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576 treatment of Placenta Prsevia have urged me to the belief, that I my reasoning on or recording a solitary case, may not be devoid of interest ;-can, indeed, instructive facts bearing upon the ques- tion of unavoidable uterine hsemorrhage, ever be without interest to the practitioner in midwiferv ? Even nnder the care of the most skilful practitioner, confident in his knowledge of his art, and skilled in the application of the means, placental presenta- tion carries but too often, and with striking velocity, its victim to the grave, showing, under circumstances most painful and morti- fying, how difficult it is for a man successfully to contend with the errors which nature herself will sometimes make. To establish correctly the proper treatment of uterine heemor- rhage from placental presentation, itseems necessary to demonstrate the exact vessels from which the hsemorrhage flows, whether the !blood be disengaged from the uterine or placental surface, or from both. To believe the blood flows altogether from the great veins left open by the detachment of the placenta, in the same manner as water flows from a bottle placed upon its side and uncorked, forces upon us the belief that uterine hmmorrhage ought, in all cases, to take place to a very con- siderable extent, where the contraction of the uterus is not perfect, a belief which receives its contradiction in experi- ence. To suppose that the haemorrhage takes place from utero- placental arteries, left open on the separation of the placenta, obliges one to suppose a something contrary to that which takes place on the laceration of minute vessels in other parts of the body; whence, then, flows the blood ? Not, I should think, from minute lacerated arteries, that seems an insufficient source ; per- haps considerably, yet not entirely, from the venous openings on the exposed placental surface, because on all occasions, and under all circumstances, haemorrhage, more or less, takes place by retrogression from the venous openings on the internal surface of the uterus. If, indeed, the torrent of blood which is often poured out in these cases, on a partial separation of the placenta, issued from great valvular-like venous openings in the lining membrane of the uterus, one would expect the complete separation to be followed by instant death; but such is not the result: on the contrary, the complete separation of the placenta before the child, has often been accomplished by nature and by art, with perfect safety to the mother, apparently being itself the check to fright- ful and dangerous haemorrhage. However, Sir, my real object ’is not to parade my own crude notions, but to detail a case which I think bears upon the question. Four years ago, I was sent for to Mrs. B., of Dean-street, Soho-square; it was about her eighth month of pregnancy. I was from home at the moment, but arrived in about half an hour. I found the patient on her back in the drawing-room, faint and pallid. I was told she had been suddenly seized with symptoms of labour; a great discharge had taken place; that she had fainted .and fallen where I found her: she was, after a little time, gently Temoved from the floor to her bed, when a profuse discharge of coagulated blood was observed over her clothes and on the floor, On examination, I discovered a great portion of the mass of the placenta in the vagina, and on further examination the child was felt in the uterus, with the feet presenting. As there were no urgent symptoms present, no injudicious haste was made. In due time natural pains and gentle means completed the intentions of nature. I do not exactly remember how long I was with this patient before the uterus was relieved of its contents, but cer- tainly more than half an hour, during which time there was no haemorrhage. Now, here was a case in which nature accomplished - a safe delivery by first removing the placenta, and with its re- I moval the haemorrhage seemed to have ceased, and returned no I, more. I should suppose the pressure of any part of the child on the great open vessels of the uterus could not have had any influence in arresting the flow of blood, as the feet presented. It may, perhaps, be as well for me to state that I have not seen any of the papers on this subject published in the Provincial Medical Journal, and the Medical Gazette. I write on reading your article in last week’s Lancet. I am, Sir, your most obedient servant, WILLIAM HARDING. Percy Street, Bedford Square, Nov. 4th, 1845. WILLIAM HARDING. THE LAWLESS COMMITTEE. To the Editor of THE LANCET. SIR,-Why is not the draught of the Charter published for the information of the members of the National Association ? Really I am disposed to ask if the Committee can act honestly and openly in a single instance ? The members have a right to demand the publication of the draught of a measure which is designed for their future incorporation and government. Where, and when, are the insults to end? Yours obediently, Tower Hamlets, Nov. 17th. ANCILLARY CAUSTIC. NEWS OF THE WEEK. ROYAL VETERINARY COLLEGE.