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the many than in the impatience of the few, and whether thegratitude of those who over-estimate our services does not morethan compensate for the neglect of those who withhold fromus the merit which we really deserve ? 1 In enumerating what Ibelieve to be the advantages belonging to the profession ofwhich we are members, there is one other part which I oughtnot to overlook. However much assistance we may in earlylife derive from attendance on lectures and afterwards fromthe study of books, the knowledge which we thus obtain,necessary as it is, is nevertheless only of a preliminary kind, andis nothing at all in comparison with that which each individualderives from his own personal experience. The consequenceis, that every succeeding year the medical practitioner be-comes more equal to his duties than he was before, and, ex-cept it be in the case of those whom an overweening self-con-fidence renders careless and indifferent, this improvementcontinues as long as we retain the integrity of our faculties ’,unimpaired by disease or age. Hence it is that medical practiceis not liable to those fluctuations of which those engaged insome other professions have too much reason to complain. Inhis own circle, the place of the experienced and judiciousmedical practitioner is not easily supplied: this his patientsfeel, and this he must feel himself. The principal source ofanxiety to a professional man in the beginning of his career,is the doubt whether he will maintain whatever reputation hehas been able to acquire. If any one case turn out less fortu-nately than he had reason to expect, he dreads (and muchmore than he needs to do) the influence which it may haveon his future fortunes; but this source of anxiety graduallydiminishes as years increase, and at last he discovers that hemay safely rely on his general character, which is independentof the successful or unsuccessful termination of a particularcase. But, after all, the value of the profession to each indi-vidual engaged in it depends more upon that individual him-self than upon any extraneous circumstance. It is an in-different and irksome trade, but it is a noble and interestingscience. If you will pursue it with credit and with comfort,you must regard it as the latter, and not as the former. Andthis explains one great advantage of a society such as thatwhich I now address, which brings us together as men ofscience, not as the proprietors of a railway or L canal, to dis-cuss the value of shares, or the amount of dividends, but tocompare our experience, to increase our knowledge, and thusto have our minds elevated above the meaner pursuits of life.

This address was listened to throughout with the deepest at.tention, and the applause at the close was loud and long con-tinued.The following gentlemen were then elected to fill the

various offtces during the ensuing year: - President : Dr.Robert Iee, F.R.S.- Vice-Presidents: : Dr. Aldis, Mr. Barnes,Mr. Gaskell, Mr. Godrich.-Treccsurer : Dr. LVoolley.-Coura-cil: Dr. Barclay, Mr. Bullock, Dr. Christian, Mr. Douglas,Mr. Ince, Mr. Martyn, Mr. Muller, Mr. Philips, Dr. Simpson,Dr. Traquair, Mr. Whitmore.-Secretary: Mr. Seaton.-Au.ditors : Mr. Keen, and Mr. Webb.The formal business being concluded,Dr. MANTELL, at the request of Sir Benjamin Brodie, then

favoured the meeting with an address on the osteology andphysiology of the colossal reptiles from the south-east of Eng-land, of which there were some unique and most interestingspecimens, and in conclusion, briefly considered that most in-teresting and mysterious physiological problem-the appear-ance and extinction of species and genera. He took a rapidand lucid view of the facts that support, if they be not regardedas sufficient to establish, the opinion of some eminent philo-sophers, that as the duration of the life of every individual ofa species is immutably restricted within very narrow limits,in like manner the existence of a genus or race on the surfaceof the earth is doomed to terminate within a certain definiteperiod. Some races may flourish a few centuries, others forthousands of years; but their final extinction is irrevocablydetermined by the law of their organization. The bearing ofthis problem on many important physiological phenomena, asthe supposed origin of epidemics from the sudden developmentof peculiar types of invisible animalcules &c., was discussed ina candid and philosophical spirit, which was warmly applaudedby the meeting. In conclusion, Dr. Mantell begged to apolo-gize for the discursive nature of the discourse, and in referenceto his observations on the past condition of the earth and itsinhabitants, as deducible from the remains of the successiveraces of animals and plants which had flourished for awhileand become extinct, and been succeeded by other types, heonly offered them as speculations to be modified or abandonedwith the advance of science; for our knowledge and our judg-

ments are in general only founded on probabilities more orless great, which it is very important, but very difficult, toappreciate at their just value.Mr.ToYNBEEwas then kind enough,at thepresident’s request,.

