337

MEDICAL DIARY OF THE WEEK.

MONDAY, APRIL 2 ......

TUESDAY, APRIL 3......

(ROYAL FREE HOSPITAL.-Operations, 2 P.M.METROPOLITAN FREE HOSPITAL. - Operations,

2 P.M.LONDON INSTITUTION. - 7 P.M. Dr. F. W. Pavy,On Experimental Physiology: Respiration."EPIDEYIOLOGICAL SOCIETY.-8 P.M. " Cholera atthe Cape de Verd." -" Cholera at Guildford in

I 1854." By Mr. H. S. Taylor.-" Cholera at Wick,Caithness." By Dr. Littlejohn and Dr. Banks.

ODONTOLOGICAL SOCIETY OF LONDON.—8 P.M.

MEDICAL SOCIETY OF LONDON. - 8½ P.M. Dr.Routh,

" On some of the Disadvantages of Em-L ploying Fallen Women as Wet-Nurses.’(Guy’s HOSPITAL.-Operations, 1 ½ p.M. WESTMINSTER HOSPITAL. - The following Opera- I

J tions will be performed at 2 P.M. :-By Mr. Holt:

I Amputation at the Thigh; for Two Cases ofStricture of the Urethra.

PATHOLOGICAL SOCIETY OF LONDON.-8 P.M.

IWEDNESDAY, APRIL 4 i

THURSDAY, APRIL 5...

FRIDAY, APRIL 6.........

SATURDAY, APRIL 7 ...

(MIDDLESET HOSPITAL.-Operations, 1 P.M.ST. MARy’S HOSPITAL.-Operations. 1 P.M.UNIVERSITY COLLEGE HOSPITAL. - Operations,l 2 P.M.ROYAL OITTHOPAKDIC HOSPITAL. - Operations, 2

P.M. LONDON INSTITUTION. - 7 P.M. Dr. T. Spencer) Cobbold, "On the Structure and Habits of the

Mammalia."OBSTETRICAL SOCIETY OF LONDON. - 8 P.M. Dr.L Bouth, " On the Treatment of Menorrhagia."(ST. GEORGE’s HOSPITAL.-Operations, 1 P.M.! CENTRAL LONDON OPHTHALMIC HOSPITAL.

!’ Operations, 1 P.M.LONDON HOSPITAL.-Operations, 1% P.M.GREAT NOBTBEBN HOSPITAL, KING’S CROSS.-

Operations, 2½ P.M.

HARVEIAN SOCIETY. - 8 P.M. Clinical Cases, byDrs. Hamilton Roe, Pollock, Sibson, Handfield

l Jones, Stewart, and Mr. Weeden Cooke.

WESTMINSTER OPHTHALMIC HOSPITAL. - Opera-’

(. tions, 1 ½ P.M.

(ST. TnoMAS’s HOSPITAL.-Operations, 1 P.M.ST. BARTHOLOMEW’S HOSPITAL.-Operations. 1½

, { P.M.

KING’S COLLEGE HOSPITAL.-Operations, 1 ½ P.M.CHARING-CROSS HOSPITAL.-Operations, 2 P.M.

NOTICES TO CORRESPONDENTS.

To Correspondents.THE POOR-LAW MEDICAL RELIEF BILL.

ON the 28th March, the Poor-law lIedical Relief Bill was brought in by Mr.Pigott, and ordered to be printed. The second reading is fixed for the 16thApril. The Easter vacation ousrht to be sedulously turned to account inforwarding petitions in support of the honourable members whose namesare attached to the Bill. The Bill could not be in better hands. But the

Poor-law medical officers must not for one moment forget that the attentionthe measure will receive in the House will be very much determined by theamount of interest they themselves evince.

TEE communication of Dr. Madden arrived too late for insertion.

Inquirer.-Our correspondent seeks information upon the methods of dealingwith church-vaults, and draws a shocking picture of the state of the churchin his parish. "The church," he says, "is very old, and so often has thefloor in every pait been disturbed for burial purposes that no two seats areupon the same level, and the aisles are foot-falls for the unwary ! Nay, youcan all but see into some of the graves." The idea of proceeding to warm sucha church, without first taking effective measures to secure the congregationagainst the danger of emanations from the dead, is as absurd as it is revolt-ing. It is not, however, possible for us, in the absence of accurate knowledgeof the details, to indicate the exact remedies that are called for.

