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while prescribing as gentlemen, instead of tinkering indrugs as tradesmen, have mistaken their vocation, and hadbetter don the apron and use the scissors behind the counter atonce. Such men, surely, pay themselves but a poor com-pliment when they acknowledge that without their cheapphysic their services would be in no request.As a doctor I have travelled over the greater part of the

world, and nowhere have I seen the medical profession, asa whole, occupying so high a position socially as at Edin-burgh. Of Edinburgh I had a pretty intimate knowledge,and I make bold to say that out of the very great numberof medical men residing there such a thing as a man sendingout a bottle of physic was unknown. Any man doing sowould never have been supposed even to pretend to theposition of a professional gentleman. But remember,"As the twig is bent, so is the tree inclined." Weshall be told that in many places it is necessary for amedical man to dispense his own drugs. My answer tothis is that in such a place we shall find a man (probably anApothecary Smith or Brown) wishing to be considered amedical gentleman, but who is not too proud to cater forpopularity by the sale of cheap physic. Let ApothecarySmith cease to undersell the legitimate tradesman, and theprofessing chemist and druggist will soon appear on thescene. We shall further be told "the system possessesgreat convenience for the public." If this is to be consideredbefore professional dignity, then let me suggest to Apothe-cary Smith the addition of tea, tobacco, and sugar to hisshop. What right have such "druggists" to expect anysocial position other than that accorded to petty tradesmen ?Could a medical officer in the army expect that his brotherofficers should sit down with him at the mess-table if theyknew that he had been engaged during the day in sellingdrugs, rolliog up pills, and wrapping up bottles ? andif such occupation is unbecoming an officer and a gentle-man in the army, why should it be less so in civil prac-tice ? But what reason can men engaged in practice in

large towns-ay ! physicians ( ?) and surgeons to publichospitals-advance for such a procedure ? Surely noneother than that of catching patients with the bait of cheappills. At a medical meeting held in Brighton last year, noone with the reputation and credit of the profession atheart could have listened without blushing when some ofthe gentlemen (?) present advocated the necessity of ap-prenticeships on the ground of teaching embryo physicians" the counter trade of the profession." Are these the menwho expect an increase of social status ? Are these the menwho by virtue of their profession ought to be worthy ofwearing Her Majesty’s uniform, or to be presented at Court?But, worst of all, are these the men with whom oneself isliable to be classed as a brother physician ? Surely therespectable non-dispensing members of the profession are

numerous and strong enough to commence a reform, and indoing so let us strike at the root of the evil, and teach ourmedical students to aspire a little higher than the obtainingof a licence from a commercial company, at present drivinga roaring trade between the sale of drugs and medicallicences. At the meeting before mentioned we were toldthat "young medical men appeared for the examinations forthe army and navy so ignorant that they could only exercisetheir profession at the risk of the lives of their unfortunatepatients." These men were, of course, rejected for theservices, but, being qualified, are in practice as civilianssomewhere-where ? Are these the men, I wonder, whocan only get on by selling cheap pills ? But what we shouldall want to know is this : From what schools these mencame, and what qualifications they held. It ought to bepossible, for the great good of the profession, to obtainthrough the War Office and Admiralty the number of re-jected men, their schools and qualifications, duringthe last ten years, and in future to have after eacharmy examination the number, schools, and qualificationsof the rejected published in THE LANCET. If this bedone, I fancy I know of a licence which will occupyunenviable precedence. The question of druggists’ pricesmay be one which the medical profession, on behalfof the public, may have to go into, as there is no reasonwhy a druggist should receive more than an ordinary tradeprofit any more than the grocer. We know by the adver-tisements of leading pharmaceutists, that drugs of the bestquality can be more than ordinarily well compounded andsold at a very low rate, so that if the druggist of the pre-sent day will not lower his prices to what will leave onlya legitimate trade profit, it may be possible for the medical

profession to combine to start men, by guarantee, whowill. The practice of a medical man having some arrange-ment about his drugs and prescriptions with local chemists,I look upon as not a whit less disgraceful and undignifiedthan having a shop in his own house in which to bait hishook for patients with a cheap bolus. If the question ofmedical reform be sincere, let us determine at once whethermedical men are to be doctors or druggists, professionalgentlemen, or petty tradesmen. Many other commonpractices greatly detract from our dignity as a profession,such as brass posters, a yard square, on every availablewall, corner, and railing about a professional man’s house;the existence of partnerships, and firms so large as almostto be co-operative societies-all of which would be con.sidered impossible amongst barristers and clergymen; but,in the meantime, let us hear some authoritative expressionof opinion as to whether or no it be fit and proper fora professional man to engage in the sale of drugs, inhowever veiled a form.-I am, Sir, yours truly,June 7th, 1882. M.D. UNIV. EDIN.M.D. UNIV. EDIN.

