1597the patient shown), except the eldest, suffered fromchorea about the fiftieth year. The patient had four

sisters, and of these one suffered from chorea at the ageof forty-nine, while two others were mentally affected. A

son of the patient was healthy. Another case was also

shown, one of so-called chronic congenital chorea " in agirl aged sixteen. The contractions were noticed immedi-

ately after birth, and the patient did not begin to walkuntil she was four years old, and it was only at the ageof eight that she could walk alone. She was also late in

speaking. She used her hands with difficulty, but her

condition showed a slow but gradual improvement. Volun-

tary movement increased the contractions. The knee-jerkwas slightly increased, but with the exception of a smalldegree of weak-mindedness the general condition was

fairly good. The case, according to Dr. von Solder, is

really one of cerebral diplegia, and, as was recently pointedout in our columns, this is almost invariably the actualcondition in cases of so-called congenital chorea ; so that

the term is probably a misnomer, and the movements

would be more correctly described as those of athetosis.

DR. RENTOUL explains in a circular that his opposition tofive successive Bills since 1890 has cost him, " out of his ownprivate means," ;E321 15s. 9d. Dr. Hugh Woods establisheda fund to repay Dr. Rentoul, and succeeded to the amount of.E50. Mr. Colin Campbell succeeded in the same way to theamount of £30. In 1894 the branch committee of theLancashire and Cheshire Branch refunded him E37 17s. 2d.These sums amount in all to E117 13s. 21/2d., leaving him still.8204 2s. 6d. out of pocket.

THE death, on the 17th inst., is announced of Mr. DanielAmbrose, M.D., Q.U.I., L.R.C.S.I., &c. Dr. Ambrose was

member of Parliament for South Louth. He belonged tothe anti-Parnellite party, and at the last General Electiondefeated another medical man, Mr. J. G. Fitzgerald.

WE regret to hear of the death of Dr. Fauvel, of Paris,whose reputation as a laryngologist is of world-wide fame.

His work on Tumours of the Larynx is one of the standardworks on thf subject.

THE ASHANTI EXPEDITION.

VERY great activity has been displayed on the Gold Coastin disembarking stores and in preparing for the advance ofthe troops on Kumasi. One of the main difficulties in the

present expedition, as on the last occasion, has been thetransport. There is no animal or vehicular transport in thecountry, and everything has to be carried by native bearers.Great care has been taken in providing and organising asnfficient force of these, and the transport work went on verysatisfactorily as far as Mansu, but owing to the difficulty inprocuring food in the country beyond, and the desertion of anumber of the native carriers, a block occurred from theaccumulation of stores at that station. This will, however,soon be overcome. As in our Indian warfare, and followingthe course adopted in the last Ashanti campaign, rest

camps have been provided along the line of route. Eightof these have been constructed, and a field telegraph will becompleted between Cape Coast Castle, which is the base, andPrahsu. The postal service which has been organised betweenthese stations is working well. The distance, it may bementioned, of Prahsn from the base is about eighty miles.A pontoon bridge is being constructed over the Prah, but thework is temporarily delayed pending the arrival of requisitematerials, and cannot be completed for many days. Threecanoes, each capable of carrying thirty men, have been con-structed for the passage of the river.Meanwhile a hospital for the troops is being provided at

Connor’s Hill, which will afford accommodation for fiveofficers and seventy-five men, and a bearer company of 600

men has been organised for the transport of the sick. Weare-not told, by the way, what the means of transport of thesick and wounded will be, whether stretchers or canvas cotsor hammocks from the naval ships, or all of these. Surgeon-Captain Eckersley has started to provide for the establish-ment of a hospital, at Prahsn for the troops on the march. Inaddition to the land hospitals at the base there will, ofcourse, be the large amount of accommodation afforded bythe floating hospital, the Coromandel, which has been spe-cially fitted up for the purpose ; and with the steam trans-ports and other communications between the Gold Coast andthis country there should be no difficulty in arranging for

the transit of invalids., Whilst preparations are being made for the advance of theforce along the line of route from Cape Coast Castle acrossthe Prah to Kumasi, a movement is also to be made con-

temporaneously with that of the expeditionary force fromthe coast, from the north, by a large force of constabularyand a detachment of Houssas and two Maxim guns. Thislatter force will, it is understood, proceed to the Nkoranzacountry, and thence threaten, and advance if necessary,on the Ashanti capital.The subordinate chiefs in the interior of the colony are-

understood to be very favourable to the expedition, and haveproffered their services and large detachments of bearers.

