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calculus, and although unable to tell whether more than onewas present, it was evident that the one felt was very small.Mr. Fergusson again sounded him, and with difficulty disco-

vered one stone. The report then goes on to say: "Jan. 15.The patient was brought into the theatre, and was put fullyunder the influence of chloroform; a lithotrite was then in-troduced into the bladder, and for some time a fruitless at-tempt was made to grasp the stone. Mr. Fergusson then de-termined to perform the lateral operation of lithotomy, andmade the usual incisions; but on introducing the forceps, andsubsequently the scoop, he was unable to get at the calculus.The staff was then reintroduced, and by means of the scoop,a small stone, not much bigger than a pea, was removed."The patient was discharged well at the end of February.

Mr. F- remarked, after the operation, " that the case wasin many respects peculiar, and more than usually interesting."From the difficulty he experienced in touching the concretionby the sound, he concluded that it must be small, "and onthis account, as also from the facility with which instrumentscould be used without causing pain or subsequent annoyance,he thought it would be well to make use of the lithotritefirst; accordingly he had passed that instrument into thebladder, but had been unable to seize the stone. He couldtouch it, however, and on that account, after the withdrawalof the lithotrite, he had not hesitated to proceed with

lithotomy, in accordance with his original intention. Thestone was one of the smallest he had ever removed bylithotomy; indeed, it might be a question with some, whysuch a stone should not have been left to pass away with theurine ? But the answer to that was readily given-for as thepatient had suffered for three years from its presence in thebladder, it was not very likely that it could have come awayspontaneously."

This, Sir, is apparently the mode of treatment advocated byone of the eminent operators of the day, and remarked upon"as in many respects peculiar, and more than usually inte-resting."

I, however, consider the whole proceeding as being contraryto the rules of scientific surgery ; as contrary to the maxim,that the art of the surgeon consists, not in operating, butin preventing operations. We all know that for the successof lithotomy, the most absolute calm and quiet is required. Ifear that a theatre filled with students and visitors is not theplace where such are likely to be found, Should the walls ofthe bladder become caught in the teeth of the lithotrite (ashas happened), would a patient under the influence of chlo-roform inform you by his cries of the event ? Another requi-site for the success of this operation is patience and persever-ance on the part of the operator. M. Civiale will some-times remain nearly half an hour at the bedside of a patient,and if unsuccessful in seizing the stone, will return the nextday and renew his attempts. I think he would well considerbefore tying up his patient, and submitting him to an opera-tion "attended with so much difficulty and hazard, as tomake it in every respect a last resource."-" Fergusson’sPractical Surgery and Lithotomy," p. 560.We might imagine that an instrument, similar to the one

with which Sir Astley Cooper removed eighty or ninetysmall calculi from the bladder, would have been useful inthis case, and obviated either lithotrity or lithotomy.However, that it was a case eminently suited for the com-

paratively simple and dangerless operation of lithotrity, isevident from the history, and from Mr. Fergusson’s proceed-ing ; why that operation was unhesitatingly abandoned, Icannot conjecture.Although the patient left the hospital cured, it may not be

uninteresting to inquire, what condition he will be in shouldanother calculus form, and should lithotomy then become thelast resource ?-Your most obedient servant,London, May 1848. A CRITIC.

THE CYCLOPÆDIA OF ANATOMY AND PHY-SIOLOGY.

To the Editor of THE LANCET.

SIR,—Whilst fully agreeing with the spirit of your remarkson the general excellency of the last part of the "Cyclopædia,of Anatomy and Physiology," I must refer to one particular,on which I think the subscribers have just ground of com-plaint. As a reason for entering but cursorily into the veryimportant subject of cancer, Dr. Walshe informs us, (p. 136,)that "as we have very fully treated the subject of cancer inanother work, we shall confine ourselves here to a statementof some few facts bearing on the morbid anatomy of can-cerous growths." The italics are mine. Now to a man who

has already disbursed ;S7 15s. for the published thirty-oneParts, doubtless, in the full expectation of each article beingperfect and complete after its kind, it sounds rather cool tobe informed that he may seek elsewhere for the knowledgewhich ought to be contained under its proper head in a cyclo.paedia. The modesty of referring to his own monograph-price,I believe, 15s: on the part of the writer, is striking.Dr. Guy, also, at the end of his excellent essay on the pulse,

excuses himself from the trouble of compiling a bibliography;lst, because, if the reader will look, he will find some referencesto modern authorities at the foot of the several pages! and2ndly, because the older works are not likely to be referred to!! !As an assiduous reader of the Cyclopsedia, and an admirer

of its many excellencies, I feel some indignation at beingcheated of my fair proportion of information. I thereforeadopt this mode of explaining to the reading minority whatthey may expect in this expensive periodical.

I am, Sir, your obedient servant,July, 1848. M.D.

UNIVERSITY OF EDINBURGH.—QUESTIONS ATTHE LATE EXAMINATION FOR THE MEDICALDEGREE.

APRIL 24, 1848.Latin.-Translate Gregory’s Conspectus Med., chap. iv.

sect. 142. Celsus, book ii. sect. 10.FIRST EXAMINATION, MAY 2, 1848.

