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greatest caution. As an instance of the baneful extent towhich a want of this consideration is carried, we may cite cer-tain statements made in a recent number of the New YorkTribune by a correspondent, who loosely reports, on the autho-rity of a French consul in China, that "the natives minglearsenic with their smoking tobacco, and that in some provincestobacco free from arsenic is not sold. The same witness assertsthat the arsenic-smokers were stout fellows, with lungs like ablacksmith’s bellows, and rosy as cherubs." Every evil result-ing from the insertion of statements such as these-whose onlypurpose is evidently to excite a morbid interest and attract theattention of the uninformed-forms a weapon for the hands ofthe enemies of a free and unfettered press.

THE trustees of the Southern Hospital, at Liverpool, havewisely adopted a proposition made by the medical men of theinstitution, that, in future, the election of officers shall be

solely guided by the merits of the candidates. It will be

greatly to the benefit of public hospitals if this plan be gene-rally adopted. At present it is too frequently not the bestman but the most active canvasser who succeeds. Many amost desirable officer is thus lost, because he is unwilling orunable to undertake the labour, or afford the expense, of

humbly soliciting from individual voters their "most sweetvoices ;" and would, like Coriolanus,

" Rather than fool it so,Let the high office and the honour goTo one that would do thus."

Correspondence.

MR. LISTON’S MODE OF PERFORMINGLITHOTOMY.

[LETTER FROM PROFESSOR SYME.]

" Audi alteram partem:’

To the Editor of THE LANCET.

SIR,-Nearly a fortnight ago, I addressed the following letterto Mr. Fergusson : " Sir,-In THE LANCET of November 8thyou say that you have for some years submitted in silence toa long list of professional calumnies from Mr. Syme’s mouthand pen,’ and that you have looked with contempt upon themany opprobrious epithets which have been applied to yourprofessional character.’ Now, as I am not aware of there beingany ground whatever for these allegations, I have to requestthat you will specify at least some of the calumnies and oppro-brious epithets to which you refer." Not having received anyreply to this letter, I must now request attention to the verypeculiar position in which Mr. Fergusson has thought properto place himself.As " calumny" means a false accusation, it implies both

falsehood and malice; and a long list of such offences, togetherwith the application of opprobrious epithets, Mr. Fergussonhas laid to my charge. Now, there can be no doubt that ifguilty of this conduct, I must have forfeited all claim to pro-fessional respect, and also that if Mr. Fergusson shall be foundto have ventured upon such a serious accusation without anywarrant or pretext, he will be no less exposed to censure. ButI am able most sincerely and positively to declare that in allwhich I have said and written publicly and privately, there isnot a word or expression that Mr. Fergusson could construeinto a calumny, or characterize as opprobrious. It is true thatI have not scrupled to express disapprobation of cutting outthe knee-joint and the head of the thigh-bone, with otheroperative procedures, in my opinion objectionable, which havebeen advocated by Mr. Fergusson, but, in doing so, I have

merely exercised the privilege of fair discussion, and dischargedthe duty incumbent upon me as a teacher of Surgery.The charges of Mr. Fergusson being thus distinctly denied,

must be either substantiated or withdrawn by him, unless he-chooses through silence to admit that he is guilty of the graveoffence unjustly imputed to me. How much further he mayhave subjected himself to blame of a similar kind by, with.equal truth and relevancy, holding me up to further odium as aF" libeller," (for defending the purity of medical evidence,) as"having quarrelled with almost every friend I ever had,", (heassuredly was never one,) as actuated by "despicable motives,"and asserting "language unbecoming a gentleman," I do notattempt to determine, but leave for the judgment of a profes-sion, to maintain the honour and promote the improvement ofwhich every effort in my power has, however unsuccessfully ,been long and earnestly devoted. In the words of mydistinguished countryman, the late Sir John Malcolm, ’* I

despise that fortune which is the reward of art, falsehood,flattery, and deceit, or even purchased by the suppression ofhonest sentiments, or useful information;" and, having alwaysregarded as the great object of professional life the good opinionof my brethren, I may appeal to that of those who have known,me longest and best for refutation of Mr. Fergusson’s -unworthyallegations. I am, Sir, yours, &c.,Edinburgh, December, 1856. JAMES SYME.JAMES SYME.

MR. THOMAS WAKLEY’S TUBULAR TREAT-MENT OF STRICTURES OF THE URETHRA.

To the Editor of THE LANCET.