THE ROYAL MEDICAL BENEVOLENTCOLLEGE.

l’o tlte Editor of THE LANCET.SIR,—In your impression of last week you very briefly

notice the benevolent and generous act of a member of the

profession, Mr. France, who a second time places a presenta.tion to the St. Ann’s Asylum at the disposal of the Councilof the Royal Medical Benevolent College, for the educationof an orphan daughter of a medical man. I would, for thesake of the widow and orplian, there were many more

amongst us able to follow so noble an example.There is one other subject in connexion with the Royal

Medical Benevolent College which just now has specialinterest for a large number of your readers, but which hasnot been noticed in your pages. I refer to the result of therecent election of foundation scholars and pensioners. Itwill gratify those who were anxious for a change in the modeof election to know that all the candidates recommended bythe Committee of Examination were duty elected : a proofof the success which has attended the working of the newrule, and of the confidence of the governors in the judgmentof the committee. With reference to the pensioners, theresult was not quite so successful, as only one of the tworecommended was elected. This is to be accounted for thus:There were twenty-one candidates on the list to fill two

vacancies, and several of these brought up a large cumulativevote from former elections. It was but natural, indeed onlygenerous and considerate, of the governors to wish to savefrom further disappointment and expense those candidateswhose claims had been urged year after year without success,even before the new rule came into force. At the same timeit was satisfactory to find that an aged member of the pro- ,

fession (eighty-nine years of age) up for election for the thirdtime, and whose chance had hitherto not been great, wasplaced at the head of the list of the unsuccessful candidates,and will in all probability be elected at the next vacancy.It is, however, much to be deplored to find that, while thelist of candidates for pensionerships and scholarships is onthe increase and more urgent, the income of the College islagging far behind what it ought to be, and is, in truth, quiteinadequate to meet current expenses, so that we have themelancholy satisfaction of knowing that not a tenth part ofthe poor widows and orphans can ever hope to be successful.A more generous response on the part of the great body of theprofession to the special appeal lately issued by the Council(10s. a year from the body of 20,000) would help to carryglad tidings to those overtaken by misfortune and brokendown by age, and to the orphan child of a brother whosuccumbed early in the battle of life, and without leavingany provision behind for a dear one now doomed to appealin vain for help. That there is great need for a larger-heartedcharity amongst us was vouched for by the chairman of theannual meeting, Dr. Jonson, who, as is well known, has formany a long year taken a deep and active interest in the wel-fare of the College, and with whose testimony to this effectI trust you will allow me to close this communication.His words have a wider value, also, as an expression ofopinion on the working of the new rule which governs theelections. Dr. Jonson said : ’ With regard to the dutyimposed on the Committee of Examination, speaking more

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particularly for himself, he might say, not only was he mostanxious to carry out the wish of the governors impartiallyand conscientiously, but he believed he and his colleagueshad fully succeeded in so doing in every way-a view en-dorsed by the result of that day’s election. He was, at allevents, quite certain of this : that the comparative claimsand needs of the several candidates had, in every instance,been most carefully and fairly weighed before being adjudi-cated upon. The more thorough investigation made in eachcase had, possibly, occasionally struck a deeper chord of sym-pathy on behalf of one candidate than another, because of hishaving been brought more closely and intimately in contactwith the friendless or more destitute among them ; but hewas quite sure that in no case, on this account, had sub-stantial justice failed to be done. He had also, perhaps,become somewhat more forcibly impressed than he wasbefore-or he might say had become more conversant withthe fact-that a good deal more poverty prevailed amongstour brethren, especially in the poorer agricultural districts,than he had an idea of. Numbers of medical men werebarely able to supply their families with the necessaries oflife ; what, then, could they do for the education of theirchildren? Absolutely nothing; consequently they weregrowing up in ignorance. This was a state of things muchto be deplored, and which could only be remedied by theexercise of a larger-hearted benevolence on the part of thoseblessed with the means and willing to aid the Council in themore active duties of charity-extending the blessings of theRoyal Medical Benevolent College."

I remain, Sir, your most obedient servant,Bedford-square, June 26th, 1882. M. R. C. S.

ARE HOSPITALS TO BECOME HOTELS ?To the Editor of THE LANCET.

SIR,—Rather than diminish the swelled numbers in theout-patient room, would payments not attract more persons,who would be less ashamed to enter when a fee was pay-able ; and would it not also compel the general practitionersliving in the neighbourhood of hospitals to reduce their feesto the insignificant charges of these institutions, or lose theirlower middle-class patients ? If amongst the same class ofpersons who now frequent the out-patient departments pay-ments were demanded, is it reasonable to suppose that asmall fee in the hospitals would impel many to pay a

larger fee to an outside practitioner? Already the treat-ment in large institutions has the advantage of beingcharacterised as "higher treatment." Self-pride alonedeters thousands of the middle class from availing them-selves of medical charity. Remove the charitable ele-ment and the pride will be extinguished.

