514 QUACKERY AND LEGITIMATE MEDICINE.

THE GLOBULISTIC QUACKS are every now and then a little

perplexed about chloroform. Their patients wish to escapefrom severe pain, and although they promise to perform suchwonders by means of minute particles of sugar, they will notundertake to prevent the pain of a surgical operation, or evento allay the pangs of labour with a homoeopathic dose. The

failure would be so immediate and apparent, that it would beevident to the meanest capacity; and this, we suppose, is thereason why they do not attempt to make a patient insensiblewith a globule. The patients, however, have sometimes agreat objection to pain, and the practitioner is obliged to relaxthe usual injunction, not to smell to strong scents. We haveseveral times heard of homœopathists allowing, or even givingchloroform to their patients; and we have just seen somecorrespondence, which shows that one of these practitionerswished to have the aid of a medical man who is in the habit of

administering chloroform at the forthcoming confinement of apatient. This medical man very properly declined to meet thehomoeopath,who is consequently left to seek other aid, or to try hisown hand at doses very different from those he professes to give.We have been credibly informed that some of the professors

of globulism lead their patients to suppose that chloroform

harmonizes with their dogmas; but by what kind of sophismthey attempt to show this, we have not been able to hear, andare at a loss to conceive. The very essence of the discoveryfor the prevention of pain by the inhalation of ether or chloro-form consists in this, that by taking advantage of the exten-sive mucous surface of the lungs to introduce a volatile medi-cine, a larger dose may be given than would be safe by the

ordinary means, and thus a greater effect can tie produced.The extravagant fiction of medicines being more powerful themore they are diluted, meets, if posssible, with a plainer refu-tation in the instance of chloroform than of other agents; forif it were true, the patient ought not to be so much affected asothers who are present, and who inhale a minute quantity largelydiluted with air; or persons passing in the street, who breathethe chloroform in imperceptible quantities, should be in-

fluenced most of all. If a homcoopath could give chloroformto relieve the pains of labour, there would be no reason whyhe might not give twenty-five minims of laudanum to relievethe after-pains, or any other narcotic to allay the suffering ofneuralgia. In short, a medical man, who gives or allows his

patient chloroform, is not a homoeopath at all; he is either alegitimate practitioner, or he is one of those trimmers who arewilling to prescribe either according to the great system ofmedicine, or the little system, according as it may please thepatient, and suit their own interests.

DR. RANKING has shown himself the zealous defender of

his profession in openly charging Dr. HOLLAND with the un-professional conduct of which he was more than suspectedby the medical men of Norwich. It is matter for regret that I,Dr. HOLLAND’S exculpation should be so very imperfect. How, Iindeed, the conduct of the Physician-Extraordinary to theQUEEN, and sometime Censor of the College of Physicians,contrasts with the honourable conduct of Dr. COPEMAN and

Mr. COOPER, who, in a former case in which the same BELLwas concerned, positively refused to see the patient until

he had been dismissed. It is pitiable to see the author of" Medical Notes and Reflections" in such a situation. Even

Dr. MURPHY, who unhappily met this same BELL, publicly

declared that he never had, and never would, " knowingly"meet a homoeopath. But it seems Dr. HOLLAND did meet

the Norwich globulist after he had been made aware of histrue professional character.

This transaction gives force to the remark we have ofteninsisted upon-namely, that whatever the crimes of globuliststowards society or the medical profession may be, they are ina great degree attributable to the countenance given to thesehumbugs by the so-called dignitaries of the profession. It is

true we are told Dr. HOLLAND expressed very emphaticallyhis disapproval of homoeopathy; but then, with the easiestvirtue in the world, he takes his account of the case beforehim from the globulist, and leaves the prosecution of thetreatment to his care. What can the patient, or the patient’sfriends, think of the ethics of Dr. HOLLAND, when he with onebreath condemns a man and his practices, and with the nextcontinues him in the most responsible situation ? We neednot ask the thoughts of the profession on observing such aspectacle.

Medĩcal Socíetíes.

MEDICAL SOCIETY OF LONDON.

SATURDAY, NOV. 15, 1851.—DR. MURPHY IN THE CHAIR.

