on those gentlemen who have been studying offered them inthe day of election last year; and though Mr. Adarns did the army, to inquire as to the advantages offered them in

the day of election last year; and though Mr. Adams did the sister service. We trust that the candidates who arenot then announce his intention of coming forward again, successful on the coming occasion will have the advantagewe are informed that votes have already been solicited in successful on the coming occasion will have the advantagehis behalf. The reappearance at the poll of a gentleman tion there given is equally useful for both the naval andwho has already served on the Council, and has lost his army medical officers.

useful for both the naval and

seat, is unusual, but not entirely without precedent; for in army medical officers. -

1862, the year of Mr. Adams’s election, Mr. Bishop, who BABY-FARMING AND ITS RESULTS.had lost his seat at the preceding election, again came for- 0 DR rulers appear to be afflicted with a deafness such asward, unsuccessfully. We discussed Mr. Adams’s claims to

is proverbially attributed to the adder, in respect of there-election last year (THE LANCET, June 19th, 1869); and reiterated demands of the press for legislative protection towe do not see anything in his recent letter to make us in

reiterated demands of the press for legislative protection towe do not see anything in his recent letter to make us in .. , .. . , .

’*’ .° ,...*,.

any way alter our opinion, nor do we anticipate that his infant life against such perils as are implied in what is now

candidature will affect the result of the election. popularly styled 11 baby-farnaino-." Women, the object ofcandidature will anect the result of the election. i , . -..

Mr. Holmes Coote has as yet made no sign, and has put whose calling is perfectly well known, continue to advertiseM r. Holmes Coote has as yet made no sign, and has put t whose calling is is perfectly well known, to advertise

forward no opinions respecting, College politics for us to for clients without the slightest attempt being made byforward no opinions respecting College politics for us to .... ° ... ’’’ °. .

...... be may - i,- MrParliament to institute a surveillance over their doings ;criticise. Anxious as he may be to join his colleagues, Mr. and disclosures shocking to humanity crop up at intervals,Paget t and Mr.Hold den, in the Council chamber ber, we f ear and disclosures shocking to humanity crop up at intervals.,Faget and Mr. Holden, in the Council chamber, we fear all of them having , n ., i., ,..,.,that silence will not prove a talisman to open the gates r allot them having so strong a familylikeness as to indicatethat silence will not prove a talisman to open the gates of beyond doubt that they are the results of an i -,ithe Elysium he has in view. The

remaining

candidates-- beyond doubt that they are the results of an abominablethe Elysium he has in view. The remaining candidates- ", .,, . i . probably iMessrs. Spencar Wells, Henry Lee, and Erasmus Wilson- systematised tramc in infant liie which is probably much

will, doubtless, continue the contest; and Erasmus be for the he more extensive than even we have knowledge of at present.will, doubtless, continue the contest: and it will be tor the The ,. i of ji Brixton baby-farming case, , . ,Fellows to decide which two gentlemen shall represent them. The particulars of the Brixton baby-farming case, whichFellows to decide which two gentlemen shall represent ’ them. appeared in the newspapers of Tuesday last, present the

THE NAVAL MEDICAL SERVICE. usual sickening details of dirty, emaciated, sick, and nar-THE NAVAL MEDICAL SERVICE. cotised infants. But read in connexion with the account

THE Director-General of the Naval Medical Department in Wednesday’s journals of an inquest held by the Surreyis to be congratulated, we think, on the selection he has coroner at Camberwell, they have a significance whichmade of the officer to succeed Dr. Rae as Deputy-Inspector cannot be mistaken. Couple the fact that a marked increaseof Hospitals and Fleets. Staff-surgeon David Lloyd Morgan, has of late been observed in the number of infant bodies

M.D., the officer in question, is a most distinguished mem- found exposed in a certain locality, with the fact that cer-ber of the Naval Medical Service, as the following epitome tain houses exist in that locality for the secret delivery ofof his services will show. pregnant women, and probably for purposes of a less inno-

