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The latest report from the hospital (Thursday night) is thatthe patient is in a less satisfactory condition than he was, the.pulse-haviing gone up to 120.

METROPOLITAN ASYLUMS.

A MEETING of the Board of Management was held on Satur-day, the 28th ult. ; Dr. Brewer in the chair. A resolutionwas passed calling upon the guardians of the poor for a contri-bation of one-eighth of a penny in the pound, yielding £ 8344.The report of the Committee for Imbecile Patients was re-ceived. They recommend-" 1st. That accommodation be

provided for 3000 patients. 2nd. That two asylums shouldbe erected, each capable of containing 1500 inmates. 3rd.That one asylum be erected on the north side, and the otheron the south side of the Thames, and that the site for eachcontain not less than twenty acres. 4th. That each of thesites be within a radius of twenty miles from Charing-cross,and in the vicinity of a railway station. 5th. That suitablesites be advertised for."Upon the first proposal an important discussion arose.Dr. HARVEY, of Islington, moved that three asylums for

1000 patients be erected, instead of two for 1500. He saidthe question was one of efficiency and humanity, and he op-posed tthe congregation of large numbers of idiots; imbeciles,and harmless insane in one building, where there would begreat difficulty in securing for each patient proper care, andwhere the classification would be incomplete. He said it wasa great mistake to suppose that idiots, although harmless,were not mischievous and troublesome; and at the harmlessstage of insanity, when paralysis came on, each patient oftentook up the entire time of a nurse. Such cases the authoritiesof Colney Hatch and Hanwell were too glad to get rid of, andhe maintained that they would be better cared for in asylumsof moderate size.Mr. CLEMENTS, one of the representatives of the City of

London Union, stated that as a manager of the Central LondonSchool he had become convinced of the inexpediency of largeestablishments, which the superintendent could not go over ina single day. He quoted a Report of the Commissioners inLunacy (1865), showing that there were only three asylumsin the kingdom which contained more than 1000 patients;that, of forty-two asylums quoted in the Report, twenty-seven had less than. 500 patients, the weekly cost of thepatients being 8s. 7½d. each per. week. Twelve asylums hadmore than 500 and less than 1000 patients, and in them thepatients cost 8s. 6d. each per week. Whilst in the threelargest the patients cost 9s. 4d. each ; and at Hanwell andColney Hatch, 9s. 7½d.Mr. TAVERNER (of Marylebone), upon being asked whether

the Marylebone Workhouse, which contains 2000 inmates, waswell conducted, replied, as a guardian, that of course it was.But, as an individual, he should say it was painfully con-ducted ; indeed, the guardians would be thankful to anyone.who would tell them how to diminish the number of inmates ;for in that case not only would the crowded state of many ofthe wards be relieved, but the remainder would receive moreattention, and be better off. This measure had been forcedupon the guardians by the medical profession and the public ;though, for his own part, he saw little humanity in takingthese poor creatures from small wards, where they were wellcared for, and congregating them-in an enormous building,where the care and supervision could not be so good as theywere now.

Mr. CULL quoted Drs. Conolly, Spurzheim, and AndrewCoombe against the propriety of large buildings.Mr. WYATT stated that, from a close personal acquaintance

with Colney Hatch and Hanwell, he was thoroughly convincedof the advantages of large establishments. Notwithstandingthe many grave cases at Colney Hatch, there had only beenone suicide and one violent death in more than 2000 patientsfor several years. He explained that the extra cost of theMiddlesex Asylum arose from the extra cost of provisions,labour, and other necessaries in the neighbourhood of London.Thus, for example, the managers of the Birmingham Asylumpaid but 7s. per ton for coals, while at Colney Hatch, where ’,3000 tons per annum were consumed, they paid £1 per ton. ’iThe cost of the patients was also increased by the necessity ofgiving the London patients better food than was required byagricultural labourers. He would like to have compared the

cost of the City of London Lunatic Asylum with that of ColneyHatch, when he believed a different result- would have beenobtained. As to the supervision of the patients, it was. truethat the magistrates did not visit the whole- ina day. Butthere were no show-rooms, and every part was, thoroughly,inspected in turn. The great saving of building large estab-lishments was in the cost of sites, the diggingof wells, tharrangements for drainage, and in,the building itself.The amendment having been put-10 voted for, and’-25

against it.The original motion was then put, and carried by a large

majority.

THE INQUEST AT REDCAR.

