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pretensions. I would tell them, that whilst Ithey continue such practices, they have as IIperverted an idea of respectability asFalstaff had of honour. A man with those i

proper principles of pride, which a culti-vated understanding gives him, recoilsfrom such unbecoming proceedings."

. I remain, Sir, yours truly,ANTI-HUMBUG.

REFUSAL TO ALLOW MR. EDWARDS TO

LECTURE.

To the Editor of THE LANCET.SIR,-In to-day’s Number of your Jour-

nal I perceive by the letter of Diego Car-los," that the conduct of the physicians ofthe Westminster Hospital in requestingMr. Edwards to discontinue his clinical re-marks on the cases under their care, is im-

peached as illiberal." Diego Carlos" is evidently unacquainted

with the whole truth, or disposed to supplyonly so much of it as shall form the ground-work of a charge,-permit me, therefore, as I

being in possession of all the facts of thecase, to lay them shortly before you.

Previous to the delivery of those lectures,Mr. Edwards signified to the Physicianshis intention to commence a course of clini-cal instruction on the 15th, and as no nega-tive was given he proceeded accordingly.Three or four of those excellent lectures hadbeen delivered, when the three Physicianswho chanced to be together at the hospitalon other business. spole to Mr. Edwardson the subject of his lecturing, and appealedto him whether he considered it proper thatin the absence of any physician’s pupil, theirpatients should be selected for illustrationto surgeons’ pupils and strangers. For in-stance, it was said,-The surgeons derivethe benefit of the fees for surgical attend-ance, and we do not see why we shouldgive surgical and other pupils the opportu-nity of entering to the medical practice of

any other hospital or dispensary to the pro-fit of others, and come here to derive alltheir medical advantages. They also re-

minded him, that Dr. Roe had already de-livered clinical lectures, and that it was hisintention, as he felt it was his duty, toil:ustrate the physicians’ cases on an tieces-sion of pupils, and thus they should alsofeel obliged to Mr. Edwards for his valuableassistance. Mr. Edwards assented to this,and immediately affixed the notice you havepublished in the surgery. Onreconsideratiora few hours after, he thought the sentence" not approving of the gratuitous commu.nication of information" liable to miscon.struction, and it was withdrawn.

Thus, Sir, I think I have shown that theinsinuation of illiberality in this case isnot just, inasmuch as the physicians havebeen, and always are, ready to communicateclinical instruction without fee to physi-cians’ pupils. Their disinclination to labourand let others bear away the profit, is cer-tainly but reasonable.

I may further state, that the physiciansare at all times happy to see and expatiate-on cases to occasional visitors, and theywould not object to the proceeding in ques-tion, but that regular attendance is Ì1nplic,l.Upon the justice of paying at all tor me.

dical practice, you, I believe, entertain

strong opinions, and most persons differ insome degree from their neighbours on thissubject; but as that is a question whichstands by itself, I trust you will argue itupon its own merits, and not be induced bya misunderstanding to involve the physiciansof this hospital in a question w;th which,individually, they have nothing to do.

I remain your obedient servant,GEO. F. KNOX.

;‘ 14, George Street, Adelphi.It December 3, 1831.

WESTMINSTER MEDICAL SOCIETY

Saturday, December 17th, 1831.

Mr. CHINNOCK, President.

THE CHOLERA.

THE preliminary business being dismiss-ed, this subject was again introduced.

The CHAIRMAN begged permiss.on to

read to the Society a paper which bad beendrawn up partly at his (Mr. C.’s) request,by Dr. Wilson Philip. (Disapprobationwas here expressed at what was considereda bad precedent, namely, the submitting ofa paper not written by a member: but thereading was ultimately permitted.)Mr. CniNNOCK accordingly proceeded:

we shall not, however, attempt to follow theobservations of Dr. Philip, now read. Thevafforded, we believe, no new point, nor didthey place old ones in a new light, but