Samory, the Mahommedan chief of a large warlike tribe inthe vicinity of Ashanti, who has a powerful army, is under-stood to be also favourable to the British enterprise.The belief entertained on the Gold Coast is that the chiefs

of the Ashantis are determined on fighting. It is rumouredthat Prempeh will be deposed and replaced by his mother, awoman of fortitude and masculine character, who is stronglyinimical to the whites. Be this as it may, the expeditionmay have to encounter some unforeseen difficulties and hardfighting before the troops succeed in capturing the Ashanticapital. The topographical difficulties and dense bush forobvious reasons offer very favourable conditions for Ashantiwarfare. The country is well adapted for raids and surprisesand sudden attacks from numerous small and concealedbodies of men.The health of the troops on the Gold Coast is reported to

be excellent. The present season is favourable in this respectfor the expedition, which cannot, however, it is believed,start for Kumasi for some time. We hope that when it doesstart the march to the Prah may not be protracted by anydefective arrangements or other obstacles, for the countryand bush are very malarious, and that when the expeditionhas accomplished its work by penetrating to the capital andsecuring its political objects the force may effect its returnmarch before the rains set in. In that case there is no reasonto suppose that the risks to health and life should prove-greater than on the occasion of our last war with Ashanti.Everything depends upon the exercise of forethought in

providing for the requirements of the force and in safe-guarding their health, as far as practicable, by good sanitaryarrangements. The previous experience of those who haveto conduct the arrangements in these respects affords thebest guarantee that we can have of their being properlycarried out.

______________

ROYAL COLLEGE OF SURGEONS OFENGLAND.

AN ordinary meeting of the Council was held on the12th inst., the President, Mr. Christopher Heath, being inthe chair.A further report dated Nov. 15th was presented from the

Board of Examiners in Dental Surgery. The chief recom-mendation was that an examination in mechanical dentistry,chemistry, physics, and metallurgy should form the first

examination for the licence. The report was referred to acommittee of the Council.

Dr. Arthur P. Luff was appointed an Examiner for Part I.of the Examination in Public Health.Two cases of alleged misconduct on the part of Members

were considered.The President stated that the Deputation Committee, at a

meeting held on the 2nd inst., had determined to furtherpostpone their report to the Council, as one of the subjectsreferred to their consideration had been selected by the

1598

Council for reference to the meeting of Fellows to be held onJan. 2nd, 1896.

The President, on behalf of himself and the Vice-Presi-dents, reported the delivery of the Bradshaw Lecture, onthe 5th inst., by Mr. N. 0. Macnamara, the subject of thelecture being, " Infective and Tubercular Osteitis as (’ausesof Arthritis in Childhood and the Importance of Early-Treatment." The best thanks of the Council were accorded’to Mr. Macnamara for his lecture, and he was requested topublish it.A letter of the 22nd ult. from Mr. Frank Marshall, honorary

secretary of the Newcastle-on-Tyne Dental Hospital, applyingfor the recognition of that institution by the College for thepurposes of teaching, was referred to the Board of Examiners’in Dental Surgery.A letter was read, dated the 20th ult., from Mrs. E. Garrett

Anderson acknowledging the receipt of the letter informing’her of the reply of the Council to the memorial from theLondon School of Medicine for Women, and expressing the’belief that the memorialists, while much regretting the ,,

decision, will greatly value the assurance contained in theresolution of the Council that, had the matter rested solelywith them, the prayer of the memorialists would have beengranted.A letter was read, dated the 27th ult., from Dr. Liveing

reporting the adoption by the Royal College of Physicians ofLondon, on the 22nd ult., of the report, dated Nov. 11th, 1895,of the delegates on the arrangements of the examinationsunder the five years’ curriculum, with the following rider-wiz : " That the College of Surgeons be informed that this’College would consider it an improvement if pharmacologywere placed with therapeutics under the head of medicine,instead of being accorded a distinct position as a subjectseparate from medicine, surgery, and midwifery." Thecouncil thereupon expressed their approval of the suggestedalteration.A letter was read from Mr. Thomas Bryant reporting the

-proceedings of the General Medical Council at their latesession. The letter was received, and the best thanks of-the Council were given to Mr. Bryant for his services asxepresentative of the College.

THE BATTLE OF THE CLUBS.—XIV.

WE have received a copy of the Rules, Code of Etiquette,&c., of the Fermanagh Medico-Ethical Association." The

objects of the Association are as follow :-The promotion of social and professional intercourse, of mutual

,protection and cooperation, of opportunities to enable members to- ubtain the advice and united support of the local profession.

To obtain increased and more efficient representation for generalpractitioners on the General Medical Council, and of medical men inParliament.To arbitrate in disputes between members of the Association.To support and protect the honour and dignity of the profession,

and to promote honourable practice, to suppress advertising, or otheranfair methods of competition, unqualified and irregular practitioners.

