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Page 1: PARIS


which our French neighbours have established for the dueadministration of their poor laws will be very useful to all

those who may be engaged in striving to solve the problemof the introduction of abetter system here; but in order torender his inquiries complete, and of practical utility, itappears to me desirable that this gentleman should inves-tigate the methods adopted in other countries, more espe-cially Protestant communities.

It is evident that much of the facility with which theFrench system is worked is due to their utilising the ser-

. vices and charities of the various religious bodies whichexist there, as well as in all Catholic countries ; and thefailure here arises, partly, from the fact that our charitableand benevolent associations work ofttimes antagonistically,and I may also say mischievously, to the Poor-law adminis-tration. This has been the case with us probably ever sincethe 43rd of Elizabeth, when, as you are aware, the PoorAct was passed consequent upon the complete break up ofreligious houses.Now it would indeed be interesting to learn in what way

non-Catholic countries utilise the charities, &c., of the bene-volent in aid of their Poor-law administration, and it wouldbe, therefore, most unfortunate if the labours of Mr. Blan-chard Jerrold should be brought to a close through in-sufficiency of means.

I trust that your appeal will be followed by a liberal sub-scription. Medical men generally can ill afford to givemoney in aid of any cause, however good; but they have aprivilege denied to other persons-they are admitted onterms of intimacy to the houses of the great, the wealthy,and the good, and they might avail themselves of these op-portunities to put ]’vIr. Jerrold’s labours before them.

I am, Sir, your obedient servant,Dean-street, Soho, Sept. 30th, 1869. Jos. BoGERS.JOS. ROGERS.


To the Editor of THE LANCET.

SiR,-The necessity -which exists for the medical men en-gaged in the treatment of lunacy to take some action re-specting the County Administration Bill, as urged in yourleader of July 24th, p. 127, is strongly confirmed by anarticle in the Gentleman’s Magazine for July, p. 247. The

statement of the writer is the more noteworthy as emanatingfrom what may be considered a rival interest. He says:

11 In rural communities, the subject which is most seriouslydiscussed just now, by provincial political economists, is thequestion of Financial Boards, and this will become a Par-liamentary topic of no mean importance. At the presenttime, quarter sessions, which consist of magistrates who aremade, as you know, by lord lieutenants, have the entire

government of counties. They spend what money theyplease ; they make what rates they choose. There is noappeal against this local court, which may be tyrannical orliberal, economical or extravagant as it pleaseth. The greatmiddle class of the rural districts, the more thoughtful ofthe agricultural community, the large ratepayers, are

awakening to the injustice of this position ; they have com-municated their views to Chambers of Agriculture, andthese bodies have raised the cry of

" Financial Boards," theobject of which is the creation of special courts, or com-mittees, consisting of magistrates and representatives of theratepayers (who are not magistrates), for the administrationof the county moneys."

If this be the basis upon which the business of the coun-ties is managed, how precarious and uncertain must be theposition of the medical officers engaged in it-a conditionwhich it is proposed to perpetuate under the above Bill.The tenth clause, in this particular, invests the new Com-mittee with all the powers of that body which it is intendedto supersede. The medical superintendents of public asylums,deprived by the nature of their appointments of the usualcivil and municipal rights attaching to residence; cannot,like their brethren of the Poor-law medical service, maketheir claims known through their representatives, and un-less the Parliamentary committees of the British MedicalAssociation and of the Poor-law officers, or THE LANCET,come to their assistance, it is doubtful whether they will be

able to make any impression on the Legislature towardsobtaining their just and necessary rights. These membersof the profession hold offices of trust, responsibility, andimportance to the community at large. They are subjectto harassing and continued calls upon their time and atten-tion, and the daily discharge of their duties is not altogetherfree from difficulty and danger. It is not equitable thatsuch public officers should be liable to dismissal without anyright of appeal, explanation, or inquiry, or be placed on adifferent footing from their brethren in the army, navy, orPoor-law service. This anomaly ought not to be permittedto continue; indeed it seems possible that the Secretary ofState may not even be aware of the prospective effect of thetenth clause of his Bill, which consigns the fortune, reputa-tion, and office of the medical officer of a county asylum tothe irresponsible authority and power of a private committeeof Poor-law guardians and justices delegated by the newFinancial Board. An assured tenure of office and a definedposition are as necessary for the comfort of the officer as forthe interests of the public. The risk of being capriciouslydisturbed cannot fail to engender in this, as in other walksof life, a certain amount of discouragement and feeling ofsubserviency ; nor could it be otherwise with an officer whohas the responsibility of a state official, with the insecurityof a menial servant. As long as this state of things exists itis in the power of a jealous, restless, or mischievous memberof a committee, by continually advocating a want of con-

