788 THE COLLEGE OF SURGEONS.

one of its staff on the Council. He puts forward an excel-lent summary of his views, which coincide, in the main,with those of Mr. GAY; and we are not surprised to see that,in addition, he urges the selection of the President irrespec-tively of the Examinership, since it must be well known tohim that Sir B. BRODIE was passed over when his secondturn came round, because he had shortly before felt it his

duty to retire from the Board of Examiners in favour ofyounger men. " That students should be examined on the

subjects they are taught, and taught those things uponwhich they are examined," may at first sight appear atruism; but unfortunately at the present moment the Ex-aminers do not keep pace with the teachers, and science

accordingly makes but slow progress. If Mr. LEE would

read " taught those things upon which they ought to be ex-amined," he would reduce to a very handy formula therelation between examiners, teachers, and pupils.

The able and elaborate statement of views contained in his

letter (which will be found at p. 797) shows that he fullyappreciates the duties and responsibilities of the office whichhe seeks at the hands of the electors, and the experience hehas had both as a teacher and as an examiner in Surgeryat the College of Physicians and the University of Londoncannot fail to make his views on medical education most

valuable and trustworthy. We are glad to see that Mr.ERICHSEN takes up the question of the representation of theFellows and Members of the College in the General MedicalCouncil, and we look forward to his election as a great ac-cession of strength to the reformers in the College.We are informed, though indirectly, that Mr. ERASMUS

WILSON intends to present himself, for the fourth time, onthe present occasion; and we regret to hear it. Whatever

may be that gentleman’s private worth and public success,it is, we think, most unusual, to say the least of it, for anunsuccessful candidate thus persistently to force himself onthe notice of the electors. Mr. WILSON has himself compli-cated his position by his liberal donation to the College ofSurgeons; for whilst the appointment of the first Professorof Dermatology is still unmade by the Council, it appearsto us most unseemly for a gentleman who is himself a pro-bable candidate for the chair to be seeking admission intothe body in whose hands the appointment rests. Mr. WILSONdoes not appear to have the most judicious advisers in theworld, but at least they might urge a more dignified line ofconduct than that upon which we are obliged reluctantlyto comment.

Mr. MACKMURDO has, we understand, informed the autho-rities of the College of Surgeons that he does not proposeto put himself forward for re-election, and we take this

opportunity of congratulating him upon his dignified retire-ment.

DR. LANCASTER’S annual report on the duties of Coronerin the Central District of Middlesex will be read at theSocial Science Association on Monday, the 28th inst.

Medical Annotations."Ne quid nimis."

THE ROYAL SOCIETY OF MEDICINE.

THE last special meeting of the Royal Medical and

Chirurgical Society for the discussion of the amalgamationscheme was but thinly attended, and the debate was brief.The remaining clauses of the scheme were duly passed, theonly one which excited any serious discussion being thatwhich proposes the formation of a class of "Associates ofthe Royal Society of Medicine," who, on the payment of anannual guinea, should have the privileges appertaining toa membership of one section only. It was argued that an-other class of Fellows of the Society would be objectionable,under whatever name they were classified; but the pro-position was carried by a majority as a means of affordingthe present members of a single society the same privilegesfor their subscription which they now enjoy.The clause authorising each section to deal proprio motu

with one-half of its income was amended, after some debate,by the addition of the words " or such other proportion asmay hereafter be agreed upon." It is evident to us thatthe compliance of the existing societies, and the futureprosperity of the sections, must eventually turn, as Dr.Greenhow pointed out in the first discussion which tookplace, upon the financial position of the sections. The ideathat individual Fellows of the future Society will save any-thing by the amalgamation appears to be a chimera; for itis evident that admission cannot be obtained to all the sec-tions of the Royal Society of Medicine under four, or pro-bably five, guineas. Now, at the present moment, a Fellowof the Medico-Chirurgical Society subscribes three guineas,and may join any other of the societies at a guinea apiece;but then the whole of his guinea goes to that individualsociety. Under the proposed arrangement, the composition-fee must necessarily be divided among six or seven sections;and it stands to reason that each will get less, although theFellow will be entitled to receive all their 11 Transactions,"and to attend all their meetings. To those few members ofthe profession whose great delight it is to spend their even-ings in 11 societies," the attraction of seven sections will,no doubt, be irresistible ; but to more ordinary mortals threesections would, we imagine, be quite the extent to whichtheir scientific zeal would reach, and we fancy they willwish their guineas to be devoted to the purposes of thesections which they themselves patronise.

STATE MEDICINE AND THE ROYAL SANITARYCOMMISSION.

THE Joint Committee of the British Medical and SocialScience Associations have arranged and issued a Schedule ofQuestions which, in their opinion, ought to be included in,or rather, we imagine, solved by, the inquiry of the RoyalSanitary Commission now sitting. The Joint Committeeadhere to their deliberate and very decided opinion that noinquiry can in any sense be satisfactory or conclusive whichdoes not embrace the entire subject, and the whole of theUnited Kingdom; and the schedule they have framed isintended to elicit the necessary details, the knowledge ofwhich is essential for the final and comprehensive settle-ment of the imperial question of State Medicine. The JointCommittee consider it important that the inquiry of theCommission should have special reference to the agency re-quired for giving effect to the laws relating to health, be-cause they are persuaded that in no other way can therequisite information be obtained, and the mutual bearings

In Mr. ERICHSEN we have a surgeon and teacher of the

first rank, and the author of the standard work on Surgeryboth in this and other countries. It is only a matter ofsurprise to us that Mr. ERICHSEN has not been brought for-ward earlier ; but, with characteristic modesty, he preferred,we understand, to wait the approach of his turn in seniority.

