Nov. *5, 1864.] ASSOCIATION INTELLIGENCE. [British Medical Journal.

witlh fine specimens of the other minerals, particu-larly the sulDhate of magnesia with only one equiva-lent of water, but iniso'luble in water, which I intendto try as a mediicciie in certain digestive derange-ments,-I asecndedI the shaft again in two minutes,meeting halfway, as before the up-going, so now thedown-oinc, cage, as a kind of apparition or flyingDutchmani.HowevLr, fromii thiscdigression into the Stassfuirt

mines, I retuirni again to -tlhe Chemiiical Section of theCongress at Giessen. Professor Strecker of Titbingenrelated the resuLlts of his experiments on the reduc-tion of nitro-comiipounds by m-eans of sodium-amalgam.Dr. Naumann then miade a commnunication on theeffect of bromiumi upon benzoic ether and nitro-benzoic ether, whereupon the meeting closed.The Sectioni for Surgery received some important

communications. Profhssor Weber of Halle gave alecture on the Effects of Comlmion Water upon Woundsand Ulcers. He thought water was by no means anindifferent acent, and should be substituted by mnilk,vegetable resinous extracts, or, best, a solution ofcommon salt in water of a certain clegree of con-centrationi. In such salt water he had let patientsbathe chancrous sores with the best effect; ulcera-tions on the feet he lhadklept for a long time in suchsolutions, and cured them-l; nay, he had performedthoracentesis upon two patients while they were im-mersed in a bath of such salt water, and cured theirempyema. In the clear salt water, it could be seenhow at the expiration the thick pus issued throughthe wound, and how at the inspiration the salt waterentered the thorax aricl waslhed out the pus. Pro-fessor Bardeleben next gave Ihis experienice on Schin-zinger's mnethod of resetting a dislocatedlhead of thehumerus. In this process, the operator puts his lefthand against the chest of the patient, and, extenclinthe arm with his right hand, rotates it outwards.The headl is said to return into the capsule withoutpain, andl easily the operation requiring no cliloro-form. In one CaSe of BL3ardeleben's, the operation didnot succeed, but the ordiniary muethod afterwards re-stored the head to its )lace; in a secoild case, frac-ture of the surgical neck took place, and a pseudar-throsis remiained. In the discussioln, Professor Loserremarked, that the imiethod was older; and that therotation had to be made, not outwards, but inwards.In one case, he had hiimiself torn oll the tubercululIminus; but the patient was well satisfied with hisarm. He said that he replaced every dislocated hu-muerus without pulley or assistant. After several suc-cessful aind unsuccessful cases of treatment by thismethod had been related, Professor Bardeleben re-ported a case in which the point of a knife had pene-trated the skull, and had then broken off. He niaderoom in the substance of the bone by mieans of alittle chisel and hammiiiier, and then withdrew thepoint of the knife. Pus ran ouit of the opening; thesymptomns of encephalitis ceased; and the patient re-covered. Roser remarked, that the chisel in suchcases had first been used by Stromleyer. ProfessorTextor slhowed an exostosis which he had success-fully removed from the fronltal bone of a girl. Themeeting of the Section then adjourned.

[To be continued.

POPULAR1 MEDICAL WORInS. Mr. Banting, of cor-pulence notoriety, has, lie tells us, sold 50,000 copiesof the third edition of hlis pamphlet. On the salethere is a profit of £171, and this sumil he distributesas follows:-To the Printers' Pension Society, £50;to the Loyal Hospital for Incurables, £50; to theBritish Homiie for Incurables, 250; to the NationalOrthopocdic Hospital, £10: 10.

BRANCH M1EETING TO BE HELD.NAME OF BRANCH. PLACE OF MEETING. DATE.

BIR?MINGHAM AND MID- Mledical Departinent, Thursday,LAN1D CrUNTIES. Birminglhamn Library, .November 10th.

[Geiielnal.] Birmingham.

SOUTH-EASTERN BRANCH: EAST KENTDISTRICT MEDICAL MEETINGS.

TIIE next meeting will take place at the FountainHotel, Canterbury, at 3 P.M., on November 17th.Gentlemen wishing to read papers are requested toforward their names forthwith to the Secretary,

ROBERT BOWLES.Fuolkestone, October 1iO4.

HULL BRANCH: GENERAL MEETING.THiE second c9eneral miieeting of the Hull Branch waslhelcl at the Vittoria Hotel, Hull, on Thursday, Octo-ber 27th, 1864. It was attended by a large numberof imembers and visitors. The chair was taken byJAMEs Dosson, Esq., President.The minutes of the last general meeting were read

and confirmled.MIedical Providenit Fund. On the proposition of

Mr. J. H. GIBsoN, seconded by Dr. CARNLEY, Dr. H.Munroe was unanimously elected a Director of theProvident Fund.

Comm,)zunications. The following comnmunicationswere made:-

1. Ascites cured by Elaterium and Aqua Regia.By J. H. G-ibson, Esq.

2. Remarkable c.se of Lithotomy. By K. King,M.D.3. The Peculiar Application of Photography to the

Recognition of Deceased Persons. By J. Dossor, Esq.4. Case of Osseous Deposits in the Muscular Struc-

ture of the Heart. By J. Browuridge, Esq.5. Microscopic Examination of Hair taken from

the Female Bladder. By H. MIunroe, M.D.6. The Magnesium Light was exhibited by T. Wal-

ton, Esq.Dinner: The members of the Branch, with their

visitors, then dined together, and spent an agreeableevening..

SOUTH-EASTERN BRANCH: WEST KENTDISTRICT MEETING.

