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are correct, but, of course, as already said, the advantage of awipe commutator and a trember coil is that frequently theengine will start on the switch.Seemingly there is keen rivalry among the petrol dealers.

Quite recently one firm advertised that they would give 5s. for every hundred petrol can seals sent in before a certaindate. Unless the car owner is his own driver I do not thinkhe will appreciate this, as it is an incentive to his chauffeurto be extravagant with the petrol ; so, though I wouldwelcome a reduction in the price of this needful spirit, Iam glad to hear that this offer will shortly be withdrawn.And speaking of petrol reminds me that a formidable rivalhas come. Lately I was at the Ordnance Wharf of the SouthMetropolitan Gas Company to examine an ambulance class,and the manager very kindly put in my car on leaving a canof benzol, which is made there, with a request that I woulduse it instead of petrol. To give it a thorough trial Iremoved one cylinder cover and thoroughly scraped andcleaned it. I then adjusted the carburettor to admit moreair, emptied out all the petrol, and filled up with the benzol.The result was satisfactory; the power was as good andafter a few days’ run I inspected the cover and still foundit clean and free from deposit. The conclusion, therefore,is that benzol, with the carburettor widely open, answersjust as well as petrol, and in addition it has this advantage-it can be had for 8d. a gallon, whilst petrol costs ls.

MEDICINE AND THE LAW.

A J1Ø’Y’S Recommendation -with Regard to UnqualifiedPractice.

AT a recent inquest at Kensington upon the body of agentleman named Oswald Thom the jury found a verdict of"Suicide while of unsound mind," and added a rider condemn-ing the practice of "allowing unqualified people to treatsuch cases." The evidence showed that the deceased, whowas subject to melancholia, lived with a Captain Denniswho acted as his companion, having known him for sixmonths. A few days before the deceased took his own lifeCaptain Dennis accompanied him to the house of a Mr.Mills, living in South Kensington, who examined him andsuggested that he should stay in London for treatment for afortnight. Mr. Mills was prepared to see him daily and tocharge one guinea for the consultation and half a guinea eachfor the daily visits. In the witness-box he described himselfas a physician qualified by a degree granted at the Universityof Philadelphia but without any qualification to practisemedicine in England. He further said that he was

a lecturer on mental and spiritual healing but not a

"Christian Scientist." He was in the habit of lecturinghis patients with regard to mental cases and in spiritualcases he emphasised the idea that God is all-powerful.He wished to describe his treatment as healing by suggestionand affirmed that part of it consisted of prayer. In spiritualcases he did not talk to the patient but sat beside him anddid the healing silently. The coroner commented upon a

system of exhortation or advice administered silently andthe death of Mr. Thom, who hanged himself with a pocket-handkerchief three days after his visit to Mr. Mills, togetherwith the jury’s rider, illustrates observations made inTHE LANCET of Dec. 12th, pp. 1759-60.

Mandamu-s to Appoint ec Medical Sitperintendent.The case of Rex (Courtenay) v. Joint Committee of Carlow

Lunatic Asylum, which came before Lord O’Brien, LordChief Justice, and Mr. Justice Boyd in Dublin, and is

reported in 42 Ir. L. T., p. 233, raised a question of con-siderable importance to medical officers of asylums. Itwas an application by Dr. Edward Maziere Courtenay,Inspector of Lunatic Asylums, for a writ of mandamus tocompel the joint committee of management of the CarlowDistrict Lunatic Asylum to appoint a resident medicalsuperintendent of the Carlow District Lunatic Asylum irFebruary, 1907, and the joint committee of that asylumdecided at its ordinary meeting held on Feb. 13th tc

adjourn the consideration of the matter to a special meetingto be held on Feb. ,27th, 1907. On Feb. 27th a motioiwas carried-

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That Dr. McKenna be appointed acting resident medical superintendent pending the permanent appointment, notice of salary fothe new appointment to be given at the next board meeting for consideration at the April meeting.