OBTURATOR FOR THE CYLINDRICAL Sr7CULUM UTERI.To tlle Fditor of THE LANCET.

SIR,-Some time ago, having had occasion to apply leeches to the os uteriby means of the glass cylinder, I found unusual difficulty in its introduction,from sensitiveness of the ostium vaginæ, which led me to consider whether aguide of simple construction could not be made for the introduction of thetube. A little reflection on the way a canula is introduced into a cavity bythe stilet convinced me that an obturator or guide for the speculum, consisting*of either three or five pieces, might easily be made, somewhat in the manner ofa boot-tree.For ordinary purposes, a speculum, five inches in length, and an inch and a

quarter in diameter, answers well. The glass being about the eighth or three-sixteenths of an inch in thickness, an interior space an inch across is left tobe filled up with the obturator, which may be in five pieces, the centre squareone being seven inches in length, so as to project an inch at top and bottom.A thickness of three-quarters of an inch will, on trial, be found to suit best forthis. Two lateral pieces, as well as an anterior and posterior one, are to beadded, rounded on the outside to fit the speculum, each an eighth of an inchthick, and with an additional thickness of an eighth of an inch at the top, tocorrespond to the rim or edge of the speculum. The pieces of which the ob-turator consists, when joined and rounded off at the top, look not unlike themale organ without urethra. The square central piece and the lateral onesare to be pierced half an inch from the bottom for a pin, which serves to con-nect the whole, serving to retain the central one in connexion with the otherswhen the speculum has to be used. The anterior and posterior portions shouldbe half an inch shorter than the others. When the speculum is used, the ob-turator is easily withdrawn by taking out the pin, when the central piece fallsout, and all the rest follow. The material used should be of some hard wood,as ebony; but if an obturator is made for experiment, soft wood will suit best,being more easily carved.The use of the guide I have suggested will allow the introduction of any

ordinary cylindrical speculum, without pain to the patient, or much trouble tothe surgeon, and a little practice makes its use quite easy. A wider one mayalso be employed than could be otherwise. Three pieces, instead of five, maybe used for the sake of simplicity ; but they do not tit to the rim of the specu-lum so exactlv.With regard to the specula, simple trumpet-mouthed tubes of glass seem to

do better for examining the os uteri, or for making scarifications or usingleeches, than expensive and complicated metallic instruments. It seems to b&convenient also to have a notch at the posterior part of the outer rim, to cor-respond to the posterior surface of the cervix uteri. Tubes such as are re-quired can be got of any form from a glass manufacturer for about six shillingsa dozen. If silvered ones are preferred, they can be coated and varnished blackby a lookiug-glass maker at a small extra cost.

I have communicated my invention to several of my medical acquaintances,and they think it likely to be useful. Yours truly,

Glasgow, March, 1860. D. m.

zi. Laigh.- We have received a letter relating’ to the case of Alfred Godfrey,alleging that the provision made for him by his family as to raiment andnourishment is inadequate. This is a matter into which we cannot enter.It may be that the means of Alfred Godfrey’s family do not admit of a moreliberal allowance.

E. F. B.-We cannot recommend any of the medicines named. Our corre

spondent shall receive a private note if he will forward us his address.

EXAMINATIONS AT THE COLLEGE OF SURGEONS.To the Editor of THE LANCET.

SIR,-I find that some of those students who intended to present themselvesfor the first examination at the Royal College of Surgeons on the 3rd of April,cannot do so till the 21th of that month, on account of the very large numberwishing to be examined. Cannot an examination be held between the 3rd and24th ? Surely the Examiners could make it convenient to hold one then, andconfer a very great favour on their students. If such an examination be notheld, many of the unfortunate gentlemen who intended to pass at the com-meucement of April, and then have a month’s holiday, will he greatly disap-pointed. It is reported also that some may have to wait till the 4th of May.

I remain, Sir, your obedient servant,A STUDENT WHO WAXTS A FORTNIGHT’S HOLIDAY

March, 1360. BETWEEN WINTER AND SUMMER SESSIONS.

