934

EXCISION OF OBSTRUCTION AT THE NECKOF THE BLADDER.

To the Editor of THE LANCET.SIR,-In concluding my Lettsomian Lectures I expressed

my regret that time had only permitted me to glance atsome of the more salient points of my subject. Much therewas that I left undone. I ought, for instance, to haveexhibited the dilatable air tampon, invented by Bushe, forthe arrest of hsemorrbage after lithotomy, and reproducedmany years afterwards in THE LANCET by Mr. Browne. I

ought to have shown that the lithotrite, recently describedby Sir H. Thompson in one of your contemporaries as new,was constructed after the principles of Mercier, whose in-strument had been introduced by me several years pre-viously in THE LANCET. I ought, further, to have exhi-bited Mercier’s aspirator side by side with Sir H. Thomp-son’s, and pointed out that the latter was but a modifi-cation of the former. It will thus be seen that inmatters of omission I have been a great offender. I am notunacquainted with Sir H. Thompson’s valuable works, andam in particular aware of his criticism on Mercier’s opera-tion, but I am also acquainted with Mercier’s reply. Thatsurgeon’s operation was submitted to the searching in-

vestigation of the highest known tribunal-a Commissionof the Académie de Medecine, from whose long report thisis an extract:-" M. Mercier s’est occupé des maladies de laprostate et notamment des saillies valvulaires qu’amene aucol vesical 1’hypertrophie de cet organe... 11 a presenteun instrument fort ingenieux pour en pratiquer 1’excision.Les faits nombreux dont votre Commission a ete temoinsanctionnent l’importance et 1’utilite de ce procédé opéra-toire" (p. 44). The report of the Commission ot theAcadémie des Sciences was still more flattering. Mercier’soperation has recently been described by that distinguishedsurgeon M. Reliquet, and its indication set forth at p. 458of his "Traite des Operations des Voies Urinaires "" L’excision est indiquee quand la rétention etant complete,le malade eprouve de grandes difficultés a, se sonder, ou ne

peut plus le faire. La disparition de la saillie contre laquellela sonde de gomme vient heurter est un résultat imn16diatet des plus importants." Much more I could add, but Ithink I have produced sufficient evidence to enable yourreaders to form a correct opinion on the merits of Sir H.Thompson’s reclamation presented by Mr. Browne.

I remain, Sir, your obedient servant,Portman-square, June 8th, 1880. W. F. TEEVAN.W. F. TEEVAN.

TREATMENT OF CANCER.To the Editor of THE LANCET.

SIR,-I notice in THE LANCET of June 5th a paragraphthat Drs. Simpson and Macdonald "have stated that intheir hands Chian turpentine, as yet, had not been produc-tive of benefit when used in cases of uterine cancer." I

presume that the cases in which the remedy was used weretreated in the Edinburgh Royal Infirmary. If such be thecase, I may be allowed to state that I have every reason tobelieve that the drug used for some time in that institutionwas not genuine Chian turpentine. Within the last twoor three weeks, however, from a specimen that I have seen,it is probable that a drug of a better quality is being’ used,although undoubtedly adulterated with some other resin.Considering the short time that the latter has been in use,comment is unnecessary. I may add that in my hands themost satisfactory results continue to be produced by the trueremedy in cancer of various organs.

I am, Sir, yours, &c.,Birmingham, June 7th, 1880. JOHN CLAY.JOHN CLAY.

FILTERING MATERIALS.To the Editor of THE LANCET.

SiR,—A paragraph from The Times has been going theround of the papers concerning my report on Filteringmaterials. That paragraph is a misleading one, and doesnot give a fair account of the conclusions arrived at. The

experiments were made to ascertain if the new materialcarferal was sufficiently good as a filtering substance to

justify its adoption for service purposes, and for that purposeit was tried against spongy iron and silicated carbon. Allthree were found good filtering media, but the balance wasrather in favour of the carferal and of the spongy iron. In.deed, the excellence of the latter material was never ques-tioned. The carferal seemed, however, more practicallyconvenient for the public service. For ordinary purposesthe spongy iron still remains one of the best filters in themarket.

I remain, Sir, your obedient servant,F. DE CHAUMONT,

Netley, June 8th, 1880.F. DE CHAUMONT,

NAVAL MEDICAL SERVICE.To the Editor of THE LANCET.

SIR,-The usual advertisement appears from the Admiraltyinforming young medical men that their services are requiredfor commissions in the Medical Department of the RoyalNavy. It does not therefore seem as if any action was aboutto be taken on the Report of the Committee which has justsat to inquire into the disabilities of the service, and it is a&

well they should be told that the circular printed for theirguidance is a snare, and that instead of medical officershaving choice of cabins according to relative rank a casenow presents itself where a cabin is being specially built onboard a frigate refitting at one of the ports for the chaplain,an officer of only three years’ service, and twenty yearsjunior to the fleet surgeon, who still is allotted the sameaccommodation as the junior lieutenant, a young man oftwenty-three years of age. This is the injustice medicalmen are invited to submit to.