.t a meeting on Sept. llth, 1907, the following motion’as carried :-

That at a meeting of the joint committee of the Carlow DistrictLunatic Asylum held on Sept. llth for the purpose of appointing aMident medical superintendent, when Dr. McKenna’s application forhe post was the only one properly before the meeting, it was resolvedhat his appointment of Feb. 27th last as acting medical superintendente continued for twelve months.

t is provided by Section 84 (2) of the Local Government Act,898, that every such officer shall be a medical practitionerIf not less than seven years’ standing and shall haveserved for not less than five years as a medical officer orLssistant in an asylum for the treatment of the insane.)r. McKenna attained the qualifying service of not lessihan five years as an assistant medical officer in an

asylum for the treatment of the insane on July 8th, 1908,met he would not qualify as a registered medical practitioner)f not less than seven years’ standing until May 20th, 1909.Dr. Courtenay addressed a letter to the joint committee onOct. 7th, 1907, calling attention to Dr. McKenna’s want ofqualification and demanding on the part of the Inspectors ofLunacy that the provisions of the law should forthwith becarried out. Further correspondence took place between thejoint committee, the inspector, and the Assistant Under

Secretary. On April 30th, 1908, the Assistant Under Secre-tary addressed the following letter to Mr. Keenan, the clerkof the joint committee: " In reply to Mr. Keenan’s letterof the llth inst., in which it is stated that the joint com-mittee of the Carlow District Lunatic Asylum at their

meeting on the 8th inst. decided to issue advertisements

calling for candidates for the office of resident medical super-intendent, the appointment to be made at the ordinarymeeting of the committee in May, and the office to be heldtemporarily for a period of 12 months, I am directed by theLord Lieutenant to inform you that His Excellency can in noway assent to the proposed limitation of the tenure of theresident medical superintendent. His Excellency is advisedthat the appointment should be made without any such con-ditions or limitations, which would be opposed to both thespirit and requirements of the law, and the joint committeeat their meeting in May must therefore elect a residentmedical superintendent without such conditions, otherwiseHis Excellency regrets that it will be necessary for him toproceed as already stated and refer the matter to the

Attorney-General with a view to the commencement of legalproceedings to compel the committee to comply with thelaw." " The following motion was carried by the jointcommittee :-

That in view of the fact that the letter from Sir J. B. Doughertyforbids the joint committee to make an appointment of a fully qualifiedresident medical superintendent for one year, and that they considerthey cannot legally carry out the instructions conveyed in that letter ofmaking a permanent appointment, they feel that the only course theycan adopt is to adhere to their original resolution of Sept. llth lastappointing Dr. McKenna to the post of acting medical superintendentfor twelve months from that date.

It appeared from the affidavit of Dr. McKenna showingcause that at the meeting of the committee held on April 8th,1908, it was resolved that an advertisement should be issuedfor candidates for the office in question, the appointment tobe made at the meeting to be held in May, 1908, and theoffice to be held temporarily for a period of 12 months, theduties and conditions of the appointment to be in accordancewith the Privy Council Rules and the Local Government

(Ireland) Act, 1898. Accordingly, advertisements in pur-suance of this resolution were issued by the joint committee,and several applications from persons duly qualified werereceived. In the meantime, however, the letter of April 30thfrom the Assistant Under Secretary was received, andaccordingly the resolution set out above was passed by thejoint committee in May. Mr. Justice Boyd in the course ofhis judgment said that in his opinion they would render

nugatory the whole of the provisions of Section 9 of the’

Local Government Act if they did not make the orderl absolute. The committee, without their acts havingbeen confirmed by the county council, had taken onl themselves to dictate who was to be appointed. The law) was express on the subject that the resident medical super-! intendent must be a registered medical practitioner of not1 less than seven years’ standing and must have served for not

less than five years as a medical officer or assistant medical’- officer in an asylum for the treatment of the insane. It was

radmitted that Dr. McKenna did not fulfil either one orl-

other of these requirements, and was therefore disqualified

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for the permanent appointment of resident medical super-,intendent. What was done and by whom’? The committee

.appointed Dr. McKenna acting resident medical superintend-ent for a limited period. In his opinion the office still,remained one to be held during the pleasure of the Lord,Lieutenant, and it was absurd to say that the committee, by’making an appointment for a fixed period, could take awaythe power of the Lord Lieutenant to dismiss at pleasure.For these reasons he was satisfied that a qi?andam?4s lay- against the joint committee, though he had arrived at thisconclusion not without some doubt in consequence of thewords of Section 9 (9) of the Local Government Act.

