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In typhus and typhoid fever, when wakefulness and nocturnaldelirium harass the patient, no more efficient or safer remedythan this supper of vinous soup can be given."

Dr. Johnson will observe that there is not a word here orindeed elsewhere of a "glass of wine with gruel." In truth, Ithink I never prescribed gruel for any case whatever of deliriumtremens. As to my alleged eliminative "theory," the sum ofwhat I stated is-get your patient sober and keep him so ;and I hardly think that to direct two or three tablespoonfulsof wine to be taken in soup at bedtime amounts to a " curiousinconsistency," nor indeed would the prescription of a glass ofbrandy.The treatment I advocate is rational and not theoretical;

that is to say, it is founded on a careful investigation of thestate of each patient. In each we have to determine "whendiet and regimen will serve, and when opium, tartar emetic,digitalis, chloroform, or the like are to be administered, andhow." I quote from my second paper, and in the same paperI thus indicate the general points :-

" In the treatment of all cases alike there are certain pointsto be attended to which may be briefly noted. The patient isto be put to bed, his clothes taken away, and all friends dis-missed. The hands and face must be washed ; the room keptcool and fresh, but not cold. No mechanical restraint mustbe attempted, but the patient governed by a calm, gentle, yetfirm and positive manner. If the breath smells of drink, itwill be expedient to await the elimination of the poison ; andnothing more than a purgative should be given medicinally,unless there is reason to suspect an overdose, when a gentleemetic may be prescribed.......... The patient should be exa-mined carefully, as opportunity offers, for any complications.More especially the attention should be directed to the head,to determine whether any injuries have been inflicted on itrecently or previously; to the lungs, with reference to pneu-monia, bronchitis, and acute congestive affections (and as tothese physical diagnosis is essential, because the ordinarysymptoms are often absent in consequence of the state of thebrain) ; to the heart and pulse; to the state of the liver; andto the kidneys and bladder, as to retention of urine, albu-minuria, &c. Inquiry should be made as to the habits of thepatient, and the kind and amount of intoxicant taken; as toprevious treatment, especially with reference to opium andstimulants ; and as to any predisposition to cerebral disorder.When the case has thus been examined as to its course andcomplications, and when the true character of the hallucina-tions &c. is manifested, independently of the direct influence ojthe intoxicant drinks or drugs, as opium or other nervines (andthis is most important), the practitioner is in a position toestablish his diagnosis and prognosis."

Dr. Johnson’s remarks seem further to imply that I objectto alcohol and opium theoretically. Now, I have nowhere dis-cussed whether opium checks elimination or not in deliriumtremens ; and, I repeat, I cannot even imagine what has ledDr. Johnson to make the statements quoted above. I have,in fact, great doubts whether " opium checks elimination." Iknow it induces both diuresis and diaphoresis in certain cases;and I have not the slightest reason for concluding that it ope-rates, when judiciously given, as a check on elimination in de-lirium tremens, or even in cholera. On the contrary, I am ofopinion that in small doses it acts conversely. And I thereforedo not wholly concur with Dr. Johnson’s theory as applied tothe treatment of the latter disease. It would interest me tobe informed exactly where Dr. Johnson found the materials foiwhat he has attributed to me; certainly in none of my ownpapers. I am. Sir, vour obedient servant,Rutland-street, Edinburgh, May 8th, 1866. T. LAYCOCK, M.D.

IODIZED COTTON.

ROBERT GREENHALGH, M.D.