THE second meeting for the eighth session, 1864-65,was held at the West Kent General Hospital, Maid-stone, on October 28th; S. MONCKTON, M.D., in thechair. Twenty-one members and visitors were pre-sent.New M6ember. Matthew Algernon Adams, Esq., of

Maidstonie, was elected a new melnber (subject to theregulations of the Association respecting confirmationat the Branch annual meeting).

Death of a Member. Jalues Connell Prance, Esq.,late of Mlaidstone, was reported, with regTret, as de-ceased. He practised for about fifty years. He leftbooks and instruments to the West Kent GeneralHospital.

Communications. The following communicationswere made.

1. Case of Severe Injury to the Brain; the patientsurviving thirteen months. By F. Fry, F.R.C.S.

53,1

British Medical Journal.] CORRESPONDENCE. [Nov. 5, 1864.

2. Case of Spontaneous Withdrawal of the Arm,and Cephalic Birth, succeeding to Arm-presentation.By George H. Furber, Esq.

Discussion. The discussion that was referred, inSeptember, to the prcsent meeting, was resumed. Theresult was as follows.

Resolved: to continue the present number of meet-ings annually-viz., four; to meet at hospitals, whenthere be such institutions in the towns at whichmeetings take place; to continue the custom of adinner after each meeting; to limit the charge ofdinners to lOs., inclusive of wine; and to continuethe rate of the present district subscription-viz.,2s. 6d.

It was announced that the number of membersamounted to sixty-one, besides four honorary mem-bers.

Charles J. Pinching, Esq., of Gravesend, was ap-pointed (subject to his approval) chairman of thenext meeting, in March 1865.

Dinner. The memlbers and visitors adjourned todinner at the Mitre Hotel.

xbnrrepirnMsaencc.TREATMENT OF PARTURIENT WOMEN.

LETTER FROM WILLIAM LEGGE, EsQ.

SIR,-In the few remarks I propose miaking on thissubject, I cannot preteind to offer anything original;and I trust it will not be thought to savour of pre-sumption, if I advance, or maintain, sentiments whichmay be at variance with those of some, whose age andexperience challenge deference; but believing, as Ido, that correct and successful practice may be ma-terially assisted by the contribution of carefully ob-served facts (the relative value of which must be thesame, however limited the sphere of observation), Iventure to submit the results of my experience, in theopinion I have formed as to the most judicious man-agement of puerperal women, especially with regardto their dietetical treatment. That there is a greatchange of opinion and practice in such treatment, fewwill deny; and I think we are justified in regarding itas one of those evidences of advancement in the intel-ligent practice of medicine, which meet us in everybranch of our profession, and mark the present as anera of scientific progress, when none may rest upontheir oars, and all adopt the motto,

" Ne cede matlis, sed conitra audentior ito."A retrospect of the steps by which this improved

position has been attained, induces a comparison,which cannot fail to be disadvantagreous to the past;yet we must not too hastily censure the seeming de-ficiencies of our predecessors, nor plume ourselves onthe possession of knowledge, either gained by thelight of their mistakes, or the result often of their ex-perience.In reviewing the practice of the past generation,

we can scarcely be surprised to find that the verygeneral adherence to depletive measures in the treat-mient of disease, influenced the management of thepuerperal state; for the fact that parturition is simplya natural physiological process, not an abnormal oc-currence, was totally unrecognised. As a disease itwas regarded; as such it was treated; low diet wasstrictly enforced, and (as we cannot but conclude)with disastrous effects. In dismissing the idea of dis-ease we also dismiss the necessity for interference,save in the shape of assistance; hence it follows that,if such interference be practised, the result will be

evil. Now, if this view of the case be correct, ourgreat aim must be to give such assistance to thepowers of Nature, as shall enable the patient to rallyfrom the exhaustion consequent on the nervous shock,the severity of the labour pains, and the subsequenthaemorrhage. First in the catalogue of mealns to thisend comes sleep,

' 'lir"d 'Nature's sweet restorer."In some cases this is most difficullt to obtain, and

every one must be familiar with instances wherewakefulness has persisted through many weary hours,despite all means used to subdue it. I have foundthis generally associated with a tendency to second-ary hoemorrhage. I am accustomed, regarlding sleepas of the utiliost importance, to admiiinister from fortyiiiinims to one drachm of vinum opii; although thismay seem a large dose, I have never found it toolarge, and in its satisfactory effect far preferable torepeated smaller doses; the severity of the after-painsis mitiigated, and the patient awakes greatly refreshed.An idea even now prevails that these after-pains arenecessary, and a provision of nature for ensuring thedue contraction of the uterus; but experience provesthat no patients do better than those in whom these arecontrolled; moreover, where the pains are excruciat-ing, the uterus will be found firmly contracted; and,again, the absence of these pains in primiparo3 is anegative proof that they are not essential.

In illustration of the impunity, or I should rathersay the advantage, with which full doses of opium canbe given, I may cite a recent case in which, after asevere labour, with arm-presentation reqluiring ver-sion, hour-glass contraction of the uterus necessitatedthe introduction of the hand for the removal of theplacenta. Great prostration followed; one drachm ofvinum opii procured quiet sleep; on the recurrence ofpain the next morning, accompanied by acceleratedpulse, the same dose was repeated with the best re-sult, and the patient recovered without a bad symp-tom.With regard to that quwmstio vexata, the administra-

tion of alcohol in cases of flooding, I think all whohave encountered this terrible foe must concede, that,however ingenious the theories which dispute its effi-eacy, alcohol is our sheet anchor, and the actual factof its efficacy is evidenced by the satisfactory result ofits adoption.In the subsequent management of the lyingo-irn wo-

man, there are two important points which, insteadof securing the attention they merit, are unfortunatelytoo often neglected. I refer to the proper applicationand retention of the abdominal bandage; and to thestrict confinement to the recumibent position for a suf-ficiently long period after delivery. Whilst it is not ne-cessary always to confine a patient to the bed, sitting upshould be prohibited, and the sofa insisted upon. Theneglect of these precautions is the undoubted sourceof much subsequent sufferingf, as is evident by thefrequency of prolapsus uteri among the lower classes.