’ fideii-ce in an officer not sufficiently deferential, to procure’ his dismissal upon insufficient or unproved grounds of com-L

plaint, and without any appeal or remedy. How many’ times has the dominant position of a member or a public

board been abused for want of kindly feeling of associationwith an officer. It is related by Sir James Clark, in his re-cent admirable memoir of Dr. Conolly (p. 53), that on hisfn-st competition for the appointment at Hanwell, the cast-ing vote of the chairman excluded him on account of hispolitics. He was known to be connected with the Societyfor the Dift’usion of Useful Knowledge ! By this circum-stance the inauguration of the system of non-restraint wasdeferred to the next election. *

The powerful efforts of a former editor of THE LANCET-

obtained for the medical profession the benefit of the Me-- dical Witnesses Act; may yours, Sir, be as successful in ob-r taining for the lunacy medical staff a recognition of their1 just requirements., I am, Sir, your obedient servant,J

September. 1869. EQUITAS.




A FEW days ago the Figaro, one of the well-known

literary journals of this city, issued a sort of album-num-ber (numero-album), containing short notes from severalscientific and literary celebrities, which had been speciallycontributed to the number. Amongst these are a few linesfrom M. Nelaton; and as they have been much commentedupon, and have already drawn forth a protest from a dis-tinguished Parisian surgeon, I am sure you will take someinterest in perusing them. M. Nelaton was desirous, itwould seem, to manifest his opinion in favour of the highvalue of clinical surgery in face of the growing pretensionsof microscopical and chemical researches, and thus ex-

pressed his thought in the pages of Le Figaro :-I am happy to see the rising generation refuse to

follow those false appearances of exact and profound scienceborrowed almost exclusively from microscopical research,and attach itself to the study of surgery, based upon thegreat indications furnished by clinical observation. It isbecause they drew their inspirations from these principlesthat the great masters of the beginning of this century,and especially Dupuytren, the most glorious amongst them,have given to the French school that legitimate renownwhich it still enjoys throughout the whole world."As might have been expected, these two short passages

have created quite a sensation among that portion of sur-

Page 2: PARIS


gical workers which they seemingly attacked, and havealready met with a sharp retort of protestation from the penof Professor Verneuil, of the Paris Faculty. The blamethus laid upon microscopical investigators by so high anauthority as Nelaton, and published in so widely circulateda journal, has stung M. Verneuil to the quick, and in thename of the injured parties he vindicates the value and im-portance of the microscope. The article appeared last weekin the columns of the Gazette Hebdomadaire. After havingstated what great results the microscope has afforded in thehands of such men as Robin, Broca, Lebert, Davaine, Vir-.chow, Kolliker, and others, and after having mentioned thatit had now become the indispensable complement of ana-tomical research in the dead-room, throwing a brilliantlight on the origin, the evolution, and the transformationof those innumerable lesions which destroy man, M. Ver-neuil asks M. Nelaton whether he believes that all surgicalscience may be acquired in the ward of an hospital. If not,and if, on the contrary, he (M. Nelaton) admits the assist-ance of the accessory sciences, if he makes use of chemicalagents and of physical instruments, if he practises vivi-sections, if he utilises statistics, if he consults J. L. Petit,Scarpa, Langen, and Syme, why should he disdain the micro-scope ? For if it is good to diagnosticate stone by the aidof a sound, polypi with the laryngoscope, an amaurosis withthe ophthalmoscope, paralysis by means of an electricmachine, diabetes with potash, why reject the lens for re-cognising leucocythæmia or spermatorrhoea ?"

Further on M. Verneuil says that, far from agreeing withM. Nelaton on the present tendencies of the French surgicalschool, he takes quite a different view of the matter. "In

approaching the difficulties of clinical study, the livinggeneration arms itself at the outset with all the resourceswhich are generally lent by the sister sciences; it holds outits hand to the ancients and to the moderns, to the English,the Germans, and the Italians, in order to borrow facts andideas; it divides its time between the laboratory and thedissecting room, the library and the hospital ; in a word, itrenounces no source of instruction, being neither so sense-

’ less nor so vain as to repudiate whatever may renderscience more complete, and practice more efficacious."

M. Verneuil has a curious remark with regard to the men-tion of Dupuytren’s name in Nelaton’s article :-" If thearticle is written but with the object of celebrating Dupuy-tren, it was really not worth the while. Enough has beensaid, I think, of that ambitious despot, who obtained fame,wealth, and honours, but has not deserved that true gloryreserved, thanks be to God, to true savants." This opinion,coming from a French surgeon, will surprise not a few ofmy readers.Such is a rapid sketch of Professor Verneuil’s article,

which has been the medical morceau of the week. I neednot say that it is interspersed with home thrusts at theSenator’s address. A somewhat invidious view of Nelaton’s- contribution to the Figa1’o has been taken by some; andamongst other things it has been said that the mention ofDupuytren’s name is a covert comparison conceived in viewof the public. But surely the celebrated surgeon-I meanNelaton—was fully justified in upholding an opinion whichis rapidly gaining ground-to wit, that the engrossing studyof infinitely small details, though having, of course, its im-portance, has thrown clinical observation rather into theshade, and that "the great lines of clinical surgery" arenot cultivated with that peculiar care which they deserve.For my own part, I believe the above remark is especiallyapplicable to this place. The practical study of surgery ismuch neglected here. The want of this necessary culture isobserved even among the rising surgeons in the Paris hos-pitals ; and I could, if I wished, back up this assertion bythe relation of certain facts which have occurred only duringthe past fortnight.

