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Medical Diary of the Week.

MONDAY, JUNE 16 ......

TUESDAY, JUNE 17......

WEDNESDAY, JUNE 18

THURSDAY, JUNE 19..,

FRIDAY, JUNE 20.........

SATURDAY, JUNE 21...

fST. 31ARK’S HOSPITAL FOR FISTULA AND OTHERDISEASES OF THE RECTUM.—Operations, 1¼ P.M.

ROYAL FREE HOSPITAL.—Operations, 2 P. M.

’’ MBTnoponTAN FREE HOSPITAL. - Operations,2 P.M.

LROYAL GEOGRAPHICAL SOCIETY.-8½ P.M.

fGuY’f HOSPITAL.-Operations, 1 1½ P.M.WESTMINSTER HOSPITAL.—Operations, 2 P.D2.

ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Professor Gulliver, " On the Blood of the" Vertebrata."ETHNOLOGICAL SOCIETY.-8 P.M. Mr. John Craw-furd, "On Colour as a Test of Race :’ - Mr. R.S. Poole, "On Egyptian Ethnolog-y."(MIDDLESEX HOSPITAL.-Operations, 1 P.M.

ST. MARY’s HOSPITAL.-Operations, 1 P.M.

UNIVERSITY COLLEGE HOSPITA.L. - Operations,2 P.M.

ROYAL ORTHOPÆDIC HOSPITAL. - Operations, 2P.M.

GEOLOGICAL SOCIETY OF LONDON.-8 P.M.(ST. GEORGE’S HOSPITAL.-Operations, 1 P.M.CENTRAL LONDON OPHTHALMIC HOSPITAL.-

Operations, 1 p.M.LONDON HOSPITAL.-Operations, 1½ P.M.

NORTHERN HOSPITAL, KING’S CROSS.-GREAT NORTHERN HOSPITAL, KINS’S CROSS.—Operations, 2 P.M.

LONDON SURGICAL HOME.-Operations, 2 P.M.WEST LONDON HOSPITAL.-Operations, 2 F,3i.ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Professor Gulliver, " On the Blood of the

Vertebrata."WESTMINSTER OPHTHALMIC HOSPITAL.- Opera-

tions, 1½ P.M.

ST. THOMAS’S HOSPITAL.-Operations, 1 P.M.ST. BARTHOLOMEW’S H0SPITAL.-Operations, 1½ P.M.KINGS COLLEGE HOSPITAL.--Operations, 1’2 P.M.CHARING-CR0SS HOSPITAL.-Operations. 2 P.M.

ROYAL COLLFGE OF SURGEONS OF ENGLAND.-) 4 P.M. Professor Gulliver, " On the Blood of the

Vertebrata."

To Correspondents.Anxious.-Deeply sympathizing as we do with the unfortunate position of ourcorrespondent, we regret to say that there appears to be no prospect ofgiving him any advice which may help him to improve his condition. Our

profession is unfortunately so constituted, that men of merit are occa-sionally prevented from taking that position to which they are justly en-titled. We would willingly place the case of " Anxious" before the readersof THE LANCET if such a proceeding could possibly be attended with anygood result. But instances of similar hardships are so common, that itwould be vain to expect that any benefit could arise from giving publicityto his unfortunate situation. It may, however, be consolatory to inform"Anxious" that some of the members of our profession who have risen todeserved eminence were subjected in their early career to great and appa-rently overwhelming privations. We advise him, therefore, not to despair.Perseverance and good conduct may yet succeed in obtaining for him therespectable position which he is desirous to occupy. If the avenues to suc-cess are beset with more difficulties than formertly, those difficulties are tobe surmounted. At all events it is clear that the recent " regulations" offer apremium to industry and talent. If the path has become narrower and morethorny, such men as our correspondent are more likely to succeed in over-coming the obstacles which have to be encountered.

Mr. Chambers.-There are many institutions of the kind. The Coppice atNottingham, we believe, receives such patients.

C. C.-It is quite possible. At a late meeting of the Obstetrical Society, Dr.Tanner alluded to a case which went to establish the fact, that a marriedwoman may conceive, may go to the full term of gestation, and may be inlabour for several hours, without having any suspicion that she is pregnant.

THE MEDICAL COUNCIL AND MEDICAL STUDENTS.