-The Veterinary College opened its medical session on Monday, November 12th, with an Address from Professor Sewell on the progress of vete- rinary medicine. In the evening, the Veterinary Medical Asso- ciation met at the Freemasons’ Tavern,-Professor Spooner in the chair ; and after the reception of the Secretary’s report, and giving audience to an admirahle oration from Mr. Spooner of South- ampton, adjourned to an excellent dinner. The title of Honorary Fellow of the Association was bestowed on Messrs. Robb, Ickyl, Wright, and Cox, for essays on the action of metallic poisons, the tests and antidotes for poisons, influenza, and diarrhaea in cattle. The subjects for the prize essays for the year ensuing were announced to be, for members, "The anatomy of the alimentary canal of ruminants and the physiology of digestion ;" and for students, "The comparative anatomy of the tarsus of the horse, ox, sheep, dog, and pig, together with the physiology of that joint, in reference, especially, to the movements of the limb." The students’ essays to be illustrated with preparations and drawings. Mr. Morton, the secretary, reported that the chief features in the progress of the association, during the past year, were, the publicity given to its Transactions, through the unrestricted dis. tribution of the Veterinary Record ; the attention bestowed on the prevailing epizootic; and the researches made into the action of mineral poisons, with their proper treatment. Among the curious cases brought under the consideration of the association, were, a chronic abscess containing hair and pill-shaped pus con- cretions ; a testis strangulated within the abdomen ; strangulated intestine, from becoming encircled by the horn of the uterus; and fractures of the cranium and pelvis, from falls on the wood pave- ment. Cattle pathology, moreover, had received a new impulse from the labours of Mr. Simonds. The report concluded with an expression of deep regret at the recent death of the late demon- strator of the college, Mr. Barth, who was suddenly cut off by a coup de soleil, in his journey to join his regiment in the interior of India. .. Mr. Spooner, of Southampton, in his oration adverted to the unfortunate introduction of schism into the profession, as a con- sequence of the recent grant of a charter. He considered the case as past the aid of surgery, and amenable only to soothing applications and remedies. Referring to the history of veterinary medicine, he remarked upon the great knowledge of that subject possessed by Virgil and Xenophon ; the subsequent degradation of knowledge during a long period of darkness, and the present revival of veterinary science. The veterinary art was greatly indebted to the labours of the successive professors of the college, St. Bell, Moorcroft, Colman, and Sewell. Colman brought about a complete reform in stable management, particularly in relation to ventilation; and the introduction of neurotomy by Sewell, might be regarded as a brilliant discovery; not less so was the discovery, by Turner, of the true nature of navicular disease-a disease for which the treatment had been directed to the shoulder. Other improvements in veterinary medicine were, the less indis- criminate employment of bleeding, tenotomy in some cases of contraction, periostotomy for splints, and the operations for hernia introduced by-Mr. Simonds. The profession still laboured under abuses, and there were none greater than the protection offered by- Government to ignorant farriers, who beset the regularly educated practitioner at every turn, who robbed him of his well-earned reward, and who spread mischief wherever they were permitted to set their feet. These abuses could never be corrected so long as veterinary prac- titioners were paid for their drugs ; they ought to be paid for that which was their real stock in trade-namely, the information which they had obtained by long, hard, and expensive study. , ROYAL SOCIETY.-The Royal Society commenced its sittings on Thursday last, Nov. 20th. The anniversary meeting for the election of officers will take place on Monday, Dec. Ist. THE CHINA MEDICO-CHIRURGICAL SOCIETY.-A meeting of the medical gentlemen in Hongkong, was held on May 13th, at the residence of Dr. Dill, for the purpose of forming a Medical Society. Present-Drs. Tucker, Kennedy, Dill, O’Sullivan, Barton, Traill, Gilbert, Holgate, Young, Little, and Webber. Dr. Tucker filled the chair, and Dr. Dill acted as secretary. The resolutions, unanimously adopted, declared, that the formation of such a society is most desirable, not only to ourselves as medical men, but to the community at large, its objects being - the bringing into more intimate intercourse medical brethren in China, for giving and receiving informa- tion on medical subjects; the formation of a library, where