to give a short statement of his researches into the normalstructure and various diseased conditions of the membranatympani, and to exhibit a most beautiful series of preparationsin illustration of them.The members and visitors then proceeded to examine the

various objects of interest and curiosity scattered about theroom. Among these were some rare books and valuable plates.lent by Sir J. Clark, Dr. Pettigrew, &c., and particularly somebeautiful plates, published by Dr. PiragoN, under the directionof the Russian government, showing the condition of the in-testinal canal after death by cholera, and some plates of aspecies of elephantiasis peculiar to Norway, issued by theNorwegian government; both these series were furnished byMr. Haden. There was also a variety of curious instruments;but nothing in the room excited more attention than the ori-ginal sketch of John Hunter by Sir Joshua Reynolds, fromwhich he afterwards painted the celebrated picture now inpossession of the College of Surgeons. This sketch was givenby John Hunter’s widow to the uncle of Mr. Knight, of WestBrompton, who kindly lent it to the Society for the occasion.

PATHOLOGICAL SOCIETY OF LONDON.

MONDAY, APRIL 1, 1850.—DR. LATHAM, PRESIDENT.(Communicated by Mr. POLLOCK.)

(Continued from p. 515.)

Mr. PRESCOTT HEWETT, in connexion with the last specimen,brought forward ten cases of ruptured bladder, which, withone exception, occurred at St. George’s Hospital within thelast few years. The first was a specimen of

EXTENSIVE RUPTURE OF THE APEX OF THE BLADDER, INTOTHE CAVITY OF THE PERITONAEUM,

from a man, aged thirty-five, who lived two days after theaccident. On his admission into the hospital, under Mr.Hawkins, a catheter was passed, and a large quantity ofbloody urine drawn off: he was then in a state of collapse,from which ho never rallied. The urine, which was always bloody,continued to be drawn off without any dinicuUy. At the post-mortem examination, extensive fracture of the pelvis was dis-covered, and a laceration of the bladder, which measuredabout two inches in length, and an inch and a half inbreadth. The bladder itself was contracted, and in its cavitywere some clots of discoloured blood. No marks of inflam-mation were found in the peritonmal cavity; an ounce only ofturbid fluid was discovered in the cul-de-sac between thebladder and rectum. The other parts were healthy. Thesecond specimen was also one of

RUPTURE OF THE BLADDER INTO THE PERITONEAL CAVITY,from a woman, whose husband, in a quarrel, threw her down,and knelt upon her abdomen with great force. She imme-diately became sensible of having sustained some severe in-ternal injury, and died twenty-four hours afterwards, in ex-cruciating agony. In this case, there were two lacerations,one of which, about half an inch in length, led into the cavityof the peritoneumńthe other, about two inches in length,into the cellular tissue of the pelvis. The preparation is inMr. Caesar Hawkins’ Museum. The third specimen was oneofRUPTURE OF THE FORE PART OF THE BLADDER, IMMEDIATELY

BEHIND THE PUBES.

caused by a man jumping on the abdomen of the patient, whenhe was on the ground; he lived twenty-three days after theaccident, aged fifty; he was taken into the hospital underMr. Tatum, two days after the injury, with an anxious coun-tenance and great pain and tension over the lower part of theabdomen, accompanied by great difficulty in passing urine. Acatheter was introduced, and a pint of bloody urine drawn off.The necessary treatment was adopted,and he progressed prettyfavourably for some days; at the end of this time, three dis-tinct tumours, presenting evident but deep-seated fluctuation,made their appearance; one of these tumours was in themesial line, immediately above the pubes; the other two inthe iliac regions. On the twelfth day after his admission, a freeincision was made into the lower part of the left iliac region,letting out about three pints of fcetid pus, with large sloughs.This was followed by a marked amendment, which lasted but