To the Editor of THE LANCET.SIR,-I was glad to notice in your last impression that your powerful aid

had been sought on the subject of " Caloiriel’s" letter. I feel sure that hiscase is that of a large number, as it is mine. I cannot help thinking that it isa manifest injustice that a man who has been articled betore the alterations inthe curricula of study had b, en, if not contemplated, at all events put intoforce, should be subject to those alterations. I was articled some time previousto 1858, and have been in attendance at a large provincial hospital for nearlytwo years. An additional four years’ study cannot fail to be to a certain extentoppressive, particularly after a hard-worked apprenticeship. Besides, I do nothesitate to say that I could with ease have passed the preliminary examina-tions when fresh from school. I should have retty considerable difficulty indoing so now. I trust you will ex"rt your powerful influence in removing, orat all events alleviating, these (what I cannot but consider) unjust grievances.

I am, Sir, your obedient servant,June, 1862. CORROSIVE SUBLIMATE.

M.R.C.P. Lond. has just cause for animadvertiig on the circular of Mr. Hare,of Langha.n-place. We have no desire to speak with undue severity of

’, Mr. Hare’s mode of proceeding; but we may express our regret that heI should have adopted the most objectionable form of circular in question.’ We have no doubt that Mr. Ilare is actuated by the purest mot ves; but it

would be well if he took a more legitimate mode for promulgating hisclaims on the consideration of those who may require his assistance. Sucha system may admit of excuse ; but we cannot exonerate him entirely froma desire to make that charity the most imperative which " begins at home."

L. B.—We know nothing of the person named, nor of his work.Dubious.-The name is not to be found either in the Register or the Medical

Directory.MERCURY IN SYPHILIS.

To the Editor of THE LANCET.SIR,-Feeling the importance of the present subject, I again beg to reply to

Mr. Weeden Cook ·.

He says my first case, J. S-, is vaguely described as syphilis, although heconcedes that it might be a case of syphilitic periostitis. Now, I feel exceed-ingly grateful for this unlookei-for coneessiorz on his part, although I didmention that the primary symptoms (expressly mentioning induration) haddisappeared. How I came to such knowledge is self-evident-viz , from theparty affected. As regards the use of the remedy, par excellence, for periostitis,Mr. BVeeden Cooke is oblivious to the very obvious fact, also stated, that he hadbeen previously treated by iodide of potassium, the patient being quite awareof the taste of that drug.

CASE 2.-J. I- I entirely agree with Mr. Cooke that the use of blue-pillfor such a long period, with exposure, must have had something to do withthe severity of the ca,e ; but after other means had failed, and I saw returninghe dth and strength follow the use of the vapour-bath, I should have been theveriest sceptic alive to have d,u )ted cause and effect. At least the patient hadno qual us of conscience about it, but rather warmly expressed his opinion whythe same means had not been used earlier in his case. The poor man reasonedonly on his own personal experience. In this case I also got the history of avery hard, obstinate chancre.CASK 3.—W. L-. My diagnosis was facilitated from having treated Mrs.L- for syphilitic psoriasis. She was quite cognizant of the came of the skinaffection. Mr. L- himself had given up all hopes of cure, and it was onlyafter the wife got well that I had the husband 10 o treat. It was for fear oftaking up your valuable space that I was so curt in my description. Mr. L-has had no relapse for eighteen months. Now, if the saliva’ion was the causeof the cerebril disturbance, why was the oculist consulted ? Mr. L - was notsalivated until seen by him; besides, as if syphilis could not cause such a dis-ease without mercury! I doubt that Mr. Cooke has fallen into the commonerror of post hoc, propter hoc. I may state that neither quinine nor wine wasgiven in this case, as the only accessory used was Dover s powder, which hadthe effect of causing the pupils to contract, and perhaps facilitating matters alittle.In the concluding paragraph Mr. Cooke shows us very plainly that he is

eminently qualified to be an authority on this subject. Still I opine that othersare also fitted to speak on this important matter. In another part he againstates that salivation is sometimes caused by one bath. Surely there must besome misunderstanding on this point, or the baths are not given on the sameprinciple.

I feel compelled to quote my old authority, as it is borne out by my own ob-servation. Mr. Lang,tun Parker says, "I never saw the most delicate patient,either male or female, whose health was injured under the plan I recommend,and 1 have very rai ely seen a disease that has not bem cured. The experiencederived from the treatment of many thousand cases warrants me in speakingthus positively on this subject."-p. 332. Again, on p. 324, he says, "The ana-logy has been made with the dry fume, which sometimes has produced such aneffect—i. e., salivation. The mixture and dilution of the vapours of mercurywith common steam and the sweating induced by the bath entirely removeany fear of this kind, and I would stake my reputation that with proper manage-ment it canoot occiti-." Mr. William Acton, writing in THE LANCET of July

