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ship, but its neglect would involve much more general hard-ship, and be really the most cruel in the end."BLOOMSBURY DISPENSARY. - Mr. Thomas Chaplm,

Resident Medical Officer, informs us, just before our going topress, " that during the week ending August 22nd, fifty-fournew cases of diarrhoea have occurred. In some the attack wasvery severe, but all have terminated favourably under theplan of treatment described by Dr. Pidduck, (the physician tothe Dispensary,) in THE LANCET of last week. One case inwhich true cholera symptoms manifested themselves wastreated with the saline powders, and is now doing well. Noother case of cholera has occurred." HEALTH OF LONDON DURING THE WEEK ENDING

SATURDAY, Au&. 19.-The number of deaths from all causesreturned for the week that ended last Saturday was 1833.Cholera was fatal last week to 729 persons. In the six weeksof its present appearance, the deaths from cholera have beensuccessively 5, 26, 133, 399, 644, and 729. The deaths fromdiarrhoea were 192.

Obituary.AT Hylton Ferry, near Sunderland, very suddenly, on the

13th, deeply regretted and respected by a large circle of friends,in his thirty-second year, ROBERT ROBSON NoBLE, M.R.C.S.

Suddenly, while on his way from Cxeorge Town to Portland,Australia, PATRICK GERARD ROBERTSON, M.D., son of MajorRobertson, of Kindeare, Rosshire.

The BRITISH MEDICAL DIRECTORY for 1855.

ALL duly-qualified Medical Practitioners are respectfully re-quested to forward, as soon as possible, their "ENTRIES" or" RETURNS" for this Annual Volume. References to theEntries in the Directory for the current year, (1854,) statingthat they are correct, will be sufficient. When alterations are

required, they should be distinctly specified, and in all casesthe names of the writers should be written clearly, and at fulllength.Address to the Editors at the "BRITISH MEDICAL DIRECTORY"

Office, 423, Strand.

TO CORRESPONDENTS.F.R.S, &c.-Many thanks for the suggestions and observations as to the management of the Norfolk County Lunatic Asylum. As regards St. Luke’sHospital for the Insane, we can only say at present that our attention hasbeen actively directed towards the condition of this institution. Since,however, the committee have suggested certain important alterations andimprovements, and amongst other points have determined, we believe, uponmaking their resident medical officer general superintendent of the wholeestablishment, we have waited to see these necessary changes fully andfairly carried out. Should there be any difficulty, or should the contem-plated improvements be long delayed, we shall certainly draw public atten-tion to the matter. There is, doubtless, much that will not bear lookinginto; but as our object is to improve the condition of the insane for thefuture, we must be content to overlook much that is past.

A. P.-We cannot recommend the work in question. Consult any respectablesurgeon. The disease is quite under the control of remedies.

Devonim8is shall receive a private note. The MS. arrived safely.

Y. Z., Mr. Andrew Rotton, &c.-The "New Vaccination Bill" amendmentswere rejected by the House of Lords; consequently the munificent paymentof one shilling to medical gentlemen, not appointed by the guardians, forevery successful case of vaccination will not be paid. The Act altogether isa complete failure, and in its main clauses most unjust and offensive to thegreat mass of the profession. It is true that Lord Lyttelton proposed "theshilling" for the " signing of the certificate;" but this was only a left-handed way of paying for the operation also !

,31-r. Girdwood will receive a private note.Scriblerus.-The entire subject of gratuitous advice is one of the utmost im.portance to the medical profession. Nothing has been done in the matterby the "committee," though they talked a good deal upon the subject.Some good resolutions, issued by the medical practitioners of Colchester,will be published in the next LANCET. The profession is annually robbed ofthousands by the abuse of gratuitous advice.

Vide et Crede.-Has Dr. Pettinger’s handbill been forwarded to the Man-chester Medico-Ethical Association ? We may, perhaps, notice the subject.

Anxious.-On examination, we cannot find the name in the BRITISH MEDICALDIRECTORY.

Yaeciraator.-In a case in which a child is brought to the surgery of a mediealpractitioner to be vaccinated, he is only entitled to the one shilling and six-penny fee, however distant the residence of the child may be.

A Subscriber.-The three years, we believe, may be passed at MarischalCollege

ROYAL MATERNITY CHARITY.

