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640 To Correspondents. THE ROYAL HOSPITALS. ’THE Government inquiry by the Charity Commissioners for England and Wales was opened on Thursday, the 26th inst., at Bridewell. The object, as stated by the Inspector of Charities, is to inquire and report to the Board as to the foundations, endowments, and objects of the Bethlehem and Bridewell Hospitals, and also as to their present circumstances, and whether any and what improvements may be made in the management thereof. £ Mr. Wills.-The mixture of oil of lemon with spirit of wine is, doubtless, of commercial value. Amongst other purposes, it might be used as a flavour- ing material. We cannot advise as to the best market for its disposal. F. P.-King’s College Hospital. M.D., (Hampshire.)-Either of the instruments named would answer the purpose. THE LEEDS SCHOOL OF MEDICINE. To the Editor of The LANCET. SIR,-I saw in your number of Nov. 14th a letter signed "Rusty Scalpel," " of which the Leeds School of Medicine is the subject. Allow me, for I think it my duty as a student of that school, to correct the statements made by him, since your readers should not be left to imagine that all Rusty Scalpel" says is true. He would lead them to suppose that the Leeds School of Medi- cine is anything but what it ought to be. I may here state that I think our school is second to none out of London both as regards the school itself and the lecturers connected with it. Now, "Rusty Scalpel" complains, first, that there is a scarcity of subjects in the school, and, moreover, he says that this scarcity has been of frequent occurrence. It is evident that he must be either a first-year’s student or one who does not know much about the affairs of the school, otherwise he would have known that during last winter session, and on former occasions, we have had subjects to spare, either to send to other schools, or to be buried without dissection. It unfortunately happens that up to the present time we have been without subjects; but it is not owing to any want of diligence on the part of the Medical Council, for they have not only applied to the usual sources in this town, but also to the authorities in neighbouring districts. Next, that second- and third-year’s students have the first chance of the parts for dissection, and that first-year’s men have to wait until the end of the session before they can dissect. Did not "Rusty Scalpel’s" conscience strike him when he was writing that untruth; for if he was not present at the time, he must have heard that the demonstrator took the names of all gentlemen who wanted parts, and allowed them to draw lots for them. Could he have acted more fairly ? If he goes into the dissecting-room now, he will see first-year’s men at work on the first subject. He also writes about the preservation of the bodies. Most dissectors do not approve of the use of spirit for this purpose, and I must say that the mode which our curator adopts enables us to keep the subjects in good condition during the six weeks allowed by Government. Thirdly, he wants to lay down the law very largely about the mode of con- ducting the library. I can assert that scarcely any books which a first-year’s student need trouble his head about have been "out for months." The rules of the library are all that they should be, and it is not considered too much trouble by the generality of the students to go and examine the catalogue for themselves at the library. A reading-room does exist in the pathological museum, and was placed there at the request of the students, as being convenient for ready access to the specimens. Lastly, what business is it of "Rusty Scalpel’s" how his fellow-students attend the lectures, and at what time the roll is called, as long as he himself is a regular attendant. In conclusion, I think I have clearly shown by the above statements, which I can prove to be correct, that "Rusty Scalpel’s" letter is not founded on truth, and therefore a direct insult not only to the Council of the school, but to his fellow-students. I remain, Sir, yours respectfully, Leeds, November, 1863. VERITAS. Studens.-" Astigmatism" results from the curves of the cornea being asym- metrical in their vertical and transverse diameters. Hence rays of light proceeding from a luminous point, and traversing such a cornea, are not brought to a focus at a single point within the globe, but each distinct place of refraction has its own focus. The etymology of the word is from a (privation), and stigma (a point). Such defect in the conformation of the cornea is, so far as is at present known, congenital. X. Y. Z., (Totnes.)-At the British Museum and College of Surgeons. ADMINISTRATION’ OF CHLOROFORM. To the Editor of TIIE LANCET. SIR,-About six years since I wrote to you from Australia upon the subject of chloroform. I stated that resorting to Dr. Marshall Hall’s mode of artifi- i cial respiration was, I believe, the means of restoring a patient upon whom I was operating. I have since seen that practice adopted in the hospital to which I was attached as acting surgeon upon three or four occasions, and it had in each instance the immediate desired effect. I mention this, as I believe in some cases time is lost by applying restoratives, cold water, &c. About two or three years since I saw (I think in THE LANCET) the mode of administering chloroform guttatim on a handkerchief or muslin (a single layer), lightly placed over the mouth and nostrils. I at once adopted that way of administering it, which has many advantages: not the least is, it rivets the attention, not of the operator, for he ought to have something else to attend to, but that of the assistant (who too frequently allows his attention to be called away from his duty-that of administering the chloroform-to the hand of the operator), by applying it guttatim slowly, each drop following im- mediately upon the disappearance of the preceding one. The assistant must of necessity watch closely its effect. It is also a more pleasing way of admi- nistration ; it is more gradual in its effect; there is no feeling of suffocation ; consequently less resistance. I apply grease to the nose and lips, for fre- quently the smarting caused by the chloroform. will retard its action. Aberdeen, November, 1863. GEORGE WIGAN, M.R.C.S. Eng. Inhalatio.