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Page 1: NEWS OF THE WEEK

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treatment of Placenta Prsevia have urged me to the belief, that Imy reasoning on or recording a solitary case, may not be devoidof interest ;-can, indeed, instructive facts bearing upon the ques-tion of unavoidable uterine hsemorrhage, ever be without interestto the practitioner in midwiferv ? Even nnder the care of themost skilful practitioner, confident in his knowledge of his art,and skilled in the application of the means, placental presenta-tion carries but too often, and with striking velocity, its victim tothe grave, showing, under circumstances most painful and morti-fying, how difficult it is for a man successfully to contend with theerrors which nature herself will sometimes make.To establish correctly the proper treatment of uterine heemor-

rhage from placental presentation, itseems necessary to demonstratethe exact vessels from which the hsemorrhage flows, whether the!blood be disengaged from the uterine or placental surface, orfrom both. To believe the blood flows altogether from the

great veins left open by the detachment of the placenta, inthe same manner as water flows from a bottle placed uponits side and uncorked, forces upon us the belief that uterinehmmorrhage ought, in all cases, to take place to a very con-siderable extent, where the contraction of the uterus is not

perfect, a belief which receives its contradiction in experi-ence. To suppose that the haemorrhage takes place from utero-placental arteries, left open on the separation of the placenta,obliges one to suppose a something contrary to that which takesplace on the laceration of minute vessels in other parts of thebody; whence, then, flows the blood ? Not, I should think, fromminute lacerated arteries, that seems an insufficient source ; per-haps considerably, yet not entirely, from the venous openings onthe exposed placental surface, because on all occasions, andunder all circumstances, haemorrhage, more or less, takes place byretrogression from the venous openings on the internal surface ofthe uterus. If, indeed, the torrent of blood which is often pouredout in these cases, on a partial separation of the placenta, issuedfrom great valvular-like venous openings in the lining membraneof the uterus, one would expect the complete separation to befollowed by instant death; but such is not the result: on thecontrary, the complete separation of the placenta before the child,has often been accomplished by nature and by art, with perfectsafety to the mother, apparently being itself the check to fright-ful and dangerous haemorrhage. However, Sir, my real object’is not to parade my own crude notions, but to detail a case whichI think bears upon the question.

Four years ago, I was sent for to Mrs. B., of Dean-street,Soho-square; it was about her eighth month of pregnancy. Iwas from home at the moment, but arrived in about half an hour.I found the patient on her back in the drawing-room, faint and

pallid. I was told she had been suddenly seized with symptomsof labour; a great discharge had taken place; that she had fainted.and fallen where I found her: she was, after a little time, gentlyTemoved from the floor to her bed, when a profuse discharge ofcoagulated blood was observed over her clothes and on the floor,On examination, I discovered a great portion of the mass of theplacenta in the vagina, and on further examination the child wasfelt in the uterus, with the feet presenting. As there were nourgent symptoms present, no injudicious haste was made. In duetime natural pains and gentle means completed the intentions ofnature. I do not exactly remember how long I was with thispatient before the uterus was relieved of its contents, but cer-tainly more than half an hour, during which time there was nohaemorrhage. Now, here was a case in which nature accomplished- a safe delivery by first removing the placenta, and with its re- Imoval the haemorrhage seemed to have ceased, and returned no I,more. I should suppose the pressure of any part of the child onthe great open vessels of the uterus could not have had anyinfluence in arresting the flow of blood, as the feet presented.

It may, perhaps, be as well for me to state that I have not seenany of the papers on this subject published in the ProvincialMedical Journal, and the Medical Gazette. I write on readingyour article in last week’s Lancet.

I am, Sir, your most obedient servant, WILLIAM HARDING.Percy Street, Bedford Square, Nov. 4th, 1845.

WILLIAM HARDING.

THE LAWLESS COMMITTEE.To the Editor of THE LANCET.

SIR,-Why is not the draught of the Charter published for theinformation of the members of the National Association ? ReallyI am disposed to ask if the Committee can act honestly andopenly in a single instance ? The members have a right to

demand the publication of the draught of a measure which isdesigned for their future incorporation and government. Where,and when, are the insults to end?

Yours obediently,Tower Hamlets, Nov. 17th. ANCILLARY CAUSTIC.

NEWS OF THE WEEK.ROYAL VETERINARY COLLEGE.-The Veterinary

College opened its medical session on Monday, November 12th,with an Address from Professor Sewell on the progress of vete-rinary medicine. In the evening, the Veterinary Medical Asso-ciation met at the Freemasons’ Tavern,-Professor Spooner in thechair ; and after the reception of the Secretary’s report, and givingaudience to an admirahle oration from Mr. Spooner of South-ampton, adjourned to an excellent dinner.The title of Honorary Fellow of the Association was bestowed

on Messrs. Robb, Ickyl, Wright, and Cox, for essays on theaction of metallic poisons, the tests and antidotes for poisons,influenza, and diarrhaea in cattle. The subjects for the prizeessays for the year ensuing were announced to be, for members,"The anatomy of the alimentary canal of ruminants and thephysiology of digestion ;" and for students, "The comparativeanatomy of the tarsus of the horse, ox, sheep, dog, and pig, togetherwith the physiology of that joint, in reference, especially, to themovements of the limb." The students’ essays to be illustratedwith preparations and drawings.

