541

protest against the whisky-and-water, in which he was al-lowed to indulge ; in fact, I thought this liquid might havebeen a fancy of his own, and certainly not a very safe beve-rage even in " the simplest form of cerebral congestion." Onthe following day, I received Mr. Mackin’s first letter, inwhich my conduct was stigmatized as "intrusive" and unpro-fessional," "officious" and " unwarrantable," and concluding witha threat to show me up in THE LANCET, which he has not thoughtproper to publish, and which I subjoin:—"From the curiousgrammatical inaccuracies contained in the recipe which youcondescendingly left for my approval, I think so classical a pro-duction should not be lost to the medical public, it will there-fore remain for consideration whether a statement of thewhole matter, with a copy of your prescription, shall be sentto THE LANCET." His second letter I returned unopened.I am at a loss to know what all this can mean; certainly it

cannot be all about etiquette, for he has condescended tonotice even an intentional inaccuracy. I have done more touphold the honour of the profession than Mr. Mackin, not-withstanding all his quibbling; and I shall never be deterredfrom doing my duty fearlessly to a friend, or a patient, what-ever may be the conventional forms of "the leading practi-tioners of Pimlico," or the insinuations of Mr. Mackin.

I have to apologize for the length of this letter, but Mr.Mackin’s assertions are much more easily made than supported.I also enclose a note from the son of the patient, corroboratingthese statements, which you may use if you please, as he waspresent during the whole of my interview with Mr. Mackin.

I am, Sir, your obedient servant,Park-place, Mile-end-road, Nov. 1S50. AUTHUR HELS]aAll, M.D.AUTHUR HELSHAM, M.D.

THE OPEN-SHOP AND SURGERY QUESTION.

HENRY TAYLOR.

To the Editor of THE LANCET.SIR,—In the letter of your correspondent, Mr. M. B. Gall-

wey, are some strictures on the conduct of general practi-tioners, in dispensing their own medicines. Every one willbe disposed to admit the justice of his remarks as regards thesale of drugs in an open shop; but the case is very differentwhen he applies the same censure to the practice of dispensingmedicines in a private surgery. Mr. Gallwey believes he ispossessed of all the arguments that can be urged in its favour,and forthwith proceeds to demolish them, in a style andmanner quite characteristic of that arm of the service towhich he belongs.

It must be observed, however, that he has not stated thesearguments at all fairly, while some of the most important arenot even alluded to. Contrary to his assertion, there aremany villages in this part of the country which have no drug-gist, and where the demand for medicines is so small that nodruggist could make a living, even if he had the whole field tohimself. I contend, therefore, that in the villages there mustoften be a necessity for the dispensing of medicines in a

private surgery. Perhaps it has not occurred to Mr. Gallwey,that the poor, the infinite majority of our patients, couldhardly afford to pay both doctor and druggist, as he would re-commend. In commercial language, there would then be twoprofits to be made, one from the medical attendance, and onefrom the drugs dispensed; whereas, by the present system,there is no profit sought to be made out of the drugs by thepractitioner ;-in point of fact, his fees are no higher than ifhe simply prescribed without dispensing the medicines.Another and a more weighty argument in favour of thepresent custom is this, that with the poor it is a charity. Incases of long and severe illness, there is often so much ex-pense incurred for medicines only, that few tradesmenwould be found to give the poor the necessary credit forthem. Then it is that the professional man stands theirfriend, whether or no there be any chance of his patient’srecoverv, or of his solvency, he is ever ready to supply himwith what is needful in the way of drugs. This is a dutywhich I conceive will be held more binding on the professionthan any considerations of social rank, or personal dignity-itis this, and not the grovelling love of trade which Mr. Gallweywould impute to us, that corn pels us to continue in our presentcourse.

