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MEDICAL ANNOTATIONS.

ravages of the disease is obviously very great in this country.A considerable mass of facts are, however, attainable; and

looking to the absence of any important labours on this sub-

ject in our literature, we think to render a seasonable serviceto the profession in undertaking this Report.

It will greatly increase the value of these labours if the

many hundred gentlemen who have had greater or less oppor-tunities of treating individual cases, or observing epidemics,would at once forward a summary of their observations to the

office of THE LANCET. The services thus rendered would be

of public value, and would be amply acknowledged.-

THE Gazette announces the appointment of Dr. THOMASWATSON as Physician Extraordinary to Her Majesty, in

the place of the lamented Dr. RICHARD BRIGHT, deceased.Dr. WATSON, who has recently been returned by the RoyalCollege of Physicians of London as their representative on theGeneral Medical Council, is well known to the Profession

for his high character and distinguished attainments, and asthe author of the celebrated "Lectures on the Principles andPractice of Physic;" and we feel certain that this recognitionby the State of the CICERO of Medicine will meet with theunanimous concurrence and approbation of the profession.

Medical Annotations." Ne quid nimis. "

A SANITARY CONTRAST.

THEORIES are of little value unless amply supported by facts.In this period of sanitary activity, when medical practitionersare constantly employed in arguments destined to developwhat is justly called " preventive medicine," it is important tobe able to refer to numerous and striking illustrations of sani-tary progress. Mr. Woodman, the clerk to the MorpethBoard of Health, has addressed the Board in a parting letterof advice, in which he draws the most instructive comparisonbetween the results of sanitary reform at Morpeth, and thestagnation in the neighbouring district of Bedlington.He says that in Morpeth the means of promoting the public

health have been attained, but much still remains to be donein order to give full popular value to those main-sewers andwater-supplies which are but means to an end. Cholera has

happily been averted; and in 1856 and 1857 there were butthree deaths from fever, two of these being remittent fever inchildren under five years. What would the people of New-castle and many other towns not give could they say the same?But in Bedlington, all those causes which produce disease

not only exist, but no adequate effort is made to remove them.It has been shown by the reports of the Registrar-General thatthe average of deaths in England and Wales is 22 in 1000, andthat in ordinarily healthy parts of the kingdom it varies from15 to 27. At Bedlington the death-rate is steadily increasingevery year. In 1856, it stood at 2313; in 1858, it stood at35’43. The poison from cesspools is increasing, and the scarcityof water is more and more felt: the necessary effects have notfailed to follow. The position of Bedlington, on elevatedground, with a rapid stream of water flowing past one end,offers great facility for the requisite sanitary works. The in-habitants have received due warning from medical authoritiesof the danger which they wilfully incur ; and the waste of lifewhich is thus occasioned has been clearly enough illustrated.Dr. Gavin and Mr. Rawlinson have both uttered propheticexpressions of fear. Cholera has twice visited the town, on

each occasion first appearing at the same house. Yet, says Mr.Woodman, " this remarkable instance of cause and effect hasproduced neither conviction nor action, and the wretchedhouse is now as well prepared again to receive its deadly guestas in 1849.

THE VALUE OF AN EYE.IT is hard to estimate the fitting indemnity for pain, the

money value of comeliness, and the compensation for deformity.It is not surprising, therefore, that civil juries find it difficultto assess the pecuniary damages which should be awarded forthe loss of an eye. It is worth nearly the value which eachman puts upon it. The loss of an eye is a less misfortune to an

ugly man than to a handsome man; it is of less injury to anelderly Benedict than to an aspiring Leander. If corporal painbe an element in the verdict, then it must be admitted thatthe claim in this respect is of exceeding gravity, and theplaintiff in one of the three cases which have lately been adju-dicated might well have addressed the jury in the words of theyoung Prince Arthur :-

" 0 heaven ! that there were but a mote in your’s,A grain, a dust, a cnat, a wandering hair-Any annoyance in that precious sense."