SIR,-In THE LANCET of the 28th of November, there ap-peared a paper " On the Tubular Treatment of Strictures ofthe Urethra," by Mr. Thomas Wakley, which had been readbefore the Medical Society of London a short time before, inwhich the following passages occurs :-" The new instrument,therefore, and the novel system of treatment which they wereintended to establish, were brought under the consideration ofthe profession through the influential medium of the MedicalSociety of London;" and a few paragraphs further on-‘‘ Itwas under the influence of these views and impressions that xplan of treatment was devised which, after the first intro-duction of the smallest possible instrument into the bladder,,secured to the operator the perfect command of the disorderedcanal." The essential principle of this mode of treatment isthat of introducing a director through the stricture, guided bywhich a catheter may pass. As Mr. Wakley justly remarksfurther on his paper : ’’ When once a guide has been intro-duced into the bladder, the power of the operator over thestricture is almost unlimited." Now, Sir, while the professionis indebted to Mr. Wakley for his advocacy of the principle, it;is but fair publicly to state, that this principle has been knownand acted upon, in the treatment of close strictures of theurethra, in this country, for more than twenty years, a muchsimpler and more efficient instrument having been invented byDr. Hutton, of the Richmond Hospital, in this city. If yourefer to the first edition of Grave’s " Clinical Medicine,"p. 497, you will find the history of a case which had beenunder Dr. Hutton’s care in 1835, in which the following pas-sage occurs:-" A small catgut bougie, of double length, wasintroduced, so that one half of it projected from the meatus;over this was slided a small gum-elastic catheter of ordinarylength, and open at both ends, until it traversed the strictureand reached the bladder; the catgut bougie was then with-drawn, and the gum-elastic catheter secured." So that twenty-one years ago this principle was known to Dr. Hutton, andthis peculiar kind of catheter used by him. I would next refer-to your own journal, of March 15th, 1845, p. 304, wherewe find a letter from Mr. Barrington, which I quote at length,as it gives a clear description of Dr. Hutton’s catheter:-

" Sir,-In your last number is given a method of introducingthe catheter brought before the Academy of Medicine, by M.Maisonneuve, as new. It has, however, no claim to noveltyxhaving been known and practised in the Dublin hospitals sofar back as five years ago, when I, along with many others,witnessed its employment in the hands of Dr. Hutton, of theRichmond Hospital. The plan there adopted differed same--what from M. Maisonneuve’s, and appears to be preferable. Afine catgut bougie, eighteen or twenty inches long, was firstpassed within the stricture. A gum-elastic catheter, open atboth ends, was then passed upon the catgut down to, and, byproper management, seemingly through the stricture. The-difference then consists in employing catgut of such lengththat enough may remain to be passed through the canal of thecatheter with facility, rendering the use of string cf any kindunnecessary. I believe this plan to possess great advantages,being at once simple and certain, &c. &c.-March 3rd, 1845,.(Signed) W. R. BARRINGTON, M.R.C.S.I."

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So that eleven years ago the profession was made aware ofthe fact of a catheter, upon this principle, having been inventedby Dr. Hutton, and used by him in Dublin.Ever since the time of its invention this catheter has been

constantly used both by Dr. Hutton and his colleagues in casesof close stricture, and is, indeed, familiarly known not only toevery surgeon in Dublin, but to most provincial medical prac-titioners, under the name of the railroad catheter. Withregard to its eniciency, I can state from my own experience,when Dr. Hutton’s resident pupil in the Richmond Hospital,several years ago, that I have often been enabled to relievethe distended bladder by this instrument when no other cathetercould be introduced, and when tapping must have been re-sorted to had it not been for the relief thus obtained. And Iam certain that numbers now practising in this city, as well asin all parts of the world, who, during the last twenty years,have seen this instrument used by the skilful and practisedhand of its inventor in the hospital, would gladly come for-ward, if called upon, to testify to its value.

I remain, Sir, your obedient servant,Dublin, Dec. 1856. JOHN K. BARTON, L. R. C. S. I., &c.

Head Demonstrator cf Anatomy, Trinity College, Dublin.

’. If Mr. Barton cannot distinguish the difference thatexists between the instruments used by Dr. Hutton and thosethat have been invented by Mr. T. Wakley, the fault does notrest with the gentleman last named. The instruments em-

ployed by Dr. Hutton appear to have been used in Dublinin cases of " closed stricture," the patients, it seems, sufferingat the time from retention of urine. Desault, the celebratedFrench surgeon, half a century ago, in a case of retention of

urine, used a catheter that was passed over a stylet. Thuseven that contrivance cannot be claimed by Dr. Hutton.The instruments designed by Mr. T. Wakley are used in

every form of stricture, and it appears quite certain that, untilso employed by him, no similar instruments were in use inany part of the world. Within the short period that haselapsed since Mr. T. Wakley first exhibited them at the

Medical Society of London, hundreds of sets have been

manufactured and sold, and distributed amongst the most important of our surgical institutions. Mr. Barton and others iappear to us not to understand or not duly to appreciate theprinciple of the treatment which these instruments were de-signed to carry into effect - viz., the cure of stricture byabsorption caused by the rapid and safe introduction of thegraduated tubes. In this respect a physiological condition wascontemplated, far superior to any mere mechanical contrivance,but without the latter it could not have been produced. There isanother circumstance which signally distinguishes the inventionof the guide and graduated tubes from all other contrivancesfor the removal of strictures of the urethra in all their forms.It is this: that from the safety and certainty of their action,they will never cease to be used so long as stricture of theurethra shall continue to be a human malady.-SUB-ED. L.

ON INFECTING AND NON-INFECTINGSYPHILITIC SORES.

