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To Correspondents.THE STUDENTS’ NUMBER OF THE LANCET

will be published on Saturday next, September 16th. Those

gentlemen holding official situations connected with MedicalInstitutions in the United Kingdom, who have not yet for-warded the necessary information to our Office for publica-tion in that Number, are earnestly requested to send itwithout the delay of a single post.

Anti-Red-Tape.—There is no doubt that the local board can demand of theirmedical officer a rigid compliance with Article 195, referring to substitutes;but there is no power on their part to prevent any medical officer nomina-ting a fresh substitute from time to time, to whom he may remit allattendance on sick paupers during his temporary or prolonged absencefrom home. To avoid any possible difficulty that may be raised, it is betterto acquaint the Clerk of the officer’s intention to leave, as follows :-Sir,-I, A. B., being compelled to leave home on pressing private business,have left my district or house in charge of Mr. -, a legally-qualifiedgentleman, whose residence is at so-and-so, and who will during my ab-sence be at all times prepared to perform any duties that may be requiredin my district.

Alpha.—The ordinary tincture of iodine is of little use for the purpose in

question. It should be made stronger by the addition of more iodine andiodide of potassium.

Dr. Francis Crumpe.—We cannot promise to publish the communication inquestion unless it be submitted to our inspection. It should be addressed

to "The Editor of THE LANCET, 423, Strand, London."A: Question.-It is stated by some writers that pigs are indifferent to the

action of strychnia. As to the truth of the statement we cannot answer.

A NEW VACCINATION ACT.

To the Editor of THE LANCET.

SIR,—Many years since I wrote a series of papers on Small-pox, Vaccina-tion, and Revaccination, and read them before the North Staffordshire Medi-cal Society. The subjects treated were discussed by the Society; but no partexcited a more animated expression of opinion than one which was given asan appendix to the paper on Vaccination, under the name of a "New Vac-cination Act."

It has now been, I believe, quite the number of years prescribed by Horacefor the incubation of a poem, in my desk. I do not think it at all improvedby the delay ; but on looking over it I still think that no better plan has yetbeen proposed for the improvement of public vaccination than the onepointed out. That there is a want of improvement in the working of thepresent Act, few will dispute. Every kind of opinion has been expressedabout the system now followed, except that it has succeeded in its object;that no one has ever dreamed of saying, although the assertion that it is atotal failure is, I believe, quite untrue. It has succeeded just to such a degreeas points out the direction in which a change should take place, and asaffords a favourable omen for the success of a law embodying such a change.

Since the papers were written of which this forms a part, and indeed longbefore, I have read much of what has been published on the subject. Thefault of most of the plans for improvement proposed has been, that theauthors forgot the two essential conditions to which all laws for such anobject must conform. Firstly, that the primary object of the law must bethe public good; secondly, that as a body of men already in existence have tobe employed to carry it out, the conditions proposed must be such as will leadthe best men in that body to undertake that duty. The first category has beenoverlooked by those who have proposed plans for the apparent object of givinga good remuneration for easy work; and the second by those whose sole objectseems to have been to get as much work done as possible, well or ill, at theleast possible expense.

A New Vaccination Act.1. That the whole of England be divided into vaccination districts, having ’.

their boundaries as far as possible conterminous with the boundaries of the sub-districts for registration of births; but that in cases where the registra-tion sub-district is very extensive, it may be divided into two or more vac-cination districts; or where they are small, two or more sub-districts may beunited into one vaccination district; but in no case shall a vaccination dis-trict be made up of parts of registration sub-districts.

I have no means of knowing the extent of the registration sub-districtsgenerally, but take them as affording great facilities for carrying out the planI propose. A good vaccination district wouid be one in which from 400 to600 births are registered in a year. Much less than this would hardly affordsuch a number of vaccinations as would secure a constant supply of freshlymph, and much larger would lead to neglect, from interfering with ordinarypractice.

2. That to each of these districts there be appointed one public vaccinator.There was a general feeling on the part of the profession that every duly-

qualified medical practitioner should be appointed a p’lh1ic vaccinator in hisown district. This feeling has died out. Most medico men have felt the in-convenience resulting from this method, and agree that the appointment isbest in the hands of a single person. What is the work of everyone is thework of no one, and that is best done which it is the duty of some individualto attend to. The same objection also, and with greater force, applies to thisdivision amongst different persons as to very small vaccination districts.