-

Mr. Morton, the secretary, reported that the chief features inthe progress of the association, during the past year, were, thepublicity given to its Transactions, through the unrestricted dis.tribution of the Veterinary Record ; the attention bestowed onthe prevailing epizootic; and the researches made into the actionof mineral poisons, with their proper treatment. Among thecurious cases brought under the consideration of the association,were, a chronic abscess containing hair and pill-shaped pus con-cretions ; a testis strangulated within the abdomen ; strangulatedintestine, from becoming encircled by the horn of the uterus; andfractures of the cranium and pelvis, from falls on the wood pave-ment. Cattle pathology, moreover, had received a new impulsefrom the labours of Mr. Simonds. The report concluded with anexpression of deep regret at the recent death of the late demon-strator of the college, Mr. Barth, who was suddenly cut off by acoup de soleil, in his journey to join his regiment in the interior ofIndia.

..

Mr. Spooner, of Southampton, in his oration adverted to theunfortunate introduction of schism into the profession, as a con-sequence of the recent grant of a charter. He considered thecase as past the aid of surgery, and amenable only to soothingapplications and remedies. Referring to the history of veterinarymedicine, he remarked upon the great knowledge of that subjectpossessed by Virgil and Xenophon ; the subsequent degradationof knowledge during a long period of darkness, and the presentrevival of veterinary science. The veterinary art was greatlyindebted to the labours of the successive professors of the college,St. Bell, Moorcroft, Colman, and Sewell. Colman brought abouta complete reform in stable management, particularly in relationto ventilation; and the introduction of neurotomy by Sewell,might be regarded as a brilliant discovery; not less so was thediscovery, by Turner, of the true nature of navicular disease-adisease for which the treatment had been directed to the shoulder.Other improvements in veterinary medicine were, the less indis-criminate employment of bleeding, tenotomy in some cases ofcontraction, periostotomy for splints, and the operations for herniaintroduced by-Mr. Simonds. ’

The profession still laboured under abuses, and there were nonegreater than the protection offered by- Government to ignorantfarriers, who beset the regularly educated practitioner at everyturn, who robbed him of his well-earned reward, and who spreadmischief wherever they were permitted to set their feet. Theseabuses could never be corrected so long as veterinary prac-titioners were paid for their drugs ; they ought to be paid forthat which was their real stock in trade-namely, the informationwhich they had obtained by long, hard, and expensive study. ,

ROYAL SOCIETY.-The Royal Society commencedits sittings on Thursday last, Nov. 20th. The anniversarymeeting for the election of officers will take place on Monday,Dec. Ist.

THE CHINA MEDICO-CHIRURGICAL SOCIETY.-Ameeting of the medical gentlemen in Hongkong, was held onMay 13th, at the residence of Dr. Dill, for the purpose of forminga Medical Society. Present-Drs. Tucker, Kennedy, Dill,O’Sullivan, Barton, Traill, Gilbert, Holgate, Young, Little, andWebber. Dr. Tucker filled the chair, and Dr. Dill acted assecretary. The resolutions, unanimously adopted, declared, thatthe formation of such a society is most desirable, not only toourselves as medical men, but to the community at large, itsobjects being - the bringing into more intimate intercoursemedical brethren in China, for giving and receiving informa-tion on medical subjects; the formation of a library, where

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periodicals and medical works of the day can be had ; the discus-sionof topics relating particularly to the diseases prevalent in China,and to the native materia medica. That this be denominated the11 China Medico-Chirurgical Society." That medical men in anypart of China do become members, on paying either twelvedollars annually, or one and a half monthly. That a meeting beheld on the first Tuesday of each month, for reading essays,and conversation. That members in other parts of China be re-quested to submit to the society any intelligence which theythink will be interesting to it. And that similar societies at homedo send us reports of their proceedings, this society promising toact in the same manner towards them.

