736

Medical Diary of the Week.Monday, May 24.

ST. MARK’S HOSPITAL.—Operations, 1 P.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.—Operations, 101 A.M.METROPOLITAN FREE HOSPITAL.-Operations, 2 P.M.

Tuesday, May 25.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFZELDS.—Operat10116, 10½ A.M.Guy’s HOSPITAL.—Operations, 1½ P.M.WESTMINSTER HOSPITAL.—Operations, 2 P.M.NATIONAL ORTHOPEDIC HOSPITAL.—Operations, 2 P.M.ROYAL INSTITUTION.—3 P.M. Prof. Grant, " On Stellar Astronomy."ROYAL MEDICAL AND CHIRURGICAL SOCIETY.—8½ P.M. Mr. G. G. Gascoyen,

" On a Case of Iritis occurring in Syphilis treated without Mercury."

Wednesday, May 26.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.—Operation, 10½, A.M.MIDDLESEX HOSPITAL.—operations, 1 P.M.ST. BARTHOLOMEW’S HOSPITAL.—Operations, 1½ p.M.ST. THOMAS’S HOSPITAL.—Operations, 1½ P.M.ST. MARY’S HOSPITAL.—Operations, 1¼ P.M.GREAT NORTHERN HOSPITAL.—Operations, 2 P.M.UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M.LONDON HOSPITAL.—Operations, 2 P.M.OPHTHALMIC HOSPITAL, SOUTHWARK.—Operations, 2 P.11.

Thursday, May 27.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.—Operations, 10½ A.M.ST. GEORGE’S HOSPITAL.-Operations, 1 p.M.UNIVERSITY COLLEGE HOSPITAL.—Operations, 2 P.M.WEST LONDON HOSPITAL.-Operations, 2 P.M.ROYAL ORTHOPÆDIC HOSPITAL.—Operations, 2 P.M.CENTRAL LONDON OPHTHALMIC HOSPITAL.—Operations, 2 P.M.ROYAL INSTITUTION.—3 P.M. Prof. Tyndall, "On Light."

Friday, May 28. ,

ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, IOJ A.M.WESTMINSTER OPHTHALMIC HOSPITAL.-Operations, 1½ P.!.I.CENTRAL LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M.ROYAL INSTITUTION.-8 P.M. Mr. J. N. Lockyer, " On Recent Discoveries in

Solar Physics made by the Spectroscope."CLINICAL SOCIETY OF LONDON.-8½, P.M. Report from the Committee on the

Use of Carbolic Acid. - Dr. Murchison, " On a Case of Cholera treatedwith Saline Injection into the Veins at a Lower Temperature than thatof Blood;" " On a Case of Gastro-Enteritis." - Mr. Holmes Coote, " Onthe Treatment of Syphilis."-And other papers.

Saturday, May 29.ST. THOMAS’S HOSPITAL.—Operations, 9n A.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.—Operations, 10½ A.M.ROYAL FREE HOSPITAL.—Operations, 1 P.M.ST. BARTHOLOMEW’S HOSPITAL.-Operations, la P.M.KING’S COLLEGE HOSPITAL.—Operations, la p.M.CHARING-CROSS HOSPITAL.—Operations, 2 P.M.ROYAL INSTITUTION.-3 P.M. Mr. Emanuel Deutsch, " On Semitic Culture."

Notes, Short Comments, and Answers to

Correspondents.THE SEWING MACHINE AND HEALTH.

ON the introduction of the sewing machine, it was to have been anticipatedthat the grounds which furnished Hood with the idea of his "Song ofthe Shirt" would have been removed; but if we can get cheaper shirts andclothing at the cost of a smaller sacrifice of human health and life now,the sewing machine has not failed to introduce evils of its own kind. Ithas been found in Paris and elsewhere that the female operators withthese machines are liable to suffer from anaemia, dyspepsia, and debility;and the muscular exertion required in working them has necessitated inhouses of correction that the ordinary diet of the female prisoners be sup-plemented in some way. We learn from the Scientific American that severalsuggestions have been made of late to remedy these evils by making thesewing machine automotor. In large establishments, where numbers ofthem are in daily use, steam has been applied, and with success. Steam

power, however, could not be introduced into ordinary dwelling-houses,and some other motor power must be employed for the purpose. The onlypractical device of the kind is the electro-magnetic automotor invented inFrance by H. Cazal, which is said to occupy so little space that it can behidden under a footstool. A short description of the machanism employedis afforded in Scientific Opinion of the 5th instant. The idea appearsto us to be excellent; but the machine of H. Cazal requires much in theway of improvement and modification in order to make it perfect. Dr.Richardson is so ingenious and fertile in expedients, that we venture tocommend the subject for his consideration during his "leisure hours."

Dr. Patrick Herozz Watson’s (Edinburgh) case of Tumour in the PterygoidSpace" shall be inserted next week.

Mr. Herbert Cotton.—We cannot give the direct information. Apply to theSecretary at the College of Surgeons, Lincoln’s-inn-fields.

THE ILKLEY CHARITY HOSPITAL.