To the Editor of THE LANCET.SIR,-I have received so many communications concerning

’the "iodized cotton" made on the 15th of last March at mysuggestion by Messrs. Bell and Co. of Oxford-street, and ex-hibited by me at the conversazione of the Obstetrical Society onthe 29th of March, that I am induced to send you the follow-ing particulars for the information of your numerous readers.It is made as follows: Two ounces of iodide of potassium andone ounce of iodine are dissolved in eight ounces of glycerine,in which solution eight ounces of cotton wool are thoroughlysaturated and then carefully dried. The best method of ap-

* Practical Notes on the Diagnosis, Prognosis, and Treatment of DeliriumTremens. Edinburgh Medical Journal, November, 1862.

plying it is to take a portion of the iodized cotton about thesize of a half-crown piece secured by some silk thread tiedcrosswise, and, passing it through a speculum, to press it firmlyagainst the cervix uteri, over which a piece of cotton woolsimilarly secured, somewhat larger, and freely saturated inglycerine, should be placed and retained in situ while thespeculum is being withdrawn. It may be applied twice orthree times a week, and be kept in the upper part of thevagina from twenty-four to forty-eight hours.The cases in which I have found the application most useful

are, subinvolution with or without congestion or induration oftissue ; in cases of chronic inflammatory enlargements andthickenings of the cervix uteri ; in one case of pruritus, ap-parently due to acrid secretion passing through the os uteri;in two cases of fibroid disease of the anterior lip of theuterus; in chronic pelvic cellulitis; in haematocele; and in onecase of epithelial cancer of the neck of the uterus.

It possesses the following advantages :-It is clean, light,and portable ; it produces no irritation ; destroys all fcetor;is considerably stronger than the compound tincture of iodine,is more readily absorbed, and can be kept in contact with thediseased tissues for a longer period. Moreover, it does notsoil the linen like the medicated pessaries and suppositoriesand many other topical applications in general use for uterineaffections.

It was only the other day a clergyman’s wife informed methat she preferred this local remedy to all others, because thelaundress of the village, of which her husband is rector, doesnot know by her linen that she has any internal disease, whichwas always the case with former applications to that part.Several of my patients, wholly unconscious of the nature of theremedy, have complained of a taste of sea-weed from four toeight hours after its introduction. If the iodized cotton bewithdrawn from the vagina in thirty hours it is nearly white,showing beyond all doubt that it has parted with the greaterpart, if not all its iodine. On analysis, a portion of the iodizedcotton which had been retained forty-eight hours in the vaginawas found to contain only a slight trace of chlorine. I shouldstate that by the aid of the silk thread attached the patientcan remove it herself at any time.

I am confident that if your readers engaged in the treatmentof female affections will give it a fair trial in suitable cases,they will not be disappointed with its effects.

I am, Sir, your obedient servant,Grosvenor-street, May, 1866. ROBERT GREENHALGH, M.D.

THE NEW BYE-LAWS OF THE COLLEGE OFSURGEONS.

To t7te Editor of THE LANCET.

SIR,-In comparing the new bye-laws of the College of

Surgeons with those in force until the beginning of the presentyear, I regret extremely to see how little change has beenmade in the present radically bad government of the College.In vain do I look for any of those reforms which have been solong and patiently expected by the profession, and so earnestlyadvocated in THE LANCET. There is no modification in the

regulations of the meetings of Fellows and Members wherebythey may obtain some share in the direction of the affairs ofthe corporation. When may we hope that the Fellows, if notthe Members too, shall meet annually and receive from theCouncil a statement of its proceedings during the past year,so that the conduct of each councillor may be scrutinised bytheir constituents before re-election ? How long are we to waitfor a regular publication of the deliberations of the Council,reporting the speakers’ names and remarks ?-these two mea-sures which, with many others, have been during a long seriesof years urged again and again on the Council by one or twoof their body gifted with a better perception of the reformsnecessary to restore to the College of Surgeons its authority asa representative of the medical profession. It is disappoint.ing indeed to find how little the efforts of the more liberalcouncillors have availed in overcoming the vis inertice of themajority of the governing body. Let the Fellows at each elec.tion of councillors not fail to send an accession of strength tothe liberal phalanx, so as to convert the present minority intoa working majority. Then those reforms so badly wantedwill be secured-namely, publication of the proceedings of theCouncil; annual meeting of the Fellows and Members; votingby proxy; and, as a consequence of these, a system of exami-nation which shall afford proof of sufficient knowledge in thecandidates for the fellowship and the membership. It is dis.