-For inhalation, either the aqueous solution of chlorine or a small portion of the chloride of lime may be placed in a proper inhaling bottle. If the latter drug be not sufficiently strong, a few drops; of hydrochloric acid may be cautiously added to develop free chlorine. If not judiciously used, or used in too concentrated a form, severe irritating effects may be I produced on the upper air-passages. Ever spasm of the glottis may ensue of an alarming character. But custom diminishes its local action, as work- e men in chemical manufactories can remain with case in so strong an atmo- 1 sphere of chlorine as would almost sufoeate others. As a remedial in- i halation, it is now rarely employed. At first, patients fancy their breathing t much relieved; but the amendment is not permanent. Dr. T. Hillier.-The paper shall be inserted if of moderate length. f - POWDERED RESIN AS A HÆMOSTATIC AGENT. To the Editor of THE LANCET. SIR,Within a few hours of reading in your last nnmber the suggestion of Dr. Arnott as to the employment of powdered resin for the purpose of assist- ing the action of the cautery in arresting haemorrhage, I met with a case ad- mirably suited for testing its power. It was that of a lady who had been blanched by haemorrhage proceeding from a mass of internal piles of exces- sive vascularity. I operated upon her with the clamp and cantery; but be- fore applying the hot iron, sprinkled the raw surfaces over with the powdered resin. A great perturbation in the shape of noise and smoke was the result, and certainly the haemorrhage was quickly arrested. But both Dr. Vine, who . was assisting me, and myself noticed one objection to the use of the resin, and this was, that the heated resin formed a waxy coating over the raw sur- face, so that if any vessel were untouched by the cautery, although bleeding, its exact point could not be readily made out; consequently I think, in this operation at least, the advantages of the resin may be couaterbalanced by ! this one defect. I shall, however, make further trial of it; but at the same time I may mention that there is no difficulty in arresting the haemorrhage with the cautery if it be properly applied and the instrument is properly shaped. When I merely used the nitric acid after clampin, the rectum, one or two cases occurred where there was more or less severe bleeding; but I have never been troubled with any bleeding after this operation with the cautery in numerous cases of the most severe description where I have re- cently employed it. I remain, Sir, yours, &e., HENRY SMITH, F.R.C.S. Caroline-street, Bedford-square, Nov. 1863. Chanapion, (Malton.)-The proceedings on the part of the registrar were quite unjustifiable. A full statement of the facts of the case, duly authen- ticated, should be forwarded to the Registrar-General at Somerset House. Dubious.-They are not generally received; but they are entitled to great consideration, and the plan is often successful in affording relief. PECULIAR CONDITION OF THE PLACENTA. To the Editor of THE LANCET. SIR,-In reference to the letter of your correspondent, Dr. S. Cartwright Reed, I would suggest that the peculiar condition of the placenta which has come under his notice is really only a more than usually complete example of a not very infrequent phenomenon. Obstetricians have long been aware of the occasional occurrence of calcareous deposits on the surface, or in the sub- stance, of the placenta. These are met with in the form either of scattered granules, of bone-like spicules, or of more considerable masses. The patho- logy of such cases is, I imagine, identical with that of similar deposits occur- ring elsewhere, as in the coats of atheromatous arteries-namely, that they are connected with fatty degeneration. When albumen becomes decomposed to form fat, its nitrogen is set free in the form of ammonia, and this ammo- nia causes precipitation of the lime-salts, previously held in solution by the blood. Fatty degeneration of the placenta at the close of gestation, as was pointed out by Dr. Druitt, (" Medico-Chirurgical Transactions," vol. 36,) can hardly be regarded, if not excessive, as a morbid phenomenon, since it occurs normally in many tissues at the termination of their period of functional activity-e. g., in the muscular fibres of the uterus itself. In the placenta it usually commences in the fcetal tufts near the circumference. The remark- able point in Dr. Reed’s case appears to be the eompleteneas of the calcareous layer, which might be supposed likely to interfere seriously with the renova- tion of the fcetal blood. Probably, however, this was more apparent than real, as the collapse of the vessels would render the interspaces, which they must have occupied, not very perceptible. I am, Sir, yours obediently, Derby, November, 1863. CHAS. A. GnEAVEs, M.R.C.S. Eng. To the Editor of THE LANCET. SIR,-Upon referring to the last 400 cases of midwifery which I have attended, I find three cases similar to that described by Dr. Reed. The whole of the uterine surfaces were studded with portions of calcareous matter, and in each instance the placenta was either partially or entirely adherent. The cause of this peculiar condition I will not venture to explain. I remain, Sir, yours truly, Brick-lane, November, 1863. WM. GAYToy, L.R.C.P. Edin. Mr. W. Squire Ward.-The report is to be found in the fifth Report of the Medical Officer of the Privy Council, 1863. A blue-book, price 2s. 6d., pub- lished by Spottiswoode and Co. A paper upon the same subject, "The Economic Value of Foods," will be read by Dr. E. Smith at the Society of Arts on December 16th; to be followed by one on "Private and Public Dietaries," at the same place, in January. FATAL CASES OF OVARIOTOMY WHICH HAVE NOT BEEN PUBLISHED. To the Editor of THE LANCET. SIR,-Your correspondent from Dublin has communicated some important facts respecting the impossibility of the diagnosis in cases of ovarian disease, and the fatality of the operation. If not greatly misinformed, an eminent surgeon in London has very recently performed the operation thrice, with fatal consequences. As no account of these cases has yet been published in any of the medical journals, I am anxious to be informed if such rumour be correct. I am, Sir, yours, &c., London, November, 1863. QUERY.