IN the year 1859 a committee of gentlemen was formed to carry out a projectfor the establishment of a convalescent institution at Ilkley, situated in amost picturesque valley of the Wharfe, and to receive the poor residents ofLeeds, Bradford, and other places, who, recovering from serious illnesses,had been heretofore compelled to regain their health as best they could inthe ill-ventilated dwelling places of these towns. In 1862 an hospital wasopened for the reception of convalescents, and the account of the lastseven years’ work has just reached us. Starting with 449 inmates in theseason of 1862, the numbers have gradually augmented to 691 in 1868, theper-centage of cures increasing in like proportion. The internal arrange.ments of the hospital seem to be very good. The building is designed forthe accommodation of male and female patients, each having large sepa.rate dining and sleeping rooms, with necessary conveniences attached.Great care has been taken to secure proper ventilation. Seventy patientscan be housed at one time. The hospital is opened from April to October,and patients are allowed to remain three weeks as a rule; but, on the re-commendation of the medical officers, and the payment of seven shillingsa week, this time can be extended. The patients are allowed to seek thepure and bracing air of the Ilkley hills, and to promote their recovery inevery possible way. The diet is a liberal one. A proposition is on foot toenlarge the institution.

..d. late Colonial Secretary, Gambia.—The practice of applying clay or earthis not, we believe, very uncommon, and we do not see that anythingwould be gained by publishing our correspondent’s letter.

THE letter of the Vicar of Seaford shall appear in our next impression.

ADMISSION TO HOSPITALS.To the Editor of THE LANCET.

SIR,—In your article on the Brighton Eye Infirmary (p. 683), the desire isexpressed "of finding a precedent for the course suggested." It is true,Manchester is not a town of "moderate population." But this is what hasso far been achieved at the Royal Eye Hospital here. In the year 1862, ap-plicants-not only accidents-began to be admitted on merely verbal appli-cation, as well as on tendering a recommendation. No rule required to bealtered, as the existing rules did not hinder any surgeon so inclined fromadopting the new practice. The number of patients thus admitted withoutrecommendation has since been increasing from year to year. In 1868 morethan half of the 4600 new cases were so admitted by the acting staff of threesurgeons; whilst in 1862, under the old system of admission, on letter only,and with six surgeons in ordinary, the number of new cases was 2289. Thatthe innovation has not injuriously affected the income of the charity isshown by the fact, that whilst the total of annual subscriptions received in1862 was .6603, it stands now very near R1300, and it is confidently hopedthat before very long it will be raised to about £1600—i. e., the amount ofsubscriptions required to bring the income to the level of the necessary ex-penditure. In this locality the charitable do not appear to be particularlyanxious to saddle their support with the condition of privilege. It is need-less to say that the guiding motive for admitting applicants thus freely isthe one urged by you-viz., the danger to the affected organ from the delayinvolved in the search for a letter of recommendation. The relief grantedat the said hospital is entirely gratuitous, and, to my mind, wisely so; forthe practice of exacting a small contribution from hospital out-patients ap-pears to me both opposed to the legitimate interests of the medical profes-sion, and as affording an easy acquittal, more apt to demoralise people thanwhen a sense of shame is left somewhat more efficiently to save them fromsnatching what really belongs to the poor alone.The foregoing has, of course, reference to out-patients only. The in-door

patients, as a rule-for in emergencies the surgeons grant admission atonce,-require either to be freed from payment by letter of a qualified party,or else to pay a certain amount, at present 10s. 6d. per week.

It is for us, the real workers of medical charities, and the depositaries,from continuous observation, of the knowledge of people’s capabilities andneeds, to strike out those paths in which our amateur administrators shalland will mostly be content to follow.

I shall consider it my duty-for, I hold, grave interests are here at stake-to supply what further information I may possess to anyone interested inthe subject, more especially to procure the last Report of the ManchesterRoyal Eye Hospital, a copy of which was, as usual, forwarded to you imme-diately after its publication. I am, Sir, yours, &c.,Manchester, May 17th, 1869. A SAMELSON, M.D.

To the Editor of THE LANCET.SIR,—On the subject of admitting out-patients to Eye Infirmaries without

any letter of recommendation (alluded to in your journal of the 15th inst.),I beg to refer you to the town of Newcastle-on-Tyne, in addition to those ofNottingham and Gloucester. At the Eye Infirmary of the first-named town,poor persons were (and I believe still are) admitted as out-patients imme-diately on application, on four days of every week, without any letter what.ever, and without any payment, except such as might be voluntarily ten-dered. Doubtless persons sometimes applied who were not proper recipientsof the charity, and for whom it was never intended. But I can bear testi-mony to the fact that during the period that I was one of the assistant-surgeons to that valuable institution, scores of poor persons were verymaterially benefited by the absence of any restriction on their admission.This was especially the case with infants suffering under purulent ophthalmia,to whom a few hours’ delay might often be of serious consequence.

I remain, Sir, yours truly,Sunderland, May 15th, 1869. R. G. GAMMAGE, M.R.C.S.E.

Velocip.—We are not aware that velocipedes are used by surgeons in coun.try practice. There does not seem to us any reason why this quick andcheap means of locomotion should not be generally adopted where thecountry is not very hilly.