In the present day, fortunately, the duLties of themedical attendant are not considered to be endedwith the successful termination of labour. In formerdays, insuperable obstacles presented themiiselves tothe practitioner who attempted to interfere with theroutine of the lying-in room. Ignorance, the parentof a thousand quackeries, here held undisputed sway,and by the aid of her ready inyrmidons, a body ofilliterate, superstitious nurses, actually coerced thedoctor into at least a tacit sanction of practices re-pucrnant even to common sense. So powerfulwas thehold acquired by this sisterhood, that opposition waseither felt to be useless, or dreaded, lest it shouldevoke resistance detrimental to profession.al success.Now the case is altered, and questions formerly con-sidered as either too unimportant to merit his atten-

532

Nov. 5, 1864.1 MEDICAL NEWS. [British Medical Journal.

a great triumphn of surgical art-a marvellous re-covery.Xr. Paget admits, with his usual candour, at least

one objection which "mmay possibly weigh against itsgeneral adoption" (i.e., punctuLre); viz., that whichrelates to seminal matters. He states that, wrhenurine cannot pass, semen cannot; nor can we assuimefor our present plan, that it would at all restore thefunction. Mr. Paget does not consider this as an ob-jection in practice; inasmuch as "he would thenonly lose it a few years, probably very few, earlierthan his compeers in age." Indeed! is it not noto-rious that the desire for, and capability of, inter-course clings to olcl men with great tenacity? and todeprive them of that solace and satisfaction in theirdeclining years is, to say the least of it, a cruel act.Again, he says, " Indeed, what bave we to promisefrem any other course? Has the result of perinTalsection been investigated in regard to this point?In wvhat proportion of operations cloes its gropingdissection spare the parts sufficiently to leave thisfunction intact ?" No, no, Mlr. Paget; you mustknow, this "groping dissection" is not correct; butthat it is a plain-sailingf, straight-forward operation,from beginning to end, without fear of emasculatingthe patient.

I must differ entirely with M.Ir. Paget, when lhestates " I believe it will not be long before perinaealsection is looked back upon as a matter of history;and its performance, when a grooved instrumuent canbe got through the stricture, is stigmatised as a inereflourish of the knife, discreclitable to surgery andsound judgment."

I must leave this strongly -worded paragraph to the,consideration of Mr. Syme, the originator of theperinaeal section-that masterpiece of surgery, whichthe highest state of intellect could only have sug-gested, and the most deterumined perseverance havecarried into practice. I am, etc.,

EDWIN MORRIS.Spalding, October 23, ISC4.

A PUZZLING CASE.LETTER FROM THOMAS INMAN, M.D.

SIR,-In your concludingf paragraph, you expressthe idea that a man who has seen a fall must lnoticea bruise. Allow me to inform you, as a matter offact, that what is called " ecchyymosis", or the miiarkof a bruise, rarely if ever appears at the timne of theinjury. I have known three days elapse ere any dis-coloration has appeared. This point is important inmedico-legal inquiries.Allow me still further to call your attention to the

fact that bruises leave two marks-one on the sur-face of the skin (points of abrasion or puncture);another in the skin (effusion of blood). The first isseen at once; the second, onlv after an interval.There is a third appearance, which none but an ob-servant and experienced eye would note; viz., awhite-waxy look of the skin, arising from the totalabsence of blood, the vessels having been forcibly,emptied, and possibly broken. It is this form whichis followed by the most intense and most tardy ec-chymosis. A witness may speak of one of thesemarks, and be understood in another sense.

I am, etc., THOMAS INMIAN.Liverpool, October 1864.

[We were not ignorant that ecchymosis (one re-sult of a bruise) does not instantaneously follow theinjury. As Dr. Inman points out, bruises leave twoor more kinds of mark; and for this very reason weemployed the general word "bruise", which com-prises them all, instead of the more scientific terms

" abrasion", " ecehymosis", " contusion", which indi-cate a particular description of mark. We miay pointout, moreover, that it was by no means implied thata man who had seen a fall would necessarily notice abruise. The point of the paragraph referred to was,that having seen the fall, and having looked for theimiark, a man would be more likely to see it than if hehad not witnessed the fall, and had no special reasonto suspect the existence of any injury. EDITOR.]

FISTULOUS COIMMUNICATION BETWEENTHE BOWEL AND BLAkDDER.

LETTER FROMi GEOrGE D. GinB, MI.D.Sir,,-Dr. Henry Goode's rare case of fistulous

commliiunication between the bowel and the bladder,published in your last number, I read with verygreat interest, as a somewhat similar one occurred toimiyself miiany years ago, in the person of a youngmarried lady, who passed faeculent matter in herurine. There was, however, this difference in hercase. The abscess was the result of acute periton-itis, and burst firstly into the bowel, and subse-quently into the bladder. TIer recovery was goodandl complete. The details of the case are publishedin the Lantcet of April 20th, 1861 (page 384). So faras miiy acquaintance goes of the literature of the sub-ject, the result is generally fatal, and recovery is theexception. I amii, etc.,

CTEORGE D. GIBB.Portman Street, October olst, 18;l.

3, IRsM ssWTtwa tbAPPOINTMEN,TS.

BAzIRn, P. Victor, M.D., app)oitited Assistant-Physiciani to theNationol 1-loopital for the Paralysed andcl lEpileptic.

