278

form of inflammation from the operation of the same causes; andhe observed that because wounds and other injuries of the skinmay fail in fifty cases to excite more than healthy inflammationof that organ, that he will not be persuaded that they may not, inthe fifty-first, excite an erysipelatous or some other unhealthyinflammation. Now, with reference to this observation, he (Mr.Alackenzie) would wish to inquire whether it does not, in reality,concede the whole question ? for upon what can a specific inflam-mation depend but upon some specific or peculiar condition ofthe blood ? Again, with regard to the veins, suppose that in amillion cases the ordinary causes of inflammation applied to them Ifailed to excite extensive obstruction of these vessels, whereasin the millionth and one such resulted, should we be justified inregarding the one case as the rule, and the million cases as theexception ? Was it not rather probable that the peculiarity inthe exceptional case was rather dependent upon some peculiarcondition of the blood, than upon any disposition on the part ofthe vein to develop such specific inflammation, in the absence ofsuch case? This view, he submitted, was at least rendered pro-bable, when it was considered how latent and insidious are someof the causes which tend to impair the normal condition of theblood. With regard to the observations of Mr. Hodgson, it didnot appear to him (Dr. Mackenzie) that the facts he had men-tioned were at all at variance with the principles affirmed in thepaper. The blood, he need scarcely observe, was liable to becomediseased or contaminated in a variety of ways; and of the causesproductive of such results, some are of a local and some of ageneral character. Now, the circumstances Mr. Hodgson hadreferred to--viz., cancerous diseases-constitute some of the moreimportant local causes, for they tend sooner or later to give riseto suppurative or unhealthy discharges; and these, on beingabsorbed into the system, tend not only to vitiate the blood, butto produce irritation or inflammation of the vessels through whichthey are transmitted, whether these happen to be absorbents orveins. As to the partieular veins which are liable to become in-flamed from a general vitiation of the blood, he (Dr. Mackenzie)believed that in the majority of cases we may recognise theoperation of certain determining causes. This question, more-over, he had fully considered in the pathological part of theinquiry, and he regretted that the time of the Society would notnow enable him to enter upon it. The facts stated by Dr. Locoekwere not only of extreme interest in themselves, bat highly im-portant to the present inquiry; indeed, in the whole course of his(Dr. Mackenzie’s) experience or reading, he had never met withsuch strong testimony to the correctness of the opinion thatphlegmasia dolens was a constitutional disease; for hereditarydiseases are, in the strictest sense of the word, blood diseases;and if, as stated by Dr. Locock, phlegmasia dolens did reallyoccur as an hereditary affection, we may deduce a strong argu-ment from the fact in favour of its being a blood disease. He(Dr. Mackenzie) did not know that any other points had beenraised in this discussion which required to be noticed, and wasunwilling to occupy the attention of the Society at greater length.He extremely regretted that the number of details which it wasnecessary to introduce into his paper, in order to substantiate theseveral propositions affirmed in it, were such as to have preventedits being brought fairly before the Society. When, however,hereafter, it shall be published entire, and the facts and inferencescontained in it fairly weighed and considered, he ventured tobelieve, with confidence, that the judgment of the professionwould be given in favour of the principles he had affirmed, andthe conclusions he had arrived at.

MEDICAL SOCIETY OF LONDON.

SATURDAY, MARCH 12.—DR. FORBES WINSLOW, PRESIDENT.

THERE was a full attendance of fellows this evening to receivethe new president. After the passing of votes of thanks to thelate president and the other officers, including the Lettsomianlecturers, and the orator, the thanks to the late orator, Dr. Snow,were coupled with a request that he would permit his excellentaddress to be published for the benefit of those who had not anopportunity of hearing it.The PRESIDENT then delivered the following address :-

Elected by your kind suffrages to the office of President of theMedical Society of London, it now devolves upon me, whenentering upon the performance of my official duties, to tender tothe fellows my warm andsincere acknowledgments for the high dis-tinction they have thus conferred upon me. I should indeed provemyself unworthy of this honour if I were not to entertain a livelyappreciation of the kind feelings which have been manifestedtowards me in placing me in this chair. Can it be otherwisethan gratifying to my mind to occupy the high position that has

been sustained, during the earlier period in the history of ourSociety, by the truth-seeking, the philosophic Lettsom, thebenevolent Fothergill, the universally-esteemed and venerableClutterbuck, and the

