794

at now if the subject were again brought under the consideration ofParliament.In conclusion, the President desires me to state that he regrets that

.he is unable to express more concurrence with the views of the memo-rialists upon the important points brought under his notice by them ;and the more especially as a somewhat lengthened official experiencehas induced him to entertain a very high,opinion of the meritoriousmanner in which the Poor-law medical officers as a body discharge theonerous and important duties which devolve upon them.

I am, Sir, your obedient servant,JOHN LAMBERT, Secretary.

Notes, Short Comments, and Answers toCorrespondents.

PROVIDENT DISPENSARIES FOR LEEDS.

AN influential meeting of persons interested in the medical charities ofLeeds was held in the Board-room of the General Infirmary on the20th inst., to consider the question of medical relief to out-patients,and the possibility of mitigating some of the evils of the present systemby establishing district provident dispensaries in various parts of the,borough, It was stated that between 40,000 and 50,000 cases of out-door medical relief are now treated annually in Leeds by the three

principal medical charities of the town, out of a population of about300,000. This, of course, takes no account of the pauper medical reliefadministered through the.agency of boards of guardians. The numberof out,patients -of . the Leeds General Infirmary has increased fromZ141 in 1867, to 12,140 in 1877.’ The other institutions show a similarincrease of out-patients, whose numbers have grown unmanageable.Dr. Heaton, Senior Physician of the General Infirmary, read a paperdealing thoroughly with the.subject, in which it was pointed out thatany provident dispensary successfully fulfilling the objects for whichit is intended should command the hearty approval and co-operationof four classes-" of the managing boards and the medical officers ofexisting medical charities in the same district ; of the general bodyof the medical profession practising in the district included in theoperations of the institution; of the benevolent public ; and of theclass of operatives for whose benefit the work is undertaken." Aftera discussion, in the course of which the Mayor expressed his readinessto do what he could, in his official capacity, to further the objects ofthe meeting,-an influential Committee was unanimously appointed to

. investigate and report upon the matter. As this Committee includesthe Mayor and the Vicar of Leeds, in addition to such well-knownnames as Dr. Heaton and Mr. Wheelhouse, there seems every prospectof a practical and satisfactory result from this effort to deal with thegrowing evils of the out-door gratuitous medical relief system inLeeds. We shall watch with interest the further progress of this im-

portant movement.

Mr. Reixach should propose the inquiry to his medical adviser.

PLACENTA PRÆVIA.To th,e Editor of THE LANCET.

SIR,-" Nelsonian," in,a late number of your journal, states : When.called early, and finding extensive haemorrhage going on, with a dilated osuteri, or dilatable sufficient to introduce my finger, my plan has been torupture the membranes, which in most cases arrests all haemorrhage,then deliver the patient by turning. Can anyone recommend a bettermode of proceeding ?"The above remarks may mislead the inexperienced, as conveying the

idea that rupturing the membranes arrests haemorrhage in most cases ofplacenta prævia, which is not the case. Rupturing the membranes isthe golden remedy for accidental haemorrhage, which in most cases itwill arrest; whereas in well-marked cases of placenta praevia the sameproceeding, unless immediately followed by turning, or the separationof the placenta-from its attachment to the uterus, would intensify thehæmorrhage.The following would appear to me to be the proper rule of practice in

cases of placenta prævia : In the early stage, rest, anti-hæmorrhagictreatment, so as to moderate the hæmorrhage, and allow time for the osuteri to dilate; but if the hæmorrhage is profuse, and the placenta iscompletely over the os uteri, recourse must be had to turning with aslittle delay as possible. In cases where turning is impossible, fromrigidity of the os uteri or some other cause, I would separate the pla-centa, from its attachment to the uterus. This proceeding would lead tothe death of the child, and should not be adopted unless in cases wherethe child is knott n to be dead, or in cases which do not admit of turn-ing, and the life of the mother is in jeopardy. In some cases of partialplacental presentation, rupturing the membranes will arrest the heemor-Thage, and the delivery may be completed without turning.

