PAINLESS SURGICAL OPERATIONS.

345 practice or the poor of this increasing place, longer hold office, other, unless compelled by sheer necessity; and a service that without either injury to the one or negleot to the other. I might, without costing the country one shilling, be made the quite agree.with you that it would appear anomalous to appoint most popular, is, by the present unwise regulations, at a considerable discount. a junior over a senior; and in this case, particularly so, were it not that, previous to my resignation, I informed the only senior This, Sir, is impolitic and unjust-first, as regards science; surgeon in the hospital of my intentions, giving him the option and secondly, as regards those who are, or may be by the neeither to remain or retire, and take his place before me in right cessity of the case, unable to make choice of a medical atof seniority, whichever he pleased; and at the same time tendant-a deprivation I feel sure my lords of the Admiralty stating, if he did not retire, that on his doing so at any future would not like to have inflicted upon themselves. The only serious objection ever urged by the Board of time, I would waive (if I was appointed) the priority of my position, and take my place as second to him in the list of Admiralty against the claims of assistant-surgeons to wardconsulting surgeons: this, I conceive, was fair and honourable room rank, was the difficulty of providing them, in the event

my part. If he did not choose to resign, that was no reason of its being granted, with suitable accommodation. Yet, why I should remain in office, to my own manifest loss and in- strange as it may appear, cabins have been erected for the naval instructor, engineers, and additional lieutenants, since convenience, till it was his pleasure to do so. I make these few remarks for the purpose of informing you that objection was first started; and so may assistant-surgeons of the true facts in connexion with this matter, and to refresh also be provided with cabins, even at this the eleventh hour, the memory of the soi-disant Governor, (?) who appears, if the Admiralty could be impressed with the necessity of wilfully, I fear, to have suppressed the truth, and which is giving encouragement to education and talent, as they have well-known to everybody in connexion with the institution. been in the case of naval instructors and engineers. A deputation from the Medical Association once waited Your statement of this letter, if you deem it worthy of your notice, will oblige-Sir, your very obedient servant, upon the hon. member for Marylebone (Sir C. Napier) on this JEROME SMITH. i very subject, who stated, in reply to some question put to him, Hamilton-square, Birkenhead, March, 1847. P.S.-You are probably not aware that the duties of this that, indeed, the position of an assistant was much improved. institution are onerous, as you have not only to take your rota since mates had received rank. I remember at the time feelin daily and weekly attendance, but to attend at the houses of ing surprised and annoyed, that a reply so palpably absurd have been received by grave and sober men as a suffithe out-patients, over a district containing 20,000 inhabitants, who are scattered over a very wide surface. How, then, is it cient answer; and only mention it now to show that even the commodore is not free from the prejudices of his class possible for any man, who has any pretensions to practice, to gallant which allot less pension to the widow of a surgeon -prejudices this and attend to his own unless aided accomplish duties, than to a lieutenant’s or master’s-which cut down a surgeon’s by an assistant, which I, not dispensing my own medicine, do share of prize-money to one-half that of a lieutenant-which not keep ? allow him to rank with, but after, a lieutenant; which have called for a commission-now sitting-with the view to dePAINLESS SURGICAL OPERATIONS. prive medical officers of the epaulettes the late Board granted; and which still withhold from my junior brethren the position To the Editor of THE LANCET. they are so justly entitled to.-I am, Sir, yours very gratehave this Dr. a of Hickman’s SiR,—I day procured copy A NAVAL SURGEON. pamphlet on suspended animation; it is dated 1824, and is in fully, the form of a letter, addressed to the late T. A. Knight, ETHERIZATION. Esq., of Downton Castle, who was much interested in the inquiry. To the Editor of TaE LANCET. It appears that he produced insensibility by various means SIR,- Physiological observations on the action of ether -viz., by the exclusion of the atmospheric air, the exhibition of carbonic acid gas, and by another method, which, he states, vapour on the nervous systems being of great interest on and of vast importance, in so far as they may produced the desired effect much sooner than any of the many accounts, us in the safe administration of it, I put together a few others, that is " by the agency of sulphuric acid and carbonate guide of lime." In this latter example, he notices that the results matters respecting the phenomena of the abolition of nervous influences as they present themselves to me in numerous inhawere " not so satisfactory; some blood escaped from the in my own person and those of others who have wounds, which did not heal so rapidly as in the first ex- lations inhaled. periment." In the gradual inhalation of the vapour, the effects, though How far Dr. Hickman is entitled to the claim of this disand running into each other, may be divided into covery, may be a question; it is perfectly clear that he is the following originator of the idea of producing insensibility under sur- the following phases:1. Abolition of common sensation-sensation of heat and gical operations. The modern introduction of sulphuretted ether is at best but an improvement of that idea, or, in other cold and tactile perception remaining. 2. Abolition also of special sensations. words, it is carrying out the original views of one party, by It was known means of a new agent suggested by another. 3. Abolition also of mental perception. that Dr. Hickman was pursuing his experiments in 1828,-that 4. Partial abolition also of excito-motory (conservative) is, four years after the date of the letter referred to,-and it is phenomena. more than probable, that subsequent improvements may have 1. I have found when I have inhaled for a short time that ’ , been made, and published, at a later date. I insensible to pain. Thus, whilst I can readily feel As the discovery is now being claimed by other parties, a am quite pin held between my fingers, I can thrust it deeply into my how are we to be assured that they have not not borrowed feeling more than under ordinary circumstances the idea from this published work?1 My only object in body I should were its head merely placed in contact with the troubling you with these remarks is, that justice may be done, skin. I am quite sensible of the difference of temperature of and that the credit of this invention may be awarded to those water into which I dip my fingers. I have performed operato whom it is fairlv due.-I am. Sir, yours very obediently, on

could

i

without

Kingswinford, March, 1847.

THOMAS DUDLEY.

THE NAVAL MEDICAL SERVICE. To the Editor of THE LANCET. Six, Your very admirable article in THE LANCET of Saturday last, on the position which naval assistant surgeons hold in the service afloat, must call forth the gratitude of every member of your profession in that department of the public service, and lead them to augur much good from such powerful

advocacy.

To every unprejudiced mind the force and truth of youi remarks must be apparent, and the necessity and justice oj giving assistant-surgeons ward-room rank undoubted. So long as this is withheld, the Admiralty regulations relative to education are worth so much waste paper; for men possessing a high standard of education will not enter-nor, indeed, will any

tions

on

persons

who, whilst sensible that the

operation was

being performed, did not feel any accompanying pain. They have obeyed my directions verbally given. 2. After a time my sight and hearing fail; but still I am

conscious of an existence. Whilst a person has been in this state I have operated, and when the patient has recovered, the state is intimated in somewhat the following manner:"Ithought you made me inhale twice, and then drew my teeth"-(a fact in this case, as the process was accidentally interrupted in the middle :) but the patient has felt or seen

nothing. 3. Next,

a total unconsciousness obtains, the voluntary muscles become relaxed, and apparently I fall into a deepsleep. In this state, though insensible to pain, and quite un-

conscious

on being spoken to, yet, on operating on a patient, excito-motory opposition, and sometimes very determined and violent, has been offered, (the patient even screaming loudly;) and yet, on recovery, the patient has been quite unconscious