789

of the different branches of the subject be so readily and sothoroughly investigated. They also affirm that no consoli-dation or amendment of the existing statutes will be ofmuch avail which does not provide an efficient machinery,both central and local, for the execution of the law in ruralas well as urban districts. We are unable to give thelengthy details in the Schedule of Questions, and can onlyindicate the main points upon which it is thought that in-formation should be specially acquired. The first is underthe head of-(a) Locality, with reference to the Act or Actsunder which the local authority is constituted, with thepopulation and the mortality. The next heading is-(b) Officer of health, and the queries relative to the exist-ence or non-existence of such an officer, his duties, his re-

ports, &c. Then we have-(c) Health officers under theArtisans and Labourers’ Dwellings Act, 1868 ; and (d) Sani-tary inspectors, with interrogatories relative to their num-ber and duties. Similar questions are put in reference to-(e) Inspectors of ports, emigrant dep6ts, shipping, andrivers; (f) Inspectors of nuisances; (g) Inspectors of lodg-ing-houses and cottages; (h) Inspectors of factories, work-shops, -and mines ; (i) Inspectors of food, markets, bake-houses ; (k) Public analysts. Next come queries relatingto-(l) Registration of births; (m) The investigation ofcauses of sickness-as, for instance, the effects of over-

crowding of dwellings, schools, &c., defective drainage andwater-supply, exposure to contagion, intramural burials,retention of the dead in crowded apartments, want of mor-tuaries &c., and the measures taken towards the abatementof these evils; (n) Record of cases of sickness; and lastly,(o) The investigation into the causes of death, especially inreference to coroners’ inquests.

THE DEBATE ON L YINC-IN HOSPITALS

AT DUBLIN.

A PAPER, of which Dr. Evory Kennedy, a late Master ofthe Rotunda Lying-in Hospital, is the author, has latelybeen read before the Obstetrical Society of that city, andhas excited an unusual amount of attention. The subject,if not new, is one of vast importance-namely, the com-parative safety, and therefore the utility, of out-door

maternities, small lying-in hospitals, and large hospitalsrespectively. Speaking of the Dublin lying-in hospitalsgenerally, Dr. Kennedy says that out of every eighteendeaths in parturition that have occurred in them for thelast seven years, fifteen women would, in all human proba-bility, have been at this moment alive had they been confinedin their own homes or in isolated cottage hospitals. In addi-tion to the metria of an epidemic or contagious character, Dr.Kennedy appears to contend strongly for what may be termeda self-generating source of the disease from overcrowding.The intimate relation between zymotic metria and the con-ditions present in large lying-in institutions has been soforcibly dwelt upon that Dr. Kennedy may be said to havedrawn up a terrible bill of indictment against all lying-inhospitals except the very small ones. Dublin has alwaysoccupied a foremost rank among the schools of midwifery.It contains some large hospitals devoted to this class of

patients, and its obstetric physicians have very naturallyobtained the attention which their experience and abilitycommanded. Dr. Kennedy’s paper, as might have beenanticipated, has been the subject of very animated and pro-longed debates, in which all the more important physiciansof Dublin have taken part. The addresses of Drs. Johnston,Atthill, T. More Madden, Kidd, Churchill, M’Clintock, andDenham, for example, are contained in the proofs beforeus; and we have since learned that Dr. Beatty, Dr. Stokes,and others have spoken. The debate having been so ex- J

tended, we venture to hope that some member of the Societywill move for a committee to furnish a report on the wholediscussion. We had prepared an article in which we enteredon a consideration of the entire subject, but we must deferits publication until the termination of the debate; althoughwe fear it will have then become threadbare, for we perceivethat any of the few remaining points which we might havehoped to advance are being one after another seized upon.In the meantime we may say, however, that Dr. Kennedy hashandled his subject with considerable vigour and ability;and that we regard the speeches of Drs. Churchill, Kidd,and McClintock as among the best and most practical ofthose we have yet read. Dr. Beatty’s address was, we un-derstand, considered by those who heard it a very ablevindication of the hospital maternities from the attackwhich has been made on them.

PROFESSOR SYME.

IT must be very gratifying to the illustrious Professor ofClinical Surgery, as he walks in his garden at Mill Bank, sur-rounded by hills that were classical even before associationwith him made them so to the medical profession, to knowthat there is a universal sense of the great value of his ser-vices to surgery, and through it to mankind, and a mostextensive desire that this feeling should find expression insome worthy way. Had Professor Syme lived in Paris, hewould probably, ere this, have been called to the Senate bya Sovereign who, whatever his faults, perceives the nobilityof genius, and the wisdom of taking it into high counsel.But as he only lives in Britain, he is pretty safe from such dis-tinction. For ourselves, though entirely sympathising withthe feeling that suggests that Mr. Syme should receive titu-lar honours, we scarcely see the appropriateness of the pre-sent time for such a suggestion. We can only regret thatso merited an honour was not offered when the possessionof perfect health would possibly have made it worth accept-ance. Mr. Syme’s greatest satisfaction now will be in theesteem of the profession which he has so long honoured andadorned. We shall not anticipate the shape which themonument of his merit will take, or at present express ourpreferences. Mr. Syme is disabled all too soon; but he isnot disabled before having achieved a very high positionamong European surgeons, and a very deep place in theaffection of his pupils.

’

THE ACTION OF TARTAR EMETIC.

THE importance of deeper investigations into the actionof medicines than any yet realised in this country is madeapparent by some of the more searching inquiries of Germanexperimenters. One of these, Dr. Nbbiling, has latelybeen experimenting on himself and on some of the loweranimals with tartar emetic, and one of the conclusions atwhich he arrives seems to us somewhat startling. The fol-

lowing are his conclusions :-1. There are two independentmodes of action in tartar emetic; one on the heart, and theother on the intestinal canal. 2. The action of the potashis on the heart, and that of the antimony is on the intes-tines. 3. Potash has a directly paralysing action upon theheart. 4. The tartaric acid is without any effect upon the

system.The conclusion to which we direct special attention is the

third, as to the paralysing power of tartar emetic residing,not in the antimony, but in the potash. Dr. Nobiling en-deavoured to ascertain the physiological effect of the differentingredients. He found 11 that while a small dose of potassio-tartrate of antimony caused death in a frog, the same doseof sodio-tartrate of antimony produced no effect." Now-

790

adays, when we are using the salts of potash by the ounce,or even by the pound, it seems rather startling to be toldthat the depressing power of tartar emetic on the heartresides in the potash, and is so great that Nobiling recom-mends the ammonio-tartrate of antimony, instead of thepotassio-tartrate, for therapeutical purposes. We draw at-tention to Nobiling’s conclusions, not because we are con-vinced of their soundness, but to illustrate the need for asounder therapeutical science, that will tend to harmonisecommon and scientific observation. It is quite possible thatpotash has a depressing power on the heart. But there isa terrible inconsistency between Nobiling’s conclusions andsome of our best daily practice.

