April 2, x88i.] THE BRITISH MEDICAL _OURNAL. 531

The.Z. CAh. Degree will be conferred only on candidates who haveobtained the degree of M.B. of the university. The fee for the examina-tion is £5. The examination comprises an examination in the theoryand practice of surgery, including operative and clinical surgery.

The Diploma in Obstetrics.-This diploma will be conferred only oncandidates who have obtained the degree of M.B. of the university.The fee for the examination is £2. The examination comprises anexamination in the theory and practice of midwifery, and the use ofobstetrical instruments and appliances.Eramination for the MV.D. Degree.-The fee for this examination

shall be £-. The degree of Doctor of Medicine may be conferred onany candidate who has obtained the degree of Bachelor of Medicine, andhas produced a certificate of having been, for at least two years, engagedin hospital or private medical or surgical practice, or in the military ornaval medical service. Provided that the candidate shall submit to themedical examiner a thesis certified by him to have been composed byhimself, and which shall be approved by them.

Candidates settled for a period of two years in the colonies or foreigncountries may, on satisfying the senate to that effect, and complying withthe conditions above described, have the degree conferred on them inabsence.The following is the full text of the curriculum, which, it will be seen,

agrees closely with that given by us in the JOURNAL of the i9th ult.The curriculum shall extend over at least four years, and shall be

divided into periods of at least two years each. It is recommended thatthe first period shall comprise attendance on the following courses ofmedical lectures-Chemistry, botany, with herborisation for practicalstudy, and zoology: anatomy and phsiyology, practical anatomy, materiamedica, and pharmacy; that the second period shall comprise atten-dance on the following courses of medical lectures--Anatomy and phy-siology, practical anatomy, theory and practice of surgery, midwifery,theory and practice of medicine, medical jurisprudence. Candidatesare further required to have attended during the first period-Practicalchemistry (in a recognised laboratory); Medico-chirurgical hospital(recognised by the senate), containing at least sixty beds ; together withthe clinical lectures therein delivered, at least two each week, duringa winter session of six months; and during the second period-Practicalmidwifery-A certificate of having attended at a recognised midwiferyhospital, with the clinical lectures therein delivered, for a period of threemonths; or of having attended a midwifery dispensary for the sameperiod ; or of having attended ten cases of labour, under the superinten-dence of the medical officer of any hospital or dispensary where cases oflabour are treated. Medico-chirurgical hospital (recognised by thesenate) containing at least sixty beds, together with the clinical lecturestherein delivered during eighteen months, including either three wintersessions of six months each, or two winter sessions of six months eachand two summer sessions of three months each.A MI.B. ofsthe university therefore, it would appear, need not have

graduated in Arts.It appears that, as in the case of the majority of the British uni-

versities, graduation in Arts is not to be an essential preliminary to adegree in Medicine. The scheme of the new Royal University differsfrom that of the Queen's University, chiefly in the following particulars.i. The place of study is not limited to certain colleges. 2. As in thecase of other universities in the United Kingdom, the degree of M.B.is preliminary to that of M.D. 3. The degree of M.D. is to beobtained on terms closely resembling those in force in the Scottishuniversities, with the difference that neither a degree in Arts nor a moreextended examination in general subjects than the matriculation ex-amination is to be required.The new University will begin work in the coming autumn. In

August, the official announcement for the first session will, it is stated,be published, and in October the matriculation examinations take place.The only important change, we understand, that has been made by theSenate in the scheme (of which we published a brief abstract in theJOURNAL of the i9th ultimo) is the addition of twelve competitive Fel-lowships, each of the annual value of £200.

ULCERATION OF THE TRACHEA IN TRACHEOTOIMY.-TwO interest-ing cases of tracheotomy followed by ulceration of the trachea by thecalnnula, wvith perforation of the bracheo-cephalic arterial trunk, havebeen reported to the Societd Anatomique de Paris. In both cases, thepatient was suddenly seized with violent haemorrhage, and the bloodpoured out in abundance through the cannula, to the amount of abouta pint and a quarter in five minutes. The patient, in one case, was achild four years old; in the other, a man aged 32. In both, the ulcer-ation appeared to be due to the friction between the external edge andthe lateral edges of the lower end of the cannula.

ASSOCIATION INTELLIGENCE,COMMITTEE OF COUNCIL:

NOTICE OF MEETING.A MEETING of the Committee of Council will be held at the offices ofthe Association, i61A, Strand, London, on Wednesday, the 13th day ofApril next, at 2 o'clock in the afternoon.

FRANCIS FOWKE, General Secretary.i61A, Strand, London, March 15th, i88i.

BRANCH MEETINGS TO BE HELD.

THAMES VALLEY BRANCH.-The next meeting of this Branch will be held at theGriffin Hotel, Kingston-on-Thames, on Thursday, -April 7th, at 6 P.Mv. The fol-lowing papers have been promised:-Dr. Urban Pritchard:- On the Simples ofAural Surgery. Dr. F. P. Atkinson: On Gout.-EDWARD L. FENN, M.D.,Honorary Secretary.-Richmond, March 3oth, Y88i.

BATH AND BRISTOL BRANCH.-The fifth ordinary meeting of the session will beheld at the Bristol Museum and Library, on Thursday evening, April 7th, at 7.30;Alex. Waugh, Esq., President. The following communications are expected: I. ACase of Pregnancy complicated with Hydatid Mass: J. Hinton. 2. Two Fatal Casesof Injury to the Spine: F: R. Cross, M.B. 3. Unusual Features in Typhoid Fever:G. F. Atchley, MB.B- 4. A Case of Lymphadenoma: R. Shingleton Smith, M.D.-E. MARKHAM SKERRITT, R. S. FOWLER, Honorary Secretaries.-Clifton, March,s88s.NORTH OF ENGLAND BRANCH.-The spring meeting of this Branch will be heldatTynemouth, on Thursday, April 28th, at 3 PMAl. Members wishing to read papers,or make other communications, are requested to write at once to the Secretary.-T. W. BARRON, M.B., Honorary Secretary, Io, Old Elvet, Durham.-March 29th,I88s.

YORKSHIRE BRANCH.-A meeting of the Branch will be held at Ripon on Wednes-day, April 27th, at 3.I5 P.I. Members intending to make communications arerequested to write at once to the Secretary.-A meeting of the Branch and the pro-fession will also be held at the Philosophical Hall, Leeds, at 5 i,.-t., on Wednesday,April 6th, to consider the report on Medical Education; P. E. Miall, Esq. (Pre-sident), in the chair.-ARTHUR -JACKSON, Secretary.SOUTH WALES AND MONMOUTHSHIRE BRANCH.-The next meeting will be heldat the Cawdor Arms Hotel, Llandilo, on Thursday, April 28th. Gentlemen intend-ing to be present,, and desirous of reading papers, etc., are requested to communi-cate with ALFRED SHEEN, M.D., Honorary Secretary, Cardiff.