Y. Y. Z., (Athlone.)-Let our correspondent take the advice of some medi-cal friend as to whom he had best consult in the matter.

Dr. Hitchman (Liverpool) must excuse us either inserting his letter oranswering his question.

737

PROTRACTED SOMNOLENCE.

REMARKABLE case of cercbro-sp;nal disease, attended with occasional con-vulsions and with protracted somnolence, is related by Dr. Joseph Jones,Professor of Chemistry in the Medical Department of the University of

’ Louisiana, New Orleans, in the Medical Record of the 1st instant. The

patient, Miss Susan C. Godsa, was exhibited at the Mansion House, in thecity of Nashville, during the month of November, 1867 ; and at the requestof her relatives and of a number of physicians, a careful examination ofthe singular phenomena presented by her was made. The history of thecase as detailed by her relatives was-that she was in her 27th year, andhad been asleep for the last eighteen years, only awaking at certain in-tervals of the day, and then only remaining awake from seven to tenminutes. Up to her being six years old she was healthy and cheerful. Atthat time she was attacked with ague and fever, from which she sufferedfor three years. Large doses of quinine and morphia were exhibited by aphysician for the relief of her complaint; and at the age of nine years, andjust after taking these large doses of quinine, she fell into the sleepingstate which is said to have rendered her case so remarkable. Since the

patient has been confined to bed she has grown three feet, her presentheight being five and a half feet. She never asks for food, and eatsonly when strongly urged by her attendants. A small quantity of water,imbibed at long intervals, satisfies her thirst. She is fond of tea and

coffee, and drinks these beverages with more relish than any other. She

expresses no choice as to food, and eats without objection what is givenher. Her periods of consciousness are said to be very regular ; waking at6 A.M., and every hour thereafter until 12 M., when she falls into a slumberwhich lasts until 3 P.M.; returns to consciousness at the time of the

setting of the sun; waking again at 9 P.M., and once or twice beforemorning. Dr. Jones says he examined Miss Godsa in the presence ofvarious medical men and students upon two occasions; each examination

extended over a period of two hours. She presented the appearance ofrepose and of deep sleep; whilst the arms and hands, crossed upon thebreast, were incessantly agitated by spasmodic contractions of the muscles.Shaking, loud talking, and the magneto-electric interrupted current failedto arouse the patient; and when the eyelids were drawn back, the pupilswere expanded, but responded to the stimulus of light, and slowly con-tracted. Dr. Jones describes some of the curious convulsive and tetanicmovements observed by him. The case appears to resemble one of hysteriaand catalepsy. If true-and we only suspect persons who exhibit them-selves for money,—the lady in question is the nearest approach to Rip VanWinkle we know of.

PAUPERISE.

To the Editor of THE LANCET.SIR,—I was glad to see that in your remarks on the debate on Pauperism,

originated in the House of Commons by Mr. Corrance’s motion, you call inquestion the right of the vicious and improvident to tax his more prudentneighbours, in order to supply him with that aid and sustenance he has hadwhen in health and receipt of income fair opportunity of providing. You- might have gone further, and also questioned the right of certain employers,and of whole classes of employers, to burden the public, under very speciousbut false pretences of duty to the unfortunate and sick, with a portion oftheir workmen’s wages. Although, except the working men themselves, weof the medical profession have the deepest interest in all questions broughtup for solution by our pauper laws, as contributing by far the most oppres-sive share of this iniquitous tax, it is a subject for very serious considerationby the country whether they are prepared to undertake the care of all thesick, aged, and infirm as a State duty. If so, they must not be surprised tofind that whole classes will take care, with very deliberate purpose and cal-culation, to throw upon the State as much as possible of that duty to them-selves and families which the laws and customs of our country so temptinglyput it within their reach to avoid. This is already too much the case. Arenot nearly all our agricultural labourers thus paid in part ? Are they nothired with the understood condition of their dependence on the State forhelp on the slightest and most trivial emergency ? Do not the employers,from which class the ruling majorities at our Boards of Guardians are taken, pretty well understand this ? Do they not feel, if they do not fullyknow, that cheap and dependent labour and pauperism go together?In entering on a crusade against poor-law abuses, our profession enters

on a wider warfare than I think it suspects. It is a question of free or de-pendent labour. If the victory ultimately be with the advocates of a socialsystem dependent on pauperism,—well this result may be most to be ex-pected : when the system is perfect, the labour will have flown, and with itmedical labour and service too, especially in many rural districts.

I am, Sir, yours, &c.,Chippenham, May 15th, 1869. W. H. COLBORNE, M.D.

CLITORIDECTOMY.WE think that in the case mentioned by our correspondent the colleagues ofthe gentleman who operated should complain, unless the operation wereperformed after a consultation of the whole staff. The case does not seemto have been suited for the operation, and it is very doubtful if any caseM so.

A CAUTION.To the -U, ditor of THE LANCET.