In the wards, we must remember that there is already aninsufficient number of beds for the present needs of deservingpersons, who when laid on a bed of sickness are unable tofollow their employment, and have but a portion of the lastweek’s wages in their pockets. That these are the folkportrayed trom pulpit and press when appeals are made tothe benevolent for funds, there can be no manner of doubt ;and the public as a body intend their donations for bestowalon this class only. It has been urged that payments shouldbe made by those persons a little above the needy class;" who could pay for ordinary medical skill, butcould not always pay for the highest available degreeof skill." If this refers to operations and other seriouscases which require unusual or special treatment, theanswer is simple enough. These are not the patients whichcrowd the hospitals. A greater latitude should be given tothe admission of such cases, as being of value for clinicalstudy and instruction. The overcrowding occurs in the out-patient departments, where the junior physicians andsurgeons, especially the physicians, are saddled with num-bers far beyond their control. The prestige of the hospitalattracts these people, but they are fortunate if circumstancespermit them to consult their physician more than once ortwice in a month, as the majority of them are under the ob-servation of students. It is idle to contend that this is" higher treatment " than could be practised by any outsidemedical man with ordinary capacity, unless we ignore thequalifications of the general practitioner to practise at all,except under the shelter of consultation.The abuse of hospitals must be met by the cold refusal

of charity to improper persons. No hard-and-fast line can

be drawn in every instance, as much depends on the natureof the disease or injury. We must remember that thisapparently harsh refusal does not debar the patient fromobtaining any medical assistance whatever. Advice may behad from hundreds of competent medical men for a fee nogreater than the travelling expenses incurred by many sickpeople who visit the out-patient department. Should opera-tions or special treatment be needful amongst this class,medical men, as a rule, recommend such cases to the hos-pitals-a plan of inestimable value to students and staff alike.The apparent remedy for the well-known abuse of the

medical charities is charity organisation, which might beattempted by the society that has already done so muchgood in the guidance of charity.

I am, Sir, yours obediently,June, 1882. ALFRED WISE, M.D.ALFRED WISE, M.D.

"THE OPERATION OF SPAYING IN WOMEN."To the Editor of THE LANCET.

SIR,—It is evident that we are playing at cross purposeswith words. " Spaying a pig" is the removal of the healthyappendages of a healthy animal. To call any operation Ihave ever done " spaying" is just as reasonable as to describethe removal of a suppurating or cancerous eyeball as a caseof " Western gouging." This is proved by the facts that Ihave published all my cases, have publicly exhibited all myspecimens, and that the majority of them have found per-manent resting-places in our public museums, particularlythe museum of the Royal College of Surgeons, where youmay see them for yourself.-I am, Sir, yours &c.,Birmingham, June 20th, 1882. LAWSON TAIT.

** The term "spaying of women" means the removal ofthe functionally active ovaries ; in German the operation iscalled " Castration der Frauen." " Normal ovariotomy,Battey’s operation, are terms which have been applied tothe same procedure. We are not playing at cross purposes.We mean the operation which Mr. Lawson Tait has beenperforming for some time past.-ED. L.

"DISPLACEMENTS OF THE UTERUS."To the Editor of THE LANCET.

SIR,—In a leading article published in to-day’s LANCETyou are good enough to quote a statement of mine for com-parison with one of Dr. Vedeler’s. This author’s researchesshow that anteflexion occurs in 68 per cent. of virgins andnulliparous women. I am quoted to the effect that I foundthis condition in 48 per cent. of the same class-a number sodifferent from Dr. Vedeler’s that inaccuracy somewhere mightreasonably be suspected.Will you allow me to point out that 48 per cent. (to be

exact, 47’7) is the proportion I found of pronounced ante-flexion. If all cases, both slight and well-marked, be taken,my figures show, out of III nulliparous women, 67 cases ofanteflexion, or a percentage of 60’5 per cent., a proportionnot widely differing from that which Dr. Vedeler found inthe same class of patients-viz., 66 per cent.

I remain, Sir, yours, &c.,Finsbury-circus, June 24th, 1882. G. ERNEST HERMAN.G. ERNEST HERMAN.

THE HERTFORD BRITISH HOSPITAL.(By a Correspondent.)

THE Hertford British Hospital is an institution which thepoorer classes of British nationality owe to the benevolentgenerosity of Sir Richard Wallace. It originated as an

appendage to an ambulance during the two sieges of Paris in1870 and 1871, but within a year it became a distinct andultimately a permanent establishment. Early in January,1871, when the siege by the Germans was at its height,Sir Richard Wallace opened for the benefit of the sickBritish poor shut up in Paris two wards adjoining his hos-pital for the wounded in the Rue d’Agnesseau, and also adispensary for the relief of out-patients.On the 1st of August all the patients, both civil and mili-