W. BENEDICT HART,District Surgeon, Whitechapel Union.

To the Editor of THE LANCET.SIR,-Certain cases have lately come under my observation, enabling me to

form some judgment as to the management of the Royal Maternity Charity;and although I feel a great disinclination to call in question the conduct ofothers, yet, after reading the observations upon this institution contained inyour last number, I cannot feel satisfied with myself without taking somemeans of making known the few following particulars of a case, which I thinkmay be taken as a specimen of the working of this Charity at the presenttime:-

I was called about five weeks since to attend a poor woman residing in this

neighbourhood, and suffering from uterine haemorrhage; she was in the lastmonth of pregnancy, and had obtained a letter from the Royal MaternityCharity; but as she understood that this did not entitle her to any medicalattendance until labour commenced, she applied to me.

After a few days’ treatment, the hEemorrhage subsided, and my visits werediscontinued ; but considering it a grave symptom as regarded her approachingpartus, I gave a recommendation to her friends, and also to the Maternitymidwife, who appeared anxious about the patient, that, in case any difficultiesshould arise when labour came on, to lose no time in calling for medical assist-ance. A few days elapsed, and I was somewhat surprised one night to receivefrom our relieving-onicer a parish order, marked " urgent," to attend the samepatient. I found that she had been in labour more than twenty-four hours,the Maternity midwife having been in attendance from the first, but had notbeen able to obtain any medical aid from the Charity, although the husbandhad applied, by the midwife’s direction, six hours previously, and had madeseveral other applications since. At last the midwife advised them to seek aworkhouse order for my attendance, thinking, as she told me herself, that, asit was late, no one would come from the Charity. I proceeded in due course todeliver the woman, the difficulties being very much increased by the delay thishad occasioned.Upon calling next day, I found that no medical man had been from the

Maternity to see her, and none called, I believe, till after her death, whichtook place on the ninth day, from puerperal fever.Had not this poor creature depended upon the Maternity letter, she would

doubtless have made some other and better provision for her " hour of trial;"at least, as a dernier resort, she would have been prepared with a parish order,in which case the same assistance which she received at last, when the casehad become difficult and dangerous, would have been atforded her at an earlierperiod, when it was comparatively safe and easy. And who knows what in-fluence this might not have had upon the ultimate result of the case? Thu.1iwhat was intended for a benefit proved to be a positive injury.In the letter from the Secretary of the Royal Maternity Charity, published

in THE LANCET of the 5th instant, it was stated, that in consequence of theefficient " system" of this Charity, a less mortality had occurred, in proportionto the number of cases, than under any other system adopted by any similarinstitution

In reference to this, I may observe that I know of cases attended from thisCharity, in which formidable diseases have followed labour-diseases arisingout of the parturient condition; and these cases have, when in a very danger-ous state, been discarded as patients of the Maternity Charity, and fallen intomy hands in my capacity of union surgeon, and these patients were given tounderstand that they would not receive any further medical assistance fromthe Charity after the ninth day.Now, as in all fatal cases of disease connected with childbirth a large pro-

portion of deaths would take place after the ninth day, it is not to be wonderedat that, according to this "system," a less proportion of fatal cases take placeunder the treatment of the Royal Maternity Charity than under any othersystem adopted by any similar institution.

I am, Sir, your obedient servant,W. BETfBBMT HART,

August, 1854. District Surgeon, Whitechapel Union.COMMUNICATIONS, LETTRRS, &c., have been received from -Dr. Marshall

Hall; Mr. Critchett; Dr. Ranke; Mr. J. H. Bolton; Mr. W. Walker; N.;Mr. L. F. Crummey; Dr. Rothman; 3,Ir. R. Howden; Mr. A. Rotton; Mr.J. C. Pigg; Mr. Francis Ward; A Subscriber; Anxious; Vide et Crede;Mr. R. B. Marriott; Mr. G. D. Nelson; Mr. Hopley; Mr. S. Knaggs; Mr.Walter Scott; Delta; Medicus; F.R.S. ; Devoniensis; Mr. Hansard, (withenclosure ;) Mr. Thomas, (Kirkdale, Liverpool;) Mr. Vaudin; Mr. Tucker;Queen’s College, (Birmingham;) Y. Z.; Mr. J. W. Morley; Mr. A. Bolton,(Newcastle;) A Medical Officer, (Madras ;) Mr. Pritchett, (Grimsby;) Mr.G. Hind; J. A., (Newcastle-on-Tyne;) Vaccinator; Mr. Aulsetrook, (Han-well ; A. X., (Banbury;) A Country Surgeon; A. O. Y., (with enclosure;)

.

Mr. F. Nuttall, (Bury, with enclosure;) Mr. J. Godden, (Oxton, with enclo-sure;) Dr. Castle, (Leeds, with enclosure;) Mr. G. Garson, (Stromnese,with enclosure;) Scriblerus; &c. &c.