my profession if they consider this justice, to be compelled to neglect business"-who compelled him?-"to give skilled evidence (sic), and to be classed on the same terms as an ordinary witness?" Mr. Brownridge was excellently answered by a fellow chemist, Mr. Hall, to the effect that he should mind his own business, and leave surgery to surgeons, whereupon Mr. Brownridge vindicated himself by saying that the wound was only a flesh wound, and-strange defence!—that he was employed by a surgeon to attend to the minor accidents at a large iron works in the neighbourhood, where sometimes more serious cases than the above occurred. This is as though a man should defend himself for stealing a sixpence by saying that sometimes he even went the length of stealing a shilling. We advise Mr. Brownridge to stick to his own business. Perhaps he is not a bad chemist, but 16s. for four days of his surgery or his "skilled" evidence is probably too much.

ATTENDANCE OF MEDICAL OFFICERS AT
HOSPITALS.

THE question has often been asked us, and again quite recently, whether medical officers of hospitals can reasonably object to some record being kept of their attendance at the institutions to which they give their gratuitous advice. We cannot see how any such objection can be tenable; for, though "officers," the medical men are still "men under authority;" and although their services are gratuitous, they must, in some sense, be under the authority of the Board which appointed them. At many, if not most, of the London hospitals a record is kept by the medical officers signing an attendance-book on entering the institution; and this is obviously a more agreeable method than being "marked" by a subordinate. At one large school and hospital, whilst no record is kept of attendances, the beadle is provided with a "Register of Omitted Lectures," and it is his duty, whenever a lecture or attendance is omitted, to bring the book to the delinquent at his next attendance, in order that the omission may be registered with his signature. Law is said to have a terror only for evildoers; and so we imagine any regulation which brings into contrast the regular attendance of the zealous officer with the perfunctory performance of duty by an indolent colleague could have no terrors for the former, whilst it would show those interested in the welfare of the establishment by whom the work was done.

HEALTH OF LONDON.

THE mortality returns for the past week are more favourable than they have been at any time since the first week in October, only 1262 deaths having been registered.

deaths from all causes.

During the fifty-two weeks ending Saturday last there have been recorded, in the metropolitan districts, an aggregate of 73,279 deaths, out of an estimated population of 3,126,600, the mortality, therefore, being at the annual rate of 23-5 per 1000. The corresponding deaths for 1867 were 70,588. In 1866 they were 80,192, and 73,460 in 1865. Scarlatina was very prevalent, especially in the latter part of the year, and caused 2838 deaths, or 39 per 1000 of the The proportionate fatality of this disease was 20.3 per 1000 in 1867, in 1866 it was 23-5 per 1000, and 29.7 per 1000 in 1865. Small-pox caused altogether 599 deaths, and was much less than half as fatal as in either 1867 or 1866, but about equally fatal as in 1865. Measles caused 1954 deaths, whooping-cough 2320, and typhus 2427 deaths. The first of these three diseases was very much more destructive than in 1867 or 1866, but less so than in 1865. The last two showed a diminished fatality as compared with the three preceding years.

DR. BROWN-SÉQUARD AND THE PARIS

FACULTY.

We are informed that in all probability Dr. BrownSéquard will shortly be called upon to occupy a chair in the Paris School of Medicine. Before the change which we mention in another part of our journal, and by which Claude Bernard's laboratory has been transferred from the Sorbonne to the Museum, it had been arranged that Dr. Brown-Séquard should take the chair of Comparative Physiology at the Museum. Now, however, in the honour of the gentleman last named, the chair of Comparative Medicine, which had been created for Rayer, and which since his death has remained unoccupied, will again be put up, and will be given to Dr. Brown-Séquard, with the new name of chair of Comparative Pathology. We are glad to be the first to mention this event, and we only see additional evidence of the high estimation in which Dr. Brown-Séquard is held, in the efforts which are being made by the French Government to attach him to one of the scientific or medical chairs of Paris.