It was agreed that the next general meeting should take placeat the residence of Dr. Holgate.Thanks having been returned to Dr. Tucker, the meeting was

dissolved.

We received the Warwick and Leamington Adver-tiser of October 18th. The proceeding of Dr. Leitch was pre-

cisely the right one. " Mr. Hall having declared his belief inclairvoyance, and asserted that such cases were by no meansrare, Dr. Leitch offered to give the lecturer £100 if he could

produce one, on condition that Mr. Hall or his Mesmeric friendsshould present a similar sum to the Warneford Hospital if he

completely failed. The lecturer, however, declined, on the pleathat the atmosphere of incredulity,’ which would be producedby the presence of any sceptic, would vitiate the experiment.Dr. Leitch then offered to seal up a few words in his card-case,and leave them with the lecturer and his clairvoyant, with twoor three believers in Mesmerism. This also being declined, Dr.Leitch said that every rational person would properly interpretthe motives of Mr. Hall for refusing to endeavour to prove thetruth of what he asserted."

UNIVERSITY OF LONDON.-Bachelors of Medicine,1845. - First Division :- Matthew Baines, King’s College ;Frederick James Brown, University Coll. ; David Peter Evans,King’s Coll. ; Frederick John Hensley, King’s Coll.; AlfredJackson, University Coll. ; John Ody, King’s Coll. ; ThomasPalmer, Apoth. Hall of Ireland ; Charles Bland Radcliffe, LeedsSchool of Med.; Samuel Hopkins Steel, King’s Coll.; WilliamPhillimore Stiff, University Coll.; Robert Bowie Walcott, St.Thomas’s Hosp.; Charles Matthew Wayte, Guy’s Hosp.; EwingWhittle, R. Coll. of Surg. in Ireland.Second Division :-Thomas Herbert Barker, University Coll.;James Duncan, King’s Coll.; Archibald Redfoord Ridgway,London Hospital.

BOOKS RECEIVED FOR REVIEW.

On the Mortality in Prisons, and the Diseases most frequentlyfatal to Prisoners. By Wm. Baly, M.D., Physician to the Mil-bank Prison, and Lecturer on Forensic Medicine at St. Bartho-lomew’s Hospital. (Transactions of Royal Med. and Chir. Soc.)London : 1845. pp. 160.The Potato Disease, its Origin and Prevention, with a Che-

mical and Microscopical Analysis of the Sound and DiseasedTubers. By G. Phillips, of the Excise, and Member of theLondon Chemical Society. London: Highley. 1845. pp. 58.- A System of Surgery. Part VIII. By J. M. Chelius. Fromthe German, with notes, &c. By John F. South, Surgeon to St.Thomas’s Hospital. London: Renshaw. 1845.Remarks on Physical Education. By James Chiopo, Super-

intendent of Fencing, &c., University College, London. Taylorand Walton. 1845. pp. 40.

Illustrations of Modern Mesmerism, from Personal Investiga-tion. By John Forbes, M.D., F.R.S. Churchill.-A smart, ableproduction. If there are still any doubters as to mesmerismbeing a fraud, we advise them to peruse this pamphlet. It cer-tainly is a prickly rod for one of the classes of quacks.

Strictures on the Evils of the present System of Ventilation ;also on the Theories of Fermentation and Putrefaction. ByFranklin Cosworthy, Ordnance Department. London: R. andJ. E. Taylor.

CASE OF SOFTENING OF THE PONS VAROLII - LEAD DETECTEDIN THE CEREBELLUM.

The following case is recorded in the proceedings of the Liver-pool Pathological Society, by Dr. INMAN, in the EdinburghMedical and Surgical Journal:

" J. M‘G-, aged twenty-four, painter, of robust frame, ad-mitted into the Liverpool Workhouse with sloughing of thenates, August, 1844.

" States that he was always a healthy man (with the exception

of an attack of painter’s colic) till four months ago, when he wassuddenly seized, while at work, with giddiness, dimness of sight,pain in the forehead, weakness and numbness in his lower extre-mities. He had great difficulty in getting down the ladder onwhich he stood, and reaching his home. and next day was unableto leave the house. These symptoms increased in severity, andat the end of a fortnight he had lost all command over the leftleg and thigh. The left arm likewise felt very weak, but neverbecame paralytic. Pain in the head has never left him. Hismind and memory have been gradually failing since the com-mencement of the disease.

