1666

deaths both of infants and of elderly persons slightly- exceeded the numbers recorded in the preceding week. Threeinquest cases and 1 death from violence were registered ;-and 65, or more than a third, of the deaths occurred in

public institutions. The causes of 18, or nearly 11 per cent.,of the deaths in the city last week were not certified.

THE SERVICES.

ARMY MEDrCAL STAFF.THE following officers will retire in 1896:-Surgeon-

Major-General Sir W. A. Mackinnon, K.C.B., Director-,General, Surgeon -Major General J. Colahan, Surgeon-Major - General H. F. Paterson, Brigade - Surgeon - Lieu-tenant-Colonel H. J. O’Brien, Brigade-Surgeon-Lieutenant-Colonel J. Barry, and Surgeon - Lieutenant - Colonel A.Kirwan.

INDIA AND THE INDIAN MEDICAL SERVICES.

The Queen has approved of the following promotionsamong the officers of the Indian Medical Services :-BengalMedical Establishment : Surgeon - Majors to be Surgeon-Lieutenant - Colonels (dated Sept. 30th, 1895) : PatrickAlexander Weir, Peter Juhnston Freyer, M.D , Percy deHaga Haig, John Lewtas, M.D., and John O’Neill, M.D.Surgeon-Captains to be Surgeon-Majors (dated Sept. 29th,.1895) : James John Pratt and Robert Shore, M.D. lYlarlras ’

Medical Establishment: Surgeon-Majors to be Surgeon-Lieu-tenant-Colonels (dated Sept. 30th, 1895) ; Edward Ferrand andFrancis Hoskins Pedroza. Surgeon-Captains to be Surgeon-Majors (dated Sept. 29th, 1895) : William Burney Banner-man, M.D., and Henry Thomson. Bombay Medical Estab-lishment :Surgeon - Majors to be Surgeon - Lieutenant -Colonels (dated Sept. 30th, 1895) : John Wilkins Clarkson.and Joseph Parker, M.D. Surgeon-Captain to be Surgeon-Major (dated Sept. 29th, 1895) : Carrapiet John Sarkies.The Queen has also approved of the retirement from the.Service of the undermentioned officers : -Bengal MedicalEstablishment: : Brigade-Surgeon-Lieutenant-Colonel HenryBlack Purves (dated Dec. 4th, 1895), and Surgeop-Lieu-tenant-Colonel William Michael Courtney (dated Dec. 7th,.1895).

NAVAL MEDICAL SERVICE.

Fleet-Surgeon James William Hambly Hawton has beenplaced on the Retired List of his rank at his own request(dated Dec. 9th, 1895).

VOLUNTEER CORPS.The following members of the Volunteer Ambulance

.School of Instruction have recently passed the proficiencyexamination for Volunteer Medical Officers conducted by theArmy Medical Staff at the headquarters of regimental andother districts thus earning the higher grant for their corpsand becoming entitled to promotion after completing thenecessary period of service :—Surgeon Lieutenant-Colonels :F. W. Humphreys, V.D., F.R.C.S., 15th Middlesex (TheCustoms and Docks) Rifle Volunteers ; T. R. Pearson, V.D.,M.D., lst North Riding of Yorkshire Volunteer Artillery ;-A. Wilson, V.D., 2nd Volunteer Battalion NorthumberlandFusiliers. Surgeon - Majors : T. F. Fleetwood, M.B.,F.R.C.S.L, Victorian Military Forces, South Australia ; F.Orton, M.D., 3rd Middlesex Rifle Volunteers. Surgeon-Captains : D. Stewart, lst Volunteer Battalion Northurnber-land Fusiliers ; H. G. Ashwell, Robin Hood Rifle Volunteers;W. R. Wood, M.A., M.D., lst Volunteer Battalion CheshireRegiment ; H. Marriott, M.B., 4th Volunteer Battalion’Cheshire Regiment ; R. Batterbury, M.D., 2nd VolunteerBattalion Bedfordshire Regiment ; H. J. Mackay, M.D.,’2nd Volunteer Battalion Wiltshire Regiment ; J. W.