SIa,-I wish to warn my medical brethren against a rogue who wasshown into my consulting-room about 4 P.M. to-day, and in less than aminute seleeted and concealed a valuable pocket-case, with which he gotoff. He was about 5 ft. 4 in. in height; not stout; his complexion and hairdarkish; whiskers and beard slight ; no moustache ; expression rather openand bright; and manner confident, but respectful. He wore a high hat,brown morning coat, dirk vest and trousers, and pretended to inquire foran account requested by a patient (unknown). Much to blame for leavingcases of instruments on the maatel-piece, which he so quickly examined andrearranged. I am, Sir, yours faithfully,

W. G. TILSY.W. G. TILEY.Tavistock-road-villas, Westbourne-park, May 8th, 1869.

FEVER : ST. GEORGE’S, SOUTHWARK.MR. RENDLE, of Newington-causeway, recently gave a lecture in the neigh-bourhood on "Fever," and the condition of the poor and their homes inconnexion with it. Mr. Rendle’s experience and earnestness as medical officerof health gave authority to his representations. He pointed out how muchthe bulk of the fever proceeds from certain houses; how comparativelyfew the centres of infection are; how pauperising are the conditions ofthe disease; for that in the last two years, 586 only of persons not paupershave been received into the London Fever Hospital, while 6681 paupershave been admitted, at the cost, of course, of the ratepayers. He expressedastonishment at the want of harmony between the Vestry and the Boardof Guardians. These two bodies together administer rates to the amountof jS50,000, and ought, he thought-and we think, to act vigorously forthe arrest of the spread of infectious disease.

THE AssUMPTION OF THE TITLE OF M.B.AT the last meeting of the Senate of the University of London, the Registrarread the following letter which he had received from a gentleman atCirencester:—

"DEAR SIR,—There is a gentleman here of the name of WilliamHodges, who has ’ M.B.’ on his door-plate, and calls himself ’Bachelorof Medicine of the University of London.’ I find, on inquiry, that he isan undergraduate, and has only passed his first examination.

" Surely this is an injustice to graduates, particularly as he makesrather a parade of his title, and has, I know, in some quarters, thecredit of having passed the higher examination. It is not a matter thatconcerns me personally; but I think the University ought to know ofsuch practices. " I am yours truly,

" P.S.-He also signs official documents as ’ I, William Hodges,Bachelor of Medicine of the University of London.’ "

In consequence of the receipt of this note, the Registrar of the Universityaddressed the following to Mr. Hodges :-

" University of London, 17, Savile-row, W., April 20th, 1869."SIR,—My attention has been called to what I am assured on good

authority to be a fact-that you place the letters M.B. after your nameon your door-plate; and as I cannot learn that you have any other titleto do so than that which you may consider yourself to derive from thefact of your having passed the First M.B. Examination in this Uni-versity, and as I am further informed on the same authority that youstyle yourself Bachelor of Medicine of the University of London,’ itbecomes my duty to ask if either or both of these statements are true,and to request such explanation as it may be in your power to give.

" I am, Sir, your obedient servant," Wm. Hodges, Esq." " WiLLiAM B. CARPENTER.

Mr. Hodges rejoins:-" Cirencester, April 22nd, 1869.

"

SIR,—In reply to your note dated the 20th instant, I beg to say thatI am in the habit of using the letters M.B. after my name in the manneryou mention, and that I have done so fully believing that custom per-mitted their use by those who have passed the First M.B. Examination;just as the privilege of styling themselves Drs. is accorded to those gen-tlemen who have passed the Second M.B. Examination.

" In further justification of myself, I beg to add that, having appealedsome time ago to the Editors of THE LANCET and the Medical Times fortheir opinions in this matter, so positively did these gentlemen expressthemselves in my favour that any doubt which may have previously ex-isted in my mind was then at once removed.

" I am, Sir, your obedient servant,Dr. W. B. Carpenter." " WM. HODGES.

The Senate at its next meeting passed the following minute:-" That the Registrar be directed to inform Mr. Hodges that the

assumption of the title of Bachelor of Medicine by any person who hasonly passed the First Ri.B. Examination is altogether unjustifiable; andthat the case cited by him as analogous gives to such assumption nosupport whatever. And that the Registrar be instructed to ask Mr.Hodges whether, after this expression of the views of the Senate, it ishis intention to continue to use the designation M.B., and to style him-self Bachelor of Medicine of the University of London.’

"

We give publicity to this matter for the purpose of repudiating theopinion attributed to us in reference to the assumption of the title ofM.B. by Mr. Hodges. If Mr. Hodges has extracted any such opinion fromus, of which we have no knowledge, it must have been through a misre-presentation. We deny the right of any undergraduate to the title of M.B.,and the Senate of the University expressly forbids in their Calendar theuse of the title of " Dr." by those who do not possess the M.D. degree.

A WONDERFUL BIRTH AND A WORTHY ACCOUCHEUR.DR. MILLER’S qualifications, according to the Register, are L.A.H. Dublin,

1847 ; M.D. Univ. Glasgow, 1850.

THE WELSH FASTING GIRL.To the Editor of THE LANCET.

