CORRESPONDENCE.

LONDON LETTER.

LONDON, July 8, 1886. Editors Review: A few months ago the authoriities at the Queen Square Hospital for the paralyzed and epileptic, determined to enlarge their sphere of action, and they accordingly appointed an additional surgeon, two ophthalmic surgeons and an aural surgeon. The fruits of this change are already beginning to come in. Within the last few weeks there has been a most brilliant piece of cerebral surgery there, which it cannot be doubted will pave the way for further efforts in the same direction.

Dr. Hughlings Jackson had under his care a man who suffered from a severe degree of epilepsy, but in the form associated with that distinguished physician's name. Indeed it was a typical case of Jacksonian epilepsy; the fits began in one thumb before becoming generalized, and Dr. Jackson having by years of patient labor made out that such attacks show an irritative cortical lesion determined to have the thumb centre destroyed. Mr. Victor Horsley was accordingly asked to undertake the operation, and he showed himself thoroughly competent for the task. Guided by the researches of Ferrier, as well as by his own investigations, he had but little difficulty in determining the spot over which to apply his trephine; this done and the dura mater incised, a small tumor presented itself exactly occupying the region of the thumb centre. This was at once removed, and at Dr. Jackson's special request the thumb centre was also destroyed. Since then the man's progress has been uninterruptedly good. The wound healed by direct union, and the man, as yet, has had no return of the fits. In a very important respect this differs from the celebrated case of Dr. Hughes Bennett, and Mr. Godlee, which, I think, I duly chronicled at the time. In that instance the patient died after three weeks from septicemia; on this occasion the wound was healed in less than a week. brilliant result is the outcome of a series of experiments on monkeys at the Brown Institute, which have taught Mr. Horsley not to put a drainage tube into a cerebral wound; he followed this hint in the case referred to with the happiest results.

This

For my part I regret that Dr. Jackson should have been so anxious to have the thumb centre removed, as it would have been of the utmost interest to see whether the simple removal of the tumor would have sufficed to cure the epilepsy, and if it did not the more radical measure could still have been resorted to at a future date. It

will, however, be instructive to see whether the man has a permanent paralysis of the thumb, and whether any secondary rigidity sets in or not.

After many years of attempts on the part of successive governments, a new medical bill has at last been enacted, though whether it will prove a real boon either to the public or the profession may well be doubted. The first point, and indeed perhaps the most important, is that a qualifying examination shall be an examination in medicine, surgery and midwifery. This qualifying examination may be held by any university or corporation which is at present allowed by law to conduct an examination in medicine and surgery, or by any combination of corporations, one or more of which is at present capable of granting diploma in medicine and one or more similarly qualified to grant diplomas in surgery. In the same way combinations between the universities or between a university and a corporation is to be recognized. The general medical Council is to appoint inspectors of examinations, who shall report on the sufficiency or otherwise of the examination in regard to the standard required from the Council.

As these clauses would have brought the Society of Apothecaries into direct conflict with the Privy Council, who are the supreme authority in all matters medical, it became necessary to provide for that difficulty, and clause five accordingly runs thus:

If a medical corporation represents to the general Council that it is unable to enter into such combination as is in this Act mentioned for the purpose of holding qualifying examinations, and the General Council are satisfied that the said medical corporation has used its best endeavors to enter into such combination as aforesaid, and is unable to do so on reasonable terms. it shall be lawful for the General Council from time to time, if they think fit, on the application of such corporation to appoint any number of examiners to assist at the examinations which are held by such corporation for the purpose of granting any di ploma or diplomas conferring on the holder thereof, if they have passed a qualifying examination, the right of registration under the Medical Acts. And the clause then goes on to specify and enlarge on the functions of these assistant examiners. As matters stand at present, there can be little doubt but that the Society of Apothecaries will have to apply for such examiners to be appointed; a few years ago they did their best to enter into a combination with the two Royal Colleges but without success, and they have since jogged along by themselves as best they could. By this clause they will now be able to escape extinction. I have not got a very high opinion of their examination or license, but the standard cer⚫

Of the other provisions in the Act some are of doubtful value, others are positively mischievous; under this head I have no hesitation in placing the section which provides for the future constitution of the General Council, whereby it is enacted that in future the council shall consist of thirty members instead of twenty-four. Anyone who has watched their proceedings as closely as I have will admit that the chief reason so little business was ever done was owing to the large number of members, and the fact that they were paid five guineas a day during the session. It is obvious that with larger numbers more time will be wasted in wrangling about trifles, and prolonging the pleasure of an inexpensive visit to the metropolis at the most attractive season of the year. The increase in the numbers is due chiefly to the ridiculous pretense of the need for direct representatives on the Council, and so we are to have five of these creatures in future assisting at the deliberations of that body; as they will probably be mere professional agitators, nominated probably by the British Medical Association, it is not likely that the council or the profession at large will be the gainers.