A VISITOR exhibited some Tambac, " valuable therapeuticagent," of which he gave a very flattering account, and de-clared that it was useful in various diseases: he had obtainedit from the Persian ambassador. The specimen brought be-fore the meeting was nothing more, however, than a mildspecies of tobacco, grown in the neighbourhood of Shiraz, andheld in much estimation by those addicted to the Orientalmode of smoking. Tambaku is the well-known Eastern nameof tobacco, and though the Shiraz specimen submitted bemilder in properties than either the American or Syrianvarieties, there is no ground for thinking that its volatilealkaloid principle is at all different from nicotiana, even thoughpossessing, as was asserted, a sedative expectorant action,resembling in this respect the lobelia.CLOSURE OF THE FISSURES IN THE BONY PALATE.-REDUCTION OF A

DISLOCATED FEMUR.

Dr. BAUER, a German physician and surgeon, brought beforethe Society two important improvements in operative surgery,which had been communicated to him by Dr. Buchring, thenephew of the late illustrious Dieffenbach. The first is anoperation to effect an organic closure of the fissura palati dura;and it has been successfully performed, more than once, byDr. Buchring, who appears to be its inventor. Dr. MasonWarren, of Boston, has proposed an operation for the samepurpose, to be effected by transplanting a portion of themucous membrane of the roof of the mouth across the fissure,and mentions some successful cases; but the operation hasfailed when tried in England, Germany, and in other countries.Up to the present time, only mechanical appliances by meansof obturators have been used, to prevent the communicationbetween the cavities of the mouth and nose, and the conse-quent diffusion of sound in speaking. Useful though theobturators may be, yet they are attended with many incon-veniences to the patient. In this respect Dr. Buchring’soperation deserves high consideration. It may be remarked,that he does not operate before the tenth, nor after thetwentieth year, the bones being at that time of life in a com-paratively elastic condition. The operation is particularly in-tended for fissures in the median line of the palate, the vomernot being in connexion with either of the edges of the fissure;but modifications may be easily introduced hereafter to meetthose cases where this connexion does exist. A pair of forcepsof a peculiar form are required to perform the operation. Thepatient is to be seated in a chair; the forceps are then intro-duced into the open mouth, one branch being passed intothe nasal cavity, as near as possible to the alveolar process,while the other is to occupy a corresponding position in themouth, so as to embrace the palate between the two cuttingedges of the forceps. The palate is then to be cut entirelythrough, the opening made being of a corresponding length to

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the fissure. It ought not to extend beyond the hard palate Haden, of Sloane-street, a patient, aged thirty-four, whoposteriorly, and ought to leave its anterior portion entire. passed a semi-solid fseeulent motion once in twenty-fourThis opening is to be made on both sides of the fissure. A hours, tinged with mucus and blood, and in addition to this,piece of leaden wire is then to be passed through one of the within the same time, four or five evacuations consistingwounds into the nasal cavity, and so on, through the other, solely of small quantities of mucus and blood. On examininginto the mouth again, where the two ends are to be bent up- the bowel with the speculum, it was found that the mucouswards. The wire is to be gradually drawn together, the effect membrane was destroyed to the extent of two inches from thebeing, that as the edges of the fissure approach each other, anus, and pus and blood were seen exuding from the ulceratedthe space between the margins of the wounds will become surface. Various local and constitutional remedies were em-wider ; or wedges of soft wood may be introduced into the ployed with little relief except a slight diminution of the dis-wounds for extending them, instead of the leaden wire. When charge. It was then suggested that the decoction of tormentillstthe edges of the fissure are near to each other, they are to be should be tried; three ounces of this root in a pint and a halfcut, in order that they may unite as in hare-lip, or caustic of boiling water were boiled down to a pint, and four ouncesmay be used to effect the same purpose by granulation. Of of the decoction were thrown up the rectum twice a-day, andcourse, while this is being done, the same pressure is to be retained each time a quarter of an hour. Under the use ofkept up until a complete consolidation of the cicatrix takes this remedy the pus and mucus gradually diminished, andplace; the pressure being afterwards gradually decreased. within five weeks the ulceration had completely healed; theThe wounds will soon fill up with callus, and close.-The only medicine taken during this time was a little castor-oil,second is an entirely new apparatus for immovably fixing the to keep the bowels loose. Mr. Coulson believed the rectum to