Your obedient servant,June 8th, 1880. VINDEX,

SEA-WATER FROM LOWESTOFT.To the Editor of THE LANCET.

SiB,—I observe in your issue of last week you hint thatthe sea-water which is being conveyed by this Companymay perhaps be obtained from the harbour or from off theNess, both of which places, you say, are contaminated bysewage from the town.

I am instructed by my Directors to state that the water isobtained from neither of those places, but from a pointabout half way down the new arm which is being added tothe North Pier. This point is outside the harbour, and wasselected by the company’s engineer as being the best forobtaining a pure supply.You also suggest that tinned water may not be good.

My Directors admit that, under given circumstances, thismay be so, but the water ex Lowestoft is in tins a few hours.only, and not long enongh, they are advised, to be affected.My Directors, however, think that experience may show

some other material to be better than tin. We first ex-

periinented with earthenware vessels covered with wicker-work, but had to give them up on account of their weight.Then we took to tin ; and now we are having made, forexperimental purposes, vessels of papier-mache, of wood,and of glass encased in wicker.

I am, Sir, your obedient servant,Great Eastern Railway, Secretary’s Office, J. HADFIELD,

June 8th, 1880.J. HADFIELD.

PARIS.(From our own Correspondent.)

THE difference of opinion between the Faculty of Medicineand the Ministry seems to be now smoothed over. The

project of creating a professorship of Pathological Anatomyhas been abandoned in favour of a histological laboratorywhich will be directed by one of the agrégés, who will1::estyled "Directeur des Travaux Anatomo-pathologiques" andrank with the already existing director of anatomical studies.Having been unsuccessful in his endeavour to create thisprofessorship for himself, M. Cornil has withdrawn from thecandidature attogether, and the new appointment will pro-bably be bestowed upon M. Cadiat, who is already wellknown, at least in France, for his microscopical labours.

935

The last two sittings of the Academy of Medicine havebeen rendered interesting by communications from M.Pasteur. Recent experiments with the virus which givesrise to the cholera of fowls have led the eminent biologist tosome conclusions relative to variola and vaccinia, v’hich areof the very highest importance. Vaccine matter, says M.Pasteur, is nothing else than attenuated or diluted vario-lous virus, and it is unnecessary that it should pass throughintermediate organisms. The experiments tend to provethat a weak dose of a specific virus gives rise to a miti-gated form of disease, which, however, is protective againstthe occurrence of the disease in its ordinary evolution.Should these views be justified by future research, andshould their application be extended to other diseases thanthose already mentioned, a new light will be thrown on thepathology of zymotic affections, and their prophylaxisrendered a matter of certainty. Disturbances have occurredat Montpellier in consequence of the appointment of twoassistant professors of zoology and botany. The studentsof the Faculty of Medicine who were in favour of an uu-successful candidate testified their displeasure with morevigour than reason at the opening lectures, and the rectorof the Academy was compelled to close the Faculty. Aministerial decree has now confirmed this action, and themost strenuous measures have been taken to repress theinsubordination. Until further notice, the students oi

Montpellier are under a kind of scientific interdict. Theiiown school is closed, and they will not be allowed to taktout their curriculum or to pa?s examinations at any otheluniversity. The tone of the decree admits of no mistake,and the sooner submission is made the better for the prestigeof Montpellier.

n

MEDICAL NOTES IN PARLIAMENT.

IN the House of Lords on June 4th Lord Carnarvon calledattention to the principle of insurance against sickness andold age under public guarantee, and proposed a compulsoryplan of insurance-viz., that within the ages of eighteen andtwenty-one every man should be ohliged to make a paymentof :E10, which would entitle him to 8s. a week in time of

sickness, and 4s. a week after the age of seventy.In the House of Commons on the 3rd inst., the Home

Secretary proposed the appointment of a select committeeto inquire and report upon the expediency of acquiring onbehalf of the inhabitants of London the undertakings ofthe existing water companies within the metropolitan area,and further to inquire and report as to the nature andextent of the power of the water companies to levy water-rates and rents, and how far it may be desirable to modifythe same. The proposition was agreed to. The Committee,which is to meet on Tuesday next, consists of the followingmembers : SirW. Harcourt (chairman), Sir J. M’Garel-Hogg,Mr. Chamberlain, Sir Richard Cross, Mr. AldermanLawrence, Mr. Brand, Mr. Pemberton, Mr. Caiue, BarouH. de Worms, Mr. Firrh, Sir Gabriel Goldney, Lord GeorgeHamilton, Mr. Thorold Rogers, Mr. Sclater-Booth, Mr,John Hohns, Mr. Parnell, and Mr. J. G. Hubbard. ThePresident of the Local Government Board, in answer to a

question from Mr. Harcourt, in the House of Commons.on the same day, whether it was the intention of theGovernment to bring in a Bill for regulating the conser-vancy of rivers, said, in effect, no, as he thought it would notbe possible, having regard to the difficulties with which thequestion was surrounded, to pass a Bill dealing with it thisaession.