A CEMETERY FOR VENTNOR.

OUR readers will remember that in the course of last year we very strongly objected to a site for a cemetery that had been selected by the Burial Board of Ventnor. The site was at the edge of what is known as the Rew Down. We thought it, geologically speaking, unsuitable, as well as inconvenient and obtrusive. We are glad to say that it has been relinquished in favour of another site, not altogether free, it would seem, from some geological objections, but very much less objectionable than the former one. sists of a portion of a field on the Rew Farm, situate on the western side of the road, leading to Newport, in the parish of Godshill. At a recent meeting of the Vestry sanction was given for the borrowing of a sum not exceeding £2500, for purchasing the site and preparing it for use. One of the chief objections to this site is its great elevation above the sea, which is, we believe, near 600 feet.

A CIVIC HONOUR.

It con

DR. SEDGWICK SAUNDERS has been placed on the Commission of Lieutenancy for the City of London, an honour conferred upon him by the late Conservative Government on the nomination of the Lord Mayor. It may be well to remind our readers that the "City" forms a county by itself, having its own justices, gaols, police, &c., and that the office of Lord-Lieutenant, instead of belonging to an individual, is in commission, each commissioner ranking at court as a Lord-Lieutenant of a county.

THE WEST BROMWICH HOSPITAL. completion. Already some £2000, or nearly half the sum THIS undertaking, we are glad to see, is approaching required, has been subscribed; the site has been chosen, and the committee have decided on the plans. The progress and working of the institution will be watched with much interest both by the profession and the public, for the medifunds of the charity in recognition of their services. cal officers will each receive an annual honorarium from the

It will be seen from a correspondence which we publish elsewhere, that the Poor-law Medical Officers' Association and the Irish Medical Association have agreed to make a common cause of their grievances, and to unite in order vigorously to further the objects sought to be attained by the respective associations.

THE scientific and medical revolution which has lately been accomplished in Spain, and which we noticed in a recent annotation, is beginning to bear its fruits. As complete liberty of teaching has been proclaimed, the School of Medicine of Madrid has become a sort of open forum, where professors and alumni, workmen and employers, follow each other in rapid succession. The homoeopaths of Spain are in a state of jubilation, as the complete freedom of teaching enables them to propagate freely their own doctrines. doubt whether the hurried and sweeping reforms which have overturned almost every existing institution in Spain will be productive of much good. The cause of science can but suffer from such precipitate measures, which will bring on a reaction, and will thus retard its slow but certain progress and development.

We

THE Pall Mall Gazette states that the Russian Government has offered a prize of 3000 roubles (£400) for the best history of Vaccination, by way of celebrating the hundredth anniversary of the introduction of that practice into Russia by the Empress Catherine II. The prize is open to all European competitors, and the history may be written in any modern European language.

It is refreshing to find that such a thing does exist as a board of guardians who can recognise the important services of its medical officer, and tender him a special vote of thanks. On the 15th of December the guardians of the Pershore Union, on receiving the resignation of Mr. Francis Davies, the medical officer of the Eckington district, recorded in the Minutes "their opinion of the able manner in which he has invariably discharged the duties attendant upon his office throughout the long period of thirty-four years."

ON Tuesday afternoon, two large Post-office vans were drawn up at Messrs. Churchill's, the well-known publishers, and received six thousand pounds in weight of literary matter for distribution in the provinces by book post, in the form of two thousand copies of the "Medical Directory" for 1869. Since the postage on each copy amounts to one shilling, the revenue has benefited to the extent of £100 by the transaction. Some eighteen hundred pounds weight of Directories are annually distributed in the London district, and this in great part by hand.

A NEW effect of the administration of chloroform was pointed out by M. Hurteloup at the last meeting of the Chirurgical Society of Paris. A woman who had been chloroformised was seized, on awaking, by a fit of sneezing, which lasted continuously during a quarter of an hour. M. Hurteloup believes that in cases of autoplastic operations on the face this may constitute an inconvenience, on account of the difficulty of maintaining the sutures of the autoplastic flaps.