Yours &c.,T. HUGHES, M.D.

Dinorwic Quarry Hospital, Llanberis, Nov. 18th, 1878.

Speculum.—The use of the sound cannot in all cases of disease in virginsbe well dispensed with ; but it generally can, and, when so, it oughtnot to be used. Its use is especially unjustifiable in cases where theobjection named may be supposed to exist. It would be likely to domischief.

An Invalid Doctor is thanked, but we have not space for his letter.

SHEFFIELD AND ITS MEDICAL OFFICER OF HEALTH.IT is eminently satisfactory to find that the Local Government Boardhas distinctly informed the Town Council and the Urban SanitaryAuthority for Sheffield that "they would not feel justified in author.ising the repayment, out of the parliamentary grant, of a moiety ofthe. salary of any medical officer of health for the Sheffield urban sani.tary district, unless such officer were required to devote his wholetime to the discharge of the duties of his office." This letter was dis-cussed in a somewhat disorderly manner .at a recent meeting of theTown Council, and a proposition that "the Local Government Boardbe informed that we are perfectly ready to take the responsibility (ofsuch an appointment), and to pay the medical officer ourselves," wasrejected in favour of an amendment to the effect, "that the letter besimply entered upon the minutes." We fear it is now too late to hopethat the Sheffield Town Council will see that they will effect no eco,nomy by making a local practitioner their medical officer of health,and that in so large a town as Sheffield the bare idea of efficient sani-tary supervision in combination with private medical practice is simplypreposterous, bringing discredit upon local health self-government.

THE LATE MR. PHELPS.

To the Editor of THE LANCET.

SIR,—In your impression of last week I was surprised to find a letterfrom Mr. Arthur Galloway, assistant to Mr. Clegg, of Epping, greatlymisrepresenting my notes of the illness of the late Mr. Phelps (sent byrequest), and reflecting upon the treatment of his case. I shall feel

greatly obliged by your allowing me to correct these statements.For some years I had attended the late Mr. Phelps, and up to October

17th, during his last stay at Epping, continued to treat him by corre.spondence. I had previously advised his family to call in a local practi-tioner if he became worse, which was done, and I was sent for by hisfamily to consult with Mr. Clegg on the.29th, and to arrange for meetingSir Wm. Jenner in consultation. As Mr. Phelps was then perfectly un-conscious, and in a hopeless condition, it was considered unnecessary forme to see him again. During the last fortnight of his illness I saw himat Epping three times, and he was perfectly unconscious. His nephew,Dr. Phelps, also saw him on several occasions, and he only seemed torecognise him once. In -my notes I said he occasionally recognisedfriends. I mentioned in my letter to you, Sir, that Mr. Clegg attendedhim at Epping ; but I presume you considered the profession would onlybe interested in the details of the illness, and not in the names of all theattendants.With respect to the reflections on my treatment, to quote Mr. Galloway’s

words : "His last illness was entirely brought on through mental exer-tions, and having to appear in public while in a weakened and nervousstate, and it -may be a warning to medical men not to allow professionalmen to resume duties requiring such severe mental strain whilst suffer-ing as Mr. Phelps was during his last appearance on the stage."Now I must say I fail to see how a gentleman, so recently qualified,

who had never seen Mr. Phelps before, can make such a statement.For many months previous to Mr. Phelps acting for the last time at

the Aquarium Theatre in February last, he had not acted, excepting fora few days at Dublin and the Aquarium some weeks before. In Februarylast he acted five times at the Aquarium, and having taken a chill, itdeveloped itself into an attack of congestion of the brain. After someweeks’ stay at Epping, he felt perfectly well again ; but in my judgmenthis brain never recovered its full powers, but a gradual failure both ofmind and body supervened, which (months afterwards) culminated in asemi-unconsciousness,with prostration during the three weeks precedinghis decease.I am afraid the country would be deprived of many of our foremost

statesmen if such advice as Mr. Galloway suggests were always to beacted upon.With regard to Mr. Galloway being present at the consultation, he is

perfectly correct in bringing it to the notice of the profession. At thesame time I may say that Mr. Clegg had been away for some daysprevious to the consultation, and in the meantime Mr. Galloway, as hisassistant, had seen Mr. Phelps with a retired practitioner in the neigh-bourhood.