Dr. Morgan entered the Navy as an assistant-surgeon on cent kind; the presumptive inference of these two factsthe 31st of December, 1846; and, after serving on the coast standing in the relation of cause and effect is at least suffi-of Africa, and on the Home and Mediterranean sta- ciently strong to warrant investigation. And it would seemtions, he was promoted to the rank of surgeon in 1854. that this view of the case has at last been taken by theAs assistant-surgeon of the Trafarlgar, he was present at police authorities; for to an intelligent sergeant of thatthe bombardment of Sebastopol, and served throughout the force the public is indebted for dragging forth into thewhole of the Russian war. In 1858 he was attached to the light of day the medium by which the secret accoucheuse2nd Battalion of Marines during the operations in China, disposes of the "ineumbrances" of which she rids herand was present at the bombardment of Canton. He was clients. So far as we can gather, the chain of evidence seems insurgeon of the Euryalus flagship on the China station the present case so complete as to warrant the hope that thethroughout her whole commission, and was placed in medi- law will leave no meshes large enough for the guilty to

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escape. A " delicate-looking young lady" is traced from thehouse of a woman who is well known in the secret :’Lccouche-ment line, to her own residence; her name, and the fact ofher having lately given birth to a child, are ascertained,likewise that the child has been put out to nurse, and thenby a stratagem the police sergeant discovers the child-nothing but skin and bone, and in a filthy condition"—ina baby-farm in a small out-of-the-way street convenientlyadjacent to hundreds of open railway arches and acres ofwaste ground. In this baby-farm were found ten otherchildren, five of them under a month old, "very dirty andemaciated," huddled together on a sofa in the kitchen, andfive others, from a year to two years old, in the yard out-side. The baby-farmer said she had been " in the business"four years, and had had in that time about forty children,all illegitimate, and that only four deaths had occurred:where the others were now she did not know. The further

investigation which is, we understand, being now carriedon, will, it is to be hoped, solve that and one or two otherpoints greatly in need of elucidation.

MR. BRADY’S SUPERANNUATION BILL.

WE learn that the Presidents of the Colleges of Physiciansand Surgeons will wait on Mr. Goschen, and urge upon thatgentleman the propriety of the Poor-law Board supportingthis Bill. In another part of our present issue will befound a form of letter to members of Parliament, sent to us

by Dr. Rogers, requesting their support of the measure.Dr. Rogers has collected a series of cases illustrating

the evils which are likely to be redressed by superannuationallowances to Poor-law medical officers. Some of these are

extremely interesting. Gentlemen of seventy years of age,who have been more than thirty years in the public service,are still hanging on to their posts because they have noother means of subsistence. They have lost their privatepractice, they are unable to go out at night, and even byday require a carriage. They are too old to attend mid-wifery, and yet, thanks to the guardians who have beentheir masters for so many years, they are permitted forbare life to remain in harness until death releases them."God alone knows what will become of me," says one,

when I can no longer work." " I have continued to work

on," says another, 11 though, at the age of sixty-seven, I feelmy labours must soon cease. I do hope that the membersof the House of Commons will give our petition a just andfair consideration, and allow some compensation to hard-worked, ill-paid public officers, who have sacrificed healthand the comforts of life whilst carrying out the importantduties which devolve upon them."We trust with confidence that such appeals will not be

made in vain. The self -sacrificing labours of medical men,particularly in sparsely populated districts, are by no meansrecognised as they should be; and in asking Parliament toread this Bill a second time on Tuesday next, Mr. Bradywill be only asking for an instalment of the justice whichis due to them.

____

ARMY MEDICAL SERVICE.

WE have received several communications from our armymedical friends regarding a recent decision of the authori-ties contained in a published circular order, to the effectthat medical officers are not to be considered as on theestablishment of regiments. This appears to have led to somemisconception; but, from inquiries we have instituted, webelieve that there is no intention to alter the position held byregimental medical officers in their respective corps. The

decision was arrived at and promulgated solely on financialgrounds, and with the view of separating the expense ofmedical administration, and including it all-whether

regimental or staff-under one and the same head. Theconstitution of the Army Medical Department remains ex-actly the same as it was ; and even by the terms of thenew warrant, about which so much discussion has arisen,medical officers holding regimental appointments wouldcontinue to hold them for five years after the date of its

being promulgated. ____

THE SUEZ CANAL.