A NOTABLE increase has taken place in the number of inscriptions recorded at the School of Medicine of Lyons during the first quarter of 1868-69. The total number of students inscribed amounts to 185. Last year, at the same period, the number of students amounted to only 159.

WE read in the Cosmos that the attempts which have recently been made to introduce into Algeria the cultivation of the chinchona tree will probably be attended by success. Analyses of the bark of the chinchona trees thus cultivated have shown that the alkaloids which constitute their medicinal properties are quite as abundant in these specimens as in others coming from the usual sources.

[JAN. 2, 1869. 25

It is announced in Italy, that Professor Semmola has presented the project of an official Italian Pharmacopoeia to the committee entrusted with the care of drawing up a new sanitary codex. It can scarcely be imagined how a civilised country, where medicine is in so advanced and flourishing a condition, can dispense with such an essential requirement.

THE services and sufferings of Dr. Blanc and his com

panions in Abyssinian captivity, have at length been acthink that the stanchest advocate for economy will conknowledged substantially by the Government. We do not sider that the £2000 granted to Dr. Blanc is a lavish sum when put in comparison with the imminent risk in which his life was so long placed.

IN an excellent article on the projected scheme for an improved water-supply to Edinburgh from St. Mary's Loch, the Edinburgh Daily Review suggests that, having regard to the sanitary aspect of the question, it would be well to give the election of four of the new trustees to the Colleges of Physicians and Surgeons. We shall take a note of this suggestion, which may by-and-by be equally applicable in the metropolis.

M. DOLBEAU and M. GUBLER, both of the Hôpital Beaujon, have just been elected Professors of the Paris School of Medicine; the former to the chair of External Pathology, and the latter to that of Therapeutics and Materia Medica.

DR. HINGSTON reports that the town of Plymouth is becoming more healthy, and as a consequence evidently of Still the town should the adoption of sanitary measures.

have its medical officer of health.

Ar the suggestion of the Rev. J. H. Rutherford, who has always taken a very active part in promoting measures for improving the health of Newcastle and Gateshead, it has towns. There is much fever in the neighbourhood, judging been determined to form a Sanitary Association for those from the medical officers' returns; and the new Association will find abundant work ready to its hand.

THE medical practitioners of Guildford have very generously agreed to supply the local Board of Health with returns of sickness without making any charge for them.

POOR-LAW MEDICAL OFFICERS' ASSOCIATION OF ENGLAND AND WALES.

(COPY.)

33, Dean-street, Soho, London, W., Dec. 23rd, 1868. DEAR SIR,-I am requested by the Council of the Poorlaw Medical Officers' Association, which now numbers nearly one thousand members, to propose to the Council of the Irish Medical Association a mutual interchange of good offices, in furtherance of the objects sought to be obtained by the respective associations.

We have recently taken steps to obtain Parliamentary influence which have proved very successful; and we should be happy to use the influence so obtained to aid, to the best of our power, the Irish Medical Association in their endeavour to secure the object which they appear most to desiderate at the present time-viz., the grant of a superannuation allowance to the medical officers of Ireland; and we should do so the more readily that we intend, in due time, to strive for the same boon for our own section of the service.

In return, we doubt not that the Council of the Irish Medical Association will be willing to enlist the sympathy and assistance of the Parliamentary representatives of Ireland

Irish Medical Association. Office, Royal College of Surgeons, Dec. 27, 1868. DEAR SIR,-I delayed answering your favour of the 23rd inst. until I was able to bring our Council together to take your communication into consideration. The Christmas holidays have caused some delay, but we have had a very full meeting, at which your letter was read; and I have been directed to acknowledge it with thanks, to express the pleasure and gratification it gives our Council to receive the approval of the members of the Poor-law Medical Officers' Association of Great Britain, evinced by their desire that we should use our respective influences for our mutual benefit.