Anatomy: Professor, Mr. Goodsir.-l. Describe the liga-ments and other structures which connect together the dorsalvertebræ; and mention the physical and structural peculiari-ties of these connecting parts.

2. Give the distribution, and enumerate the relations, of theradial and ulnar arteries, from the division of the humeral tothe wrist.

3. To what muscles is the hypoglossal nerve distributed?Chemistry: Professor, Dr. Gregory.-l. What is the nature

of the action which takes place between the basic or alkalineoxide of a metal and a hydrogen acid, when they are mixed ?State it both in words generally, and in one case by an ex-ample in symbols.

2. How is ollalic acid prepared ? Give its formula, both inthe dry and the hydrated state. Mention the best antidoteto it when a poisonous dose has been given.

3. Describe briefly the alcoholic or vinous fermentation ofsugar, and state in symbols the products of this fermentation,as well as the composition of the sugar from which they arederived.

4. Among the following gases-namely, oxygen, hydrogen,nitrogen, ammonia, chlorine, hydrochloric acid, which of themmay be collected over water, and which of them cannot be socollected ?

5. From what source is phosphorus best obtained ? Describethe properties of phosphorus, and state what is the nature ofits compounds with oxygen and with hydrogen respectively.

MAY 3,1848.P7tysiology.- Professor, Dr. Allen Thomson.—1. Describe

the minute structure of striated and unstriated muscles, andstate the phenomena of contraction more obvious and minute,which are observed in both kinds of muscular substance.

2. Describe the structure of the medulla oblongata, andstate its functions, in so far as thev appear to be known.

3. -State the principal sources of aliment for plants and foranimals in general. Give a classification of the chief nutri-tious principles required in the food of man, the chemicalformulae of their principal types, and the changes they un-dergo in digestion.Botany: Professor, Dr. Balfour.—1. What are the causes

which influence the movements of fluids in plants ?2. Describe the different kinds of vascular tissue in plants.3. Enumerate and give the characters of the great divisions

of the vegetable kingdom, under the following heads: (1.) Thenature of the embryo. (2.) The structure of the stem. (3.)The nature of the reproductive organs.Natural History: Professor, Mr. Jamieson:—1. State the

general laws which regulate the trade winds, the monsoonwinds, and sea and land breezes.

2. Give an account of the duration of hybernation in verte-brate and invertebrate animals.

3. State what is known in regard to the temperature, cir-culation, and respiration of hybernating animals during hyber-nation.

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4. Have fossil remains of man been found in rock forma-tions older than the diluvial?

SECOND EXAMINATION, FIRST PAPER, JUNE 5, 1848.Surgery: Professor, Mr. Miller.-l. Describe the pathology

and treatment of erectile tumour.2. The diagnosis of hernia and hydrocele.3. The nature and treatment of cancrum oris.4. The causes and treatment of retention of urine.

Midwifery, Professor, Dr. Simpson.—1. State the diagnosis,the natural terminations, and the treatment of presentationsof the shoulder.

2. The mode of management of a twin-labour.3. The nature, symptoms, and cure of fibrous polypi of the

uterus.4. The effects and treatment of inflammatory ulceration

and induration of the cervix uteri.Materia Medica: Professor, Dr. Christison.—1. State the

nature, composition, principal chemical properties, and specialtherapeutic uses, of " naphtha," or pyroxylic spirit.

2. State the principal characters of the elaterium plant, thenature, source, and preparation of elaterium, its proximateconstitution, and its actions on the body.

3. State the characters, composition, and principal phar-maceutic preparations of iodide of iron, and how it may be bestused so as to escape decomposition before being administered.

4. State the effects of cantharides administered internally;first in large, and secondly, in small doses.

SECOND EXAMINATION, SECOND PAPER, JUNE 6, 1848.Practice of Physic: Professor, Dr. Alison.—1. Describe the

diagnostic symptoms of scarlatina, and state the chief dan-gers, or modes of fatal termination, to be apprehended in thatdisease.

2. When phrenitic effusion has become chronic, whatsymptoms does it produce, and what ulterior changes, favour-able or unfavourable, may be looked for ?

3. What are the symptoms which chiefly demand, and thosewhich contraindicate, the repetition of bloodletting in pneu-monia ?

4. What are the essential articles of a truly tonic regimen?Legal Medicine: Professor, Dr. Traill.-l. Describe poison-

ing from copper; the symptoms, treatment, and modes ofdetection.2. Infanticide.-Marks of the child being born alive; pre-

cautions necessary to arrive at a just conclusion in such cases.3. Dangers arising from manufactories in which minute

dust is given out.4. Detection of spots of blood.General Pathology: Professor, Dr. Henderson.—1. State the

morbid alterations in the proportion of salts in the blood; thediseases in which they occur; their causes and effects.

2. Describe the pathological conditions supposed to resultfrom the morbid agency of oxygen on the body.

3. Describe the several ways in which uric acid may be-come deposited in the urine, as in gravel.Prescriptions.-(The names, quantities, and directions to be

written in Latin words without contractions.)—1. Prescribearsenic as a remedy for epilepsy.