METROPOLITAN COUNTIES BRANCH: NORTHERNDISTRICT.

A MEETING of this District was held on Tuesday, February 22nd, atthe house of Dr. Hilliard, Upper Holloway; Dr. HILLIARD presided.Cornrnunications.-The following communications were made.

I. Mr. Pearce Gould showed a patient upon whom he had operatedfor the cure of a Varicocele by means of the Galvanic Cautery. Thecase gave evidence of a most excellent result. The veins having beencompletely obliterated, were hardened and shrivelled. Mr. Gould saidthat this was the twelfth case upon which he had operated in a similarmanner, and they had all been invariably successful. He describedthe steps of the operation, and gave many important details as to howand when the operation should be performed.

2. Dr. Thorowgood read some practical observations on the use ofthe Hypophosphites of Soda and Lime in the Treatment of Phthisis.In pulmonary consumption, there were three agents at work to destroythe lung and wear out the patient, viz.: I. The products of inflamma-tion in the form of caseous and cellular deposits; 2. Septic actioninduced by the suppuration going on in cavities, maintaining fever, andso wearing out the patient; 3. The true miliary tuberculosis, growingrapidly in the lymphatic and subepithelial connective tissue, invadinaalso the serous membranes generally, and rapidly destroying life. Thefirst and inflammatory element might form the starting-point for the twolast-named conditions; hence the importance of early treatment. Thecases narrated showed that, in pneumonic phthisis and scrofulous pneu.monia of the apex of the lung, the hypophosphites of soda and limemight be given with, very marked benefit. Over true tuberculosis inits miliary form, hypophosphites, like other medicines, had but littlecontrol.Paying Hospital for North London.-Dr. POTTER introduced the

subject of a paying hospital for North London. Hospitals, he said,were extensively abused; many persons seeking hospital treatmentwho could well afford to pay for attendance at home. This wasperhaps more due to the confidence felt in that treatment than toavarice. The speaker thought that the present system of hospital admi-nistration had, in some cases, reached the climax of absurdity, and

532 THE BRITISH MEDICAL 7OURNAL. [April 2, 188i.

hoped that sharp criticism would be succeeded by radical reformation.It was obvious that charitable institutions should only be used by theneedy. Experience had demonstrated that the best results of medicaland surgical science were obtained in hospitals. It was, therefore,natural that those who could not obtain the highest professional skill athome should, in extreme cases, seek it at those institutions. Dr. Potterproposed to recognise this natural feeling, 'and'to provide the best pro-fessional skill, with hospital management, on a paying basis. Manypersons, he said, would thus be saved from pauperisation and loss ofself-respect; whilst the poor man's doctor would be preserved frommuch injurious competition. The case of North London, Dr. Pottersaid, was peculiar. There was a district as large as Manchester orGlasgow, which, as had recently been shown in the BRITISH MEDICALJOURNAL, was practically -without hospital accommodation. This dis-trict was inhabited by large numbers of the middle classes-people whohad both the sense to value and the means to pay for hospital treat-ment. Reviewing the advantages and the disadvantages which mightarise to the family doctor'from the establishment of such an institutionas was proposed,' Dr. Potter thought that 'the former would far out-weigh 'the latter. The chief disadvantage would he, the occasionaltransference of a chronic patient from the doctor's list to the wards ofthe hospital. But would notthis frequently be a relief rather than a dis-Qdvantage-? The advantages, it was-' contended, would be neither fewnor small.. Among other things, a healthy stimulus would be impartedto professional activity; chronic cases, which, from bad home manage-ment, baffled the doctor's skill, would b'e placed in the most favourablecircumstances' whilst "those peculiar products of an advanced civilisa.tion called ' provident dispensaries'-would be checked in their develop.ment, and their unfitness for survival experimentally demonstrated".-The reading of the paper was folloved by'ah'nanimated discussion, atthe, close of which it was proposed,' a-d carried unanimously' that aspecial meeting be called for the renewed consideration of the subject.

JAMAICA BRANCH: ANNUAL MEETING,.THE annual meeting of this Branch was -held at. Kingston on Thurs-day, December 30th.' The chair was taken by the retiring President,D. P. Ross, M.D., Senior Medical Officer to the Public Hospital.

Officers and Council.-The following were elected:-President:James Ogilvie, Esq. Vice-President: C. Greyleard, Esq. Zonorady Secre-tary: M. Stern, Esq. Council: J. Cargill, M.D.; J. H. Clark, Esq.;B. W. Davis, AL.D.; J.C. Phillipps, Ml.D.; D. P. Ross, M.D.; A. R.Saunders, M.B.; J. Ternprett, Esq.Medical Legislation.-A Committee of the Council was appointed to

draw up a report on the state of the existing medical law in Jamaica;there being certain clauses open to grave objection, as affecting boththe honour and the interests of the profession. *A deputation, consist.ing of Dr. Ross, Mr. Ogilvie, Mr. Gayleard, and Mr. Stern, hadwaited on the Colonial Secretary, and pointed out to him what wasobnoxious in the Act. The'Colonial Secretary, who agreed in themain with the views of the deputation, suggested that the professionshould memorialise the Government. Steps have been taken to carrythis suggestion into effect.Dinner.-At 8 P.M., the annual dinner took place at Park Lodge, to

which prominent members of the learned professions, and other leadingmen in the community, were invited. The guests present were : theHonourables E. N. Walker, Acting Colonial Secretary; H. H. Hocking,Attorney-General; S. C. Burke, M.C.L. and Assistant to the Attorney.General; H. J. Kemble, Custos of Kingston and Chairman of theMunicipal Board; Captain O'Brien, Deputy-Director of Roads; theReverends T. Radcliffe, Thomas Porter, WY. G. Downer; Drs. JamesScott, F. Saunders, and Parker, A.M.D.; Mr. H. B. Shaw, Inspectorof Prisons and Reformatories; Mr. Capper, Inspector of Schools; etc.