The Council of the Irish Medical Association will be happy to promote the good work your Association has so successfully commenced and so energetically carried on, and will only require to have pointed out to them how they may best carry out your wishes; and they have directed me to express their thanks for the kind offers of assistance conveyed in your communication, which they will be happy to avail themselves of when the progress of their Superannuation Bill requires the exercise of Parliamentary influence. I remain, dear Sir, yours very faithfully, E. J. QUINAN.

To Dr. Rogers, London.

THE DRY-EARTH SYSTEM IN MADRAS.*

To those who may be desirous of obtaining a good practical acquaintance with the subject of the dry-earth system in its application to sewage, we would strongly recommend the perusal of an official document, compiled by Mr. J. L. Ranking, the Sanitary Commissioner for Madras. The following is a summary of the conclusions which, he considers, the evidence obtained from a practical working and observation of the system justifies him in adopting :

That dry earth is an efficient and cheap deodoriser, and capable of arresting, or keeping in abeyance, putrefactive changes in night soil. That its use in latrines will be found relatively inexpensive; not so, however, in urinals, in which, owing to the large quantity of earth required to be provided and of mixed earth and urine to be removed, the outlay would be considerable. 2.5 lb. of dry earth is an adequate quantity for effecting the deodorisation of an ordinary dejection, assumed to consist of 5 oz. of solid and 11 oz. of fluid feculence. It requires, however, 36 lb. of earth to absorb and deodorise every gallon of urine. Estimating the amount of this excretion at one and a half pints or pounds per man per diem, we find that for 1000 men per annum rather over 1099 tons of earth would be required. Although this outlay may be reduced by substituting McDougall's disinfecting powder, or preparations of carbolic acid, for the dry earth, or by using an admixture of these substances, the enormous quantity of earth required seems to us to introduce an element of such difficulty that the application of the system to large towns is simply impracticable. The selection of earths is of importance, that best suited to the purpose being a rich garden mould. Dr. Blacklock has shown that 7 lb. of clay have the same deodorising power as 171b. of ordinary sandy loam procurable at Madras. The pug-mill, a machine for incorporating the earth and ordure, if properly constructed and efficiently worked, effects such admixture of earth and excrement as renders the compost inoffensive, and admits of its retention upon the premises until its removal is convenient. The mill is recommended as a desirable adjunct to latrines for European troops. The poudrette may be kept in a dry state for long periods, without any putrefactive changes being set up in it; but if water *"Further Report and Order of the Madras Government upon the Dryearth System of Sewage in the Madras Presidency." Extracted from the Proceedings of the Sanitary Commissioner for Madras. 1868.

gains access to it, decomposition may ensue. Mr. Ranking found that, when buried in pits and covered over, it was free from smell at the expiration of six months. The sites for such pits, however, should be carefully selected with reference to the "dip" of the strata forming the surface or subsoils of the locality, in order to guard against contamination of the water-supply.

THE NEW INFANTRY EQUIPMENT.

THE Committee appointed to inquire into the present mode of accoutring the infantry soldier has concluded its labours, and presented a fourth and final report. It will be remembered that the new equipment consists of a waist-belt and frog; two pouches capable of holding twenty rounds each; a ball bag; and a valise, made large enough to hold the service kit, to be worn at the lower part of the back; the whole being carried by a brace yoke. The weight of the accoutrement and kit was diminished, and distributed more generally, and in such a way as to prevent it interfering with the play of the muscles about the chest, or exerting undue pressure over vital parts. An extensive trial of this equipment was ordered a few months since. A thousand sets were distributed among several regiments, and taken into use for three or four Practically a unanimous decision has been given in favour of the mode of carrying the kit and the accoutrements proposed by the Committee. One or two insignificant alterations only have been made. An objection has been raised to the valise on account of the heat which it occasions about the loins, and the consequent perspiration; but the Committee agree that this is not a valid objection, and that the inconvenience complained of is due to the mode in which the valise is put on.

months.