SALARIES OF DISPENSARY MEDICAL OFFICERSAT BELFAST.

THE positive line of action taken by the Irish Poor-lawBoard in a case of obviously gross injustice towards thedispensary medical officers of Belfast deserves a specialcommendation, if only that it presents so marked a contrastto that which is usually taken by the authorities at GwydyrHouse. The town of Belfast has very greatly increased,both in extent and population, since the introduction ofdispensaries seventeen years ago. It is estimated that theincrease since 1861 has been 25 per cent. There was, in

consequence, a proportional increase of dispensary duty. In1856 the number of patients attended was 13,351, and in theyear ending September, 1866, 18,294. The six medical

officers, under these circumstances, very fairly demanded tohave their salaries increased from X75 to =8100 per annum.The Board of Guardians refused to comply with their

request, on the ground that the salaries were estimatedin connexion with other duties-viz., vaccination, registra-tion, &c., the payments for which raised the total sum paidfrom the poor-rate to what the guardians please to call fairremuneration. The matter was then referred by the medicalofficers to the Poor-law Board, and a letter was instantlydirected to the guardians recalling their attention to thequestion, and stating that the salaries of the medical officersshould be considered with reference only to the amount ofduty which they may be required to perform in that capa-city, irrespective of other duties or emoluments which maybe charged upon the rates. They further stated, that inthis view of the case, the salaries of the medical officers inthe Belfast districts do not appear to be in proportioneither to the salaries paid in other districts of the union orthe general average throughout Ireland. Notwithstandingthis remonstrance, the guardians resolve to oppose the Poor-law Board, and they have had recourse to the usual style ofargument, carefully ignoring the facts upon which this ap-plication was made, and also the very proper directions ofthe Poor-law Board. Thus they argue, that the increase ofpopulation has only increased the sphere of lucrative pri-vate practice ; that low salaries are compensated by the in-troduction to public life and practice. One gentlemanwont so far as to say, that if the office were to be disposedof by public tender, highly qualified men would give from.6400 -to -.8500 to obtain the situation; and another that suchappointments were only intended to be sources of employ-ment for young men commencing their career in the world,and not permanent situations. The guardians have, there-fore, resolved that their medical officers are amply andliberally remunerated. We hope, however, that the Poor-law Board will firmly perform their duty. The guardiansboasted that in a money question they would be certain ofsuccess. But it is clear they reckon without their host.Half the salaries of the medical officers is paid in Ireland, asIn England, from the Consolidated Fund, and that payment

cannot be made without the consent, and order of the-Poor-law Board. If that con-sent be withheld, as, under the air-cumstances, it must be, the entire salary must henceforthbe paid out of the local rates. A mere intimation of sucha result will probably be sufficient to bring the guardians totheir senses.

____

DR. RICHARDSON AT THE POLYTECHNIC.

ON Tuesday afternoon Dr. Richardson delivered a secondlecture at the Polytechnic, to a large medical audience, onthe phenomena attendant upon death by lightning, withexperimental illustrations from the great coil. After abrief recapitulation of the chief points of the previous lec-ture, Dr. Richardson explained the arrangement of Leydenjars "in cascade," and showed that the flash thus obtainedwas immediately fatal to animal life, although it producedso little change in the animal killed that the position andappearance of life were for some time preserved. The heartcontinued to beat for a considerable period after respirationhad ceased, and hence recovery might be possible in cases ofapparent death. Interment would not be justifiable prior tothe appearance of decomposition, unless either there wasgeneral rigidity of muscle, especially of the chest muscles, orcoagulation of the blood in the veins. To ascertain the latterpoint, a large superficial vein should be freely opened forexamination. The lecturer then proceeded to discuss therelative conducting power for electric currents of the differ-ent bodily tissues, and showed some beautiful experiments,suggested by Mr. Tobin, by which differences in this re-spect could be rendered visible. A tube, filled with thematerial to be tested, was made to form part of the circuitconveying the current to one of Gassiot’s vacuum cascades,and the brilliance of the luminous phenomena was dimi-nished when the tube contained an imperfect conductor.Each tube was a foot long, bent at a right angle ; and,when the tube was filled with animal fat, this resisted thecurrent entirely, and the spark passed across through theoutside air, forming a luminous hypothenuse to the rightangle. Arrangements are in progress for rendering thistest exact, and capable of nmnerical expression; but atpresent it appears to show that the blood offers less resist-ance to electricity than any of the solid tissues, and must,therefore, be the medium of its conduction within the

body. If this result be fully confirmed by further experi-ment, it will lead to considerable modification of the viewsabout " localised electrisation," through the medium of themuscles and of the nerves respectively, that have been putforth by Duchenne and Ziemssen, and that are now gene-rally accepted. Dr. Richardson, at the close of his inter-

esting lecture, mentioned other points to which he wishedto refer ; and, with the warm approval of his auditory, pro-mised to deal with them on Tuesday, the 22nd instant, at5 P.M. A vote of thanks to the lecturer was carried by ac-clamation before the meeting dispersed.

DISTRICT PAUPER SCHOOLS.

WE are glad to observe that Mr. Goschen is alive to theimportance of appropriating these schools to classes insteadof districts. By such means only is it possible to separateorphan and deserted children from those who, with theirparents, are continually going in and out of workhouses.Such children, from their short residence, reap no real ad-vantage from the instruction offered, and only bring intothe school every kind of disease and all sorts of contami-

nating influences. They impair the usefulness of the

school, and carry out with them the ophthalmia which theytoo often acquire there. We hope that Mr. Goschen willdeal with this important question with a strong hand.