13th, 1850, after describing the method then in use, says, "In old chronicaffections which do not yield to mercury given internally, the most marvellouseffects are often produced. I have seen cases, resisting all other treatment,get rapidly well under this plan, and 1 would recommend a trial to my profes-sional brethren in the numerous instances that come before them of obstinate

complaints. I am, however, by no means convinced of its geaeral application,or that it is likely to supersede the mineral given internally." Mr. Acton’sobjections, however, are more on the score of inconvenience, as, in speaking onthis subject, he says, "These peculiarities explain why fumigations have falleninto disuse, as the pi oper means of application are not always at hand." Letit be understood that it is the dry fume that is here spoken of.Having taken up so much of yuur valuable space, I may mention the method

usually ordered by me at the patient’s own house. A common pail or woodendish is tilled wi h about three inches of water at 100° Fahr., into which twobricks, heated r, d hot, are placed, one on the top of the other; this is imme-diately placed below a cane-bottomed chair, over which a bit of soft flannel isspread. The patient, being seated, is immediately enveloped, his head remain-ing free, with a blanket wrung out of hot water, over which one or two otherblankets are placed. He or the attendant scatters about sixty grains of calomelover the uppet surface of the brick. From twenty to thirty minutes is longenough to remain, after which the body is well dried; the patient then going tobed, some extra covering is placed over him, warm gruel, with ten grains ofDover’s powder, being given to keep up diaphoresis. If it should be judgednecessary to act gently on the gums, where time is a matter of the first Im-portance, the patient has only to keep his head under the blanket for a fewminutes at a time; but, except in very obstinate cases, it is not advisable.Iron, quinine and iron, iodide of potassium, antimony, chlorate ofpo’ash, cod-oil, or wine can be given during the day, according to indications, or the opinionof the practitioner as to the comparative value of these drugs. Quinine dis-solved in citric acid, with iodide of potassium, iodide of iron, and tincture oforanges, is a very good a(Ijuvtiit to the bath.

I have to correct one misapprehension under which Mr. Cooke has fallen-namely, my reference to Sangrado, who said, ’’ I have written a book;" meaningI have committed myself to a system, and dare not withdraw, because myfame rests on it. He was himself a book-writer, and therefore e book-writingcould not have been an offensive thing in his eyes. I do not know why Mr.Cooke should fancy anything about rusty claymores execpt upon the principlethat the wound made by such a weapun does not heal well.

I remain, Sir, yours very truly,Hartlepool, June, 1862. ROBT. INGLIS, M,D.

*** This controversy must now terminate.-ED. L.

653

The Indian Medical Service.-In the article on the above subject in our issueof May 30th, the word preparation was misprinted appreration; andfurther on, when speaking of the long continuance of the assistant-sur-geons in their rank as such, owing to the non-retirement of the surgeons,whom they would naturally be desirous of succeeding, we intended tostate= We are sorry to say we see no remedy. Amongst those who couldhelp, if so disposed, by stirring the question in the House of Commons, noone feels sufficient interest in this injured body of public officers to take anytrouble in the matter," &c. We have reason to believe that the amalgamationscheme of Colonel Norman is not likely, after all, to be sent to India for reo Iconsideration; but as it offers no inducement to old officers to retire, theonly good its promulgation is likely to do is to set men’s minds at rest onthe subject. It is high time that something more definite should be accom-plished with respect to this important matter.

Student would be admitted to the preliminary examination by making an appli-cation to the Secretary of the College.

Mr. E. Broyan.-Inquiry shall be instituted into the statements made in thecommunication. Without at present offering any opinion upon the matter,care will be taken that the complaint of our correspondent shall meet withthe attention it deserves.

M.R.C.S., (Devon.)-The etherial solution of the oleo-resin of the male fernshould be given in drachm doses to an adult as a vermifuge in tcenia.

ON THE RECENT DEATH CNMB CHLOROFORM.To the Editor ofTHE LANCET.

SIR, I have read in THE LANCET of the 7th instant a brief judgment on acase of death under chloroform, to which I cannot subscribe. As I a’n per-sonally concerned in the matter (reported by me in your impression ot May17th, 1862), 1 hope you will be so kind as to allow me to make a few remarkson this point, so interesting on several heads. Already the public have aknowledge of the case by Mr. Gant’s evidence alone, and have not been able toform an accurate opinion upon this unfortunate death.

If this case concerned myself only, 1 should entirely withdraw from the dis-cussion ; but as it concerns equally all the medical profession, I teel it my dutyto lay down the facts plainly and honestly, leaving everyone to form his ownjudgment. My proposition is this: In the present state of science it is quiteimp rssible to foresee accidents by chloroform.