Paris, Sept. 28th, 1869.


I SHOULD not have considered it necessary to notice the

communications which have appeared in your recent

numbers condemnatory of antiseptic surgery, had some ofthese not emanated from correspondents in Glasgow, who,

from their local opportunities of information, mightnaturally be expected to understand the subject, and whosestatements may, therefore, carry more weight in somequarters than they are entitled to. I have no intention of

following those gentlemen through the unargued assertionscontained in their letters, satisfied that they are dailybeing refuted by observation and experience, in support ofwhich I would refer them to Dr. Keith’s rejoinder in yournumber for last week. I cannot refrain, however, from

giving Dr. Black’s statement, that the bulk of the profes-sion in Glasgow are looking on antiseptic surgery withfeelings of derision, an unqualified contradiction; so farfrom this being the case, they are hailing it as the result ofcalm and scientific deduction, and are watching its success-ful progress with deep interest, surprise, and pleasure.Antiseptic surgery does not consist, as your correspondentsseem to think, in dressing a wound with carbolic acid, or anyother disinfectant or antiseptic; that is the least of thesystem. No ; 3 let anyone read Mr. Lister’s papers withattention, or, better still, see his practice in his wards, and(be the sporule theory right or wrong) he will find theresults obtained are consequent on the most careful atten-tion to minute scientific details at every step of an opera-tion, or of dressing a wound-the thorough application of anantiseptic, the exclusion of atmospheric air, the torsion ofarteries, the carbolised ligature, and other points requiringan amount of care and time which few surgeons can affordto give to their hospital duties. Hence one reason of thefailures in other hands. The fact is, in Mr. Lister’s wardsunion of wounds of all descriptions without suppuration, byfirst intention in short, is the rule instead of being the ex-ception. I thoroughly recommend Drs. Morton and Blackto avail themselves of the few weeks Mr. Lister is still to bein Glasgow, to follow him in his hospital visits, and sure amI they will come out wiser men. Mr. Lister addresses him-self to our judgments and candour, not to preconceivednotions and prejudices.The remarks in your last number regarding the injustice

which would have been done to Dr. Penney, by appointinga professor of technical chemistry in Anderson’s University,are quite in accordance with the professional feeling here.I am glad to inform you that at a meeting of the trusteesheld last week, all that had been done in the matter wasannulled. Whether Mr. Young may renew his munificentoffer to Anderson’s University in an amended form, foundan independent school of chemistry, or withhold the antici-pated gift altogether, remains to be seen.Glasgow, Sept. 27th, 1869.

Medical News.APOTHECARIES’ HALL. - The following gentlemen

passed their examination in the Science and Practice of Medi-cine, and received certificates to practise, on Sept. 23rd :-

Andrews, Arthur, Colney-hatch.Harris, Andrew, Manchester.M’Gill, Arthur Fergusson, King’s College Hospital.Palmer, William James, Great Yarmouth.Sherratt, James Swindells, Granby-street, N.W.Wilke, Oscar Adolph Gotthilf, Winchester-street, Pimlioo.

The following gentlemen also on the same day passed theirfirst professional examination :-Henry Bennett Bailey, Frederick Howard Clarke, and George DavidsonDeeping, Guy’s Hospital; Philip Thornton, London Hospital.

At the preliminary examination in Arts, held at the Hallon Sept. 24th and 25th, 114 candidates presented them-selves, of whom 41 were rejected, and the following 73passed and received certificates of proficiency in GeneralEducation :-FIRST CLASS, IN ORDER OF MERIT.-James Hewett Paley, Caleb WilliamBowles and William Edward Tofts, Jas. E. H. Mackinlay and WilliamHugh Beresford, Varley Geo. Fay and M. A. Messiter, George HawsonKeyworth, Thomas Buckle.

SECOND CLASS, IN ALPHABETICAL ORDER.— Thomas Gunton Alderton,John Edward Allen, Sidney Allen, Thos. 0. F. Alsop, Samuel Andrews,G. P. Arrowsmith, Benjamin R. Baker, George William Baker, AdolphusBevan, William Boulting, Peter Bradford, Edm. Selwyn Bray, RichardBrayn, John R. Burton, George William Caswell, Henry L. Champneys,Charles B. Dalton, Arthur G. Don, Herbert M. Ellis, Joseph V. Farfan,Francis M. Fay, George F. Fenton, John F. Fry, Benjamin G. Godfrey,