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conclusive. They are the sole judges. "1 Dentists can appealto the courts it may be ; so can the medical profession. Butthe courts do not approve of barristers or solicitors adver-tising, and the courts would like to see "the dental professionin the same high position as other medical men." 2 The

Incorporated Law Society has converted the legal professioninto an honourable condition. It is for the General MedicalCouncil to take the dental in hand and assist us, as it hasbeen doing lately, to weed out the advertisers.

I am. Sirs, yours truly.HENRY BLANDY.

"HOW UNION APPOINTMENTS ARE MADE."To the Editors of THE LANCET.

SIRS,—"M.R.C.P." complains that union appointmentsare generally given to the man who buys the practice, and Iventure to think ninety-nine men out of every hundred wouldsay, "and rightly so too.

" With your permission, I will ask"M.R.C.P." this question : Suppose, for argument’s sake, hebuys a village practice and I obtain the union appointmentwhich had always belonged to that practice and worth, say, from;S50 to C60 a year, and the work scattered over six or seven ormore parishes, could I live and keep a horse on my appoint-ment ? If not, what follows? I must, to obtain the merestbread-and-cheese existence, be constantly poaching on thepractice he has bought. What it may be in very large townsor cities I am not prepared to say, but in a village practice itwould be impossible to do without the appointments such asunion and clubs, and, badly as we are remunerated for thiswork, they help to form an important total. The amounts,though small, are paid regularly, and we know when to

expect them, which is not the case with private patients.Under these circumstances an opposition doctor in a villagepractice would be not only a farce, but the profession mustin various ways be degraded thereby, and one of the twomust inevitably come to grief. How would "M.R.C.P.,"after purchasing the practice, like to be the victim ? Besides,I think it is mean and unprofessional in any man to opposeanother after he has invested his small capital-perhaps allhe has-in one of these practices. From "M. R. C. F.’s

" styleof argument it seems to me that the election was right when ihe was elected, but wrong when he was not. III am, Sirs, yours faithfully,

M.R.C.S. Eng. &c.

CANCER PLASTERS.To the Editors of THE LANCET.

SIRS,-An inquest was lately held at Chester-Ie-Streetwhich throws a strong light on the unsatisfactory state ofthe existing laws with regard to "quacks." A woman agedfifty, in spite of medical advice, went to a cancer curer,"living close to Durham, who for a consideration of 15s. for thefirst visit and 5s. for each subsequent one applied plasters toa scirrhus of the breast about the size of a " small hen’segg." The "treatment" was continued at the rate of a

plaster a week from the end of September, 1892, till death onFeb. 13th, 1893. The surgeon, who had originally advisedoperation, stated at the inquest that (although all operativetreatment was refused and the persistent use of the plastersagainst his urgent advice made him decline to attend the casefurther) he thought it probable that the woman would havelivedforabout another two years had not death been "accelerated bythe application of caustic plasters. " Pressed by the coroner asto the composition of the plasters, with considerable hesitationthe woman stated that they were made of "the herbs woodbetony, crow’s toe and yarrow, " dried, powdered, mixed withwhite of egg and spread upon bladder skin. She swore that nocorrosive or other drug was used. After an hour’s deliberationthe jury returned a verdict "that deceased died from a cancerin her left breast, " declining to express any further opinion.After the medical evidence one must regard such a verdictwith great dissatisfaction. Within the last few months threecases of such treatment have come under my notice, two ofthem the result of the same woman’s handiwork.

Case 1.-A domestic servant aged twenty-nine applied tothe above woman for what from the history was a small

1 See report in the Journal of the British Dental Association, vol. xiii.,p. 223, April, 1892.

2 Master of the Rolls : Ibid.

warty growth on the dorsum of the right hand, about the-centre of the metacarpal bone of the little finger. She was told’that it was a "shell cancer, " and that after a series of plasters. it would drop off. Some ivy plasters were applied. When Isaw her there was a large, foul, dark-coloured oval sloughover the above position, filling up an ulcer measuring oneinch and a half by three-quarters of an inch. The sheaths.of the tendons were eaten through, the metacarpal bonewas eroded and the metacarpo-phalangeal joint opened up,necessitating amputation of the little finger with a largeportion of its metacarpal. The wound rapidly healed andshe is now at her duties. The ulcer showed every sign of a.corrosive action, and neither slough nor portions of skinremoved showed any signs of malignant growth.Case 2.-A joiner aged fifty-nine presented himself with epi-

thelioma of the lip and the angle of the mouth. Five years agohe burnt his lip with a clay pipe, which left a small sore, whichgrew harder and never healed. For the last ten months hehad been under the same woman and had numbers ofplasters. The growth extended from almost the centre ofthe lower lip backwards to the left angle of the mouth ; it.then ran backwards for about one inch into the cheek, where.there was a mass of epithelioma the size of half a walnut.Its removal (there were no enlarged glands) necessitated avery extensive loss of tissue, resulting in considerabledeformity. The cheek healed well, but when seen in Januarythere were signs of recurrence on the lip.

Case 3.-A miner aged fifty about three years agonoticed a I I marble " under the skin of the left thigh justabove the patella. About two months before being seen henoticed that the lump was growing rapidly. He consulted aman who professed to cure cancers, and who gave him a bottleof liniment to use and "punched" the tumour to try and" burst it." Fortunately he did not succeed, for an encap-suled sarcoma, hæmorrhagic, the size of a child’s head, wasremoved, together with a large portion of skin implicated,from just above the left knee. The tumour had no deep con-nexions, and the large raw surface left after so large aremoval of skin slowly granulated up. I have no doubt, fromthe appearance presented by the first two cases, that the

plasters contained some powerful corrosive. The nature ofthe herbs mentioned I do not know. I think if all such cases.were reported it might lead to some more stringent regula-tions being adopted. I am, Sirs, yours truly,

SELBY W. PLUMMER, M.B., B.S.

"SOME REMARKS ON THE PATHOLOGY ANDTREATMENT OF TYPHOID FEVER."

To the *-Editors of THE LANCET.SIRS,—It was with considerable interest and pleasure that I

read Dr. Latham’s remarks on the pathology and treatmentof typhoid fever. During the past seventeen years I have-used calomel in the treatment of every case of the disease-that came under my care, and always with the same results.I found it to lower the temperature, clean the tongue andbrighten the patient, and in a large number of cases occurringin healthy subjects, and recognised early, the treatment was.followed by a complete abortion of the disease. Being a.general practitioner, the cases I have treated came earlyunder my observation-that is, within the first ten days-consequently the mischief had not taken deep hold of theglandular structures of the bowel. Calomel may not possiblyhave acted so impressively had this been otherwise. It is.obvious that the main influence of the drug is in its germicidaland antiseptic properties. Yet I have been much impressedwith the idea that much of its beneficial influence rests onthe effect it has in relieving portal congestion, which is alwayspresent, producing a condition of turgescence in the immediateneighbourhood of the glandular mischief that much in-tensifies the disease. I have also observed that afterthe first few doses of calomel my patients passed muchlarger quantities of urine, which, no doubt, relievedthe system of poisonous results. I have never venturedto give larger doses than two grains, generally one grainand a half, three times daily, either alone or combinedwith compound ipecacuanha powder or opium, according tothe frequency of the purgation. My fear of larger quantitieshas rested on a dread of increasing the peristaltic action ofthe bowel, thus preventing that rest which I recognise as.necessary wherever inflammation is present. I have alsofound the counter-irritant effect of a large mustard plasterover the abdomen on first recognising the disease as very