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A MOTION to abolish the entrance fee to the Medical Societyof London was discussed at the last Council meeting; it waswithdrawn, however, for the present. There are many societieswhich seem to flourish without the imposition of any fee ofthe kind-such as the Hunterian, the Epidemiological, andthe Anthropological; and the promoters of the motion in ques-tion were prompted, no doubt, by the success which has fol-lowed its removal in these instances, in suggesting to theMedical Society the adoption of a liberal policy in the matter.

REGISTRATION OF VACCINATION.

WHATEVER difference of opinion may exist as to the utilityor otherwise of registering cases of successful vaccination,which has been pronounced essential for ensuring the widestpossible extension of the protection against small-pox whichefficient vaccination affords, we must all admit that the func-tionary who has for fourteen years directed the modu.s operandiof such registration is entitled to a fair hearing for the expres-sion of any conclusions he may have arrived at as the resultof his experience, even though they may be in a measure ad-verse to the course which has so recently been decided on bythe Government and by Parliament.In his last Annual Report the Registrar-General gives a sketch

of vaccinatory legislation since 1840, and then summarises thework which it has entailed on his department. In the thirteen

years ended in 1866 there were sent out from the central officeto the 2200 local registrars no less than 7,743,000 notices tobe given to parents and others registering births; 133,159books to be given to medical men, containing 14,000,000 cer-tificates ; and 17,866 books, containing spaces for nearly9,000,000 entries, to be used by the registrars for recordingthe certificates of vaccination.The registered births have averaged about 707,000 annually

during the last ten years; and it follows, therefore, that theforms were supplied to the registrars on the assumption thatthey would be required for every child attaining the statut-able age for vaccination.The Registrar-General evidently grieves over the waste of

forms and of the time of his officers-the registrars-consequenton the failure of the certificate registration. As a rule, the cer-tificates, he says, never reached the registrars, the exceptionalcases being those in which the two offices of public vaccinatorand registrar were combined. The absence of the certificates

deprived the register of all its value: " the labour of the regis-trar was thrown away, and, through no fault of his own, hewas thus deprived of the fee which he was led to expect bythe Act of Parliament. For statistical purposes the imperfectrecords were useless." The hardship to the registrars was,however, equalled by the tiresome and unprofitable dutiesimposed on the vaccinators. " The medical man, in the midstof his practice as a public vaccinator, had, after each operation,to lay down his lancet, take up his pen, and write the par-ticulars of each case in his own book, and, after inspection ofthe arm, to fill up two certificates, -to place the first in thehands of the parent or other person, and to transmit, by postor otherwise, a duplicate to the registrar of the sub-district inwhich the operation was performed." For the small fee whichthe vaccinator was allowed, the wonder is how it could everhave been anticipated that the certificate system would work.The Registrar-General puts the case every fairly for the vacci-nators as well as the registrars: they were required to dosomething without being adequately paid for it, and the resultwas what usually happens under such conditions.Under the new Act, both the vaccinators’ and registrars’ fees

are increased ; but the Registrar-General is not very sanguinethat his officers will even now get their due. "Itwillbemyduty," "he says, "to see that if the new measure becomes law, it doesnot fail through any default of the officers under my control,who if under this, as under the old law, fail to get paid, as I

fear may be the case, must trust to the wisdom and justiceof Parliament for redress." The fear which the Registrar-General seems to entertain, that the stringent working ofthe Vaccination Act will act as "a clog on the registrationof births," will, we hope, turn out to be unfounded. Itis, of course, most undesirable to throw any obstacles what-ever in the way of birth-registration; the aim should ratherbe to encourage it to the utmost, and if it can hereafterbe proved that any such untoward result has followed theoperation of the Act, the proposition that "it is necessary toseparate distinctly the public registration from the efficientperformance of vaccination," must then be considered as analternative which may get over the difficulty. At present itseems but right that the Act should have "a fair field and nofavour " for a term sufficient to show its full capabilities, andwhen those are known it will be open to us to consider howfar they satisfy the public need.

It is quite certain that, unless the vaccinators are sufficientlyremunerated to ensure the performance of all their obligations,the registrars will not derive the full benefit clearly contem-plated by the Act; it remains, therefore, to be seen how farthe new principle of "payment by results" will make up forthe admitted insufficiency of contract prices. Until this isascertained it will be well to avoid anything like a hasty con-clusion ; the just claims of the profession must eventually besatisfied.That the Registrar-General has exercised a legitimate right