NEWVBIGGIN-BY-THE-SEA.-The sanitary history of this districtduring I88o was sufficiently uneventful. A number of cases of scarla.tina were reported, but the disease was stamped out by the energy ofDr. Reid. Measles and rubeola' were both prevalent, but the con-tinued absence of croup and diphtheria is remarked upon. Dr. Reidsays it is twenty years since he had a case of the former disease, and hehas never seen or heard of another so far as he can recollect. Rheu-matic fever, notwithstanding the exposure of so many of the inhabitants(both men and women) to the weather, is very seldom met with; -andhe questions whether there'have been six cases during the last thirtyyears. The total number of deaths from all causes was 28-equal to arate of i8.96 per i,ooo.

CORRESPONDENCE,HEALTH-INSTITUTES.

SIR,-By the above term is meant an institution which shall partakepartly of the nature of a sanatorium, and partly of a hydropathic estab-lishment; but, whereas the former is associated in the lay mind withan inebriate or lunatic-asylum, and the latter in the medical mind witha particular form of quackery, this commits one to nothing, and pre-sumably would be interpreted to mean a health-giving, or health-restor-ing, institution; -and such, in truth, it is intended to be. The onlyrespects in which it would differ from the above institutions would bein the personel and in the mode of treatment. Patients would notnecessaily be under the care of the superintendent of the establish-ment; but might, if they pleased, be attended by their own familyphysician ;- and, as to the mode of treatment, it would not be exclusivelyhydropathic,. but hydropathy would be used as an adjunct to legitimatemedicine.

It is believed that an institution of this nature, in the immediateneighbourhood of London, which should contain all the appliances thatare met weith in first-class hydropathic establishments, and under thecharge of one in whom the profession had confidence, would supply awant long felt, and receive the support of the great bulk of the pro-fession.A meeting, to take this subject into consideration, was held in the

rooms of the Medical Society, Chandos Street, on Saturday, the 5thinstant-Dr. Farquharson,- M.P., in the chair-at which the followingresolutions were unanimously agreed to.

I. Moved by Dr. George Harley, and seconded by Mr. David \V.Nell: "That this meeting having heard Mr. Holthouse's proposal toestablish institutions, in which the practice'of hydrotherapeutics shouldbecarried out on scientific principles, and as an adjunct to legitimate me-dicine, -pledges itself to co-operate with him in carrying it into effect."

2. Moved by Dr. E. Symes Thompson, and seconded by Mr. T. H.Eve: "That immediate steps be taken to ascertain the conditions onwhich 'Rockhills', Sydenham, and 'The Mansion', Richmond Hill,can be obtained; and to report the sameto the next meeting."

3. Moved by the Rev. R. A. Westhorp, and seconded by Dr. DeHavilland Hall: "That, to carry out the foregoing resolutions, alimited liability company be formed, to be called 'The Health InstitutesCompany'; and that the following gentlemen be a provisional commit-tee, with power to add to their number-Drs. E. Symes Thompson andDe Havilland Hall; Messrs. Butler, Chapman, Eve, Gould, Nell, C.H. J. Walker, C. C. Walker, and the Rev. R. A. Westhorp."

4. Moved by Mr. Alfred Pearce Gould, and seconded by Mr. C. H.J. Walker: " That the best thanks of the meeting be given to Dr.Farquharson for his kindness in taking the-chair."Any gentlemen who may be willing to co--operate in this movement

may receive further information on application to, sir, yours faithfully,15, Percy Street, W., March 8th, i88i. C. HOLTHOUSE.

THE DENTAL REGISTRATION CLAUSES.SIR,-Mr. Tomes appears, in his letter of March 5th, to entirelyfail to make out his case against the Medical Council; in fact, from

his own showing, it is perfectly clear that the Medical Council, in thefirst instance, under Dr. Rolleston's scheme of examination rules, de-sired not to be called upon to originate a scheme; and that, under Dr.Quain's subsequent motion, they again desired that the Bill should bebrought into conformity with the Lord President's Bill, which, as youhave already quoted, contained a clause enabling the Dentists' Associa-tion, or any person, to submit a scheme for examination, licensing,and registration; and this view they adhered to after the communica-tion of Mr. Jenkyns's letters on July ist, since Dr. Quain's motion wascarried on July 4th. 1ler. Tomes may, if he please, of course, repu-diate all responsibility for the acts of Mr. Jenkyrs; but it is generallyunderstood that a parliamentary draftsman only carries out instructionsgiven to him; and it is perfectly clear that, if Mr. Tomes and Sir JohnLubbock had any responsibility in respect to the Bill-and I do notunderstand that they disavow it-they are the persons responsible,conjointly with the Government, for the defects in the Act now com-plained of. These; defects were foreseen by some of the members ofthe Medical Council, and would not have occurred had the resolutionson the subject passed by the Medical Council on July 4th been re-spected by Mr. Tomes and Sir John Lubbock, and carried out by Mr.Jenkyns. The Bill was spoiled by being prematurely hurried throughthe House of Lords; and, in presence of the documents here quoted byMr. Tomes, it is perfectly futile to blame the General Medical Councilin a matter in which they are obviously quite blameless. They are

536 TIlE BRITISH MEDICAL _OURNAL. [April 24188.

by Mr. Poyntz Wright, after a severely-contested election. The salaryof the post has beeni Liob a y ar, a moiety of which has been repaidby the Local Goverhment 'Board, -thus giving the latter, by virtue oftheir grant, a control 'over the 'appointment. At the time of Mr.Wright's 'election an attempt was niade to redUce the salary by one-half, but the London Board refused to sanction this proceeding, statingthat 'if it were persevered 'in-they 'would withdraw fom-Paying anyportion. Like too many appointments of the kind, Mr. Wright'stenure of office has unfortunately 'been only a 'yearly one, 'so that atresi'election 'has'been nedessiate& everyr Mtch. This' year- a move-men h'bas' been begun 'by certaan' of the"`frie'nd& and ri-at'tn 'of thefdrimei'eme'dkal offitedr of health, to' reinstate him' by shelving fMr.Wright. This, however, was'impossible'so long as the Local Govern-mein .'Bdard rxetainied their 'control' over the appointmienf, inasmuch asthey" wo-d''fio doubt have 'deliiied Ito-cofifirm'the election df an officerwlo'ihad'previously been requiked ty tliem to' 'resign. This being thecase, Wliei'the day'fo- re-election arrived, on the 24th ultimo, a reso-uitioh' was passed by- the Authorifty, reducing'the 'salaty of their medicalofficer fromr£too-to so56, relinquishing the' gtant paid by the Lond'ortT'h`ard, 'and thus getting 'the entire bontrol' of the" appointment in theirown 'hands; Th-e aUT'hority 'ack-ano'wledge they h-ave a medical officerwho'has peiforim'ed his duties to :thehir' entire' satidsfadtion *but,' insteadof'askiing'Mr."WNright if'h'e wa'' willing to-ritaiT thedappdintnieht,'and 'be kre-elected 'at the 'reduced' silary, 'they passed'a' cond resolution,to'the effect that the app6int'mene shall be'throwh''open and- publicly'advertised, thus giving Mr. Wright 'the expense of a fresh canvaass and'a contested election, to say nothing of possible "defeat. 'There sedi tobegrouhds for the belief'that' severall'fiedical practitibners in the neigh.bourhood intend to oppose Mr. Wright.at the' election, Which is fixedfor the' 7th 'inst. 'Having, however, faithfully and' well perfoimed- theduties of the appointhient for'the6last two years 'anid a-half,'to the satis-faczton' of "the l&l 'authority, 'as' well as of' the Local GovernmentRoard, Mr. Wri'ght clearly has the first claim bn the suiffrages '6f' theguardians'; and we trust they may see 'fit to 're-elect him to the' office-which he has filled 'with so much credit. '