Hodgson, lst Devonshire Volunteer Artillery ; J. S. Forrest,,2nd Northumberland (Percy) Volunteer Artillery. Surgeon-Lieutenants : P. M. Yearsley, F.R.C.S., 16th Middlesex

.(London Irish) Rifle Volunteers ; G. Herschell, M.D.,M.R.C.P., 22nd Middlesex (Central London Rangers) RifleVolunteers; F. J. Warwick, M.A., and A. C. Tunstall,M.D., F.R.C.S., Bearer Company East London VolunteerBrigade ; T. Brushfield, M.D., and F. Hird, Bearer Company;Surrey Volunteer Brigade ; R. E. South, 2nd Volunteer Bat-talion Lincolnshire Regiment; S. A. Mugford, 2nd VolunteerBattalion Essex Regiment; G. McIntyre, M.B., 4th Volun-teer Battalion Scottish Rifles; G. H. Ward-Humphreys,1st Gloucestershire Volunteer Royal Engineers ; H. W.

Laing, M D.. ht Fifesliire Volunteer Artillery ; T. Forrest,M.B., 3rd Lanarkshire Rifle Volunteers ; W. J. Sprott,M.D., Robin Hood Rifle Volunteers; J. T. O’Hagan, M.B.,5th (Irish) Volunteer Battalion the King’s Liverpool Regi-ment ; K. W. 1. Mackenzie, 5th (Isle of Wight, Princess

Beatrice’s) Volunteer Battalion the Hampshire Regiment) ;R. Jackson, Al.B , 2nd Lancashire Volunteer RoyalEngineers ; J. H. Stacey, 1st Volunteer Battalion Norfolk

Hegiment; J. B. Stevens, 2nd Volunteer Battalion (PrincessLouise’s) Argyll and Sutherland Highlanders ; R. P. Mac-kenzie, M.B., lat Shropshire and Staffordshire VolunteerArtillery; W. A. Bond. M.A., M.D., M.R.C.P., 2nd LondonRifle Volunteers ; A. Thorne, lst Cinqne Ports Rifle Volun-teers ; C. Vise, M.D., lst Volunteer Battalion the Queen’s OwnRoyal West Kent Regiment; R. Odell, 1st Volunteer Bat-talion Bedfordshire Regiment,; W. G Mitchell, M.A., M.D.,5th Volunteer Battalion the Gordon Highlanders; H. H. du

Boulay, 1st Dorsetshire Volunteer Artillery : R. Beveridge,M.B., 3rd Volunteer Battalion Durham Light Infantry; S.Lodge, M.D., 3rd Volunteer Battalion the Prince of Wales’sOwn West Yorkshire Regiment ; W. Murdoch, M.D ,3rd Volunteer Battalion the King’s Own Scottish Borderers :James Ta,ylor, M.D., 6th Volunteer Battalion the GordonHighlanders ; E. W. St. V. Ryan, 16th Middlesex (LondonIrish) Rifle Volunteers; L. E. Shore, M.A., M.D., CambtidgeUniversity Rifles.At the distribution of prizes to the 1st Middlesex Volunteers,

R.E., on Dec. 13th, a preentation of a handsome silverbowl and illuminated address was made by Field MarshalSir John Lintorn Simmons, K.C.B., K.C.M.G., &c, the

Honorary Colonel, on behalf of the officers, past and pre-sent, to Surgeon-Lieutenant-Colonel Baines. V.D., M.D., onhis retirement after thirty-six years’ service in the Corps.

THE ASUAXTI EXPEDITION.

As far as the health of the troops and the medico-

sanitary aspects of the expedition are concerned the pro-spects remain as satisfactory as they were. The attitudeof Samory, the chief of the Mahommedan tribe, seems

doubtful however, and this introduces a factor of

military importance, as they are a warlike people andwell armed. It is rumoured, too, that King Prempehhas arrested the only two white men in Kumasi as spies.Large quantities of stores have been landed at Cape CoastCastle and are being rapidly pushed to the front. SeveralBritish officers have made rapid marches to Prahsu to com-plete all the necessary arrangements and to construct thebridge over the river Prah. There is no lack of nativebearers to act as transport ; the chief difficulty that is to befeared in regard to them is that no dependence can beplaced upon their courage, as they will probably fly in theevent of any attack. No change appears to have beenmade in the plan of the expedition. Satisfactory assuranceshave been received as to the attitude of the Koranza tribe,through whose country it is proposed to make a diversion toKumasi on the advance of the force over the Prah to the

capital. The tribes inhabiting the country generally havesuffered too much from their Ashanti neighbours in the pastto have any love for them. Surgeon-Colonel Taylor, the

principal medical officer of the force, has issued a leafletcontaining a number of simple and practical suggestions forthe information and guidance of the soldiers. Great pro-gress has been made in the hospital arrangements for theforce and in the formation of rest camps along the line ofmarch, and a great deal has been effected in the way ofclearing a road for the troops. The health of the expeditionis reported to be satisfactory. A certain amount of sicknessand fever was in any case to be expected, but it has been sofar very small, and not at all of a severe character.