If any contradiction of my letter had been needed, I think it veryimprobable that Mr.. Clegg would have left this duty to his assistant.

I-am, Sir, faithfully yours,Camden-road, .N.W., Nov. 26th, 1878. G. F. DELA COUR, M.D.

Dr. Fisher should make such a representation as he makes to us to thebodies whose diplomas are held by the registered author of the dis-graceful advertisements referred to.

Mr. T. H. Tidswell, (Morecambe.)-The specimen is the pregnant femaleof a tick, Ixodes, or a very close ally. The animal infests men, horses,and other animals.

Dr. Allen Duke’s paper will appear next week.

"A CASE OF DISTRESS."

To the Editor of THE LANCET.

SIR,—Allow me to thank you for.your insertion in your journal of mylate appeal. Through the kind response I have ’met with from several ofyour readers, I have been .enabled to raise a sum of .about .69 towardsthe alleviation of the distress of the poor family whose cause I pleaded.I trust that, through the help thus opportunely given, they may be en-abled to go forward and prosper in their new position. As, however,

’ further means are still necessary, may I be allowed to state that any’ contribution that may be afforded for this object will be most thankfully

received and acknowledged by me, when I shall he only too glad to givesuch details as may be required.

I remain, Sir, yours faithfully,J. JOHN HUNT,

November, i:8’l8, Curate of St. Mary, Hornsey.rise, N.

795

THE USE OF THE FORCEPS WHEN THE OS UTERI IS PARTIALLY A STEP IN THE RIGHT DIRECTION.DILATED. IT is a matter of great satisfaction to announce that the Town Com-

AT a recent meeting of the Dublin Obstetrical Society, Dr. George missioners of Burton-upon-Trent have recently obtained an Improve-Johnston, ex-Master of the Rotundo Lying-in Hospital, read an inter- ment Act, which commenced to take effect on the 7th inst., and whichesting paper on the Use of the Forceps in that institution from 1868 contains a section compelling notice to be given of persons sufferingto 1875. Omitting all reference to that portion of the paper in which from certain infectious and contagious diseases. There are five sub-the use of the forceps in ordinary cases is discussed, we would draw sections, which make it in effect compulsory on the occupier or personattention to those cases in which they were used before the os uteri was having the management or control of the building in which the patientfully dilated. The forceps were applied in 69 cases, 44 of which were pri- resides, or the medical practitioner, to give immediate notice as to th&miparæ, where the os uteri was two-fifths of its normal dilatation, the existence of these diseases, the onus of the matter resting, however,principal causes of interference being early rupture of the membranes on the occupier only in the absence of any medical attendant ; so that(42 cases), pressure on anterior lip of uterus (8), prolapse of funis (2), practically the medical attendant is the responsible individual, and is.and convulsions (2). In 18 the head was above the brim, in 17 in the to be paid by the Town Commissioners a shilling for each certificate.brim, and in 24 in the cavity. Of the 59 children, 48 lived, 9 were born There is, however, a serious defect, to which our attention has beendead, and 2 died ; and of the mothers, 53 recovered and 6 died. In drawn by a practitioner in the neighbourhood. The list of diseases to-the second division, where the os was three-fifths dilated, there be reported includes small-pox, cholera, typhus, typhoid, scarlet fever,occurred 71 cases, 53 being primiparæ, the operation being due in 43 diphtheria, and relapsing fever; but, as is pointed out, measles ie.instances to early rupture of the membranes, and in 13 cases to pres- omitted-a malady that should undoubtedly be included in the sche-sure on anterior lip ; the forceps were applied in 6 above the brim, in dnle. We trust, however, that this is a remediable omission, and have36 in the brim, and in the cavity 29 times respectively, with a result to congratulate the Commissioners of Burton-upon-Trent on being,that 58 children lived, 7 being born dead, and 6 died ; while of the according to our knowledge, the first sanitary authority that hasmothers, 2 succumbed, one from gastro-enteritis and the other from taken, as to this very important matter, a step in the right direction.uterine diphtheria. Where the os uteri was four-fifths dilated, 39 R.S—The behaviour seems very bad ; but the question is simply one ofcases occurred, 26 being pnmiparse, with a result of 9 deaths to the legal contract.