3. That it shall be the duty of every registrar of births at the end of eachmonth to send to the public vaccinator of his district a list of all the childrenregistered during the month.The registrar is now paid for giving the notice to the parents and making

the entry of cases returned as vaccinated. The same remuneration which henow receives would do for this diminished duty.

4. That it shall be the duty of each public vaccinator to vaccinate, or tosee duly vaccinated, during the next six months every child contained in this

list, except death, removal to a distance, or illness of the child should pre-vent.The present arrangements as to time and place of vaccination will in most

cases be quite sufficient ; but there will be a few cases which it will be theduty of the public vaccinator to seek out.5. That on the receipt of the list of births from the registrar, it shall bethe duty of the public vaccinator to copy out into books provided for thatpurpose the list, and on vaccinating any child he shall enter in the propercolumn the date of the vaccination, and such description as may be necessaryto keep as a record of its character; or in case of his not having vaccinatedthe child, the reason for his not having done so.

6. That at the end of six months from the date of birth in the last entry ofthis record, he shall prepare a copy of it duly attested, and this copy shall beforwarded to the Board of Health for the inspection of some person or per-sons appointed to the duty.

7. That the person so appointed shall, in case he finds any entry there un-satisfactory, make such inquiries as may enable him to decide whether allthat is possible has been done to protect the child from small-pox; and hebeing so satisfied, shall certify to the number vaccinated, which certificateshall be the evidence of the number for which the vaccinator shall be paid.

I believe that this inspection is necessary. No returns will be made thatare not quite correct; while the idea that the returns have to be inspectedwill lead to much greater care than is now taken in vaccination. It isthoughtlessness rather than want of knowledge which leads to bad vaccina-tions.

8. That besides the columns above mentioned, the book shall contain acolumn to be left vacant at the time, but in which shall be afterwardsentered a statement of the occurrence of small-pox, or death from small-pox,in the case of any person in that list; and to secure a due record of suchcases, it shall be the duty of parochial medical officers or of medical officersof health where they exist, when cases of small-pox come under their obser-vation, or of registrars of deaths, in cases of persons dying of small-pox andbeing registered by them, to transmit notice of such occurrence to the publicvaccinator of the district in which the person so sickening or dying wasborn and of this report a copy shall be made in the reserved column.

9. That at the time of forwarding to the Board of Health the list as beforementioned, the public vaccinator shall forward a copy of the notice of sick-ness or death by small-pox, such notice to be entered in the duplicate copyin the possession of the Board of Health.The en’ect of keeping such records of the final result of vaccination will be,

that in time a knowledge would be acquired of the exact relation between thecharacter of the vaccination and the degree of protection resulting from it.Vaccination would become a scientific operation, instead of being what it isnow, an empirical practice; and this scientific knowledge would lead to cor-rect opinion as to the necessity for revaccination, the influence of the personvaccinated from, and of the state of health of the person vaccinated, or theresult of the operation.

10. That the public vaccinator shall be paid for every vaccination certifiedby the person appointed to that duty a fee for the operation, such fee to bepaid from national funds.This is quite necessary. The principal cause of the failure of the last Vac-

cination Act was its being placed under the control of boards of guardians.As an example of the result of such control, the board of guardians of aparish in this neighbourhood have attempted to reduce the number vac-cinated by threatening to publish the names of the vaccinated as of paupersreceiving relief, hoping that rather than be so published parents would leavetheir children unvaceinated.

11. That it shall be the duty of the public vaccinator to make inquiries asto the birth of children who may not be registered, and secure to them theadvantages of vaccination, such cases being entered by him on his list ofvaccinations as addenda to the list received from the registrar of births.

I do not know what number of such cases there is likely to be; perhapsnot many, but they should be provided for.

12. That the public vaccinator shall be appointed by the local authoritiesof the district, &c.; but shall not be removed from his office except by con-sent of the Board of Health.

13. That the records of vaccination shall be kept as long as it may bedeemed necessary; but that from time to time they shall be destroyed, theorder for such destruction being given by the Board of Health.

I remain, Sir, yours, &c.,Hanley, Staffordshire, Sept. 1865. JOHN SCOTT, M.R.C.S.

Saltburn by the Sea.-A small pamphlet has been published, entitled Salt-burn by the Sea (in Cleveland), its Scenery and Climate, and its generalcapabilities as a Marine Watering-place." A copy may be obtained (gratis)on application to J. E, Mackay, Esq., Secretary of the Saltburn Improve-ment Company, Darlington.