As our readers are aware, there is a service of Indianoverland troop-ships for the conveyance of troops andinvalids to and from India. The service consists of several

very fine steamers, and one of these, the Jumna, havingsailed from Bombay on 15th April with the 77th Regimenton board, arrived at Suez on lst May, and on the 3rdentered the 11 Suez Canal," and completed the passagethrough the canal in a very satisfactory manner. Whatwith a climate like that of the hill stations of India, asystem of overland steamers passing through the canal,and vessels for the long voyage round the Cape, there oughtto be no great difficulty in meeting the various require-ments of the sick of different regiments, provided theinvalids were carefully selected. The system of railroadsand telegraphs in India, telegraphs between that country andthis, and the short route through the canal, cannot fail toeffect eventually a marvellous change in all that regardsour government of that country. There is ample scope for theadministrative capacity and zeal of such men as the Duke ofArgyll and Mr. Cardwell in adjusting the Imperial policy inconformity with the best system of sanitation for the troopssent there.

____

NEW PRESERVING FLUID FOR PREPARATIONS.

M. MÉHU, Pharmacien of the Necker Hospital, statesthat for the last two years he has been experimenting withvarious antiputrescible fluids for the preservation of ana-tomical specimens, and has at length discovered one whichanswers excellently. This liquid only contains a small pro-portion of alcohol, and hence does not cause any consider-able contraction of soft textures, which with him have

chiefly been portions of the mucous membrane of the

bladder, prostate, &c. It contains arsenious acid, whichpreserves them from decomposition, and the development ofcryptogamic vegetation is prevented by the addition of asmall quantity of crystallised carbolic acid. The formula

is-Arsenious acid, 20 parts ; crystallised carbolic acid, 10parts; alcohol, 300 parts; distilled water, 700 parts. The

preparation of this fluid has led him to notice the greatsolubility of arsenious acid in alcohol, which has not

hitherto attracted attention.

THE DREADNOUGHT SEAMEN’S HOSPITAL.

IT does not appear that any diminution is likely to takeplace in the number of patients received by the Seamen’sHospital Society. We are informed that the change oflocale from the Dreadnought to the infirmary of GreenwichHospital has resulted in an increase in the number of

entries, particularly as to medical cases; for the total dailyreturn has lately indicated a larger number of inmatesthan were ever housed in the Dreadnought during the cor-responding months of the last ten years. This fact speakswell for the future of this hospital ; and we are glad tonote that all acute medical cases received and quartered inthe small three. bed wards, have done remarkably well. As,indeed, the majority of the wards contain but three beds, itwill be instructive, in the interests of sanitary science, tolearn by observation how both medical and surgical casesprogress towards recovery. For these small wards are very

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fairly ventilated, well lighted, and are each provided withan ordinary open grate. The institution is well worthya visit; and we are glad to record that the committee

have continued the facilities formerly afforded on boardthe Dreadnought for the residence of pupils or students

within the walls of the building, under the superintendenceof their chief medical officer. We trust that no exertions

will be spared by the professional as well as the adminis-trative staff to make this hospital second to none in smart-ness and usefulness; and we can assure the general com-munity that it is now specially deserving of public support.

REVACCINATION AS A SAFECUARD ACAINSTSMALL-POX.

WE have heard a good deal about small-pox of late, andmany persons have probably been deterred from visitingParis by the reports from that city. It seems to us that

people have not taken a proper estimate of the protectivevalue of revaccination. Let us take the records of our own

army (the average strength of which is something under200,000) for the five years ending 1868. Our troops aredistributed all over the world. They are to be found atJapan, where small-pox is endemic; in Bengal, where itoften prevails as an epidemic; and in the United Kingdom,where, as in 1864, it is only exceptionally very prevalent.The English army is consequently exposed to greater risksof contagion than a similar number of civilians. Duringthe five years we find that there have been altogether 970admissions and 87 deaths from small-pox; or, in other

words, only about one soldier in a thousand was attacked,and less than one in ten thousand died of that disease. In

the English army, for more than ten years, it has been thepractice to vaccinate or revaccinate every recruit on enlist-ment, without exception; and the care that has been takento carry out this practice of revaccination has, if anything,increased of late years. At High Wycombe no person thathad been revaccinated was attacked with small-pox, andthe experience at other places and during other epidemicshas been very monotonously to the same effect. It is sur-

prising that sensible people should, in the face of facts likethese, give any heed to the mischievous outcry of thosewho ignorantly oppose the practice of vaccination.