pelvis, while a luxated femur is being reduced. In cases of be occasionally the seat of inflammation, attended with muco-recent and sudden luxations this apparatus may not be abso- purulent discharge, which, if unchecked, proceeds to the de-lutely requisite; but in chronic luxations, where the reduction struction of the mucous membrane of the bowel, and to theof the caput femoris can only be effected in the course of formation of abscesses in the neighbourhood of the anus.weeks or months, especially in those luxations arising from A frequent desire to go to stool exists in these cases; andcoxalgia, this apparatus will be found invaluable. The pre- unless this be yielded to at once, the motions come away ofsent method of establishing counter-extension is not only in- their own accord, loose, and mixed with blood and mucus; atainioient in regard to fixing the pelvis, but is intolerable to last the patient’s health gives way, and he is worn out by con-the patient when he has to endure it for a length of time, tinued suffering. Mr. Coulson showed a preparation takenwhereas Dr. Buchring’s invention not only perfectly fixes the from a patient who had died of this complaint: the cellularpelvis, but may be used for any length of time without causing tissue round the anus was hardened, the mucous membraneany inconvenience whatever. While the apparatus is in use, of the rectum completely destroyed, and the internal surfaceand the femur is being extended, this invention throws the of this bowel presented elevated hypertrophied muscularwhole force of the counter-extension upon those parts of the fibres, between which there were several openings commu-body best calculated to bear a great amount of pressure with- nicating with external abscesses, so that these in fact wereout inconvenience-namely, upon the tubera ischii. The the result of the disease of the interior of the gut-the dis-apparatus is made in the following manner:-First a model is eased action without being continuous with that within. Thetaken with plaster of Paris, of the posterior surface of the ulceration of which he had been speaking was not to be con-pelvis, extending so far inferiorly as to include the tubera founded with the fissured rectum which often occurs fromischii. From this model an exact impression is to be taken in mechanical causes, or the ulcerated rectum which is some-cast-iron, so that it will fit exactly to the corresponding parts times found in persons labouring under a syphilitic taint.without any undue pressure on any portion of the surface. These conditions of the bowel were very painful, and the sourceFrom the superior ridge of the plate of iron two strong curved of great distress to the sufferer, but they easily yielded to re-pieces of iron are to be brought round the pelvis as far as the medies,-as the black oxide of mercury ointment (one drachmanterior superior spine of the ilium, keeping at a distance of of the black oxide to an ounce of lard), or if this failed, to aabout two inches from the body. At each of the two ends division of the surface of the ulcers,-and when left to them-there is to be a screw, capable of being turned by the hand, selves did not destroy the patient. Mr. Coulson said it wasarmed with a well-bolstered pelote, and the screw is thus to most desirable, in all diseases of the rectum, to make an ex-be turned until it becomes firmly fixed upon the anterior amination of the bowel with the speculum; and he would takesuperior spine. The apparatus is to be fixed to the bed, and this opportunity of showing one which was a modification ofthe extension may then begin. Mr. Hilton’s and Mr. Curling’s. The difference consisted in

the handle being loose, so that the same instrument could beINFLAMMATION AND ULCERATION OF THE RECTUM: IMPROVED used for any part of the bowel, which was not the case

SPECULUM RECTI. when the handle is fixed. This alteration was suggested byMr. CouLsoN said, that in September last, he saw, with Mr. Mr. Hovell, of Clapton.

