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, MEDICAL MAGISTRATE. - Mr. Frederick HeroSimmons, M.R.C.S. Eng., L R.C.P. Lond., has been ap.pointed a justice of the peace for 11 harreekloof District,Hope Town, South Africa.THE SANITARY INSTITUTE.-At an examination for

inspectors of nuisances, held in London on April 10th andHtn, eighty-nine candidates presented themselves, of whom.sixty were certified to be competent as regards their sanitaryknowledge to discharge the duties of inspector of nuisances.ROYAL INSTITUTION.-Dr. E. E. Klein, F.R.S.,

Lecturer on Physiology at St. Bartholomew’s Hospital will,on Tuesday next, April 28th, begin a course of three lectureson "Bacteria, their Nature and Functions" (The TyndallLectures); and Mr. H. Graham Harris, M.Inst.C.E., will,on Saturday, May 9th, begin a course of three lectures on ’,the "Artificial Production of Cold."

A MAD WOLF.—News from Vienna states that onthe 19th inst. a wolf appeared in the village of Rohozna,near Czernovitz, and bit everyone coming in its way. Theanimal was not killed until it had wounded no less thanthirty-two persons. An inquiry was set on foot, and it isbelieved the wolf came from the neighbouring province ofBessarabia, suffering from rabies. The injured persons, it isstated, will be sent for treatment to the Pasteur Institute,Paris.FOOTBALL CASUALTIES.-A man named Barlow

(the Sleaford professional bowler), whilst playing football,severely injured his knee-cap.-At Killimer, West Clare, onthe 13th inst., during a football game, a player was fatallyinjured in the abdomen, and died shortly afterwards.-Amember of the Sparkbrook football team, aged twenty, ofBirmingham, in a match on the llth inst. between the Spark-brook team and the Worcester Rovers, fractured his collar-bone.-During a practice on Easter Tuesday of the St.Paulinus’s football teams, in the Borough Park, Dawgreen,a young player sustained a broken ankle.MEDICAL DEFENCE UNION, LIMITED.—The first

annual meeting and dinner in connexion with the SouthWales and Monmouthshire division took place at the ParkHotel, Cardiff, on April 8th. Although this division hasonly been in existence for twelve months, it numbers ninety-eight members. The president of the Union, Mr. LawsonTait, and Dr. Leslie Phillips were both present at the dinnerand delivered very interesting speeches. The after-dinnerproceedings were enlivened by the singing of Miss AliceGomez. Other districts would do well to copy the exampleset by the South Walians, and establish a branch of thisuseful society in their midst.THE METROPOLITAN ASYLUMS BOARD.-This Board

met on Saturday at the London County Hall, Spring-gardens, Sir Edward Galsworthy presiding. The chairman,referring to the returns of fever and small-pox cases, saidthat with regard to fever there was a reduction of 90 cases.as compared with .the previous fortnightly return, whenthere were 1295 cases under treatment. Proposals camebefore the managers for the purchase of a site for anadditional fever hospital for 400 patients. The hospitalwas required for the relief of the Eastern Hospital, whichhad been almost continuously full for years. The onlyacceptable offer received was a site in the neighbourhood ofStamford-hill, fifteen acres, the price of which was £12,000.The committee in their report recommended that a contractshould be entered into for the purchase of this site, subjectto the approval of the Local Government Board. The reportof the committee was agreed to.

MEDICAL NOTES IN PARLIAMENT.

The Indian Opium Traffic.IN the House of Commons, on Monday last, Mr. MacLean asked the

first Lord of the Treasury whether, considering the anxiety caused inIndia by the division of last Friday night, and the necessity for lettingthe Indian Government know what are the real intentions of the House- of Commons with regard to the opium revenue, he will give a day forthe discussion of the main question raised in the resolution of the hon.baronet the member for the Barnard Castle Division of Durham, and ofthe amendment proposed by the right hon. baronet the member for the’City of London.—Mr. W. 11. Smith at present saw no prospect of beingable to find time for the renewal of the discussion in order thut a- definite decision on the whole question may be arrived at. - Sir JosephPease announced that it was not his intention to ballot in order to

place his motion on the paper as a substantive motion before the House,as tie felt it would be extremely inconvenient to introduce the subjectat this period of the session.

British "Medical Men in France.Dr. Tanner asked the Under-Secretory of State for Foreign Affairs

whether, under the provisions of the recent medical law enacted by theFrench Government, no British medical man would be permitted topractise in France without having obtained the diploma of doctor ofmedicine in one of the State faculties, except when a special dispensa-tion was granted by the Minister of State ; and whether French medicalmen were permitted to practise their profession in England.-Sir J.Fergusson: We are not aware in what form the Bill in question haspassed the French Legislature, or if it has passed, but inquiry is beingmade. French and other foreign medical men are free to practise theirprofession in this country, subject to certain disabilities, unless they areregistered under the Medical Act of 1886; but the provisions of thatAct in this respect do not take effect unless the country to which theybelong has conceded reciprocal privileges.