THE ABYSSINIAN CAMPAIGN.

The Italian War Office is sending out large reinforcementsto strengthen their garrison in Abyssinia after the unfor-tunate reverse they lately sustained in that country. It is

everywhere recognised that the officers at the late Oglit atAmbalagi, by their extreme bravery and devotion under mosttrying circumstances, reflected great credit on the Italian

army. The Italia Militare states that after the deharturefor East Africa of the fint nine battalions, five otherbattalions also sail during this month with two additionalbattalions of mountain artillery. A large contingent of theMedical Service, with hospital stores and equipments, will berequired with this force, especially as the arrival of theItalian troops in Abyssinia will probably soon be followed by

1667

active operations against the Shoans, who are, by the way,said to be suffering from lack of provisions.

THE COMMANDER-IN-CHIEF.inc speeches made uy Btsuuuub tvuiseicy al yvouiwicu

and Sandhurst have, we think, created 11 very favourable

impression. They are quite in keeping with the viewshe has always expressed in regard to the army beingmade to offer in the future a professional career for officers,and his desire to see the bond between them and the menunder their command not one of mere discipline, but of com-radeship also. We are glad to notice, too, that the Com-mander-in-Chief has, by his example, recently practicallydiscouraged unnecessary extravagance at mess. This is a

step in the right direction now that a larger proportion ofyoung men of relatively small means are entering the armythan was formerly the case.

THE MADAGASCAR EXPEDITION.

The health of the French force in Madagascar is said tohave much improved of late. It will, of course, take sometime before those who have contracted malarious fever ofeven a mild type can have their health fully restored, butmost of those who have been seriously attacked or

who have suffered from dysentery and were fit totravel have been already invalided from the country. Theclimate of the uplands is comparatively healthy, and nowthat the French troops occupy quarters in the capital, andare, we trust, fairly fed and provided for in every way, theirhealth and strength should become far more satisfactory.The late expedition was of a most arduous kind according toall accounts.VUV+J.

THE INDIAN CHOLERA REGULATIONS.A committee has been appointed by the Government of

India-consisting of the Quartermaster-General, the PrincipalMedical Officer of Her Majesty’s Forces, the Sanitary Com-missioner with the Government of India, and ProfessorHankin-to consider and revise the cholera regulations forIndia.

Correspondence.

"CHELSEA HOSPITAL FOR WOMEN."

"Audi alteram partem."

To the Editors of THE LANCET.

SIRS,—I beg to be allowed to correct an error of factwhich has crept into your editorial article of Dec. 21st onthe action taken by the council and governors of the ChelseaHospital for Women in relieving a member of the honorarystaff of his duties. You say "as a result of that report[of the Committee of Inquiry in 1894] the medical staff ofthe hospital resigned, and the lay management should havedone the same." As a matter of fact, the board of theChelsea Hospital for Women did resign at the same time asthe medical staff, and the present council (the great bulk ofwhom are new members) was elected by the governors at ameeting held on Nov. 28th, 1894.

I am, Sirs, your obedient servant,Dec. 23rd, 1895. GLEVESIi.GLENESK.

* ** We are sorry to be compelled to correct Lord Gleneskin matters of fact in the recent history of the hospital overwhose fortunes he presides. The lay management of the

Chelsea Hospital for Women did not resign upon the presenta-tion of Lord Balfour of Burleigh’s condemnatory report. Thisreport was presented in July of last year, and the medicalstaff immediately resigned. The lay management stuck tooffice and set about electing a new medical staff. A resigna-tion of the lay management took place in the followingNovember, but that is not "the same time," nor did thisresignation depend upon the fact that severe censure hadbeen passed upon them; at least, if it did, Lord Glenesk,who tendered it, gave a different reason.-ED. L.

To the Editors of THE LANCET.