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heartening, indeed, to contemplate the present superficialmethod in which the men are tested. As an example of thishaphazard system I may mention that, on a recent occasion, oneof the veteran examiners was unable to retain in his memorythe answer to a question he had put, even while the reply wasin course of delivery; so that the unfortunate student had to"try back" as he went along to refresh his inquisitor’s recol-lection of what he had just said. This incident reminds me

by contrast of an examination of candidates for licence to prac-tise the healing art I once witnessed in Pavia. There, one hotJuly day, while strolling through the quadrangles of the Uni-versity, seeking a cool place in which to pass an hour or twoof the blazing heat, I turned into the Hall, where a public ex-amination was going on. At the moment of my entrance the

neophyte was being pretty severely cross-questioned on thediagnosis he had delivered of the disease of a patient lying inhis bed in the area before all the world. The questions and.answers were put and given in a voice loud enough to be heardby the spectators, of whom there was a goodly number. ThisI ascertained on inquiry was a part of the ordinary examina-tion for the diploma of the University, without which licenceto practise is not granted in Pavia. Why what is found to beexpedient there should be dangerous innovation in London, Iam at a loss to conceive.

I am, Sir, your obedient servant,May, 1866. A LONDON FELLOW.

RUDMAN VERSUS ARMSTRONG.

JOHN C. ARMSTRONG.

To the Editor of THE LANCET.SIR,-In your article upon the late trial in which my father

and myself were defendants, you have somewhat misappre-hended the nature of the evidence given by Mr. Vinall, ofHackney, and have consequently made some remarks which Ifear may have given some annoyance to that gentleman, andwhich I should wish to be allowed to correct. I have verygood reason for believing that Mr. Vinall was subpoenaed with-out in any way being informed of the nature of the evidencerequired. I also wish to state, that in the witness-box heacted in the most straightforward and gentlemanly manner,and his evidence told decidedly against the plaintiff.

I remain, Sir, your obedient servant,Gravesend, May 16th, 1866. JOHN C. ARMSTRONG.

NEWCASTLE-ON-TYNE.

(FROM OUR OWN CORRESPONDENT.)

THE suspected poisoning of the three brothers Bushby atPonteland is still the principal topic of professional interesthere; and the matter has now, indeed, reached a stage fur-ther than mere suspicion, as arsenic has been detected in theportions of the body of John Bushby which were submitted toanalysis. I may tell you that this result has surprised no onehere in the profession who has watched the history of theeases, for it was believed, long before the coroner’s inquest wascommenced, that the symptoms, on the whole, were hardlyreferable to any known disease, but that they pointed unmis-takably to some irritant metallic poison. Popular instinct,too, although often on the side of error, seems in this case tohave been guided towards truth, for there appears to havebeen a feeling of some strength in the neighbourhood that theBushbys were victims of intentional or accidental poisoning.I here give you a condensed account of the coroner’s inquiryso far as it has gone. The certificate of death was produced,signed by Messrs. Dodd and Atkinson, assigning as the causelow fever and paralysis.-Jane Watson, late servant at Don-kin’s houses, deposed to her illness on Thursday, Dec. 21st,about an hour or two after a dinner of boiled beef and pudding.Messrs. John and George Bushby, the housekeeper, and alittle boy, partook of the same meal, and about six o’clock thesame day all who had this dinner were seized with sickness.She had much vomiting, with thirst, but no purging, on thenext Saturday, commencing about an hour after breakfast.She was sick in the same manner after meals, and sufferedfrom numbness and pricking pains in her limbs, until the 29tbof January, when she left the farm for her mother’s, fromwhich period she gradually recovered.-Mrs. Elizabeth Brown,who lived at a cottage near the Bushbys, and occasionally

went to help at the house, deposed to the illness of the in-mates, and on the 27th of December she saw the brothersJohn, William, and George vomiting. On one occasion herson, about ten years of age, went into the house about teno’clock in the morning. He had some bread and butter to eattowards evening, and the same night was very sick, with painin hip stomach, and vomited green matter. He was also