After all, it remains to be proved whether the " honour andrespectability of our calling" is in any way compromised bythe mere act of compounding drugs; and here I must takeleave to remind Mr. Gallwey that in dispensing our own

medicines, we are doing nothing worse than is done by everymedtcs.1 officer in her Majesty’s service; and I venture to say,that even in the Ordnance Department the surgeon has some-times to demean himself by " dabbling with drugs," and that

without losing anything in the eyes of his brother officers, whohave probably more sensible ideas of what really constitutesthe dignity and usefulness of medicine. The great error inour present system, and which has been entirely overlookedby Mr. Gallwey, in the warmth of vituperation, is, not the dis-pensing, but the charging for medicines-the custom of sendingpatients an invoice of their drugs at fictitious prices.

This is an evil which cannot be defended on any score; butit is one which the growing intelligence and liberality of theage will soon enable us to remove.Having replied to the strictures of your correspondent, I

will conclude by stating what is, in my opinion, the cause ofthe low esteem in which the profession is held by the public.I believe it is not the dispensing nor vending of drugs-butcertain vices and failings in the professional character, thatare as conspicuous now as in the days of Moliere and Le Sage.I mean, the dissensions and bickerings among ourselves,the jealousies and intemperate abuse of rival systems, thepuffing and touting; and more than all, the presence in ourranks of men who are totally unfitted, either by nature oreducation, for the exercise of their calling-men with coarsemanners, and coarser minds, without any scientific acquire-ments, or even a competent knowledge of their art, who woulddegrade any profession to the level of a trade, and whom noexternal rank or distinctions could elevate to the characterof " divine philosophers."

If 1:.Ir. Gallwey can suggest any remedy for these evils, Ishall be happy to hear of him again.

I am, Sir, your obedient servant,Guildford, October, 1850. HENRY TAYLOR.

THE ORTHOPÆDIC HOSPITAL.A REAL CASE OF DEFORMITY.

To the Editor of THE LANCET.SIR,—I have been for many years a governor of the Royal

Orthopaedic Hospital, and am well aware that the surgicalstaff consists of a surgeon and two assistant-surgeons.

In my intercourse with the patients, I have learnt, to myastonishment, that one of the assistant-surgeons neither ope-rates nor, indeed, has had any patients under his care, for thelast three or four years; notwithstanding which, it appearsthat the number of ont-patients is such, that an extra day isset apart, to get through the duty. This being the case, Ishould be glad to learn why two officers should be overworked, pand the third remain idle. Perhaps, Mr. Editor, you willkindly assist me in ascertaining the reason of this apparentlystrange affair, and discovering the spirit which animates thegoverning body of an institution where such an anomalyexists.Not only is this the fact, but rumour has sounded the note

that the appointment of a fourth medical officer is contem-plated !-for what?You, Sir, have been engaged in unravelling many knotty

points, and succeeded beyond all hope; I therefore trust youwill also, in this case, lend a helping hand to fathom thedepths of this mystery.

I remain, your obedient servant,London, Nov. 5, 1850. POLLUX.

*%* In noticing this commmunication, it is necessary thatwe should quote one sentence verbatim, - ° Perhaps, Mr.Editor, you will kindly assist me in ascertaining the reason ofthis apparently strange affair ; and discovering the spiritwhich animates the governing body of an institution wheresuch an anomaly exists."

In the first place, we must be allowed to observe that wecan discover no reason in such a strange affair. Secondly, itis a difficult matter to discover the spirit which animates thegoverning body, because it is quite evident the governingbody has no spirit, or else such discreditable proceedingswould not be allowed amongst the officers of the institution.It is equally clear that a spirit does animate a certain

governing body, and that the said spirit is a very evil one. If,then, the nominal governors of the institution would butassume and exercise their proper functions, and be guided intheir proceedings by a just, honourable, and wise spirit, theevil one will either relinquish his functions, or be altogethercast out of the establishment. If much further tampering beallowed with the management of this hospital, the chance ofits doing good will be much diminished. We can assure our

542

correspondent that unless something be done, and speedily,towards applying a remedy for the grievance of which he sojustly complains, we shall be compelled to raise a veil thatwill disclose a scene which will excite no little astonishmentin the minds of the great majority of the liberal governors ofthis well-supported charity.-ED. L.