Mr. W. H. Palmer.-There are some good suggestions in the letter for-warded ; but it would be almost impossible to carry them out.

THE CATTLE PLAGUE.

To the Editor of THE LANCET.SIR,—Some sixteen years back you did me the honour of inserting a paper,

headed "The Leech Barometer," in which a question was then put, andwh;ch is still unanswered, "Has the electrical condition of the atmosphereanything to do with the movements of the leech ?"The poison that is playing such frightful havoc amongst the cattle is cer-

tainly not in the earth, or in fire. Therefore it must be either in the air orwater, both of which elements the leech requires to be pure and wholesome;if not, he soon evinces his troubles. Does this frightful disease arise fromcontagion ? Or from atmospheric causes ? Or are both combined Or is itthe miasm of contagion ? Or contagion produced by miasm ? (as mentionedby Dr. Good).

Before quitting the subject, in these wholesale poisoning times, allow me,through your widely-read columns, to suggest to the faculty at large theutility and practicability of the application of the leech in the vicinity of theumbilicus in suspicious cases, which I think would at once indicate foulplay (where any had been practised), and, compass-like, point in the rightdirection how to steer. In cholera, a disease in which the blood is deficient(of the water of blood), people will find that the leech either refuses to biteat all, or, if he does, will at once coil up and terminate his existence; and solikewise with all poisons affecting the vital stream. "A cripple on the rightroad will sooner reach the distance-post than a racer on the wrong." (Swift,)

I am, Sir, your obedient servant,Sussex, August 24th, 1865. WM. H. ATTREE.

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Bob Logic.—The Professorships of the Faculty of Medicine in the University St. Pancras.-The conduct of Mr. Turnbull is not to be commended. Insteadof Glasgow are chiefly of recent establishment. The Professorship of the of attempting to throw blame upon a professional brother, he should have

. Practice of Medicine was created in 1637, but was long suppressed from shielded him. Mr. Claremont satisfactorily proved that there was no wantwant of revenue; it was revived and endowed in 1713. The Professorship of attention on his part; but that his non-attendance was the result of anof Anatomy, with which Botany was at first associated, was founded in error in the address furnished to him. We are glad to perceive that the1718; a separate Professorship of Botany was established in 1818. Those guardians had the good sense to ignore Mr. Turnbull’s attack by exonera-of Surgery and Midwifery in 1815; Chemistry in 1817; in Materia Medica, ting Mr. Claremont.although a Lectureship was established in 1766, there was no Professorship THE letter of A Yestryman of St. George’s shall receive our attention atuntil created by the Crown in 1831; the Professorships of the Theory of the earliest opportunity.Physic or Institutes of Medicine and that of Medical Jurisprudence in A Sufferer.—Lichen tropicus and eczema solare are produced by the same1839. causes, and run one into the other.

Hon. Assist.-Surgeon, B. V.-An assistant-surgeon in a militia or volunteer Inquirer.—Yes, if he possess the diploma of a recognised College, .or theregiment is not allowed forage for a horse, except under special circum- degree of a University.stances; therefore he cannot claim exemption from tax on a horse if he Dr. C. R. Bree is mistaken. The article was in type before his letter was.keeps one for his own convenience. received.

M.R.C.S.L.—They can certainly charge for medical attendance, and probably C. K., we think, has exercised a wise discretion in the matter.for medicines supplied.

Senior.—We believe two courses are required by the Board in question. MIDWIFERY STATISTICS.

To the Editor qfTHE LANCET.MATERNA IMPRESSIONS. SIR,—On reading Mr. Loney’s Analysis of Midwifery Cases," I find a very

To .,-,,.. of THE LANCET. large number (nearly one per cent.) of cases of prolapsed funis-viz., 15 inTo the Editor of THE LANCET. which the presenting part of the child is stated, and 14 without such infor-SIR,—On referring back to THE LANCET of June 3rd, I find some remarks mation (I presume in consequence of the entry thereof having been omitted).

by the President of the Obstetrical Society of London "On the Influence of If Mr. Loney will state whether any of the funes were of great length, or,in.Mental Impressions as a Cause of Bodily Deformity." I think the following serted into the placenta near the os uteri, or if the liquor amnii were inexces-case, which occurred in my practice on Sunday, August 13th, 1865, will fully sive quantity, or if there were present any other causes (other than mal-pre-bear out the above remarks :- sentation of the child) to produce this fatal complication, he will oblige,