’

children, and one death, a primipara, due to convulsions. Dr. Johmston ’

QUININE RASH.has long been an advocate for using the forceps in cases of a similar

To the Editor of THE LANCET.kind, and he states that the results generally are very satisfactory ;but remarks that the forceps should not be used under similar circum- SIR,—I have read with interest, in your report of the last meeting ofstances, except by a practitioner who is thoroughly acquainted with

the Clinical Society of London, Dr. Farquharson’s remarks on quininestances, except by a practitioner who is thoroughly acquainted with rash, and, as cases of it are of interest and rarity, I send you the follow-the process of parturition, and has also obtained the necessary de. ing notes of a case which occurred in my practice early in 1876.licacy of touch and accuracy of manipulation. The patient, a sea captain, was ordered a mixture containing small

doses of quinine, and on seeing him the following day he said, "Doctor,"DISGUSTING ADVERTISEMENTS." you have put quinine in my medicine, and I shall have the rose." I de-

To tTce Editor of THE LANCET. sired him to continue the medicine, and on the third or fourth day (ITo the Editor of THE LANCET, really forget which at present) large patches of erythema appeared on

SIR,-A friend, who was disgusted by the filthy bills posted in urinals, the arms and legs. Of course the quinine was immediately stopped, andtelling our youth how they may gratify their brutal lusts with impunity, appropriate treatment substituted for the erythema, which lasted severalwrote to Col. Henderson on the subject, and got this reply :- days. I was much struck with the case at the time, especially as the

" SIR,—I have to acknowledge the receipt of your letter, calling atten- patient knew the effects of his taking quinine, and had at once recognisedtion to the encouragement given to immorality by disgusting bills being the drug even in small doses; so about ten days afterwards I requestedposted up in street urinals, and to acquaint you, in reply, that the police him to submit to experiment, and take some more to oblige me, to whichare fully alive to the necessity of checking this disgraceful system, and he kindly consented. After a few doses had been taken, he sent for me,have prosecuted numerous offenders to conviction ; but the bzll-stickers as the rash was appearing, and, without doubt, it was reproduced to myare the onLY persons ck,7ainst whom proceedings can be taken," entire conviction.Now, Sir, as the authors of these filthy, vice-promoting contrivances I am, Sir, your obedient servant,

,

and advertisements must be well known to the police, is it not unjust WM. CAIRNS WICKS, M.B. Edin., &c.that they should be left unmolested, whilst the poor bill-sticker is Newcastle-on,Tyne, Nov. 16th, 1878.punished ? It is like punishing the weapon of the murderer instead ofthe criminal who wields it ! Yours truly, .LO the Editor of THE LANCET.Trinity-square, S.E., Nov. 19th, 1878. DANIEL HOOPER, M.B. SIR.—The recent discussion at the Clinical Society of London on the

