of 1 /1
70 that no one is to be allowed to sell opium or laudanum, or any other poison, without * licence. Of this licence, and the man- ner of granting it, we intend to speak on a future occasion; at present, we wish to observe that the comparative liberty allowed to the trade in opium seems almost to render nugatory the other provisions of the Bill. Out of forty cases of fatal poisoning alluded to in the public prints as having occurred in this country during the last twelve months (about one-tenth part only of the total deaths from this cause annually), we find that twelve were cases of poisoning by opium or laudanum; one hundred and twenty persons may therefore be supposed to die annually in England from this drug. How many are slowly killed by the pernicious aud terrible habit of opium- eating-which, as we have the means of showing, is increasing to an enormous extent in this country, especially in the eastern counties,-Heaven only knows ! Besides the use of opium as an intoxicant, the poor in all quarters will now be driven to this drug as a mild and certain means of death, when life has become intolerable, placed kindly within their reach by an in- dulgent Legislature. The prescriptions of medical practitioners, and medicines compounded by them or at their order, are rightly excepted from the provisions of this Bill. But the exception also is applied to legally-qualified pharmaceutical chemists, who may accordingly make up or compound, and vend, just what seems good to themselves. And, worst of all, the provisions do not extend to the sale of any pateitt medicine. THE NETLEY HOSPITAL. AN active discussion upon the propriety of the site of the Netley Military Hospital has just issued in the public report of i the committee specially appointed. This controversy will have served one most important end if it fixes public attention on the necessity for giving more care than hitherto to the impor- I tant sanitary principles involved in the construction of civil and military hospitals, and the essential value of medical counsel on all these points. After an immense expense had been incurred in building upon a site selected mainly for convenience, a medical remon- strance was submitted to the government, which induced them to stay proceedings and institute committees of inquiry. The first committee reported in dubious terms. At the instance of Parliament, a second was appointed. They declared that both site and climate were unsuitable for the purposes of a general hospital and invalid depot. This report was referred back to the original committee, who have finally reported favourably. They declare a climate more relaxing than that of Torquay to be sufficiently bracing for Indian and tropical invalids. Com- mitted to the Netley-hospital plan of wards and corridors, they uphold it; whilst, with singular inconsistency, convinced of the superior excellence of the entirely-opposite Aldershott plan, they uphold it also. There cannot be any doubt in the minds of strictly impartial men of the vast superiority of the Alder- shott plan of construction, as precluding the necessity for arti- ficial ventilation, diminishing the cost of medical attendance, and as being infinitely less expensive architecturally. This report is self-contradictory, and stands therefore self-con- demned. THE ELECTION OF A HOUSE-SURGEON AT LEAMINGTON. A SINGULAR injustice has been perpetrated by the governors of the Warneford Hospital, at Leamington, which is, naturally enough, exciting great attention there, and which deserves very general and strong reprobation. From the account of the proceedings in the Leamington Courier, we learn that on Thursday week a meeting was called to elect a house-surgeon, at which about fifty governors were present. The advertise- ment previously inserted in THE LANCET announced that candi- dates for the appointment must belong to the College and Hall. Three of the candidates, possessing apparently local influence, were devoid of the required qualifications ; a fourth, Mr. Adsetts, possessing them, had obtained first-class testimonials, and travelled down from London to answer questions. Mr. Adsetts had so strong testimony in his favour, as a man of unusual talent, of singular industry, and high character, that he might well have carried the appointment over most com- petitors ; but in this instance, where his opponents were gentle- men whose qualifications were not such as the advertisement required, his claims were paramount. The unfairness of appointing a person not qualified according to the advertise- ment was strongly placed before the meeting, nevertheless a large majority of votes were given in favour of the appoint- ment of Mr. Alderson, who was not so qualified. In protesting against this proceeding, we must not be under- stood to question in any way the ability or talents of Mr. Alderson; but since he has not yet attained the age of twenty- one, and does not therefore hold the diploma of the College of Surgeons, his appointment is in violation of the contract made by the committee in their advertisement. We regret this transaction on every ground: firstly, as a simple act of inde- fensible injustice; secondly, as injuring the public faith in the integrity of hospital committees and the significance of their promises, and so deterring the best men from competing for offices in their gift; finally, as being likely greatly to injure the hospital in the esteem of the people of Leamington, where the affair has made much stir, so that we find in the local journal, the Leamington Advertiser, paragraphs such as this :- "The repetition of such inconsistencies as have marked the whole transaction will go far to destroy public confidence, and jeopardize the prosperity of this highly useful charity. The success of an hospital where the patients require medical treat- ment, must depend mainly upon the skill and experience of the medical officer. If the appointment is merely made that a young surgeon may have a school for experiments, so as to acquire experience, be it so. But deal frankly with the patients and the public, and let them know the real state of things. Don’t advertise for a member of the College of Surgeons who is also a licentiate of the Apothecaries’ hall, and then ignore your own requirements! If local influence is allowed to lower the standard of qualification, then age, skill, and experience go for little or nothing in a surgeon for the Warneford Hospital. Justice Shallow supposed, when Falstaff preferred Wart to Bullcalf, that the knight did not know how to choose a recruit; but Bardolf was in the secret and knew better." INFLUENCE OF PRISON DISCIPLINE ON HEALTH. OUR attention has recently been drawn to the subject of prison punishments and dietary, by the publication of a series of reports and papers by Dr. Edward Smith, who, in connexion with the inquiry which it is well known he has in hand, has made this a special subject of research. In the papers which are published by him in the " Transactions of the Society for the Promotion of Social Science," and to which we shall at a future time recur, he discussed the principles upon which the system of both dietary and punishment are founded; but the observations to which we now wish to direct attention are found in two papers recently read before the Department of Punishment and Reformation, of the same Society, and pub- lished in the May number of the Philanthropist. They refer to the inequality in punishment and dietary in the different county prisons in England. Knowing the pains which have of late years been taken to make English justice even-handed, and, in some degree, to ap portion punishment to crime, we not unnaturally assumed that a sentence of punishment in one part of the kingdom meant much the same thing as a similar sentence elsewhere, and, therefore, we cannot sufficiently express our surprise at the astounding diversity which Dr. Smith has shown to exist over the whole country. It now appears that " Judges on circuit may, with the same sentence and for the same offence, con- demn the prisoner to four times as much punishment in one prison as in another." This has been ascertained by the re- plies of upwards of sixty governors of gaols to questions ad- dressed to them by Dr. Smith, and one of the papers referred to is mainly an analysis of these original retjrnf. Dr. Smith states, by way of résumé,—