purged.-Mrs. Anderson, who went to the house to assist onthe occasion of William Bushby’s death, an hour after a dinnerof mutton-chops and potatoes experienced pain at the breast,and was seized with vomiting, after which she got relief.-John Fletcher, a workman on the farm, on Jan. 4th, an hourafter tea and girdle cake, felt unwell with pain and sense offulness at the stomach; was purged that night, and afterwardssuffered from numbness and uneasiness in the right arm andleg.-John Stokoe came to the farm on Jan. 9th. From the22nd he began to suffer like the others; had pain in the sto-mach, vomited bitter green matter, and had loose and bloodystools. Had great thirst. Still suffers from numbness in his

right hand and foot. His illness came on after taking coffee.He gave up the use of coffee for some time, using instead milk,from which he experienced no ill effects. The housekeeperprepared the coffee. About the beginning of February hecommenced the use of coffee again, and after drinking it twiceor thrice was seized with illness as before. He fancied thecoffee was not all right, as it had a bitter taste. The house-keeper hearing him make this remark about the coffee at thetime, said " that there was nothing in it-it was all right."He saw the housekeeper vomit between his first and secondattack.-Mr. Marreco, analytical chemist, had found arsenicin the liver of the body of John Bushby, and also in the rightkidney, with a little mercury. Arsenic was also present in thespleen, with a trace of mercury, but the largest quantity ofarsenic was found in the intestines. He could not determinethe exact amount present, but had not the slightest doubt of itsexistence; had examined various samples of articles broughtfrom the farm-house, and, with the exception of a sample ofvermin paste, had found no arsenic in any of them.-The evi-dence of Mr. Dodd, surgeon, of Ponteland, as to the symptomsobserved by him at the farm, was in substance similar to thatgiven in his paper read before our Medical Society, and towhich I fully referred in my last letter ; and he furthersaid that" when Dr. Heath first saw George Bushby he hadsore-throat, it was swollen, and of a deep-red colour. Therewere also traces of sore-throat in the case of Watson. Theprincipal subject of discussion between Dr. Heath and myselfwas, whether it was a case of disease or poison: there wasnever that sensation of heat we would expect to find in thecase of poison." But having heard the result of the analysis

,

which had been made, he (Mr. Dodd) was of opinion that’ death was produced by arsenic administered in repeated large’ doses.-Mr. Atkinson, surgeon, of Wylam, spoke to similar. facts. "From deceased’s symptoms he could not form any de-

finite idea of the disease under which he laboured, but con-cluded it was the paralysis of diphtheria. Had examined and, tested the water at the farm, but found nothing in it. Testeda portion of the liver and kidney on the 18th, and detectedarsenic. A month afterwards examined a portion of fluidobtained by washing the stomach, and found arsenic and mer-

r cury. Was positively and decidedly of opinion that John Bushby.

died from arsenical poisoning, and he believed that the otherssuffered from the same cause. He had seen Mrs. Bushby on

’ the 14th of April, and she was suffering from paralysis in her> legs and arms-confined to bed perfectly helpless. -The coroner

said there were several witnesses he was anxious to bring) before the jury, Mrs. Bushby particularly, whose helpless con-

dition he had that week heard of from her own medical man,’

and he could not say when she would be able to come to New-r

castle; he therefore adjourned the inquest until the 24th of’ this month.

Newcastle-on-Tvne. J’rlav llth. 1866.

Medical News.ROYAL COLLEGE OF SURGEONS OF ENGLAND.- The

following gentlemen, having undergone the necessary examina-tions for the diploma, were admitted Members of the Collegeat a meeting of the Court of Examiners on the 22nd inst. :-

Adams, Edward John, Charlton, Kent.Archdall, Gordon, Bundoran, Co. Donegal.Birch, George, Kingsland.Carver, Charles Handasyde, Nottingham.