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comments on Mr. Hawley’s inspectorial work, but we aredriven perforce to make some additions to the criticismsalready passed on his style of reporting. And first let us say,in justice to Mr. Hawley, that his reports do at least con-trast very favourably with those of Mr. Gulson. Not onlydoes he give a certain amount of detail in his individualreports, but in the general report which he sends to the Poor-law Board he takes some pains to discriminate between theworkhouses which are, and those which are not, in a properstate. Moreover, he remonstrates with earnestness againstsome of the worst defects of workhouse management, and pro-nounces the nursing, in particular, to be unsatisfactoryin a large number of cases. We are glad to be able to say thismuch, since it has given us great pain to be obliged to criticiseseverely the public performances of a gentleman of whose pri-vate worth and excellent intentions there can be but oneopinion. Nevertheless, it is our duty to call attention to thefact that this very series of reports, though in some particu-lars it reflects credit on Mr. Hawley, contains new proof ofthe extent to which the faults of workhouses escape his eye.Of this we can give no more striking instance than the factthat the Farnham workhouse is not mentioned at all in thegeneral summary of defective workhouses; and that the specialreport on it only calls attention to three defects-viz., theabsence of a paid night nurse, the want of an infirmary forchildren and of detached infectious wards. The drainage andventilation are positively spoken to as sufficient and good. Notone word about the filthy privies, the periodically chokeddrains, and the hideous open sewage tank into which theepileptic afterwards fell; not one word about the disgustingscantiness of the towel supply ; in fact (not to weary ourreaders with its numerous omissions) this report fails utterlyto convey the idea of any serious general defects in the con-struction and management of the place. And we regret to saythat this is not the only instance, by any means, in which ourCommissioners, from their personal acquaintance with a par-ticular workhouse, are aware that Mr. Hawley’s report uponthat house is worthless from its imperfection.We cannot, however, find space to continue in detail our

remarks on the work of inspection as performed in the respec-tive districts, and on the facts which it has brought to light.We must endeavour in a few general remarks, to convey thepith of the lesson which these reports teach us. And first, asregards the mode of inspection adopted, it will be plain toanyone acquainted with workhouse matters, that the inspec-tors who had had their eyes opened (before these documentswere written) by being brought into personal collision with theworkhouse scandals exposed by medical Commissioners arejust those who in this Blue-book are found complainingseriously about numerous matters connected with the countryworkhouses generally, and whose reports, taken as a whole,convey to the unprejudiced reader the distinct idea that theexisting system is generally faulty and bad. Those inspectors,on the other hand, who speak with complacency of the generalstate of things in their districts, and who find little or nofault with the several workhouses under their care, are pre-cisely those who had not been startled from the apathy ofroutine by being brought unexpectedly in personal contactwith a scandal detected by better-educated eyes than theirown.

What are the public and the profession to believe about thismatter ? Does human nature, and especially guardian nature,vary so strangely in different districts of England as to makeit probable that such gross neglect of the poor exists as thatwhich Mr. Cane describes as prevalent in the larger part ofhis territory, while in the workhouses of the south-west ofEngland, under the searching eye of Mr. Gulson, all is peace,order, happiness, and efficiency ? Let those believe it whocan; for our part we are convinced that such extraordinarydifferences are impossible. And as Mr. Cane gives specificfacts, while Mr. Gulson expresses himself in monosyllabicgeneralities, we are compelled to believe that the latter gentle-man’s optimist view of the situation is no representation of thereal facts, but that he has missed them, because he has notsearched for them in the proper manner.As regards the indications for future action which this Blue-

book affords, we may say that they are unmistakable and ofpressing importance. It is now evident that boards of guar-dians everywhere, with the exception of a few large townswhere, from accidental circumstances (as at Manchester,Liverpool, &c.), men of unusual intelligence and liberality takean active part in parish affairs, are utterly incompetent to theduties assigned to them. It is obvious also, that the in-efficiency displayed in regard to the management of the sick is

equally displayed in the local treatment of all varieties of pau.perism. The hideous social ulcer is not checked, but aggra-vated by the cruel (and really wasteful) parsimony of theboards. Pauperism is increasing in this country withalarming rapidity, as Dr. Stallard has recently demonstrated.We again urge Lord Devon to grasp the whole seriousness ofthe situation, and to move for a Royal Commission of Inquiry,which shall deliberately reconsider the entire machinery ofour Poor Law ; and we are happy to be supported in this pro-position by the opinion of Miss Florence Nightingale, thanwhom no one better understands the existing state of things,and who has recently stated that no partial reforms can effectany large benefit, but that the whole Poor-law system requiresreconsideration.

ENTHETIC DISEASE IN THE MERCHANTSERVICE.