[NOTE FROM MR. M. H. STAPLETON.]To the Editor of THE LANCET.

SIR,-My attention having been drawn to an original com-munication in the October number of the Briti81L and ForeignMedico-Clairurgieal Review, "On Infecting and Non-InfectingSyphilitic Sores," by Mr. Henry Lee, and finding in it a pas-sage containing a gross perversion of statements, enunciated aswell by Mr. Langston Parker as myself, I feel called on at theearliest opportunity to expose it. At page 500 occurs the fol-

lowing passage :-In England, opinions have been as varied as in France.

Thus in the third edition of Mr. Langston Parker’s work, wherehe speaks of the circumstances which particularly indicate theuse of mercury in primary syphilis, the author includes ’allsores which have yielded a characteristic pustule by inocula-tion.’ The indication for the employment of mercury," Mr.Parker says, "is still more pressing if the primary sore beaccompanied by bubo. "-p. 15.

In support of this opinion, he quotes the following from M.Ricord:-

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" In such cases, six months never elapse without secondarysymptoms manifesting themselves, unless a specific treatmentbe employed. This is an universal law, which there is nomeans of eluding but by mercurial treatment. "

These quotations profess to be taken from Stapleton’s trans-lation of Ricord. What M. Ricord himself, however, says isexactly the reverse of this :-

" Tout bubon qui suppnre specifiquement, c’est a dire, quifournet du pus’ inoculable n’est jamais suivi d’accident d’infec-tion constitutionelle."

Hicord’s opinion, as here quoted from the original, is quite inaccordance with the author’s experience, and in direct opposi-tion to the published views of Mr. Langston Parker.Now, in my analysis (not translation) of M. Ricord’s letters,

I state the propositions and conclusions arrived at by him aftertwenty years’ experience, viz. :-

"1st. Every bubo which suppurates specifically-that is tosay, which furnishes inoculable pus-is never followed bysecondary constitutional contamination: a sign more valuablethan the absence of induration in chancre, which has precededand which may deceive.

" 2nd. Multiple indolent bubo, consequent upon induratedchancre, is a further and sometimes the sole proof of constitu-tional infection, when we have’ not an opportunity of witness-ing the induration of the chancre." *

It will be here observed that Mr: Lee only takes notice ofthe first propositions, but that the second, which is the onethat Mr. Langston Barker alludes to, he seems not to haveseen, and it is to this multiple indolent bubo (Pleiades) that M.Ricord refers when he uses the emphatic language correctlyquoted by Mr. Parker-" Six months never elapse without syphi-litic poisoning manifesting itself"Although Mr. Henry Lee quotes M. Ricord, yet, as through-

out his essay he does not once allude to the multiple indolentbubo, I can only account for the very extraordinary blunderinto which he has fallen, by snpposing him to be unacquaintedwith M. Ricord’s views.

I am, Sir, yours, &c.,MICHAEL HARRY STAPLETON.

Mountjoy-place, Dublin, Dec. 1856.MICHAEL HARRY STAPLETON.

ALLEGED GRIEVANCES AT ST. BARTHO-LOMEW’S HOSPITAL.

To the Editor of THE LANCET.

SiR,-As a quondam clinical clerk of Dr. 111’est’s, and froma debt of gratitude I owe to one who first taught me to inves-tigate uterine disease, I feel bound to answer the charge laidagainst him in your journal of the 13th inst., by Mr. Cooper.No one who knows Dr. West personally, and has seen his de-sire to impart instruction to students who visit his ward, canhave read your correspondent’s letter without feelings of pain,evincing, as it does, a fault-finding spirit, as also his igno-rance of both the practice and department of uterine disease.

Dr. West has a ward devoted to uterine disease in St. Bartho-lomew’s Hospital, and Mr. Cooper complains that whenoperative proceedings are deemed requisite on’ his patients,they are not brought into the operating-theatre, a room wherelight is only admitted from the ceiling, forgetting the firstprinciple of midwifery-viz., the axis of the female pelvis, andasking why, with as much reason, should not labial tumoursand femoral hernias be obscured from their view in the opera-ting-theatre.The class of operations that are under Dr. West’s care are

such as can only be seen by two or three in the immediateneighbourhood, and to my mind it would be impracticable,useless, indelicate, and injurious for Dr. West to accede tothe request contained in Mr. Cooper’s letter. For the in-vestigation and operative proceedings of uterine disease,light is mostly, if not always, required just in front of thepatient. On that ground, therefore, it would be imprac-ticable to use the operating-theatre, where the windowsare in the roof; useless, from the fact that very frequently noexposure of the patient takes place; indelicate, because no in-formation can be gained by 100 students at ten or a dozenyards distant, gazing at the open end of a speculum, or watch-ing the removal of a polypus, or puncturing of an ovariantumour under a patient’s clothes; and injurious both to thepatient and the profession generally, as increasing in thepatient that hysteria and nervous temperament under whichwomen with uterine diseases labour, and which is often a greatdrawback to their recovery; and to the profession at large, as

* Analysis, page 47.