_ subject of quinine rash leads me to send you notes of a case that occurredREMUNERATION FOR POOR-LAW MEDICAL WORK. in my practice some few weeks since.MR. W. S. SIMPSON, medical ofracer of the workhouse, Pontefract, having Mrs. B-, middle-aged, health generally good, came under treatment.resigned in consequence, we believe, of finding that his salary of £40, on August 27th, complaining of pains in the head, face, &c., diagnosedand no extras, only paid his expenses for drugs &c., and that the as neuralgic. ordered two grains of quinine every four hours.

to have.and no extras only paid his expenses for drugs &c., and that the

Un Aug. 29th I was requested to call, as she was supposed to haveguardians would not increase it, advertisements were issued for a suc- scarlatina. On my visit I found her literally covered with a bright redcessor. We are glad to see by the local paper that no applications erythematous rash, great irritation of skin, gastric disturbance, and in-were made for the office. It was then proposed to advertise again at creased pulse and temperature. The quinine was ordered to be discon-an advanced salary of Lio. We hope the profession of the neighbour- tinued, and a saline mixture substituted.

,

hood will not be tempted by £10 a year to forego their attitude of dig- On Sept 6th, the rash having then quite disappeared, and the neu-

ralgia continuing, she was again given two-grain doses of quinine, withmned independence. It is highly creditable to them that they should on the following day precisely the same results-erythema, elevation ofsupport Mr. Simpson in the stand he is making for fair remuneration temperature, and gastric disturbance.

..,

for hard work. Unless Pontefract is very unlike the other towns of I may add that the diet on each occasion was particularly inquiredYorkshire, its population must be growing, and the work of the work- into, with the view of discovering some cause for the eruption otherhouse officer increasing. Moreover, medical services are increasing in

than that of quinine. M.R.C.S. &o.

value; in other words, medical men are beginning to see that they Carlton-road, N.W., November, 1878.have made themsplves too cheap. It is refreshing to see guardiansapparently confronted with the alternative of being without a medical SANITATION IN MANCHESTER.

officer, or giving something like a reasonable salary. THE Manchester and Salford Sanitary Association have recently sent tc*the Corporation of Manchester a very important memorandum on a.

BACTERIA IN C A R B U N C L E. memorial to the Health Committee’s published report, praying for the,To the Editor of THE LANCET. application to that city of the Artisans and Labourers’ Dwellings Act-

SIR,-Can any of your numerous readers kindly inform me whether it It appears that the Council do not consider the application of the Actis common for bacteria to be found in the blood of those suffering from necessary, because, in the opinion of its members, they already possesscarbuncle As instances of what I have myself observed I would quote sufficient powers for the effective improvement of the town. The Sani-the two following cases.

1. A small carbuncle situated at back of neck. Bacteria present in tary Association above referred to do not, however, regret the adversethe blood taken from the immediate neighbourhood of disease, but not decision, because, among other chief reasons, it called forth a mostin blood from any other part of the body. able report from the medical officer of health. From this it appears

2. A large carbuncle sitnated in the lower part of right thigh. Bac- that there is a specially unhealthy zone of dwelling-places, some 600teria in blood from Your all parts obedient of the servant, body, and equally distributed. acres in extent, within which reside nearly one-third of the population.WM. THOS. JACKaqAN, M.R.C.S., The death-rate in some of the sub-districts comprised in this area.

Assistant Medical Officer, Greenwich Union averages above 30 per 1000 of the population. Mr. Leigh suggests aNov. 18th, 1878. Infirmary. variety of improvements, chiefly connected with the back-to-backDr. Semple.—After the disclaimer which we inserted a week or two ago houses, and the Association above referred to are so sanguine as to the-from the Chairman of the Committee on Croup and Diphtheria, we ameliorating effect that these alterations would have upon the healthcannot accept Dr. Semple as the authorised spokesman of that Com- of the general population that they look forward with great confidencemittee ; and we would suggest that he should reserve the expression to a speedy reduction of the death-rate to 13 per 1000. This may, ofof his views on the subject for the forthcoming discussion at the course, be utopian ; but it is refreshing to see an Association, or in-Medico-Chirurgical Society. The views of an individual member of a deed any public body, upholding cordially, and quoting extensively,Committee may differ widely from the conclusions of the Committee the report of the medical officer of health, whose advice is generallyto which he happens to belong. too little appreciated.