NOTTINGHAM DISPENSARY.

THE books of this well-conducted charity give the numberof patients treated during last year as 8169, of whom 1236were attended at their homes; while the dental cases appearas 2043. Owing to the very healthy condition of the townduring the greater part of 1869, and particularly to theabsence of diarrhoea, these figures, as compared with thereturns of the preceding year, show a gross decrease of2567-to wit, 2415 out-patients and 194 home-cases; whilethe dental cases exhibit an increase of 42. The number of

deaths in 1869 was 110, as against 130 in 1868; showing adiminution of 20.In spite of munificent donations and legacies, the ordinary

income of the institution has failed to meet the necessaryoutlay of the year by about .840. This is to be regretted;as the population of the town and neighbourhood is rapidlyincreasing, and the resources of the charity ought to mul-tiply in the same ratio.

Besides pecuniary failure, the dispensary has lost the co-operation of Mr. T. D. Atkins, the assistant-surgeon, whohas resigned on account of ill-health; and-a still heaviersacrifice-Dr. Isaac Massey has been compelled by otherengagements to dissolve his connexion with the institution,to which, as honorary surgeon, he has long rendered suchsignal and disinterested service. In recognition of Dr.

Massey’s claims on their gratitude, the committee have

invited the governors of the dispensary to join them inpassing a special resolution to the effect that Dr. Massey berequested to accept, with all the privileges attached to it,the post of consulting surgeon for life.

REMOVAL OF KNIGHTSBRIDGE BARRACKS.

IN a financial point of view, the site of the Knights-bridge Barracks would, if sold, in all probability realise anamount sufficient to erect barracks for the whole regimentof Guards, whilst the removal would enhance the value andchange the aspect of the richest and most prized part ofLondon. No one can doubt that removal would afford the

opportunity of increasing the accommodation for officers,men, and horses, but we confess there appears to us no

reason why these advantages should entail completeremoval from the park. A cavalry barrack, to be effectivein times of riot, requires to be free on all sides, so that theregiment can debouch and form without the possibility ofobstruction. If a row occurred in Albany-street, a well-determined crowd with a few ropes could prevent the regi-ment from leaving the barrack square. But in Hyde-parknot only is there ample space for the erection of suitableaccommodation for 500 men and officers, but the buildingmight be an ornament without interfering with the comfortof a single person. -

THE SANITARY CONDITION OF MERCHANTSEAMEN.

THE Merchant Shipping Code Bill, with its hydra-headedclauses, was read a second time in the House of Commonson Monday night, when Mr. Graves, the member for Liver-pool, reiterated his conviction of the necessity for an inquiryinto the physical condition of our merchant seamen. Thehon. gentleman took occasion to remind the House that theresult of evidence gleaned some months ago by a Liverpoolcommittee tended to show that at least 65 per cent. of theseamen composing the mercantile marine of this countryhad deteriorated in physical condition. We have manytimes urged upon the attention of our readers and the publicthe points indicated by Mr. Graves, and would once againremind those interested in this question that, unless directlegislative means are adopted to provide for our ships soundand healthy crews, wrecks and disasters of various kindswill continue to increase. An inspection of all hands beforesigning articles, and a refusal on the part of the under-writers to insure a vessel or her cargo unless this conditionis complied with, are absolutely and essentially necessary.For, inasmuch as it appears that nothing will be done inthe matter of scales of diet, it is superlatively importantthat the master of a ship should at the outset be providedwith good vital material (which is of as much importanceto him as good gear), so that the vessel may at all events start fair." It is not pertinent to matters medical totouch upon other clauses of the Bill that bear indirectlyon the same subject; but if the code be referred for con-sideration to a select committee, with power to examinewitnesses, there will be no difficulty in producing evidenceto confirm the opinions that we have so very often expressedwith reference to the sanitary means that should be adoptedfor the purpose of securing the safety of our ships at sea.