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To Correspondents.THE ROYAL HOSPITALS.

’THE Government inquiry by the Charity Commissioners for England andWales was opened on Thursday, the 26th inst., at Bridewell. The object,as stated by the Inspector of Charities, is to inquire and report to theBoard as to the foundations, endowments, and objects of the Bethlehemand Bridewell Hospitals, and also as to their present circumstances, andwhether any and what improvements may be made in the managementthereof. £

Mr. Wills.-The mixture of oil of lemon with spirit of wine is, doubtless, ofcommercial value. Amongst other purposes, it might be used as a flavour-ing material. We cannot advise as to the best market for its disposal.

F. P.-King’s College Hospital.M.D., (Hampshire.)-Either of the instruments named would answer the

purpose.THE LEEDS SCHOOL OF MEDICINE.

. To the Editor of The LANCET.

SIR,-I saw in your number of Nov. 14th a letter signed "Rusty Scalpel," "

of which the Leeds School of Medicine is the subject. Allow me, for I thinkit my duty as a student of that school, to correct the statements made byhim, since your readers should not be left to imagine that all Rusty Scalpel"says is true. He would lead them to suppose that the Leeds School of Medi-cine is anything but what it ought to be.

I may here state that I think our school is second to none out of Londonboth as regards the school itself and the lecturers connected with it.Now, "Rusty Scalpel" complains, first, that there is a scarcity of subjects

in the school, and, moreover, he says that this scarcity has been of frequentoccurrence. It is evident that he must be either a first-year’s student orone who does not know much about the affairs of the school, otherwise hewould have known that during last winter session, and on former occasions,we have had subjects to spare, either to send to other schools, or to be buriedwithout dissection. It unfortunately happens that up to the present time wehave been without subjects; but it is not owing to any want of diligence onthe part of the Medical Council, for they have not only applied to the usualsources in this town, but also to the authorities in neighbouring districts.