WE have been gratified by the perusal of a circular issuedby the Board of Trade, consisting of a letter from Dr. WalterDickson on the above subject, in which the extension of theContagious Diseases Act, with a few necessary modincations,is advocated, in order that the mercantile marine may profitby its operation to the same extent as the seamen of the RoyalNavy.

Dr. Dickson points out that seamen of the mercantile marineare equally exposed to those diseases with men of the Armyand Navy, and that they suffer incalculably more from theirconsequences, inasmuch as the great majority are so circum-stanced that they cannot have access to medical aid. He

hopes that benefit may result from carrying out the medicalinspection of seamen recommended in the " Merchant Ship-ping Act of 1867"; but he considers that it is only by a generaland thorough application of the personal test-that is, by ex-amining all such women as there are good grounds for sus-pecting, by withdrawing all diseased prostitutes from theirvocation, and placing them under treatment till they arecured,-that we can hope to encounter the evil with a fairprospect of abating its ravages among the seafaring commu-nity. The measure should be applied to all ports; and of thenecessity for it in the port of London there can be very littledoubt. Dr. Dickson considers that provision would have to bemade for the accommodation of between three and six hundredin this port, and as it would require to be more ample at theoutset than afterwards, he recommends the appropriation oftwo large hulks as a temporary expedient, and suggests thatan efficient and inexpensive administration might be securedby appointing naval or military officers from the half-pay list.In the new metropolitan infirmaries, to be erected under thedirection of the Poor-law Board, wards might be hereafter setapart for this class of patients. Meanwhile, if the hulks wereused as temporary lock hospitals, they could be moored someway down the river, and dispensaries or other offices could beprovided in towns for the inspection of the women.

Dr. Dickson estimates the current expenses of such hos-pitals at from £8000 to £12,000 per annum. And the questioncomes, how is this considerable charge to be defrayed? Unlessthe scheme should be merged in the project of metropolitanhospitals for the destitute sick indicated above, it would seemunreasonable to expect from the public purse, Dr. Dickson

’ thinks, more than the expenses of administration, as salariesof officials, &c. He considers that shipowners, and masters

: and their crews, ought to contribute in some fashion their dueproportion to the maintenance of the necessary establishments,

’ considering the great advantages they would derive from theadoption of such legislative measures.

MEDICAL TEACHERS’ ASSOCIATION.

THE next General Meeting of the Association will be heldat 37, Soho-square, on Monday, the 16th of March, at eighto’clock r. M. precisely, when the following resolutions will besubmitted to the meeting :-That in the opinion of this Association it is desirable that

the out-patient department of hospitals should be systemati-cally utilised in clinical instruction, and that a committee beappointed to draw up a scheme for the purpose, with a viewto its being considered by the Association.

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That it is desirable that the Medical Teachers’ Associationshould take into consideration the supply of anatomical sub-jects to the schools.

On Editcational Reform.That the present medical curriculum urgently requires

revision.That botany and elementary chemistry should be removed

from the list of subjects taught at the medical schools, andform a part of a preliminary scientific examination to be passedby students before the commencement of their professionalstudies.

That separate courses of lectures on comparative anatomyat the individual medical schools should be discontinued.That courses of lectures on botany, chemistry, and compa-

rative anatomy should be delivered annually by eminent pro-fessors of these sciences at some central institution in themetropolis, and be expressly adapted for the purpose of teach-ing the sciences to those who are destined for the medical pro-fession.That compulsory attendance on more than a single course of

lectures on any of the subjects required by the examiningboards should at once be abolished.That instead of the present certificates required from medical

students of having attended the medical and surgical practiceof a recognised hospital for a certain number of years, evi-dence should be adduced of proficiency in dressing, in thephysical methods of examining patients, making post-mortemexaminations, and performance of operations.

Correspondence." AiLidi alteram partem.11

MEDICAL EDUCATION.To the Editor of THE LANCET.

SIR,-I have been for seventeen years engaged in teaching ;for the last three years I have been a student of medicine, andI therefore venture to hope that you will allow me to say inyour columns what I think upon the subject of medical edu-cation.With Mr. Simon, I regard the present system of schedules

as worthless. Schedules do not certify that a man has gainedany knowledge, and are an annoyance, I believe, both toteachers and taught. But I think that the majority of lec-tures are equally unnecessary and annoying. Take, for in-stance, a lecture on Anatomy. Who could learn, say thetemporal bone, simply from hearing it described by the lec-turer, or get up the relations of the axillary artery by thesame process ? What student depends upon lectures for gain-ing a knowledge of materia medica, or chemistry, or anythingelse that may be learned from books ?