I was called to attend Mrs. C-, of this town, on the afternoon of the Your obedient servant,above day. There was nothing remarkable about the labour, which was com- September 4th, 1865. CORDON OMBILICAL.pleted in a few minutes after my arrival; but upon examining the child’s lefthand, there was a deficiency of all the fingers and thumb, and in their place To the Unkrzozvzz Friend.—The pamphlet was forwarded at the instigation ofsmall bended pieces of integument like small toes, two of which had perfect the surgeon who wrote the notice in THE LANCET. We have conveyed tonails. the purport of our correspondent’s note, which it is unne-On questioning the mother, she distinctly recollected during the early part him personally the purport of our correspondent’s note, which it is unne-of her pregnancy a beggarman coming to the door, and as soon as she opened cessary to insert.

it, he drew his hand, destitute of fingers, suddenly out of his coat, and held Medicus, (Noyfolk-strect.)-Dy application to the Secretary of the Navalit up before her, which gave her such a fright that she was some time before Medical Service, Admiralty, Somerset House, London.she got over it. She said it was the man’s left hand. IF A S’zcbscriber were summoned in accordance with the provisions of theI have met with several cases of acephalous focuses and spina bifida, but -,, . summoned in accordance with the provisions -, thein none could I trace mental emotion as a cause of bodily deformity where the Medical Witnesses Act, he has a legal claim against the Coroner, and canfacts were more conclusive than in this.

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enforce it in the County Court.I am, Sir, your obedient servant, T. H. M.—We are not acquainted with the position and prospects of the

Salford, August 24th, 1865. JOHN SLACK STEEL, M.R.C.S.. Office namedA CAPTION.

M.D., (Grange, Edin.)-The medical session in Paris begins on the 1st of To t7te Editor of THE LANCET.November. Any letter addressed as follows will receive attention :-

, , .

M. le Secretaire de la Faeulte de Médecine de Paris." SIR,—I may as, well let you know for the benefit of others that there is aperson on the old prigging dodge. In my absence yesterday a woman, agedA. G.-It would appear from the account of an inquest lately held at Queens- about thirty, pretty well dressed, called, and said she wanted to engage me

land, Australia, that the well-known " Shire’s snake-bite antidote" consists to attend her at her labour. She was told to wait in the front parlour-of strong liquid ammonia, with some colouring matter in it. Shortly afterwards she was found by the servants in the back room, when

L.R.C.P. Lond.-The suggestion is good in some respects; but there would she asked for a glass of water, and said she would call aaain. She walked offbe great difficult insuggestion is good in some respects; but there would with two silver tablespoons, teaspoons, and some linen. She walked off

be great difficulty in carrying it out. , with two silver tablespoons, teaspoons, and some linen. Yours very truly,be great difnculty in carrying it out. Yours very truly,

E. H. asks if it be proper to administer carbonate of ammonia to a patient Kennington, September 5th, 1865. J. M.in a comatose state from Bright’s disease.

A Young Begimzer should be making up his mind, as the time is approachingTHE GRIFFIN TESTIMONIAL FuND. when he will be called upon to fix himself in London. Let him pitch his.

tent near to the hospital; he can take exercise away from it.To the Editor of THE LANCET. C. J. E., (Attleborough.)-Under such circumstances our correspondent

SIR,—At the last meeting of the Committee it was resolved that the above should be paid, and handsomely too.Fund should be definitely closed. Intending subscribers will oblige by for- M.D.—It is most important that inquiries be made into the moral characterwarding their contributions Yours on or obediently, before October 3lst proximo to, of assistants previous to engaging them.ROBERT FOWLER, M.D., .

Treasurer and Hon. Sec. COMMUNICATIONS, LETTERS, &c., have been received from - Dr. Barnes;145, Bishopsgate-street Without, Sept. 6th, 1865. Dr. Simpson; Mr. Fry; Mr. Rawnsley, Bradford; Dr. Griffiths, Sheffield;

Mr. Ashford; Dr. Edmunds; Dr. Carr; Mr. Kyng, Dr. Orwin; Mr. Muller ;St. John’s-wood.—If Dr. Croft, of Mandarin Villa, is in possession of what he Mr. Andrews, Norwich; Mr. Willing; Mr. Atkinson; Mr. J. Wright;

calls a "valuable recipe for Asiatic cholera," it is his bounden duty to Dr. Maclaurin; Mrs. Baines; Mr. Bodington, Saltburn; Dr. Philipson;make it public. We may state, however, that we have no confidence in Mr. Herbert; Dr. Muspratt, Liverpool; Mr. Nowell (with enclosure);"nostrums," with whomsoever they may originate. Dr. Beverley, Norwich; Mr. Watts; Mr. Clark; Mr. Ellis; Mr. Gairhead;