796

THE DEATH-RATE OF DUBLIN.AN influential deputation from the Dublin Sanitary Association had aninterview last week with the Chief Secretary for Ireland, in order topresent a memorial calling attention to the high death-rate of Dublinand its’sanitary condition, and praying that an inquiry might be in-stituted. The memorialists believe that a searching investigation isurgently required, as an essential preliminary to the institution ofmore active remedial measures than have yet been entered upon. Weinsider that the causes of the excessively high mortality in Dublinare tolerably patent to those who have given any attention to thematter, and may be summed up as arising principally from (1) the stateof the River Liffey ; (2) the want of proper sewerage, more especially theconnexion between the private drains and the public sewers ; (3) over-crowding among the poorer classes, and absence of proper sanitaryarrangements in a very large number of the wretched tenements theyoccupy ; (4) the filthy condition of the streets and lanes; and (5) the in-temperate habits of the artisan and labouring classes of the population.The Chief Secretary promised that the subject should receive theattention of the Government, but guarded himself against acquiescingin any special form of inquiry.

WE are reluctantly compelled to defer the publication of letters byDr. George Johnson and Mr. Rushton Parker till next week.

CONSULTATION IN CASES OF RAILWAY INJURY.To the Editor of THE LANCET.

SIR,—On the 17th of July a Mr. Skelding called upon me, accompaniedby a friend, and said he was surgeon to the London and North-WesternRailway Company, that he wished to consult with me about a patient Iwas attending, who had met with an accident on some portion of thatrailway. He told me he had visited and examined my patient. (This Ithought cool, to say the least of it, but made no remark.) I gave him allthe information I could, and promised to persuade my patient to settlethe matter. After detaining me about half an hour he left. Some timeafter my patient wrote me a note, requesting me to send him my account.Before doing so, I wrote to Mr. Skelding, stating that, as the consulta-tion was at his request, and not my patient’s, I should expect the Com-pany to send me a fee of JS2 2s. Ten days after he wrote me : "TheRailway Company informs me that all charges were included in thecompensation received by your patient." I wrote back to say I knewnothing of my patient’s business with the Railway Company; that ifthey were mean enough to take advantage of my not demanding my feeat the time, I would take care it was the last time they would have theopportunity to do so.

If you will kindly publish this letter, and also give me your opinion onits contents, you will greatly oblige, Yours truly,

Brighton, Nov. 19th, 1878. J. HARRIS Ross, M.D.P.S.-I have informed Mr. Skelding of my intention to write to you.

** Dr. Ross is clearly entitled to the fee which he claims.-ED. L.

Mr. Howison. - We are not aware of there being any communicationfrom Mr. Howison in our possession.

’COMMUNICATIONS, LETTERS, &c., have been received from-Dr. Fenwick,London; Mr. J. E. Adams, London ; Mr. Bond, London; Dr. Cavafy,London; Dr. Dolan, Halifax ; Mr. Wakefield, London; Dr. Burnet, Lon.don ; Dr. Bramwell, Newcastle-on-Tyne; Mr.Ward, London; Dr. Semple,London ; Dr. Segismund, Frankfort-on-the-Maine; Dr. Craigie, Lon-don ; Dr. Trentler, Uckfield ; Dr. Bacon, Stallingborough ; Mr. Gray,Poplar; Dr. Masten, St. Helens ; Dr. Fritsche, Warsaw; Mr. Howison,Darlington; Mr. Lediard, London; Dr. Wolfe, Glasgow ; Dr. Neale,London; Dr. Fisher, London; Dr. Gillespie, London ; Mr. White,London; Dr. Limbeck, Langendreer; Dr. Whalley, Bradford; Mr.Mason, Burton-on-Trent; Mr. Teevan, London ; Mr. Allen, Bath;Mr. Lang, Skeasington ; Dr. Lowe, King’s Lynn; Mr. Smith, Clifton;Mr. Ormrod, Workington; Mr. Lucas, Hull; Dr. W. Pratt, Newtown;Mr. Clay, Birmingham ; Dr. Hicks, Hendon; Mr. Williams, Truro;Messrs. Newbery and Son, London ; Dr. Corner, London; Dr. Sankey,Andoversford; Dr. Allbutt, Leeds ; Dr. Coombs, Castle Cary; Dr.

