678

QUEEN’S HOSPITAL, BIRMINGHAM.THE energy with which subscriptions for the extension of

this institution are collected by the working men hasalready resulted in a very considerable sum. According tothe Fifth Quarterly Report, dated April 28th, 1870, we findthat the C1713 12s. 9d’., which was the amount collected upto the fourth quarterly audit, has now swelled to the sumof C2157 5s. 2d.,-an increase which is all the more credit-able when the necessarily small sums which the workingmen have it in their power to raise is taken into consider-

action. ___

SIR THOMAS WATSON.WE are happy to be able to report that Sir Thomas

Watson is making most satisfactory progress towards re-covery. ____

CLASCOW UNIVERSITY.

THE old college buildings ceased to exist for academicpurposes on Friday, the 29th ult., when the winter sessionclosed. The next session will open in the magnificent newedifice at Gilmore-hill, which has been erected at a cost of£250,000, of which, to the great credit of the Glaswegians,not more than £3000 remains to be subscribed.

Ws call the attention of our readers to the May number of our contemporary the Practitioner, in consequence pf its Ibeing a more than usually good specimen of this excellentperiodical. In this utilitarian and busy age medical menwant to get at all the best information they can about thetreatment of disease, the action and value of new remedies,and the best methods of treating diseases generally. A

monthly journal of therapeutics was really required, andDr. Anstie appears to us to conduct the Practitioner withadmirable ability. Among the original communications wemay mention one by the editor and staff, on the Dieteticand Medicinal uses of Wines ; on the use of Sarsaparilla,by Dr. Clifford Allbutt ; on Chloral in Phthisis, and itsantagonism to the poisonous effects of Calabar Bean, byProfessor Hughes Bennett, and a note on the use of theHydrate of Chloral, by Dr. J. W. Ogle; contributions to thePathology and Therapeutics of Diabetes, by Dr.,A. Dupre;on the use of Bromides in cases of Continued Fever com-

. plicated with Sleeplessness and Nervous Symptoms, by Dr.William Moore; also a short suggestive note about

Epilepsy, by "Quaerens;" with reviews, a clinic for themonth, and some well-selected extracts from British and

foreign journals, &c. ____

DR. HUGHLINGS JACKSON is a candidate for the post ofphysician to the Seamen’s Hospital. Another candidate isDr. Oppert; but even were this gentleman’s claims equalto those of Dr. Hughlings Jackson, he is, we believe, dis-qualified on the ground of age.

THE paper at the Medical and Chirurgical Society onTuesday next, by Sir Henry Thompson, in which he willbring his personal experience in lithotomy and lithotritybefore the profession, is -likely, we understand, to attractseveral of the leading provincial surgeons, whese experiencein the treatment of stone has been extensive.

DR. DALY, of Hull, has been made a magistrate for theEast Riding of Yorkshire.--Mr. Frederic Ruffe, M.R.C.S.,of Tamworth, has been placed on the Commission of thePeace for that borough.-Drs. Wm. Rayner and Edward P.Twyford have been placed on the Commission of the Peacefor the county of Lancaster.

PROFESSOR FRANKLAND’S Report on the Quality of theMetropolitan Water-supply during April is satisfactory.The waters of all the Companies were clear and transparentwhen drawn from the mains. The amount of solid im-

purities was much less than usual, probably owing to theremarkable absence of the customary April showers, whichwash surface impurities into the rivers and streams.

THE Board of Trinity College, Dublin, by a decree datedthe 19th of March last, has founded forty exhibitions, ofthe annual value of £25 each. These exhibitions are in-tended to aid deserving students in the prosecution of theirundergraduate course, and will be awarded by competitiveexamination. They can be held for a term of two years, orless if the answering is not sufficiently good.

AT the annual meeting on Saturday last (30th ult.) of thesupporters of the East London Hospital for Children, itwas stated that during last year 450 in-patients had beenadmitted, and 3972 out-patients treated. The total ex-

penditure had been £2027, and the mortality among thein-patients six per cent. ____

THE South Bucks Free Press records with satisfaction therapid abatement of the small-pox epidemic at Hig h Wvcombe.We are glad to observe that the P1’ess urg.es that the lessonsof the past should be a warning for the future in respect ofthe need for general sanitary improvement in the town.

SMALL-POX continues increasingly fatal in Paris, thedeaths having risen to 166 last week.