SIR,—I desire, with your permission, to set forth in the columns of THBLANCET the result of my visit to the

" Welsh fasting girl of Carmarthen-shire." It was my impression that her parents courted inquiry; but I wassorely disappointed when the mother told me openly that no medical manshould attempt to prosecute any scientific investigation, either by examina-tion of the mouth for starch, mlk, and probably cod-liver oil, or per rectumin the shape of introducing the finger or administering an enema. When Iheard this I could come to no other conclusion than that the whole affairwas a hoax, in order to obtain money from credulous people. There was ashilling on the child’s chest, which was an incentive to visitors how to actbefore taking leave of the wonderful little girl.

Cardigan, biay l8th, 18B9. I remain, Sir, yours truly,

Joalv THOMAS.Cardigan, May 18th, 1869. JOHN THOMAS.

738

CERTIFICATES OF CAUSES OF DEATH.Mr. D. W. Parsons, Honorary Secretary to the Liverpool Northern Medical

Society, has written to us stating that, in claiming to have suggested inTHE LANCET the form of medical certificate upon which Mr. Dyte hassubsequently improved, we have overlooked the fact that the credit of theoriginal suggestion belongs to the Liverpool Northern Medical Society.We can assure Mr. Parsons that we have not the least desire to wearborrowed plumes, and that we would willingly accord to his excellentSociety whatever of honour may attach to the conception of an improvedform of certificate. But we are unable to admit for a moment that theform suggested by us (THE LANCET, June 27th, 1868) is in any wise the"offspring" of the form proposed by the Liverpool Northern MedicalSociety (THE LANCET, May 16th, 1868). On the contrary, whatever rela-tion exists between the two forms is one of contrast, and not of simi-larity. The Liverpool form, like the old one of the Registrar-General,provided only for one class of cases, and therefore failed to satisfy us.THE LANCET form was expressly drawn to provide for each of the tlweeconditions under which a practitioner might be required to certify a causeof death. It is not always easy to trace a fully developed proposition backto its original idea; but it happens that in this instance Mr. Parsons willfind in the article in which THE LANCET form of certificate was given thatwe have there indicated a source of inspiration in respect of medical certi-ficates which in point of time has two years’ precedence over the sugges-tion of the Liverpool Northern Medical Society. In the 27th Annual

Report (published in 1866) of the Registrar-General, Dr. Farr entered veryfully into this question, and gave forms of certificate to meet certain con-tingencies ; and in so far as the legitimate parentage of our own form isat all open to question, we should point to Dr. Farr and not to the Liver-pool Medical Society as its progenitor. We may further remind Mr.Parsons that in the same Report Dr. Farr recommended the appointmentof registration medical officers, whose duty it would be to investigate andcertify all causes of death not otherwise duly certified. The suggestionof the Liverpool Northern Medical Society in regard to "inspectors ofdeaths" has, therefore, been anticipated by one made officially by thechief officer of Death Registration two years previously.

Dr. William Thomson’s (South Yarra) letter and stethoscopes have been re-ceived. The former shall be inserted, and the latter shall be examined asdirected.

PROFESSIONAL ETIQUETTE.To the Editor of THE LANCET.

SIR,—It may now, I suppose, be fairly presumed that Mr. Reilly has com-pleted his case against me.The public (such of them as it interests) may be left to judge as to the

value of the evidence adduced on either side. On my side, that of two medi-cal gentlemen, of eminently respectable standing, both social and profes-sional, who made a most diligent and careful inquiry into the mattersalleged against me. On Mr. Reilly’s side, that of Edward Magee (a hawker)and of Barbara Smiles, Mr. Reilly’s housekeeper at Castle Eden Colliery,whose evidence, in order to make it pass current, it was necessary to stampwith the name of Mr. Johnstone, a young magistrate, whose new accessionto that dignity may account for his unlawful* use of it in this emergency.

I can only declare that the whole charge brought against me is withoutfoundation, and I sincerely believe that the odium which Mr. Reilly hassought to cast on me will recoil on himself. I will venture also to prognos-ticate that long after Mr. Reilly has passed away from this district (like hispredecessor), I shall retain the affection and respect of a wide circle of friends,which I enjoyed years before Mr. Reilly’s advent.

Here, so far as the public are concerned, the interest of the affair ceases ;but I may yet think it advisable to place the correspondence in the handsof my solicitor.—I am, Sir, yours faithfully,

’

ALLAN WILSON, M.D., L.S.A. Lond.,Medical Officer to the Wingate District of the

Castle Eden, May 10th, 1869. Easington Union.* Act 5 & 6 W. IV., c. 42.

L.R.C.P. Edin., M.R.C.S. and L.M. En,g., and L.S.A. Lond.—There is nonew point in our correspondent’s letter. The subject is threadbare. Wecannot see the difference in principle between one who, having passed thefirst M.B. examination, goes on to use the title of M.B., and one who, onthe strength of a licence to practise medicine from a College of Physicians,calls himself Doctor, unless the title is conceded by universal consent.And our annotation of last week arose out of the fact that this is not so.The case of the apothecaries is a very hard one, and we hope to see someregulation for giving them easil3 a surgical qualification.

POOR-LAW MEDICAL APPOINTMENTS.To the Editor of THE LANCET.