791

THE. ELECTION OF CORONER.

THE particular reform in the mode of electing coronerswhich we have persistently for a long series of yearslaboured to obtain seems at length to be at hand. It

will be remembered that we protested, a few weeks since,against that portion of the County Coroners Bill, now beforethe House of Comfnons, which vested the power of electionin.the hands of the Lord Chancellor or the Home Secretary.On the second reading of the Bill a few nights ago, Mr.Goldney stated that he proposed to make amendments inthe Bill, to the effect that the voters should be freeholderson the Parliamentary roll, and that the polling placesshould be held at the Parliamentary polling places. TheHome Secretary suggested that the Bill should be speedilyrecommitted p1’O yofMM in order to introduce the amend-ments, which must therefore have the approval of theHome Office. We do not doubt that the House of Com-mons will pass the Bill as amended, thus defining onceand for ever what is meant by 11 a freeholder," and anni-hilating the unfair influence for the future of " graves" and" long-shore men," which has for years past introduced anelement of utter uncertainty and an opportunity for whole-sale bribery into the election of coroner, and has made it adisgrace to the administration of the English law. Weneed not repeat the arguments in favour of allowing coro-ners to be selected by the voice of the people, for which thelate Mr. Wakley so stoutly contended. We will only saythat Mr. Goldney’s Bill, in its amended form, if it pass, willentirely remove a condition which rendered it next to im-possible, in most instances, for men of special fitness for theoffice of coroner to become candidates, and it will tend in nolittle degree to advance the utility and dignity of the post.

EFFECTS OF BREATHINC COMPRESSED AIR.

DR. G. vor LiEi3iG has just published in the Zeitschriftjiirt Biologie a paper in which are communicated the resultsof numerous experiments on the effects of breathing air

compressed by a pressure of from 320 mm. to nearly 500 mm.of mercury in excess; or, in other words, of breathing in achamber in which the barometer would stand at from 43 to50 inches, instead of 30 inches. Similar experiments havebeen undertaken by Lossen, Vivenot, and others, with vary-ing results. The apparatus required is large and expensive,and considerable experience and practice in both operatorand subject are required to arrive at satisfactory conclusions. ’,The general results obtained by Dr. G. von Liebig are :1. That the number of respirations under high pressure,when the subject is accustomed to the mode of breathingrequired, does not greatly differ from that occurring atordinary temperatures. 2. That the quantities of air respireddo not materially differ under the two conditions. 3. Thatthe amount of carbonic acid eliminated under the two con-ditions is almost identical.

THE LINCOLN DISPENSARY.

AN important change was made at a meeting held on the25th ult. in the arrangements of the Lincoln Dispensary,by the appointment of two medical practitioners of the cityas paid officers to attend the out-patients. By these ap-pointments the house-surgeon is enabled to devote his wholetime to visiting; and the assistance of the honorary con-sulting officers will only be sought in extraordinary cases.The payment to the two gentlemen appointed was fixed at20 a year each; and the subscribers seemed to be fullyaware that this payment was acknowledgment, but not re-muneration. We are pleased to observe, moreover, that itwas remarked at the meeting that the tendency of these

appointments would be to diminish the number of improperapplicants (that is, of applicants able to pay) amongst theout-patients. Messrs. Lowe and Lomax were elected to the

newly created offices; and the proceedings terminated withthe usual vote of thanks to the chairman. We shall watchthe effect of the new system with much interest; and augurfavourable results from its adoption.

THE ABUSES OF HOSPITALS.

IN a short pamphlet just published, Mr. Joseph Wilkin-son, the energetic secretary of St. Mary’s Hospital, hasgiven his views as a layman of some of the abuses to whichour hospitals are exposed. He shows that the hospital ismeant to prevent pauperism, and not to provide for or makepaupers; and believes that the proper recipients of in-

patient relief are labouring men and artisans, who are in-capable of bearing the expense attending a serious accidentor grave attack of illness. Another class fit for admissionto hospital is that of domestic servants; since, as Mr. Wil-kinson well remarks, " when attacked by severe illness, thepoor servant, without home or friends, is at once got rid of,and, were it not for hospitals, must of necessity become aninmate of the workhouse infirmary." If employers moregenerally recognised their responsibility in the care of theirservants in both health and disease, this need not be; butit is probably much better for the patients themselves tohave hospital care, if only their employers were to contri-bute towards their maintenance while there.

Among the abuses of hospital charity, Mr. Wilkinsonclasses the admission of well-to-do tradesmen; of personsin good circumstances who have to undergo an importantoperation, but who, if referred to a junior surgeon, mightpay a fee more moderate than that of the senior hospitalsurgeon; of shopkeepers’ assistants, whose principals sub-scribe to the hospital as the cheapest way of getting theiremployes attended; and, lastly, of members of the policeforce. With regard to this last class, we quite agree withMr. Wilkinson, who expresses his ‘‘ surprise that, with soextensive a body as our Metropolitan Police, a distinct andproper hospital for their reception during severe illness isnot already provided as part of the establishment."As regards out-patients, Mr. Wilkinson has no very effec-

tual remedy to propose,-except, indeed, their total aboli-tion, to which he evidently inclines. He appears to be

hardly aware that there are already numerous practitionersfrom whom the artisan can obtain advice and medicine forIs. or Is. 6d.; but, unfortunately, this does not appear tomeet the difficulty or prevent the overcrowding of out-

patient rooms.We would ask what the Committee appointed by the

Metropolitan Branch of the British Medical Associationsome weeks back has done in the matter of hospital reform.So far as we can learn, the Committee has not as yet beencalled together. -

CHOLERA livy INDIA.

CHOLERA has broken out in the cantonments at Nee-

much, and three fatal cases have been reported. Onecase among the Artillery, and some eight or nine inthe ranks of the 28th Bombay Native Infantry, had alsooccurred. The Royals, who sunered so severely on a

former occasion at Nusseerabad, appear to have escaped inthis outbreak. At the cantonments at Mhow and Deolalie,also, cholera is said to be prevailing. The number of casesof this disease which have occurred amongst the Britishtroops serving in the Bengal presidency during the presentseason, and up to the latest accounts, has been thirty-nine,of which no less than thirty are said to have proved fatal.

