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in this state of the disease, he (Mr. Harvey) thought it had beenfar too much overrated; and the simple contrivance of the auris-cope, such as suggested to the Society, and which he had himselfbeen in the habit of using for some time, would, he thought, ob-viate the necessity for such frequent practice, always uncertain,and, in hands unaccustomed to it, not without danger.

MEDICAL SOCIETY OF LONDON.

DR. FORBES WINSLOW, PRESIDENT.

FIBRINOUS MENSTRUATION.

Dr. CRISP showed a specimen of fibrinous coagulum from theuterus, with drawings of the microscopical appearances. Thesubject of the case is a delicate woman, about thirty years of age,who has been twice pregnant. For some months past she has Isuffered from leucorrheea discharges, sometimes of a purulent I

character. She complains also of pains in the back and loins,with a sensation of bearing-down of the womb. There is tender-ness on pressure over the uterine and ovarian regions, but thisis not constant. She is likewise hysterical and hypochondriacal.On making a digital examination, the os uteri is found ratherhot, and slightly swollen, but no ulceration is perceptible by thefinger. During several of the last menstrual periods she hassuffered great pain, attended apparently with expulsive uterineefforts. These have been sometimes followed by the dischargeof fibrinous clots of a mottled red and white colour, arising fromthe intermixture of fibrine and red blood corpuscles, the formerbeing more abundant. The clots are about the size of a largealmond, and tney assume somewhat the form of the uterinecavity.Microscopical Examination.-The red portion of the concre-

tion consists chiefly of blood-globules of a stellate or granularappearance, of lymph-globules, and of granular corpuscles. Thefibrinous part exhibits the usual filamentary characters of fibrine.On making a section of the concretion, and placing it under a

power of forty diameters, the fibrine is seen interspersedthroughout the clot, forming a net-work of white bands, themeshes taking generally the form of irregular squares, the redcorpuscles occupying their centres. No vessels can be seen inthe clot, but it is probable that if it had remained a little longerin the uterus, it would have become vascular.

Dr. Crisp said he believed that but few microscopical examina-tions of the clots had been recorded: two were described in thelast volume of the London Pathological Transactions, by Drs.Handfield Jones and Tyler Smith. The almost symmetricalarrangement of the fibrinous bands in the case described, Dr.Crisp thought was a point of some interest, and worthy of futureinquiry.

a

CASE OF CROUP.

Dr. WILTSHIRE exhibited the larynx, trachea, &c., of a little Igirl of four years of age, who had died from croup. It was orb- iserved that the preparation illustrated one of the forms of thedisorder most common in this country-viz, that in which theaffection has its point de depart in the aerian passages, and notin the throat, or at the fauces, uvula, &c., as in the diphtheriticvariety, so common on the Continent. Here it might be seen thatthe base of the tougue, the tonsils, &c., were free from all deposit.Further, it might be remarked that the croupose exudation onlyinvaded the larynx, the trachea being quite free, though evidentlyinflamed. The lungs did not appear to be involved in anymaterial mischief, and the case seemed to be one of those whichmight have favourably admitted of the operation of tracheotomy,if the following points could have been determined-1st, that(during life) the deposit was confined to the larynx; 2ndly, thatthe operation would be permitted early in the course of the dis-order ; 3rdly, that the circumstances, &c., in life of the patientwould permit of those hygienic, &c., cases necessary to accom-

pany such an operation. In the present instance neither of theseconditions could be maintained; for, 1st, it was not diagnosedthat the exudation did not extend below the larynx; 2ndly, thepatient was not seen until the disease had run a course of severaldays; 3rdly, the patient belonged to the lower ranks of life, andthe effects of the operation would by this circumstance have beenuntowardly influenced.

CAUTION To DRUGGISTS.-At Kilmarnock a pre-scription was sent to a druggist, which was prepared by anignorant person left to attend in the absence of the proprietor.Instead of compounding the proper ingredients, the druggist’sdeputy used poison, which proved fatal to the patient. An in.quest has been ordered.