MEDICALNEWSSArTH CARIES' HALL.-The.folbovwj ggent1emen passed their Ex-anlinafiqn iAtle :cienead c of hieiine, ad <receivXd certificates to. pFatise, on Th rsdagy, March 24th) I881.Callaway James; jo, City Road, E.C.Moore,; AktartdLr A~fthew, 47?, N~ke'ross Road, S.E.X,York;Tionuas Hutten, Brady Street,.iBehnal Greenr.. :The dlawing gentlemen also on the same day passed their PritaryPlofessioinal Examination.Haddock, William Isaac, Charing Cross-Hospitai.,Nichojls, trederick ILucius, Charing Cross Hospital.Statham, eginmad Whiteside, St. Thrmas! Rospital.

MEDICAL: VtA.'cCAIES. ;.THE following vacancies are annouwced :_ .-BETHLEM HOSPITAL - Two Resident iXedical Stud.nts. ApPlications bY,April gth..,BLRM I N(TPI A BQROUGI-I LUNATIC ASYLUAM-Assistant Medical Officer.SalarY, 4 20 per annum. Applications by April 2114.BOURNET 1OVTA GENERAL DISPENSARV-'Resident Medical Officer.Salary, Li!d pier annum. Applicatiois on Or before the 2nd April.BRITISH LYIING-IN HOSPITAI§-Physiclan to the 5Ont-Patient Department.Applications. on or before April 9th.CARLISLR .DISPENSARY- .Assistant, House.Surgeon.. :Salary, 90o per annum.Applications to the HonorWry Secretary.CARRICK]4ACRQSS UXION-_ Iledial -.Qfller. for Pqqaghmnoyne DispensaryDistrict. Salary, Z oo per annum, With £I5 per annun 4$5 Wedicaj1 Officer of* Hdalth,rldistraeioald vaccinationtfees. ElectiOn on the ixth inkt.'CHARrNG CROSS 'HOSPITAL, West Strant-A'sistant Stfrgeon. Applications on or before Saturday, April 2nd.CITY OF AfBERDEEN-Aedical Officer for the City. Salary, £3oo per annum.-Applications by April gth.DUNDALK IJNIqN-Medical Officer for Barronstqwn Dispensary DistrictSalary, Zi2i per annum, with Z2i yearly as Medical Officer of Health, registra-tionand vaccinatiox fees. Election on the 7thin'tant;GENERAL INFIRAIARY, Hertford-House-Surgeon and Secretary. Salary,Zioo per annum. Applications on or before April 22nd.HOLLOWAY AND NORTH ISLINGTON INFIRMARY - Two MedicalOfficers. Particulars from the Resident Medical Officer.LANCASTER UNION-Medical Officer. Salary, 445 perannum. Applicationsby April 15th.LEITHIj-OSPITAL-Assistgnt House-Surgeon. Salary, 46o per annum, withboard. Applications on or -before April 8th.LIVER-POOL ROYAL INFIRAIARY-Resident Aledical Officer. Salary, Lionper annum. Applications by April 20th.

PARQCHrAL BOARD OF KILARROW AND KILMENY -Medical OfficerApplications to Mr. Peter Chisholm Bowmore, Islay.POPLAR HOSPITAL FOR ACCIDENTS-House-Surgeon. Salary, 4xooperannum, SAlso Deputy House-Surgeom. Applications to the Secretary.$T. MARYLEBONE GENERAL DISPENSARY-ObstetricPhysician. Applications by April 4th. c iSUNDERLAND IINFIRMIARY-Two House-Surgeons. Applicationsby May4th.'TOTrENHAM' TRAINING. HOSPITAL-HouLse-Surgeon (single). Saiary.I50 per annum. Applications by April 3oth.WEST SUSSEX, EAST HANTS, AND CHICHESTER GENERAL IN-FIRMARY.,- House-Surgeon. Salary, 48o per annum. Applicafions on orbefore April gth.WHITEHAVEN AND WEST CUMBERLAND INFIRMARY AND FEVERHOSPITAL-House-Sirgeon. Salary, £150 per annum. Applications beforeMay zst.

BIRTHS, MARRIAGES, AND DEATHS.The charge for inserting announcements of Births, Marriages, and Deathsis 3s. 6d., which should beforwarded in stanms with the announcements.

BIRTH,O'RoR;E.-On March 24th, at Park View, Ballinrobe, co. Mayo, the wife of C. T.J. O Rorke, L.JK.Q.C.P., L.R.C.S.I., of a daughter.

MARRIAGES.MOORE-ARMSTRONG.-On Tuesday, March 15th, 88Sr, at Christ Church, LeesonPark, Dublin, by the Rev. Maurice Neligan, D.D., John William Moore,. A.D.Univ. Dubl., F.K.Q.C.P., of.4o, Fitzwilliam Square West, Dublin, to LouisaEmma, youngest daughter of the late Edmund John Armstrong, Esq., J.P. andD. L. of the County of Clare, of 44, Lower Leeson Street, Dublin*VACHER-BRAIDWOOD.-On March 3oth, at St. Mary's, Hornsey Rise, London,Francis Vacher, F.R.C.S.Ed.., Medical Officer of Health, Birkenhead, to Isabella,younger daughter of the late Rev. John Braidwood, M.A.