Medical News.ROYAL COLLEGE OF SURGEONS.—The following

gentlemen, having undergone the necessary examinations forthe diploma, were admitted members of the college, at themeeting of the Court of Examiners, on the lst inst.:-

BEVAN, GEORGE PnILLIPS, Beaufort, Breconshire.DAY, MARK ROWLAND, Oxford.DICKENSON, JAMES EDWARD, Hart-street, Bloomsbury.FLETCHER, ADAM, Bury, Lancashire.LANG, Joarr FRANK Ross, Newcastle-upon-Tyne.LEWIS, ROGER, Narbeth, Pembrokeshire.M’CARTHY, JAMES, Romford, Essex.NICHOLSON MARK EDWIN BULLEN, Cambridge. i

ROBINSON FRANCIS, Nova Scotia, North America.SIDLEY, GEORGE HUGH, Royal Navy. (This gentleman

passed as Naval Assistant, Feb. 7,1845.) ’

WRIGHT, HENRY GooDE, Hereford. ’

At the same meeting of the court, Mr. JAMES SMITH AYERSTpassed his examination for Naval Surgeon: this gentlemanhad previously been admitted a Member of the College, hisdiploma bearing date April 12,1847.

APOTHECARIES’ HALL.—Names of gentlemen whopassed their examination in the science and practice of medi-cine, and received certificates to practise, on

Thursday, Oct. 31, 1850.BRADY, JosEpH, Dewsbury.SYKES, REUBEN, Snaith, Yorkshire. _

PRIZES OF THE SOCIETY OF APOTHECARIES. -Three prizes are annually given by the Society.-]. A goldmedal; 2. A silver medal, with books on Botanical Science;and 3. books only. The successful competitors for the bo-tanical prizes in the present year are,—Mr. Frederick WilliamHeadland, of King’s College, first prize; Mr. George D.Brown, St. Thomas’s Hospital, second prize; Mr. John Z.Lawrence, University College, third prize. In materia me-dica and therapeutics, (in the present month,) first prizeawarded to Mr. F. W. Headland, of King’s College; secondprize, Mr. D. T. Morris, Charing-cross Hospital.A WARNING TO MEDICAL PRACTITIONERS.—Ann

Jones, a middle-aged woman, was charged with stealing atable-cover, a stomach-pump, &c. The prisoner had been inthe habit of calling at the houses of medical gentlemen to taketheir advice respecting some malady under which she repre-sented herself as suffering, and then, being shown into a wait-ing-room, appropriated whatever portable articles were athand. In one instance, she called on Mr. Hobbs, a surgeon,of 35, Southampton-row, and, during the temporary absence

. of the assistant or porter, carried off a table-cover and a fewtrifling things which had been left on the table. On anotheroccasion, she called to see Mr. Blair, a surgeon, in GreatGeorge-street, Bloomsbury, stating that she had come from alady in hourly expectation of her confinement. During thedelivery of her message she disappeared with a stomach-pump.Mr. Henry having been informed that there were many othersimilar charges against her, remanded the prisoner for furtherexamination.—Times, Nov. 4.ALLEGED CHARGE OF PROCURING ABORTION.-

Mr. Edwards,surgeon, against whom a charge of procuring abor-tion had been some time ago made, surrendered to take his trialon Thursday morning, the 24th of Oct., at the Central CriminalCourt: the prosecutrix was, however, not forthcoming, and thecounselof Mr. Edwards addressed the court, to the effect that thatgentleman had been no party directly or indirectly to the ab-sence of the prosecutrix; on the contrary, although strenuouslyurged in the first instance, by the present prosecutors, to fleethe country and avoid the charge, he had determined to meetthe fullest investigation of his conduct. Mr. Justice Erlestated that he felt it his duty to adjourn the case until thenext November sessions; if the prosecutrix did not thenappear, Mr. Edwards would be entitled to his acquittal.

BRADY, JOSEPH, Dewsbury.SYKES, REUBEN, Snaith, Yorkshire.