A riny Medical Officers,Mr. Bartley asked the Secretary of State for War whether he proposed

to grant to army medical officers the composite titles suggested by LordCamperdown’s Committee. -Mr. E. Stanhope: I am quite ready torecommend to Her Majesty the grant of composite military and medicaltitles if such a concession meets the wishes of officers of the ArmyMedical Staff ; but I am met with the difficulty that this concession,although asked for in Sir Andrew Clark’s letter of January 17th last,appears to be repudiated in his later letter of March 7th. These officers,I should state, have not approached me or his Royal Highness theCommander-in-Chief through any recognised official channel, but Iassume that Sir Andrew dark is expressing their opinion on thesubject.

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THE METROPOLITAN HOSPITALS INQUIRY.The Select Committee of the House of Lords on the Metropolitan

Hospitals resumed their inquiry on Monday, Earl Sandhurst pre-siding.

The Relations of General and Special Hospitals.Dr. Stretch Dowse, examined by the Chairman, said he was a phy-

sician, and practised as a specialist in nervous diseases. As a studenthe had attended Charing-cross Hospital, and to several special hospitalshe had been attached. He had been connected with the AVest-endHospital for Nervous Diseases. He resigned his appointment abouteighteen months ago. To his mind the hospital was not being managedas such an institution ought to be managed. During his connexion withthe hospital there was a great deal of difficulty and disturbance. Severalother members of the staff were almost entirely opposed to the views ofDr. Tibbits as to how a hospital should be conducted, a.ad thatgave rise to a great deal of disturbance. They never had thehospital properly organised. Sometimes they had a chairman andsometimes they had not. He objected to the management ofthe hospital, not to the treatment adopted by Dr. Tibbits.-The Chairman : You objected to the unbusinesslike organisa-tion ?—Witness: That is the very word to give it. There was no

business about it. He did not think that the subscribers knew verymuch about the hospital. They gave them money as an act ofcharity. All those special hospitals had begun in a very small way,possibly in a house of two rooms. The necessity for them aroseJrom the presence of disease rather than from the interests ofmedical men, although in his opinion nearly all the special hos-pitals were started by medical nitrn. It occurred to a medical manthat he could make his mark by establishing a hospital for specialdiseases, and he did so. As a rule, he stat ted under difficulties. He beganwith two or three rooms, and if successful he soon made a large hospital.Many men of high position in London at the present time owed theirsuccess in a large measure to their originating or being attached tospecial hospitals. To be successful, the thing must be a commercialsuccess. The medical man received no direct financial profit from thehospital he started, but he gained indirect financial profit and reputa-tion. Only a dishonest man would make profit out of the funds of thehospital. Being himself a specialist, he was in favour of special hos-pitals. He did not think the community could do without them. Hedid not think that special hospitals had been started in order to createa demand. General hospitals were not equal to the demand made onthem. Some years ago no man on the staff of a general hospital wouldfor a second be permitted to act on the staff of a special hospital. Nowthere was scarcely a special hospital in London, certainly not a specialhospital which had gained any reputation, that had not one of thegeneral hospital men on its staft.—The Chairman : Has it ever occurredto you that there could be a certain amount of cooperation betweengeneral and special hospitals? Assuming that a very bad nervous casewere taken to a general hospital, requiring massage or other specialtreatment, would it not be possible to have some method of organisa-tion by which the case might be passed on to a special hospital ?-Witness : I do not see how it could be done very well, butalthough it is not done openly at present, I think it is done inother ways.—The Chairman : Is it not the case that instead of thesevarious institutions working with one another they are all competingagainst one another?—Witness : It is so. I quite agree that there is afeeling among the staff of the general hospital against the staff of thespecial hospital.—The Chairman : Why could there not be a working-inof these two classes of hospital ? Is it because of jealousy ?-Witness:The difficulties of organisation would be too great. It might, however,be done.—The Chairman: Might there not be a consultative com-

mittee ? I would rather have a consultative committee made upof the lay governors, who could arrange for cases being passedfrom place to place.—Witness : That is quite so, but before thatcould possibly come to pass I think you would have to organiseand make use of those State hospitals and Poor-law infirmaries.I think that the utilising of those infirmaries might in all pro-bability engender a nucleus which might work something of the kind yousuggest.—The Chairman: Do you think that medical men keep hold of aninteresting ease rather than pass it on?—Witness : Distinctly that isso. They would not send away to another hospital a valuable teachingcase. Continuing his evidence, Dr. Dowse said that in his opinion thegrowth of special hospitals ought to be checked. He did not think itshould be in the power of any man to start a special hospital and

