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Correspondence.THE NEW MEDICAL REFORM BILL.

" Audi alteram partem."

To the Editor of THE LANCET.

SIR,—A letter in your last number, signed "M.D., M.R.C.S.Edin." contains the following assertions :

" The liberal framers of the Reform Bill of the ProvincialMedical and Surgical Association have excluded in toto fromthe physicians’ list about 700 gentlemen, graduates of St. An-drew’s and Aberdeen, but have wisely retained the existingpower of the Archbishop of Canterbury. Physicians withforeign diplomas may be registered, but men who have passedan examination at the universities above alluded to are to bedegraded for ever," &c.

These assertions are entirely erroneous, and I will, with yourpermission, answer them seriatim.

1. It is not true that the graduates of either St. Andrew’sor Aberdeen, or of any Scotch university, are excluded fromthe physicians’ list under the Bill in question. On the con-trary, they are all admitted under the twentieth section.

2. It is not true that the existing power of the Archbishopof Canterbury is retained under the Bill. On the contrary, itwould cease altogether (supposing the Bill were passed thissession) on the lst of November next.

3. It is not true that physicians with foreign diplomas maybe registered, there being no such provision in the Bill.

Perhaps it might not be altogether inconvenient if gentle-men who are desirous of criticising this measure would takethe previous precaution of reading it.

I am, Sir, your obedient servant,A MEMBER OF THE REFORM COMMITTEE OF

June, 1855. THE PROVINCIAL ASSOCIATION.A MEMBER OF THE REFORM COMMITTEE OF

THE PROVINCIAL ASSOCIATION.

MR. HEATH’S CASE OF UNUNITED FRACTURE.To the Editor of THE LANCET.

SIR,-I can scarcely describe my astonishment when I read,the case of ununited fracture, published in THE LANCET byMr. Heath, of the Newcastle-upon-Tyne Infirmary. Heseems to have led his students away with the false idea that hehad treated that case by an entirely original method; for hesays, " With regard to the operations that have been proposedfor ununited fracture, as the insettion of ivory pegs, sawing offthe ends of the bone, the insertion of a seton, the rubbing ofthe ends of the bone, or the putting up the limb in such a wayas to apply great pressure to the seat of fracture, each of thesehas succeeded, and they have all failed frequently." But whatI would draw attention to is, that " Mr. Heath, after dulyweighing the circumstances of the case, came to the conclusion,that an operation which should bring the parts as nearly aspossible into the condition of a recent simple fracture, was themost likely to bring about the desired result, with the leastconstitutional disturbance, and the least confinement." Thiswas done in the manner described in the hospital report-book.In what manner was this done ? By passing a small tenotomyknife obliquely down to the fracture, and dividing freely themembrane investing the ends of the bone; afterwards intro-ducing a strong curved needle between the ends of the bone,and breaking up the fibrous tissue uniting them freely; lastly,putting up the arm in a starch bandage, &c. Now, Sir, this isno new operation-a fact of which I have no doubt youare well aware, although one of which Mr. Heath seems igno-rant ; but was proposed as long ago as 1848 by ProfessorMiller, and published by him in the Monthly Journal ofMedical Science, and it will be seen in Mr. Miller’s works onSurgery, published since that time. I have now before me thelast edition of his "Principles of Surgery," and at page 696this operation is described, and in the very same language asthat used by Mr. Heath on the occasion referred to, with oneexception, that Mr. Heath applies starch bandaging, whereasMr. Miller recommends the collodion or plaster, the subsequentsteps being those of an ordinary fracture. I was a pupil ofProfessor Miller for three years, and remember as well as if itwere yesterday, his descriptions of the operations proposed forununited fracture, and amongst others, this one proposed byhimself.

I am, Sir, your obedient servant,Edinburgh, June, 1355. CHAS. F. OGILVIE, M. E. C. S. Eng.CHAS. F. OGILVIE, M.R.C.S. Eng.