Next, that second- and third-year’s students have the first chance of theparts for dissection, and that first-year’s men have to wait until the end ofthe session before they can dissect. Did not "Rusty Scalpel’s" consciencestrike him when he was writing that untruth; for if he was not present atthe time, he must have heard that the demonstrator took the names of allgentlemen who wanted parts, and allowed them to draw lots for them. Couldhe have acted more fairly ? If he goes into the dissecting-room now, he willsee first-year’s men at work on the first subject. He also writes about thepreservation of the bodies. Most dissectors do not approve of the use ofspirit for this purpose, and I must say that the mode which our curatoradopts enables us to keep the subjects in good condition during the sixweeks allowed by Government.Thirdly, he wants to lay down the law very largely about the mode of con-

ducting the library. I can assert that scarcely any books which a first-year’sstudent need trouble his head about have been "out for months." The rulesof the library are all that they should be, and it is not considered too muchtrouble by the generality of the students to go and examine the cataloguefor themselves at the library.A reading-room does exist in the pathological museum, and was placed

there at the request of the students, as being convenient for ready access tothe specimens.

Lastly, what business is it of "Rusty Scalpel’s" how his fellow-studentsattend the lectures, and at what time the roll is called, as long as he himselfis a regular attendant.In conclusion, I think I have clearly shown by the above statements, which

I can prove to be correct, that "Rusty Scalpel’s" letter is not founded ontruth, and therefore a direct insult not only to the Council of the school, butto his fellow-students. I remain, Sir, yours respectfully,

Leeds, November, 1863. VERITAS.

Studens.-" Astigmatism" results from the curves of the cornea being asym-metrical in their vertical and transverse diameters. Hence rays of lightproceeding from a luminous point, and traversing such a cornea, are notbrought to a focus at a single point within the globe, but each distinctplace of refraction has its own focus. The etymology of the word is froma (privation), and stigma (a point). Such defect in the conformation of thecornea is, so far as is at present known, congenital.

X. Y. Z., (Totnes.)-At the British Museum and College of Surgeons.

ADMINISTRATION’ OF CHLOROFORM.To the Editor of TIIE LANCET.

SIR,-About six years since I wrote to you from Australia upon the subjectof chloroform. I stated that resorting to Dr. Marshall Hall’s mode of artifi- icial respiration was, I believe, the means of restoring a patient upon whom Iwas operating.I have since seen that practice adopted in the hospital to which I was

attached as acting surgeon upon three or four occasions, and it had in eachinstance the immediate desired effect. I mention this, as I believe in somecases time is lost by applying restoratives, cold water, &c.About two or three years since I saw (I think in THE LANCET) the mode of

administering chloroform guttatim on a handkerchief or muslin (a singlelayer), lightly placed over the mouth and nostrils. I at once adopted that wayof administering it, which has many advantages: not the least is, it rivets theattention, not of the operator, for he ought to have something else to attendto, but that of the assistant (who too frequently allows his attention to becalled away from his duty-that of administering the chloroform-to thehand of the operator), by applying it guttatim slowly, each drop following im-mediately upon the disappearance of the preceding one. The assistant mustof necessity watch closely its effect. It is also a more pleasing way of admi-nistration ; it is more gradual in its effect; there is no feeling of suffocation ;consequently less resistance. I apply grease to the nose and lips, for fre-quently the smarting caused by the chloroform. will retard its action.

Aberdeen, November, 1863. GEORGE WIGAN, M.R.C.S. Eng.

Inhalatio.-For inhalation, either the aqueous solution of chlorine or a smallportion of the chloride of lime may be placed in a proper inhaling bottle.If the latter drug be not sufficiently strong, a few drops; of hydrochloricacid may be cautiously added to develop free chlorine. If not judiciouslyused, or used in too concentrated a form, severe irritating effects may be

I produced on the upper air-passages. Ever spasm of the glottis may ensueof an alarming character. But custom diminishes its local action, as work-

e men in chemical manufactories can remain with case in so strong an atmo-1 sphere of chlorine as would almost sufoeate others. As a remedial in-i halation, it is now rarely employed. At first, patients fancy their breathingt much relieved; but the amendment is not permanent.