792

THE MARSHALL HALL MEMORIAL.

THE Executive Committee are anxious that those gentle-men who have already requested that their names may be Iadded to the list of subscribers, and who have not handedin their contributions, as well as those who intend tosubscribe to the memorial fund, should forward their ,subscriptions to the treasurer, Dr. Russell Reynolds, 38, ’IGrosvenor-street. An appeal has been widely made by ’,circular to the profession in various parts of the country, IIand the Committee have received a large number of answers.We trust that the subscription list will be a good one, andenable the Committee to found a worthy memorial of the I

great man whom it is proposed to honour. It is impossible, Ifof course, for the Executive Committee to appeal directly ’to each member of the profession, and we are therefore re-quested to be the mouthpiece of the Committee in the mat- ’’

ter, in order that they may not seem to be neglectful in ’,making personal application to individuals. ’

INDISCRIMINATE MEDICAL RELIEF.

IT having been found by the Holborn Board of Guardians z’

that a medical order had been given to a person well ableto pay for medical advice, it was resolved "that the reliev-ing officers, before granting orders for medical relief, beinstructed to make such inquiries of the person applying asshall satisfy them that the applicant is a pauper; and thatin the event of any circumstance being elicited which makesthis doubtful (such as occcupation, rental, &c.), the relievingofficers make the necessary inquiries before granting suchorders." The enormous increase of orders for medical ad-vice must be regarded as a sufficient proof that great laxityvery generally prevails. It would seem that the relievingofficers have been in the habit of granting orders to allcomers, leaving the propriety to be determined by a subse-quent visit. The law clearly intended that, except in casesof great emergency, inquiry should precede the administra-tion of all kinds of relief; and the Holborn guardians de-serve the thanks of the profession for having directed publicattention to what we believe to be a very serious and grow-ing burden upon the Poor-law medical officers. In theresolution just passed we have another strong argument infavour of a system of inspection for out-door relief ; and itis certain that no reform of the present imperfect arrange-ments can be hoped for until something of the kind is done.Let us hope that the proposed dispensaries will be placedin charge of a competent inspector, in order that somethinglike fairness and uniformity may result.

SANITARY STATE OF CIBRALTAR.

SOME anxiety seems to prevail regarding the sanitarystate of Gibraltar. It appears that the new drainage worksare so far completed that most of the houses in the townare now connected with the main sewer; but the flushingof these sewers is at present totally unprovided for, andthe closets, privies, and surface drains, being without water,or improperly trapped, are mere sewer ventilators, in numer-ous instances opening into the narrow patios or courtyardsof this much overcrowded city. Ventilating traps withcharcoal pans have been introduced in the streets at inter-vals of 200 or 300 yards; but the deficiency of the water-supply renders the emanations from these outlets very offen-sive. The rainfall this year has been far below the average.For some weeks past the troops in the south have beenon a daily allowance of water, and in the town most of theprivate, and many of the public, tanks are completely ex-hausted. Some cases of enteric fever have occurred, one ’,or two of which were fatal; but the troops are otherwise I

healthy. It is notorious that all the barracks are over-

crowded ; that some-for example the Wellington Fort, nowoccupied by the 74th Highlanders-are unfit for humanhabitation. Considering that the hot weather is setting in,and that an epidemic of fever is said to have been ragingthroughout the centre and north-east of Spain, we ventureto think the residents on the Rock require to be on thealert. In the event of any outbreak of epidemic disease,the best thing for the authorities to do would be to removeat least half the garrison to England.

THE CHOLERA AT THE CAMBIA.

WE are sorry to hear by the latest intelligence that thecholera continues to prevail in the Gambia. The loss sus-

tained by the military, composed of a portion of a WestIndia regiment, is very small compared with the mortalitywhich has ensued among the native population. This isdescribed as appalling, and there is some difficulty in dis-posing of the dead. In March there were one hundreddeaths at M<Carthy’s Island, and thirty more at a placecalled Doomassaysang, since which the disease has spreadto Bathurst. Admiral Patey, administering the govern-ment, has set apart a large building as a cholera hospitalto leeward of Bathurst. The few Europeans and medicalofficers stationed in the locality have been unremitting intheir efforts to relieve the necessities of the people, and toguard against the spread of the disease among the military.As this is said to be the first occasion on which cholera hasoccurred in this part of Africa, the origin and cause of theoutbreak will form an interesting and important subjectfor future inquiry, in regard to its bearing upon such dis-tant colonies as New Zealand, for example, where cholerahas never prevailed.

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NAVAL PROMOTIONS.A GREAT spur has been given this week to naval officers,

by an unusually large promotion. It would have been satis-factory to observe something done for the medical officersat the same happy juncture, to improve the present un-satisfactory state of a long list which shows an abundanceof disappointed staff-surgeons of thirty years’ standing, ofsurgeons employed as assistant-surgeons, and of assistant-surgeons who have been over twelve years in the service.We trust that the rumour of additional promotion fromthese ranks is soon to be realised, and that the list will be

conspicuous by its rewards to those officers whose zeal andtrustworthiness have caused them to be ever foremost on

foreign service, as such a step would be the very strongeststimulus to a branch of our profession which is subjected tostrong temptations to seek repose rather than the discom-forts inseparable from a sea-going life.

THE DRAINACE OF ST. PANCRAS WORKHOUSE.

FOR months past the medical officer of the St. PancrasWorkhouse has been undergoing a process of rapid poison-ing by sewer-gas, by which his health has been underminedso that he was at length compelled to resign his post. Overand over again the attention of the guardians was drawnto the subject, but without effect. A thorough investigationhas at length been made, and a passage has been foundrunning along the basement of the infirmary, and contain-ing an immense quantity of fetid matter. When opened, itwas found impossible to remain near it for any length oftime. In two days, 2266 gallons of black fluid were ladledout. The passage appears to have been intended as a reser-voir of pure air for the supply of the ventilating shafts ofthe infirmary wards. Instead of this, it has simply servedto distribute sulphuretted hydrogen.