I beg to state that I have administered chloroform many many times inParis when a pupil of the hospitals of that city, and since 1 have been in Lon-don I have attended numerous cases. I have always used the lint in a foldednapkin, and I have seen it used in that mode in the hospitals eight times outof ten. By this process you are quite able to admit a free access of air, asmuch as necessary, and this was precisely what I did in my case, as you willsee by my own report of the 17th of May, thirteen days previous to the inquest,the patient being quite awake after five minutes. Moreover, you will ee inDr. Ktdd’s work on Chloroform, p. 111, that the French Academy of Medicinehas declared that the napkin has nothing whatever to do with death fromchloroform. To argue that Dr. Snow’s inhalers are sater. might be perfectlytrue; but it is very far from proved, as you will find in the medical journalstwo cases of death under the care of Dr. Snow. To sav that with the napkinyou cannot measure the quantity of chloroform absorbed, is true; but you canmeasure the quantity poured on the napkin, and that was done in my case. Ihad an ounce bottle, and I employed not quite one-third of the bottle. Every-one has had eases where the anæsthesia was prolonged for thirty minutes,forty, and even more than an hour. For my part I have recently operated suc-cessfully on a young lady for a tumour, lor which she was under the influenceof chloroform forty-two minutes, and a great deal more than halfan ounce hadbeen used. You can certainly be assured that, with the present atn.osphere inMay, ot one-third of an ounce at least one-hilt is evaporated in the air.

Finally, I conclude for the first point that Dr. Snow’s apparatus and all theother apparatuses, excellent as they may be, afford no guarantee that youwill not meet with an accident, and I think that this is the general opinion ofsurgeons, English and foreign. If they did not entertain this view, theywould constantly use the apparatus, and everyone is aware tha:, even now the’napkin is generally more used than the apparatus. Apparatus or napkin, thatis a matter of taste-nothing less, nothing more.

1 now come to a more important point, the state of the heart and lungs;and beforehand I beg to state that I had examined the breathing and theheart of the deceased three times previously, as it has been witnesed by per-sons belonging to the refinery of Messrs. Rothschild, and I found them quitehealthy. 1 might have been mistaken, and it would appear by Mr. Cant’s evi-dence that such was the case; but, begging Mr. Gant’s pardon, I must still sayI do not agree with him, even utter Ins post mortem examination. I do notdoubt for a moment the perfect veracity of Mr. Gant, and that he has rep rtedwhat he thought was the truth. But this gentleman made the post-mortemexamination alone. I was not invited to attend. He describes the heart as soft;no disease of the valves; the right overture (auriculo-ventriculaii-e) largelydilated, so that he could introduce four fingers instead of two. Very likely ythe thmgs stated by Mr. G mt were as reported by himself in his evidence;but after a man has been buried seventeen days (the deceased died on the 12th,and 1 think the post-mortem examination took place ou the 28th of H.iy), is itnot possible that in the mot.th of May a certain amount of putrefaction willallow to exist the same state of the right side of the heart, attributed by Nlr.Gant to disease of the circulatory centre? But let us suppose for a momentthat Mr. Gant’s opinion of the stare "f the heart was right, would i be pussiblethat a man with an overture of the heart much too big to be cumpletely ob u-rated by the valve (they were sound in Mr. Gallt’s opinion) could do hardwork Yes, said Mr. Gant i his evidence a man could do it if he was broughtup by cle-rees. I was not aware titl now that a man could get accustomed toheart disease. But he should have a bruit de souffet (insuffisance valculaire),moreover a little cyanosis of the face, and that cardiac appearance that every-one knows so well. On the contrary, the deceased had no p,lpitation of theheart, at least he never complained of it (Mr. Dti’nenit’s evidence), and hadnever been known to be ill previously for the nine years he had resided in Loli-don, with the exception of an asscess, w’ich caused his nstuta. All thesephysiolugical pruots, the absence of any abnormal bru’ts ufthe heart, and thehard work the deceased used to do, lead me foeirbly to an entirely differentview from that of Mr. Gant.