In the elections that are now proceeding to gratify Mr. Gladstone's love of office, the medical profession have not been very fortunate, as several of those who won seats at the last election have already lost them, and notably Dr. Foster, of Birmingham, who was a pronounced Gladstonian, and who had the advantage of the personal support of Mr. and Mrs. Gladstone during his canvass. Mr. Mitchell Henry who was a useful and independent member of the house, and a retired medical man, has lost his seat, and Dr. Alfred Carpenter has again failed to attain the object of his ambition, having been easily defeated. Sir Guyer Hunter on the other hand has retained his seat for one of the metropolitan constituencies, and Dr. Farquharson will doubtless be again returned for Aberdeenshire.

There is very little doing in the medical world now. The Ophthalmological Society, always the last to give up work, held their annual meeting last week, when Mr. Jonathan Hutchinson delivered his retiring address. He has been president for three years, and is succeded by Mr. Hulke, the senior surgeon to the Moorfield's Eye Hospital. In a few days the medical schools will have broken up, and every body who can get away will do so, for the heat in London has been very great lately. Yours,

R. M.

--THE

MEDICO-CHIRURGICAL COLLEGE OF PHILADELPHIA.-During the last five years the Medico-Chirurgical College which was chartered by the Legislature in 1850, has been located at the S. W. corner of Broad and Market streets. The needs of this rapidly developing institution have outgrown its present quarters, and for some time the trustees have been looking for more commodious buildings. Recently they completed the purchase of a large property on Cherry street, near Logan Square. The location is most excellent for the intended purpose, being near the centre of the city, and yet sufficiently retired to give students and hospital patients the requisite quietude. The lot is 134 feet square. It is partly occupied by two large and substantial brick buildings, three stories high, with good light on all sides. Extensive alterations will be made, including the construction of an amphitheatre, clinical lecture room, laboratories and dissecting room, besides all the departments of a well appointed hospital. The lecture room will be fitted up with an eye to the comfort of the students, individual chairs replacing the benches usually supplied. for practical work will have all their the latest and most approved pattern. pital wards will overlook, and have easy access to, the large garden attached. Plans for the alterations are now being prepared by the architect, and when finished, the corporation will have one of the most complete college buildings in the country. Within the ample bounds of the newly acquired property will be located the following institutions:

The rooms fittings of

The hos

1. The Medico-Chirurgical College, founded in 1850.

2. The Medico-Chirurgical Hospital, chartered in 1882.

3. The Philadelphia Dental College, now at 10th and Arch streets.

4. The Hospital of Oral Surgery, whose clinics have no rival in that specialty, has coalesced with the Medico-Chirurgical Hospital.

5. The Philadelphia Hospital for Skin Diseases, now at 923 Locust street, which will be also continued as a department of the above named institution.

The grouping of several institutions with allied objects in a single organization is a new feature in the history of Philadelphia Medical Charities. The old simile of a fagot in a bundle of sticks is most apposite here. While each retains its individuality and independence of action, the union permits each to assist the others, and by avoiding duplicate expenses, enables the authorities of each to accomplish more with the funds at their disposal.

Several notable changes have lately taken place in the faculty of the Medico-Chirurgical College.

Prof. Wm. H. Pancoast, who for twenty-seven years has been teaching anatomy at the Jefferson Medical College, has resigned his professorship in that institution, and has accepted the same chair in the Medico-Chirurgical College, to which he was elected by the trustees. He brings with him the extensive Anatomical Museum, collected by himself and his father, which for so many years was employed in teaching the classes at the Jefferson College.

Dr. John V. Shoemaker, lately lecturer on Dermatology, and teacher of Skin Diseases in the Post-Graduate Course at the Jefferson College, has become Professor of Dermatology at the Medico-Chirurgical.

Dr. E. E. Montgomery, Obstetrician to the Philadelphia Hospital, and surgeon to the Women's Hospital, has been elected Professor of Gynecology.

Some other changes, of interest to those who wish the old-time reputation of Philadelphia as a medical centre to be maintained, will be found in the annual announcement of the Medico Chirurgical College, which will soon be published.

NOTES AND ITEMS.

"A chiel's amang you takin' notes, And, faith, he'll prent 'em."

-The "Boston Medical and Surgical Journal," July 22, says: "A veracious newspaper story comes from the West of a man"-What is the West of a man?"

-The Association of American Physicians (Limited) is the way a correspondent of the "Journal of the American Medical Association" puts it. -An exchange speaks of "Tonsillar Orchitis and Ovaritis." When a man gets orchitis in his tonsils, or a woman has tonsillitis of her ovaries, the case must be interesting.

-A recent incident in the Michigan College of Medicine has been a source of much anxiety to all parties concerned. One of the professors of clinical medicine was giving his final lecture to the class upon the subject of venesection. Νο patient being at hand upon whom could be demonstrated the operation, volunteers from the class were invited. One, more enthusiastic than the rest, responded. The demonstration was a complete success, but subsequent events rather dampened the ardor of the youthful enthusiast. Inflammation of the wound, followed by abscess, erysipelas, blood poisoning, and grave danger to life, kept the student, his fellows and the faculty in a state of worry and anxiety for many days. The patient is convalescing, and is probably a

sadder and wiser man, particularly on the subjects of venesection and erysipelas.