I " On admission, the muscles of the face were unaffected ; bothpupils dilated, but obedient to strong light; tongue protrudedslightly towards the left side. The left arm is weaker than the

right, but he can grasp pretty firmly with both. The left leg iscompletely paralyzed and -almost deprived of sensation, a hardpinch or prick being necessary to excite it. The right leg isweak, but he has command over it, and its sensation is tolerablyperfect. No reflex motions excited by any irritant. There is no

priapism. Urine and fseces passed involuntarily. Complains ofdull heavy frontal pain. The mind is weakened, the memoryimpaired. The tongue is dry and brown ; the teeth covered withdark sordes ; the speech is hesitating ; the enunciation imperfect.Pulse 96, soft; respiration easy, abdominal. No delirium orcoma; sleeps well ; appetite bad. There is no blue line roundthe gums. Says he never had syphilis, or any injury of thehead. There are extensive sloughs over the sacrum and tro-chanter, which have not as yet begun to separate."The treatment applied was unsuccessful, and the patient died

in about a fortnight. After death the following appearanceswere observed:-

" Face and scalp greatly congested; calvarium dense andthick; membranes greatly injected, but not thickened or opaque.Brain was extraordinarily firm ; lateral ventricles containedabout four ounces of transparent serum, and their lining mem-brane was slightly rough. A good deal of fluid was found alsoat the base of the brain. No other lesion was detected till thePons Varolii was divided, when a number of small foramina werenoticed filled with softening matter, more numerous on the rightthan the left side, and giving the idea, when they had been sub-jected to a stream of water, as if they had been made by worms.On making a section on the right side, a cavity was found largeenough to hold a small pea. The white and grey parts of thepons were distinct, and both equally affected. The rest of thepons seemed perfectly healthy."-The cerebellum being incinerated, treated with nitric acid, and

tested with iodide of potassium, sulphuretted hydwogrn, andmetallic zinc, gave perceptible proofs of the presence of lead.The question then arises how far the presence of the lead wasconcerned in the production of the disease, and how far theabsence of the blue line on the gums can be received as evidenceof the absence of lead from the system. These questions thewriter does not pretend to answer, but refers to a case of epilepsy,in which the disease of the brain seemed to be connected withthe presence of lead in that organ. The subject deserves furtherinvestigation.

, THE BUFFY COAT OF THE BLOOD.-The following conclu-sions are some of the results of a large number of experimentsmade on this subject by Mr. Gulliver, and recorded in an elaboratepaper contained in the same journal:-

" 1. There is a remarkable acceleration, after a few minutes, ofthe rate with which the red corpuscles sink in the liquor sanguinis;and in the serum alone, though to a less degree.

" 2. This acceleration may be increased by increasing the ag-gregation of the corpuscles; and prevented or reversed by pre-venting or destroying the aggregation of the corpuscles.

" 3. The sinking of the corpuscles may be slower in bloodthinned by weak saline solutions than when mucilage is addedwith the salt.

"4. The sinking of the corpuscles is slower in serum madethinner and lighter by weak saline solutions, than in serum madethicker and heavier by mucilage.

"5. In the blood of the horse, the buffy coat forms regularly;and the red corpuscles unite, as if partly fused into each other,and collect into masses.

" 6. There may be no buffy coat, or but a comparatively thinone, on this blood when it has been made thinner, and its coagu-lation retarded.

" 7. The formation of the buffy coat is neither due to an at-tenuation of the liquor sanquinis, nor to a diminution of its specificweight, nor to its slow coagulation ; but to an increased aggrega-tion and quickened sinking of the corpuscles.

"8. These facts are favourable to the old doctrine of vis-cidity of the blood and union of the corpuscles, and against the

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more recent doctrine of attenuation of the blood in inflamma-tion.

"9. The corpuscles of the horse sink much quicker in hisserum than the corpuscles of man do in his.

° 10. Increasing the proportion of corpuscles hastens coagula-tion, and diminishes the formation of the huffy coat more thanincreasing the serum only.