2. Prescribe an astringent mixture for diarrhoea in a childaged five years.

THE UNIVERSITY OF EDINBURGH.

A COMPARISON OF THE EXAMINATIONS FOR THE DEGREE OF M.D.

AT THE UNIVERSITY OF EDINBURGH, AND FOR THE LICENCE OFTHE ROYAL COLLEGE OF PHYSICIANS IN LONDON.

To the Editor of THE LANCET.SIR,—The monstrous assertion made by Dr. George Bur-

rows, before the late Parliamentary Committee on MedicalRegistration, that " a, doctor of medicine is not necessarily aphysician," thereby implying that he is unworthy and incom-petent to be entrusted with the treatment of diseases, inducesme to offer a few remarks in defence of the University ofEdinburgh, of which I am a graduate in medicine. I hopethat the graduates of the other universities of Scotland andIreland will not fail to refute the foul calumnies of the seniorcensor of the London College of Physicians, and will provethemselves, in point of classical and medical education,scientific tastes and acquirements, sound physiological andpathological views, and the manners and feelings of gentle-men of cultivated minds, at least the equals of the president

and senior censor. Let us now strictly analyze the medicaleducation and examinations required to be undergone toobtain the licence of this 8oi-disant gentlemanly and classicalRoyal College of Physicians of London, which presumes tobe the fountain and origin of everything refined and polite,and which will not suffer a Scotch or Irish M.D. " to comebetween the wind and its nobility."

In the Royal College of Physicians-1. Candidates must have unimpeached moral characters,

and not be less than twenty-six years of age.2. They must have devoted five years to the study of medi-

cine, and attended courses on anatomy and physiology, theoryand practice of physic, forensic medicine, materia medica andbotany, and the principles of midwifery and surgery. Also,they must have attended for three years the physicians’ prac-tice of some hospital containing 100 beds, in Great Britain orIreland.Now in the foregoing it is not laid down what the duration

of each course is to be, whether of three or six months, noris more than one course on each subject required; thereforethis portion of their education may possibly be of a mostlimited nature, and may or may not be conducted in uni-versities or great medical schools. Again, the hospital musthave 100 beds, and a medical and surgical staff, but it may bea provincial and not a metropolitan one.

3. Candidates who may not have gone through the fore-going may be admitted for examination, provided that theyhave been in previous practice, and are forty years of age, andsatisfy the college of their general and professional character;that is to say, the college has the power of conferring itslicence upon any person, forty years of age, of the mostlimited and inferior qualifications.

4. The examinations are held at three separate meetings ofthe censors, the viv(l voce part in Latin, except when the boardwishes to put questions in English, which are to be replied toin the same language; in other words, if the candidate haltsor declines a Latin colloquy, he is allowed to express his ideasin his mother tongue.I 5. We now como to the boasted "classicality" of this almamater. " The college is desirous that all who receive itsdiploma should have had such a previous education as wouldimply a knowledge of Greek, but it does not consider this in-dispensable, &c. It cannot, however, on any account, dispensewith a familiar knowledge of the Latin language, as eonsti-tuting an essential part of a liberal education; at the com-mencement, therefore, of each oral examination, the can-didate is called on to translate, vivic voce, into Latin, a passagefrom Hippocrates, Galen, or Antaeus; or if he declines this,he is at any rate expected to construe into English a portionof the works of Celsus or Sydenham, or some other Latinmedical author." Verily, here is a facilis decensus, theclassicality becoming " fine by degrees, and beautifully less."

First. Greek is desired, but not required; then Hipppcrates,Galen, and Antaeus, are to be translated into Latin, but thecandidate may decline the " soft impeachment." He is finallywooed by the insinuating censors to -construe into EnglishCelsus or Sydenham; but again he has a loop-hole, and mayrun to some other Latin medical author more familiar to hiseyes. So much for the dead languages,-dead truly to allintents and purposes when kept in the custody of suchexaminers.Let any impartial judge compare the above process for the

making of a licentiate of the Royal College of Physicians ofLondon with the education and examinations undergone byan M.D. of the Edinburgh University, or even by the licen-tiate of the London or Dublin Apothecaries’ Hall. The Edin-burgh M.D. has been required to devote at least four years tothe study of medicine in some university, and to have attendedseventeen courses of lectures or instructions, with hospital at-tendance, thirteen of them occupying six months each, andfour of them three months each. He has had to undergo aLatin examination in certain authors, and to write Latin pre-scriptions, without the power of declining to do so. He hasbeen examined, vivâ voce or in writing, on two separate days,by the several professors in all branches of medicine. He hasbeen obliged to write a thesis in Latin or English on somemedical subject, and to defend the same before the MedicalFaculty on another day. Altogether, the duration of thoseexaminations amounts to at least four hours.From this exposition of the preliminary education and ex-

aminations of the Edinburgh M.D., I think it will hardly becontended (except by the mandarin president and his censors)that this degree of doctor of medicine is not superior as a pro-fessional qualification to the fellowship or licence of the Col-lege of Physicians of London.