--Masturbation in Children.--Dr. A. Jacobi, in a monograph upon the subject of "Hysteria in Children," quotes masturbation as one of the causes which produce the train of functional nervous disturbances, and cites one case of masturbation observed in a child nine months old. I feel quite certain that I have met cases in children younger than this, and am positive the habit is much more prevalent than is generally supposed. The acts of masturbation in these young subjects bear a strong resemblance to epileptoid convulsions, but may be distinguished from them in that the child never completely loses consciousness. and the paroxysm never occurs during sleep."K. C. Med. Index.'

They commence bad habits early in life in New York, but they are even more precocious in Kansas City. We venture the opinion that no where else in the wide world can a physician be found who will testify to having observed such horrible infantile depravity.

-Our old friend, Dr. George Mills, of St. Louis. has removed to Tampa, Florida, and is now editor and one of the proprietors of the "Tampa Tribune," one of the leading journals of Florida.

The doctor, when in St. Louis, was thoroughly appreciated by his friends of the medical, clerical, legal, commercial, artistic and journalistic circles, but over none had he more magnetic power and fascinating influence than his patients. Very few physicians have the faculty of attaching their patients to them so tenaciously as did Dr. Mills; they one and all truly mourn his absence from them as they would a parent or an elder brother. This animal magnetism and superb dignity of bearing, coupled with a high order of medical talent, is indeed a rare combination, and we regret that journalism has again seduced the doctor from that which, we feel sure, is his first and best love. While medicine in St. Louis has met with loss, journalism in Florida has received great gain.

-We observe in the "Clinical Record" that Dr. Roberts Bartholow recommends nitro-glycerine for irritable heart. We wish the professor would prescribe a dose of his remedy for the irritable hearts of some of his irritable associates who are antagonizing, in a contemptible "dog in the manger" manner, our great International Medical Congress. Unless they quiet down and act in a more manly way, he has our consent to add dynamite to the prescription.

-The "Journal of the American Medical Asso

ciation" in its last issue, has a full page ad. of a good brand of soap. We trust that this will not produce a "soaporific" effect upon the editorial

staff.

doses of five to fifteen drops. When arsenic is indicated there is no remedy that will give as a rule more positive and satisfactory results. It is almost a specific in those exudations which so frequently occur, engrafted upon the malarial cachexias.

If the remedy is given indiscriminately to every patient having an eruption on the skin, without regard to the indications for its use, it will, as might be expected, prove not only valueless but positively injurious. The same may be said of any other remedy given any other class of diseases.

to

In a recent article by Dr. Geo. Henry Fox, of New York, "On the Useless Administration of Arsenic in Skin Diseases," he concludes as follows: "If this drug were henceforth to be banished from the pharmacopeia and from the apothecary shops, its loss would not be felt by the dermatological specialist, while the general practitioner, thus forced to leave the rut in which he has so long been traveling, would, undoubtedly, achieve better results in the treatment of his cases. I feel inclined to offer to my readers the following advice: Stop the use of arsenic entirely, or at least place far less reliance upon its curative qualities! Resort to every available hygienic measure. Use local treatment as judiciously as your experience will permit, and give any internal remedy which will improve the health of your patient without any regard to its specific action on the skin."

This is every word true, and it is not less true of any other given remedy the author may select, inasmuch as we possess no specific for any single disease of the skin so far as I am aware.

cial brother. My advice would be, understand thoroughly the physiological action of arsenic, as well as all other remedies; only prescribe it when indicated; and rest assured that the therapeutic action will be as satisfactory as from any other remedy you may employ.

HYPERIDROSIS.

The following remarkable case was recorded by Dr. Myrtle in Medical Press, Feb. 25:

An old man 77 years of age was seized with a light rheumatic attack, which was promptly relieved by small doses of salicylate soda. In three weeks he began to perspire pretty freely, and continued to do so copiously at intervals for about ten days. Then the pains left him entirely. He was treated now for the sweating only, which continued, by arsenic, cinchona and sulphuric acid during the day, and quinine and belladonna at bedtime, the body being sponged with a solution of common salt containing eau de cologne and vinegar once or twice a day, and the clothing changed as often as practicable. The patient at this time feeling well except for the sweats, had no fever, no thirst, the urine being normal in quantity and quality. The sweats came on suddenly, literally pouring from every duct, continuing for minutes or hours, and invariably stopping as suddenly as it began. Ague being suspected, Warburg's tinct. was given and the quinine and belladona continued, but no improvement took place, and later "the sweat became very offensive, giving the same heavy smell as that passed by a horse after a smart gallop on a hot day." The cause being attributed to paresis of terminal branches of the nerves supplying the sweat glands, ergotine was tried, two doses of three grains each being given at intervals of eight hours; soon after the second dose toxic results were noticed, from which recovery took place under stimulants, hot bottles and sinapisms applied about the body, but the sweat kept up as before. In the following twenty-four hours fifteen distinct bursts of perspiration were observed, lasting from a few minutes to a cou