Hopgood, Stow-on-the-Wold; Dr. Shaw, Birmingham; Dr. Palmer,Birmingham; Dr. Eberle, Easingwold; Dr. Thursfield, Shrewsbury ;Mr. Lewis ; Mr. Thorn ; Mr. R. E. Clark ; Mr. Rinxach; Mr. HarveyMr. Robinson ; Mr. Broughton; Mr. Dale, Scarborough ; Mr. Wright;Dr. Netherclift, Chelsea; Mr. Moxhay, Reading; Mr. Parker, Liver-pool ; Mr. Nichols ; Mr. Lyddon, Oldbury ; Dr. De la Cour, London;Dr. Bergmann, Wiesbaden; Mr. Alexander; A 1878 M.R.C.S ; H. H.T. C. A. ; An Invalid Doctor; The Harveian Society ; A FellowThe Obstetrical Society ; W. A. M. ; Speculum ; S. C. R. ; &c. &c.

LETTERS, each with enclosure, are also acknowledged from-Mr. Williams,Darlington; Mr. Fitzgerald, Newfoundland; Mr. Williams, Brent.ford; Mr. Griffith ; Dr. Duke ; Mr. Hamper ; Mr. Armstrong; Mr,Ricketts; Mr. Hunt; Mr. Kenyon ; Dr. Stevens, Stoke NewingtonDr. Davies, Ebbw Vale ; Dr. O’Meara, Sheffield ; Mr. Hepworth,Eccles ; Mr. Hoare; Mr. Horton ; Mr. Covey, Puckridge ; X., ThirskM.D. ; R. V., Derry; J. M. ; F. Y. S. ; Carte; Surgeon, BarnsleyDoctor, Newington ; Medicus, Pontypridd; Ley ton ; C. C., GreenwichJ. A. C. B., Greenwich ; W. C., Accrington ; M. ; Surgeon; KilburnSurgeon; Medicus, Uxbridge; C. P. ; W. ; Surgeon, Notting-hillM.D., Stoke; C. A. R. L.; B. M., Romsey.

Middlesex Mercury, Morning Chronicle, Liverpool Weekly Albion, ArgusHalifax Coitrier, Evening Star, jfansfield Reporter, Britannic, Bwmingham Daily JIatl, &c., have been received.

METEOROLOGICAL READINGS.

(Taken daily at 8 a.m. by Steward’s ln8truments.)THE LANCET OFFICE, Nov. 28th, 1878.

Medical Diary for the ensuing Week.Monday, Dec. 2.

ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS. - Operations,10 A.M. each day, and at the same hour.

ROYAL WESTMINSTER OPHTHALMIC HOSPITAL.—Operations, 1½ P.M. eachday, and at the same hour.

ST. MARK’S HOSPITAL.—Operations, 9 A.M. and 2 P.M.METROPOLITAN FREE HOSPITAL.—Operations, 2 P.M.ROYAL ORTHOPEDIC HOSPITAL.—Operations, 2 P.M.ROYAL INSTITUTION.-5 P.M. General Monthly Meeting.MEDICAL SOCIETY OF LONDON.—8½ P.M. Dr. Leared : "A new Explana.

tion of a Proximate Cause of Dyspepsia."