SIR,—Will you inform me what notice union medical officers must give toguardians if they wish to retire ? Public vaccinators have to give twenty-eight days, and I am not sure whether union medical officers have to givethe same or a quarter’s notice. Yours obediently, .

May, 1869. SOUTIl DEVON.

*** Whilst the Poor-law Board in their General Order lay down the rulethat every officer, from the clerk down to the porter, shall give a month’snotice of resignation of office, the medical officer, not being named, isclearly at liberty to resign at once; so that "South Devon" may if hechoose elect to vacate his appointment directly after the Board dayanterior to which he has given a written notice to the clerk or guardians.We would advise him not to do this, but intimate that in fourteen ortwenty-eight days, if most agreeable to the guardians, he would resign.This we suggest solely in the interest of the sick poor, but such a courseis clearly at the option of the medical officer.

MB. TOREENS’S ACT IN THE CITY.MR. HAYWOOD, the City Engineer, has reported to the Commissioners of

Sewers the satisfactory termination of the first proceedings taken in theCity under the Artisans and Labourers’ Dwellings Act, by the demolitionof eight houses certified by the medical officer to be in a state dangerousto the public health, and unfit for human habitation. Mr. Haywood ex-presses his opinion that Mr. Torreiis’s Act has been the means of effectingin the locality a great public improvement, and, possibly, of saving manylives.

A Constant Subscriber.—We should recommend our correspondent to applyto the Secretary of the Royal Victoria Dispensary, Northampton, for acopy of its last Report, in which will be found a complete and admirableset of rules of the nature of those sought by our correspondent. We re-cently gave them in outline in THE LANCET.

AMENDMENT OF THE PHARMACY ACT.To the Editor of THE LANCET.

SIR,-In your issue of this date you appear to congratulate the generalpractitioners on the Lord Advocate’s Amendment of the Bill for Amendingthe Pharmacy Act, 1868. Assuming your copy of the clause to be correct,to me it seems to miss its mark. Exemption from the first fifteen sectionsof the Act will, indeed, allow them to sell poisons, or keep an open shop todispense them, as druggists; but the real grievance is the seventeenth sec-tion. From the restrictions of this section, legally qualified apothecariesare expressly exempted by the Act itself so far as regards medicines sup.plied by them to their patients ; whereas the Lord Advocate’s Amendmentdoes not extend this privilege to other practitioners : they are left to dis-pense, under the same conditions as druggists, even the medicines suppliedto their patients-conditions which materially interfere with their practice.I presume this must be due to oversight, as it is manifestly unjust.

I remain, Sir, yours truly,Temple, May 8th, 1869. W.

*** The retention of the word "apothecary" in the seventeenth section ofthe Pharmacy Act is undoubtedly an oversight, which, we understand,will be rectified when the Amendment Bill reaches the House of Lords.

Dr. Taaffe has written to the Chairman and Committee of the Sussex CountyHospital on the mode of election of medical officers. He recommends the

plan followed at the Birmingham Children’s Hospital, where the medicalofficers are chosen by a Committee of Election, composed of the President,Vice-Presidents, Committee of Management, Honorary Secretary, Trea-surer, Auditors, the Honorary Medical Staff, the Senior Physicians andSurgeons of the General Hospital, the Queen’s Hospital, and the GeneralDispensary, and twenty Governors of the Children’s Hospital elected bythe Committee of Management by lot.

Hamilton.—The illegality is doubtful. The bye-law referred to is in thecase of the London College.

VACCINATION DIRECT TBOM THE HEIFER.To the Editor of THE LANCET.

SIR,—My arrangements being at present complete, I am prepared to vac-cinate with cow-pox, taken direct from the heifer, every Monday and Tues-day from 11 to 1 o’clock.As the system I advocate requires only to be known in order to be gene-

rally accepted in England, as it has been so extensively on the Continent, Iwould feel greatly obliged if you would lend me the assistance of your in-fluential journal in making known to the profession and to the public thatany person can be vaccinated or revaccinated, free of charge, on the above-mentioned days. Both friends and adversaries of " animal vaccination" areinvited to witness themselves the results obtained, reserving their judgmentuntil after a careful examination of the whole system; when I have nodoubt here, as elsewhere, vaccination with cow-pox direct from the heiferwill be hailed by all as an immense improvement on vaccination withhuman lymph. Yours obediently,

9, Bedford-street, Bedford-square, May, 1869. H. BLANC, M.D.

Mr. C. C. Claremont.—Our correspondent is not singular in having receivedby post one of these pamphlets. It is a scandal that the law does not

protect decent people against such productions, by administering a "vitalrestorative" to the authors in the shape of a little imprisonment withhard labour.

A Constant Subscriber to THE LANCET is informed that the best way toascertain all matters connected with the degree of M.D. Berlin, is to writedirect to the Dean of the Faculty of Medicine, who will forward the neces-sary prospectus. The letter may be written in English ; but the directionhad better be as follows := Dem Herrn Dekan der Medicinischen Facultätzu Berlin."

3,fr. Pritckard.-SVe agree with our correspondent.

THE DRAINAGE OF HASTINGS AND ST. LEONARDS.To the Editor of THE LANCET.