Then, "feeling what small things are boisterous there," theymight have adjudged more fitting recompense. The differencein the amounts awarded is indeed considerable. To a poor ladwho lost an eye by the incautious brutality of a smith who" jobbed at him with a hot iron," three pounds were awarded !Upon a substantial farmer, who lost an eye in consequence ofan injury from a missile directed at him by some young menreturning from the race-course, X700 were bestowed by arbi-trators. In a third case of injury to the eye, not destroyingits vision, inflicted accidentally by a child on a young Frenchphysician, the damages were laid by him at 15,000 fr. He hadbeen confined to his house three weeks, and professed to havesuffered injury in his practice, upon which he had only justentered, and which needed the careful " nursing" which he wascompelled to bestow upon himself. Dr. Tardieu reported thatthe injury was very slight; but he said that the visit was paidat a favourable moment, and when the eye was free from itscustomary access of inflammation. The father treated the com-plainant somewhat after the manner of King Lear :-" 0 ho !are you there with me ? No eyes in your head, nor no moneyin your purse ? Your eyes are in a heavy case, your purse in alight, yet you see how the world goes." He offered him 150 fr.as a compensation. The civil tribunal which tried the cause

’ assessed the damages ultimately at 1800 fr., to be paid in three’

sums of 600 fr. at intervals of six months. Unable to generalizeupon decisions so diverse in principle, we must be content with

recording these judgments for the guidance of some future Solo-’

mon.

A DIPLOMA FOR SALE.

ROGUERY at the antipodes simulates closely the dodgeswhich are in force here. The difference of character betweenthe people of a newly-founded colony, and the manners of aprimitive society, contrasted with the social refinements of theelder and more subtle phase:of civilization in which we rejoice,only shows itself in the more nayf and open parade of those de-vices which are here very cunningly masked and, if possible,carefully concealed. The sale of diplomas is not unknown in" the old country;" and occasionally some cunning impostorhas possessed himself of the certificates of a deceased practi-tioner, and has known how to convert them to his own use.But it is only in Australia that such a proposition could bepublicly made, and the fraud invited by a handbill. Mr. Kelly,in a recent book of travel, describing a druggist’s shop at Mel-bourne, tells how the proprietor spoke of his prospects being" decent," but somewhat damped by the premature death ofthe M.D. of the hill, who "slipped through in a fit of delirium

64

tremens." " He then took a written advertisement wafered inthe window, which he seized as by a happy thought, andplaced in our traveller’s hands, with an expression of facecapable of being translated into " the very thing for an in-telligent new chum; it will suit you exactly," watching himnarrowly while he read as follows :-

" To BE DISPOSED OF, ON MODERATE TERMS, the first-classdouble Diploma of the late Dr. T-r. Apply to his discon-solate widow, at the old surgery in the tent next the EuropeanNational Restaurant, Clarendon-street, Emerald-hill."

Glancing at the druggist, as he thought enquiringly, he

quickly asked, " Would you like to find out the tent, sir?"He was somewhat taken aback at being asked in return, "Forwhat purpose?" He however eventually admitted that, "inhis opinion, a tolerably smart man, of good address and generalknowledge, with a smattering of Latin, would make a fairaverage colonial doctor, as, the country being new, it was nottroubled with any dangerous variety of diseases, beyond dysen-tery, ophthalmia, rheumatism, and a few of a secret type.Now and then," he added, " a bad lying-in case occurred; butas the midwife was held responsible, the doctor need not beuneasy about the consequences." The amusing facility withwhich the whole plan is exposed, and the simplicity of thearrangements, are alike remarkable. Assuredly the registraIis as greatly needed in our colonial possessions, as he was athome.

A PESTILENT FOLLY.

THE plot thickens at Bengazi: the plague progresses, andthe people become more infatuated. The passive enduranceof its ravages is substituted by a fanatic opposition to sanitaryimprovements. Recent letters afford a sad insight into theconfusion wrought by their pestilent folly. The local authori-ties continue to refuse all co-operation with the Medical Com-mission, and the people are desirous of assassinating the phy-sicians. The one who was at Ogela only saved his life byflight : the inhabitants wished to kill him, because, as theysaid, the infidel sullied the holy town by his presence. In the

evening of the 12th of December, a detachment of soldiers,placed to protect the sanitary guardians, and to assist themwhen necessary, were attacked by the Arabs, who woundedtwo of them, and killed two horses. The garrison of Bengazi,in this serious state of affairs, only amounts to 120 men. The

governor, Mahmoud Bey, one of the worst of the class, has

requested the Medical Commission to suspend its functions.During the fifty-six days that the Commission has been atBengazi, it has not received a single letter from the SanitaryBoard at Constantinople; and it is really most unfortunatethat, before sending a Commission to the country, some suremeans of communication had not been established.