Correspondence.

THE MEDICAL REFORM BILL.

"Audi alteram partem.11

I To the Editor of THE LANCET.SIR,-I trust as an old medical reformer, who sat with you for

several years on the Council of the British Medical Association,advocating a Faculty of Medicine in England, Ireland, and Scot-land, upon the representative principle, that yon will allow, atthis important crisis in medical affairs, the insertion of the enclosedletter to Viscount Palmerston, on the subject of the Reform Billof the Provincial Association Colleges and Corporations, whoseunjust and iniquitous proceedings, Sir, you have so frequently con-demned in your pages. They are now, it seems, to be rewarded fortheir past misdeeds, by giving them aa amount of power over theeducation and examination of the great bulk of the medical profes-sion of this country which they have not hitherto possessed. Asfar as I can see, the general practitioner, if this measure shouldbecome law, will be a mere cipher, and have no power in the.management of the Council. Oxford, Cambridge, the University ofLondon, each supply one member of the Council. The Presidentsof the Colleges of Surgeons and Physicians are ex efficio members,and these Colleges send each five members besides their presi-dents. The Secretary of State is to appoint six members, so thatthere may not be one general practitioner; or if the Secretaryof State should appoint (a very unlikely circumstance) six generalpractitioners, what power can they possess when opposed by thenominees of the Colleges?

Let the general practitioners of England consider these mattersbefore it is too late to remedy them. Let us see a draft of thenew Charter of the College of Physicians and its emendations,before we pledge ourselves to any crude measure of reform.

I am, Sir, your obedient servant,Parliament. street, April, 853. EDWARDS CRISP, M.D.

To the Right Hon. Viscount Palmerston.My LoRD,-In the report of the deputation to your lordship

on the 18th of March, on the subject of Medical Reform, someerrors occur, which I am desirous of pointing out to your lord-ship.

I have, my lord, for nearly twenty years been a zealous advo-cate for a Faculty of Medicine upon the representative principleof government-public examinations and election by concours atour royal hospitals. I therefore, my lord, can consistently opposethe introduction of such a Bill as the one framed by the rzclers ofthe Provincial Association-a measure, my lord, which, if allowedto pass in its present form, will, I believe, serve to perpetuate theevils from which we have long suffered; for under the cloak ofliberality and uniformity of examination, it covertly encouragesa system of grades and unmerited distinctions, which are alikeinimical to the progress of science and to the welfare of thepublic. There should be no grades, my lord, in the sick man’schamber-death knows no distinctions-and disease will not suitthe taste of the pure surgeon and physician, confine itself to theirlimits ; and yet, my lord, the corporations, (especially the Collegesof Surgeons and Physicians.) who have uniformly supported thissystem, are to have the chief control of the education and exami-nation of the general practitioner, who, possessing usually both amedical and surgical qualification, is in many respects superior tothe pure members of these Colleges. My lord, the general prac.titioner, (the physician and surgeon of the multitude,) from whoseranks many of the best men in the profession have sprung, are,under this Bill, unrepresented.

But, my lord, let me come to the chief object of my letter-viz., the errors in the report of the deputation, (THE LANCET,.March 26th.) It is there stated, that "the Bill has been re-

peatedly submitted to the profession through the Medical,ISocieties." Why, my lord, I believe the Bill has not yet beenbrought before any Medical Society in London, Dublin, or

Edinburgh ; and the account of the proceedings at one ofthe district meetings (Brighton, 1850) shows that some of theframers of this Bill have not been very just in their political pro-ceedings ; to use an election phrase, they have been rather warmpartisans.

Another grave error, under which your lordship appears tolabour, is that respecting the varied character of the deputa-tion ;" and before I point it out, allow me to remind your lord-

ship of a fact with which you are probably not acquainted-viz.,, that the Colleges of Physicians and Surgeons are nearly in a statei of bankruptcy; and to replenish their empty coffers, to improvethe res angustce domi, or, in British parlance, 11 to raise the

EDWARDS CRISP, M.D.

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