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appeal to the public for charity unless it were made evident that thehospital was worthy of charity and conducted upon straightforwarcl andbusmesslike lines. At the present time any man could start a hospital.Witness could get a committee together from among his own friends,as in the case of the West-end Hospital. Dr. Tibbits used to attendthe anuual meeting. His wife was matron, his brother-in-law was thesecretary. The whole thing wan therefore a little family party. Thatwas a thing which he could not recognise at all. He condemned everyhospital which was of a proprietary nature.-By the Earl of Kimberley :There were twenty-four Poor-law infirmaries in London, containingover 12,000 beds. Those institutions were well officered and wellmanaged, but the organisation might be greatly improved, andwhat was known as Gathorne I3ardy’s Act should be thoroughlyand consistently carried out. They should be managed andcontrolled by the County Council, and steps should be taken to organisea staff of visiting physicians and surgeons to give clinical instructionto advanced medical students. If the present superintendents did notfeel sufficient confidence to undertake teaching there were many youngmen of talent and position who would be glad of the opportunity. Hewould strongly protest against such men being selected as teachers ifthey held appointments in general hospitals. His reason for suggestingthe County Council as the managing body was that he wished to avpidundue partisanship for particular patients. He wished to have a perfectlyindependent body.-By Lord Saye and Sele : Any evidence he had givenmust not be regarded as personally antagonistic to Dr. Tibbits.-By LordThring : If a hospital were ostracised by the Hospital Sunday Fund itwas ostracised by the medical profession, and ought to be ostracised bythe public.-By the Chairman: He considered that the out-patientsystem was abused, and should be better organised. Much of themedicine given at the hospital was not taken by the patient for whomit was prescribed. He was told that people wishing cod-liver oil for afriend went to a hospital for it.

The Metropolitan Hospital Provident Fund.Mr. Arthur Henry Sandiland, licentiate of the Royal College of Phy-

sicians &c , examined by the Chairman, said heresided in Southgate road,and practised in the neighbourhood of the Metropolitan Hospital. Hewished to enter his objection to the statement made to the Committeethat the medical men in the neighbourhood of the hospital had with-drawn their opposition to the provident scheme now in force. He didnot know that any of them had withdrawn their opposition. Thisscheme was of no use to the poor, because, after a man had made onevisit to the hospital, he was told that he must either contribute to theprovident fund or go somewhere else. It was an injustice to local prac-titioners, because people able to pay for medical treatment in theordinary way were admitted to the scheme. It was utterly untrue thatthe local practitioners acquiesced in the scheme. They had made nocomplaint, for the simple reason that they had no one to whom to com-

plain. He and other practitioners held that the hospital authoritieshad no right to devote the funds given them for the sick poor to thisprovident scheme. The institution remained no longer a free hospital.Mr. George Locke, M.R.C.S , &c., of Kingsland-road, gave evidence of

a corroborative character. This provident scheme, he said, was under-mining private practices. He had no sympathy with provident schemes.

S’t. Peter’s Hospztcct for Stone.Mr. Walter E. Scott, secretary to St. Peter’s Hospital for Stone,

examined by the Chairman, said there were in the hospital twenty-four beds and two private wards. Last year in the out-patient depart-ment each attendance cost 10¼d. and each bed cost £130. The gr tntfrom the Hospital Sunday Fund being very small, the authoritiesrefrained in 1883 from making an application for it. They had,however, renewed their application this year. It had certainlybeen hinted that a grant would be tefused altogether. The institu-tion was in no sense a proprietary hospital. The income was appliedto the expenditure of the year or funded. Many of the patientsinsisted on making a payment towards the cost of their treatment.Those patients who required expensive drugs were asked to pay forthem. Each patient in the out-patient department was asked to payIs. for drugs. He was not always able to make the payment, butreceived treatment all the same.Mr. Hurry Fenwick said he was as,ociated both with St. Peter’s and

the London Hospital, and it was his habit to draft patients from thegeneral to the special hospital. He found no opposition to this practiceon the part of his colleagues. Witness explained to the Committee themedical organisation of St. Peter’s Hospital.The Committee then adjourned.The Committee met again on Thursday, Earl Sandhurst presiding.