REYNOLDS, J. ltissell, AI.)., appoinited Physician to the NationalHlospital for the Paralysed and Epileptic.

*SIEsVE:tNGo, E. H., M.D., appointed Physician to the National Ilos-pital for the Paralysed atnd Elpileptic.

AR21IY.ASTITON. StaFi-Assistant-SuIrgeoII W., M.B.,rto be Assistant-SurgeonRoyal Artillery, rice '1'. Kennedly.

CS5ALK, Staff-Assistant-Surgeoni F. H., to be Assistanlt-Suirgeon 2ndFoot, rice H. S. Lodge, 1ID.B.

FEnoGTTsoN, Staff-Surgeon J., to be Surgeon lt;th Foot, vice J.Clarke, M.D.

M\AtITIN, Sir J. Ranald, C.B., to have the local rank of Inspector.General of 1flospitals while holding tle office of l'i-esident of thelondon Medical B3oard for the Examiiniationi of Officers of HerM1ajesty's Indiani Service.

PAXTON, Staff-Assistant-Su1rgeoit J., M.D., to be Assistattt-Surgeon30th Foot, rice I). Alilroy, -M.D.

Woons, Assistant-Surgeoin D., 11th1-Jussars, to be Staff-Assistant-Surgeon1, vice J. Ferguson.

ROYAL NAVY.LE GRANDE, Frederick W., Esq., to be Deputy Inspector-General ofHospitals and Fleets on the Retired List.

VOLUNTEERS, (AN. = Artillery Volunteers; R.. =Rifle Volunteers):

HTART. W., Fsq., to be Honorary Assistsnt-Surgeoni 2nd Surrey A.V.LLEWELLYN, W. P. J., MI.D., to be Surgeon 2nid Surrey A.V.

n'ILSON, J. IV., M.D., to be Surgeon 3rd Middlesex A.V.

DEATHS.BLETCIILY, Edmund, Faq., Surgeon, at 19, Tabernacle Pow, onOctober 29.

CLUTTERB'UCK. Oni September 9th, at Jhatisi, Tndia, aged 17 months,Jewis J. E., only child of J. E. Clutterbuck, M.D., Sitrgeon 42nidRoyal Highlanders.

CRAIs, John S., L.R.C.P.Fd., at Stratford-on-Avon. on October 28.FALCONER. On October 30th, at Bath, aged 19, Walter W., secoiidson of *11. W. Falconer M.D.

*TIORPE, George B., Esq., at Staveley, Derbyshire, aged 49, onOctober 25tb.

535

British Medical Journal.] MEDICAL NEWS. (Nov. 5, 1864.

MEDICAL MINISTER OF STATE. Dr. Lanza, a medical man, forms one of the present Italian ministryHe is minister of the Home Department.THE EDINBURGH UNIVERSITY CLUB will hold its

second dinner meeting at the Wellington Club, at sixo'clock, on Monday, the 71th inst.MR. ALFRED STMEE has issued an address, offering

himself as a candidate for the representation in par.liament of the city of Rochester.THE PROFESSORSHIP OF PRACTICAL ANATOMY in

the Medical School of Trinity College, Dublin, has be-come vacant by the resignation of Dr. Barton. (DublinMedical Press.)WE understand that Lord Wodehouse, the new

Lord Lieutenant of Ireland, has conferred the officeof Surgeon-in-Ordinary on Mr. Butcher. Dr. Hatchell,now Inspector of Lunatic Asylums, occupied the postunder the Earl of Carlisle. (Dublin Medical Press.)UNIVERSITY OF EDINBURGH. The half-yearly meet-

ing of the General Council (constituency of graduates)of the University of Edinburgh was held on the 28thult., Sir David Brewster, Principal and Vice-Chancel-lor, in the chair."DR." HENERY. The charge against Osterfield

Wray aclias Henery, and Anderson alias Wilson, hasbeen again adjourned to Tuesday next. Andersonalias Wilson was in a sufficiently recovered state fromdelirium tremens to be able to be brought up fromthe House of Detention.MR. MITCHELL HENRY, well known to the profes-

sion as once surgeon to the Middlesex Hospital, hasissued an address to the electors of Woodstock, andintends to offer himself as a candidate to representthat borough in parliament. Mr. Henry's returnwould be a great boon to the profession; for he wouldbe, in fact as well in word, a representative of medicalknowledge in the House of Commons.NATIONAL HOSPITAL FOR THE PARALYSED AND EPI-

LEPTIC. The medical staff of this hospital, previouslyconsisting of Drs. Ramskill and Radelyffe, physicians,and Dr. Hughlings Jackson, dssistant-physician, hasbeen increased by the appointment of two physicians,Drs. Sieveking and Russell Reynolds; and an assist-ant-physician, Dr. Victor Bazire.SCOUNDRELS. An officer of the Royal Navy writes

to a daily paper: " A set of blackguards, trading un-der the title of ' surgeons,' have been in the habit, forsome time, of sending their filthy publications to offi-cers of ships forming the Channel fleet. I hope therecent exposure of one of these disgusting vagabondswill lead to the discomfiture and ruin of the wholelot. One of their dirty books was lately sent to amarried officer in the army, and opened by his wife."MILITARY HOSPITALS AT CHATHAM. A portion of

the invalids have been transferred from the garrisonhospital to Fort Pitt hospital. Under the new ar-rangements, Fort Pitt is intended for a hospital forthe entire barrison, the other military hospitals beingclosed. The buildings at Brompton hitherto used asthe garrison hospital will be converted into quartersfor the troops of the line.ENGLISH WEEDS AT THE ANTIPODES. In New Zea-

land, our common English weeds or plants are sup-planting the native flora. The water-cress of ourbrooks has become a positive nuisance to the NewZealander; indeed, the rivers of the country threatento be choked up by the intruder. One stream, calledthe Avon, is so filled with water-cress that the annualcost of keeping tile river fiee from the weed is said toexceed £300 a year. The stems grow to a length oftwelve feet, and a diamneter of three-fourths of aninch.