SIR,—I observe in your last impression a letter signed J. Alton Hatchard,extolling, very deservedly, the admirable drainage of "West" St. Leonards.(Where is East St. Leonards ?) But why single out the blandishments ofMiss St. Leonards, when her mamma, Mrs. Hastings, is surely entitled toequal commendation ? This looks rather like a lodging-house manoeuvre,and is anything but fair and ingenuous. The drainage of both parts of thetown is perfect, and their hygienic qualities are unquestionable.

Again, Sir, why does Mr. Hatchard, of " West" St. Leonards, flirt so con-spicuously with "Mr. Bazalgette, the eminent engineer," and leave Mr.Andrews, the eminent Hastings town surveyor, in the cold shade, especiallyas the latter conducted the drainage engineering of Hastings, three or fourtimes more difficult and comprehensive than that of the St. Leonards dis.trict ? Yours, &c.,

Hastings, May 17th, 1869. MICROSCOPE.

739

WANDSWORT]L COMMON.

MR. BtrcKMASTBB, Churchwarden of Wandsworth, has had to appear in aPolice Court for endeavouring to prevent the enclosure of part of Wands-worth Common by a builder. The magistrate dismissed the case, because,as he said, a question of right had been raised which he thought veryimportant. Of the wrong of permitting builders to rob the public of thesmallest part of an open space so valuable in a sanitary point of view,there is no question whatever in our minds.

THE papers of Dr. Eustace Smith and Dr. Edwin Payne are in type, and shallappear next week.

Mr. Edward Hotchin, (New Rotherham.)-Let our correspondent consult arespectable practitioner, and avoid quacks. There is no end of the latterwho would, no doubt, willingly undertake to cure " the noise in his head ";but he would find the noise in his head remain, whilst the cash in hispockets had vanished.

One who i8 Interested.-The practice of receiving commissions" from under.takers and that of accepting significant presents from proprietors oflunatic asylums are alike, and decidedly to be eondetimed. It is scarcelyconceivable that a medical man shou:ld do two things so unseemly andundignified.

L.K.Q.C.P.—We believe not. See an annotation on the subject of Titles inour last number.

BONE-SETTERS.To the Editor of THE LANCET.

SIR,—In reference to Dr. Foster’s complaint, I can assure him that theannoyance he writes of is a very common one with medical men for a circuitof many miles around Watford. I had to suffer it on two or three occasionsmyself, but not to the extent some of my medical friends in this districthave. The patients who consult this celebrated bone-setter are by no meansconfined to the humbler and uneducated class; and when decent and re-spectably educated people go to bone-setters for advice, as they frequentlydo, we can only wonder at the credulity which is so rife among all grades ofsociety. Education, at least, so far as the ordinary education of youth ex-tends in this country, has, I think, very little to do with it, but rather awant of " common sense." This supposed universal faculty appears to bethe rarest of all the senses.Regarding the suggestion of a remedy, a medical friend, who was lately

much annoyed by a ease silnita-r to that related by Dr. Foster, told me hehad resolved upon a course of action which he thought would effectuallydeter any future patieat of his from Applying to these individuals. Hewould, he said, be sure to make his patient feel that he was doing sometkingfor his relief by workin- the joint or limb in all concieivwbler positions—arather sharp practice, and one not always likely to be successful. Whetherthe above resolution has been acted upon I cannot say. I leave to your de-cision and that of your readers the question of the propriety of practicallycarrying it into execution. All that I can take upon myself to recommendis this, that in every accident affecting the bones or joints, we should takeespecial and even extraordinary care to be minute in our examination, andto use every available means for the alleviation and cure of our patients.Regrets and annoyances will then have no existence for us, either as affect-ing our professional ability or as touching our pockets.

I am, Sir, yours, &c.,Amersham, May 17th, 1869. WILLIAM PROWSE.

To the E, ditor of THE LANCET.SIR,—Having read Dr. Foster’s letter in your last number and your foot-

note-" we can see no other cure for the evil but the spread of education,"-I cannot refrain from remarking that I am afraid it is not only the poor whoare treated by these men, but the rich and educated also. Two cases havecome to my knowledge within the last three months, where one of these"bone-setters" had been applied to; in both the most eminent men (sur-geons) of our profession had previously been consulted. The tale was muchthe same as that told to Dr. Foster’s patient. In one case the whole hand(palm as well as back), together with the fingers and thumb, were ecchy-mosed for more than a fortnight after the bone-setter’s supposed cure. Ican see no way of stopping such things as long as persons of standing andeducation are foolish enough to believe that these men can do more thanthe leading surgeons of this metropolis.-Yours obediently,May 17th, 1869. A SURGEON.

LAVISH EXPENDITURE FOR SANITARY PURPOSES.THE municipal authorities of Arundel appear to entertain very primitive, if

not absolutely funny, ideas about drainage. Some time since the TownCouncil appointed a committee to consider the drainage of the town, withpower to spend 95. With this large capital at command the committeewent to work, and effected certain improvements, the cost of which hasactually amounted to twenty:five shillings! It is clear that the Rev. C.

Kingsley has no need to go to Arundel to teach the good folks there themeaning of thrift.