I believe the teachers under whom I have studied are able,conscientious, and industrious; but I also believe that boththey and the students under them have wasted many a valu-able hour by following too closely the traditions of the elders.One lecturer on Anatomy, I am glad to say, has broken

through the old system. Instead of merely demonstrating aportion of the subject each morning, he announced that hewould not lecture at all, but would examine (or ° grind ")during the hour usually devoted to lecture. The part onwhich he would examine was mentioned beforehand, and eachstudent was expected to read it up.

I admit that nothing can compensate for clinical lectures.The art of diagnosis can never be learned from books, anymore than can a knowledge of the variations in general treat-ment which may be required by the circumstances of eachparticular case ; but many of the courses we are required toattend are nothing but useless nibblings at our time, and, if

they are intended to teach, very generally fail in their object.But if lectures are so objectionable, what system is to be

substituted ? I venture to suggest that each teacher shouldbe allowed to please himself as to how he communicatesknowledge; that attendance on his teaching should not becompulsory ; that at the end of a student’s first year he shouldbe compelled to undergo an examination at the school at whichhe is a student in certain subjects-osteology and chemistry.-and, should he fail, be still counted a first year’s student ;that at the end of his second year he should be compelled topass another examination in anatomy, physiology, and materiamedica, either at his own school or at some recognised board

of examiners, with the same penalty for failure; that at theend of the third year he should be examined in midwifery andsurgery, and at the end of his fourth be allowed to presenthimself before the examiners of the body of which he wishesto become a member.A student would thus be compelled to gain a definite

amount of knowledge each year-how gained matters little.He would become a fourth year’s student by hard work, andnot by mere lapse of time. If he found the lectures valu-able to him he would attend them; the best teacher wouldhave the largest class, and both teachers and students wouldreceive a stimulus beneficial to each.

Hospital attendance ought not to be insisted on until theend of the second year. Each hospital physician and sur-geon should have a separate class (the best teacher wouldhave the largest), instead of each student being expected toattend each physician and surgeon; and a six months’ dresser-ship should be compulsory.

Such, Sir, are the changes which might, in my humbleopinion, be introduced. The present system is burdensomewithout corresponding advantages. It is a relic of the past ;like the old Brown Bess, it is more blustering than effective,and too cumbersome to be retained long in use, except byveterans whose fighting days are long since over.

I am, Sir, your obedient servant,Feb. 4th, 1868.

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SCALPEL.

RETIREMENT OF INSPECTOR-GENERAL MOUATON HALF-PAY.

To the Editor 0/THE LANCET.SIR,-In your issue of the 7th inst. a correspondent, under

the very questionable signature of " Fair Play," accuses othersof misrepresentation on the subject of Inspector-GeneralMouat’s retirement, and professes to enlighten your readerson the facts of the case.You, Mr. Editor, I presume, consider him a good authority,

or of course you would not have published his communication.As a general rule, it is not usual for officers to notice anony-

mous statements in the newspapers, unless affecting their con-duet or character. In the present instance I cannot refrainfrom pointing out that your correspondent’s remarks regardingmy case are unfounded. As I am in possession of a copy ofthe proceedings of the Board, I am enabled to state that Ihave not been found unfit for general service. Nor have I re-fused to proceed abroad in my turn; on the contrary, I haveexpressed my willingness to do so at all risks, notwithstandingthe recommendation of the Medical Board that I should beallowed, on account of my state of health, to proceed at theend, instead of the beginning, of the hot weather-as I wasordered to do. Your correspondent is equally in error regard-ing the duties of Medical Boards, who are bound to findspecially, in accordance with their instructions. And he hasmisrepresented my service abroad, which exceeds the regularperiod by eighteen months; the greater part of the time, ifnot actually an Inspector-General, performing the duties ofone. The cases of the gentlemen referred to by name areanalogous to mine in one respect only-they have been placedon half-pay : whether deservedly or not it is not for me to say;but even if they were, it is no argument in favour of a systemif wrong or unjust.As I have been thrust out of the service with what may

almost be termed unseemly if not indecent haste, and in amanner calculated to reflect on my character, I feel constrained,in self-defence, to print the whole correspondence for privatecirculation; when my friends, as well as my enemies (for nosuccessful man can pass a long period without making some),will have an opportunity of judging how far the circumstancesjustify the extraordinary proceedmg. Your correspondent,under a mask, has had the bad taste to sneer at my services;but as he has prudently, though not valiantly, withheld hisname, it is impossible to say what right he has to do so. Ican safely afford to leave him to the contempt his mean at-tempt to prejudice my case and mislead your readers deserves.

I am, Sir. vour obedient servant.J. MOUAT,

Inspector-General of Hospitals (Half-pay).

THE CASE OF CAROLINE SIDDLE.To the Editor of THE LANCET.

SIR,-In the notice of the case of Caroline Siddle, whichappears in THE LANCET of the 7th inst., an allusion is madeto the amount of my extras, and to the supposed fact that I