536

'UNIVERSITY COLLEGE HOSPITAL. The followinglegacies are announced, viz., X£0 by the late ZadokAaron Jessel, Esq., £100 by the late Henry Lloyd,Esq., and £5,000 by the late Jacob Stiebel, Esq.GLASGOW UNIVERSITY. The winter session of the

Glasgow University was formally opened on Mondayat a meeting held in the common hall of the college.The Very Rev. Principal Barclay occupied the chair.THE SALE OE HASCHISCH has been interdicted by

the Turkish government, except for purely medicinalpurposes. The Gazette Jlftdicalc d'Algerie wishes foran analogous prohibition in Algeria, where its abuseis carried to an alarming extent.QUARTERLY MORTALITY IN ENGLAND. The deaths

in the quarter ending September 30th, were 112,133.The annual rate of mortality for the quarter in Eng-land and Wales was 2-139 per cent., against 2-000 asthe average. With the exception of the summer oflast year, the death-rate was higher than in any pre-vious corresponding season since the cholera summerof 1854. The causes which operated to produce thisexcess attacked town and country.HARVEST HOME AT THE STAFFORD COUNTY LUNATIC

ASYLUM. The annual festivity of "harvest home,"lately took place in the grounds of the institution.Between 200 and 300 of the inmates, of both sexes,partook of old English fare. The order and decorumobserved was astonishing. After dinner tobacco wasserved out to those who wished to indulge in a pipe(and the number was by no means small), and avariety of amusements and games was provided.ELECTION OF MEDICAL OFFICER OF HEALTH FOR

MARYLEBONE. On Thursday week the election of amedical officer of health for the parish of Marylebone,in the room of the late Dr. Dundas Thomson, tookplace, and, as was expected, resulted in the appoint-nent of Dr. Whitmore. The ballot between Dr.Stevenson and Dr. Whitmore, the two candidatesselected as having the highest numbers at the pre-vious meeting, opened at eleven and closed at one;having been closed, the scrutineers announced theresult to be-Dr. Whitmore 81; Dr. Stevenson 15.SALE OF CYANIDE OF POTASSIUM. Suicides by

means of cyanide of potassium have of late been sofrequent as to suggest to chemists much more cau-tion in retaining this highly poisonous salt. It istrue that photography is a very popular art, andelectrolytic gilding is occasionally practised by ama-teurs; but we may recommend chemists only to re-tail the salt to those personally known to them. Byso doing many suicides will no doubt be prevented,and something will also be done to avoid the forcedrestriction on the sale of such articles which will ine-vitably be placed if the use of the cyanide for the pur-pose of suicide should extend. (Chemical News.)ARMY AND NAVY MEDICAL SERVICES. The compe-

titive examinations of the army medical service areheld at Chelsea, usually in the months of Februaryand August. The candidate is not required to pro-duce any other qualification than his license to prac-tise; but in the naval service a candidate mustproduce all his certificates. He is examined by Dr.Hooker on Natural History, Botany, Chemistry, andMateria Medica; by Dr. Parkes on Medicine, Thera-peutics, Pathology, Pharmacy, and the writing ofPrescriptions; by Mr. Hewitt on Surgery and Surgi-cal Appliances; and by Mr. Busk on Anatomy, Phy-siology, and Comparative Anatomy. For the firsttwo days his examination is a written one; on the thirdand fourth days he is examined vivci voce; and on thefifth and sixth days he is tested by the diagnosis ofdisease at the bedside in the hospital, and by opera-tions on the dead subject. A certain number of can-

TO CORRESPONDENTS.

didates, whose answering has been satisfactory, but a

not sufficiently so to entitle them to a place, are s

offered appointments on the Coast of Africa, at Sierra cLeone, Gambia, and Cape Coast Castle. If the can- Ididate accept the appointment, he is sent out at lonce, without the period of probation to which others I

are subjected at Netley Hospital. He is allowed to Ispendl a year at home, on full pay, for every year Espent in Africa; and the entire period at home and Iabroad counts as service for pension. The promotion Iis only too rapid, owing to the dangerous nature cfthe climate; and we have kniown the rank of full Isurgeon reached in five years from the date of ap- t

pointment as assistant-surgeon. The competitor,who has been so happy as to obtain a place, is obligedto undergo a probation of four months at NetleyHospital, near Southampton, where he is compelledto attend the following lectures-viz., Hygiene, byDr. Parkes; Pathology, by Dr. Aitken; MilitarySurgery, by Mr. Longmore; and Tropical Diseases,by Dr. Maclean. The candidates also attend thehospital, to make themselves acquainted with the sys-tem of recruiting, and the mnodes of keeping the armymedical returns. They are also called on to makepost meortene examinations, to operate on the deadbody, and pass through laboratory practice on themodes of recognisingf the qualities and adulterationsof food, and on microscopic examination of morbidtissues and of adulterations of food, etc. During thispreliminary training, the candidate is understood tobe in her Majesty's service; he wears uniform, is

under military discipline, and receives pay at therate of 5s. per day, and 2s. per day for lodging money,if not provided with quarters in the hospital. At thetermination of the four months he is again examninedin the subjects in which he has been instructedl dur-ing that period, his marks are added to those ob-tained by hini at the competitive examination, andhis position on the list of merit determined by thetotal. He is then gazetted to his regiment, and en-

