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HOSPITAL INSTRUCTION.

Tn the Editor of THE LANCET

SIR; The zealotis and perseveringmanner in which you follow up, andmake public, every thing yonr activoand correct judgment conceives to beconducive to our welfare and improve-ment, entitles you to the warmest grati-tnde of every Stndent. Will you increasethe obligation we are already under, bydoing an act of justice to one who hasalso ever shown himself the Pupil’sfriend ?

I am induced to trespass on your timein consequence of a letter in your lastNumber, (p. 189,) headed, " HospitalInstruction," and signed, " A MedicalStudent," in which your Correspondentcomplains how few the bed-side remarksof the Hospital Physicians and Surgeonsare; or, as it is expressed, " the scauti-ness of oral communication." With re-

spect to many ot the individuals in ques-tion the complaint is justly founded ; butis it possible yonr correspondent couldever have followed Mr. Lawrence roundthe wards, and afterwards have meantto include him in the sweeping accusa-tion the letter contains?

I hope, for the sake of the complain-ant’s judgment, that he has yet to enjoy,for the first time, that treat, for such,indeed, it is to hear Mr. Lawrence’s fulland detailed account of every case worthyof note; his remarks exhibiting no ordi-nary share cf intellect, and his opinionsclear, decided, and replete with origina-lity; whilst occasionally, by extendingthe field of his observations, he shines asthe man of extensive general information.

Firmly relying on yonr liberality andjustice, giving " tribute to whom tributeis due," allow me to subscribe myselfa Pupil, and

A FRIEND TO FAIR PLAY.

St. Bartholomew’s Hospital,Tuesday, 1st Nov.

P.S. I am sorry again to differ fromyour Correspondent, but I deem it mo-rally impossihte for- " a thonghtful anddiligent Student" to follow any Physi.cian or’Snrheou through the wards and" walk ont again ju,t as wise as hewalked in."

HOSPITAL REPORTS.

ST. BARTHOLOMEW’S HOSPITAL.

Case of Pneumonia.—Application of theStethoscope.

M. A., a delicate and interesting girl of19 years ofage,t)ad been labouring underquinsey for about four days, and whichshe contracted by catching cold fromgetting her feet wet, when, from overexertion, she suddenly became faint,was carried to bed, and awoke butto experience one of the most violentas well as the most stubborn attacks ofpneumonia that could well be conceived.The following were the particulars eli-cited : she stated that a medical gentle-man was immediately called in, who bledher to about a pint; from this she derivedlittle or no relief; a blister was then or-dered to be applied to the chest, and onthe following day from this, connectedwith the action of purgative medicineswhich had also been administered, shefelt benefited ; but the symptoms stillrunning high, it was deemed prudentagain to abstract blood to the same qnan-tity as before, and the aperient medicineto be continued.But little abatement even of the pain,

which was aggravated by pressure, andwhich now affected the right side as wellas the chest, ensued, and none whatever ofthe other symptoms ; a freqnent harassingcough came on ; she was prevented fromhaving her wonted sleep, the features be-came attenuated, and the frame emaciated.Twelve leeches were now ordered to thechest, and repeated on the following day;the application of these in some measureailbrded relief, and, to judge from thedescription of the girl, the disease hadassumed the subacute form. About thistime, which was the tenth day of theattack, her menses returned, and duringtheir continuance the other symptomswere decidedly diminished ; an expecto-ration, on the menstrnal discharge ceas-ing, succeeded the cough, and from tt)3use of medicines the symptoms grewmilder, when, for the first time, she ob-served blood brought up with the mucus.She now became greatly alarmed, sentto the Aldersgate Dispensary, and wasattended by Dr. Clutterbuck, who, fromthe symptoms which then existed, againbled her to a pint, and on the followingday ordered two blisters to be applied,one to the side and the other to the chest,which had the effect of almost completelyremoving the pain for three succeSSive

days, when, however, it again returned,