WOUND OF THE PALMAR ARCH.To the Editor of THE LANCET.

SIR,—I have read with much interest Mr. Skey’s formidablecase of Wound of the Palmar Arch, and if you deem the an-nexed case worthy of insertion in THE LANCET, be so good asto give it a corner.One Sunday morning, some years ago, a labourer, aged forty,

and addicted to drinking, was seized with vertigo, whilst inhis wood-house, which caused him to fall to the ground, and inhis descent his right hand came in contact with the edge of ascythe, causing an extensive wound completely across the palmof the hand ; he bled most profusely, and some neighbourscoming to his assistance, as quickly as possible tied up his handvery tightly with some handkerchiefs, which greatly restrained,although they did not completely stop, the haemorrhage. Theman walked two miles to me, and as soon as he reached myhouse he fainted. When I removed the handkerchiefs, to exa-mine the hand, arterial blood spirted very freely from thewound, and before I could apply the tourniquet to the brachialartery, a considerable hfemorrhage occurred, and the manfainted a second time ; it was therefore evident that the palmararch of the ulnar artery was wounded. I strapped up thewound with adhesive plaster, and placed a firm compress oflint over the plaster, bandaging the hand and forearm mode-rately tight, occasionally wetting it with cold water. I alsokept the tourniquet sufficiently pressing upon the brachialartery to moderately check the impetus of the circulationthrough the limb. The man was carefully removed home and putto bed, and ordered cool and spare diet. No further bleedingoccurred, and as the wound remained easy, I did not removethe dressing for six days, when I was gratified to find it hadnearly healed by the first intention. The patient was kept inbed a fortnight, by which time the wound was quite healed,and he soon regained his usual health and strength.

This case shows, that when Nature is a little assisted, whatserious injuries she is capable of repairing, and reminds me ofwhat the late Mr. Abernethy used so frequently to say to thestudents, when going round the wards of St. Bartholomew’sHospital: ’’ Oh that I had pure air and country constitutionsto deal with !"

I am, Sir, yours, &c.,Wendover, June 16th. J. T. SAVORY.J. T. SAVORY.

PROFESSIONAL ADVERTISING.To the Editor of THE LANCET.

SIR,—With reference to Mr. Curling’s complaint, at page618 of your journal of the 10th inst. I beg to observe that the"Guide to Living Medical Authors" is not published for the aCI7vantage of individuals only, but also for that of the communityat large; and unless there be an advertisement of a book cor-responding to each subject notified in the "Guide," the ideais not carried out as I intended it to be, nor is the " Guide"complete. How far Mr. Curling has acted bonâ fide in thismatter, I leave your readers to judge from the following nar-rative of facts and correspondence. He says that on the 17thult. he wrote to the proprietor of the Medical Circular (myself),stating " his disapproval of the advertisements being headedwith the authors’ addresses, and requesting the withdrawal ofhis work from the list." Such a letter I received, and hereit is :-

39, Grosvenor-street, May 17th.MY DEAR SIR,—I must decline the advertisement of my

work on " Diseases of the Testis" in the -3fedical Circular, notonly because the book will not be ready before October next,but also because I cannot approve the mode of advertisement.I was not aware that it was your intention to head the notices

of works with the addresses ofthe authors, which seems to me soobjectionable that I must ask you to withdraw my work onthe Rectum from your list.

I am, dear Sir, yours faithfully,Jas. Yearsley, Esq. T. B. CURLING.

I briefly acknowledged the receipt of this note, stating thatthe withdrawal of the addresses had been already determinedupon, and that they would not again appear after the names.On the 28th of May (not the 23rd, as stated by Mr. Curling),

I received another communication, of which the following is acopy :-

39, Grosvenor-street, May 28th.DEAR SIR,—I have given you no authority for the continued

advertisement of mv work on the Rectum, and I now sendyou notice that you have no permission from me for its inser-

T. B. CURLING.