Let u. now consider the state of the lungs. I repeat I had au-cultl.ted thepatteor previously with Krett care, and ton d his respiration perhctl. s.mnd.No wonder, even after the post-mortem. The deceased was a poBBer ul man,with a large and well-developed chest. For a very long time he had not been

ill of the chest, and the tight adherence mentioned by Mr. Gant, which. Iadmit willingly, were vestiges of ancient pleuritis, which was not very extended,or else it would by those tight adherences have produced a certain amount ofdeformity of the thoraaic cavity, and such was not the case. Moreover, it isnot stated by Mr. Gant that the lungs (that is, the pulmonary parenchyma)were at all diseased. No tubercles, no focus haemorrhagieus, no induration, noinjection, no dilatation of the bronchi-in a word, no disease whatever of thepulmonary tissue, nothing but ancient adherence of the pleura parietalis withthe pleura visceralis. Now, what could I discover by auscultation in such acase but a very good vesicular murmur? I had no contra-indications what-ever, and this is why I gave the chloroform.The man died, it is true; but is there any scientific medical man in the year

1862 who can account for death from chloroform ? When we read all that hasbeen written on the point, we see so many opinions, that we can yet quotewhat M. Hervez de Chegoin said before the Surgical Society of Paris, 1859," whether it would not be wiser to give up chloroform entirely than to remafnunder the threat of a danger beyond all provisions till now." (Bulletin de laSociété de Chirurgie de Paris.) " Since that time," says Dr. Vigouroux, (in anexcellent memoir on Chloroform, presented to the Institute of France inFebruary, 1861, in Gazette ziiedicale of Paris, 1861.) "new cases of death bychloroform have been produced, and we can say that science is not done on.this point."Now, I repeat after Dr. Vigouroax, who wrote in February, 1861, that new

cases of death by chloroform have been produced, and in the most skilful andexperienced hands, with the apparatus and without the apparatus. We read inthe British Medical Journal, 16th November, 1861, that Mr. Lane, of St.Mary’s Hospital, had an autoplastic operation to do, for which Mr. Edwards,chloroformist to that hospital for the last eight years, administered the anxs-thetic agent. Notwithstanding all the skill of that practised and learned gen-tleman, the patient died. This was a child of eight years-thnt is to say, avery favourable subject for chloroform. Mr. Edwards had administered thechloroform more than 4000 times, and a post-mortem showed the circulatoryand pulmonary organs perfectly sound; and this is the case in general, whichproves, against the evidence of Mr. Gant, that there is also danger when thelungs and heart are sound in administering chloroform. But I will add thatlearned medical men in England, as well as abroad, are of opinion that heartdisease has nothing to do with accidents in chloroform. Dr. Kidd held thisview, and Dr. Sinsom also (see THE LANCET, May llth, 1861). If I quote theseopinions, it is to say that on the chloroform question, quot capita, tot sententiawhich proves that we do not know whether the death frem chloroform ariseaby coaglilation of blood in the pulmonary capillaries, according to Dr. Faure’stheory, (" Archives de l2edecine," 1858,) or by asphyxia, or by paralysis of thecentral nervous system, which, byreflex action, stops the movements of the heart.It suffices to quote the names of Dr. Bamsbotham, Mr. Paget, Dr. Murphy,Dr. Snow, and lastly, Mr. Edwards, of St. Mary’s Hospital, without speaking ofMessrs. Malgaigne, Roux, Richet, and Marjolin in France, and other Germanand Belgian surgeons, to prove that, with the greatest prudence, the utmostamount ot’practical skill and science, it is impossible to foresee the dreadful mis-adventure which I had the misfortune to meet in the case of M. Pelletier. Irepeat 1 do not doubt for a moment the word of a man situated in Mr. Gant’sposition. He has seen the heart dilated, and the lungs adherent. Very likely,had I been present at the post-mortem examination, I should have agreed withhim as to the facts themselves ; but I will only show by this that facts can beinterpreted in many ditferent ways. I think Mr. Gant knows that grammatidcertant, and he will excuse me if I say that he used, perhaps with not measuredreserve, the authority of his high siruation before a jury of quite unprofessionalmen, who could not contrul in the least the accuracy of his evidence, so easilyquestionable; but fortunately I found a Coroner, who, although not a profes-sional man, has prcved himself a man of that common good sense characteristicof the English nation, who understands that to God alone belongs infallibility.

I am, Sir, your obedient servant,Southampton-street, Sttaud, June, 1862. A. DIEUDONNE, M.D. Paris.

Pharmaceutist.-The matter requires to be far more closely and impartiallyexamined before we can conclude that the tincture of henbane is such aninert agent ag some late writers would have us believe. We think that theletter of Dr. Bagot, alluded to by our correspondent, contains very weightyevidence in proof of the power of henbane.

A Scotch Graduate.-The Repo-t of the Scotch Universities has already beenpublished, and is to be obtained by order of any bookseller.

A QUERY.To the Editor ofTHE Lsxcs2.