We have already expressed our hearty approval of the have now been sufficiently tested to warrant its general adopyoke system recommended by the Committee. Its merits tion in the army. The new equipment is calculated-and this is the point of prime importance-to prevent those evils which have unquestionably followed under the old system, to the damage of the heart and lungs, not only authorities are to be congratulated upon the result of of the experienced soldier, but the recruit. The military the present inquiry, and it is to be hoped that the infantry soldier will soon enjoy the benefit of the Committee's unremitting exertions during the last four years.

THE SITE OF THE NEW INFIRMARY, EDINBURGH.

EDINBURGH Continues to be agitated on the question of the site of the proposed hospital. The subject has been most elaborately discussed both at the Medico-Chirurgical Society, and by the Edinburgh Architectural Institute. The balance of opinion is against the present site, and in favour of that of the George Watson's Hospital grounds, and sun, and not more than five minutes' walk from the as being cheaper by probably £20,000, more open to air University. Dr. Andrew Wood made a very forcible speech in favour of the new site, at the Medico-Chirurgical Society, and in the discussion which followed, Professor Syme spoke strongly in the same direction. We sincerely hope that the managers will not decide in favour of the old site, so hemmed in as it is, without duly weighing the arguments against it, which seem to us most potent. Can nothing be done in the way of a temporary hospital, as Sir James Simpson suggests? The unhealthiness of some of our most expensive hospitals is distressing. The Surgical School of Edinburgh would earn a new fame if it could show us a simple, efficient hospital, built so cheaply that it could be abandoned (at any rate temporarily) in favour of another

THE LANCET,]

when indications of a poisoned atmosphere appeared. This suggestion will not excite the enthusiasm of architects; but we make it seriously, and in the belief that our great hospital system is attended by most objectionable con

sequences.

Correspondence.

"Audi alteram partem."

NATIONAL VACCINATION.

To the Editor of THE LANCET.

SIR,-As you have appealed to the verdict of the medical profession, in your article of last week, respecting the advisability of handing over to a Government official (out of the pale of practice) the vaccination of the country, I for one beg leave to offer a strong protest (in which I think a large majority of practitioners will concur) against any measure so arbitrary and objectionable. It is bad enough, so a number of mothers think, both old and young, that their offspring should be compulsorily subjected to so trying an ordeal, and Government has already incurred a full share of odium for enforcing so precautionary a measure; but to enact that all our babies must be taken to a public official, and there to receive a Government stamp, in preference to the unostentatious method at present in force, will, I fear, be too much even for modern mammas. But the family doctor has to be considered, and when he sees a public functionary step between his patient and himself (to say nothing of his own children), and perform an operation so obviously a part of his duty, it must produce a feeling of great dissatisfaction, in which most likely the family would join.

As a remedy for the inefficiency of the present system, I would suggest that, as vaccination is made compulsory, the State should become responsible to the extent of one-half of the fee, the patient to pay the remainder, determined according to distance, &c. In the case of paupers, the present system would remain unaltered, the "parish doctor" of the district taking all such cases as belonged to him; but in the case of the class you refer to in your leader, it should be lawful for any medical man to claim from the State a fee, say of 18. or upwards, according to circumstances, for every successful case of vaccination proved, at the same time that it should be lawful for him to claim a like amount from his patient. In the upper classes, where the fees range from 5s. and upwards, it would be impolitic in the medical attendant to claim anything from the State. It ought not to be the duty of the medical practitioner to "look up" babies, but that of the registrar or such like officer. I am, Sir, your obedient servant, Stepney-green, Dec. 21st, 1868.

EDMUND POPE.

To the Editor of THE LANCET. SIR,-The article in THE LANCET of December 19th on the suggestion by The Times of the appointment of public vaccinators, who should be debarred from private practice, has caused considerable excitement in the profession.