" Immortal Jenner, whose gigantic mindBrought life and health to nearly half mankind’

the shining lights of former epochs,-the distinguished physiciapsand philosophers of the era in which they flourished ? I main-tain it to be no light distinction to be called upon by your kind-ness to succeed in this chair men who were respected andbeloved by all, and reverenced as the great and noble benefactorsof the human race. It is impossible to over-estimate or exaggeratethe importance of a society like the one with which we have thehonour to be associated. Apart from the great advantages re-sulting from the frequent unions of medical men, producing acommunity of sentiment, exciting a spirit of honourable emula-tion, destroying all acerbity of feeling, it has other, and perhapshigher, claims to our consideration and support. We meet herefor the promotion of one common object-viz., the noble andexalted pursuit of truth; to advance our knowledge of the mostefficient means of arresting the march of disease, alleviatingsuffering, and promoting the duration of human life. This is notthe arena for the mere display of the higher flights of oratory, orfor the practice of the graces of elocution. We do not assemblehere to prove how dexterously and easily we can trip up andversary, or with what facility we can detect fallacies in theargument of an opponent. We do not meet in this room, likecounsel in a court of law, each with his separate brief and specificinstructions, predetermined to enforce a particular line of argu-ment, irrespectively of the truth of the cause or principles he isadvocating. No, the discovery of truth is-the great, the exclu-sive, the ostensible object of all our discussions ; it is the solebond of our union, the spirit of our fraternity, the common battle-ground upon which we unfurl our banner and take our stand.Without depreciating the cultivation of other branches of phi.losophy, or decrying other professional occupations, I think Imay with truth assert that there is no study so calculated toenlarge the capacities, invigorate the intellect, discipline theunderstanding, chasten the fancy, and improve the heart, as thatof the science of medicine, if cultivated in a cautious, truth-loving,honest, and philosophic spirit; and yet, at the same time, it mustbe admitted that our science peculiarly exposes us to manysources of error and fallacy, unless we apply to its cultivation thegreat principles of the inductive philosophy, and constantly bearin mind the truths taught by its illustrious founder-

The great deliverer, he who from the gloomOf cloistered monks, and jargon-teachmg schools,Led forth the true philosophy."

There are but few gifted men in our profession, or in any walkof modern science, of whom it could be said that they could affordto dispense with the patient study of facts, or with the recognisedformulœ of logical and inductive reasoning. It was remarked ofthe immortal Newton, that he seemed to arrive per saltum at aknowledge of principles and conclusions that ordinary mathema-ticians only reached by a succession of steps, and after the resultof much labour, long-continued and profound meditations. It is

only by applying rigidly the principles of the inductive process ofreasoning, by which we conclude that what is true of certain in-dividuals of a class, is true of the whole class, or that which istrue at certain times, will be true under similar circumstances atall times, that medicine will take rank with the exact sciences,and its cultivators have a right to claim a foremost position amongthe distinguished philosophers of the day. In the study ofmedicine, perhaps more than in any other science, we are pecu-liarly exposed to the danger of adopting false facts, of beingseduced by specious and hasty generalizations, and led into errorby deducing general principles from the consideration of a fewparticulars-the bane of all right and sound reasoning-thefoundation of all bad philosophy. In estimating the effects ofmedicine under given circumstances of alleged disease-in the in-vestigation of the science of morbid anatomy, we are often ledinto great error by neglecting the principles of inductive reasoning.But whilst strongly urging upon your consideration a carefuland rigid adherence to the principles of inductive reasoning,and a jealous examination of phenomena alleged to stand inthe relation of cause and effect, I would caution you against aspirit of unphilosophical scepticism, occasionally exhibited bythos-’ professedly engaged in the cultivation of science. Thereare some men who obstinately refuse to recognise the laws of legs-timate causation. Voltaire fully appreciated, in his day, this viciousmedical scepticism. I have ventured, gentlemen, thus cursorily torefer to one or two points of great interest connected with thelegitimate object of our weekly associations in this room. I

’ sincerely trust that, influenced by a love of philosophic truth-

279

actuated by one noble purpose-combined by the promotion ofone great object-pursuing the same rugged path, and all bendingtowards the same goal,-it may be our happiness, at the close ofour eventful and useful career, to glance retrospectively upon thepast with feelings of honourable pride and pleasure. Again,thanking you for the high distinction conferred upon me, I sin-cerely hope that, when the time has arrived for me to return intoyour hand the responsible office entrusted to my care, I mayhave the gratification of feeling that I have neither been neglect-ful of your interests nor have merited your displeasure.