The instrument is of a conical form, four inches long, three-quarters of an inch at the small extremity, and an iuch andone-eighth at the large. Upon the larger end is a ring, twoinches and a half in diameter, with one-third of its circum-ference removed. In this ring are seven holes, halt an inch

apart, into either of which the handle can be screwed, thuspermitting the handle to be placed at any inclination to theopening in the speculum. This is of use sometimes; for whenthe handle and the opening are in the same line, the latteris in the way of the patient’s thighs. In the speculum is an

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opening, one inch at. the largest end, and three-quarters of aninch at the point. Into this is fitted a metal plug, which justfills up the opening, so that a perfectly conical tube is formedfor introduction. After introduction, the instrument is turnedround until the plug is just opposite the ulcer; the latter isthen withdrawn, and the diseased portion is then very clearlyseen falling just into the opening of the speculum. Noattempt to introduce the plug while the speculum is in therectum should be made; but the finger should be passedinto the speculum for the withdrawal.Mr. B. W. RICHARDSON read a paper on

THE FIBRINOUS ELEMENT OF THE n;:’OoD IN RELATION TO

DISEASE.

The author, after a few brief preparatorv remarks, pro-ceeded to observe, that although it was not his intention todiscuss those points which pertain purely to the physiology offibrine, yet that he should not fail to make use of those physio-logical facts which bear directly upon the pathology of thiselement, whenever lie found that the recital of such factswould assist in elucidating obscure parts of his subject. Hethen assumed the presence of niu’ine in healthy blood, andtook for the standard of its amount the figure derived fromthe mean analyses of Laennec,--viz., three parts in the 1000-as being at once the most simple and correct estimate. Duringhealth, fibrine is held in solution by the serum, and perhapsby the salts of the blood, and in its course through the bodyis associated with a pretty constant quantity of albumen. Itis also particularly worthy of remark, that even in health it isalways undergoing slight changes in quantity: sometimes areal change, by virtue of an increase or decrease in itself; andat other times a relative change only, arising from correspond-ing alterations in the other constituents of the blood. Thefibrinous element of the blood during disease may undergodistinct changes in quantity and in quality: 1. It may be in-creased. 2. It may be decreased. 3. It may be altered incharacter.Increase of F’ilwine never occurs without being attended with

a diminution of some other constituent of the blood. Thus,Simon shows that in inflammations the increase of fibrine is

accompanied with decrease of blood-corpuscle, and so on. Thisis a very important fact, inasmuch as it shows how dependent ieach element of the blood is on the other, and how careful Ianalytical observers ought to be, before they conclude that Ia separate constituent of the blood is either increased or de-creased in quantity. But admitting the full force of this re- 1.mark, it must be allowed that the fibrinous element is capableo’f undergoing increase, and it becomes interesting thereforeto inquire-What are the circumstances which lead to suchincrease ? It is now fully demonstrated that the respiratorya.ct is intimately concerned in the formation of fibrine, andthat the proportion of this element in the body is increased ordecreased in proportion with the amount of oxygen imbibedin the respiratory act. Thus the beautiful series of experi-ments lately performed by Dr. Gairdner, prove that the bloodof animals which have been exposed to an oxygenized atmo-sphere soon becomes highly charged with fibrine; and theexperiments of Prevost and Dumas, and the more recent onesof Nasse and Poggiale, show, that in those animals whoserespiration is most active, such as birds, the amount of fibrineis greater than in other creatures; while, on the contrarv, theobservations of Dr. John Davy prove that in all cases wheredeath is induced by any process which deprives the lungs ofatmospheric air, the blood remains destitute of the property ofcoagulation, either from deficiency of fibrine, or alteration inits quality. From this fact, then, it is by no means difficult todiscover how it is that in some diseases fibrine shall be in ex-cess. We may not be able to prove that a highly oxygenizedatmosphere ever produces snoli a state, but we can prove theexistence ofa condition in which the respiratory acts, and cÜ"-culation through the lungs, are so abnormally increased, asto cause a greater exposure of the blood to the atmosphere thanis consistent with health, under which circumstances, rest,snfficient to prevent an equivalent waste of fibrinf, is onlyrequired, to ensure an increase of this element in the blood.And this, Indeed, is just what occurs in practice. In no

diseases is the fibrinous element so increased as in pulmonaryinflammations. Bronchitis, moreover, affords positive audnegative evidence of the fact in question, since, in the firststages of this disease, when a large quantity of blood is ex-posed too frequently to atmospheric influences, the fibrine is

