449

Hospital, in May, 1850. She stated that she had been firstseized with the symptoms under which she laboured when inan advanced stage of pregnancy six months before, and thatshe had never had rheumatism, inflammation of the chest, norany other disease to which her illness could be ascribed. Shesuffered from palpitation, great difficulty of breathing, and asevere pain in the epigastrium, extending thence to thespine, and down the left arm. A loud systolic murmur washeard over the upper part of the sternum, and this was i

succeeded by an imperfect second sound, terminated by adiastolic murmur, which was most distinct at the lower part ofthe sternum. While in the hospital she improved so as to beable to resume her usual avocations, and Dr. Peacock did notsee her again for some months. She then applied at thehospital as an out-patient, and stated she had been pretty welltill she had again become pregnant, and her breathing wasthen extremely difficult. She died about two months ago,three or four days after her confinement. The heart wasfound very large, and the left ventricle especially was muchhypertrophied and dilated. The aortic orifice was consider-ably diminished in capacity, the outlet measuring in circum-ference only twenty-two French lines, and at this point therewas a very considerable deposit of atheromatous material underthe lining membrane. The inlet of the orifice was relativelylarge, measuring thirty-one lines. The valves were diseased;the left and posterior valves being much thickened and theirsacs very shallow, while the right valve, together with thecorresponding series of Valsalva, had undergone considerabledilatation, and presented at its most dependent part an orificeby which a column of fluid freely regurgitated from the aortainto the left ventricle. The case afforded a good example ofone of the modes in which alterations in the relations as tocapacity of the inlet and outlet of the aortic orifice operateupon the valves so as to occasion their incompetency.

THE ROYAL COLLEGE OF SURGEONS OFENGLAND AND HOMŒOPATHY.

THE following letter, from Dr. J. C. Hall, of Sheffield,addressed to the Council of the College of Surgeons, has beenplaced in our hands for publication. We shall be curious tosee what answer the Council will give to it; it is quite im-possible that that body can longer remain silent. We are cer-tain Dr. Hall will have the thanks and best wishes of everyhonest member of the profession.To the Council of the Royal College of Surgeons of England.

. Sheffield, November 1st, 1851.

GENTLEMEN,-I very much regret that beyond a formalacknowledgment of the receipt of my last letter, dated Sep-tember 22ud, 1851, by Mr. Belfour, you have not thoughtproper to give me any reply to the questions then put to you-viz.:

lst. Does a Member of the Royal College of Surgeons of Eng-land by practising homœopathy render himself, in the judgment of.the Council, disgraceful to the College? and,

2ndly, If a Member by so ctcting be considered to have brought‘ disgrace upon the College," are you prepared at once to put intoforce the powers you possess for his removal?

I can assure you the continuance of this correspondence ismost painful, for I cannot but remember how proud I havebeen of the friendship so long extended to me by several ofthe members of the Council of our College; and I most deeplyfeel the course you are now taking with regard to the pro-fessors of the homoeopathic quackery who are members ofour College, is little calculated either to reflect credit uponthe Royal College of Surgeons, or to promote the cause ofhonesty and truth; nay more, fear that much of the quackeryat present existing, has, to some extent at least, arisen fromthe apathy you have displayed.

I have now under my care, in common with the other pro-fessors at the Sheffield Medical Institution, a number ofyoung gentlemen who hope to become Members of the RoyalCollege of Surgeons of England, and who are looking forwardto the time when, having passed their examination, they mayobtain the honour of your diploma. But how can we urgeupon them to walk honestly in their profession ? how can webid them do their duty in that state of life unto which it haspleased God to call them how can we beg of them to re-member that the day will come when they will be requiredto "maintain the dignity and welfare of the College," and totake a solemn oath, calling on God to help them so to do,when you are so indifferent, or at any rate apparently so in-different, to the conduct of your members as to permit cer-

tain of them to practise a quackery the most foolish andwicked, and that, too, in direct violation of the oath theyhave taken, without expulsion-even without admonishingthem that such conduct is improper, and cannot be permittedby you so long as they continue members of this College ?

I must again most respectfully request that an answer maybe given to the questions to which your attention has beendrawn. If you do not think it right to exclude from theCollege lists the followers of the homoeopathic quackery-,ifyou think it right, and are desirous that your own names shouldstill mingle on the same page with their names,-

" Pares cum paribus,-"well: but it will be for myself, and for the great body of themembers of the Royal College of Surgeons of England whofeel with me, whose assistance I ask, and whom I am verycertain will act with me also, to say whether this state ofthings can be permitted to continue.For my own part, however painful, I scruple not to say that

if the honour and dignity of the College cannot be maintained,.if the open enemies of science and of medicine are not ex-cluded, by the powers you possess, from the walls of the Col-lege, it will only remain for me to return into your hands thediploma of your College, and thus to do myself that justicewhich, up to this moment, you have thought proper to deny.With every good wish for the prosperity of our College,

I have the honour to be, gentlemen,Your obedient servant.

JOHN CHARLES HALL, M.D.,Fellow of the Royal College of Phy-

sicians, Edinburgh; Lecturer onAnatomy, Pathology and Physi-ology at the Sheffield Medical In-stitution.

P.S.-A copy of this letter will be sent to THE LANCET.

Correspondence.

COMPLICATED INJURY TO THE LEG.—QUESTIONOF PRACTICE.

"Audi alteram partem."

To the Editor of THE LANCET.

SIR,-Riding with another medical man past a quarry, in ø.very remote district, we were requested to see a labourer whohad just suffered a frightful mutilation by a fall of stones andearth from the quarry roof. There was a scalp wound ex-tending from the vertex to the top of the forehead; a piece ofthe pericranium, the size of a half-crown, was stripped off thebone; there were fractures of the tibia, with a bleeding open-ing at the shin; compound fracture, and dislocation inwards,of the knee-joint; and a laceration of the thigh above theouter condyle, exposing the torn edge and tendon of thebiceps. Through this laceration I put my forefinger into theknee-joint, and took away two pieces of bone, about the sizeof a broad-bean, cartilaginous on one side, rough on the other- pieces, so far as I could judge from the hurried glance Igave them in passing them into the hands of my medical com-panion, of the inner condyle of the femur. The joint, there-fore, was laid open, and the ligaments lacerated to a greatextent. There appeared to be other fragments of bone; butas the man was suffering great agony, and as I at once madeup my mind that the only course was to wait for, or rather tryto bring about, reaction, and then, if nothing forbade, to ampu-tate the thigh, I did not attempt to remove them from thejoint. Twenty-eight hours after the accident, reaction wasestablished, and I gave the friends my opinion that the timewas come to try to save the man’s life by amputation. Ilearnt, however, that a bone-setter of great local reputationhad been sent for; and knowing the strong prejudices of thevery worthy but very primitive peasantry in his favour, Ithought it in vain to be displeased, or to remonstrate in anyharsh tone, and therefore merely warned them that they were,in my opinion, running a much greater risk, in attempting tosave the limb, than would be incurred by removing it.Meeting the bone-setter, (who had the coolness to ask me

whether I meant to attend with him,) I thought it my dutyto inform him also of the serious nature of the accident, andwarned him that he was incurring a very serious responsi-bility in undertaking a case like this, by the consequences ofwhich he must abide. However, he went forward, and, atwhat agony to the patient may be supposed, adjusted thelimb. The operation could not have been more severe thansuch a " setting:’