to place on record an authentic statement of his views on thesubject of vaccinatory registration is unquestionable; and espe-cially as, during the discussions which the passing of the newAct provoked, reference was frequently made to what weresaid to be his opinions on, and objections to, the measure. Butwhen he proceeds to raise a doubt as to whether the legislationin regard to compulsory vaccination has, after all, done muchto exterminate small-pox, we feel bound to object to such anad ca2taadicrz argument. He shows statistically that, oncomparing the period when the voluntary Vaccination Actswere in force (1841-53) with the subsequent period of compul-sory law (1854-66), the annual mortality from small-pox wasreduced in England from 30 to 20, and in London from 38 to28, per 100, 000 living; and this diminished fatality is admittedto be " fairly ascribed to the progress of vaccination." Anannual saving of ten lives on every hundred thousand of thepopulation during twelve years is surely something worth thedoing ! It is very little to the purpose to say that the com-pulsory system has "failed," because it has not realised theexpectations of its " sanguine supporters"—that it would" stamp-out small-pox." The Registrar-General loses sight ofthe important fact that it is not the " principle" of compulsoryvaccination, but the "machinery" by which it was sought tobe worked, that has failed hitherto. The " principle" standsfirmly rooted in the minds of a large majority of those whocarefully study the laws of disease and the means for its pre-vention, in regard to the great masses of our fellow-creatureswho are not sufficiently educated to know what is best forthemselves. The " machinery" has hitherto prevented thefull development of the " principle," and it may be that wehave not even now eliminated all impediments to its progress;time and experience will best prove this. But until there issomething more satisfactory in the way of proof of failurethan is to be gleaned from the past history of compulsory vac-cination, we contend that the Government was fully justifiedin refusing to go back to a voluntary system. It is commonlybelieved that the effect of recent sanitary legislation has beento reduce the fatality of diseases of the zymotic class; but be-cause we cannot show that any of these diseases have been

"stamped out," should we therefore be justified in saying thatour sanitary legislation has failed?

.

THE CASE OF EDWARD McDONNELL, THEMURDERED BANDSMAN.

WE complete the notes of this case, with the post-mortemappearances, for which we have to thank Mr. Shoppee, thehouse-surgeon of University College Hospital, whose attentionto the case has been unceasing.

Oct. 3rd. -10 A.M.: States he passed a bad night, havingslept very little, but was not kept awake by pain. Appears toremain in much the same condition as yesterday. Pulse 132 ;

, respiration, 44. Physical signs of chest the same.

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Seven r.M.—This evening the patient seems worse ; he isweaker than he has been before. His face is covered witha cold sweat; his countenance looks anxious, and his conditionis evidently less satisfactory. He vomited once during theafternoon, after taking some nourishment. Pulse 110, weakand compressible; respiration, 48, very shallow. Twenty-five minims of solution of morphia were given at midnight.

Oct. 4th.-Half-past nine A.M.: Has passed a better night,having slept several hours, and says he feels more comfortable.His face has a calmer aspect, but the sweating still continues.The expectorated matter is less bloody and tenacious, and thequantity diminished. Breathes with less difficulty. Respira-tion, 40; pulse 130, soft and small.Soon after ten A.M. the patient changed decidedly for the

worse, the pulse becoming weaker, sweating more profuse,and a cold clammy feeling of the hands and feet was present.It soon became evident that the poor fellow was sinking fast,and his condition was at once reported to the surgeons of hisregiment at Windsor. Brandy was frequently administered,and hot bottles placed to his feet.About one o’clock, Colonel Marshall, of the 2nd Life Guards,

arrived, and remained with McDonnell, who was quite con-scious, till his death, which took place at a quarter tothree P.M.

Mr. Erichsen also visited the patient, but found him i2iarticulo mortis.

Oct. 7th.-The post-mortem was made twenty-four hoursafter death by Mr. Erichsen; several of the medical staffattached to this hospital, as well as Drs. Kerin and Spry, ofthe 2nd Life Guards, were also present.The appearance of the body was greatly changed, the whole

of the subcutaneous cellular tissue having become emphyse-matous after death, before which not a trace of emphysemacould be found.On removing the sternum, the cavity of the right pleura

was found nearly full of a dark bloody fluid, evidently a mix-ture of blood and serum, in which some masses of lymph wereHeating, as well as a few small clots of blood. This fluid wasremoved, and measured three pints.The surface of the pleura was seen covered by a soft spongy

layer of fibrin, and adhesions had formed in several places;one of these existed a little above the wound, where breathinghad been heard during life.On tracing the track of the ball, it was found to have per-

forated the anterior wall of the thorax, below the cartilage ofthe fifth rib, close to the right border of the sternum, and,passing through the base of the right lung, had made its exitthrough- the fifth interspace, a little external to the angle of thescapula, the ribs having escaped injury. Both the anteriorand posterior apertures were discovered with difficulty fromwithin, being almost occluded by the inflammatory productspoured out. The track of the ball through the lung beingopened, the adjacent pulmonary tissue presented the appear- ’,ance of a mass of coagulated blood, the surface of the woundbeing irregular and almost uniformly black.The base of the left lung was much congested ; very little

fluid found in the pleura of this side. The pericardium wasopened, and about an ounce of dark-coloured fluid escaped, inwhich were found floating a few masses of lymph; and someadhesion had taken place at the posterior part.