joys all the ranik andl honour, pay anid privileges of an

assistant-surgeon, as provided by the regulations. In

proportion as the demand for appointments in the

armiy has decreased, the ardour for those in the navyhas augmented. The pay in both services being the

same, the expense of living in the army being so muchgreater, the number of applicants for naval appoint-mnents has rapidly increased. The curriculumi is in

almost all respects the same as that of the army. Theexaininations are held at Whitehall, but they take

place at no stated period, and are frequent or at longintervals, according to the number of candidates pre-senting themselves. As soon as the list contains

eight or ten nalnes the candidates are summoned to

London, and are at once examined on Anatolmy, Sur-

gery, Medicine, aiid Chemistry, by the Director-Gene-

ral and by the Deputy-Ilnspector of hospitals. The

most noteworthy fact in connection with the examin-ation is, the importance attached to a sufficient know-

ledge of Latin; the candidate is obliged to translate

passages from Gregory's Conspectus; and unless this

part of the exanuination be satisfactorily passed, the

candidate is not permitted to proceed further on the

trial of his competency. The successful competitoris not subjected to any probation at Netley Hospital,"out is at once appointed as acting assistant-surgeon

o. his ship, and enjoys from the publication of his

"gazette" all the pay, privileges, and advantages of

his rank. (Dzttblin Mledical Press.)

GRATUITOUS MEDICAL SERVICES. In our judgmentone of two things should be demanded of all thesec''ase charities -either that their privileges be con-

fined to paupers, or the professional attendants be re-

inunerated for the time and services rendered those

able to pay; anmd the voice of the profession at largeshould be raised against the practice now too frequent,of indiscriminate gratuitous service. The generalprofession, as well as those who serve, has a clearmoral right to the income of which they are thus de-prived. Section 9 of Article 5 of the National Code ofMedical Ethics, reads as follows. A wealthy phy-sician should not give advice gratis to the affluent,because his doing so is an injury to his professionalbrethren. The office of a physician can never be sup-ported as an exclusively beneficent one; and it is de-fraudin, in some degree, the common ftunds for itssupport, when fees are dispensed with, which mightbe justly claimed." (Americaa Medical Tinees.)

OPERATION DAYS AT THE HOSPITALS.

NosNDAY......M}Aetropolitain Free, 2 P.I.-St. Mark's for Fistinlaand other Diseases of the IRectiiin, 1.3i r.u. -[loyal

London Ophthalmic, 11 A.M.TUESDAY ....G 1uy's, IA v.mr.-Westminster,2 P.M.-Royal London

(OphtllalliC, 11 A.M.WEDNESDAY... St. Mary's, 1 P.M.-Middlesex, 1 P.M.-IJniversity

Collese, 2 p.u.-London, 2 P.m.-hoyal lonmdon. (ph-ttllmliC, 11 A.M.-St. Bartholomew's, 1i30 Pml.

TnURsDAY.....St. Georpe's, 1 P.mI.-Celitral London Ophltlhalmic1 P.M.- Great Northern, 2 P.si.- Londoms SUm-ei'sAlHomile, 2 P.Mn.-Royal Ortlhopisdic, 2 P.M.- RoyalILondon Ophthalmic, 11 AM.

FRIDAY....... Westmlinster Ophthalmic, 1.31 P.M.-Royal Lonidon

OphltbPltnic, 11 A.M.

SATURDAY......St. Thomas's, 1 Pa%r.-St. Ilartholomew's, 1.30 P.M.-King's College, 1-30 P.M.-Chsrhig Cross, 2 P.M. -

J.ock, Cliniical Deimnonistrlationi amid Operationts. 1 P.m.-Royal PFree, 1.30 P.m.-loyal Lomidon Ophthalmic,

A.M.

MEETINGS OF SOCIETIES DURING THE

NEXT WEEK.

MIONDAY. Medical Society of LomIilon, 8 e.wr. General M\Teeting.Dr. Gibh, "Oni 'I'liront-Couhii"; A. ialmanilto Squire. \1.11.,"On l)iseaaes of the Skini caulsed bv tite Ar(!us."-1E,pidelni1u-losical Society, 8 A.Address by t10e Presitdent.-Fittoil0olo-gica;l.

TUESDAY. Roval MedicAl andit Clmi2urgieal Societs. 8.30 P.m. D)i.Robert lj.ee, " Ott thfe 'Nerves of tie SHart": Dr. Gibb,

` Ott

Renivoval of a Grostlii from the El)ig,lottis."-Zoological.-Eftllnolog,ical.

WEDN'ESDAY. 'Microscopical.FI JDAY. Astrootionici1t

TO CORRESPONDENTS

t All letters and coinmtinications for t7he JOITUNAL, to be address.edto the EDITOR, 37, Gr-eat Quieen St.,Lincoln's Inn Fields,W.C.

CORRESPONDENTS, WhO wish notice to be taken of their communica-tione, should authenticate them with their niames-of course,not

necessarily for publicationi.

COMMUNICATIONS.-To prevent a niot unicommon misconception, we

beg to infoim our corresponidents tlhat, as a ruile, all etmlnunica-tiOIis which are inot returnied to their authors, nie retained for

p)ublication.AN AssocIATE's opiniion quiite agrees with ouir ownt-lhat itifitar-o

atn embargo shouild be laid upon tile epistolary lucubrationis of thekgeijtlemani aliuided to.

QuEnr.v.-The Royal College of Surgeons will assuire(liy not grant itsLicentse in Midwsifery to aniy person wVlo is ii t qualified to prtc-tise Surgery.