. reviewed in a clear manner the facts con-nected with the physiology and patholosvof cholera. In introducing the subject, thewriter thought it proper to premise, that mwhat followed he was not speaking from, personal experience of the disease : he wasonly giving his opinions, formed from theiaccounts ot others, and assisted bv twentyyears’ study of the phenomena of animallife. For an enlarged view of the phvsio-. logical data upon which he should start, hè

referred to his own works and to his papers

445

in the Philosophical Transactions. He ob-served that all the more perfect animals I

possessed three sets of functionary powers : Ithe nervous, muscular, and sensorial, eachso dependent on the rest, that upon one ceas-ing the others could not long survive.Well, then, an inquiry should be instituted,which of them was primarily affected incholeric attacks The answer was, the ner-vous. To this might easily, then, be tracedthe imperfection of the voluntary motions,the loss of caloric, and the injury arid in-action of the assimilating processes. Re-ferring to the particulars of the consequencesof so powerful an attack upon the nervoussystem, it would be found that they nolonger influenced, with this due proportion,the energies of the muscular structures;consequently the heart ceased to impel, withaccustomed vigour, the vital fluid throughthe arteries. Thus the primary effectsbecame the secondary cause. The blood,slowly sent on, no longer received itsproper supply of oxygen in the air-cells ofthe lungs ; dark venous blood was carriedthrough the arterial vessels; and as a ne-cessary consequence, the want of oxygena-tion caused a deficiency of caloric, and thetemperature of the whole body would fall.The blood in this state returned to theheart, and the same cause being still ir

operation, the results became worse anc

worse; the expirations were cold, and th(minlltp superficial vessels being tlasartad by

arterialized blood, the surface of the bodyassumed a purple hue. Such was the effectof some hidden cause upon the nerves, andsuch the result on the muscular svstem,whilst the sensorial was the last affected,and we consequently found that the mentalpowers were not lost. With regard to thetreatment to be considered rational underthis view of the operation of the disease,Dr. Philip referred to Dr. Barry’s relationof the effect of the actual cautery ; and ofthe post-mortem appearances, the phlo-gosed condition, and even ramollissement,of the spinal marrow. As the spine, there-fore, appeared to undergo inflammation, Dr.Philip thought well of powerful irritationbeing excited along its course, as, from the

spine, it should be borne in mind, arosethe nerves supplying the vital organs. Gal-vanism as a remedial agent also found favourin Dr. Philip’s estimation, from its well-known influence on the nervous energiesafterdeath. But there were some drawbackswhich threw a great doubt on the proprietyof trying its efficacy and the probability offinding success. In this analysis we havenot, perhaps, done justice to Dr. Philip’spaper, but have stated enough of his viewsto give a clue to the references made to ilin the ensuing discussion.Mr. SEARLE thought galvanism useless.l’ o. 434.

Mr. Wmsi.ow rose to submit a paper oncholera, but the reading of two papers dur-ing one debate was decided to be contraryto the rules of the Society.

Dr. SIGMOND, condemning Dr. Philip’spaper as unworthy the reputation of thatgentleman, reverted to his own opinions re-lative to the action of the choleric poison onthe brain, conveyed through the medium ofthe olfactory nerves. Some one in answerhad remarked that then there would be foundappearances of inflammation of the brain, buthe thought that the progress of the attack was,in most instances, too rapid to allow this.Inhydtophobia, and death from dissection-wounds, there were no traces of the effectsof the morbific agents. As to the mode ofconveyance, he would instance intoxication

produced by holding the head over certainfumes merely. He would have gaseous in-halation tried in cholera.

Dr. GILCHRIST remarked, with respectto Aretseus, that that author had describedall the prominent characters of this disease.The use of the actual cautery, which hadbeen recommended, was not a newly-pro-posed remedy, being well known in India.

Mr. CHEVALIER designated this diseaseas one of suppression. The deleterious ele-ments, which ought to be found in the bile,went into the system-the carbon was notto be found in the breath, but remained in.the blood; the urinary bladder was in astate of emptiness. Let them observe the

consequences of the suppression of themenses, of sweat, of the urine, and say if itwas not reasonable to attribute all the badsymptoms of cholera to the suppression of £the secretion of bile in the liver, and car-bon in the lungs. Experience showed thewant of bile to be a sufficient cause for the

7suppression of every other important secre-, tion. The strict difference, however, be-i tween the terms " retention" and " sup-f pression " should be borne in mind. Heknew of a case of suppression of urine, which had continued four days, when it- was relieved by rubbing a composition of. extract of belladonna one-third, and myrrh11 two-thirds, over the pit of the stomacla.e This excellent anti-spasmodic had not been.e brought into notice in considering the treat-ment of the cholera.Dr. STEWART wished to 1-now why bark,the remedy which had so long been con-sidered a specific in pestilential fevers, hadbeen so little noticed in discussing the cho-lera ?