AN inquest was held last week at; Redcar which involvedmany points of special interest to the profession. The deceasedwas a labouring man, named Errington, about fifty- years ofage, who, after drinking freely and taking some quack medi-cine, became affected by retention of urine, consequent pro-bably on spasm supervening on a permanent stricture of th,-urethra. This was on Monday, Sept. 16th. The following,.morning Dr. Bennett was called in to see-him, and made some-ineffectual attempts to pass a catheter. He left after a time,and directed that Errington,should be placed in a warm bath; gbut this was not done until some hours afterwards. Anotherattempt was made to enter,the bladder, but again unsuccess-fully; and Dr. Bennett then advised his removal to the infir-maryatMiddlesborough. This advice, which seems most sensibleand practicable, wasnot followed ; but on the. following after-noon, about four or five o’clock, Dr. Locke was, sent for, and,according to the evidence of a woman who lived with Erring,.ton, "he tooli the water from the deceased immediately."Errington, however, died at ten o’clock on Friday morning,about forty hours after Dr. Locke was first called in. We

regret to say that this gentleman refused to give a certificateof the cause of death, and addressed a letter to the coronerof the district, calling upon him to hold an inquest, on theground that he considered Dr. Bennett’s " conduct and treat-

ment culpable," An inquest was accordingly held.Dr. Nathan Deas received an order from the coroner to make

a post-mortem examination of Errington. Dr. Deas’s evi-

dence, which was clear and creditable to him, is thus reportedin .the Middlesborough Gazette :-

" The body was in an extreme state of decomposition, whichrendered it more difficult to come to a decided conclusion. Myattention was principally directed to the state of the bladderand the urethra. There was no disease in the bladder itself,except that the coat was thicker than usual. There was astricture in the urethra, which must have been of some stand-ing. All the other organs connected with the bladder werequite healthy, indicating no disease. The kidney, lungs, andheart were perfectly free from disease. In the absence of suffi-cient organic disease to account for death, I attribute his deathto nervous depression, produced by suffering, and no doubt

accelerated by a retention of urine in the bladder. I coulddiscover nothing else to account for death. I can only attri-,bute death to the irritative fever caused by retention of the.water. I speak positively to that being the cause of death.The. stricture would cause him to have difficulty in passing hisurine frequently before this. Drinking would, cause irritationand bring it on. There was extensive congestion of the ure-thra, but more caused by decomposition than anything else.There was nothing caused by any foreign substance havingbeen in the urethra. I have known urine retained a deallonger without the effects in this case. In all cases of strictureI would be very careful before using any instrument. Wheninstruments are required, the case is urgent. I do not saythat it was more easy to take the urine away on the Thursdaythan on the Tuesday; but it was naturally more urgent. Therewould be no more difficulty on one day than the other. Thereis often very great difficulty in passing the catheter. In somecases you may not pass it, and go again in a few hours and passit easily."

Dr. Locke, with singular want of consideration for a brotherpractitioner, proceeded to cross-examine Dr. Deas, evidentlywith theobj ect of showing that Dr. Bennett’s "conduct and

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treatment were culpable." He was, however, very properlystopped by the foreman of the jury, who said : " There is nocharge against Dr. Locke, and, therefore, he (the foreman) didnot see why he should be allowed to continue to examine wit-nesses in this manner." The jury being satisfied with the evi-dence, returned the following verdict :-" That death wascaused from nervous depression, occasioned by great sufferingproduced by retention of urine and natural causes."We should have been glad if we could say that with the verdict

the proceedings in this case terminated. Not so however. Dr.Locke felt it incumbent upon him, with " profound and sincereregret, after the manner in which the coroner’s inquest of thisday terminated, to afford the public his statement in the case,prompted by a sense of public duty as well as doing justice tohis deceased patient," and addressed a letter to the editor ofthe Middlesborough Gazette, in which it would appear his objectwas to prove that the jury should have passed a censure uponDr. Bennett’s conduct and treatment. With " profound andsincere regret" we cannot characterise the conduct of Dr. Lockeeither as just or charitable. Moreover, did he not infringe therecognised laws of medical etiquette? He appears to be anintelligent practitioner, and, therefore, could not be unac-quainted with the occasional difficulties of treating spasmodicstricture, even under favourable circumstauces. But howmuch more were these difficulties enhanced by the circum-stances of this painful case. Why, then, should he havesought to place his professional brother as a culprit, or perhapsa criminal, before the world ? Surely he must have been awarethat a catheter might meet with such obstacles at a certaintime, in such a case, as to render its passage impossible. Thebest surgeons have failed to introduce an instrument in suchcases. But in a few hours after, when the spasm had ceased,a catheter might be passed with the most perfect ease. It isvain and idle to attempt to raise our profession in the eyes ofthe public as long as medical practitioners so far forget theirduty to their brethren as to cavil at their treatment of difficultcases, and to call for coroners’ inquests to investigate suchcases as this.

OLD STUDENTS’ DINNERS.