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a few days. The incision became unhealthy, and the urine,which had for some time been passed without inconvenience,now flowed freely through it. At the post-mortem examina-tion, the peritonseum was found extensively stripped off fromthe parts in the neighbourhood of the bladder, as well as fromboth iliac fossae and from the walls of the abdomen, as high asthe umbilicus; the cellular tissue in these various regions wasin a sloughy state, and filled with large quantities of foulmatter. The bladder presented, in its fore part, a rupture ofabout an inch in length, and half an inch in breadth, which ledinto a perfectly circumscribed cavity in the surrounding cellulartissue, the walls of which were so thick and so well formed, that,at first sight, it appeared to be one of the sacculi so frequentlymet with in this organ; towards the lower part of this cavity,the wall of the cyst had, however, become detached from themargins of the rupture, so that here there was an openingthrough which the tip of the little finger was easily passedinto the bladder. The bladder itself was very much con-tracted, and its mucous membrane, of a dark colour, was in

I

various parts covered with lymph containing a sandy deposit.The fourth was also a specimen of

RUPTURE OF THE FORE PART OF THE BLADDER INTO THE CELLULAR

TISSUE, IN CONNEXION, HOWEVER, WITH FRACTURE OF THE PELVIS.

The patient, aged twelve, was admitted, under Mr. Cutler, ina state of collapse, some twenty hours after the accident, aheavy weight of iron railings having fallen on the lower partof the abdomen. No urine having been passed, a catheter wasintroduced, and a small quantity of bloody water drawn off.The belly became tympanitic, and tension, swelling, and red-ness made their appearance in the lower part of the abdomen,in the scrotum, groins, and upper part of both thighs. Thesesymptoms were soon followed by delirium and low fever, andhe died six days after the accident. At the post-mortemexamination, the bladder was found to be ruptured in twodifferent places in its forepart; the margins of the ruptureswere sloughy and sufficiently large to allow of the passage ofa large bougie. Urine had been extensively infiltrated intothe cellular tissue of the pelvis, and some of it had made itsway into the upper part of both thighs, scrotum, &c., bypassing through the obturator foramina; large sloughs existedin various parts; the pelvis was extensively fractured, and asmall quantity of blood was found in the cavity of the peri-tonseum.

(To be continued.)

MEDICAL REFORM.

DEPUTATIONS TO SIR GEORGE GREY, BART.(AUTHENTIC REPORT.)

ON Thursday, the 2nd instant, a numerous deputation repre-senting various associations in the provinces, waited, by ap-pointment, on Sir George Grey, with whom was the LordAdvocate, on the subject of Medical Reform.The deputation consisted of Messrs. W. Watson Beever,

Daniel Noble, and George Southam, Manchester; ThomasTomkin, Witham; R. S. Nunn and Samuel Philbrick, Col-chester ; Dr. Henry Johnson, G. Arrowsmith, F.R.C.S., andWilliam Clement, F.R.C.S., Shrewsbury; Peploe Cartwright,Oswestry; W. P. Brookes, Wenlock; Dr. Lloyd Williams,F.R.C.S., North Wales; Dr. Reyner, Stockport; Dr. Hast-

ings, President, and J. P. Shepherd, F.R.C.S., Secretary, ofthe Provincial Medical and Surgical Association; and GeorgeBottomley, Chairman of the Associated Surgeons. They wereaccompanied by Mr. Brotherton, M.P.; Mr. Ricardo, M.P.;Mr.Wakley.M.P; Alr. Baldoch, ill.P.; Mr. Folev, M.P.; LordJohn Manners, M.P.; Col. Beresford, M.P.; Sir John Tyrrell,M.P.; Mr. Hardcastle,liLP.; Mr. Bramston, M.P.; Mr. Rufford,M.P.; and Mr. Milner Gibson, M.P.The deputation having been introduced,Mr. CARTWRIGHT, of Oswestry, stated that he had the

honour to submit to Sir G. Grey’s consideration certain pro-positions, emanating from the Combined Deputation of Pro-vincial Physicians and Surgeons. This deputation expressedthe sentiments of the surgeons of Manchester, of Stockport;of Essex, of Salop, and North Wales, and, in the person of thelearned President of the Provincial Medical and SurgicalAssociation,the sentiments ofthe Central Council and branchesof that large Association. The propositions were identicalwith the memorial which he had had the honour to forward inJune, 1849, signed in a few days by about 500 legally qualifiecprovincial physicians and surgeons resident in Shropshire anè