greatly increased; while, in the later stages, when a mucoussecretion is poured out upon the bronchial membrane, thuscutting off the directness of communication betwixt the bloodand the atmosphere, the fibrine falls to its natural standard,

or even below it. This mode of reasoning, however, onlyaccounts for the extraordinary increase of nbrine in pulmonarydiseases; it does not account for the ordinary increase offibrinefound in all Innammations. With reference to the question-What is the true cause of increase of fibrine, and of the ac-companying fever ? - the author, after explaining the in-

accuracy of the hypothesis on this subject by Dr. F. Simon,remarked, that to him it appeared that the inflammation gaverise to the increase of nbrine, and this to the accompanyingexcitement which we call fver; and he related, in corrobora-tion of this view, that in some experiments on rabbits, recentlyconducted by himself, lie had not only found fibrine increaseafter respiration of oxygen, but had observed, also, that inproportion with this increase, there came on quickened cir-culation, arterial tonicity, great heat of skin, and other ofthose symptoms which would indicate inflammatory fever inthe human subject. It might, however, be supposed, that insome cases the increase of fibrine was owing to the samecause as the inflammation itself. Thus, erysipelas was adisease arising purely from atmospheric causes; and in thisdisease there was an increase of the fibrinous element. Theanalogy might be carried out, more or less, to other inflamma-tions. In some diseases, the increased amount of fibrille maybe relative only, owing to a diminution in the other bloodconstituents. Thus, the increase in phthisis, where the skinand bowels often act so freely, may arise from this cause; andso also in Bright’s disease of the kidney, where large quantitiesof albumen pass off with the secretion from the kidneys. Thequestion, whether venesection causes increase of fibrine, isnot yet fairly settled; but the inference is strong that it doesdo so, but only in a slight degree, and by no means in proportionwith the great increase of water, which follows the same cause.Scurvy would seem to hold an anomalous position in thismatter, inasmuch as it is induced by the very causes which,according to modern experiment, lead to a decrease of fibrine ;and yet in the experiments of Dusk on scorbutic blood, it wasfound buffed, and rich in the fibrinous element. Was itpossible that the patients on whose blood these experimentswere performed, were suffering at the time from slight inflain-mation, which gave rise to a temporary increase ot fibrine, assometimes happens in typhus fever ?

Decrease (1 Fibrine. -The causes which lead to decrease offibrine are those which arrest the process of fibrination, oroverwhelm the blood with its other constituents,-such as re-moval of the pure atmosphere from the lungs, absence ofnutritious food, suppressed perspiration, and suppression ofthe other secretions. Hence this decrease is common totyphus and continued fevers, purpura lioemorrhaaica, and thelike. Excessive fatigue also leads to the same results, andfibrine is therefore found deficient in over-driven animals.This fact strongly supports the view, that fibrine is powerfullyinfluenced by the respiratory process. In these cases, themuscles are for a long time worked, and the demand for fibrineis therefore very great. At the same time, the respirationgets impaired from the exercise; the blood consequently isnot fihrinized in proportion with the amount of fibrineimplied; hence such blood is found deficient in fibrine. Fromseventy reports of cases of death by ardent spirits, in whichthe blood was observed bv three American physicians, Drs.Peters, Goldsmith, and Moses, it would seem that alcoholicdrinks lessened the fibrinous element. Mr. Richardson heretook occasion to criticise the present habit of calling that ex-citement of the system which follows all iafla;z;mation, andthat state of prostration which arises from polluted air or fromcontagion, by the one name, fever. He contended that thesestates were different, both pathologically and symptomologi-cally, and that a strict regard for scientific truth demanded adistinction to be made. He aLo criticised the custom of givingsaline medicines (especially nitrate of potash) and alcoholicand profuse watery drinks, in true typhus fever, arguing thatthese substances tended to lessen the consistency of tile plasticelement, which was alreadv deficient in consistency.