THE annual St. Bartholomew’s Hospital dinner took placeon Tuesday evening, at Willis’s Rooms, and one hundred"old Bartholomew’s men were present. The duties of chair-man were performed in an unprecedentedly brilliant mannerby Mr. Paget, who was supported on his right hand by theTreasurer, Dr. F. Farre, Dr. Henry Monro, and Deputy-Inspector-General Smart, R.N.; and on his left by Drs. Bur-rows and Paget (of Cambridge), and Mr. Firth (of Norwich).Mr. Paget, in proposing the health of the Prince and Princessof Wales, alluded most happily to the honour lately conferredon St. Bartholomew’s Hospital by having as its president ourfuture king. He then said: " I am sure that you are allanxious to know the exact state of health of the Princess ofWales. Those who now sit around me can fully comprehendthe gravity of the malady under which her Royal Highnesshas been labouring, and it is a profound and heartfelt pleasureto tell that I left the Princess on Sunday in the possession ofexcellent health, that she is now able to walk for somedistance without pain or difficulty, and that the condition ofthe limb has, indeed, regularly and progressively improvedsince the departure of her Royal Highness from this country. Itis a source of superlative gratification to know that the Prin-cess will shortly return to England, fully able to take anactive part in the duties and pleasures of that exalted positionwhich she so pleasingly and gracefully adorns." A touchingand very eloquent tribute of respect and regard was paid bythe chairman to the memory of Lawrence and Jeaffreson, andthe company separated after a cordial toasting of Mr. ThomasSmith, whose indefatigable exertions greatly contributed torender the dinner a marked success.The annual dinner of the old students of University College

was held, on the 1st inst., in the fine library of that institu-tion, Dr. Carr (of Blackheath), an old and distinguishedstudent, presiding over a most successful meeting. Dr.Sharpey, in returning thanks for the professors, spoke of thegratification it was to welcome back old pupils, particularlywhen they brought their sons with them to join the medicalprofession. Dr. Wood acknowledged the toast of the College

of Physicians, and Mr. Erichsen that of the College of Sur-geons, taking occasion to note the little sympathy which thatinstitution excited among those connected with it, and thewant of progress which characterised it, as compared with theCollege of Physicians. Dr. L. 0. Fox, in acknowledging thetoast of the Apothecaries’ Hall, facetiously followed Mr.Erichsen’s example, and "repudiated" the body with whichhis name was connected.On Tuesday, the 1st inst., the past and present students of

the London Hospital dined together at the London Tavern,under the presidency of Mr. John Adams, F.R.C.S., the seniorsurgeon. About 120 gentlemen sat down. This was the firstgeneral dinner of London Hospital men, and it proved exceed-ingly successful, so as to create a very general desire on thepart of those present to make it a recurring festival. Theusual loyal toasts were given by the Chairman ; and, on risingto return thanks for the Volunteers, Mr. Gowlland receivedfrom his old friends a marked tribute to his great personalpopularity among them. The most important speech of theevening was made by Mr. Hutchinson, who, in returningthanks for the toast of the London Hospital Medical College,spoke strongly of the necessity for a large increase in the medi-cal staff of the hospital, especially in the out-patient depart-ments. He hoped that the time was at hand when the present.invidious distinctions between full and assistant physiciansand surgeons would be done away with, and when the exami-nation and treatment of out-patients would devolve upon asufficient number of officers for all the cases to be thoroughlyinvestigated. Mr. Hutchinson evidently carried with him thesympathies of his audience, and was loudly cheered. Theother toasts customary on such occasions were done full justiceto; and the guests did not finally separate until past midnight.

ON THE USE OF CARBOLIC ACID.To the Editor of THE LAKCET.

SIR,-You will, I hope, pardon me for expressing my sur-prise that, on the authority of an anonymous newspaper letter,you should allege that I have been anticipated in the treatmentof compound fractures, wounds, and abscesses, lately recom-mended through the pages of your journal.The book that is mentioned I have not seen; which will

hardly seem surprising, since it does not appear to have at-tracted the notice of our profession, or produced, in the countrywhere it was published, any practical effects such as mighthave been anticipated from its alleged contents.Your correspondent who has been investigating the surgery

of Paris will be able to tell you whether or no he has therewitnessed anything similar to the practice that has beenpublicly conducted in the Royal Infirmary of this city duringthe last two years and a half. For my own part, I may saythat, of all the gentlemen from Great Britain and both con-tinents who have recently visited Glasgow, not one has everexpressed the slightest doubt that the system in question wasentirely new; the novelty, 1 may remark, being, not the sur-gical use of carbolic acid (which I never claimed), but themethods of its employment with the view of protecting thereparatory processes from disturbance by external agency.The truth is, that the treatment which I advocate has

arrived at the second stage of its progress in professional con-fidence. So lately as at the Association meeting in Dublin afeeble attempt was made to decry it as useless; and now it isrepresented as not original. Trusting that such unworthycavils will not impede the adoption of a useful procedure,

I am, Sir, yours &c.,Woodside-place, Glasgow, Sept. 28th, 1867. JOSEPH LISTER.JOSEPH LISTER.

WEST WORTHING SEWERAGE.To the Editor of THE LANCET.

SiR,-The filters as adopted at West Worthing are not onlyemployed as mechanical agents to retain the solids, and thenitrogenous matter held in suspension, but are also intendedto operate chemically, by decomposing the salts held in solu-tion, which I presume Dr. Fairmann, by his observations, isnot aware of.

If the filters only succeed in retaining the solid matter, andthat which is held in suspension, it is effecting much ; but bysubmitting the materials with which the filters are packed toa chemical process, very much more ia effected ; inasmuch as