"11. Increasing the proportion of water simply does not hastenthe coagulation of the blood, as increasing the proportion ofSerum does."THE TREATMENT OF PLAGUE.-Mr. Robertson, R.N., in his

" Medical Notes on Syria," published in the same journal, makesthe following remarks on this subject, and hazards the opinion,11 that this disease is as amenable to remedial agents as any other with which the human race has been visited. That it should notbe so, we can see no reason. But it requires a treatment variedand diversified in its three different stages; and no one line oftreatment, or no one kind of remedies, can ever prove successfulin a disease so very varied in the mildness and severity of itsattacks,-so changing and changeable in its course, and thatformer experience must be made to bear on the various compli-cations, and moulded according to circumstances. In bringingthis to a conclusion, we would remark, after carefully studyingthe symptoms and course of the disease, that the most probablemeans of affording relief appears to us, in the first stage, to en-deavour to rouse the entire capillary tissue from its depressed andoverpowered state by warm medicated baths and by diffusiblestimuli; in the second, to control the state of reaction by thevarious contra-stimulants in use, to relieve local and urgentsymptoms by local depletion, and those other remedies whichnaturally suggest themselves to every practitioner of some expe-rience ; and in the third, and during convalescence, to combat thedepression by the various means in our power; to endeavour tobring the eruptions as speedily forward as possible, and whensuppuration takes place, to open the tumours as early as possible,obviate profuse suppuration by constitutional and local remedies,and ward off a debility, which oft proves fatal, (in Sidon, sixteenfell victims to it,) by liberal diet, and, if possible and practicable,by a removal to a more salubrious district, The excessive orindiscriminate use of purgatives should be avoided."

" Adhesion is a result of inflammation, and one of great im-portance to the surgeon; it is to this process to which we lookfor the cure of many formidable wounds; it is upon this, processwe depend for re-union of the parts after the removal of morbidexcrescences, and after the amputation of limbs. Although in agreat proportion of cases, it is our purpose to promote this as asalutary process, we are sometimes called upon to obviate theconsequences of preternatural adhesion, as producing hideous de-formities, as impeding the motion of limbs, or interrupting thesalutary functions of organs. Union by adhesion, or what has,ever since the days of Galen, been termed, union by the firstintention, has been considered under two different conditions:when the part divided by fracture, rupture, laceration, or other-wise, has no communication with the external atmosphere, bymeans of a wound in the superincumbent parts; or when thewhole of the separated parts are divided by a wound penetratingfrom without inwards, or vice versa, and when, of course, acommunication exists with the external atmosphere,’- Sir GeorgeBallingall’s Outlines of .Military Surgery.

ROYAL COLLEGE OF- SURGEONS.Gentlemen admitted members on Friday, November 14th, 1845 :-R. Bab-

ington, A. C. Tweedie, J. Walker, G. Foote, P. Jones, J. T. Hooper, S. W.Hurrell, A.. Ward, D. J. Edwards, J. D. Kilner, H. B. Beck.

APOTHECARIES’ HALL, LONDON. -

Names of Gentlemen who obtained Certificates of Qualification to prac-tise as Apothecaries, on Thursday, November l3tb, 1845 :-John Eddison.Worksop; Gustavus Foote, Tavistock-street, Covent-garden ; CharlesHowell Collins, Chew Magna; James Smellie, London.

CORRESPONDENTS.An Old Subscriber.-Dr. Marshall Hall’s work on the " Diseases and De-

rangements of the Nervous System" is the only one from which the requi-site knowledge can be collated.

Verba.-All is designed by nature to remain, at least for a time.The letters of Mr. Hassall and Mr. Denham shall appear next week.Lector.-The quotation respecting the "inert condition of the Vaccine

Board," was made from the -4ledico-Chirurgical Review for October, andnot, as accidentally misstated, from the British and Foreign MedicalReview.A report of the case mentioned by Mr. Slyman would possess consider-

able medical interest.

The subject mentioned by Mr. H. Jones is under consideration. It is amatter of considerable public importance.Mr. Marchant.-Not in the present Bill. The question is entirely

omitted.The report of the case forwarded to us by Mr. David Davies, of Lough-

borough, shall be inserted in an early Number..

The letter of Chiron, and several others, are unavoidably excluded thisweek.Before we can answer the question which has been proposed to us by

Mr. S. J. Thomas, it is necessary that we should have an opportunity ofinspecting a copy of the summons, or order, that was served upon him to.secure his attendance at the inquest. Was it signed by the Coroner, or bythe constable? Mr. Thomas appears to have been must unhandsomely, ifnot unlawfully, treated.Does R. H. object to the publication of his name. The profession gene.

rally, we apprehend, pay little attention to the recommendations of par.ticular modes of treatment when they rest only upon anonymous authority.An Apprentice (communication dated Nov gth.)-To the first question we

reply, aro to the second, yss to the third, we answer, it is not likely thatthe provisions of a new Medical Act would materially affect the studies orexaminatioos of the existing students in medicine. We reply to the fourth-question, by stating that we cannot recommend the school that our cor-respondent has named; two or three of the teachers are blockheads, and oneof them somewhat worse.