SIR,-Could you or any amongst your correspondents inform me of the ad-vantages, and most advantageous way, of emigrating to Australia in my pre-sent capacity-namely, that I have served my apprenticeship to a surgeon,and am acting as assistant in general, but have not attended hospital practiceor lectures. I have understood that a few years ago such a one might havea free passage. Is this iioiv the case, and what compensation should I be likelyto obtain ? Would New Zealand be a better field for one in my position ?

I am, Sir, yours faithfully,June, 1862. S. G. S.

Sceptic is not more a doubter than ourselves. Nevertheless, in the volumerecently pubii-thed of the "Transactions of the Medical Society of NewYork," Dr. Purdy has related a case in which complete suppression of urineis said to have continued for nearly six years ! The patient was an unmarried,

lady, thirty-six years of age. ’I lie clue to the mystery probably lies here.An Izztezading Student, (Birmingham.)-Both books are good. Ellis’s we con-

sider the best.

, DEIT:SB: DEGREES IJf BUENOS ATXES.To the Edito,’ ofTnB LANCET.

SIR,—In answer to " M.D." in THE LANCET of May 10th, you state that aBritish graduate can practise in Buenos Ayres without an examination. Such

is not the case, as in addition to presenting his diploma, he has to pass anexamination in the Spanish Lmnguage, to prove his fitness for which he has to

’

pay .B20. My knowledge of the matter is derived from a brother who is resi-dent th re, and from a copy of the Reglemento de Li Facultad de Medicina

, do Buenos Aire!-," i’sued in 1852, which was sent to me this year as being theregulations snll in force. Yours, &c.,Jedburgh, Jiiiie, 18G2. JOHN BELL, M.D.

i ‘ The notice referred to a medical examination En. L.

654

W. R. F., (Manchester.)—As a rule, an advertiser ought to be avoided. Anyrespectable surgeon can treat the case satisfactorily. The books upon the

subject, when written for the public, are in all instances to be shunned.They are written with the object of alarming patients, and of magnifyingvery trivial disorders into serious diseases. By acting upon the minds oftheir victims, the quacks too often succeed in robbing them not only of theirmoney, but of their health.

TEN ORPHANS OF THE LATE DR. AND MRS. JONES.

To the Editor of THE LANCET.

SIR,—In my last letter to you on this subject, I mentioned my intention ofconveying to every subscr:ber (whose addrebs was known to me) to the fundraised on behalf of these children a statement of the method of applying themoney collected; and the promise so made in your columns I have endea-voured to fulfil. As, however, very many small sums have been sent anony-mously, tlie donors of which will in all probability he glad to know the resultof the collection, I tronble you with a further communication, to ask that youwill kindly insert so much of the enclosed circular as may seem to you sum-cient to effect the purpose of apprising all t hose of your readers who subscribed-of the manner in which their contributions have been disbursed.

I am, Sir, your obedient servant,Bucklersbury, June, 1862. B. B. ORRIDGE.

"The subscribers to the fund for promoting the welfare of the orphan chil-dren of the late Df. and Mrs. Jones of Deptford, will learn with satisfaction’that the amount contributed has proved sufficient to provide a home for thetwo little boys in the London Orphan Asylum."Shortly after the publication of my letter calling attention to the case,

some connexions of the late Dr. Jones, who reside on the Continent, gene-rously sent over for the infant and the little girl, and undertook the respon-sibility of their future management and educati m, leaving whatever summight accrue from the appeal to public sympathy to be applied for the benefitof the two other children.

"It was suggested by several correspondents that admission should besought for these boys at the Medical Benevolent College; it becomes neces-

sary, therefore, to explain that inmates are not received by purchase into thatinstitution-that the next election does not take place until May, 1863 -andthat there are in general several annual applications before a candidate is suc-cessful. It is obvious, therefore, that the advantages of that valuable charityare not available for cases of extreme urgency like this, when a sheltering roofand a guiding hand are matters of immediate necessity."Under these circumstances, and after mature deliberation, it became clear

to those to whom the money had been confided that thf most expedient coursewas to arrange for the reception of these children in the London Orphan Asy-lum; and, accordingly, from the sum of £266 subscribed a payment of £231has been m:ide for their admission to that establishment, in retnrn for whichthey will be maintained, clothed, and educated, up to the age of fifteen years. The residue (less a small expense for printing and postage) has been paid for the benefit of the children into the savings’ bank attached to the institution. ’,

"It would be unseemly to close this statement without alluding to the warm interest taken in the case by the Rev. B. S. Ffinch, rector of St. Paul’s, Dept.ford; or remarking that the kind feeling shown towards these orphans by theEditor of THE LANCET has been shared by the Editors of the Daily News,Daily Telegraph, Kentish Mercury, Morning Herald, Horning Star, and Stan-dard (I name them alphabetically) all of whom were good enough to findspace calling attention to the distressing circumstances attending the death ofthe parents. It is, indeed, through the publicity given by the press that somany persons have been enabled to join in the good work of helping thosewho are powerless to help themselves.

