751

that the method described by him haa been triedbefore-in fact, I myself strongly advocated its use inTHE LANCET of Nov. 14th, 1896, p. 1373. I am very gladDr. Reid has found it so satisfactory, as I firmly believethat for burns, skin grafting, and surface wounds generallyit only wants to be tried to be far more extensivelyused than it is now. The principle can be adoptedeven in cases where the burn extends right round thelimb, at any rate in children, by slinging the limb as fora fracture treated by Bryant’s method and fixing a sort ofmeat-safe cage over it. If, too, in suitable cases the partaffected is at once thoroughly cleansed with antiseptics mostif not all of the dangers of sepsis and absorption of

poisonous substances may be done away with. The part iskept clean without fear of absorption of the lotions used.

I am. Sirs. vours faithfullv.

King’s College Hospital, March 7th, 1898. J. R. BENSON.

TEST-TUBE REACTIONS BETWEEN COBRAPOISON AND ITS ANTITOXIN.

fo the Editors of THE LANCET.

SIRS,—We beg leave to correct an error in your report ofthe communication read by us before the PathologicalSociety of London on March lst. The quantity of serumnecessary to neutralise 0’1 milligramme of cobra poisonshould read 0.1 c.c. and not 1.0 c.c. Further, the explana-tion offered of the fact that multiple doses of pyocaneoustoxin are not neutralised by corresponding amounts of serumis Wassermann’a, not ours.

We are. Sirs. yours faithfullv,

March 8th, 1893.J. W. W. STEPHENS,W. MYERS.

*** Oar report was perfectly correct, but a decimal pointescaped impression.-ED. L.

" THE FELLOWSHIP OF THE ROYALCOLLEGE OF PHYSICIANS OF

LONDON."To the Editors of THE LANCET.

SIRS,-Although one cannot expect to do much with anunreformed corporation whose proceedings are kept secretunder oath, yet I was glad to read your annotation on thesubject of advancement to the Fellowship of the College ofPhysicians. Any Member of the College who gets elected asan assistant physician (unless he is an obstetric) to a Londonhospital, and who, as such, "devils" for the physicians, isjust as certain of his Fellowship as if he proceeded to thathigher distinction at his will and at his own time. But therethe certainty of the Fellowship ends : no matter whether aMember has "distinguished himself in medicine" in theprovinces or in any of the public services, unless he hasthe stamp of a London hospital staff he might as well havecontented himself with any of the minor medical qualifica-tions. He will never be a Fellow, or if he is it will be whenhe is of a certain age and reputation and can very well affordto care no more for the empty honour.

I do not begrudge the young London physician anythingwhich enables him to make a better living than he otherwisewould do or which ornaments the prospectus of the Londonhospital schools. The young London physician is handi-capped enough as it is by having to live in a style far beyondhis means; but there might be some consideration shown tomen in other departments of medicine who from whateverstandpoint you like to regard them are as worthy as theirLondon corafreres and are as likely from their social positionto maintain and uphold the dignity of the College and, if thewhole truth were told, have distinguished themselves in thepractice of medicine quite as much as the young gentlemenwho see out-patients and make themselves generally usefulto their seniors at the London hospitals in the certain hope ofbeing promoted by them to the Fellowship.The boycotting of obstetric physicians-cf asylum phy-

sicians-men who have greater responsibilities and themedical care of more patients than any hospital physician inLondon, must have been observed by the profession at large.But owing to the secresy which is maintained in the Collegedeliberations the part which personal spite plays in prevent-ing a man from obtaining his Fellowship may be known onlyto a few. There have been Fellows whose love of j ustice has

been in conflict with the obligation of their oath of secresy,and they have told a tale which showed how entirely at themercy of one individual is the chance of a Member obtaininghis Fellowship if anything is said against him in camerd.So petty a thing, too, as a man’s asking a personal friend tonominate him is quite sufficient to damn him in the eyes ofthe immaculate censors.

I am. Sirs. vours faithfullv.

March 8th, 1898. M.R.C.P. (AND LIKELY TO REMAIN SO).

Ma.rch8tb.l898.

TRANSPOSITION OF THE HEART ALONE.To the Editors of THE LANCET.

SIRS,-In THE LANCET of Feb. 26th, at page 607, Mr.W. H. Brown, of Leeds, mentions an interesting post-mortemexamination in which the heart was found on the right sideand was the only transposed viscus. Transposition of theabdominal viscera generally and even of the lungs have fre-quently been noticed, but a transposition of the heart aloneis extremely interesting. There is, unfortunately, no men-tion in Mr. Brown’s note of whether the aorta turned to theleft as in mammals or to the right as in birds. The commonlyaccepted explanation of the transposition of unsymmetricalviscera is the retention and development of a right aorticarch instead of a left one, and it would add much to thevalue of the case if Mr. Brown could give us some furtherparticulars of the relations of the cavities of the heart, thepericardium, the aortic arch, and the position of the aortictrunk in regard to the spinal column.

I am. Sirs. vours faithfullv.March 8th, 1898. ANATOMIST.

NOTES FROM INDIA.

(FROM OUR SPECIAL CORRESPONDENT.)

Plague ín Bombay.I REGRET to have to record the death from plague of

Miss Morgan, one of the English nurses who had been onduty at the General Plague Hospital at Poona, and also thatDr. H. W. Bruce, on duty at Malegaun, has had a severeattack of plague. He is fortunately now out of danger. A

European nurse at the Parsee Plague Hospital has also con-tracted the disease. It would appear that the supposedimmunity of Europeans is perhaps questionable, as whenexposed to infection the frequent occurrence of cases provestheir vulnerability. Under ordinary circumstances they areplaced under slight dangers of infection compared withnatives, while their mode of life also safeguards them fromcontracting, or succumbing to, the disease.An important scheme of great magnitude is about to be

carried out in Bombay. Four camps have been preparedwith accommodation for nearly 20,000 people. It is pro-posed to empty one of the most populous and most infecteddistricts of the city. The most insanitary houses will thenbe opened up by the military engineers and the whole will bethoroughly disinfected and limewasbed. After about a weekthe people will be permitted to return to their homes andthen another district, if necessary, will be treated in thesame way. This method has been adopted in several othertowns with great success and it seems a great pity.that sucha move was not taken here much earlier.The extent and virulence of the epidemic have been rising

week by week until last week 2195 deaths were recorded, ofwhich 1257 were officially returned as due to plague. Thismortality equals a death-rate of over 135 per 1000 per annum.As the returns show great increases under the heads of feversand phthisis it is reasonable to suppose that the number ofdeaths from plague has been very much larger. There isfortunately some indication that the epidemic has reachedits height. In addition to plague a large number of cases ofrelapsing fever are admitted into the fever hospital. Manyinteresting cases illustrate that the two diseases can run con-currently in the same patient. The mortality of relapsingfever is only about 10 per cent., whereas that of plague atthe present time is nearly 80 per cent. The prognosiswhen the two diseases occur together does not seem to berendered more grave. Small-pox is prevalent and a largenumber of cases of chicken-pox are also to be met with,but there are no deaths from the latter disease.