DEATH.'ARR9IMAN.-On March 24th, at West Lodge, Putney Common, after a few houts'illness, John Merriman, Surgeon, Apothecary-Extraordinary to the Queen, andformerly General Medical Attendant on H.R.H. the Duchess of Kent and thePrincess Sophiit, late of Kensington Square and The Priory, Mlariborough,aged 8o.

A BILL for the regulation of the practice of pharmacy has beenbrought before the Legislature 'of the State of Massachusetts.DR. WILLANIA PEPPER, Professor of Clinical -Medicine in the Uni-versity of Pennsylvania, has been appointed Provost of that University.One of his first official acts was to confer the degree of LL.D. uponPresident Garfield.HEALTH AND WEATHER.-A very interesting and important lecture

on the "Weather and Health of London" was read on March z5th,at the Royal Institution, by Mr. Alex. 'Buchan, the secretary of theMeteorological .Society of Scotland. Its scope was a very valuabledigest tof the statistics of diseases. and deaths in the Metropolis forthirty years,.with a view to show the relationship between the weatherat different periods of the year and the diseases which attained theirmaxima and minima of deaths within them. The researches. have beenMrcrried Out by, the lecturer and'Dr. Arthur Mitchell; and London wasselected as the typical region, because it: was considered that, on accountof its vast size, its large population, and the more perfect' statisticalreports which had been made in regard to it, its details in every waywould be the.most advantageous for correct reasonings and deductions.The lecture was illustrated 'by a very large number of diagrams andcharts, showing the averages and excesses and deficiencies for most ofthe 120 diseases which are recorded in the present official reports. Thefirst important result of the investigations has been to show that thedeath-rates constitute true constants according to their different causes,and that each -is specially favoured or discouraged in development bysuch particular.periodic seasons of the year as really constitute climaticchanges. Taking the total of death-rates, it was shown that the curveof intensity had during the year two maxima; one, the greater, corre-sponding to the period between November and March, and the otherto the period between July and September. If from this total view thedeaths from abdominal diseases were taken out, the form of the curve ofintensity was entirely altered, it having only one maximum and oneminimum; the latter commencing to descend in January and continuingbelow the average to September. The abdominal diseases were thusshown to be concordant with the heats of summer. By taking awaydiseases of the nervous system, the form of the curve was againaltered materially; but after this the particular curves of the remainderof diseases gave much slighter modifications, but still sufficient to assigneach to its proper climatic portion of the year's season. By this means,also, light was thrown upon the true causes- of deaths in the respectivediseases by assigning to each a position in the class of diseases charac-terising the special climatic seasons. The period of fog was thusnoticeable for its influence on asthma, which attained within that

A 2

period its highest death-rate. Divisions of ages, sexes, and soils, withcorresponding sanitary arrangements, were dealt with in similar scientificresearches, and the results were equally well marked in every case.Using the system of classification as a means of deduction, the greatplague of i666 was assigned to the category of abdominal diseases, anda diagram was given showing the curve of its extraordinary intensity.London at that time had 384,000 inhabitants, and in the four weeksending 30th September 26,800 persons perished. Estimating a likeproportion for the increase of the Metropolis at this day, and the fear-ful death-rate corresponding to that dire event would equal the wholeexisting population of Glasgow. Some few glances of the correspond-ing influences of climate over the general globe confirmed the deductionsmade upon the statistics of the London area. Further, the increasedintensities of diseases specially subjected to the influences of heat orcold were singularly confirmed by the like analyses of the statistics ofNew York, which possesses a climate ten degrees hotter in summerand ten degrees colder in winter than our own.

NON-HEREDITARY DEAF-DUMBNESS.-A member of the Associa-tion residing in Shrewsbury has sent us the following interestingnote. Thinking the following account of the family of Mr. andMrs. Williams, who formerly resided at Newport in this county,may be interesting to some of the members of the British MedicalAssociation. The father and mother are both living, and theirspeech and hearing are both perfect. They, whilst in Shropshire,had a family of fourteen children, seven of whom were born quite deafand dumb, and one nearly so. No ancestors of this family, so far ascan be traced, were deaf and dumb. They have numerous relativesliving, and not one of them is suffering from the same deprivation.They are a fine looking, strong and healthy family * some of them areabove the average height. They are fairly intelligent generally, andthose who are deaf and dumb are very quick and observant. I.Thomas, born I839; speech and hearing perfect; married i86o; hashad a family of nine; all could hear and speak. 2. Hester, born 1841;single; speech and hearing perfect. 3. Charles, born 1843; deaf anddumb; married 1871; wife can hear and speak; -they have fourchildren who can all hear and speak. 4. Louisa, born i846; -speechand hearing very imperfect; single. 5. Francis, born I848 ; deaf anddumb; married 1878; wife deaf and dumb; they have one child whocan hear and speak. 6. Fanny, born i850; deaf and dumb; died1877; single. 7. Alfred, born I851; speech and hearing perfect;married I872; has four children, all can hear and speak. 8. Ethelinda,born 1853; single; speech and hearing perfect, 9 and io. Lucindaand Catharine, twins, born I855; both deaf and dumb; Catharinesingle; Lucinda married I877; husband deaf and dumb, said to havebeen deprived of his speech and hearing when a child by a loud clap ofthunder. They have three children who can all hear and those whoare old enough speak; two of them are twin girls, born i88o; theyare the fifth generation of twins in a direct line in the family, com-mencing with the great great grandmother of the last named birth. Shehad two more descendants, who gave birth to twins, a daughter twiceand a grand-daughter three times. II. Helena, born 1856; deaf anddumb; married I870; husband deaf and dumb, caused by fever whena child; they have one child who can hear. 52, Walter, born I86o;deaf and dumb; married I88o; wife can hear and speak. 13. Amelia,born 1862; died soon after birth. 14. Bertie, born I865 ;,hearing andspeech perfect.PUBLIC HEALTH.-The annual rate of mortality last week, beingthe twelfth week of this year, in twenty of the largest English towns