793

THE ORDER OF THE BATH.

WE are very glad to perceive, from a supplementaryGazette promulgated on the occasion of the late commemo-ration of Her Majesty’s birthday, that several members ofour profession belonging to the public services have receiveda titular recognition and reward of their labours. We

cordially congratulate army medical officers on the distinc-tions which have been conferred on their department in thepersons of their head and other of its members. We are

likewise glad to notice that their confr&egrave;res of the navy sharethese honours with them. We cannot but regret, however,that the honour of a K.C.B. has not been conferred on thelate Director-General of the Naval Medical Department, Dr.Bryson, C.B. It would have been a graceful and deservedrecognition of his late position and services. The respectiveheads of the two medical departments might, in our opinion,with benefit to the interests of the public service, alwaysbe promoted to the rank of K.C.B. on attaining their posi-tion as Director-General. Mr. Saunders was, no doubt,selected for the C.B. on account, more especially, of thevery arduous character of his professional duties in Chinain 1865-6, when, it will be remembered, he occupied aposition of grave responsibility. The disastrous epidemicamong the garrison at Hong Kong on that occasion wassubsequently inquired into by a Committee of the House ofCommons, and Mr. Saunders’s conduct was the subject ofwarm encomium. The following is taken from the list ofpromotions and appointments in the London Gazette of the1st instant :-" To be Ordinary Members of the Military Division of the

Second Class, or Knight Commanders of the said MostHonourable Order : Thomas Galbraith Logan, Esq., M.D.,C.B., Director-General of the Medical Department of theArmy. To be ordinary members of the Military Divisionof the Third Class, or Companions of the said Most Hon.Order: Inspector-General of Hospitals and Fleets George eBurn, M.D.; Inspector-General of Hospitals George Ste-ward Beatson, M.D.; Deputy Inspector-General of Hos-pitals Hampden Hugh Massy, M.D. ; Staff Surgeon-MajorGeorge Saunders. To be ordinary member of the CivilDivision of the Third Class, or Companion of the saidMost Hon. Order: John Grant Stewart, Esq., M.D., Inspec-tor-General of Hospitals and Fleets."

THE ASSAULT AT LAMBETH WORKHOUSE.

WE learn that the Poor-law Board, having called uponMr. George Catch, the master, and Mr. Stuckey, the residentmedical officer, of Lambeth Workhouse, for an explanationof their extraordinary proceedings connected with the at-tempt to force out Caroline Bailey from a chimney in a wardof the workhouse, in which they supposed she was hiding,by the employment of the suffocative fumes of some corro-sive fluid, and which ward was at the time occupied byseveral female paupers, who were much affected thereby,and these officers, in their reply, having admitted the sub-stantial accuracy of the statements which had been made,the Poor-law Board at once called upon them to send in the

resignation of their appointments.

THE PLYMOUTH PROVIDENT DISPENSARY.

THE rules of the Plymouth Provident Dispensary, to thefoundation of which we referred in THE LANCET for March27th, have come to hand. We are glad to find that thepromoters of the dispensary have adopted the principle ofthrowing it open to all resident medical practitioners whochoose to take part in its operations. We are quite surethat there is no other basis on which such an institutioncan be successfully or fairly conducted; and we hail itsprompt recognition as a good omen for the lasting pros-perity and usefulness of the undertaking.

MORTALITY AT DIFFERENT ACES.

As the question, What is the average death-rate of theEnglish population at different periods of life ? occurs veryfrequently, and is not at all times easily to be answered forlack of the official documents in which such statistics are

periodically published, we subjoin the latest authentic in-formation upon the subject, derived from the ThirtiethAnnual Report of the Registrar-General, just presented toParliament. For the benefit of any of our readers who

may not be much accustomed to the study of statistics, itmay be said that the two columns here given represent theaverage annual deaths occurring in the thirty years 1838-67to persons of either sex at the stated periods of age, out ofevery thousand persons of corresponding ages estimated asrepresenting the average yearly population during the

thirty years.

I The Supplement to the Registrar-General’s Twenty-fifthAnnual Report contains, perhaps, the most valuable infor-mation on record as to the mortality of children in differentparts of the country. -

’ ANIMAL VACCINATION.

OUR readers will have seen the case of Dr. Skelton, who waslast week brought up at Bow-street and fined for refusing tohave his child vaccinated. We refer to it in order to correct amis-statement made by Dr. Skelton on the occasion. He is

reported to have said that the virus now used by Dr. Blancin Beclford-street, "was produced by vaccinating the heiferfrom a child, and probably had been passed from child tochild for years." This is not the case; and the virus in

question has never been passed through any child at all. Itwas derived from a case of spontaneous cow-pox, and hasbeen transmitted only from heifer to heifer. The questionis one of so much importance, that no mistaken impressionswith regard to it should be left uncontradicted; and we

therefore briefly notice Dr. Skelton’s error, although weare compelled to postpone, until after further observation, a.full account of Dr. Blanc’s methods and results.

THE IRISH RECISTRATION REPORT.

WE have received a copy of the first Annual Report ofthe Irish Registrar-General; but as the facts to which itrelates are all for the year 1864, we must really be excusedif we consider them too old for commenting on in the middleof 1869. The Registrar-General apologises for the delay inpublication, alleging the many difficulties which have at-tended the introduction of registration among the "nume-rous population" of Ireland. We may accept the apology,because we shall hope for better things in future. Last

week we were obliged to take the Scottish Registrar-Generalto task for being two years and a half behind-hand with hisReport ; but his Irish colleague is twice as far in arrear.Why should not the Annual Registration Reports for eachof the three divisions of the kingdom appear as nearly aspossible simultaneously ?

794

THE SURCERY OF BICYCLES.