To watch Parliamentary proceedings affecting the profession andgive the members the opportunity of expressing their views thereon.To consider and take action upon the relations of medical officers

with all forms of club practice, and with regard to Poor-law and otherofficial appointments.To circulate a Code of Ethics and information as to various scales

of medical tariff amongst the members.To promote the improvement of medical fees, and the adoption of

some " wage" or "valuation" limit for those entitled to free attendancefrom Poor-law medical officers.To establish, maintain, and circulate amongst the members a patients’

black list.WITH REGARD TO CLUB PRACTICE.

To enforce a wage limit.To insist on a medical examination for all new members and an

’examining fee.To raise the usual rate of subscript ion for females and juveniles.To safeguard the tenure of office by a three months’ notice on either

side.

’The code of medical etiquette set out by the Association is,’with some additions, that adopted by the ManchesterMedico - Ethical Association. It contains directions for

nearly every conceivable point that can possibly arise in the’relation of practitioners to patients or to one another. A

very full and carefully drawn-up table of fees is given.’With regard to the question of club practice the FermanaghMedico-Ethical Association does not seem to have made upit, mind. Appended to the rules and code are the rules.adopted for club practice in Cork, and those drawn up by theEastbourne Provident Medical Society, of which latter

a full account appeared in T)fM LANCET of Oct. 5th, 1895.In the matter of Cork, the Fermanagh Medico-EthicalAssociation consider that the wage limit- £200 a year-istoo high, and that the practice of charging for a familyirrespectively of numbers is not nearly so desirable a practiceas charging for each member of a family. In these twoopinions we cordially agree. For a man with an income off,200 a year to belong to a club is absurd, or would be inEngland ; but the question of medical attendance in Irelandstands upon a somewhat different footing. In our opinion,the club difficulty is best solved by the formation of provi-dent medical associations like those at Eastbourne and Bex-hill, and the Portsmouth Medical Union.

CHELSEA HOSPITAL FOR WOMEN.

THE CASE 0F ME. 0’CALLAGHAM.

OX Wednesday afternoon a special meeting of the

governors of the Chelsea Ilospital for Women was held inthe board-room at the hospital, under the chairmanship ofLord Glenesk. The purpose of the meeting was " to con-sider the propriety of the governors dispensing with the

services of a member of the honorary medical staff, and topass a resolution thereon." There was a fair attendance.At the opening of the proceedings, Mr. O’CALLAGHAN

asked if Mr. Charles Russell, his solicitor, who was helpinghim in the case, might be allowed to speak for him. Thiswas not granted at first, but Mr. BURDETT-COUTTS, M.P.,appealed to the council in the interests of fair play. Hesaid that the case of Alr. 0’Callaghan should be fully andfairly stated before the governors proceeded to a decisionon the subject.The CHAIRMAN said that this need not be made a formal

matter of motion. Mr. Russell had no real locits stan(li, butas there was a disposition on the part of some of the

governors it would be advisable to admit him, and hewould take it upon himself to do so.

Mr. RUSSELL was then admitted into the room.The CHAIRMAN said that the council had considered

themselves obliged to summon this meeting to decide uponthe council’s conduct in a matter affecting the hospital.Rumours had got abroad about the hospital, as if some

scandal had occurred in it connected with the patients andwith matters of that kind. That was not the case. He hadonly to repeat the strong terms of praise he used when theylast met regarding all responsible for the carrying on ofthe hospital, including of course Mr. O’Callaghan, of whoseskill no one had ever had the slightest doubt. Mr.O’Callaghan had circulated a pamphlet in which he repre-sented himself quite unfairly as a victim, not because ofprofessional jealousy but because he was a reformer, andthat he was meeting the usual fate of reformers-martyrdom.His reform consisted of interfering with the general law ofthe hospital by forbidding the resident medical officer tointerfere with his (Mr. O’Callaghan’s) patient. It was a ques-tion of hospital discipline, not of Mr. O’Callaghan’s efficiencyat all. Mr. O’Callaghan had found fault with the residentmedical officer for touching the dressings of a patient. Thatwas a medical question upon which only medical authoritiescould determine ; but immediately after this the councilfound that the case had not been entered up in the books ;that the woman had died on June 18th; and that on the26th, when the weekly board meeting was held, there was nonotice of the death, and the case was not written up. There

again they thought Mr. O’Callaghan had been in default.Mr. O’Callaghan virtually attributed the death to the residentmedical officer-to a secondary shock received from his treat-ment. That was a serious allegation ; and the council found,upon further inquiry, that Mr. O’Callaghan had invited Mr.Bland Sutton and Dr. Duncan to state their opinion in away that both gentlemen considered a violation of medicaletiquette. It had been his (Lord Glenesk’s) painful duty toinform Mr. O’Callaghan that he had lost the confidence ofthe board, and it had been thought he would at once resign.Mr. 0’Callaglian did not take that course, but called forfnrther investigation, and Mr. Burdett-Coutts made his

appearance on the field of battle and suggested a modusvivendi, to which they were all most ready to listen.But the whole medical stafl’ then intimated that they