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Correspondence.THE PROPOSED HOSPITAL AT SMYRNA AND

SIR JOHN FORBES.

"Audi alteram partem."

To the Editor of THE LANCET.Sir JOHN FORBES presents his compliments to the Editor,

and will be obliged by his stating, in the next number of thejournal, that Sir John Forbes resigned, last week, the appoint-ment of Medical Superintendent of the Civil Hospital atSmyrna.Old Burlington-street, Feb. 21st, 1855.

THE PROFESSION AND THE WAR.

GEO. BELLASIS MASFEN.

To the Editor of THE LANCET.SIR,-I am directed by the committee of the Manchester

Medico-Ethical Association to send you the enclosed copy of apetition which has just been sent to Mr. Milner Gibson, M.P.,for presentation, and to request that you will be so good as togive it insertion in an early number of THE LANCET.

I am, Sir, your obedient servant,Manchester, Feb. 1855. GEO. BELLASIS MASFEN.

[COPY. ]To the Honourable the Commons of Great Britain and

Ireland in Parliament assembled.The humble Petition of the Manchester Medico-Ethical

Association,Humbly sheweth,-That the Army and Navy medical services have proved de-

fective in organization, and numerically inadequate to the

exigencies of war.That the system of routine and general management in the

Army Medical Department has led to most disastrous conse-quences, and that a thorough reorganization of the entire

system is imperatively required.And that the naval assistant-surgeons, who have received a

liberal education as their passport to an enlightened andhonourable profession, have not obtained the respectful con-sideration to which such gentlemen are entitled ; hence an im-perfect supply of competent men when their services are sourgently needed.Your petitioners therefore earnestly entreat that an inquiry

be instituted into the causes which have led to these fearfulresults, and that the attention of the legislature be directed totheir speedy removal.And your petitioners will ever pray, &c.

JAMES L. BARDSLEY, Knt., M.D., President.JOHN AIKENHEAD, M.D.,GEO. BELLASIS MASFEN, Hon. Secretaries.

SUGGESTIONS FOR IMPROVING AND PRE-SERVING THE HEALTH OF THE ARMY INTHE CRIMEA.

To the Editor of THE LANCET.

SIR,—It is own almost a month since it was stated officiallyin Parliament that the medical military system in the East hadbroken down. It is better to deliberate than to act rashly andimperfectly; but it is not good to loiter while time presses, andthe lives of hundreds, possibly of thousands, are at stake.There are rumours of arrangements being made for a largehospital at Smyrna. This is good as far as it goes, but little isheard as yet of more comprehensive plans, and still less of thesolid principles which should govern their formation.The extent of sickness in the army is a sad, undoubted fact,

and the excess of deaths in proportion to the number of thesufferers is another still more to be deplored. According to thelist published in The Times, the deaths at Scutari alone have oflate amounted to upwards of fifty daily, whilst in London hos-pitals, the average of deaths in four thousand patients would beat most twelve a day, and these would include patients of allages, who had suffered from all kinds of disease and accident,many of which would have had a fatal tendency from the be-ginning. In the East, except for special reasons, which oughtto be inquired into, even a smaller average of deaths ought tcprevail. The men are all young; all have been, up to a certainperiod, strong in health, and the diseases under which they

succumb are controllable by medical treatment in this country,for here a fatal termination to either dysentery or diarrhoea iscomparatively rare, whilst the mortality of fever does not ex-ceed twenty per cent. It is proper, therefore, to inquire whythese diseases are so fatal at Scutari; the previous exhaustion,fatigue and unsuitable diet, though sufficient to cause the dis-eases, are not sufficient to account for their resisting better careand treatment, since the power of young constitutions to recoverquickly from the effects of want and exposure is notorious, aswell as the capability to repair injuries, even when organiclesion has taken place, in consequence of long-continued neglectin dysentery and diarrhoea. Much as I should regret to castreproach upon the military medical department, it is to befeared that the answer must be looked for in its inefficiency. Iwould be the last man to be unjust towards that devoted staff,many of whom have shown as perfect heroism in their unshrink-ing self-sacrifice, as the bravest soldier in the army, yet itcannot be concealed that want of sufficient skill in treatingthese diseases must be regarded as the cause of a gTeat portionof the evil. The army medical officers ought not, however, tobe reproached for the absence of that knowledge which theyhave had no opportunity of acquiring. When we read of spe-cifics used for the cure of chronic disease, we may partly accountfor the ill success, though we dare not censure them for the lackof sounder medical science. They are, in fact, surgeons, notphysicians; they have had little opportunity, before enteringthe service, of perfecting a knowledge of disease, small time towatch the experience of others, and while on duty they havebut narrow fields of observation, insufficient to enable them tolearn while practising. In times of peace this system for thearmy might work sufficiently, but for seasons of great need likethe present, it must prove utterly inadequate.The skill of men wholly devoted to medicine, with the

