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his communication to your columns. I would venture tocast a little light upon the obscurity by expressing myhumble opinion that Mr. Hudson would be acting morewisely if he persuaded certain members of the staff of theMiddlesex Hospital to meet at once the demand which hasbeen publicly made and reiterated during the last six monthsfor a public inquiry into their mismanagement of the RoyalBritish Nurses’ Association, a body which he goes out of hisway to eulogise.

In your Editorial note to this letter you, Sirs, state thatthe views of the leaders of the Medical Practitioners’Association "must be received with caution." Those viewshave been clearly set forth on many occasions in print, andare as follows: That nurses should be properly trained forthe responsible duties they are required to fulfil ; that theymust work under the direction and control of medical menand not as independent practitioners ; that at present nursesand midwives are, to a large extent, untrained, and arealmost entirely uncontrolled ; and that this state of affairsis dangerous to the public and most detrimental to medicalpractitioners. I much regret to find that you consider thatthese " views must be received with caution."

I am proud to know that the Association of which I havethe honour to be president is slowly but surely arousing themedical profession to the great truths that in self helpand union are to be found’ the best, the most manly, andtherefore the most certain remedies for the many difficultiesand drawbacks from which medical men suffer. The Associa-tion has never yet claimed to speak for the whole of theprofession." I cannot, therefore, consider it generous uponyour part to deny our right to a claim which we have nevermade. At the same time I may assert with some confidencethat recent events have proved that the Association-even atthis early stage of its career-possesses the support and theconfidence and expresses the views of a very considerablesection of the profession.

I am, Sirs, yours faithfully, HUGH WOODS,

President of the Incorporated Medical Practitioners’Highgate, N., Feb. 8th, 1898. Association.

*** We desire to point out to Dr. Hugh Woods, that, firstly,we have not made the general statement he attributes to usand that, secondly, we have not denied the right of his Asso- iciation to any claim, whether made or not by the Association.Mr. G. B. Hudson, M.P., asked us a definite question-if weconsidered the Incorporated Medical Practitioners’ Association .. entitled to speak authoritatively in the name of themedical profession." To this we gave the only truthful ianswer, and no one who takes the trouble to read Mr. Hudson’s letter intelligently can possibly see anything I,ungenerous in our statement. Dr. Hugh Woods would !,better consult the dignity of his position and the welfareof his Association by infusing a colder accuracy into his accusations.-ED. L. ’

THE ACCIDENTS OF VACCINATION.

To the Editors of THE LANCET,

SIRS,-A distressing case of post-vaccinal erysipelas whichhas just come under my observation prompts me to ask oncemore in the columns of THE LANCET whether it is notdesirable and practicable to take some further steps to lessenthe chances of similar disasters ? The State ordains that forthe good of the individual and the community a certaininoculation should be practised. The operator satisfies him-self that the inoculation is successful, but after that theState takes no further interest in the matter and the woundsare left to heal up as best they may subject to thechances of various contaminations. No doubt these disastersare infrequent, but when they occur they make an

indelible impression on a more or less considerable section ofthe community. It is useless to explain that the vaccinationwas not the direct cause but that the erysipelas might just aswell have followed a cut or a scratch. It is these preventableaccidents which are responsible for very much of the feelingagainst vaccination and very naturally so too.

Is it not the duty of the State, having carried out theoperation, to see that the wounds heal up under properconditions ? I am, Sirs, yours faithfully,

Harley-street, W., Feb. 5th, 1898. T.COLCOTT FOX.

DR. CLIFFORD ALLBUTT’S " SYSTEM OFMEDICINE."

To the Editors of THE LANCET.

SIRS,—Might I venture to make the suggestion to ProfessorClifford Allbutt that he should bring out a tropical edition ofhis great 11 system of Medicine "-that is, one volume whichwould contain all the articles on tropical diseases? Such abook would have a ready sale among men in tropicalcountries who shrink from adding five or six heavy volumesmore to their book box, already heavy and costly enough tocarry about on frequent transfers.

I am, Sirs, yours faithfully,Buxar, India, Jan. 13th, 1898. CIVIL- SURGEON,

THE ARTIFICIAL LIGHTING OF HOSPITALWARDS.

To the -Editors of THE LANCET.

SIRS,-Can any of your readers give us advice with regardto the artificial lighting of the two wards of a small hospital ’*There are in each ward five beds ranged along one wall; thefireplace is in the centre of the opposite wall and at presentthere is a two-arm bracket with ordinary batswing burnerover the fireplace. The windows are at either end. Thewards are about fourteen feet across, lofty and well venti-lated. It has been proposed to fix two brackets with incan-descent burners on the wall against which the beds areranged, but there is some doubt as to the healthiness of theseburners. Unfortunately electricity is out of the question.

I am, Sirs, yours faithfully, --

Feb. 7th, 1898. H. P. H.

*** Our opinion on the Welsbach Incandescent Gas patentswas based on exhaustive trials 1 and was very favourable tothis system of lighting. Our experiments showed the

illuminating power of the mantles to be very high and thefouling of the atmosphere trifling-much less than is usuallycaused by lighting with gas. After-events have provedthe accuracy of our report to which we refer our corre-

spondent.-ED. L.

THE PLAGUE IN INDIA.

(FROM OUR SPECIAL CORRESPONDENT,)

THE municipality of Bombay is still strongly supportingthe inoculations of M. Haffkine. Further stations have been

opened and large numbers of people of all classes are beingdaily inoculated. There is still, however, the same passiveopposition on the part of the Plague Committee to thesemeasures. The chairman of the committee has recentlywritten stating that the committee cannot undertake to

encourage inoculations for the purpose of exempting personsfrom detention in quarantine or segregation camps. It isdifficult to understand the opposition of the Plague Com-mittee. If there were any mistrust that bribery might inter-fere with legitimate inoculations there are now plenty ofBritish medical men to perform and record the inoculations.The statistics already published showing the result ofM. Haffkine’s prophylactic measures have not been ques-tioned and the observations establish the preventivepower of inoculation beyond any possible doubt. Themunicipality has had an offer from Professor Lustigfor his assistant to visit Bombay and employ his curativeserum. This has been accepted. It will be rememberedthat the serum claims to be curative rather than prophylacticlike the serum of M. Haffkine. From a cultivation of plaguebacilli in agar of which the virulence is known a substancecan be procured which, inoculated into animals in smallquantities, makes them refractory to the most dangerousforms of infection. From animals thus two or three timesvaccinated we can obtain a serum with, it is said, a decidedlycurative and preservative action. Of seven very serious cases

1 See Report of THE LANCET Special Analytical and Sanitary Com-mission on the Incandescent System of Gas Lighting, THE LANCET,Jan. 5th, 1895.