Uncertainty would be in no danger if he were to adopt immediately thestep he has proposed. His present qualification would be deemed amplysufficient in any Medical Bill that is likely to pass the legislature.Mr. T. Stokes.-The examination for the diploma of the College of Sur-

geons is the most difficult of the two. It is quite a matter of opinionwhether the diploma of the College of Surgeons or the extra licence of the.College of Physicians gives the highest status. We should certainly preferthe diploma.

Beta, on a moment’s reflection, will perceive that nothing positive can-be stated on the subject; but, in all probability, if he were to matriculateimmediately, and become a resident Student of a College, he would succeedin his object without any difficulty. It cannot be expected that the NewMedical Bill will operate, retrospectively, on the interests of qualifiedpractitioners, but with the knavish quacks it should deal without mercy.The reply of Dr. Roden, of Kidderminster, to the statement of Mr.

Philbrick, contained in the last number of THE LANCET, is much too longfor insertion. We shall extract for publication in the next LANCET, thoseparts that relate to Dr. Roden’s own position in the question. We canassure Dr. R. that we have no predilections in the case, all the practitionersof Kidderminster being, perronally, equally unknown to us. The followingpungent note, on the same subject, has been addressed to us by Mr. Brighton,of Kinver :-

Kinver, Staffordshire, Nov. 17th, 1845.To the Editor.-Sir: I am unwillingly compelled to notice a letter written

by a Mr. Philbrick, surgeon, of Kidderminster, and contained in yournumber of Saturday last, in which I find a perfect stranger has taken theunwarrantable liberty of introducing my name, in connexion with a dis-agreement apparently existing between some of the medical practitionersof Kidderminster and himself, but with which I have nothing whatever todo, and of the details of which I am entirely ignorant.

Considering the transaction as of a purely personal character, I called onMr. Philbrick, accompanied by a friend; but findinghim determined not tosurrender the name of his informant, neither to retract the assertion he hasput forth respecting me, I have evidently but one course left, that of pub-licly repeating to Mr. Philbrick, through the medium of the periodical inwhich his cowardly libel was inserted, the information I gave him personallyon Sunday evening-viz., that he has been guilty of writing and printing agross and deliberate falsehood, so far as his letter relates to me.In the year 1842, from the number of poor persons whom I was in the

habit of gratuitously attending, I found it necessary to adopt some arrange-ment by which I might secure myself from the heavy expense, I couldvery ill afford, of supplying this large number of persons with medicines aswell as advice. I was therefore induced to accede to their request, ofestablishing a self. supporting dispensary, and, on referring to its books, Ifind five members only belong to Cookley. I have only to add further, thatthe system of self-supporting dispensaries first commenced at Cookley, inthe year 1834, five years previous to my purchase of the practice I now hold.

I am, Sir, your obedient servant, JOHN BRIGHTON.’ If the letter of Dr. Roden had been equally brief it should have been pub.

lished this week.

Has not Dr. Moore received a private note from the Sub-EditorThe report of the paper read before the MEDICAL SOCIETY Of UNIVERSITY

COLLEGE by Mr. JOHN MARSHALL, on the Anatomy and Physiology of theBrain, shall be published next week. It is a highly interesting production.

Just as we were going to press, we received a second Communicationfrom Dr. Roden, but there was not time to alter our arrangement.Communications have been received from, Beta, Mr. T. Stokes, An Ap-

prentice, Mr. May, Uncertainty, Mr. Griffins, Mr. Stevens, Mr. Brighton,1 Mr. Heath, Mr. Roden, Mr. H. Jones, (Bristol,) Mr. D. Davies, Mr. JohnJones, Mr. Coxworthy, 0., (Alpha-road,) Dr. Merton, Juvenis, One of the

Deluded, A Member of the College, Mr. Gaskill, A Student, (Birmingham,Verax, Dr. C. T. Mackin, Mr. Lory Marsh, Dr. G. Moore, and The Brent-ford Union affair, (vaccination.)