A DOUBTFUL LUNATIC.

SOME of the Lincoln guardians are in great trouble be-cause their medical officer has refused to send an old manof eighty-four years of age to the lunatic asylum. The

poor old creature is evidently in his second childhood. The

other inmates had teased him about some tobacco until, ina temporary fit of frenzy, he threw himself over the balustersof the staircase, and broke both his thighs. The medical

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officer admitted that he was liable to "violent attacks of

impetuosity ;" but we agree with him that this is not a

sufficient reason for sending him to a madhouse. The faetis that the condition of the "old men’s" wards in work-houses is often intolerable. There is no occupation, no amuse-ment, no one to look after the old people or care for them.They quarrel and tease each other without hindrance, untilthey scarcely know what they do. The Lincoln guardianshad far better turn their attention to the discipline of theward, than seek for information from the Poor-law Board.With reasonable supervision there ought to be no fear ofan old man of eighty-four committing suicide.

NATURAL SCIENCE AT ST. JOHN’S COLLEGE,CAMBR!DGE.

NATURAL SCIENCE now forms a regular part of the teach-ing in this College, and also of the examination for theaward of scholarships and exhibitions at the close of theacademical year. As a result of the examination just held,A. H. Garrod has obtained a foundation scholarship of thevalue of £50 per annum, tenable for five or six years; H.

Blunt receives an exhibition of -,20; and H. N. Read oneof £10. This is, we believe, the first occasion on whichnatural science has been admitted to form a part of a

college examination on a par with elassics and mathematics,and is an evidence of the progress which that science is

making at Cambridge. -

THE MEDICAL DISTRICTS OF ST. PANCRAS.

THE guardians of St. Pancras are proposing to divide thisextensive parish into four medical districts, in the place ofsix, and to place each district in charge of a medical officerwho shall be debarred from private practice. The effect ofthis arrangement would be to deprive the present districtmedical officers, some of whom have held the appointmentmany years, of their posts. These gentlemen have memo-rialised the Poor-law Board not to sanction the arrange-ment, on the ground that the poor will not have the sameguarantee of skilful attendance which is afforded by theappointment of gentlemen who have a reputation to sus-tain. It may be remembered that similarly unjust arrange-ments were originally proposed in Bethnal-green, wherethe guardians, in deference to the wishes of the Poor-lawBoard, have continued the system of employing gentlemenwho are engaged in practice in the parish. We have our-

selves frequently pointed out the disadvantages resultingfrom restriction from other than pauper practice, and wehave every reason to believe that our views are in accord-ance with those of the Poor-law Board. We therefore hopethat the guardians of St. Pancras will not be permitted tocarry out their scheme. ____

MEDICAL OFFICERS ON THE WEST COASTOF AFRICA.

AFTER the subject had been several times postponed, Mr.Raikes brought forward his motion in the House of Com-mons on the 14th instant. The occasion appears to havebeen singularly inopportune, for the Speaker, proceeding tocount the House, found that only twenty-four memberswere present. It is much to be regretted that the subjectwas not fully discussed. Whatever may be the opinion asto the interpretation that should be put upon the numerousregulations s.f!’ecting the West African medical service,there can be no doubt that these have been framed in a waycalculated to mislead ordinary readers. The fact that anyquestion should have arisen at all says little for the wisdomof those who framed the regulations on which the medicalofficers volunteered for the African service.

MR. SYME.

IT is with much regret that we find ourselves unable toreport any improvement in Mr. Syme’s condition. He isstill conscious, but has not regained the power either tospeak or swallow. ____

BARON LIEBIC.FROM private sources we learn that the accounts of Baron

Liebig’s illness are greatly exaggerated. He has been

suffering from carbuncle in the neck, from which we arehappy to say he is now recovering.

THE PATHOLOCICAL SOCIETY AND AMALGA-MATION.

THE adjourned special general meeting of the Patholo-gical Society, for considering the details of the scheme ofamalgamation proposed by the Medico-Chirurgical Society- the Society having already given a general assent to thescheme,-will be held at 53, Berners-street, on Monday next,June 20th, at half-past 8 P.M.