INDIA MTITLICAL SERvICE.-A surgeon writes fronsi TIndia: " Tile me-

clical miieln out here aie iii armns .t this mtewv Waii alit of Sir C.

Wood's. Owing to the regimental reductions, tlhele will be inextto ito leave for tlhem."

D. H.-We regret that we canniot find the patper from which the

extract was iiiatde.537

Nov. 5, 1864.1 (British Medical Journal.

British Medical Journal.] TO CORRESPONDENTS. [Nov. 5, 1864.

TuIE DAVENPORT BROTIIERS.-We really caninot oceipy our spaceand insult the initelligetice of our professional bretliren by anllyserious allusion to the legerdemain tricks of these Yankee gents.The only interest wlicil such a tale can have with miiembers of ascientific professioni, is the ex;hibition thereby afforded of someserious fault or gap in tlle instruction of wvllat are called the" educated" classes.

CORONFR AND MEuCcA. FEEs.-A correspondent writes:-" A few(lays since, an assistatit of mine, who is MI.D., M.R.C.S., attenldedan iniquest, anid toade s post tmorttea examirtation for miie; i. e., thesummons waS matle out tco me, as tle principal, altho Th IT kisewnothling about it. attd Dr. - lad inivestigated it, and made theexamiceatiott. Tite cotonier took lies evidenice, andA theni refused togive hitn the fee, because lie was scot registered, stating that hewas legally preeltided from so doinig. Was lee legally preclutdedfrom giving the fee? I believe tilat he is legallv warranted itswithholditeg it, as I did Ilot attend the inquest; btit he iinsists thatlee is legally pr-ecludAed from giving it. I wislh to convince hirm (ifhe is wrong) thlat Ice was not legally precluded from giviilg it."[We leave obtainied the best opinlion to be lead oii the point

ref6rred to, anid it is thlis: "tA coroteer caiitiot be legally conmpelledto pay a ceon-regristered practitioteer, as a medical witiiess. Thereis certainlyino law to prevenit lIim aind ie the case of lis takitegthe evidence of a qetalified medical man, lee breaks tIe spirit wliilstadlieriiig to the letter of tlIe law. In givinig evidenice, the law doestiot reqeiire that a mete slhould leold any license to practise at allIlis evidence incest be taken for wlicat it is worth. I-Ie can, leow-ever, rotly recoulpetse Iiine as ael orditnary witness. In the case ofoa ieledical man asking anotleer to ieislee a post moatest, or give evi-deuce for himie, the coroteer can refeise to take the evidence, if leplease; bult if lee takes it, lee is bound ite hoioour to pay for it,although he canteot be compelled to do so." EDITOR.]

INTERMITTENT RESPIRATION.- Tehe phenomenon neests simply"exhatustion" of tlie respiratory inuseles. It is coneteeon on theapproaclh of deatle; it is commons eteider nausea; it is produced bysiieci poisons as digitalis; it follows or accompatlies convulsiveattacks, as sighing; it is coinision amongst delicate females ormales. Its analogue is intermnittenet action of tie heart, which itusually accompainies. ANiheni cny oiegan acting rhytlimically isexhausted, it loses its rhytlcui. Irregularity thcens implies ex-haustiote from olle cause or ateother. The natural deductioln is,tiat diffusible stimuli" are indicated. Practice enidorses theinference. The progneosis its such a case is grave, so long as thesymptom lasts. T. I.

TIIE GRIFFIN TESTTMIONIAL Ft:ND.-Sin: The following stibscrip-tions hcave been ftirtieer received ote belialf of the ahove Fued:-ir. C. Wildeqsh, Esq. (1ast Ashford), 10s. 6d.; R. Davies, Esq.(M)uninow), rs.; '. A. Stephlensonot, Esq. (iRadford), 5s.Anmount previously ansnouneced, ;C91: 6. Received at tie Lan-

cet office, .5:13.1 asn, etc., ROBERT FOWLER, M.D.,

T'reasurer and Hon. Sec.115, Bishopsgate Street Witleout, November 2nd, 1864.

COMMUNICATTONS have been received from: -Mr. J. VosESOLONMON; Dr. W. B. ITAY; Dr. J. B. PITT; MXTr. PoPFo ; Dr. TnOM%rAsTNMAN; D)r. I. TTARE; 'Mr. C. S. SMITHT;nMr. T. W*ALTON; THEREGISTRAR OF THE MEDICL, SOCIETYr OF LoNDON; Mr. RICoAmRDGRIFFIN; Alr. J. N. .A)CLIIFF; 'Mr. R. B. CARTER; AMr. OLTVER]EtnER.TON ; Br. TIiuncrTcui; TiE P-e(eNORARY SECRETARIES OFTISE IIARVEIAN SOCIETY; D)r. GEosrGE D. GiBB; THE HONORARYSECRE,TALRIIuS OF TIIF EPISDEMIOLOGICAL SOCIETY-; Dr. MoIRGAN-TSr. IIunDT Dr. I. FowTER,; TatE IHONORIARY SECRETARY OF TIIERJOYAL MEDICA.L AND CiiunutGICAT, SOCIETY; Dr. C. ItADCLYFFEHALL; Dr. J. TItOMPeSONN; Mr. F. FRy: Mr. G. H. FuRnBEu : ANASSOCIATEr; Dr. F. J. BnROwN; MTr. G. B. R. ATACCARTHY; Mr. S.WOOD; Mr. GAINE; ANTICACOETesES; and Mr. WHARTON JONES.

BOOKS RECEIVED.1. De h'Emplol The6rapeutique des Lactates Alealins dans les 'Mals-

lies F"otietionelles de l'Appareil Bigestif. Par J. E. P6trequin.Paris et Lyon: 1864.