MEDICAL CACOGRAPHY.

WHILE we are employed in setting our houses in order, thereare a few minor points of practice which may very well be dis-cussed. Reform should begin at home, and there a few motesare floating about which we may very easily and advan-tageously remove. There is a small matter standing againstus, with which we are occasionally reproached, not withoutgood ground. Physicians affect, or lapse habitually into, acabalistic style of caligraphy, which can serve no good end thatwe can see, while it has led to more than one serious error in

dispensing, and preserves in the popular mind a notion of mys-tery connected with all forms of prescription, that is unde-sirable for many reasons. If the art of writing were to concealthe purpose of the writer, as the art of speaking has been de-fined to conceal the thoughts of the speaker, that object couldnot be more effectually served than by the cacography whichtoo many prescribers still affect. "I have longs suspected."

says a learned professor, "that they write in Coptic, andthat they thus conceal the magic incantations which DiodorusSiculus attributes to their predecessors." But the secret ofHermes is no longer concealed beneath the symbols of the phy-sician, and it is sufficiently obvious that it is not in accordancewith the dignity of professors of a great science to assume asuperficial air of mystery in small things. One practical reasonfor adopting a clear and legible hand is, that it obviates thepossibility of those frequent errors which inexperienced dis-

pensers commit, while it saves much unnecessary trouble to abody of men, who are, in the main, industrious, intelligent,and ill-remunerated. It should be remembered, moreover, thatby investing every form of prescription with a mysterious dig-nity, which rests upon the well-known principle of Tacitus,"Omne ignotum pro magnifico," an additional facility for im.posture is afforded to the multitude of quacks, who find it totheir interest to purchase importance for their formulæ on thesame easy terms, and who always find their profit in an ob-scurity for which they can quote so many illustrious examples.,

COLLEGE OF DENTISTS OF ENGLAND.

LECTURES ON THE MEDICAL HISTORY AND TREAT-MENT OF DISEASES OF THE TEETH.

DR. RICHARDSON resumed his lectures on Tuesday evening,his subject on the occasion being " Purulent Diseases of theDental Structures." The lecture was opened by a descriptionof the pathology of purulent disease, and the nature and causeof purulent exudation. The general symptoms attending for-mation of purulent matter were next given; and the varioussequelae of symptoms, as the exhaustive, typhoid, and pyæmic,were described. Thence, the lecturer proceeded to the consi-deration of those purulent disorders which specially concernthe surgeon-dentist,-namely, abscess of the antrum; abscessof the dental pulp; abscess of dentine; abscess of alveolus;purulent ulceration of the gums. and mucous surface of themouth; and abscess of adjoining structures from dental irrita-tion. The most interesting parts of the lecture, perhaps, werethose which related to the purulent affections of the gums ofchildren, and to abscess of the alveolus. Regarding the firstof these diseases, the lecturer pointed out the folly of retaining,in respect to it, the term " can.crum oris." He agreed withMr. Tomes in ascribing this ulcerative disease to a defectivehygiene, but could not accept with that author a classificationof the disorder into two divisions, -one as involving the gums,the other as involving the mucous surface of the cheek. Theconditions for the ulcerative process being supplied, the positionof the ulcerated spot became a mere matter of accident; with-this exception, that the points most favourable to the ulce-rative process were those where the saliva was most easily re-tained-such as the angle of junction between the gum andinner surface of the cheek. Dr. Richardson also dwelt at somelength on the character of the salival secretion in these cases,and showed that while the generally enfeebled state of bodyfavoured the ulcerative process in mucous membrane, the pro-bable exciting cause was the irritating and acrid salival se-cretion.

In passing, towards the close of the lecture, to the treatmentin its bearings on the diseases noted above, the lecturer dis-cussed the principles of treatment, mainly entering, however,freely into detail by way of illustrating the principles enforced.In this section he warmly advocated the modern view of judi-ciously supporting the system whenever purulent matter hasformed. He compared purulent exudation to a modified hæmor.rhage, and showed that in proportion as the system was re-duced by loss of purulent fluid, so was the tendency to furtherexudation sustained. The local, medicinal, and the hygienictreatment of the purulent ulceration of the mouth in children,formed the last topic. The hygienic treatment was one moststrongly enforced, specially with reference to diet, the point ofpractice suggested being that of lessening the amount of starchyfoods, and the selection of milk as the most efficacious dieteticremedy.