THE MEDICAL TEACHERS’ ASSOCIATION.

THE Council of the Medical Teachers’ Association hasdetermined not to call that body together this month, asaction is not advisable during the present unsettled stateof medical legislation. It congratulates the Associationon the progress which has been made in the cause ofmedical education since the establishment of the Associa-

tion, and rightly, we think, attributes much of it to theinfluence of the teachers.

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; THE DROUGHT.

WE are happy to have the Registrar-General’s authorityfor saying that hitherto the public health has shown nosigns of suffering from the continued absence of rain, whichis giving rise to so much anxiety as regards vegetation andfood supply. Seventy out of the last 86 days have beenabsolutely rainless, while the fall at Greenwich on the

remaining 16 days was only 1¼ inch. The average rainfallof April and May at Greenwich is 4 inches; in the last twomonths it has been only one-fifth part (0’8 inch) of thatquantity. ’The driest year on record is 1864, when 7tinches less than the average fell; but whereas in the firstfive months of that exceptionally dry year the rainfall was7 inches, it has been only 4’9 inches this year. The resultsfor the other large towns of the kingdom have not been sounfavourable, as quantities varying from 15’6 inches inGlasgow, to 86 inches in Sheffield, 6’9 inches at Liverpool,and 5’1 inches at Norwich, have been measured.

MUTUAL MEDICAL AID.

The Graphic observes that if the Mutual Medical Aid So-ciety is not really self-supporting, persons of honourablefeeling, however strained in means, will shrink from asso-ciating themselves with it. On the other hand, if it is self-supporting, there can be no reason for refusing anyone whois desirous of subscribing. Why, in fact, should persons ofunlimited means pay more for services than the market value ?

Why indeed only that the principle of professional remu-neration is not that of the Mutual Medical Aid Society. Wewould advise the eminent medical promoters of this tradingscheme to look out sharply for their own fees. How do

they know that the committee will not begin by putting upthe posts of consulting surgeon and physician to publiccompetition in order to ascertain the market value of thecommodity they require ? a Such a competition might notadd to the dignity of the profession, but it would perhapsenable us to estimate the value of consultees from a tradingpoint of view.

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THE Duke of Argyll has written to Sir Walter G. Simpson,stating that he has received an order from her Majesty toconvey to the family of Sir James Simpson 11

an expressionof her Majesty’s warmest sympathy in the loss they havesustained, and an expression also of her Majesty’s ownsorrow on account of the loss which the country has sus-tained in the death of so great and good a man."

THE Council of Queen’s College, Belfast, have, in con-formity with the will of the late Dr. Sullivan, founded twoscholarships in that University, for the benefit of personswho have acted for at least two years as teachers or assistantteachers in Irish national schools. The first examinationwill be held in October next.

THE Emperor of China has forwarded for presentation toDr. Lougheed, of the 21st Fusiliers, a gold medal, in recog-nition of the valuable services rendered by that officer whenattached to the Chinese forces in the recent campaigns inthat country. ____

THE Lords of the Privy Council have awarded gratuitiesfor successful vaccination to the following public vac-cinators : Mr. Jas. E. Peirce, of Brynmaur, ,612 13s. ; andMr. Chas. P. Stevens, of Biggleswade, .819 12s.

THE Senate of the Queen’s University of Ireland haveadopted resolutions claiming that its Doctorate of Medicineshall admit to the State examination under the new Medical

Bill, and that diplomas granted under that Act shall notspecify in what division of the United Kingdom candidatesmay have been examined.

FURTHER debate on Mr. Candlish’s Vaccination ActAmendment Bill has been postponed to Wednesday, the6th of July. It might as well have been postponed adGrcecas kalendas for all the chance it has of becoming lawthis session.

____

WE learn with satisfaction that the Royal Surrey CountyHospital, which was closed last week in consequence of theappearance of two cases of scarlet fever, was promptly re-opened on the recommendation of the medical officers. Dr.Morton continues to report favourably of the health of

Guildford, the town being almost free from scarlet fever.