QUARANTINE REGULATIONS IN SWEDEN. - Thesystem of quarantine against the cholera, abandoned as uselessin almost every other state of Europe, prevails in Sweden inits utmost rigour. It is not only enforced against all personsentering the country from abroad, but the several provincesare closed against each other. If the disease appears in anyplace, it is cut off from all communication with the neighbour.ing towns. In the interior, the isolating system was put inforce before it was adopted in the capital. In all the largertowns, a guard at the gates sends back all travellers who can.not prove that they have not visited any infected place forten days. At Sodertelge, a ship of war is placed, that com.pels all vessels as they arrive to anchor in the quarantine sta-tion. In the North of Sweden, these regulations are only en-forced against persons; but, in the town of Lund, they are ex.tended to goods, if they are imported through Malmö.-Times,Nov. 5.HEALTH OF LONDON DURING THE WEEK ending

Saturday, Nov. 2.-The return exhibits a considerable increaseon the mortality of previous weeks. In the first three returnsof October, the deaths registered were successively 839, 860,and 845; in the last week they rose to 945. In the ten corre-sponding weeks of 1840-49, they were, on the average, 959.Deaths from fever, which in the two previous weeks were 54and 49, rose last week to 65. Scarlatina appears to makeprogress; it was fatal in 41 cases, and prevails in some partsof Walworth and Camberwell. Last week, small-pox carriedoff seven children and two adults ; measles, 21 children;hooping-cough, 20; and croup, eight. Erysipelas numbersseven fatal cases; and of ten women who died after child-bearing, seven sunk under puerperal fever. Decline of diar-rhœa and dysentery in the last three weeks is shown by thenumbers being successively 37, 30, and 22. Last week, threedeaths from cholera were returned, but none of the cases hadassumed the malignant form. Diseases of the respiratoryorgans discover a small increase of mortality, which may beviewed in connexion with a fall of the weekly mean tempera-ture from about 50° in the earlier part of October to 42°towards the end of the mouth. The increase is observed inpneumonia amongst children, and also in bronchitis amongstagad people. Nine old pensioners died in the Royal Hospitalof Greenwich, between the 24th and 29th of October, and thattheir ages, the lowest of which was 61 years, and the greatest90, averaged rather more than 74 years; 71 deaths were regis-tered during the week in metropolitan workhouses, and 83 inhospitals and other public asylums. A girl, five weeks old,died from "an over-dose of syrup of poppies." The birthsof 770 boys and 749 girls, in all, 1519 children, were registeredin the week. The average of five corresponding weeks in theyears 1845-49 was 1361. At the Royal Observatory of Green-wich the mean height of the barometer in the week was29.625 in. The temperature rose gradually and almost con-tinuously during the week. The daily mean, which was 40.2°on Sunday, was 560 on Saturday, and the mean of the weekwas 46.3° The mean temperature was below the average ofthe same days derived from seven years, till Thursday. Onthe last two days, it was from seven to ten degrees above it.

ASSURANCE OFFICES WHICH PAY ALL MEDICALPRACTITIONERS TO WHOM THEY REFER.

Architects ........................

Britannia ...........................British Mutual ..................

Church of England ............Commercial........................East of Scotland..................East of England Mutual......Engineers, Masonic, and Uni-

versal ...........................English and Scottish Law ...English Widows’ Fund ......

European Life Insurance andAnnuity Company............ J

General and Mining ............ y

General Benefit ..................

Great Britain.....................

Indian and London ............

Industrial and General.........Kent Mutual .....................

Kent Mutual Life AssuranceSociety .....

69, Lombard-street, London.1, Princes-st., Bank, London.17, New Bridge-st.BlackfriarsLothbury.112, Cheapside, London.1, Bank-street, Dundee.Chelmsford.

345, Strand.12, Waterloo-place, Lonaon.67, Fleet-street.

10, Chatham-.pl., Blackfriars,4, Bridge-street, Blackfriars.4, Farringdon-street.Waterloo-place, and E-ing-

William-street.King-William-street, and 14,

Waterloo-place.2, Waterloo-place, Pall-Mall.High-street, Rochester.

6, Old Jewry, London.