ETTMAN sorrows, it is seen on all hands, keep pace withhuman progress,-the new mode of transit being no ex-ception to the universal law. Within the last few months,both in this country and in France, surgeons have had totreat a great variety of injuries, the results of accidents from ’,the bicycle; some of them being, in one sense, special andpeculiar to the novel risks attendent on the machine-the-position of the rider, but more particularly on his rela-tion to the law of balance, whether in progress or retro-

gression, on the level, ascent, or descent. Dislocation ofthe upper extremities, and especially of the radius, havebeen the most common ; some few fractures of the ulna

have, however, been observed, with severe sprains of thewrists. In some instances the lower extremities have been

injured, - sprains being more common than fractures.General shock of the nervous system has been sustainedby others in consequence of a complete capsize, the bicyclerunning backwards down an incline, unseating the rider ina manner directly the opposite of a head-pitch.

SANiTARY STATE OF KIDDERMINSTER.

THE Town Council of Kidderminster have apprised theBoard of Guardians of that union that the necessary stepsfor the adoption of the Local Government Act in the

borough have been taken, and that plans and particularsfor drainage and sewerage works have been prepared forsubmission to the Secretary of State. Upon receipt of thisintimation, the guardians resolved at their next meeting tofully consider the sanitary state of Kidderminster, and thepropriety of asking the Secretary of State to direct an in-spector to visit the town, and examine its condition as to sew-age and water-supply. We presume these two distinct 11 localauthorities" have no intention of working otherwise thanharmoniously together; to suppose that they do not so in-tend would be tantamount to regarding sanitary improve-ment in Kidderminster as indefinitely postponed. That actionhas thus far been taken is, no doubt, greatly due to thereports of the union medical officers calling attention tothe unhealthiness of the town, as well as to the efforts ofDr. Rose in giving a wider publicity to the facts in our owncolumns. 1

THE PILCRiMACE TO MECCA.

THE pilgrimage of Mahometans to Mecca has passed offthis year without any outbreak of disease; the deaths, webelieve, being merely nominal, when we take into considera-tion that between a hundred and twenty and a hundred andthirty thousand people are said to have taken part in thevarious religious rites. This good result is, no doubt, ingreat part to be attributed to the arrangements made bythe health authorities on the spot for destroying the refuseresulting from the slaughter of the sacrificial victims, andfor cleansing the streets where the pilgrims lived duringtheir sojourn. -

"SHUT YOUR MOUTH!"WE have received a copy of the third edition of the

amusing pamphlet under the above title, in which Mr.Catlin argues that all the diseases incidental to civilisation

are due to breathing through the open mouth. We confess

that we are at least half converts to the views of the author ;and we commend his book to the notice of our readers. Its il-lustrations are infinitely humorous, and display greatartistic talent. The old gentleman asleep after dinner; andthe ideal portrait of a horse with its mouth open, as well asthe contrasted groups of Indians and of English bumpkins,are admirable both in conception and execution. The author

pushes his argument much too far, and excludes other mor-bific causes of very general operation. But we think therecan be no doubt that the action of the nasal passages,whether in warming the air, or in freeing it from impuri-ties, must be of the highest importance. Mr. Catlin should

certainly carry all the ladies with him, if they will butstudy the effect of the open mouth on their appearance, andwill lay to heart the author’s dictum, 11 that idiots asleepcannot be angels awake."

WORKSHOPS RECULATION ACT.

THE Workshops Regulation Act does not appear to bealtogether acceptable to the class whom it was designed tobenefit. The enforced Saturday short time obliges millinersand sempstresses either to submit to diminished earnings,or to take their work from what may be tolerably com-fortable workrooms in the establishments they serve, totheir own less convenient and probably less healthy homes.It is quite clear that the Act needs very judicious and dis-criminating application. -

THE first pair of buildings of the National Cottage Hos-pital for Consumption and Diseases of the Chest at Ventnor,are now close upon completion ; and active preparations arein progress for the ceremony of laying the foundation-stoneof the second pair of houses in July next, by a memberof the Royal Family, in the name of her Most GraciousMajesty the Queen. The Right Hon. Sir Lawrence Peel,Mr. Frederick Leaf, and Dr. Richard Hassall, have alreadycontributed most liberally to the Furnishing Fund, it beingthe desire of the General Committee that the cost of thefurniture should not be defrayed out of the general, butfrom a special, fund. -

THE late Dowager Lady Truro, after disposing of certainportions of her property, made over the residue to beequally divided between various charities, including theDreadnought and Guy’s Hospitals, and, what was termed inthe will, Ir the Orphan Asylum at Wandsworth." The onlyinstitution of the kind at Wandsworth is the Royal PatrioticAsylum ; but a law-suit, in which eleven counsel were en-gaged, was instituted to decide whether this institutionwas meant by the testatrix. The costs, which must havebeen heavy, fell upon the estate, to the detriment of theinterests of the two medical charities concerned. What ascandal upon the equity of English law.

THE Royal Sanitary Commission continues the taking ofevidence on Mondays and Thursdays. Mr. Simon, F.R.S.,the medical officer of the Privy Council, was under exami-nation on Monday and Thursday last. We understand thatthe Commission is confining its inquiries strictly to the ope-ration and administration of the sanitary laws, upon whichit will first report, leaving the consideration of systems ofdrainage, of inspection, of registration, &c., for a subsequentreport. -

ON Monday next, a paper will be read in the Public HealthSection of the Social Science Association, by Dr. AlfredCarpenter, of Croydon, on the 11 Influence of Sewer Gasupon the Public Health, and the Theory of Ventilation asrequired in Sewers." Dr. Carpenter’s experience at Croydon,where the liquid system of drainage is supposed to havebeen carried to perfection, will be of some value to engineersand others now interested in the drainage question.WE are authorised to state that Professor Syme will not

preside at the dinner of the Royal College of Surgeons, asannounced by circular.

795

DR. SysoN, in his Report on the Vital Statistics of Salfordfor the year 1868, states that diarrhoea was alarmingly pre-valent in that borough during July, August, and September,causing 367 deaths, whereof 266 were of infants in theirfirst year. Dr. Syson regards the diarrhoea, which was epi-demic, as in reality a variety of typhoid fever-an opinionin which, he says, he has been supported by every medicalman with whom he has conversed on the subject.