" B. B. ORRIDGE, Hon. Secretary to the Fund."

An Inhabitant, (Brighton.)-The scheme proposed is highly creditable to thehouseholders of Brighton. The idea of emptying the sewage into the seawas as absurd as it was filthy.

A Surgeon, (N.B.)-The new haemostatic is composed of the very fine palese ofa delicate and beautiful fern, a native of Java. The name is CibotiumSchiedii. The action must be purely mechanical.

THE CARE OF LUNATICS.To the Editor of THE LANCET.

SIR,-I should be obliged if you would kindly answer the following questionIn the next number of THE LANCET:-A medical man receives an insane patient into his house. Is it necessary for

him to have a licence, or to inform the Commissioners in Lunacy of hisdoing so ? :’ Your obedient servant,

June, 1863. AN OLD SUBSCRIBER.

*** It is necessary to inform the Commissioners of the circumstance.-ED. L.

T. J. B.-He could certainly "demand" a "re-election;" but his demandwould not be complied with.

A Governor of St. Thomas’s Hospital.-THE LANCET was the first and onlyjournal that ponted distinctly and decidedly to the Royal Surrey Gardens asthe future site of the new hospital. An opportunity now offers of erectingclie of the finest modern institutions in the world.

TESTS FOR ATMOSPHERIC IMPURITIES.To the Editor of THE LANCET.

SIR,-I observe that a correspondent, under the signature of "Medicus," inyour number of the 15th of March last, asks where he can meet with a descrip-tion of the method ofnsing solution of permaganate of potash for the detectionof organic impurities in the atmosphere. If 1 mistake not, the information re-quired will be fouud in the fifth edition of Ure’s " Dicti ,nary of Arts, Ilailu-factures, and Mines," at the artiele on Sanitary Econumy, which was writtenby Dr. K Angus Smith. An acconnt ot the air-test will also be found in apamphlet by Mr. Condy, on the Purification of Water and Air," published byDavies, of Princes-street.Your correspondent, ‘’ J. L. M.," of the 23nd llarch, in the last-named work

will meet with a good deal of valuable information about the testing ot water.

Gibraltar, June, 1862. Yours obediently,

P. P. C.Gibraltar, June, 1862. P. P. C.

HAS Medicus any proof that the person who circulates the unprofessionalhaiidbills, to which lie has directed our attention, assumes the title of

"surgeon" without being qualified to do so’ The provisions of the MedicalAct with respect to the assumption of titles are so unsatisfactory, that it isdifficult to determine the position of so-called "medical practitioners."Under a more wholesome st ite of the law, many prevalent grievances might becombated with success. But so long as a man may assume a title to whichhe has no legitimate claim, abuses of the most flagrant character can be con-tinued with impunity.

Mr. S. Anderson Srnith.-The communication on "Marriages between Aliens"was received, and shall be published.

THE gentleman who has forwarded to us the paliie note from Hanley takes avery just view of the case. Dr. Brown-Séquard’s address is Cavendish-

square. Our correspondent will excuse us addressing him privately.

THE SANITARY CONDITION OF LIvERPooL.To the Editor of THE LANCET.

SIR,-I had hoped that if Dr. Kcbbellnoticed my letter in your impressionof Stay 21th, he would have had the candour to admit the unsoundness of thedata on which he relied in support of his statement, that Liverpool has ahigher mortality than any other town in the kmgdom. I pointed out that hisc’ata referred to the worst portion only-not the entire town-of Liverpool;the best portion, comprising a population of 180,000, being excluded from thecalculation. His reply is to the effect, that, at all events, ten years ago themortality of this worst district was higher than that of (the good and bad dis-tricts of) any other town in England, and that this may still be the case. Verypossibly it may; hut that is not the point in question. If the worst district ofLiverpool is to be taken for comparison, it should in fairness be comparedwith the worst districts of other towns; or, if other towns are to be thestandard, they should be compared with Liverpool as a whole. Were Liver-pool declared to be the most healthy town in England, on the ground that aparticular portion of it, with 180,000 inhabitants, had a lower mortality thanany other tcwn with an equal population (which could easily be shown), Dr.Kebeell would, no doubt, think the comparison unfair; and yet-reversing theterms of the proposition-this is precisely the comparison he has made.