St. Peter’s Hospital for Storte.Mr. Hurry Fenwick attended in order to amplify his evidence with

regard to this hospital. Usually he said the ca-ses dealt with in thehospital were chronic cases which had passed through the hands ofordinary practitioners, and which required special treatment. A gooddeal of the educational value of the special hospitals could be utilisedif those institutions were affiliated with the general hospitals, andmuch of the antagonism to the special hospitals would in this way beremoved. Special hospitals withdrew from consulting members of theprofession a great amount of special material useful for their ownexperience and for teaching purposes. 1hey affected othermembers of the profession in a monetary way. He did notthink that the profession objected to specialism in the ab-stract. Every medical man was at heart a specialist, but whathe objected to was that specialism should be abused. He believedthat the word "hospital" could and should be most strictlyguarded. No place should use the word unless under a speciallicence. All hospitals should be licensed, the licensing body toconsist of the heads of the profession, who would be in a position tojudge without bias of the merits of the proposed hospital, and thenecessity for its establishment. He considered special hospitals to bea growing evil. There were a number of them which should not exist.All the teaching at the special hospitals should be made open, not onlyto students but to practitioners. At present most of the special hos-pitals were closed in thi. respect.—By Lord Thring : He thought themedical profession should have the p"wer of vetoing a special hospital.A quack hospital would not come within the province of the profession.Such an institution should be repressed by law. He spoke mert-ly froma professional point of view. By the Chairman : St. Peter’s Hospitalwas founded about twenty years ago. It commenced in a very small

way. An anonymous donor gave £10,000 for the erection of the presentbuilding.

The Hospital for Sick Children.The, Hospital for Sick Children.Mr. Arthur Lucas, vice-chairman of the Hospital for Sick Children in

Great Ormond-street, and Cromwell House, Highgate, examined by theChairman, stated that the institution was founded in 1852. He objectedto describing it as a special hospital; it was a general hospital with alimit of age. They had 127 beds at present, and when the wing nowbeing built was complete, they would have about ninety more. TheHouse Committee met once a month, and oftener if necessity arose.There wasatreble check oftheaccounts. Theaudit was done by charteredaccountants, who reported four times a year to the Committee, andthey had also tn audit by the Finance Committee. When the newwing was complete, they proposed to allow wards where infection hadbroken out to be fallow for a time. There were in London fourteen.hospitals devoted to c:hildren; his hospital was practically a freehospital. Disease was the qualification for admission. The in-patientslast year numbered 20,604 and the out-patients 11,570. Their expendi-ture amounted to £12,045 and the income to £12,074. Their endowmentsyielded an annual income of £431. They had a lady superintendent,eight sisters, eleven staff nurses, eleven probationers, eight lady pupils,and seven sisters engaged in private nursing outside the hospital. Allnew hospitals should, in his opinion, be licensed. He should not wishwithout further consideration to express an opinion M to the composi.tion of the licensing board ; but he certainly thought it should not becomposed entirely of doctors, because they would be influenced by pro-fessional jealousies. New hospitals undoubtedly sprang up where theywere not wanted. He thought the abuse of out-patient departmentshad been exaggerated.-By the Earl of Kimberley : He would not con-nect the licensing board with any local body.-Lord Cathcart: Can you,grind all the grist that comes to your mill? - Witness : Yes, with(hfliculty in connexion with the out-patient department.-By the Chair-man : His board thought of giving up the Convalescent Institution atHighgate, its situation being now practically in London. They did notthink of erecting a new building, but of affiliating themselves withsome existing institution.Dr. W. B. Cheadle, senior surgeon of the hospital, said he was in

favour of separate hospitals for the treatment of children. A certainnumber of students received instruction in the hospital. The fees wentdirect to the lecturers, who received proportions in accordance with thework they did. There were also some female clinical clerks. Severalof the staff were attached to other hospitals. Affiliation of the providentdispensaries with the hospitals was very desirable, although there were.many difficulties in the way of affiliation. In all hospitals he thoughtthere was a tendency to make nurses work too long hours.

The West London Llospital.Mr. R. J. Gilbert, secretary of the West London Hospital in Hammer-

smith, examined by the Chairman, said that the institution was foundedin 1856 as a dispensary, and in 1860 as a hospital. There were 101 beds,of which ten were in special wards. All in-patients must bring aletter of recommendation. If an out-patient came without a letter ofrecommendation, and was found to be in urgent need of treatment, he-was treated at once and told to bring a letter of recommendation. Theaverage number of new cases in the out-patient department for the lastthree years was 21,000. He received a salary of s6250 with a house-allowance of £50. The hospital was assessed at £310.The Committee afterwards adjourned.

METROPOLITAN ASYLUMS BOARD.

Return of Patients remaining in the several Fever Hospitalsof the Board at midnight on April 21st, 1891.

SMALL-POX.—Atlas hospital ship, 18.* Infant with mother.

Appointments.Successful applicants for Vacancies, Secretaries of Public Institutions, and

others possessing information suitable for this coluinn are invited toforward it to THE LANCET Office, directed to the Sub-Editor, not laterthan 9 o’clock on the Thursday morning of each week for publication inthe next number.

BALFOUR, T. S., M.B., C.M.Edin., has been appointed House Surgeon-to the Edinburgh Royal Maternity and Simpson Memorial Hospital,vice Marshall.

BARNES, L. J. J., M D., L.R.C.S. Irel., has been appointed IledicabI Officer for the Erith Cottage Hospital.