A Graducate of the University of London.-It is reported that lllr. Grote, theillustrious historian, a member of the Senate, may be induced to stand forthe University.

An Assistant.-l, He cannot be registered under the new Medical Act.-2. Fullinformation will be found in the Students’ Number of TxY LANCET.

IF lIIedic!ls has commenced his professionad stndies, lie is exempt. He shouldwrite to the Secretary for the regulations, which are very clear on the sub- -

ject.THE MEDICAL REGISTER.

To the Editor of TaE LANCET.SIR,-It was announced that the Medical Register for 1&60 would contain

only the names registered up to the 1st January, 1860. As the printing of thevolume will take a considerable time, it is to be hoped that a Supplement atthe end of the book will give the names entered between the Ist of Januaryand a few days previously to the day of publication. This will accommodatethose late bir is, the members of the "Dilatory Society," as well as those whoobtained diplomas in January and February. Yours, &c.,March. 1860. MEDICAL REGISTER.

338

Mr. T. Occleston, (Blackburn.) - The article forwarded, called by a mis.nomer coffae, is certainly admixed to a large extent with chicory. The

Excise regulations require that when coffee and chicory are sold in themixed state, they should be labelled as a mixture, and any parties selling themixture without such label are liable to prosecution and fine by the Exciseauthorities, who in the present case would be the proper parties to whom toapply.

THE NEw PHARMACOPŒIATo the Editor of THE LANCET.

SIR,—As there is about to be published a single Pharmacopoeia for the wholeof Great Britain and Ireland, it seems a fitting opportunity to offer one or twosuggestions respecting it before it is finally promulgated by the MedicalCouncil.What I would wish to call attention to is, that there should be a greater

uniformity throughout those preparations for which distinct rules are laiddown in the Pharmacopeeia. The uniformity I would propose is that regulatedby the dose. Such an arrangement would simplify the process of prescribingto a very great extent, and, from its dispensing with a great effort of memoryon the part of the prescriber, would tend greatly to prevent mistakes.Thus the dilute acids might be so diluted that the medium dose for an adult

should be the same in all. The aquae are already prepared in this manner; andwhy should this arrangement not be extended to all the other preparationswhich admit of it?The confections, decoctions, infusions, liquors, mixtures, spirits, tinctures,

and wines, might surely be all prepared so that there should be one uniformmedium dose for each preparation. Many of them are already partly so pre-pared ; but being only partial, this in itself is a source of perplexity, and re-quires a considerable effort of memory to retain the dose, proper for each, inthe mind. If, however, there were one medium dose for each preparation, thisconfusion would be entirely removed. How much easier and simpler it wouldbe, for instance, if all the tinctures were so prepared that the medium dose ofeach should be the same; and this is equally true of the others. There wouldstill be plenty left to exercise the memory, in remembering the doses of thesimples, extracts, &c., which cannot be brought under any such rules.

Simplicity and clearness are of such great importance in everything, that Ihope a proposal like the present, tending so materially to relieve the memoryof the working practitioner, who has already so much to keep constantly inhis mind, may meet with favour in the eyes of your readers, and those espe-cially who have the arrangement of the new Pharmacopoeia in their hands.

Berne, March, 1860. I remain, Sir, yours faithfully,

G. C. R.Berne, March, 1880. G. C. R.

Mr. F. B. Ryott.-The object may be accomplished by free ventilation, thedoors and windows being kept open as far as practicable day and night;the abundant and continuous use of chloride of lime or hypochlorite ofsoda; while all articles of clothing, bedding, curtains, &c., should be sub-

jected to a temperature of about 250 degrees, which will not injure thefabrics in the least.

A District Medical Officer.-Yes, if the contract can be satisfactorily proved.CHLOROFORM IN PROTRACTED LABOUR.