A Medical Man’s Dzcty as Witne..Q8.In the course of a prosecution in Tromso of a person

accused of spreading venereal disease the medical man bywhom the accused stated that he had been treated was.summoned as a witness. The accused consented to the

practitioner giving evidence ; but the latter refused ’to giveany evidence as in his opinion his duty as a medical man andhis right to plead professional secrecy prevented his doingso. He argued that his books contained -several namesidentical with that of the accused, but that he did notremember the accused, could therefore not identify him, and,in these circumstances were he to make a statement abouta patient he might confuse one patient with another and,thus betray that other patient’s confidence. He refused

altogether to state whether he had treated the accused ornot. The court, dealing with this point, found that a

medical man’s exemption from giving evidence on confi-dential matters does not justify him in withholding evidencewhen the patient has consented to such evidence being- given. In these circumstances the status of a witness isthe same for medical men as for others. But if the

practitioner is unable to identify the person concerned"his evidence must be limited to a statement of this fact,without his being forced to give any further explanation. Inother words, the medical man is bound to give an explana-tion, though with the same limitations applying to all

witnesses-i.e., he need not commit himself to statements,the accuracy of which he is not positively certain of. Themedical man brought the point before the Court of Appeal,the decision of which agreed with the judgment quoted andthe reasons given therefor.

THE CASE OF MABEL FLORENCE JONES.

Dr. F. J. WALDO, at the City coroner’s court on Dec. 30th,1908, resumed the inquiry concerning the death of Mabel!Florence Jones, aged two years and seven months, who re-sided with her parents at Henley-street, Battersea, and diedon Dec. 18th. Mr. Maurice N. Drucquer, instructed byMr. R. Tweedy Smith, appeared for the National Anti-vivisection Hospital, where the child was first treated for afracture of the skull prior to her death at St. Bartholomew’sHospital on Dec. 18th.Mr. DRUCQTTER at the commencement of the proceedings asked if he

might examine the house surgeon (Mr. N. Davis) from St. Bartholomew’s’who appeared at the last hearing.The COROER: If you have any questions to put as regards the

death of the child you will have an opportunity of putting them to anyof the witnesses who are to be called. Dr. Waldo then proceeded togive a review of the evidence given at the previous sitting on Dec. 19th.’That evidence was to the effect that about three months ago the childwas playing in the back yard when a youth named David George Winsonliving two doors away threw over the wall a small pick-axe which hadbeen borrowed and had struck the child on the head. She was taken to’the Battersea National Antivivisection Hospital, where her head wasstitched by the nurse in charge. The stitches were taken out on thefollowing day, and according to deceased’s sister she was told that the’child need not attend again. Some weeks later the child suddenlybecame ill, and after being seen by a local doctor was taken to St.Bartholomew’s Hospital, where she died a few days subsequently. It’was found that her skull had been fractured and death was due to septicmeningitis. The child’s head was said to be dirty, and Mr. NewtonDavis, house surgeon from St. Bartholomew’-s Hospital, gave it as hisopinion that at the National Antivivisection Hospital the fracture oughtto have been detected and that if the child had been admitted and properlytreated the meningitis would not have arisen, or at least the child’slife would have had a better chance under hospital treatment.EMILY Louis. JONES (recalled) was the tirst witness at the adjourned

inquiry. Questioned by Counsel fortheNational Antivivisection Hospitalshe said she took the child there on Sept. 27th with the youngmanWinson.The head was washed carefully and the child was taken to Mr. Da Costa.She actually saw the child’s head stitched by Nurse Davis. While the- second stitch was being put in she (witness) had to go out, she could notstand it any longer. She saw the three stitches in the head. Next day"she again took the child to the hospital and saw the other nurse, Nurse

Powell, not the doctor first. Nurse Powell told her then not to bringthe child again. No one reprimanded her about the dirty state of thechild. The doctor did not tell her to bring the child next day. The doctordid see the child next day at about 11 P.M. She first went to the nurse topay the fee of 4d. Nurse Powell took out the stitches. She (witness) hadwaited there since 6 o’clock. She took the child to St. Bartholomew’sHospital on Dec. 15th. She never told anyone that the child had beenstruck 14 days before. Winson’s mother saw to the child’s head andused to bathe it, from Sept. 29th, and she (witness) attended to it also.She could not say why the child was not taken back to the National Anti-vivisection Hospital. It was not a fact that the child was not taken backbecause the nurse had reprimanded her very severely about the dirtycondition of the child. Witness further stated in answer to a Juror thather mother was blind in one eye and nearly blind in the other.Mr. NEWTON DAVIS (recalled) said he understood that the child had