Dr. T. Hillier.-The paper shall be inserted if of moderate length.f- POWDERED RESIN AS A HÆMOSTATIC AGENT.

To the Editor of THE LANCET.SIR,Within a few hours of reading in your last nnmber the suggestion of

Dr. Arnott as to the employment of powdered resin for the purpose of assist-ing the action of the cautery in arresting haemorrhage, I met with a case ad-mirably suited for testing its power. It was that of a lady who had beenblanched by haemorrhage proceeding from a mass of internal piles of exces-sive vascularity. I operated upon her with the clamp and cantery; but be-fore applying the hot iron, sprinkled the raw surfaces over with the powdered

resin. A great perturbation in the shape of noise and smoke was the result,and certainly the haemorrhage was quickly arrested. But both Dr. Vine, who.

was assisting me, and myself noticed one objection to the use of the resin,and this was, that the heated resin formed a waxy coating over the raw sur-face, so that if any vessel were untouched by the cautery, although bleeding,

its exact point could not be readily made out; consequently I think, in thisoperation at least, the advantages of the resin may be couaterbalanced by

! this one defect. I shall, however, make further trial of it; but at the sametime I may mention that there is no difficulty in arresting the haemorrhage

with the cautery if it be properly applied and the instrument is properlyshaped. When I merely used the nitric acid after clampin, the rectum, one

or two cases occurred where there was more or less severe bleeding; but Ihave never been troubled with any bleeding after this operation with thecautery in numerous cases of the most severe description where I have re-cently employed it. I remain, Sir, yours, &e.,

HENRY SMITH, F.R.C.S.Caroline-street, Bedford-square, Nov. 1863.

Chanapion, (Malton.)-The proceedings on the part of the registrar werequite unjustifiable. A full statement of the facts of the case, duly authen-ticated, should be forwarded to the Registrar-General at Somerset House.

Dubious.-They are not generally received; but they are entitled to greatconsideration, and the plan is often successful in affording relief.

PECULIAR CONDITION OF THE PLACENTA.To the Editor of THE LANCET.

SIR,-In reference to the letter of your correspondent, Dr. S. CartwrightReed, I would suggest that the peculiar condition of the placenta which hascome under his notice is really only a more than usually complete example ofa not very infrequent phenomenon. Obstetricians have long been aware ofthe occasional occurrence of calcareous deposits on the surface, or in the sub-stance, of the placenta. These are met with in the form either of scatteredgranules, of bone-like spicules, or of more considerable masses. The patho-logy of such cases is, I imagine, identical with that of similar deposits occur-ring elsewhere, as in the coats of atheromatous arteries-namely, that theyare connected with fatty degeneration. When albumen becomes decomposedto form fat, its nitrogen is set free in the form of ammonia, and this ammo-nia causes precipitation of the lime-salts, previously held in solution by theblood. Fatty degeneration of the placenta at the close of gestation, as waspointed out by Dr. Druitt, (" Medico-Chirurgical Transactions," vol. 36,) canhardly be regarded, if not excessive, as a morbid phenomenon, since it occursnormally in many tissues at the termination of their period of functionalactivity-e. g., in the muscular fibres of the uterus itself. In the placenta itusually commences in the fcetal tufts near the circumference. The remark-able point in Dr. Reed’s case appears to be the eompleteneas of the calcareouslayer, which might be supposed likely to interfere seriously with the renova-tion of the fcetal blood. Probably, however, this was more apparent thanreal, as the collapse of the vessels would render the interspaces, which theymust have occupied, not very perceptible.

I am, Sir, yours obediently,Derby, November, 1863. CHAS. A. GnEAVEs, M.R.C.S. Eng.

To the Editor of THE LANCET.SIR,-Upon referring to the last 400 cases of midwifery which I have

attended, I find three cases similar to that described by Dr. Reed. The wholeof the uterine surfaces were studded with portions of calcareous matter, andin each instance the placenta was either partially or entirely adherent. Thecause of this peculiar condition I will not venture to explain.

I remain, Sir, yours truly,Brick-lane, November, 1863. WM. GAYToy, L.R.C.P. Edin.