A Benighted Brother.-We will request our correspondent in future not touse such hard names.

Physician and Surgeon will, if registered, receive a copy of the new " Nomen-clature of Diseases."

Arts Student would be exempted from such portion of the examination bya medical examining body. A degree in Arts unquestionably confers asmuch advantage upon a medical man as upon any other. It serves, at

any rate, to show that its possessor has received the education of a gentle-man.

IMPORTANT QUESTION FOR CLUB SURGEONS.To the Editor of THE LANCET.

SIR,—The members of an Odd Fellows Lodge, so that they may admithim a sickness member, require me to certify a person as healthy who is notvaccinated. He comes up to the ordinary standard of health in other re-spects. I refuse to certify that he is healthy. Am I right or wrong ? Theopinion of my professional confreres will greatly oblige,

Yours truly,Framlingham, Suffolk, May, 1869. G. E. JEAFTBESON.

W. A.—No. The 40th clause is too loosely constructed to be of muchuse even for a grosser misuse of titles than that complained of; but,though it would be difficult to prove it to be illegal, such a use of a wrongtitle is dishonourable, and not binding upon others.

COMMUNICATIONS, LETTFUS, &c., have been received from - Prof. Lister,Edinburgh; Prof. Halford, Melbourne ; Mr. Hamilton; Mr. Proudhon;Dr. Parsons, Liverpool; Mr. Watkins; Mr. Henry, Hastings ; Dr. Macrae,Whitby; Mr. Home, Leeds; Dr. Thornton, Dewsbury; Dr. Jeune, Ostend;Dr. Wheatley; Mr. Walpole; Mr. Curry; Dr. Milner, Selby; Dr. Moore,Wolverhampton; Dr. Jeaffreson, Framlingham; Dr. Pritchard; Mr. Vane,Harrow; Mr. Barrett; Dr. Blanc; Mr. Phillips; Dr. Hughes, Amwch ;Mr. Bradley, Pensnett; Dr. Thorne; Dr. Harmer; Dr. Thomas, Cardigan;Dr. Norris, South Petherton ; Mr. Prosser; Mr. Hall; Mr. Allison, Brid-lington ; Mr. Pence, Brynmawr ; Mr. Buckell; Dr. Wilme ; Mr. Hands,Hornsey; Mr. Lumley; Dr. Sutcliffe; Mr. Dempsey; Mr. H. Butterfield,Southampton; Mr. Jones; Dr. Arthur; Mr. Gammage ; Mr. Henderson;Mr. Harrison ; Mr. Cameron ; Dr. Colborne ; Dr. Foss; Dr. Drinkwater,Liverpool; Mr. Walker; Mr. Le Neve Foster; Mr. Kidd; Dr. Hopgood,Royal Surrey County Hospital; Dr. Donovan ; Mr. J. Hales ; Dr. Adams,Bumgay; Mr. Hoskin; Dr. Forbes; Dr. Lowther, Hawes ; Mr. Bamford,Horton; Dr. Coombs, Bedford; Dr. Curran, Downpatrick ; Mr. Anderson;Mr. Webb ; Mr. Geffrae, King William Town ; Dr. Monekton, Wadebridge;Dr. E. Smith; Mr. Wade; Mr. Price; Mr. Riley, Edgbaston; Mr. Brown;Mr. Hotchins ; Mr. Brooks; Mr. Griffith ; Dr. Kay ; Mr. Settle ; Dr. Sealy,Barbadoes ; Mr. Maclean ; Dr. Gaye ; Mr. Kent; Dr. Purdon; Mr. Draper;Dr. C. S. Fitzgerald; Dr. Tiley; Mr. Platt, Pont Blyddyn ; Mr. Bickersteth,Liverpool; Dr. Crosbie, Kingston, Jamaica; Dr. Macleod; Mr. Halkin,Braintree ; Dr. Adams, The Punjaub ; Dr. Hitchman, Liverpool; Dr. Skae,Edinburgh; Dr. Wardell, Tunbridge Wells; Mr. Daniel; Mr. Herring,Sandbach ; Dr. Crane; Mr. Coates; Mr. Hyde; Dr. Fryer, Manchester;Dr. Rendle ; Dr. Kitchener, Jersey; Dr. H. Lawson; Messrs. Argles & Co.;Mr. Davies; Dr. Prowse, Amersham ; Mr. Crampton; Mr. Cotton, Wash-brook ; Mr. Callow, Douglas; Dr. Williams, Sudbury; Dr. Hornbieyer,New Orleans ; Mr. S. Wood; A Surgeon; L.R.C.P. Edin.; Boscobel ; W.;A Doctor’s Wife; Honorary Secretary of the French Hospital ; J. X. X. X.;Microscope; The Vicar of Seaford; A Benighted Brother; South Devon;Arts Student, Edinburgh; Physician and Surgeon ; Velocipede, Preston;One of Mr. Syme’s Thousand Old Pupils ; L.K.Q.C.P. ; X. Y. Z. ; Medicus ;A Constant Subscriber to THE LANCET; Quarter Century, Madras ; L.M.;T. Q. R. ; One who is Interested; Anti-Quackery; &o. &c.

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