Mr. DENDY then read his paper on " Psychotherapoeia," illus-

trating the pathogenetic influence of the mind upon the body byrecorded and original observation, and the importance of attend-ing to it in the treatment of disease.

Drs. CRISP, CAMPS, RADCLIFFE, SNOW, WILLSHIRE, andDANIELL, and Messrs. CHIPPENKDALE and HINTON took part inthe discussion.We may mention here that the subject of the Fothergillian

Essay for 1855 is, ’’ On the Pathology and Treatment ofDiabetes."

Correspondence.

NAVAL ASSISTANT-SURGEONS.

"Audi alteram partem."

To the Editor of THE LANCET.

SIR,-Having read in the Times of the 22nd February, withmuch pain-indeed, I may say with something very nearly akinto disgust-the discussion which took place in the House ofCommons on the preceding night, on the subject of naval assistant-surgeons, I am induced to ask from you, what you have veryfrequently on previous occasions given me, space in your valu-able columns for a few observations, which appear to me to beimperatively called for on the present occasion.

I was not a little surprised at the tone taken by Mr. BernalOsborne, who, if I recollect rightly, did, on former occasions,when the grievances of these most ill-used officers were broughtbefore the notice of the House and the country, take a veryprominent part as their advocate, and from whom, as an ex-military man, a more liberal feeling towards these officers mightbe supposed to have been engendered by his knowledge of theperfect social equality upon which their brethren of the army arereceived by all ranks of their brother officers, from the com-mandant to the junior ensign ; but it would seem as if Mr. BernalOsborne, as an independent member of the House, and Mr.Bernal Osborne, the Secretary to the Admiralty, are two verydifferent persons.

Mr. Osborne would seem to pooh-pooh the resolution of April,1850, by saying that " it was carried by surprise in a thin Houseof eighty-eight members." I wonder how he would have votedhad he made the eighty-ninth on that occasion! Well, in replyto his observation on the thinness of the House, I shall just saythat it was competent to the Admiralty to attempt to obtain areversal of that vote by again referring the subject to a largerHouse. But did their lordships do so? No, no. Consequentupon it, they promulgated their celebrated circular, No. 65, datedJuly 17th, 1850,-a circular which, for shuffling and evasion,stands without parallel, and is, indeed, neither more nor less thana most ingenious device to burk the vote of the House of thepreceding April. Their lordships drew a distinction, by virtueof which they cousticuted two classes of assistant-surgeons,-adistinction which does not exist in the line, in the artillery, or inthe service of the East India Company,-a distinction which, inpoint of fact, has no existence, save what was produced in thecreative minds of their lordships by their determination, as faras in tliem lay, to nullify and to render inoperative the vote ofthe House. To the first class, thus created, they gave ward-roomprivileges, and cabins, " when the accommodation and space onboard will admit." And whom did their lordships constitutejudges of this 11 accommodation and space ?" Why, the verymen who, from time immemorial in the service, were opposed tothe entry into the ward-room of the assistant-surgeons-the verymen to wlcoiiz the vote of April, 1850, was gall and wormwood!As might easily have been anticipated,-as, indeed, it would seemto have been designed and intended by the Admiralty,-everypossible difficulty was thrown in the way of providing cabins forthese cfficers, and in cases even where they had gotten them,they were deprived of them on the most frivolous pretexts-e. g.,the case of Mr. Duigan, of the Qucezz, 120, in the Mediterranean.This officer was most harshly treated bv Admiral Sir WilliamParker, and was turned out of his cabin to make room for a

lieutenant who did not even belong to the ship, but was on boardin sonte temporary and sztpergzumerary capacity.