THE NETLEY HOSPITAL

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that no one is to be allowed to sell opium or laudanum, or anyother poison, without * licence. Of this licence, and the man-ner of granting it, we intend to speak on a future occasion; atpresent, we wish to observe that the comparative libertyallowed to the trade in opium seems almost to render nugatorythe other provisions of the Bill. Out of forty cases of fatalpoisoning alluded to in the public prints as having occurred inthis country during the last twelve months (about one-tenthpart only of the total deaths from this cause annually), we findthat twelve were cases of poisoning by opium or laudanum;one hundred and twenty persons may therefore be supposedto die annually in England from this drug. How many areslowly killed by the pernicious aud terrible habit of opium-eating-which, as we have the means of showing, is increasingto an enormous extent in this country, especially in the easterncounties,-Heaven only knows ! Besides the use of opium asan intoxicant, the poor in all quarters will now be driven tothis drug as a mild and certain means of death, when life hasbecome intolerable, placed kindly within their reach by an in-dulgent Legislature.The prescriptions of medical practitioners, and medicines

compounded by them or at their order, are rightly exceptedfrom the provisions of this Bill. But the exception also is

applied to legally-qualified pharmaceutical chemists, who mayaccordingly make up or compound, and vend, just what seemsgood to themselves. And, worst of all, the provisions do notextend to the sale of any pateitt medicine.

THE NETLEY HOSPITAL.

AN active discussion upon the propriety of the site of theNetley Military Hospital has just issued in the public report of i

the committee specially appointed. This controversy will haveserved one most important end if it fixes public attention onthe necessity for giving more care than hitherto to the impor- Itant sanitary principles involved in the construction of civiland military hospitals, and the essential value of medicalcounsel on all these points.

After an immense expense had been incurred in buildingupon a site selected mainly for convenience, a medical remon-strance was submitted to the government, which induced themto stay proceedings and institute committees of inquiry. Thefirst committee reported in dubious terms. At the instance of

Parliament, a second was appointed. They declared that bothsite and climate were unsuitable for the purposes of a generalhospital and invalid depot. This report was referred back tothe original committee, who have finally reported favourably.They declare a climate more relaxing than that of Torquay tobe sufficiently bracing for Indian and tropical invalids. Com-mitted to the Netley-hospital plan of wards and corridors, theyuphold it; whilst, with singular inconsistency, convinced of thesuperior excellence of the entirely-opposite Aldershott plan,they uphold it also. There cannot be any doubt in the mindsof strictly impartial men of the vast superiority of the Alder-shott plan of construction, as precluding the necessity for arti-ficial ventilation, diminishing the cost of medical attendance,and as being infinitely less expensive architecturally. This

report is self-contradictory, and stands therefore self-con-demned.

