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fracture a thin edge of newly deposited bone was found; theedges of the fracture smooth and rounded off, and in one partthe line of fracture quite obliterated from deposit of newbone; inlaid between the contiguous surfaces of the wholelength of the fracture was some dense fibrous tissue, withscattered calcareous particles deposited in it. In the case offracture of the base of the skull reported by Mr. Lee, thepreparation of which is in the Museum of the College of Sur-geons, complete bony union has taken place in some parts, theinjury having occurred two years previous to the death of thepatient. The mode of reparation of fractures of the skullappears somewhat similar to that of other bones; lymph isthrown out between the edges and surfaces of the fracture,soon becoming converted into fibrous tissue, in which calea-reous particles are deposited. The same material of unionwas found between the fractured edges at the base and alsothose of the vertex-an interesting fact, as the mode of de-velopment of these parts is different.Dr. BENCE JoNES exhibited a

CYSTIC OXIDE CALCULUS,from a man, aged forty-five. Nov. 22nd, 1848: Had excessivehaematuria for three weeks, which was stopped by drachmdoses of tincture of muriate of iron; some tenderness in rightloin at times, and has frequently passed calculi for last twentyyears-at one time, many together, like sugar-candy. Urinewas acid, at 12.30, contains much pus, and albumen in con.siderable quantity.-Jan. 24th, 1850: Was dying; had occa-sional attacks since Dr. Bence Jones saw him for the hsema-turia ; no effusion in chest, and no disease of the heart.-Jan.26th: Died. Body well formed. One large calculus and somesmaller pieces were found in the left kidney; the calculus wasnot loose in the pelvis, but adhered, and required to be cutout. The mammary processes of the kidney were absorbed,and the cortical structure encroached on. The irregularcavity thus formed by the dilatation of the pelvis contained aquantity of highly offensive purulent fluid; the ureter appearedpervious, but was thickened, and the lining membrane wasinflamed. The right kidney was very small, being less thanone-half its natural size; it was remarkably thin; the capsulewas firmly adherent. When removed, the cortical surfacewas very rough with a granular surface; no urinary cysts wereobserved in it. On section, the cortical structure was seenvery much wasted, and of a deep colour. A considerablequantity of fat surrounded both kidneys, closely adhered tothe surface of the capsules and to the surrounding cellulartissue. The mucous lining of the bladder was, near its neck,more vascular than natural; otherwise healthy. Other visceranot examined.

Mr. COULSON exhibited a specimen ofCANCER OF THE PENIS,

removed from a man, aged sixty-six. Two years ago, a wartappeared on the left side of the corona glandis, which increasedvery little for the first twelve months, but after that, rapidly,till it attained its present condition. The left portion of theprepuce is everted, ulcerated, and converted into a scirrhousmass; the right portion not everted; on its inner surface thereis a large mass of encephaloid disease, connected, in someparts, with the glans. The glans is in part destroyed, andthe remainder converted into this encephaloid structure, fromwhich could be squeezed an abundance of cream-like fluid;under the microscope, numerous cells, some stellate, somecaudate, and others elongated at both extremities, were ob-served ; a few were round. The pubic extremities of thecorpora cavernosa contained no cancer cells. For some time,there had been a very copious, thin, offensive discharge fromthe part, and latterly occasional profuse haemorrhage, andoccasional shooting pain, but this symptom had not beensevere. He looked pale and enfeebled, but this appearancehad not manifested itself till the last week, soon after the lastbleeding. The glands in the groin were natural.Mr. 1I0LTHOUSE exhibited a specimen ofFRACTURED CERVIX FEMORIS WITHIN THE CAPSULAR LIOAMENT,

from a male, aged fifty-six, taken to Westminster HospitalSchool of Medicine for dissection; and remarked that thespecimens of this accident contained in the various museumsexamined, might be grouped under three heads. 1st. Thosein which perfect bony union had taken place between thefractured extremities-a very rare result. 2nd. Those in whichligamentous or fibro-cartilaginous union to a greater or lessextent had taken place. 3rd. Those in which no union what-ever had been effected. The specimen was an example ofthe last-mentioned condition, and presented the following

appearances. The head of the bone was within the aceta-bulum, but that portion of it which originally was continuouswith the neck, had become hollowed out into a shallow cup-shaped cavity, resembling a second acetabulum; the surfaceof this concavity was hard, smooth, and polished. The neckof the bone had disappeared in all but -its root, which wasrounded off and polished into a sort of head that played inthe above described cavity; a chain of smooth oval bodies,like loose cartilages, connected together by ligamentous struc-ture, was found in the interior of this false joint.

Dr. PEACOCK presented from Mr. Gay, aPORTION OF INTESTINE WHICH WAS PUNCTURED IN TAPPING THE

ABDOMEN FOR ASCITES.