averaged 21.7 per I,ooo of their aggregate population. The rates ofmortality in the several towns were asfollow: Salford 17, Norwich17, Nottingham 17, Birmingham I8, Wolverhampton i8, Brighton 18,Sheffield 20, Bristol 20, Bradford 20, London 2i, Leicester 21, Man-chester 21, Newcastle-on-Tyne 22, Sunderland 22, Oldham 23, Hull23, Leeds 25, Portsmouth 25, Plymouth 26, and Liverpool 28. Scarletfever showed the largest proportional fatality in Bradford and Sunder-land; and whooping-cough in Newcastle-upon-Tyne, Leeds, Sheffield,and Portsmouth. Of the 17 deaths from diphtheria in the twentytowns, 7 occurred in London, 3 in Portsmouth, and 2 in Bristol. Thedeath-rate from fever (principally enteric) was highest in Portsmouthand Oldham. Small-pox caused 52 more deaths in London and itssuburban districts, one in Birmingham, one in Newcastle-upon-Tyne,and none in any of the seventeen other provincial towns. In London,2,640 births and i,5I6 deaths were registered. ,The deaths were asmany as 256 below the average, and the annual death-rate was 21.3.The I,5I6 deaths included 49 from small-pox, 48 from measles, 28from scarlet fever, 7 from diphtheria, 33 from whooping-cough, 2from typhus fever, II from enteric fever, 2 from ill-defined forms ofcontinued fever, 9 from diarrhoea, 2 from dysentery, and one from simple

cholera; thus, I92 deaths were referred to these diseases, being 49below the' average. The'deaths referred to diseases of the respira-tory organs, which had been 419, 384, and 345 in the three precedingweeks, were 348 last week, and no fewer-than 122,below the average;210 were attributed to bronchitis, and 85 to pneumonia. Differentforms of violence caused 52 deaths; 46 were the result of negligence oraccident, among which were 20 from fractures and contusions, 2 fromburns and scalds, 4 from drowning, and 14 of infants under one year ofage from suffocation. Five cases of suicide were registered. AtGreenwich, the mean temperature of the air was 39. 5°, and 2.4ebelow the average. The general direction'of the wind was westerlyand the horizontal movement of the air averaged 14.9 miles per hour,which was 2.2 above the average. Rain fell on six days of the week,to the aggregate amount of' o.39 of an inch. The duration of re-gistered bright sunshine in the week' was equal to ITO per cent. of itspossible duration. The recorded amount of ozone showed an excess onThursday and Friday, but it was below the average on each of theother days of the week.HEALTH OF FOREIGN CITIEs.-The following facts may be gathered

from a table published in the Registrar-General's last weekly return,and compiled from the most recent statistics furnished by the variousauthorities of thirty foreign cities. The death-rate in the tbree Indiancities averaged 33.2 per Iooo, and was. equal to 25.8 in Calcutta, 32.2in Bombay, and 42.4 in M-adras; fevers, principally remittent, werevery fatal in all these cities, and small-pox caused 28 deaths in Madras.In twenty European cities, according to the most recent weekly returns,the average annual death-rate was equal to 29.5, which showed a markedexcess upon 21.7, the average rate in the twenty large English townslast week. In St. Petersburg, the rate was equal to 51.8; and thefatal cases of typhus and typhoid fever rose to 85, from 74-in the previ-ous week. In the three other northern cities of Stockholm, Copen-hagen, and Christiania, the death-rate did not average more than 26.4;the highest rate being 28.7 in Stockholm, which,however, showed adecline. The Paris death-rate was equal to 31.2, and was higher thanin the previous week; 32 deaths were referred to small-pox, and 45 totyphoid fever, showing an increase upon recent weekly numbers. Thedeath-rate was equal to 25.9 in Brussels, and to I6.7 in Geneva; feverfatality was proportionately excessive in the latter town. In Amster-dam, Rotterdam, and the Hague, the rates were respectively 27.3,25.6, and 27.4; and all the three towinswere comparatively free fromzymotic fatality. Among the six German and'Austrian towns in-cluded in the Registrar-General's most recent list, the death-rateaveraged 25.5, and ranged from 22.7 and 24.1 in Berlin and Dresdento 32.2 and 35.0 in Vienna and Buda-Pesth.' Small-pox caused 23deaths in Vienna, and i8 in Buda-Pesth; diphtheria showed' fatalprevalence in Berlin,. Dresden, and Munich; and six deaths were re-ferred to typhus in Hamburg. In the four Italian cities,.still higherrates prevailed, and averaged 29.6; the rate was 29.9 in Rome, 25.2in Naples, 37.0 in Turin, and 31.0 in Venice.. Small-ipox'caused twodeaths in Rome, and six in Venice; and typhus and enteric fevers werefatally prevalent in Naples and Turin. In four of the largeVt Americancities, the rate did not average more than 25.5,. altho6ugh diphtheriawas fatally prevalent in New York, Brooklyn, and Baltimbrd-; in Phi--ladelphia, 49 fatal cases of small-pox were recorded, showing an in-crease of five upon the number in the previous week. The last returnof the Registrar-General contained no contribution from Lisbon orAlexandria.THINGAL RURAL DISTRICT.-Dr. Scott Kilner shows so many signsof being an active and efficient officer of health, that it is a pity he

should disfigure his otherwise capital report by giving delusive death.rates for each of.the parishes in his district. No deductions of anypossible value can be drawn from such rates, calculated necessarily onvery small figures 'and they serve only to confuse and alarm- Thusthe death-rrate of one village is given at the 'enormous figure of 58.3 peri,ooo. Reference to the tables shows -this rate to be made -up of sevendeaths, four of which were in persons over sixty years of age-!-Obviouslyno reliance can be placed on a death-rate such as this. The rate forthe whole district was 13.2 per .Iooo, against 16.5 in-1879 and 52.5 in1878; and the proportion of infantile deaths was.123.6 per i,ooobirths. Of zymotic diseases, the most prevalent was diarrhoea, 56 casesof which were reported. Scarlatina was found in'several villages, anddiphtheria in others. One case .of .the latter was interesting throughthe fact, that, some weeks before the patient was taken il, nearly all thefowls in his father's yard (amounting to several hundred) were attackedby, and many ofthem died from, a disease very closelyresembling diph-theria. Among the sanitary improvements attempted during the year,the repression of overcrowding received particular attention, a greatmany houses being visited, and 76 of the worst cases being remedied.

April 2, i88i.] THE BRITISH MEDICAL YOURNAL. '537

538 THE BRITISH MEDICAL 7OURNAL. [April 2, 1881.

OPERATION DAYS AT THE HOSPITALS.

MONDAY...... Metropolitan Free, 2 P.M.-St. Mark's, 2 P.M.-Royal LondonOphthalmic, II A.M.-Royal Westminster Ophthalmic, I.30 P.M.-Royal Orthopaedic, 2 P.M.

TUESDAY...... Guy's, I.30 P.M.-Westminster, 2 P.M.-Royal London Ophthal-mic, II A.M.-Royal Westminster Ophthalmic, 2.30 P.M.-WestLondon, 3 P.M.-St. Mark's, 9 A.M.-Cancer Hospital, Brompton,3 P.M.