In the House of Commons on the 4th inst., ColonelAlexander asked the Secretary of State for War whetherhe would place the medical officers of the Guards on anequality with the other medical officers of the army asregards pay and promotion under the Royal Warrant ojNovemher 27th, 1879. Mr. Childers replied that the WatOffice had it now under discussion to propose a New Warrantwith respect to the medical officers of the Guards, but hecould not undertake-considering their very great advan-tages in other respects-that they should be put on an

identical footing with medical officers of the army gel1eraIJyas to pay and promotion. He thought he ought to add thatthere was no difficulty—and he understood there never hadbeen any ditliculty-in obtaining efficient medical officersfor the Guards.

On Monday, at the time of private business, the GlasgowFaculty of Physicians and Surgeons’ Widows Fund Bdl,from the House of Lords, was read a second time.

In the House of Commons on Tuesday evening, in thecourseof a discussion as to the maintenance of pauper lunatics,Mr. Hibbert intimated that the Government were f,j,%,4)ur-able to provision being made in workhouses for the care andcustody of harmless imbeciles Mr. R. Paget, who movedfor a Select Committee on the whole subject, stated in thecourse of his speech that imbeciles kept in workhouses as anexperiment had had to be sent back to the Somerset CountyLunatic Asylum ; and it was fouud that, during their stay inthe workhouses, they lost weight, and their mental conditiondeteriorated. He recommended that different counties shouldhe allowed to combine in establishing branch asylums forimbeciles. His chief point, however, was a strong objectionto the present system of distributing criminal lunaticsamongst the county asylums ; aud he contended that theState should provide a prison asylum. Mr. Peel, replyingon behalf of the Home Office, suggested that BroadmoorAsylum might be used exclusively for the worst class ofcriminal lunatics. With regard to chronic lunatics, one ortwo applications had been made to employ disused work-houses for their reception ; but a comparatively small pro-port.ion of cases were considered fit for removal even to thefirst-class workhouses. There was a large class suffering fromsenile dementia, and it was curious to note how few of themwere judged by medical officers of the asylums to be fit to beremoved, with any prospect of good. At Hanwell, out of1840 inmates, there were only 50 females and 15 malesreported as fit for removal to a first-class workhouse, suchas those in the metropolis ; at Colney Hatch, out of a totalof 2178, 20 males and 40 females ; and at Banstead, out of1600, only 40 males and females together were so certified.It was truly said that lunacy law was a maze of statutes,and they undoubtedly needed consolidation and amendment.In March, 1879, the late Home Secretary appointed aDepartmental Committee, including many gentlemen un-connected with the Department, who were qualified byspecial knowledge, to consider (1) whether it was desirablethat criminal lunatics should be separated from pauperlunatics to a greater degree; (2) whether special provisionshould be made for the care and custody of imbeciles ; and(3) whether Broadmoor had answered its purpose. ThatCommittee did not report to the House in consequence ofthe intervention of the dissolution. He was prepared topropose the reappointment of that Committee, but wouldreserve for the present the terms of the reference. In replyto Mr. Peel, Mr. Dodson promised to communicate with theHome Office with a view to an enlargement of the reference,and Mr. Paget thereupon withdrew his motion for a SelectCommittee.On Wednesday afternoon the second reading of the

Medical Charities (Ireland) Bill was moved by Mr. Meldon.The Bill proposes various changes in the administration ofmedical relief under the Poor Law, one of them being asystem of lending medical tickets to persons in temporarilystraitened circumstances, and there is also a proviso for thesuperannuation of aged medical oflicers. Mr. MitchellHenry opposed the Bill in the interest of the medical oflicersand on the ground of surpiise, and after further hostilecriticism, Mr. Meldon himself moved the adjournment ofthe debate, which was agreed to. At the same sitting, Mr.Meldon moved the second reading of the Births and DeathsRegistration (Ireland) Bill, which proposes to assimilate theregistration law of Ireland to that of England. Dr. Lyonsdescribed the Bill as a partial measure, and said, if itwere passed, it would shut the door to a more completesettlement of the question. It sought to continue thesystem of making it everybody’s business to give notice of adeath ; and of course, what was everybody’s business wasnobody’s business. It also left matters open for srvea days,which, in his opinion, was too long a period. He thoughttwenty-four hours would be quitesufficient. The whole of thisquestion had extensive medico-legal bearings. These pointshad been fnlly considered in Continental legislation, and atolerably complete process of yerificatioll of death had beenfor some years at work in France, Gerrnauy, and otherconntries. He desired to see introduced in this country somemode of verifying death under the hand of responsible andscientifically educated persons. He would impose on re-latives the responsibility of reporting the occurrence of adeath within a few hours to a medical officer speciallycharged with that duty, who should immediately go to see