Change of dlaracter.-In this section of the subject theauthor confined himself to the consideration of fibrine, asundergoing coagulation in the living body. That fibrinecould coagulate in the heart and vessels during life, was nowcapable of being fully established, the circumstances whichlead to such a state being super-fibrination of blood, reductionof the ordinary diluents of fibrine, slowness of motion in thevessels. Dr. Burrows, in his Croonian lectures, has pointedout cases in which a coagulation of fibrine in the veins arosefrom retardation of vascular motion, and led to arrest ofthe circulation in the extremities. A case of like kind,ending in gangrene of the toes, had fallen under the observa-tion of the author, and was related by him at some length.

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The patient in whom this occurred had had two or threeattacks of this kind, and had once recovered under the use ofmercury, and twice under the free use of saline medicines.Rest was highly injurious to this patient. The formation ofsolid massos of fibrine in the heart is a subject of greatinterest. Mr. Richardson not only believes in the depositionof such masses, but opines that in cases where the blood issurcharged with fibrine, and where an indurated valve exists,there may be suddenly left upon that valve a deposit of fibrilleof sufficient size to block up the orifice, and at once lead todeath. A case in the essay of Dr. Crisp illustrates this modeof death. The peculiar state of the valves, left sometimes byrheumatic fever, cannot, however, be fully accounted for onthe deposition theory. According to the old writers, thetendency to coagulation of fibrine during life has sometimesoccurred in an epidemic form. Two epidemics of this kindwere described. The existence and effects of fibrinous con-cretions in the heart in a chronic form were known to the oldwriters; Gould, Queye, Goetz, Cullen, and many others, par-ticularly notice them, and speak of them as being very liableto produce death by syncope, by plugging up the outlets ofthe heart. The violent palpitations which exist when theseconcretions are present have at all times excited great atten-tion. In the modern school Dr. Hughes has produced anelaborate paper on this subject, and has given cases of suddendeath from these concretions. The author agreed withDr. Hughes, that the right side of the system was the mostcommon seat of such deposits. He also fully coincided withthe opinion of Dr. Barclay, that fibrinous concretions weremost commonly formed in early life. Lastly, in cases ofasthenia, where fibrinous concretions exist in the heart, thevery cessation of the act of life may be owing to their presenceand gradual increase, the central organ of the circulationbecoming literally choked by them. The author concludedby observing that in the construction of his paper he had triedto combine pathological and practical observation withphysiological fact, and therefrom only to draw conclusion. Hewas aware that the attempt had been a rude one, but itoccurred to him that this mode of procedure, however im-perfect, was in the right direction, and that by eliciting theknowledge and criticism of others, it could not fail in the endto prove in some way serviceable. At all events, it was farsuperior to the system of mere empirical medical observationand argument, a system which not only robs its advocate ofmuch real pleasure, but forms the ground-work of the mostabsurd schisms, and impedes mightily the onward and truthfulprogress of a, grand and useful science.A discussion followed, in which Dr. Handfield Jones, Mr.

Chippendale, Dr. James Bird, Mr. H. Lee, and Dr. Crisp tookpart.

__________

Correspondence.

QUERIES RESPECTING SMALL-POX ANDVACCINATION.

"Audi alteram partem."

To the Editor of THm LANCET.SiR,—The importance of the subject on which I am about to

address you, and the interest which it excites at the presentmoment, render it unnecessary that I should offer any apologyfor trespassing upon your valuable time and space.What is the extent of the protection which vaccina:ion is

capable of affording against small-pox? What are the conditionswhich must be observed to render the operation as effectual aspossible? What are the tests which should satisfy us that it hasbeen properly performed? How mnch of the present mortalityfrom small-pox is due to the imperfect performance of vaccina-tion ? How much to the neglect of it? How much, or is any,to be accounted for by its protective power being of limitedduration, or by the lymph employed having been deteriorated inpassing through a succession of human beings? These are a few,and only a few, of the questions which for some time past haveoccupied the attention of the Small-pox and Vaccination Com-mittee of the Epidemiological Society.To arrive at any definite and satisfactory conclusions, it was

found necessary, not only to re-examine existing documents, butto obtain facts from the experience of men engaged in practicethroughout the kingdom: and one of the first acts of the com-mittee was to draw up a set of queries for the purpose of

eliciting the desired information. It was obviously most desirablethat these queries should be addressed to every medical practi-tioner, and this would have been done, had the funds of the