Dr. LicKE did not agree with Dr. Wil-son Philip, that the lungs were diseased incholera. In all the cases he had seen inIndia, collapse of the lungs was the most re-markable of the post-mortem appearances.They were just as if belonging to an infantwho had never breathed. In answer to the

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opinion respecting the bile, advanced byMr. Chevalier, he observed that childrenwould often appear in excellent health,with a clear complexion, and yet evacuatewhite motions. If bile therefore was se-creted, it would certainly appear either inthe motions, or display itself in a jaundicedhue.A GENTLEMAN asked why so little stress

was laid on the use of. the actual cautery,which had been followed at Cronstadt bythe cure of twelve out of fourteen cases ofcholera.Mr. WALKER thought this instance no

proof positive of the efficacy of the remedy. IIf the comparative mortality were a test oftreatment, the remedies used at Sunderlandshould be looked to, where only 149 deathshad occurred in 500 cases.

- Mr. KING took up Mr. Chevalier’s pro-position respecting suppression. The bile,he would observe, might be secreted of a.different colour, instead of being brown oryellow, and if so there must have occurredsome alteration in the blood to cause this

change. That alteration m the blood wasascribed, by physiological reasoners, to theinfluence of a morbific poison, producing ap-pearances resembling nothing so much asthose witnessed in pestilential fever. Theprogress of the disease in Sunderland tendedstrongly to corroborate the position takenby Dr. Johnson from the first. It had beenmost prevalent amongst the lower ordersthere, who were existing in an almost in-conceivable state of filth and wretchedness.M. Majendie had told him that the houseswere, many of them, built over the river,and at low water there was left a completebed of the filthiest mud, sending up sucha powerful exhalation that he, although astrong man, was convinced he could notlong remain exposed to them with impu-nity. There were, too, in most of thesepoor habitations, no privies, and the refuse,therefore, was sometimes discharged uponthe tops of the houses, as they were onebelow another. Having recurred to the

employment of bli..ters over the abdomen,Mr. COSTELLO suggested an improve-

ment on the usual cataplasms. lt was byusing the gl’ey, instead of the yellow, mus-tard, the former of which was found muchthe better. The linseed flour should bemixed in the accustomed manner, and whenmoistened with vapour the grey mustardshould be placed upon it. There was one

remedy, the cajeput oil, which had been somuch extolled that it was said the druggistshad " made a fine thing of it," and he wassurprised that he had heard no mention ofit during the lengthened discussions.

Mr. SEARLE said, that cajeput had beentoo highly extolled. Sinapisms were of

comparatively little service in the cholera.

It was wrong to attach so much importanceto spasms, which really, if important in anyrespect, were only so as indicative of afavourable result. As to bark, it was foundvaluable after the secretions had been re-stored.Mr. BULLEN (late " Surgeon-Major to

the Polish Generalissimo") wished to makea few remarks on the cajeput. He had seenit used with great success at Berlin, andhad also observed its good effects iu casesunder his own care. He was sorry to findso prevalent a desire for specifics, for thosephysicians who had watched their patientswith the greatest care, and prescribed forthe different stages and symptoms, werethe most successful; and amongst the namesof the successful practitioners, he wouldmention those of Messrs. May and Bu.chanan. He bad himself, when assistant-surgeon in the cholera hospital at Warsaw,always followed the maxim of prescribingfor circumstances.The discussion here closed, and the Pre-

sident announced that the sittings of theSociety were adjourned till the 7th of

January.

LONDON MEDICAL SOCIETY.

December 19, 1831.Dr. STEWART, President, in the Chair.

THE CHOLERA.

Tms subject having lost none of its zestwith the members of the medical societies,still occupies the whole of their attentionwhen in conclave assembled. Indeed, thegreater its terrors to the public out of doors,the more numerous are its charms to the

professional coteries within, and a realIndian-cholera female patient in London

just now, might have scores of Æsculapiansat her feet in an hour, wooing her with tentimes the ardour of the Dvke of Gloster to-wards the Lady Anree, even though she heldthe " sharp-pointed sword of contagionready to

" -- hide it in those true breasts,And let the souls forth that adored her."

The discussion last Monday night was onthe cholera, and this evening it was againdebated. After the minutes had been read,Mr. DENDY begged for further informationon the subject fromMr. SEARLE, who thereupon read a paper

on the pathology and treatment of the dis-ease, founded on the experience he had

acquired in India and Poland ; but as so

much had already been said on the former,some impatience was manifested at those

parts which did not bear immediately onthe treatment. Mr.Searle enforced, chiefly,