Mr. Osborne reminded the House that the Commission of 1840had reported that " there were practical difficulties in the wav ofallowing assistant-surgeons to mess in the ward-room." Now,Sir, with regard to these " difficulties." On reading the reportof that commission, I had the honour to address a letter to you,in which I stated that I had served as an assistant-surgeon onboard a three-decker, on board of frigates, and in a corvette;and that I was familiar with, and had often been on board of,every other description of vessel that carries a pendant; and thatI was prepared to state on my oath that, in my opinion, no diffi-culties," either " practical" or otherwise, did or do exist. I be-lieve it was long subsequently to that commission, and to thatreport, that additional lieutenants were, in many instances,appointed to ships ; and I believe no " difficulties" were found tobe in the way of giving these officers a place in the ward-room,and a cabin. This shows iticontestibly that the same might havebeen done in the case of the assistant-surgeons, and that it wasnot the way but simply the will that was wanted.

Admiral Berkeley took a part in the present discussion, andstated that the Admiralty had " done all that was possible tocarry into effect the resolution of April, 1853." Strange thatthe assistant-surgeons, to a man, have, wherever they could withsafety do so, declared the contrary. They say-and doubtlessthey truly say-that the spirit of the order has been evaded anddeparted from in every case where the slightest pretext for doingso could be found or formed. But, (assuming for an instant thatit was carried out in a liberal spirit,) at best, it was in itself butan attempt (and a very ingenious dodge it was) to evade the voteof April, 1850. Where in that vote can be found the slightestground for the division into two classes? The vote declaredthat "the accommodation provided for assistant-surgeons wasinadequate and insufficient," &c. And, as a remedy for thisstate of things, these officers are classified, and one of the classesis condemned to a three years’ further endurance of the " accom-modation" which the popular branch of the Legislature haddeclared to be " insufficient for securing their professional ser-vices." .P/’o7t pudor, my lords of the Admiralty !

Well, the gallant Admiral proceeds to inform the House thatthe mates are the superior officers of the assistant-surgeons.What a truly miserable subterfuge is here ! The Admiralhimself was. of course. at one time a mate. and he knows well

that neither in his time nor now would, the pay of a mate allowhim to mess in the ward-room; and as to the superiority-whythe mate, as an executive officer, is of course the superior officerof all those in what is called the Civil class of the navy-that is,he would, in the absence, by death in action, or from any othercause, of the captain, and of all the lieutenants, and of the master,take the command ; and he would then, pro tem, be the superiorofficer not only of the assistant-surgeon, but also of the surgeon,the chaplain, the paymaster, and the marine officers, though allthese officer hold a rank superior to his. (Vide the Times ofFeb. 23 on this particular part of the subject.)

Admiral Berkeley also stated, that " so far from there being awant of candidates, no fewer than fifty-four had entered withinthe last few months. This may be so, but I can only say that,by a private letter which I received a very few days ago, I aminformed that the Admiralty is at this moment in a regular fix"-a complete " dead lock"-for want of assistant-surgeons ; andthat they contemplate again addressing the several colleges onthe subject. And, certes, if there be, as stated by AdmiralBerkeley, such an abundant supply of these officers, it is passingstrange that, within the last ten days, two additional surgeonshave been appointed to the flag-ship at Portsmouth; and forwhat purpose think you, Sir? Why for the performance ofduties at Haslar Hospital, which hitherto have always been dis-

charged by assistant-surgeons. This is very significant, and, atall events, it appears very much at variance with Admiral

Berkeley’s statement. In anticipation of any appeal which theAdmiralty may make to the colleges, I have felt it my duty toaddress the president and council of the Irish College of Surgeons;for though I am a member of the London College, and a graduateof the University of Edinburgh, I feel little identification witheither of these institutions ; and I look upon my own nationalcollege (of which I have the honour to be a fellow) as my "almamater." I have directed the attention of the president and of thecouncil to the discussion of the 21 st of February, and I have alsopointed out to them the case of Mr. Duigan, who, by the way, isan alumnus of the Irish College, and whose case will consequently

, receive from that body the very best consideration. You may,, Sir, rest assured that to any appeal made to our college by the

Lords of the Admiralty (whilst assistant-surgeons are treated as

they now are) a suitable reply will be given.L Well, Sir, the assistant-surgeons, and those who advocated their