Tuesday, Dec. 3.Guy’s HOSPITAL.-Operations, 1½ P.M., and on Friday at the same hour.WESTMINSTER HOSPITAL,-Operations, 2 P.M.NATIONAL ORTHOPEDIC HOSPITAL.-Operations, 2 P.M.WEST LONDON HOSPITAL.-Operations, 3 P.M.PATHOLOGICAL SOCIETY OF LONDON,-8! P.M. The following Specimenswill be shown :-An unusual form of Pneumonia ; Primary Cancer of

the Supra-renal Capsule, with Secondary Growth in the Lung;Lung containing Gummata and Tubercle ; Disease of the Hair latelydescribed as "Piedra"; Haemorrhage into the Pons Varolii; Sar-coma of the Scapula in an Infant, followed by Multiple Sarcomata;Specimens illustrating the comparative Growth of Fungi in Ring.worm and Favus ; and other Specimens.

Wednesday, Dec. 4.MIDDLESEX HOSPITAL.-Operations, 1 P.M.ST. MARY’S HOSPITAL.-Operations, 1¼ P.M.ST. BARTHOLOMEW’S HOSPITAL. - Operations, 11 P.M., and on Saturday

at the same hour.ST. THOMAS’S HOSPITAL. - Operations, 1½ P.M., and on Saturday at the

same hour.KING’S COLLEGE HOSPITAL. - Operations, 2 P.M., and on Saturday at

1 P.M.LONDON HOSPITAL.—Operations, 2 P.M., and on Thursday and Saturday

at the same hour.GREAT NORTHERN HOSPITAL.-Operations, 2 P.M.UNIVERSITY COLLEGE HOSPITAL. - Operations, 2 P.M., and on Saturday

at the same hour.SAMARITAN FREE HOSPITAL FOR WOMEN AND CHILDREN. - Operations,

2* P.M.OBSTETRICAL SOCIETY OF LONDON.-8 P.M. Specimen : Twins with Pla-

centa, by Dr. Edis.-Papers : Adjourned Discussion on Dr. Roper’spaper, " On Anteflexion of the Uterus"; Dr. Jas. Braithwaite, ’’ OnDigital Dilatation of the Os Uteri in Labour."

EPIDEMIOLOGICAL SOCIETY. - 8 P.M. Dr. Airy, "On Infection con-sidered from a Darwinian point of view."

Thursday, Dec. 6.ST. GEORGE’S HOSPITAL.-Operations, 1 P.M.ST. BARTHOLOMEW’S HOSPITAL.-1’ P.M. Surgical Consultations.CHARING-CROSS HOSPITAL.-Operations, 2 P.M.CENTRAL LONDON OPHTHALMIC HOSPITAL. - Operations, 2 P.M., and on

. Friday at the same hour.

. HARYEIAN SOCIETY. - 8 P.M. Dr. Hughlings-Jackson, "On the Dia-

gnosis of Diseases of the Nervous System."

, Friday, Dec. 6.

’ ST. GEORGE’S HOSPITAL.-Ophthalmic Operations, 11 P.M.ST. THOMAS’S HOSPITAL.-Ophthalmic Operations, 2 P.M.

; ROYAL SOUTH LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M.

, Saturday, Dec. 7.- ROYAL FREE HOSPITAL.-Operations, 2 P.M.

TERMS FOR ADVERTISING IN THE LANCET.. For 7 lines and under.... Zo 4 6 For half a page .......... ;e2 12 0’ For every additional line. 0 0 6 For a page ..... 6 0 t

The average number of words in a line is eleven.Advertisements (to ensure insertion the same week) should be delivered

’ at the Office not later than Wednesday, accompanied by a remittance.! N. B.-All letters relating to Subscriptions or Advertisements should

be addressed to the Publisher. ____

’ Agent for the Advertising Department in France-Mons. DE LOMINIE, 208, Rue Grauelle St. Germain, Paris.