met with some injury a fortnight before her admission to St. Bartholo-mew’s Hospital. If the child had been going about those 14 days it wasdue to great carelessness on somebody’s part, and if the child had beenleft to the care it had for nine weeks after fracture of the skull heshould expect to find what he saw, The fracture was through bothtables of the skull. The outer layer of the periosteum was brokenthrough and it must have occurred at the time of the fracture. Puswas oozing from the wound. He found a piece of bone quite separatelying under the fracture. He could not tell whether the injury was anactual cut, and when he saw the wound it was in such a state that itwas impossible to tell whether it was affected by the process of theseptic meningitis. The wound was full of granulating tissues when hesaw it. In known cases of fracture of the skull he never allowed achild to go out of the hospital. In looking for symptoms of fracturedskull he would first of all examine the wound and ascertain whetherthere was any exposed bone and depression of the skull, then lookfor any rough edge, any suffusion of the eyes, and any bleedingat the eyes or nose, sickness, enlarged pupils, or coma. Ifthere were none of those symptoms he would probe for splinteredbone. In some cases although splintered bone was present it would bepossible to probe and not find it, but not in the present case where thefracture was at the seat of the injury itself and the bone was separated.If after such an instrument as that produced (the pick-axe) a blow waseffected on the head and a wound was caused and there was injury ofthe periosteum and fracture,-in that case if the wound had beenexamined with ordinary skill, in his opinion the fracture would havebeen discovered by probe. Fractures could be divided up into directand indirect. In cases of direct fracture like the present case thefracture was at the seat of the injury, in indirect cases the fracture wasnot at the seat of the injury. In his opinion a fracture could not becaused without the instrument going right down to the bone itself. Inany case where there was no fracture but only a clean wound therewould be negligence in stitching the wound up if it were not firstproperly examined and sending the case’away, but no negligence if thewound was proved to be only a clean cut. It would be very negligentfor a doctor to dismiss even a clean cut from the hospital within twodays after the stitches were removed. It was possible for the stitchesin the course of nine weeks with a suppurating wound to have workedthemselves out from the decayed surface. It was very unusual for achild of deceased’s age to have a fractured skull and then run about,as stated, for nine weeks. He would not say it was impossible, if thechild had fallen on its head, for the wound to have been caused

thereby.The CORONER: There is no evidence of any injury to the child

between the first injury and the time that Mr. Davis saw her.Questioned by the Coroner Mr. DÂV ]further stated that at the post-

mortem examination Mr. Gordon Watson dissected the body in hispresence and he (witness) made notes of the conditions.Mr. EDWARD RONALD DA CosTA stated he was a registered medical

practitioner and resident medical officer at Battersea General Hospital-the National Antivivisection Hospital-and he resided there. He wasa retired army doctor and had been at the National AntivivisectionHospital three years. He was also on the active reserve of the IndianMedical Service. On Sunday, Sept. 27th, at 12.30 P.M. as his accidentbook showed, he was sent for by the staff nurse who informed him thatan accident case had been brought in-the child in question. He sawthe child and Nurse Davis was with her. He remembered seeing alsothe young man in the room but not the sister of the child. The

young man told him that the child had been struck on the head with apiece of iron. The nurse was washing the child’s head clean and thechild herself was in a dirty condition. He could find no depression on’the skull or any loose fragment of bone. After doing manual examina-tion he used the probe. There was a fairly clean-cut incised wound onthe right parietal region. He examined most carefully and the probedid not reach bone at all but was absolutely on flesh. He told the nurseto stitch the wound and she put in three silk sutures. It was No. 1silk; they never used silver wire at the hospital.The CORONER : Is it usual for a nurse to do these minor operations,

such as stitching up ?WITNESS replied that their nurse was quite capable of doing it; she

was a fully qualified nurse. She put the sutures in under his direction.No ansesthetic was given. The wound was dressed with gluto andbandaged antiseptically and he told the sister, after the bandaging, notto disturb the dressing and to bring the child again next morning. Hedid not consider the case was one for admission as an in-patient. Inthe National Antivivisection Hospital there were 30 beds and some cotsfor children. They could make up a bed in an urgent case.The CoRONER: I notice on page four of the Annual Report for 1907 of the

National Antivivisection Hospital, Battersea, this statement: " There areno vivisectors on its staff, no experiments on patients, and there will beno vivisection in its schools when they are established." No experimentson patients-what is meant by that ?WITNESS: I do not know; I do not know that any hospital has experi-

ments on patients.The CORONER: Is it usual in general hospitals to experiment on

patients ? PWITNESS : No, sir; but other hospitals are equally at liberty to put that.

Mr. Da Costa in his further evidence said that the hospital had some-thing like 21,000 out-patients in a year and had 230 in-patients last year,270 operations, 1271 accidents, and 10 deaths. He did not attend any-body outside the hospital; his hands were fairly full. He had seennurses put in stitches in other hospitals in England. The child was per-fectly conscious, with no signs of haemorrhage or fracture of the skull ordifference in the size of the pupils or paralysis. The sister of the child