widest possible experience, could alone be equal to the workof treating these diseases, attacking violently such multitudesof invaluable lives; and whilst treating them, to make suchneedful investigations as the surgeons, unprepared and over-worked, cannot possibly attend to.Examinations after death can hardly fail to reveal -some

guiding truths; and who is there, in the anxious, hurriedduties of the hospitals at present, who can find time for such astudy ?The projected hospital at Smyrna, from its situation, can

serve only to assist the convalescents. It is obvious, that inthe trying state of a severe disease, an additional voyage tothat place should not be thought of. Nothing but a large CivilMedical Department at Constantinople could meet the evil;and that would prosper only if guided by a man both of scienceand experience-one who is actively engaged in the duties, andunderstands the working, of an hospital, and one who has tactand judgment to conciliate existing authorities. No staffcould be effective, unless composed of hospital physicians; andthe assistant offices should be filled up from men who, also inhospitals, have occupied the less responsible positions. Sucha staff would require little organization to fall almost instantlyinto their course of duty; and it would be a happy arrange-ment if a great proportion of the sick from disease were with-drawn from the hospital at Scutari, the spacions wards ofwhich will, unhappily, according to all human probability, besoon wanted for the reception of the wounded.

In regard to measures for the preservation of the generalhealth of the army, I am surprised that some few obvious im-provements in the diet have not been yet adopted. Lamenta-tions on the effects of such food as is now sent out are clamorousenough, but no advice is given how to change it. Such altera-tions as the following might be made with ease:-

Cocoa might take the place of coffee. Whilst diarrhœa anddysentery are present, coffee is unsuitable, since on most

persons it acts as an aperient. Cocoa has not that property,and its oily nature is both healing to the bowels and nutritious.Cocoa is as cheap as coffee, and more portable-more easilyprepared for immediate use, and admits of no mistake aboutthe roasting. Tea would be better than coffee, but not so goodas cocoa. All three contain the same nutritious principle, theoil being added to the cocoa only.

Pork, in any form, is bad, and should be replaced by anyother kind of meat. It is most indigestible, and from theunclean habits of swine, is likely to induce bowel attack inthose who live upon it.

Whilst the cold weather lasts, a hint might well be takenfrom the habits of the Russians. " Fas est et ab hoste doceri."Whatever be the latest theory of animal heat, one point isestablished-viz., that it is engendered by the use of fat indiet. Lard could be sent from this country in any quantity,

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and its use, whel’t butter or fresh fat is unattainable, would beboth warming, nourishing, and healing.The unremitting issue of rice to the troops has been already

advocated in The Times of the 13th inst., and very properly :it is a useful astringent.One word on diet for the hospitals, which the benevolent

caterers for the sick may possibly attend to. Suet and milk,in the proportion of two table-spoonfuls of the former to a pintof the latter, shredded fine, and carefully dissolved andstrained, with or without a small quantity of brandy, is thevery best nourishment that can possibly be given to a patientunder either dysentery or diarrhoea.

I remain, Sir, yours very truly,February 15th, 1855. M. D.

TREATMENT OF SURGEONS IN THE NAVY.

JAS. WEAVER.

/1’0 the Editor of THE LANCET.SIR,—Will you oblige me by giving the few following re-

marks a place in your valuable journal; for I think you willagree with me that it is right the profession should be madeacquainted with them.

In the month of August, 1854, I made application for anassistant-surgeoncy in the navy. In a few days I was orderedto London, had passed the Examining Board, and on the 24thI joined H. M.S. Waterloo at Sheerness, to wait passage out tothe Prince Regent, 90, then serving in the Baaic. On the26th, myself and one or two others left England in the hiredtransport Holyrood for our destination. After joining myship, (off Revel, in the Gulf of Finland,) I remained on board,and endeavoured, as far as lay in my power, to give everysatisfaction to the patients under my care; but I soon found tomy cost that the remarks I had so often seen in the pages ofTHE LANOET were too true, and that the navy was not theplace for any man who had the slightest spark of gentlemanlyfeeling about him. (I speak of the medical branch of the ser-vice. ) Early in November we came into Portsmouth harbour,and I at once sent in my resignation to the Admiralty Com-missioners, which they accepted, and on the 26th I left herMajesty’s Royal Navy at my own urgent request. Now, Sir,would you believe it that in the " Navy List" for the presentquarter my name figures under the head "Discharged fromthe Service."Such conduct at the hands of the Government, I think, is

most disgraceful.most disgraceful. I am, Sir, your obedient servant,

Nantwich, Feb. 1855. ______________

JAS. WEAVER.

PRACTICE OF MEDICINE BY CHEMISTS ANDDRUGGISTS.

To the Editor of THE LANCET.