SIRS,-From your report of the meeting it would convey tothe profession that 123 governors had voted and that only 17

vvcac ava uac and wavavauvavm, VVH’(j’LC(1J only u rcaavma vvcu-w

40 against and 17 for me; but the majority of 40 included22 persons who were members of the board and staff andtheir families, and therefore personally interested in the

question they voted upon. Of the remaining 18 I amadvised one was not qualified to vote, so that of the

independent voters 17 were for arbitration and 17

against. Neither my wife nor I voted, although entitledto do so. The result was therefore brought about bythe iniquitous system of cumulative voting in vogueat this hospital. Furthermore, many influential governorswho were unable to attend either wrote or wired to the chair-man demanding inquiry. These facts speak for themselves.The question which naturally arises in the professional

mind after reading the many inaccurate statements (whichwere after careful pruning sent to the daily papers, while thepowerful common-sense speech of Mr. Burdett-Coutts, the-late vice-chairman, was suppressed) is, Why did the boardwant me to resign ? 1 The following letter written by me tothem will explain :—

June 23rd, 1895.GENTLEMEN,—I beg to acknowledge your letter of the 20th inst., and

to say that it is quite true that I have expressly forbidden your residentmedical officer to interfere in any way with my operation cases. It is.quite untrue that my staff nurse treats my patients beyondcarrying out my instructions. With regard to your remarksas to rules, I know of no rule that can interfere with my re-sponsibility in the care and treatment of my patients, and I willnot share with an inexperienced resident medical officer thisgrave responsibility in any serious operations which I may havefrom time to time to undertake. Both he and my staff nurse andmatron are instructed that, in case of any condition arising in whichmy presence is required, they should wi.e for me, or, if at night, send a,hansom. My time is my patients’, and in less than an hour I can always-be at their bed-side. This is the system to which I always have beenaccustomed, and to wlich I mean to adhere. That it is no experimentis evident from the fact that in the Samaritan Hospital, which may be-called the parent institution for abdominal surgery, under Sir SpencerWells and his successors the medical staff have persistently refused tocommit their cases to a house surgeon, and to this system they attributetheir great success, which is a matter of common notoriety. Thenecessity for this arrangement has been forcibly brought before me bythe treatment of my last hysterectomy by the resident medical officer.

The treatment referred to is this : Within eight hoursafter a hysterectomy the house surgeon tightened up theserre-noeud which was on healthy uterine tissue, removed allthe dressings superficial and deep, which meant lifting upthe pin and taking out the pressure pads, and interfered asecond time the next morning early, all this being done with-out sending for me, which he had strict orders to do. These-are facts which are undeniable ; I saw all these dressingsnext day. For this disobedience to my wishes I repri-manded the house surgeon, and he took the very un-

usual course of reporting me to the board-hence myletter. I leave my action towards him and my views.on this subject gladly to the criticism of any abdominal

surgeon in Europe. All that I insisted upon in my so-called" reform " was that the after-treatment of these grave casesshould be left to me alone. I never placed the house surgeonin an inferior position to a nurse ; he had complete charge ofall my other cases. This was only one of many red herringsdrawn across the track while evading the main point. Theboard asked me to withdraw this letter, which I refused to,do, as I felt conscientiously that those were the only con-ditions under which such terrible operations were justifiable,hence their antagonism to me. It is some satisfaction to feelthat such men as Sir Spencer Wells, Mr. Jonathan Hutchinson and Dr. Robert Barnes found cooperation with this board im-possible, and that since their resignation no man of positionin London could be found willing to accept the post of con-

sultant, although many men of mature wisdom andexperience have been approached to this effect. Why doesthis state of affairs exist ? Public inquiry is the only meansof solving this question. I am ready to place my case in the’hands of any such tribunal, and to prove the veracity of allmy statements.Here I can only simply deny the insinuations made against

me by the chairman and some of the staff. For the present,I leave my reputation, and their treatment of me, cheerfullyto the judgment of my professional brethren, feeling certainthat as "Right is might" I will yet get an opportunity ofmeeting my enemies in the gate.

I have the honour to be, Sirs, your obedient servant,Harley-street, W. ROBERT O’CALLAGHAN.ROBERT O’CALLAGHAN.

2c the Editors of THE LANCET.

SIRS,—The scrutiny of the votes given at yesterday’&.meeting resulted as follows : for the resolution put from