Mr. W. Squire Ward.-The report is to be found in the fifth Report of theMedical Officer of the Privy Council, 1863. A blue-book, price 2s. 6d., pub-lished by Spottiswoode and Co. A paper upon the same subject, "TheEconomic Value of Foods," will be read by Dr. E. Smith at the Society ofArts on December 16th; to be followed by one on "Private and PublicDietaries," at the same place, in January.

FATAL CASES OF OVARIOTOMY WHICH HAVE NOT BEEN PUBLISHED.To the Editor of THE LANCET.

SIR,-Your correspondent from Dublin has communicated some importantfacts respecting the impossibility of the diagnosis in cases of ovarian disease,and the fatality of the operation. If not greatly misinformed, an eminentsurgeon in London has very recently performed the operation thrice, withfatal consequences. As no account of these cases has yet been published inany of the medical journals, I am anxious to be informed if such rumour becorrect. I am, Sir, yours, &c.,London, November, 1863. QUERY.

641

N. H. 0. J.-1. He would not be exempt on the grounds stated. 2. He canmake all proper reductions for expenses incurred in carrying on his pro-fession. These can scarcely be less than one-fourth of his income, and wethink might reasonably be so stated.

T. T. may try any or every method of ventilation that has been recommended;but he will unquestionably arrive at the fact that no sure and rapid modeof changing the air can be obtained without the production of someamount of draught somewhere or other in the chamber.

MEDICAL TITLES.

To the Editor of The LANCET.SIR,-"Alpha" has, I think, hit the right nail on the head, and shown the

way in which we can extricate ourselves from our present anomalous and, asfar as the surgeons are concerned, degraded position. They have not, in fact,recovered from the state of degradation into which surgery was thrown whenthe practice of medicine fell into the hands of the priests and monks in thedark ages. After an edict of the church, forbidding the priests from attend-ing surgical cases, this branch of the art of healing became the inheritanceof the barbers, from an idea, no doubt, that as they were so adroit in usingthe razor, they would be equally so in the use of the scalpel! To this we owethe separation of medicine and surgery, which, until then, had always beenunited, and which ought never to have been separated.Let the College of Surgeons, then, apply the remedy by obtaining a new

Charter, so as to become the one-faculty College or School, as advocated byyou and by every man of common sense. No more pure physicians, no morecorporations of old women, as " Alpha" rightly designates them, otherwise weshall soon have the young women taking their place, as well as that of theregular practitioner.If the Council of the College of Surgeons do not take the matter in hand, I

would recommend the members, or the general practitioners, to form them-selves into a league, found a College,-a Medico-Chirurgical College,-andthen apply to Parliament for a Charter; as, after all, they are the only pro-perly qualified practitioners in England. If they be not entitled to the titleof Doctor and Physician, I wonder who is; certainly not the corporation,whose members are not able to open a vein, set a limb, or reduce a disloca-tion on an emergency. As a compensation, however, they are well versed inLatin and Greek, and, possibly, in the occult sciences, which will account fortheir success in practice. For the want of these desirable acquisitions, theyrejected Mason Good and Armstrong, although the former had written awork on Nosology, and both had been in practice twenty or thirty years,attending precisely the same cases as they would have to attend as physicians.What a farce ! or, rather, what an injustice !Let the surgeons and general practitioners of England rise up like men,

and break asunder the chains by which they are now bound. Although num-bering thousands, they have hitherto allowed themselves to be trampledunder feet by a dozen or two of aristocrats, whose only title to distinctionhas been their long purse and a residence at Oxford or Cambridge. Thereshould be no aristocracy in science but the aristocracy of talent.

I remain, Sir, your faithful servant,London, November, 1863. A SURGEON.

Hygeist.-Small-pox reached a very high point in the month of May last; thenumber of deaths for the week ending May 9th being 71, and for the fourweeks ending May 30th, 268. 1600 persons died from variola during thefirst eight months of the present year.

Mr. Benjamin Baker, (Brentwood.)-The pamphlet appears to be a fair state-ment of the case between himself and the guardians.

A CASE OF ATTEMPTED SELF-CASTRATION.To the Editor of THE LANCET.