I believe such a proposition will be received with the utmost disfavour alike by the public, by the present public vaccinators, and by the profession generally. The public will object to it as an unjustifiable interference with their liberties. There is an insuperable repugnance among many people to having their children vaccinated by any but their private medical attendant; they trust in his judgment, and would bitterly resent any legislative interference in this

matter.

Private practitioners would hardly acquiesce in a measure which, while depriving them of a portion of their fees, would cast a slur upon their ability to perform an operation like vaccination. But the change would press with peculiar hardship upon the present public vaccinators, whose vaccination fees form a welcome addition to their often inadequate stipends. The system proposed by The Times will

[JAN. 2, 1869. 27

be received by them with something like dismay. It would require a much stronger case than has been made out to justify a measure so destructive of their individual interests. You say that if it relieved medical men of a portion of their fees, it would relieve them of a great responsibility. But medical men, who are accustomed to the heavy responsibility involved in the daily practice of their profession, can well afford to bear the small additional responsibility of having to vaccinate their patients.

Then it is said that the profession at large would be gainers, inasmuch as the appointment of public vaccinators, who should be the direct servants of the State, would be in some sort a recognition of medicine by the State. I confess myself unable to see anything in this last argument. If it were of any advantage to the profession that some of its members should be the direct servants of the State, it would still be possible to point to the medical services of the army and navy, which are "in relation with a department of the Government."

It seems extremely likely that if the appointment of public vaccinators were transferred from boards of guardians to the central government, our metropolitan brethren would get the lion's share of such appointments. Private practitioners would entirely lose their vaccination fees, which would pass into the hands of a class of specialists who would be neither surgeons, physicians, nor general practitioners.

We have been educated by THE LANCET into the heartiest distrust of specialism in medicine and surgery; yet, surely, no form of specialism has ever been more objectionable than the specialism recommended by The Times. I am, Sir, your obedient servant,

Bradford, Dec. 21st, 1868.

JOHN FOSTER.

POOR-LAW MEDICAL INSPECTORS.

To the Editor of THE LANCET.

SIR,-Your admirable strictures on the Poor-law Board and its doings must have given great satisfaction to that large body of ill-used men, the Poor-law medical officers.

I trust the powerful influence which your journal possesses will have its weight on the new President, and induce him to carry out the recommendation of the Lords' Committee by appointing Poor-law medical inspectors.

There is no remedy that could be adopted that would be so likely to put an end to the grievances of which Poor-law medical officers have so long complained. The perversity of Lord Devon in appointing barristers rather than medical men, in opposition to the Lords' recommendation, shows the deep hatred to the profession which has existed at the Poor-law Board. The absurdity of appointing legal men to inquire into matters which relate to medicine is too evident to need remark; and it is by no means surprising that so many shameful abuses in workhouses should have escaped the notice of barrister inspectors.

Apart from the important duty of watching the condition of inmates of workhouses, a medical inspector would have important duties. The question of remuneration of the medical officer in rural districts, which form a very large proportion of unions in England and Wales, would come before him for inquiry and report. At present, the number of population is taken as the basis of payment, without regard to the circumstances of the district, as to situation, usual percentage of sickness, kind of roads, or distance of paupers from medical officer's dwelling.

Many of the districts might be advantageously altered, so as to render medical aid more accessible to the poor, instead of, as now, in many cases, compelling them to travel eight or nine miles for the doctor, and the same distance over again for medicine.

himself has been a medical officer and is practically acquainted In all questions or matters of dispute, a medical man, who with everything which relates to union practice in the provinces, would be an arbiter between the guardians and the medical officer, and the appointment of such would tend to allay the grievous heartburnings which have so long existed in the service. The question of forming dispensaries, where, and where not, eligible, their inspection as to supply of drugs, &c. &c., would come before him, and various other matters which are obvious.