THE news from India that the Government of the North-West Provinces is taking measures to enforce the new

regulations for suppressing infanticide will be received withsatisfaction in this country.

NOT only the epidemic of small-pox, but also the generalmortality of the city of Paris, has markedly declined. Thesmall-pox deaths last week were 165, and the general death-rate was ,29 per 1000, instead of 32-35, as it had been inprevious weeks.

____

DR. LANHESTER held an inquest last week on the bodyof a child, aged twenty months, who had died from small-pox, never having been vaccinated. The mother stated that,when she registered the birth, she received no vaccinationpaper from the registrar. Has the Registrar-General’s at-tention been called to this alleged negligence on the part ofone of his officers ?

____

THE deaths in London from scarlet fever have risen gra-dually during the last seven weeks from 68 to 103. The in-creased fatality of last week was almost exclusively in thewestern district of Kensington.

Correspondence.WOMEN AS PRACTITIONERS OF MIDWIFERY.

"Audi aiteram partem."

To the Editor of THE LANCET.

Sir,-In all popular movements, however one-sided andirrational they may seem, there is some foundation of truth,the grain of common sense in the bushel of chaff. And soit is with the movement that is now taking place withrespect to the admission of women into the rank of medicalpractitioners. I believe, most conscientiously and thoroughlythat, as a body, they are sexually, constitutionally, andmentally unfitted for the hard and incessant toil, and forthe heavy responsibilities of general medical and surgicalpractice. At the same time I believe, as thoroughly, thatthere is a branch of our profession--midwifery---to whichthey might and ought to be admitted in a subordinateposition as the rule.

In France, and in many other parts of the Continent,this division of labour in midwifery is fully carried out,and with great advantage to both parties-to the regularpractitioner, who is relieved of part of his most arduous,most wearing, and most unremunerative duties, and to thewomen who have a vocation for medicine, who are able,thus, in large numbers, to gain a respectable living in theprofession they wish to practise.

I think I may safely say that there are very few medicalmen who have been ten years in practice who would notgladly, thankfully, hand over to a body of well-educatedand friendly midwives their half-guinea or guinea mid-wifery cases. To a young practitioner there is the charmof novelty, and the desire to improve, which make remune-ration altogether a secondary consideration. But after tenyears’ practice, often long before, a very decided changecomes over the spirit of the dream. With experience comesthe power of judging what is likely to take place; and thenthe only really interesting cases, those that present anyreal charm are those which are called the bad cases, theunnatural presentations, and the accidents of midwifery.When battling with such cases, the experienced accoucheurfeels like the experienced captain of a ship in a storm, likethe veteran in the field before fire, and all weariness, allregret at the utter waste of valuable time, are lost in theintense sense of the importance and responsibility of theduties to be performed. -

But nineteen cases out of twenty are mere ordinarycases, in which there is little or nothing to do but to watch;and what words can describe the weariness and impatienceof a busily employed practitioner in attendance on such

patients, when unremunerated or badly remunerated. Thegolden hours passing away, the daily duties neglected, thenight’s rest lost, and all just to "keep a practice together."For the mere humanitarian feeling becomes deadened byforce of habit. If all is right, if there is no difficulty, nodanger on the horizon, the cries and laments of the

parturient female fall on the ear of the old accoucheurpretty much like the chimes of the clock, merely telling himin the next room, by their tone, at what period of the labourthe poor sufferer has arrived.Now in France midwifery practice, in my humble opinion,

is better managed; and I think that we should do well toimitate the French division of labour, the more so as weshould thus satisfy the craving for medical employmentwhich has got hold of some of our fair countrywomen.There is a very large midwifery hospital in Paris, andsimilar ones in other large towns, in which women studentsare alone admitted, and regularly educated by a well-selected staff of accoucheurs, aided by female teachers. Inthese " midwives’ hospitals and schools " no male studentsare allowed to enter, and thus the revolting mixture ofyoung male and female students in the study of theanatomy, physiology, and pathology of the sexual organsis avoided, and respect shown to those feelings of delicacywhich pertain to Christian civilisation.Once these midwives have obtained their diplomas, they

settle in practice both in town and country, and attend