SIR ,-The case of suicidal mutilation which appeared in your impression ofOctober 17tb, p. 448, reminds me of one which came under my care in privatepractice in the year 1831, although the latter was of a less wholesale chaoracter than that related. The following are the principal particulars of thecase :-

J. H- was a married man, thirty years of age, and the father of onechild. His wife was considerably advanced in pregnancy of her second child.In the afternoon of Monday, March 30th, I was called to him, and, on makingan examination, found the left testicle exposed and lying on the abdomen, stillattached, however, by the spermatic cord. He had employed his pocket-knifeto effect his purpose; and on my proceeding to replace the testicle, he ex-pressed a wish that I should cut it off. I found it necessary to enlarge theincision before the return of the testicle could be effected. His wife informedme that he had been in a desponding state for some days, and had talked ofhis intention of committing the act. He appeared perfectly sane, and gaveas his reason for his conduct that his wife was always ill, and unfit for sexualintercourse. The man was able to resume work on the fourth day, and gotrapidly well. I am, Sir, yours truly,Ripley, Yorkshire, November, 1863. JOHN DAVIES, M.R.C.S.

W., (Worcestershire.)-There may be some objections to the regulationsmentioned; but they are not likely to be attended by the serious conse-quences contemplated by our correspondent.

T. D. should consult some respectable practitioner in his immediate neigh-bourhood.

Mr. S. Watts (Manchester) is advised to place himself in communication withMr. W. Adams, Henrietta-street, Cavendish-square.

THE TITLE OF "ESQUIRE."3’o the Editor o/’THE LANCET.

SIR,-The accompanying statement, taken from the article Esquire of thenew (eighth) edition of the " Encyclopaedia Britannica," might not be unin-teresting to the readers of THE LANCET, as showing, according to a high andthe most recent authority, the true position of physicians in general society:"The following are also reputed Esquires :-Officers of the Queen’s Court

and household; officers of the army and navy, down to captains inclusive;doctors of law; serjeants and counsellors at law; physicians; justices of thepeace, while in commission ; and the sheriffs of counties for life. The headsof some families are also accounted Esquires by prescription."

November, 1863. I am, Sir, yours, &c.,

C. D.

Dr.Thomas Fielding.-The article referred to was purified wood naphtha, andnot cleaned methylated spirit. It may be obtained of the patentee inMincing-lane. It was not affirmed that this wood naphtha was chemicallyundistinguishable from alcohol or spirit of wine, but only that it was notso by the senses of smell and taste, or by the potash or mercurial test.

A Regular Subscriber.-It cannot be obtained at any English, Scotch, or IrishUniversity. The second question is indefinite; but if the degree be ob-tained without examination, it would not be registered by the GeneralMedical Council.

A STRANGE COMMUNICATION FBOM A FOREIGN PHrSICIAN.THE following letter, received by a physician of the metropolis from a foreign

physician, has been by the former handed to us for publication. It disclosesa new "dodge:’ It was felt as an additional impertinence that the postageof this foreign epistle was unpaid, and had to be defrayed therefore by thereceiver :-

"Rome, 3rd November, 1863." SIR,-Having devoted many years to the study of the only true medi-

cine, ’the medicine of similars,’ I employ all the means in my power toextend the knowledge of it as rapidly as possible. One of the obstacles toits diffusion, especially among persons travelling, is, that they often do notknow where to seek its aid when they require it. This arises, perhaps,chiefly from the little intercourse existing between its practitioners indifferent countries. I have, in part, overcome this difficulty by forming re-lations with some of my medical brethren abroad. Thus the principalhomoeopathic physicians of France and Belgium are now in corrcspondencewith me, and they have agreed to an interchange-i. e., they send to meboth individuals as well as families that have been under their medicalcare, and that may be coming to pass a season at Rome, and I direct thoseof my patients to them as may happen to be going to France or Belgium."May I take the liberty, Sir, of proposing the same plan to you P I be-

lieve it to be alike useful to the resident physician and to the travellinginvalid.

’, "With regard to myself, I have no other testimonial to offer you than alist of a few medical books which I have published here, as follows :-I Trattato delle Malattie Speciali della Donna (Treatise on the Diseases ofWomen), in 3 large vols.; Trattato di Patologia; Trattato sulle MalattieCroniche (Diseases produced by Chronic Miasma); Omiopatia e Allopatia,of which latter work a new edition has just been printed.