THE ROYAL COLLEGE OF PHYSICIANS.

DR. RISDON BENNETT’S LUMLEIAN LECTURES ONINTRATHORACIC CANCER.

LECTURE II.

DR. BBNNBTT’s second lecture was delivered on the 5thultimo. He commenced it with a description of those casesof intrathoracic cancer in which the disease is limited to acertain portion of the lungs, many of which, he said, pre-sent a, strong resemblance to cases of limited tuberculardisease, especially those in which the early indications ofpressure are absent. One of the most striking cases ofintrathoracic cancer simulating phthisis which he had seenwas one of primary cancer of the posterior mediastinum,ulcerating into the oesophagus, and attended with profusehaemorrhage and by a gangrenous cavity in the left apexand a certain amount of surrounding consolidation. Therewas dulness at the apex and increased vocal resonance, nolocal symptoms of the tumour, but there were an infrequentpulse and an apathetic manner. The cavity in the lungwas found post mortem to be formed between the lung andthe pleura by destruction of the lung substance, limited bysurrounding pleuritic adhesions. This destruction was

clearly due to inflammation set up by the neighbouringgrowth. The case afforded an illustration of the tendencyof cancerous tumours outside the lung to produce inflam-mation of the adjacent lung tissues and leura. Suchgrowths within the lung have little tendency to producechange in the surrounding parts. Death by haemorrhageas a consequence of pulmonary cancer is very rare. In acase recorded by Dr. Church, the patient died after bringingup four pints of blood, and the haemorrhage resembled thatof aneurism so closely that it was supposed to be due tothat cause. Slight haemoptysis in the earlier stages ofcancer of the lung is often noticed, and is sometimes theearliest symptom. It may take place probably in a stageprior to the actual existence of cancerous deposits.The cavities found in the lungs in pulmonary cancer are

sometimes due to gangrene, but more frequently to thebreaking down of encephalomatous masses, and the sym-

679

ptoms may closely simulate those of phthisis. Moreover,there is often a limited falling in of the thoracic parietes inthe subclavian regions, with alterations in the vocal reso-nance and respiration, which render the resemblance stillcloser, and this even before there is any breaking down oflung. Dyspnoea, is the result chiefly of pressure upon thenerves and vessels, the latter causing pulmonary congestion.Accordingly, we find these symptoms best marked wherethe bronchial glands are chiefly implicated, and the canceris in the upper part of the mediastinum.

In mediasbinal tumours there is much greater diversityin the symptoms during life, and in the effects produced onthe lungs and other contents of the thorax. The lungs maybe invaded or not, and with or without ulceration. The

signs of pressure are connected mainly with the vessels,nerves, or bronchi; and with any of these, and unquestion-able evidence of intrathoracic tumour, there may still be,difficulty in deciding between cancer and aneurism. Theco-existence of pleuritic effusion and early occlusion of thebronchi, may add to the obscurity. The varying conditionof the lungs in these cases is an important feature in con-nexion with the diagnosis. In an almost typical case ofmediastinal cancer, the main bronchus was occluded, theleft pneumogastric nerve destroyed, the correspondingbranch of the pulmonary artery obstructed, and yet thetissue of the lung had undergone little change, and wasstill tenacious and crepitant.In considerable opposition to this case was another, in

’which all the phenomena were at first referable to the

lungs and to some obscure cause of irritation of the bronchi.For a considerable period after the patient came under ob-servation the symptoms were those of an ordinary case of’bronchitis, and then there gradually developed the distinctivesigns of an intrathoracic tumour. In this case the displace-ment of the heart was greater than usual, for it is remark-able how little displacement of the heart there often iseven when the size of the tumour is very considerable.

THE CONTAGIOUS DISEASES ACTS.

The Times of the 4th inst. contained a report of an im-portant meeting held at 12, Cavendish-square, on the 3rdinst., in relation to the above Acts. In addition to a very