society permitted. But the postage alone of 12,000 copies, (anumber, I believe, considerably short of what would have been re-quired,) allowing to each paper of queries a second penny stamp tofrank the return, would have amounted to £ 100, and would thushave absorbed a much larger proportion of theiucome of the societythan could be spared for one object; and the attempt was, on thisaccount, obviously impossible. The committee were thereforeobliged to limit their applications to those members of the profes-sion who were known to them and to the council as most likelyto afford the information desired; to hospitals and publicdispensaries; and to union medical officers, as a class of menhaving probably the largest experience of the subjects of inquiry.The distribution to union medical officers, which had been sus-pended for a long time for want of funds, is now going on, andwm soon, it is trustea, De compieteci. JutGgetner tne number otpapers sent out amounts to above 1000, and to these between250 and 300 answers have been received. Even the pennystamp affixed to each paper has failed to bring back the remain-ing 700 and upwards. We have thus 700 who have been appliedto, and have not answered; and at least 10,000 more, to whom,not from personal disrespect, but simply from want of means, noapplication whatever has been made. Yet there is not onemedical man in the kingdom who has it not in his power to giveinformation worth possessing on some one or other of the pointsinvolved in this inquiry; and if the paper of queries be wellexamined each would find two or three of them at all events, to,which he would be able to give an answer. The eighteenthquestion, for example, is one to which every one could reply,and if to this alone we had two, three, or five thousand answers,we should have acquired information valuable by its extent andby its being of that definite kind which we so much want. Imay further remark that the important bearing of many of thefacts communicated in the returns we have received, has provedto us how much may be elicited by such inquiries as we have.instituted, and has made us more and more urgent for additionalreplies, in order that we may be enabled to fix our conclusions onthe widest possible basis.But how are these replies to be obtained ? 2 We have ourselves

no further funds to devote to this object. and without assistanceab extra it cannot be done. But with such help, and in the wayI am about to point out, I believe that it may be accomplished.

If you, Sir, would re-publish, in a conspicuous place in yourwidely-circulated journal, twice,-at intervals say of a fortnight,-the whole of these queries, and exhort with your powerfuleditorial pen, which has more than once been wielded on behalfof this inquiry, each and every member of the profession beforewhom they may come, for the sake of our science, and of the in-terests of humanity so deeply involved in the solution of thepoints in dispute, to furnish replies to such of them as he mayfeel able satisfactorily to answer, and to forward them to thehonorary secretaries of the Society, 38, Berners-street, much ofwhat we desire would certainly be done. We do not doubt of

obtaining your help, and we feel ourselves entitled to call uponthe whole profession for their assistance, to enable us to completelabours undertaken solely in the cause of truth, which task ourenergies, absorb our thoughts, and trespass upon our means, butthrough the instrumentality of which we trust to arrive ultimatelyat conclusions based on irrefragable facts, which shall determinemany questions now disputed. Foremost among these is that all.important one, upon which we have lately been informed (onwhat is generally considered high authority) that the majority ofthe profession, in all latitudes and hemispheres, are in doubt, buton which their doubts cannot’be too soon set at rest,-" Are theadvantages, present and prospective, to be found on the side ofvariolous inoculation or of vaccination ?"

I am, Sir, your obedient servant,EDWARD C. SEATON, M.D.,

Hon. Sec. to the Small-Pox and Vaccination Com-mittee of the Epidemiological Society.

Sloane-street, Nov. 1851.

1. Have you any record of the cases of small-pox which havefallen under your observation, whether,

a, Natural ;b, After a previous attack of small-pox ; or,c, After vaccination ;

and if so, would you state the number of each kind, and anyparticulars you may be acquainted with, especially with regardto the ages of the patients and the character of the attack in eachclass of cases?

2. What has been the mortality in each class that you havespecified, and in how many cases, especially in those (1fae1’ vacci-na.tion, could the death be fairly ascribed to small-pox, or to pre-

vious, coincident, or superadded disease ?

I 3. In each case of small-pox after vaccination, how long period had elapsed since the performance of the vaccination ?