" In the event of your approving what I propose above, I shall always,according to a custom I have adopted with others, write to give you pre-vious notice of every one I send recommended to you. The letter maysometimes serve to enable you to know the parties beforehand; and Iwould beg of you to favour me in the same manner should you enter intomy views.

" Pray direct to me at Piale’s English and American Library, Piazza diSpagna, Rome.

" I have the honour to be, Sir, with profound respect," Your obedient servant,

"To Dr. G. Rogers, M.D., &e. &c:’ "DR. UFFREDUCCI ACHILLE.

Chevalier d’Industrie.-According to Berthelot, the principles which givewines their vinous flavours may be isolated by shaking a wine with ether,and evaporating the ether at a low temperature without the contact of air.The resulting extract (which is rapidly changed by atmospheric exposure)contains the "bouquet."

X. Y. Z., (Aberdeenshire.)-If the questions are pertinent, let him put themto Dr. T. himself.

Mr. S. G. Freeman.-The communication arrived too late for insertion thisweek.

MEDICAL TREATMENT OF THE DEAF AND DuMB.To the Editor of THE LANCET.

SIR,-Will you or any of your numerous readers inform me whether thedeaf and dumb have ever been treated by general medical advice ? As a latepublished Report from the Irish Commissioners announces their congenitalcondition, and as no registration has hitherto been adopted, and mothers andnurses are mostly ignorant of the state of hearing at the earliest period ofinfancy, from whence could such information be collected ?

I am, Sir, faithfully yours,Bath, November, 1863. WILLIAM PARKER, M.R.C.S.

ERRATUM.—In our number of last week, page 609, a misprint occurred in theparagraph headed Kensington Lying-in Hospital. It should have been

"Kingstown Lying-in Hospital."

COMMUNICATIONS, LETTERS, &c., have been received from-Dr. Pavy; Mr.Holmes Coote; Dr. Reynolds; Dr. Carrington; Dr. W. Budd, Clifton;Mr. Orell, Over; Mr. Parker, Bath; Mr. Sutton, Timberland; Mr. J. Bird ;Mr. P. le Neve Foster; Dr. Sadler, Barnsley; Dr. Helsham; Mr. F. Peake;Mr. Wigg, Southminster; Mr. Spencer, Washington; Mr. Lows, (with en-closure ;) Dr. Fussell, Brighton; Dr. Partridge, Birkenhead, (with enclo-sure ;) Mr. Dibb; Mr. Goodall, Silverdale; Dr. A. Wood; Mr. W. Grainger,Winchester, (with enclosure;) Mr. James, (with enclosure;) Mr. Greaves,Derby; Dr. Graily Hewitt ; Dr. Brittain, Chester; Dr. Brown, Rochester;.Dr. Leared; Mr. Leach, Heywood; Dr. Johnston, Dover, (with enclosure;)Mr. Shedden, Dudley, (with enclosure;) Dr. Gayton; Mr. B. Baker; Mr. A.Shaw; Dr. Russell, Birmingham, (with enclosure;) Dr. Carson, Articlave;Dr. Macdonald, Glasgow; Mr. Kempster; Mr. Ward, Newark; Mr. J. Gell,Birmingham; Dr. Devenish; Mr. C. Spencer, Norwich, (with enclosure;)Dr. Davison, Nice; Mr. Hitchcock ; Mr. J. Sharman, (with enclosure;) Dr.Wise, Banbury; Mr. T. Roberts, Market Drayton, (with enclosure;) Mr.Jennings, (with enclosure;) Messrs. Hewitt and Co., Liverpool ; Mr. Sharpe,Hull; Mr. Tomlin, Richmond, (with enclosure;) Mr. Pollard, St. Albans ;Dr. Gale, Stoekport; Mr. Salt, Birmingham; Dr. Brody, (with enclosure;)Mr. Llamire; H. D.; Pharmaceutical Society; Dubious; M.D.; X. Y. Z.;C. H.; C. D.; W.; Anthropological Society; Female’s Champion; G. H. J.; ;Jehan-i-gureet; A Regimental Surgeon; Y. Z. ; &c. &c.