The puncture was made about an inch below the umbilicus,but nothing passed through the canula. The trochar was thenintroduced about an inch below this, and the fluid drawn off.This latter wound healed; the former remained open; no dis-charge took place for some days, and then some thin, bilious-looking fluid oozed out. Ten days after the operation, theliver could be readily defined, and the edge of the left lobefelt as low as the umbilicus-below this, and on each side ofthe wound a resonant sound was elicited-the fluid from thewound was bile, with little or no odour; the bowels actedregularly. In five weeks the sore was completely healed.The peculiar sensation referred to by Dr. Bright as diagnosticof adhesions of the peritonaeum was communicated to thehand; for a day or two the sensation was like a bag of smallstones-as if the gall-bladder filled with calculi had beenwounded and was adherent to the abdominal wall. She diedthree months after the operation, from disease of the liver.The liver was extensively diseased and large, especially theright lobe; the gall-bladder natural; opposite the first punc-ture the jejunum was firmly adherent to the abdominal wall;this was obviously the seat of injury to the intestine; theomentum had contracted adhesions just above the femoralring on the right side, and a portion of small intestine, in-cluding the wounded piece, had passed through an aperturein this peritonseal duplicature, and retained it in the positionin which it was found.Mr. TOYNBEE exhibited specimens ofOSSEOUS TUMOURS DEVELOPED FROM THE PARIETES OF THE

EXTERNAL AUDITORY MEATUS,removed from a man aged seventy, who was not known to-havebeen deaf. In the early stages of development these tumoursare not usually accompanied by a diminution of the power ofhearing, but they sometimes increase so much in size, that themeatus is entirely obliterated. In each of the specimens onetumour is observed to grow from the anterior, and a secondfrom the posterior, wall of the meatus; they are opposite eachother, and are situated midway between the membrana tym-pani and the orifice of the meatus. In each the tumour ori-ginating from the posterior wall is larger than that from theanterior. In the right ear the canal is reduced one half; inthe left, to one third its natural size. The structure of thediseased growths is much the same as that of the surroundingbone; the whole of the petrous portion is, however, moredense than natural. In some cases these tumours are denseand smooth, like ivory. In the recent state they were coveredby the lining membrane of the meatus, which tended consider-ably to diminish the calibre of the tube. Although thisdisease is far from being rare, it does not appear to have beendescribed by any writers on diseases of the ear. In the rightear an additional abnormal condition is observed; it consistsin the deficiency of the osseous sulcus lateralis in two places,and here the mucous membrane lining the mastoid cells is incontact with the dura mater, forming the anterior wall of thelateral sinus. In each ear the canalis carotidis is contractedto one half its natural size.

MEDICAL REFORM.

MEMORIAL TO SIR GEORGE GREY, FROM THECOUNCIL OF THE NATIONAL INSTITUTE.

To the Right Hon. Sir George Grey, Bart., Her Majesty’sPrincipal Secretary of State for the Home Department, &c.

The National Institute of Medicine, Surgery, and Midwifery,4, Hanover-sq., Mayt6th,18SO.

SiR,ŇThe Council of the National Institute of GeneralPractitioners in Medicine, Surgery, and Midwifery, beg againto address you on the subject of medical affairs, and they

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respectfully offer a few additional observations for your con-sideration, with a view to explain certain statements, to cor-rect a few inaccuracies, and more especially to point out somemost important points of agreement, in the principles containedin the memorial of the Provincial Medical and Surgical Asso-ciation, when compared with the principles advocated by theNational Institute.The Council of the National Institute respectfully repre-

sent-

1st. That the provincial physicians and pure surgeons,havingdistinct and separate interests, however competent to adviseon matters relating to their own colleges, are neither properauthorities, nor parties sufficiently disinterested, to advise orinterfere with the education or the examinations of the generalpractitioners; and the Council of the National Institute havereasonable grounds for believing that the representations madeby the Provincial Medical and Surgical Association are notentitled to be considered the legitimate opinions, or as advo-cating the true interests, of the General Practitioners inMedicine, Surgery, and Midwifery.

2nd. That the district meetings of the members of the Pro-vincial Medical and Surgical Association, alluded to in theirmemorial, were very scantily attended,.-thirty-two personsonly having attended the meeting at Bath, seventeen of whomwere either physicians or pure surgeons; at the North Walesbranch, held at Wrexham, fourteen persons attended ; whilstat Shrewsbury there attended but ten or eleven. The attend-ances at the other branches being of a similar character, as tocomposition and numbers, are yet held up in the memorial asrepresenting the opinions of the general practitioners ofEngland!

3rd. The memorial recently presented to the Right Hon,the Home Secretary, by the Society of Apothecaries, ver3explicitly states the conditions upon which they would be pre.pared to surrender the examinations in medicine, &c., ancthese conditions are quite at variance with what is inferred uthe memorial of the Provincial Medical and Surgical Association.

4th. The unanimity of the Provincial Medical and Surgicalmemorialists, in opposing the establishment of a new collegeof general practitioners, assuming this to be, as stated, theopinion of the district meetings, (an assumption by no meanswell authenticated,) cannot in the slightest degree invalidatethe evidence afforded by the National Institute, that a newand independent college is the deliberate and most anxiousdesire of a vast majority of the general practitioners in town andcountry; and the Council of the National Institute having ob-tained the medical statistics of various localities from whencepetitions have emanated, take the liberty of stating that, atCroydon for instance, where an influential member of theProvincial Medical and Surgical Association (Mr. Bottomley;resides, they discover that out of fourteen medical practitioner;residing in that town, thirteen have subscribed their name:to a petition praying for a new college, one individual onl]dissenting, and that one being Mr. Bottomley himself.