large gathering of the more eminent members of our pro-fession, the meeting was numerously attended by noblemen,members of Parliament, and other persons of political andsocial influence. Sir Thomas Watson was unhappily absentfrom illness, and the chair was taken by Mr. R. Quain, who,in the course of his remarks, stated that the committee hadcome to the conclusion not to recommend any further ex-tension of the Acts until the public had become betterinformed on the subject, in regard to which much prejudice,through misapprehension and ignorance, had been raised.lie was in favour of the legislation advocated by the asso-ciation, because he considered it most important for thewelfare of the community. He had come to that conclusionnot only from his own professional experience, but fromthe confirmation this had received from inquiries in which hehad taken part some years ago. The evidence he had thenacquired was quite conclusive to his mind. As the Legislaturehad taken upon itself to hinder disease by various Acts ofParliament - as those to prevent propagation of small-pox by enforcing vaccination, by the Nuisances RemovalActs, by the Acts dealing with overcrowded dwellings--ifthe Legislature could deal with contagious diseases whichattacked the population by the means which these Actsremoved, ib followed that Acts to prevent contagion whichextended to the unborn were more necessary than all others.Mr. Berkeley Hill read a report, dealing with the subjectin all its bearings, and gave statistics showing that there wasno room for doubt as to the beneficial effect of the Acts uponall the populations of the towns in lessening immorality anddisease. As Lord Charles Bruce remarked, however, thequestion is one of paramount importance to the welfare ofthe nation, but the great difficulty was that it could notbe brought before the- House of Commons. We are veryglad to see that Earl Russell readily gave the support ofhis name to the cause, and that the Rev. Dr. Barry, andother persons of influence, who were unable to attend the

I meeting, saw no reason for changing the opinions theyheld as to the necessity and good effected by these Acts.

It will be perceived, we think, that all those who are bestqualified to know the extent of the evil arising from a

do-nothing policy, and to arrive at a correct judgment inthe matter, were unanimous in approving of the objectsaimed at by recent legislation. Even of those who areopposed to the extension of the Acts at present in force, alarge number do not deny the necessity for our doingsomething; but not one of them has succeeding in devi.sing;a better, or anything like so good a scheme for dealing ’with the evil as that already in existence. They havesucceeded, however, in causing a temporary delay, whichwill only cause a development of the evil ; and the time -must come when the facts will have to be met and grappledwith by our Legislature. Mr. Fowler, M.P., intends shortlyto move for the abolition of these Acts at our militarystations; but he will, we understand, be opposed by Dr.Lyon Playfair, who will doubtless receive the support ofthe Government.

ST. ANDREWS MEDICAL GRADUATES’ASSOCIATION.

A MEETING of the Council of this Association was held on-

Friday, the 29th ult., to consider the provisions of the Go-vernment Medical Bill in so far as they affected the Uni-

.

versity of St. Andrews. After a prolonged discussion thefollowing resolution was unanimously adopted :-

" That this Council is in favour of the proposed estab-.lishment of an examining board in each division of theUnited Kingdom for the licence to practise medicine andsurgery; but it protests against the power given in clause20, by which degrees may be granted by a university with--out special examination."

Correspondence.

THE BOUGIE A BOULE AND THE BOUGIEOLIVAIRE.

"Audi alteram partem."

To the Editor of THE LANCET.SIR,-It is with surprise and regret that I find my friend.

Mr. Foster does not know a bougie from a catheter, nor ismy regret lessened when I think of the many advantages hehas enjoyed during his long and intimate connexion withSir Henry Thompson. The following are Mr. Foster’s wordsin your journal of last week :-" Further, although Mr.Teevan has asserted that no history of the bougie à boule,or of the bougie olivaire, has appeared in THE LANCET., thelatter was also described by Mr. Acton in your valuablejournal so long ago as January 12th, 1856."Now, if your readers will refer to your journal of that

date, they will find that the instrument there engraved and-,described is not a bougie, but a catheter!Mr. Foster states that "the instrument has long been na-f.

turalised in this country under the term *’ bulbous-endedbougie.’’ " The first part of this statement is directly con-tradicted by Sir H. Thompson, who, at page 33 of his "Clinical Lectures," published by Messrs. Churchill twoyears ago, says,= It is one of the most extraordinary in-stances of English conservatism that these instruments are found in so few hands." Will Mr. Foster kindly tell you,Sir, who was that English surgeon who rebaptised theolivary bougie by the barbarous and incorrect term " bul-bous-ended bougie :’ and when and where the christeningtook place ?Mr. Foster is annoyed that I made no reference to Sir H.

Thompson. In giving a history and description of the

bougie à boule, and bougie olivaire, it was perfectly unne-cessary to refer to that gentleman, inasmuch as he did notinvent those valuable instruments, nor did he modify eitherof them; nor was he the first to describe either; nor was hethe first to introduce either into hospital practice. Mr.