To the Editor o/Tnz LANCET.SIR,-There can be no doubt that in publishing his case of " Chloroform in

Protracted Labour," (THE LANCET, ante, p. 192,) Mr. Ross, like his brotherpractitioners in general, had only the benefit of the profession in view. Hewill then, I am confident, be rather pleased than otherwise at my proffering anobservation or two on the subject.In the first place, I would suggest that the ergot would have been a most

appropriate remedy under the circumstances, and I should be glad to learn theIesult of his trial of it on a future occasion. The presentation was natural, asappeared upon examination; the membranes protruding, and the parts welllubricated, the only apparent cause of delay being the rigidity of the os uteri.Under such conditions, it appears to me the ergot would have proved mostbeneficial.And secondly, I may here be permitted to remark that, from long and exten-

sive experience, I am decidedly of opinion that if accoucheurs would but "bidetheir time," many of the difficulties they otherwise encounter would be avoided,and much suffering prevented; for nature, simply aided, not forced, will ofherself accomplish results perfectly astonishing to less experienced practi-tioners. It is a rule I have long adopted, and the exceedingly few instanceswherein I have had to resort to the forceps or other manual assistance demon-strate the soundness of the practice.

Your obedient servant,Pembroke Dock, March, 1860. W. TiEromAs, L.R.C.P. Edin.

Mr. F. T. White.-l. Some appointments have been made.-2. The Presidentof the Council.

College of Dentists.-The Secretaries of this College write as follows" There is no desire on the part of the Council to deny that it is intended

by the College to institute an examination test for membership, and that theform of certificate you printed would have been correct if the words surgicaland mechanical dentistry’ had been substituted for the words dental-sur-geon.’

"

Enquirer.-He can practise both medicine and surgery in England, but not asan apothecary. The Apothecaries Act was not repealed by the Medical Act.

B A N D A G I N G AFTBB D E L I V E R Y.To the Editor of THE LANCET.

SIR,-Has the absurdity of putting a bandage round the abdomen of a woman. after parturition ever struck any of your readers ? I say absurdity, because,although I have been in the habit of folding two or three books, each nearly aninch tliiek, and placing them under the bandage, I have still been quite sure

that in less than half an hour the bandage has slipped up round the waist ofthe patient.My object in writing to you is that perhaps a plan, which has lately sug-

gested itself to me, may be thought worthy of adoption by some not alreadyacquainted with it, as I fancy it is really useful, especially after flooding. Theplan consists in simply applying a three-tailed bandage, made of a bolstercloth, and a napkin sewed to the middle, and passed between the thighs, to bepinned (over the books before alluded to) in front.

March, 1860. I am, Sir, your obedient servant,

HOLMBOOK.March, 1860. Hotatsoos.

X. Y.-It is desirable that surgeons in the Indian army should register. Thefee is C2 for the registration of diplomas obtained before January, 1959;JE5 for those obtained afterwards.

H. B., (Belgravia.)-He can assume the title of licentiate in medicine, orapothecary.

PROPESSIONAL TITLES.To the Editor of THE LANCET.

SIR, Permit me, in reference to your article on "Medical Degrees andMedical Titles," to suggest a mode of rendering justice to the M.B.s and non.graduate physicians with respect to the use of the title "doctor," which willneither require any alteration of the Medical Act, nor lessen the number of exa.minations for the degree of M.D. It is that the long-established custom ofaodressing physicians (not being M.D.s) by the title of "doctor," founded ontheir privilege "of teaching (docerdi) medicine," should be sanctioned andconfirmed by Royal Charter. This could now be easily done, as new Chartersare about to be granted to all the Royal Colleges of Physicians.This privilege would constitute no injustice to the M.D., as it is the mere

title of "doctor," and not the degree of M.D., which would be conferred;neither would it be likely to confound the M.R.C.P. or M.B. with the M.D., asthe qualification by virtue of which the title of " doctor" was used could alwaysbe affixed to the name. Thus-

Dr. C. Metcalf Babington, F.R.C.P.Dr. Lionel Beale, M.B.Dr. Thomas Mayo, M.D.

would be distinguished much in the same way as Knights are distinguishedfrom Baronets, or as Knights of the various orders of Knighthood are fromeach other. I remain, Sir, your obedient servant,

Bristol, March, 1860. JAS. GAGE Peasoxs, L.R.C.P. Ed., F.R.C.S.

Rex.-We believe that the deficiencies will be remedied in the present sessionof Parliament.

Minie Bijleman.-He is fully qualified for the appointment.