I may add that Dr. Kebbell is mistaken in supposing that Dr. Greenhow’swork is the latest authority on the subject. The published Reports of theRegistrar-General come down to the present year, and I challenge Dr. Kebbellto point to any town in the kingdom where the ratio of improvement has beenso great as it has been in Liverpool. Could he succeed in doing so, it wouldbe a heavy blow and a great discouragement to the cause of sanitary reform,which he has laboured to promote; for it is certain that no other town hasexpended money so liberally to improve the health of its inhabitants. We havethe testimony of the Registrar-General that" the expenditure has borne amplefruits," Your obedient servant,

Liverpool, June, 1852. W. H. DuNCaN, M.D.

An Elector.-Dr. Edwin Lankester is in every way qualified for the office ofCoroner. By the unanimous support of the medical profession, his electionwill be certain.

Mr. 7F. Maithew8 (Scarborough) will find in the last Students’ Number ofTHE LANCET all the information he requires. It would be impossible in thisplace to answer his questions satisfactorily,

Therapeuticus.-The bromide of potassium has been strongly recommended asan antaphrodisiac. Opium may be tried also; but this agent will occa-sionally act in just an opposite way.

Mr. W. F. Lovell.-The Orthopædic Hospital, Oxford-street; the City Ortho.pædic Hospital, Hatton-garden; the Spinal Hospital, Portland-road.

COTTAGE HOSPITALS.To the Editor of THE LANCET.

SIR,-I am desirous of establishing a Cottage Hospital in an extensivemining district-a plan I am encourged in by the expressed wish of many ofthe clergy of th tt district.

I should feel deeply obliged to any of your readers who may be connectedwith such au hospital if they would kindly furnish me with a cupy of the ruleswhich regulate them, and any information they may be disposed to give as tothe working of the hospital when established.

I am, Sir, yours obediently,June, 1862. PHYSICIAN.

COMMUNICATIONS, LETTERS, &c., have been received from - Dr. Farr; Mr. D.Walker; Mr.’Potter; Dr. Hall; Dr. W. Fergus; Mr. J. Howell, Salford; Mr.Dodgson, Cockermouth; Mr. Rose, High Wycombe; Dr. Gill, Dover, (withenclosure ;) Mr. W. Martin; Mr. Croft, Newark, (with enclosure ;) Mr. T.Parsons, Leicester, (with enclosure;) Mr. Forshaw; Mr. Harvey, Berkhamp-stead ; Mr. C. S. Jones, Chichester; Mr. M. Trevan, (with enclosure;) Mr.W. J. Burgess, Bristol, (with enclosure;) Mr. T. Chambers; Dr. T. Williams,Swansea; Mr. Lovell, Compton Martin; Dr. Mackintosh, Downham ; Dr.Kidd; Mr. Evans, Eglwysbach, (with enclosure;) Dr. John Bell; Dr. Walker,Glasgow; Dr. Duncan; Mr. Palmer, Halifax, Nova Scotia; Mr. Smith; Mr.Hart, Layer Breton, (with enclosure;) Messrs. J. Parkes and Son, Birming-ham ; Mr. Massey, Thornbury, (with enclosure;) Mr. Hunter; Mr. Sprague,Kimbolton; Messrs. Groom and Co., Whitchurch, (with enclosure;) Mr.Betts, Sutterton, (with enclosure;) Mr. Elliott; Mr. Keele, Portsmouth;Mr. Hickman, Shrewsbury, (with enclosure;) Mr. E. Weton, Stafford, (withenclosure;) Alessrs. T. Murray and Son, Glasgow; Mr. Hough, (with enclo-sure ;) Dr. Garden, Simla; Mr. Oxley, (with enclosure;) Mr. Jones, Aber-dare, (with euciosure;) Mr. Nourse; Mrs. S)kes; An Elector; Anxious;A Governor of St. Thomas’s Hospital; L. B.; An Inhabitant, Brighton ;Studens; Tyro; Medical Bencvolent College; Ethnological Society; J. W.,(with enclosure;) J. T. P., (with enclosure;) Pharmaceutical Society;Leeds Dispensary; )’. D. C.; University of Melbourne; An Intending Stu-dent; S. G. S.; Military Medical Book Club, Alder.-hott, (with enclosure ;)E. B.; Spectator; Dubious; Corrosive Sublimate; M.R.C.P. Lond. ; &c. &c.