SIR,—At an inquest held lately in this neighbourhood,by Mr. Coroner Carter, some incidents occurred of too greatimportance to be passed over in silence. I therefore trespassupon your known liberality and sense of justice to publishthem in THE LANCET. The case was this :-A poor man lefthis work on Thursday last, and stopped at the White HartInn, Godstone, being ill, and unable to reach his home thatevening. Throughout the following day (Friday) he lay therein a very suffering and dangerous state. The Board ofGuardians of the Godstone Union held their weekly meetingon that day at the White Hart; I, the medical officer of thedistrict, being present for upwards of three hours at the housein question, and another medical practitioner being also inattendance upon one of its inmates. Notwithstanding thesefacilities for obtaining competent professional aid withoutdelay, no application was made, either to the Board or to anymedical man, on behalf of the sufferer; but he was attendedthrough the day by a person calling himself a chemist, who, inhis evidence, admitted having administered calomel, croton oil,rhubarb, castor oil, enemata, &e. In the evening, the mangetting worse, a medical order for my attendance was at lastobtained and forwarded to my surgery; but through the in-advertence or negligence of my assistant, who received theorder, and unwisely sent some medicine without seeing thepatient, I was not informed of the application which had beenmade for my attendance during my absence from home. Thepoor man died the following morning at six o’clock, and thefirst intimation 1 received of the case was brought to me bythe superintendent of police, who came to announce the deathand the necessity of an inquest. The inquest was held, andadjourned for two days while the Coroner engaged a neigh-

bouring practitioner to make a post-mortem examination. Theevidence (most conclusive) of this witness was to the effect" that the deceased died of entero-peritonitis of long standing,"and that " had the order received immediate attention, hislife could not have been prolonged for a minute," (I quotethe ipsissima verba of this witness,) "if all the medical men inthe world had attended him. " After I had been sworn, andhad deposed to the unfortunate and painful circumstance whichoccasioned my non-attendance on the deceased, I took theliberty to advert to the loss of time and opportunity whichhad been caused by the intervention of the druggist, and to.the impropriety of such persons visiting patients and administering such powerful remedies as croton oil and calomel.-Mr.Coroner Carter interposed with-" Quite right, quite right! Iwould myself have done my best under like circumstances. "-Dr. Boulger (loquitur): Then you advocate illegal practice,do you ?"-Mr. Carter : "I do not. "-J)r. Boulger : " I saythis is downright advocacy of illegal practice."Now, Sir, whether or not it is right that illegal persons

should undertake the care of the sick while competent pro-fessional aid is close at hand, I will leave to the public andthe profession to decide. In conclusion, I will merely remark,that when a judge openly advocates an infringement of thelaw, what prospect is there that interested persons will con-form to it ?

T remain. Sir. vour obedient servant.

Bletchingly, Feb. 13th, 1855 EDWARD BOULGER, M.D.

NAVAL ASSISTANT-SURGEONS.

MEETING OF STUDENTS OF THE MIDDLESEXHOSPITAL.

A NUMEROUS meeting of the students of the MiddlesexHospital was held on Friday, the 16th of February,-Mr.SIBLEY in the chair,-at which, the following resolutions wereunanimously carried, and which, it is hoped, will be adoptedby the several metropolitan and provincial hospitals :-Proposed by Mr. HUSBAND; seconded by Mr. PLASKETT,—" That this meeting, in common with the nation at large,

views with deep and unfeigned regret the ill success whichhas attended the many efforts made by members of Parlia-ment and the public press to ameliorate the condition of thenaval assistant-surgeons. It anticipates with anxiety andalarm the unnecessary loss of life that will ensue, should anaction occur, while the navy is so inefficiently supplied withsurgical aid, and enters its earnest protest against regulationswhich are derogatory to the medical profession, and detri-mental to the efficiency of the naval service."

Proposed by Mr. EDSALL; seconded by Mr. BRAUND,—" That, as a preliminary step, this meeting resolves, that no

student present, on becoming a member of the medical pro-fession, shall accept an appointment in the navy during theexistence of the present Admiralty regulations; but as the

meeting is deeply impressed with the urgency of the crisis,and is desirous of offering to the country those services it isentitled to claim, it trusts that the grievance complained ofwill be immediately redressed."

Proposed by Mr. NORTON; seconded by Mr. SPICER,—’’ That, for the purpose of attaining the object of the meet-

ing, a copy of the resolutions be forwarded to the variousmedical schools in the United Kingdom, and their co-operationsolicited. "

Proposed by Mr. CRIBB; seconded by Mr. CARVER,-" That a subscription be entered into to defray the neces-

sary expenses."Proposed by Mr. Ross; seconded by Mr. BAXTER,-

That a committee, consisting of three members, be ap-pointed to carry into effect the foregoing resolutions."

THE CIVIL HOSPITALS AND THE WAR.

THE following circular has been addressed, at the suggestionof Mr. Gray, of St. George’s Hospital, to the governors of theprincipal hospitals and dispensaries. We trust that the appealthus made to the patriotism and humanity of these gentlemenwill be handsomely responded to, and that every encouragement