QUERY.To the Editor of Taa LANCET.

SIR,-Will you or some of your readers kindly inform me what is the bestmode of treatment in the following case ? I have tried every drug possible,but without success:-Three years ago the patient, aged thirty-seven, complained of intense thirst,

(she was enceinte at the time, but got worse on being confined ;) in fact, she wasin the habit of drinking three or four quarts of water at a time. Has pains inthe loins; complains of great coldness in the extremities; says she is alwayscold. No emaciation; appears to grow fatter; excessive pain and bleeding attimes of the gums ; appetite bad. The catamenia entirely disappeared beforethese symptoms, and have never returned. Aspect of patient is not un-healthy ; tolerably stout; tongue clean; skin dry; specific gravity of urine1004, which is of a faintly yellowish hue. Is this diabetes insipidus ? ?

Yours obediently,March, 1860. LEo.

.A Northumbrian Assistant and Subscriber.-1. He is not subject to a penalty,unless he assume a medical title.-2. Sign for the employer.-3. It is

printed in the Medical Register, or can be obtained by order of a bookseller.

SCARLATINA.To the Editor of Tas LANCET.

SIR,-Will any of your experienced readers inform me whether they haveever seen a case of " scarlatina sine exanthemate" followed by desquamation ofthe cuticle ? Yours, &c.,London, March, 1860. I&NOBAMus.

tl? M., (Mamhilad.)—We are not in a position to furnish the address of thepractitioner required by our correspondent.

C. R. C. F. shall receive a private note.

DISEASED SHEEP.To the Editor of THE LANCET.

SIR,-At this season of the year many sheep are attacked with diarrhaea orsome intestinal disease, which rapidly proves fatal. When the disorder is dis-covered early, some sort of medicine is given by the shepherd; and if theanimal gets worse, it is slaughtered, conveyed clandestinely to the butcher, andsold by him as good and wholesome food. Other sheep during the process offattening are seized with giddiness, slaughtered, and disposed of in the samesort of manner.

I wish to be informed whether such meat is wholesome or not, my opinion,having been solicited, being unsatisfactory both to the owners of the sheep andthe butchers. Yours truly,March, 1860. AN INQUIRES.

ERRATUM.-IN our last number, p. 309, Messrs. David Goyder, Lancashire, and’ Erskine Burnett Grant, Aberdeenshire, were erroneously stated to have been

admitted licentiates of the Royal College of Physicians, Edinburgh. Theparagraph should have been headed The Royal College of Surgeons, Edin-burgh."

COMMUNICATIONS, LETTERS, &c., have been received from-Dr. Balfour, Edin-burgh ; Mr. Bigg; Messrs. Kingbury and Whitmore; Mr. J. Bates; Dr. R.Sisson; Dr. J. R. Wolfe, Paris; Mr. Henry Goode; Mr. R. Griffin; Mr. R.Haynes; Mr. F. J. Bailey; Mr. J. Mackenzie, Bilbao; Mr. J. Robertson;Mr. W. Thomas; Mr. Caldwell; Dr. W. Baker; Mr. F. D. Fletcher, Liver-pool, (with enclosure;) Mr. B. Rogers, Thornley; Rev. J. Williams, Wells,(with enclosure;) Mr. R. Hodges, Rochford; Mr. P. D. Muir, Openshaw,(with enclosure;) Mr. Sharp, Bradford, (with enclosure;) Mr. T. F. Hale,Chesterfield; Dr. E. M. Sinclair, H.M. 97th Regiment, Bundelkund; Mr. S.Staniland, Bristol; Dr. Bradshaw, India; Mr. H. Hugman, Ottery, (withenclosure;) Mr. E. Lloyd, Norwich ; Mr. J. Shapland, South Molton; Mr.F. Homfray, Bridgnorth, (with enclosure;) Dr. Corry, Belfast, (with enclo-sure ;) Mr. H. Lineker, Nottingham; Mr. W. Fenerry, Bristol; Mr. Jas.Witchell, Lower Tooting, (with enclosure;) M.R.C.S. ; A Constant Reader ofTHE LANCET; V. C.; T. S.; Junius; X.; Equality; T. B.; &c. &c.