5th. To the principles contained in the aforesaid memorialof the provincial medical and surgical practitioners, andwhich are considered by the memorialists as the only principlesfor legislation on medical affairs which would be satisfactoryto the profession-namely, the principle of uniform and effi-cient qualification in every branch of medical science, withequal right for all persons so qualified to practise throughouther Majesty’s dominions, and the adoption of the representa-tive principle in the formation of the governing councils ofthe respective Colleges, so far as they apply to the great bodyof the profession, the general practitioners-the Council ofthe National Institute give their unqualified approval; theyare points upon which the entire body of general practi-tioners are quite agreed, and their opinions have been so ex-pressed, and most strenuously insisted upon by every partyassuming to represent them; by the Society of Apothecaries,by the Provincial, Medical, and Surgical Asssociation, andmore especially by a large preponderance of the generalpractitioners of the kingdom, expressing their sentimentsthrough the National Institute of Medicine, Surgery, andMidwifery; ss the supporters, therefore, of a high and end-cient standard of qualification for all persons exercising theonerous and important duties that daily devolve upon themedical profession, the general practitioners are unanimous.The National Institute, on the part of the general practi-

iioners, repudiate the assumption laid down by the council ofthe College of Surgeons, that the infallible consequence of

raising unduly the standard of education would be practicallythe evasion of any qualification, and the surrender of thepoorer classes, under any surgical emergency, into the handsof the vendors of drugs and other uneducated persons." TheCouncil of the National Institute unhesitatingly affirm thatsuch an assertion is quite at variance with all experience, andthat if it should unfortunately so mislead her Majesty’sgovernment as to induce it to legislate upon such a principle,it would prove the greatest impediment to the progress ofscience, and be highly detrimental to the public interests.

I have the honour to be, Sir, your most obedient servant,NATHANIEL CLIFTON, Vice-president.

THE MACCLESFIELD MEDICO - ETHICALASSOCIATION.

[MEMORIAL TO SIR GEORGE GREY.]To the Right Hon. Sir George Grey, Bart., Her Majesty’s Prin-

, cipal Secretary of State for the Honae Department.Sin,łWe, the undersigned president and honorary secretary

of the Macclesfield Medico-Ethical Association, formed for thepurpose of determining the ethical relations, and supportingthe interests of the medical profession, beg leave respectfullyto submit the following memorial, with reference to theMedical Bill you contemplate introducing to the legislature.That there is a large number of unauthorized practitioners,

resident and migratory, who, by assumed and fictitious titlesand qualifications, impose upon the credulity, and trifle withthe health and lives, of a very considerable portion of herMajesty’s subjects.That of this class of persons there are not a few who become‘

accessory to criminal modes of effecting abortion among youngand unmarried females.That the increasing ratio of illegal practitioners far exceeds

that of the duly qualified, and that every unsuccessful attempt,, from time to time, on the part of the enlightened members

of her Majesty’s Government, to legislate on the subject, tendsl seriously to extend and perpetuate the evil, inasmuch as it

furnishes a presumption with the interested parties that noavailable remedy can be devised.

3 That the inefficiency of the Apothecaries’ Act for thesepurposes has long been deplored by the members of the pro-

fession as a practical anomaly.8that your memorialists therefore trust, that the Bill’pro-Iposed may embody a measure, by which, on summary convic-1- tion before the local civil authorities, the above evils may infuture be remedied.,t Siamed on behalf of the Association.

EDWARD MILNER, ChairmanJAMES WEIGHT, Hon. See.

THE MEDICAL PROFESSION AND THE INCOMETAX.

To the Editor of THE LANCET.SiRł1 am an old subscriber to THE LANCET, and a general

practitioner in a rural district. I have been accustomed tolook to your journal for the exposure, and consequent redress,of such grievances as bear with undue severity upon the bodyof which I am a member. The grievance of which I com-plain is the Income Tax, or rather, of a tax levied under thatname. I was surcharged under a bonâ fide return of myactual receipts, after deducting expenses : such as dogs, horses,assistants, servants, &c., and told that every book-debt con-tracted within twelve months preceding, was income, unless Icould prove such debts to be bad, either by failure on my part

in some legal process for obtaining them, or by the bank’ruptcy of individuals indebted to me.Can this be the law ? If so-is it not a monstrous hardship

on every general practitioner, calling for redress? Everymember of the profession will confirm my assertion, that alarge proportion of book-debts remain unpaid for years,-andthat, to a moral certainty, a large proportion of such debts isnever paid at all. Is it not, therefore, an injustice to charge

bool-;clebts as income? I will not intrude upon your timeand space, but conclude with the hope that if you considerthe case worthy of your editorial notice, you will devote aspare corner of your journal to the subject, and so confer anobligation on myself as well as the profession at large.

I am. vours.A COUNTRY GENERAL PRACTITIONER.May g, 1850.