2. Quelqeses M'ts sur l'Acide Lactique et les Lactates Aleslins etTerreux. Par M. Beiriru dit Beuissoi. Paris et Lyon: 1861.

3. A System of Sasrgery. Edited by T. Ilolmes, MLA.Cantab. InF"our Voluisies. Volume tice Fourth. Londorn: 1864.

4. First Help itn Accidenlts. By C. H. Schaible, M.D. London:1864.

5. Dilatation of the Lacteals. Further Observations on the Waxyor Amyloid Form of Briglht's Disease. On a Ca3e of SyphiliticAffection of the Liver. 13y T. G. Stewart, M.D. Edinburgh:1864.

C. An Address to the Students of St. Bartholomew's Hospital. ByG. W. Callender. Lotidon: 1864.

ESTABLISHED 1818.

J Baxter Langley, Professional* nduMEDICAL AGEN\CY, 0, Liicoln's Ini Fields, V.C.

3ligible and Genuine Practicesfoi- TIZANSFEl1t at preseiit on 'BIr. LaDgley's Register:-

895.-Unopposed Cotuntry Practice. 500 a year. Premium by easyinstalments.

903.-Consulting Practice in the Channiel Islanids. Premium £650.919.-Nucleus of Genieral Practice, with Retail, in South London.

Price £100, in two instalments.922.--At a fashionable Wateriio, Place. Receipts £100.941.-A Nucleus onl the Soutli Coast. Easy terms.91G.-Well established Rletail, with privata connection. Cash re-

ceipts 15 weekly. IPrice £1150.948.-In a large towni in the Midland Counties. £1800 a year. Two

years' Partnership Introduction.811.-Within fiftv miles of London, a well-established Practice of

£1500. Ilalf-slhare for negotiation.953.-A good General Practice in the Eastern Counties. Premium

£1500.954.-In a fashionable townI in the West of England. Receipts

£1150; ceipable of immediate increase. Price £80.951-.-In a healthy town in Lincoloshire. Population 10,000. Average

receipts £350.902.-Excellent Ntueleus, in a good mnarket town, about fifty miles

from Lottdon. Cost of coiinin- in £75.9G5.-In Derbyshire. Receipts £300. Appoinitmenits £89. Premium

£200.969.-In a pleasant village, within a muile of the sea. Population

2000. Price £100.971.-Partinership in Som-lersetshire. Average receipts £800 a year.972.-Old established Counitry Practice. lleceipts £400. Terms

very monderate.974.-Old-established Practice in Leicestershire. IReceipts £400.

Onle year's purchase required.975.-In a nmarket town itt Lincolnshire. Receipts £200. Very

transferable. Terms liberal.976.-Ihalf share in a Partnership in one of the largest towns on the

south coast. Income £800. Price £400 for the half share.977.-In Kent. Receipts over £200. Inmproving neighbourliood.

Terms moderate.980.-Nucleus of Private Practice, with Union appointment, in the

S.W. district. Premium 2200.981.-A liratlch Practice of £100 in Bucks. Terms easy. A

capital opening for a sinigle gentleman.982.-In Yorkshire, near the sea, a Nucleus. Prioe £50. Appoint.

ments £115 a year. Receipts £170.983.-Country Practice near a large town. Receipts £200. Appoint-

inents £140. Price £150.984.-E]xcellent iinopposed Practice in a manufacturing town. Re.

ceipts £X00. Appoinitments £109. Price £500, by instalments.985.-Unopposed Coutntry Practice. £500 a year. Appoinitments

£150. Price £500, in two payments.988.-Nucleus its the North-East district, upon very easy terms.989.-Private Practice, in R beautiful spot, withini tllirty miles of

Lonidon. Receipts £250. Appoitltments £100. Price £150.990.-Itt Sonmersetshire. Receipts .250. Appointments £50. No

Premiuim. Furniture, etc., at a valuation.991.-Devolishire. Average returnis £S00, inicreasing. No op.

poilenit within five miles. One year's purchase.991.-A Branch Practice in Somersetshire. Succession secured.

Receipts £360). Appointments £150. Price £210.99.5.-Capital Nucleus in Warwickshire. Price £100.197.-In ati improving district in Yorkshire. Receipts £400. Ap.

pointments £150. Unopposed and perfectly transferable.lPrice £400, by inistalnietits.

1004.-Village Practice. Receipts £240. Patients of a good class.Easy work. Premiutn £200, by instalments.

1005.-Excelletit Private Practice, with retail and appointments.Income £500. Rettt £50. Price £400.

1OO5A.-Capital well established Family Practice in one of the besttowns in Nottinghamshire. lIeceipts upwards of £1000.Appointments £70. Premium£l,500,byinstalmentsproperlysecured.

1007.-Ass old established Practice in Cheshire, with the veryhighest connections. Appointments £60. Income £600.Terms liberal.

1008.-Small well established Country Practice, with good connec-tions, easily worked. Receipts £300. T'o an immediatepurchaser, very easy terms would be offered.

1010.-In a good town, on an island on the coast, an increasingPractice. Receipts about £300. Terms 250 guineas.

1015.-West-end Practice. Iticome £600. Premium £1,000, with sixmonths' introdtmction.

1017.-Well established Retail, in a fashionable watering-place.Receipts £1,000 a year. Premium one year's purchase;plerfectly transferable.

1018.-Private Practice, with open Surgery, in Lambeth. Price£120.1019.-Famliy Practice in a beautiftil town in Surrey. Price 360

guineas. An excellent opening.PROFESSIONAL and MEDICAL AGENCY, 50, LINCOLN'S

INN FIELDS, LONDON, W.C.

538