STEPS have been taken at Cambridge University to allowstudents to be admitted to attend professors’ lectures andtake degrees without being admitted at Colleges. The

necessary expenses for such non-collegiate students will besomewhat less than for those who become members of col-

leges. There is no restriction on the ground of religiousopinions in either case.

-

THE Weekly Board of the Birmingham General Hospitalhas unanimously passed a resolution expressive of its deepsorrow on the death of Dr. James Johnstone, late consultingphysician to that institution, and of its full appreciation ofthe many and valuable services rendered by him to the hos-pital during the long period of thirty-six years.

THE governors of St. George’s Hospital, finding that thestate of their finances is most unsatisfactory, are making aspecial appeal to the public for assistance, in default ofwhich they will be obliged to close some of the wards. A

public meeting is to be held this day (Saturday) at Willis’sRooms, to take into consideration the position of the hos-pital ; the Duke of Devonshire will preside.

IN the case of the fictitious charge of criminal assaultpreferred, some three weeks ago, against Dr. Windsor

Berry, of Wimbledon, and promptly dismissed by the magis-trate before whom it was brought, we are glad to find thatthe woman has now been committed to take her trial for

perjury at the next session of the Central Criminal Court.

THE result of the official inquiry relative to the proposalto abolish the Herbert Hospital, at Shooter’s-hill, has re-sulted in the committee recommending the hospital to

remain as at present. The Marine Infirmary, which it wasproposed to make the Woolwich Hospital, will, it is under-stood, be converted into infantry officers’ quarters.

THE clerk to the guardians of the Aylesbury Union hasbeen informed by Dr. Wagstaffe, one of the inspectors ofvaccination, that the state of vaccination in that union isso satisfactory as to entitle all the public vaccinators (withone exception) to recommendation for the gratuities awardedby the Privy Council under the Vaccination Act.

DURING the week a grand bazaar, for the benefit of theGerman Hospital, Dalston, was held, under the patronageof the Queen, the Princess of Wales, and other Royal per-sonages and illustrious ladies. The authorities are anxiousto clear off a debt of .62000, and, if possible, to open a newward with twenty-five beds.

ON Thursday, May 27th, Dr. Joseph T. C. Constable, lateof Dulverton, was presented, by a committee of patientsand friends, with a handsome silver teapot, as a token ofrespect and esteem for past services.

THE Queen’s Hospital, Birmingham, has received a legacyof .81000, from the late Mr. Thomas Crowley, of Edgbaston.

THE debate on the Army Estimates will be resumed onThursday, June 10th.

IT has been unanimously agreed by the Cardiff Board ofGuardians to petition for the application of the ContagiousDiseases Act to the town of Cardiff.

WE are happy to congratulate the town of Guildford

upon the entire disappearance of scarlatina, according tothe report of the medical officer of health.

THE President and Fellows of the College of Physicianshave issued cards for a conversazione, to be held on Wed-nesday evening next (June 9th).

THE ROYAL SOCIETY OF MEDICINE.

THE adjourned meeting of the Fellows of the RoyalMedical and Chirurgical Society, for the purpose of con-

sidering the scheme for the Royal Society of Medicinewhich had been prepared by the Council, was held onThursday evening, May 28th. ,

Dr. Burrows again presided. The attendance was not

large. Amongst those present were Dr. Quain, Mr. Solly,Dr. Pitman, Mr. Holmes, Mr. Charles Hawkins, Dr. HallDavis, Dr. Cholmeley, Dr. Begley, Dr. Stewart, Mr. CooperForster, Dr. Pollock, Mr. Savory, &c.

After a few remarks from the President, the SECRETARY(Mr. Gascoyen) read the Resolutions 1 to 13, which hadbeen agreed to at the previous meetings.

Mr. SOLLY then proposed, and Dr. HALL DAvis secondedthe adoption of Resolution 14 :&mdash;" That Fellows, Members,or Licentiates, of the Colleges of Physicians or Surgeons ofGreat Britain and Ireland; Doctors or Bachelors of Medi-cine, or Masters or Bachelors of Surgery, of the Universitiesof Great Britain and Ireland, or of the Colonies; Membersof the Faculty of Physicians and Surgeons of Glasgow;Licentiates of the Society of Apothecaries of London, or ofthe Apothecaries’ Hall of Ireland; or foreigners whosequalifications are satisfactory to the Council; be eligiblefor admission into the Society by nomination and election,as at present is arranged in the Royal Medical and Chirur-gical Society ; and that their recommendation be signedby three Fellows of the Society, two of whom, at least, shallbe members of a section to which the candidate declareshimself desirous of becoming attached."

Mr. HEATH suggested that the words 11 registered medicalpractitioners" might with advantage be substituted for’thelist of qualifications in the resolution.The PRESIDENT and Mr. HOLJB1ES, however, stated that it

was intended to include more than registered medical prac-titioners ; as, for instance, distinguished foreigners andmany medical graduates of universities who might not bepractising.

, The resolution was then agreed to.Resolution 15 was then proposed by Mr. COOPER FORSTER,

and seconded by Mr. GEORGE COOPER :&mdash;" That in adjustingthe scale of payments, consideration be had to the numberof sections which each Fellow may join, and for the privi-lege of using the library of the Society and of receivingcopies of the Transactions and Proceedings of the severalsections."

Dr. DRYSDALE asked if it was proposed that the scale ofpayments should be adjusted before the scheme was trans-ferred to the other societies.Mr. COOPER FORSTER replied that the arrangement of the

payments would have to be left in the hands of a professionalaccountant.The PRESIDENT said that in the original scheme presented

to the Council by the Committee the subject was consideredin detail, but on reconsideration it had been thought betterto leave the question undetermined, the Council not feelingthat they were equal to adjust it satisfactorily.

After some remarks by Mr. Solly and Dr. Stewart,Mr. HOLMES said that the original report of the Committee

was accidentally made public, and in that, the Committeethat should ultimately be formed would have before themthe scheme of payments then suggested. That scheme wasnot included in the resolutions before the meeting, lest itshould be looked on as a pecuniary offer which they were