THE ELECTION OF A HOUSE-SURGEON ATLEAMINGTON.

A SINGULAR injustice has been perpetrated by the governorsof the Warneford Hospital, at Leamington, which is, naturallyenough, exciting great attention there, and which deservesvery general and strong reprobation. From the account of the

proceedings in the Leamington Courier, we learn that on

Thursday week a meeting was called to elect a house-surgeon,at which about fifty governors were present. The advertise-ment previously inserted in THE LANCET announced that candi-dates for the appointment must belong to the College and Hall.Three of the candidates, possessing apparently local influence,were devoid of the required qualifications ; a fourth, Mr.Adsetts, possessing them, had obtained first-class testimonials,

and travelled down from London to answer questions. Mr.Adsetts had so strong testimony in his favour, as a man ofunusual talent, of singular industry, and high character, thathe might well have carried the appointment over most com-petitors ; but in this instance, where his opponents were gentle-men whose qualifications were not such as the advertisementrequired, his claims were paramount. The unfairness of

appointing a person not qualified according to the advertise-ment was strongly placed before the meeting, nevertheless alarge majority of votes were given in favour of the appoint-ment of Mr. Alderson, who was not so qualified.

In protesting against this proceeding, we must not be under-stood to question in any way the ability or talents of Mr.Alderson; but since he has not yet attained the age of twenty-one, and does not therefore hold the diploma of the College ofSurgeons, his appointment is in violation of the contract madeby the committee in their advertisement. We regret thistransaction on every ground: firstly, as a simple act of inde-fensible injustice; secondly, as injuring the public faith in theintegrity of hospital committees and the significance of theirpromises, and so deterring the best men from competing foroffices in their gift; finally, as being likely greatly to injurethe hospital in the esteem of the people of Leamington, wherethe affair has made much stir, so that we find in the localjournal, the Leamington Advertiser, paragraphs such as this :-"The repetition of such inconsistencies as have marked the

whole transaction will go far to destroy public confidence, andjeopardize the prosperity of this highly useful charity. Thesuccess of an hospital where the patients require medical treat-ment, must depend mainly upon the skill and experience ofthe medical officer. If the appointment is merely made that ayoung surgeon may have a school for experiments, so as toacquire experience, be it so. But deal frankly with the patientsand the public, and let them know the real state of things.Don’t advertise for a member of the College of Surgeons who isalso a licentiate of the Apothecaries’ hall, and then ignoreyour own requirements! If local influence is allowed to lowerthe standard of qualification, then age, skill, and experiencego for little or nothing in a surgeon for the Warneford Hospital.Justice Shallow supposed, when Falstaff preferred Wart toBullcalf, that the knight did not know how to choose a recruit;but Bardolf was in the secret and knew better."

INFLUENCE OF PRISON DISCIPLINE ONHEALTH.

OUR attention has recently been drawn to the subject ofprison punishments and dietary, by the publication of a seriesof reports and papers by Dr. Edward Smith, who, in connexionwith the inquiry which it is well known he has in hand,has made this a special subject of research. In the paperswhich are published by him in the " Transactions of the Societyfor the Promotion of Social Science," and to which we shall ata future time recur, he discussed the principles upon which thesystem of both dietary and punishment are founded; but theobservations to which we now wish to direct attention arefound in two papers recently read before the Department ofPunishment and Reformation, of the same Society, and pub-lished in the May number of the Philanthropist. They referto the inequality in punishment and dietary in the differentcounty prisons in England.Knowing the pains which have of late years been taken to

make English justice even-handed, and, in some degree, to apportion punishment to crime, we not unnaturally assumed thata sentence of punishment in one part of the kingdom meantmuch the same thing as a similar sentence elsewhere, and,therefore, we cannot sufficiently express our surprise at theastounding diversity which Dr. Smith has shown to exist overthe whole country. It now appears that " Judges on circuitmay, with the same sentence and for the same offence, con-demn the prisoner to four times as much punishment in oneprison as in another." This has been ascertained by the re-plies of upwards of sixty governors of gaols to questions ad-dressed to them by Dr. Smith, and one of the papers referredto is mainly an analysis of these original retjrnf.

Dr. Smith states, by way of résumé,—