Correspondence.

MONOMANIA AND HOMICIDE.

" Audi alteram partem."

’1’0 the Editor of THE LANCET.

SIR,-It is officially announced that the sentence of deathupon Louis Bordier is to be carried into effect on Tuesdaynext. There is but scanty time to debate the question whetherin his and other such cases strict law is justice; I would, how-ever, ask your powerful aid to bring under the notice of theauthorities the considerations that seem to me to render Bor-dier’s execution impossible, without further inquiry into hismental state.

Bordier was arraigned on the 27th of September last, forwilful murder. It was proved that he had cut the throat of

the woman with whom he had lived for thirteen years, andhad intended to kill his three children by her, and afterwardshimself.

Dr. Simpson, the first medical witness for the prosecution,gave consistent and unshaken evidence to the effect that hehad found distinct delusion in Bordier’s mind; he had readthe letters written by the prisoner before the murder, pro-duced in Court, and they evinced the presence of monomania ;that the man’s general appearance and manner were those of alunatic ; and the witness had no doubt that he was of unsoundmind, and irresponsible for his actions. Dr. Simpson men-tioned, incidentally, that, although in general practice, he hadhad considerable experience in cases of insanity.i Two other medical witnesses were called, one of them thesurgeon of the gaol. The evidence of these gentlemen wassimply negative; they had daily seen the prisoner since hiscommittal, but had discerned no indication of insanity; theyhad not examined him as to any alleged delusions, nor as tothe causes or the circumstances of his crime.The counsel for the e prisoner pleaded insanity for the defence,

but called no witnesses, relying upon the evidence of Dr.Simpson, the insane nature of the documents in court, and thegeneral history of the case.

Mr. Justice Montague Smith, in an able and impartial sum-ming up, bearing, if anything, to the side of mercy, left thejury to determine whether the prisoner were insane or not, atthe same time directing them to find him guilty if they thoughthe knew at the time of the murder the nature and quality ofthe act he had committed.The jury unanimously brought in a verdict of " Guilty, and

the judge then, with "evident emotion," pronounced the sen-tence of death upon the prisoner, who heard it with " stolidindifference," and, deaf to the "wailings" of his two littlegirls, walked unconcernedly from the dock.

I believe, and I speak not without considerable experienceof such diseases, that Bordier is a "monomaniac," and if he behung the cruel absurdity will be committed of inflicting capitalpunishment upon a lunatic, and fixing upon his kindred theunjust stigma of relationship to a responsible and cold-bloodedassassin.

I am aware it will be said that insane homicides, by theEnglish law, are responsible, and therefore Bordier is legallycondemned; but if so, why should the prosecution by theCrown be conducted as it was in this case, and has been inother cases? Why should not the lunacy have been admitted?The prosecution proved by their own witness, Dr. Simpson,that the prisoner was insane; they brought forward no medicalevidence to controvert this opinion, except the negative testi-mony already described, and rested their case entirely upon thefact that, insane or not, the prisoner might and did know thathe was "doing wrong."

I do not believe that twelve men could be found who wouldunanimously bring in a verdict of wilful murder against a manactually, or even presumably, of diseased brain, unless theywere bewildered by the legal doctrine that the prisoner’s know-ledge of the distinction between right and wrong is the solepoint to determine. There are few English juries who wouldfail to see that, in the case of an insane man, the conclusion asto whether in a particular act he knew right from wrong, isoae that no jury can arrive at, and upon which no doctor, spe-cialist or otherwise, should venture to give a decided opinion.Except upon legal grounds, no jury would find a madmanguilty of wilful murder. Judges are not less merciful thanjuries. In the case of Hatfield the judge virtually stoppedthe trial upon clear evidence being given that the prisoner wassuil’ering under delusion. Recently, in the case of Townley,the learned judge impressed upon the jury the importance ofthe question as to whether the prisoner acted under " delu-sion ;" and although the existence of any "delusion" was swornto by only one unsupported medical witness, who was, more-over, entirely mistaken, the judge caused further inquiry tobe made, and the prisoner was respited for that purpose. The

case of Bordier stands upon no imagined "delusion" or false, theory of insanity. The disease of brain in Bordier is shown by.

insane letters, by insane words, by insane intentions, and aninsane act. Then, in his case, why should not inquiry be

’ made ? If, after due examination, he be pronounced sane, lethim undergo his deserved punishment; if insane, send him to

- a criminal asylum; or, if the law inexorably demands his life,3let him be hung as a declared "madman." Such an execution

might lead to a revision of that ruling of the twelve judgeswhich makes the knowledge of right and wrong the test of

r responsibility; such a declaration will at least be common jus-E tice to the prisoner’s family. It may be some consolation to