WEDNESDAY.. St. Bartholomew's, 1.30 P.M.-St. Mary's, 2.30 P.M.-Middlesex, IP.a.-University College, 2 P.M. -London, 2 P.M.-Royal LondonOphthalmic, II A.M.-Great Northern, 2 P.M.-Samaritan FreeHospital for Women and Children, 2.30 P.M.-Royal WestminsterOphthalmic, 1.30 P.M.-St. Thomas's, 2.30 P.M.-St. Peter's, 2 P.M.-National Orthopedic, sO A.M.

THURSDAY.... St. George's, 1P.M.-Central London Ophthalmic, I P.M.-CharingCross, 2 P.M.-Royal London Ophthalmic, II P.M.-Hospital forDiseases of the Throat, 2 P.M.-Royal Westminster Ophthalmic,1.30 P.M.-Hospital for Women, 2 P.M.-London, 2 P.M.-North-west London, 2.30 P.M.

FRIDAY........ King's College, 2 P.M.-Royal Westminster Ophthalmic, I.30 P.M.-Royal London Ophthalmic, II A.M.-Central London Ophthal-mic, 2 P.M.-Royal South London Ophthalmic, 2 P.M.-Guy's,2.30 P.M.-St. Thomas's (Ophthalmic Department), 2 P.M.-EastLondon Hospital for Children, 2 P.M.

SATURDAY .... St. Bartholomew's, 2.30 P.M.-King's College, I P.M.-Royal Lon.don Ophthalmic, Is A.M.-Royal Westminster Ophthalmic, 1.30P.M.-St. Thomas's, I.30 P.M.-Royal Free, 9 A.M. and 2 P.M.-London, 2 P.M.

HOURS OF ATTENDANCE AT THELONDON HOSPITALS.

CHARING CROSS.-Medical and Surgical, daily, I; Obstetric, Tu. F., I.30; Skin,M. Th.; Dental, M. W. F., 9.30.

Guy's.-Medical and Surgical, daily, exc. Tu., I.30; Obstetric, M. W. F., I.30 ; Eye,'M. Th., 1.30; Tu. F., 12.30; Ear, Tu. F., 22.30; Skin, Tu., 12.30; Dental, Tu.Th. F., 12.

KING'S COLLEGE.-Medical, daily, 2; Surgical, daily, 1.30; Obstetric, Tu. Th., S.,2; o.p., M. W. F., 22.30; Eye, M. Th., I; Ophthalmic Department, W., I; Ear,Th., 2; Skin, Th.; Throat, Th., 3; Dental, Tu. F., Io.

LONDON.-Medical, daily exc. S., 2; Surgical, daily, 1.30 and 2; Obstetric, M.Th., 2.30; O.P., W. S., I.30; Eye, W. S., g; Ear, S., 9.30; Skin, W., g; Dental,Tu., 9.

MIDDLESEX.-Medical and Surgical, daily, I; Obstetric, Tu. F., 1.30; O.P., W. S.,1.30; Eye, W. S., 8.30; Ear and Throat, Tu., g; Skin, F., 4; Dental, daily, g

ST. BARTHOLOMEW'S.-Medical and Surgical, daily, 7.30; Obstetric, Tu. Th. S., 2;o.p., W. S., p; Eye, Tu. W. Th. S., 2; Ear, M., 2.30; Skin, F., 1.30; Larynx,W., 2.130; Orthopmdic, F., 22.30; Dental, Tu. F., 9.

ST. GEORGE'S.-Medical and Surgical, M. Tu. F. S., I; Obstetric, Tu. S., I; o.P.,Th., 2; Eye, W. S., 2; Ear, Tu., 2; Skin, Th., I; Throat, M., 2; Orthopaedlc,W., 2; Dental, Tu. S., p; Th., 1.

ST. MAREs.-Medical and Surgical, daily, 1.15; Obstetric, Tu. F., 9.30; o.p., Tu.F., 1.30; Eye, M. Th., 1.30; Ear, W. S., 2; Skin, Th., 1.30; Throat, W. S., 12.30;Dental, W. S., 9.30.

ST. THoMAS'S.-Medical and Surgical, daily, except Sat., 2; Obstetric, M. Th., 2;o.p., W. F., 22.30; Eye, M. Th., 2; o.p., daily, except Sat., 2.30; Ear, Tu., 12.30;Skin, Th., 22.30; Throat, Tu., 12.30; Children, S., 22.30; Dental, Tu. F., 2o.

UNIVERSITY COLLEGE.-Medical and Surgical, daily, I to 2; Obstetric, Ml. Tu. Th.F., I.3o; Eye, M. W. F., 2; Ear, S., 2.30; Skin, Tu., a.30; S., 9; Throat, Th.2.30; Dental, W., 10.3.

WEsTMINsTaER.-Medical and Surgical, daily, 2.30; Obstetric, Tu. F., a; Eye, M.Th., 2.30; Ear, Tu. F., p; Skin, Th., I; Dental, W. S., 9.iS.

MEETINGS OF SOCIETIES DURING THENEXT WEEK.

MONDAY.-Medical Society of London, 8.30 P. m. The President (Dr. Broadbent)will exhibit a Patient suffering from Double Facial Paralysis. Dr. W. H.Day: Tubercular Meningitis, and the Mode of Treatment. Dr. R. J. Lee:Cutaneous Diseases in Infants and Young Children.-Odontological Society ofGreat Britain, 8 P. m. Special General Meeting to consider a Special Resolu-tion. Mr. Stocken: On Certain Remedies in the Treatment of Inflammationof the Periodontal Membrane and of Neuralgia. Casual communications byMessrs. Sewill, Betts, Thos. Murphy, Felix Weiss, Morton, Swete, JohnAckery, J. Brindley.

TUESDAY.-Pathological Society of London, 8.30 P.M. Mr. Rushton Parker: I.Carcinoma and Adeno-fibroma of Breast; 2. Hyaline Myxoma; 3. Odontoma,Nasal Epithelioma, etc. (card). Mr. Brailey: Cranium and Brain of Hydro-cephalic Adult. Dr. S. West: I. Case of Pulsation in Hepatic Region (livingspecimen); 2. Aneurysm of Pulmonary Artery (card). Dr. Hale White,Dermoid Tumour of Soft Palate. Mr. Malcolm Morris: Case of Lupus (liv-ing specimen). Sir Joseph Fayrer: Abscess of Liver following Dysentery.Mr. C. J. Symonds: Unreduced Dislocation of Patella (card).