adjacent counties. The propositions also were identical witha memorial presented to Sir G. Grey last June, signed by 160surgeons of Manchester and its neighbourhood, and withanother memorial recently presented from Essex, signed byupwards of 100 provincial surgeons, and were identical also inthe most essential points with a memorial that would to-daybe presented from the Provincial Medical and Surgical Asso-ciation, which mustered nearly 2000 members. It was neces-

sary to mention this, to show that this deputation representeda large body of provincial surgeons, in contradistinction towhat had been stated at the meeting of the National Institute,that they were the representatives of the general practitionersof the kingdom. The National Association, of which they arethe remnants, numbered a large body of members, but is nowreduced considerably by the separation of those who disap-prove of a new incorporation. Provincial surgeons are placedin circumstances occasionally of great exigency, and it is im-perative, therefore, that they should be properly and suffici-ently educated; and they can have no guarantee that such willbe the case unless surgeons in general practice are admittedin part to the governing council of the college to which theybelong, so as to afford to them the means of superintending theeducation of their class. The provincial surgeons do not seekthe emoluments and offices of a new college; they are desirousthat the Government should alter and amend existing institu-tions, as suggested in their propositions. Having read the firstproposition, Mr. Cartwright submitted that there was muchthat was valuable and honourable in the ancient colleges, andthe deputation regretted that any body of their professionalbrethren should seek to alienate themselves from them; itwould be far better for all if these institutions were renderedsuitable to the requirements of the great body of the profes-sion at large, by the institution of a conjoint board embracingall branches of medical and surgical science, before whichevery one should present himself for examination, by whichhe should be tested as to his qualifications, and from which heshould receive a state licence to practise. If this reorganiza-tion were effected, with certain alterations in the constitutionof the College of Surgeons (embraced in the second and thirdpropositions), a college of general practitioners would be su-perfluous ; if independent, it would be a rival to the Collegeof Surgeons, and destroy those funds now appropriated to im-portant purposes; if inferior or supplemental, it would degradethe practitioners enrolled in it. It was due to the council ofthe College of Surgeons that the profession were threatenedwith a third college and its attendant evils; the prayer of thedeputation, therefore, was for an extension of the franchise ofthe College, and the admission of surgeons in general practiceto form a part of the governing council, that their rights maybe protected, a proper education secured, and that every man,if he had talent, should find the highest honours in his profes-sion accessible to him. Mr. Cartwright further stated thatthis was the vital point of the question, and as the other par-ties concerned were on the spot, and the members of the de-putation resided at a great distance, and attended at consider-able expense and inconvenience, he respectfully solicited,what he hoped might be accorded at the present interview,that before the Queen’s sign manual was put to any newor amended charter, that a draught of it might be submittedto the inspection of the profession; and in handing in the pro-positions which he had read, he hoped they would be found so

moderate and just that her Majesty’s Government would ulti-, mately accede to them.

The propositions were then read to the right honourablebaronet, which were as follows :-

: 1. That the Colleges of Physicians and Surgeons,once placedin just and harmonious relation with their respective members,; and re-organized so as to ensure uniformity and sufficiency ofl education to all, are amply sufficient for the requirements of, the medical profession in England; and that the institution of, a College of General Practitioners, under such circumstances,

would be a needless complication, prejudicial to the interestsof the profession and the public.

) 2. That the Charter granted to the College of Surgeons, in- 1843, forms the principal obstacle in the path of medicallegislation; and that the recent alteration of the said Charter1 proposed by the Council of the College of Surgeons is insuffi-, cient, unsatisfactory, and unjust; as also the resolutions of the

Council of April 23rd, 1850.1 3. That all who were members of the College prior to thes Charter of 1843, -as they attain respectively a standing of1

fifteen years, shall be admitted to the fellowship; and that

s fellows resident in the provinces be eligible to the Council, ofi which they may constitute one-third part.1 4. That as no fee was demanded from those on whom the