L.R.C.P. Edin. (Liverpool) will perceive by a leading article published in a Mr. Gay (with enclosure) ; Mr. Bishop; Mr. Hills, Dartmouth; Mr. Hall;late number of this journal that our attention has already been directed to Dr. Williams; Mr. Balding; Dr. Moffat; Mr. J. Davis; Dr. March (withthe subject of his note. enclosure); Mr. W. Robertson; Dr. Fowler; Dr. Daly; Dr. Cryan, Dublin;

A Subterfuge.—What might be naturally expected on the occasion. " Let the Dr. J. A. Scott ; Dr. Plumbe, Maidenhead ; Mr. Jakins; Mr. Milner;galled jade wince !-our withers are unwrung." Mr. Robinson (with enclosure); Mr. Davison; Mr. Dunn, Feckenham;

Mr. Meadows; Mr. R. G. Brown; Mr. Powne, Nottingham; Dr. Wilson,THE MEDICAL DIRECTORIES. Whitby; Dr. Thornton (with enclosure); Mr. Reade, Congleton; Mr. May;

To the Editor of THE LANCET. Mr. Knight; Dr. Nevins; Mr. Roos; Dr. Edwards, Cardiff; Mr. Harper,

, Leith; Dr. Fleischmann, Cheltenham; Mr. J. Smith; Mr. Leslie, Kenmay;SIR,—Your correspondents, "J.M. A." and "P. Y.," and others who think Mr Scott, Hanley; Dr. Bree Colchester; Mr. Packman; Dr. W. J. Smith;with them, are not to be envied. Because, forsooth, they cannot appreciate Mr. Scoot Hanley Renton ; Mr. Hamilton; Dr. A. D. Hall, Philadelphia; Dr. Mackinder,the value of the information contained in the Medical Directories, they would Mr. Renton; Mr. Hamilton; Dr. A. D. Hall, Philadelphia; Dr. Mackinder,

have these useful publications narrowed to accord with their own limited re- Gainsborough; Mr. Henderson; Dr. Canniffe, Canada; Dr. Lowe, Lynn;quirements. If " J. M. A." finds that they contain too much, let him try the Mr. Bennett; Dr. Crumpe; Mr. Watts (with enclosure); Mr. Bush; Mr.Medical Register; but let him not quarrel with his neighbours because his Rose ; Dr. Ritchie; Mr. Palmer; Mr. Sandell; A Dispenser; Inquirer;own name may appear less brilliant than theirs. And I would suggest also Rose ; Dr. Ritchie ; Mr Palmer; Mr. Sandell ; A Dispenser ; Inquirer ;to " P. Y.," that when he wants more detailed information about "parochial W. K.; J. M. ; R. B.; H. J.; Hon. Assist.-Surgeon, R.V.; M.D.; Freddy;matters" and " county hospitals for the insane," a letter and a postage-stamp Cordon Ombilical; M.R.C.S ; T. H. M.; L.R.C.P. Lond.; T. C. S.; M. W.;will, doubtless, assist his purpose.

.. Beta; Precincts; A Workhouse Surgeon; A Senior Surgeon-Major; C. K.;In my opinion ,the chief value of the Medical Directories consists in the Registered; A. R. P. &c. ; S. C. ; R. O. ; A Constant Reader, Madras; R. L.;information they furnish respecting every individual member of the profes- Constant Reader, Madras ; R.L. ;

sion. If that were abolished, their usefulness would cease, and, in common F. W.; A Young M.D. (with enclosure); G. B.; Jonas; Medicus ; D. J. S.with the majority of their supporters, I, for one, should no longer be what I L.R.C.P. Edin. ; J. F. (with enclosure); Anti-Red-Tape ; &c. &c.have always been, a subscriber. But I do not anticipate that the Messrs. THE Whitby Times, the Glasgow Herald, the Ozcdh Gazette, the BirminghamChurchill will bestow further notice than a passing smile on these cries of Daih 1’ost, the Warrington Guardian, the South London Press, the London-petty jealousy. Yours faithfully, -Daily Post, the Wctrriizgto2z Guardian, the South London Press, the London-

September, 1865. R. L. derry Sentinel, and the Scientific Review have been received.