WEDNESDAY-Obstetrical Society of London, 8 P.M. Specimens will be shownby the President, Drs. Godson and Cory, and Mr. Alban Doran. The Dis-cussion on Dr. B3arnes's paper On Missed Labour will be resumed; after which,A Case of Delivery through an Imperforate Vagina, by Dr. Heywood Smith;and other cornmunications.-Hunterian Society, 7.30 P.M., Council Meeting.8 P.M., Dr. Hughlings Jackson will exhibit Cases of Disease of the SpinalCord. Dr. Port: On a Case of Disseminated Sclerosis.

THURSDAY.-Harveian Society of London, 8.30 P.M. Dr. T. C. Hayes: FibrousPolypus of Uterus; Dr. Cheadle: The Treatment of Empyema.- Ophthalmo-logical Society of the United Kingdom, 8.30 P.M. Report of the Committeeon Colour-Blindness (presented by Dr. Brailey). Living Specimens at 8 P.M.Dr. Hughlings Jackson: A Case showing the State of the Discs Ten Yearsafter Recovery from Optic Neuritis. Mr. Waren Tay: Case of Disease atYellow-Spot Region in an Infant.

FRIDAY.-Clinical Society of London, 8.30 P.M. Dr. B. O'Connor: A Case ofSyphilitic Psoriasis. Mr. Rushton Parker: A Case of Arterial Hxematoma ofthe Forearm. Dr. Steavenson: A Case of Meningocele (patient will be shown).Mr. T. H. Morgan: A Case of Progressive Painful Inflammation of theArteries.

LETTERS, NOTES, AND ANSWERS TOCORRESPONDENTS.

COMMUNICATIONS respecting editorial matters should be addressed to the Editorx6s, Strand, W.C., London; those concerning business matters, non-delivery of theJOURNAL, etc., should be addressed to the Manager, at the Office, i6i, StrandW.C., London.

AUTHORS desiring reprints of their articles published in the BRITISH MEDICALJOURNAL, are requested to communicate beforehand with the Manager, i61A,Strand, W.C.

CORRESPONDENTS not answered, are requested to look to the Notices to Cor-respondents of the following week.

PUBLIC HEALTH DEPARTMENT. -We shall be much obliged to Medical Officers ofHealth if they will, on forwarding their Annual and other Reports, favour us withDuplicate Cophies.

WE CANNOT UNDERTAKE TO RETURN MANUSCRIPTS NOT USED.

THE CANTONAL HOSPITAL AT GENEVA.DR. ALFRED WVISE, Visiting Physician to the Infirmary for Consumption, MargaretStreet, writes to us :-This hospital was built in 1850, at a cost of goo,ooo francs;it now contains 320 beds, which, on emergency, can be increased to 350. On the

ground-floor are surgical wards of i6, 14, 8, and 5 beds, operating theatre, andoffices. The first floor contains a similar arrangement of 'Pmedical" beds; andabove this is accommodation for paying patients, of whom seven only are undertreatment at present. Baths, sculleries, and water-closets are within the building,in the long corridors which communicate with the wards by doors and windows.A free movement of air in these corridors is available by means of windows openingexternally.The system of ventilation is on the propulsion principle. During the winter,heated air, ranging from I7' to 22° Centigrade (53.6' to 71.6' Fahr.), according tonecessity, is forced into each ward, by means of a fan worked by steam power.This air is taken from the garden, passes into caloriflres, and is moistened by theevaporation of water before being propelled along the channels which distribute it

to the " salles". Fifteen thousand cubic metres are thus supplied every hour, orabout 47 or 48 cubic metres for each patient. The inlets for this air (numberingone for every four or five beds) can be closed separately, in the event of a wardbecoming too warm. Six feet below these openings, and one or two feet from thefloor, are others which act as outlets (one underneath each bed), and communicatewith a shaft, making its exit on the roof.Numerous windows on the corridor side of the wards, and on the opposite side,which faces the open, supply the interior with abundance of light. The floors are

of polished oak, in the Swiss style of Parquet"; this gives a clean and cheerfuleffect to the whole of the "salles", and obviates the necessity of water being usedfor cleansing purposes. The beds are of iron, without curtains, etc., but appearrather voluminous to an English eye from the addition of the usual continentaleider-down quilt.The nursing appears to be efficient, but is not viewed here as a "department"of the hospital establishment. Male nurses attend to male patients, female nurses

to female patients; one to every seven or eight sick. The male attendants arequick, intelligent, and well fitted for the dirty and heavy work entailed in nursingmen, especially in surgical wards.The particular feature connected with this hospital is a large garden, in which

are nine "pavilions"; each "pavilion" is made to contain tell or twelve beds. Thesides are closed by canvas divided into panels, and attached to the uprights whichsupport the wooden beams. They can be opened or closed at will by means ofrods and rings, like curtains, or be rolled up on a roller placed above, after thefashion of a shop-window, by the aid of cords and pulleys, which permit them tobe raised or lowered as desirable. The roof is covered by slate, and below it iswainscot. Two feet off the main roof, an additional top-roof allows of a free escapeof foul air. The triangle formed by the roof at the gable-ends is filled in withboards; and the floor, of the same 'Material, is raised about two feet off the ground,with free ventilation underneath.Surgical cases and others dwell in these " pavilions" from the end of April to themiddle of October, weather permitting. The cost of one of these structures is about

6,ooo francs, without beds, etc.Only one case of surgical erysipelas occurred during the past year, and one caseof pymmia; this latter happened after an operation for scirrhus of the breast, anattack of pneumonia preventing the free dressing of the wound.Within the hospital, there are at present about three hundred patients under

treatment, nearly I30 of which are under the surgical care of Professor Julliard.The teaching in this department, and in the medical wards, by Professor Revillod,is comprehensive and thorough. Much time and care is bestowed on the clinicalinstruction of students, and there is by no means a dearth of material; although,perhaps, not the variety compared to large cities like London or Paris, advantageis taken of every case of interest that appears, and the subject clinically exhausted.Daily visits, commencing at eight o'clock, are made by the physician and surgeonof the " clinique", when the instruction mentioned is given.'he system of selecting in rotation one or two students each day, for consulta-tions on cases, cannot be overestimated in its value as a means of impressing on aclass the practical knowledge of disease. One cannot help remarking that thismethod might replace, with advantage, some of the numerous lectures delivered tostudents in the various schools of medicine.Geneva, February 2ISt, i881.