" OVER-EXAMINED AND UNDER-TAUGHT."

958 should be to proceed step by step in dissection. Thus after he has fairly mastered the bones, he should dissect the extremities, paying minute attention only to the muscles and ligaments and general attention to the great vessels and nerves. This dissection impresses thoroughly on the mind the bones and muscles, for the dissector in laying bare thecourses and connections of large muscles has the bony proand surfaces most prominently brought to his entering minences mind and memory, and a foundation of the best kind is laid for his future dissection. In the same way he should dissect the abdomen and the thorax, and lastly, if he has time, the head should come under his notice towards the end of his first winter. I stared with astonishment when a young relative, whom I asked when he commenced dissecting the leg, told me that he had been directed to trace out all the superficial nerves and the minute vessels. Surely such a plan of dissecting is not one calculated to make an anatomist, and lays upon the student’s untrained memory such a mass to remember at once that it is not wonderful that some students become disgusted and careless. The logical way of teaching anatomy doubtless is : first the skeleton; the bones, and how these are held together; then how these bones are moved in each way by the muscles, then the vessels to supply the power to move, and the governing force, the nerves. It may be objected to this plan that the supply of subjects is not equal toit; but an easy way to overcome this would was immediately extinguished. be to let two students dissect together each part, and it would also be well that the demonstrator sees that each of the first few parts is thoroughly dissected down to the last " OVER-EXAMINED AND UNDER-TAUGHT." ligament and synovial membrane before it is taken away. To the Editor of THE LANCET, This, as far as anatomy is concerned, would, I feel assured, a better result, and one more abiding, than the produce SlE,—From the last number of THE LANCET it appears attempt to cram the first year’s student with all the superthat Mr. Marshall’s scheme for compelling all medical ficial and other nerves, and all the minute vessels contained students to appear before properly constituted authorities in the parts of his first winter’s dissection. A weekly class for examination in Anatomy and Physiology at the termi- examination, with a running commentary by the lecturer nation of their first year of study is likely to be altogether instead of one lecture, would probably do more good than a examination as suggested to be undertaken by shelved, or so far modified as to be rendered practically use- systematic the College of Surgeons.-I remain, Sir, yours, &c., less. It is urged against this scheme that our students are AN OLD ANATOMY LECTURER. already over-examined, and work so well that they require no extra stimulus to exertion. With reference to the first CHIAN TURPENTINE IN CANCER. of these objections it may be observed that Oxford and " Cambridge undergraduates are obliged to go up for" smalls" To the Editor of THE LANCET. before the end of their second term ; failing to pass this SIR,—It became the manifest duty of every man engaged examination they are recommended to leave the University for a time. They have to go up for "mods"before the in treating the diseases of women, after reading Professor termination of their fourth term ; yet we do not hear com- Clay’s ingenious paper in your issue of March 25th, not plaints of their being over-examined. As to the work of to criticise it theoretically, but honestly, carefully, and our first-year students, we can only judge of that by its to test the action of Chian turpentine upon results ; and THE LANCET not long since stated that forty- thoroughly cancer of the female generative organs. three per cent. of medical students fail at the primary Mr. Clay’s recital of such marvellous improvement in such examination of ’the Royal College of Surgeons. To my mind this is a very unsatisfactory condition of things. From brief periods justifies me in now stating my own experience. I was able in a short time at the Women’s Hospital and the frequency of the occurrence medical students seem to have become almost indifferent about being plucked-a state in private practice, to place eight patients under the inof feeling we cannot too strongly deprecate, for no right- fluence of the drug, and in no single case has the progress minded young man can fail at a public examination without of the cancer been checked, or indeed, at all affected by to have

a fireproof dress made of felt, saturated with ammonia sulphate, and supplied with a reservoir of oxygen and a soda chamber. A fireman might in this way go into any house, and pass through any gases, to rescue persons in the house, subject still to the dangers of high temperature and accidents from falling materials, but able to breathe freely in any air. Dr. Richardson also suggested that the appliance would be of the greatest use for mines where there had been an explosion, and where there was choke-damp. In fact, if a light could be invented that would not cause explosion a man in this dress might move in any part of a mine, the air of which was charged with irrespirable vapour, to the assistance of suffering persons, or for other purposes. The dress might also be used for entering wells or other places where carbonic acid gas was escaping. At this stage, in proof of the efficiency of the dress, Dr. Richardson had Fleuss introduced into a glass chamber, which was lent by the Royal Institution, and which was once used by Professor Tyndall for showing the action of a mask that would prevent the entrance of some noxious vapours and of smoke into the lungs. The chamber was charged by Mr. Orchard, of Kensington, with carbonic acid, and Fleuss remained in it for a quarter of an hour, showing the audience the irrespirable character of the atmosphere by vainly endeavouring to light a candle. A lighted taper was also let down from the roof of the chamber above Fleuss’s head, and

f

loss of self-respect. Beyond this, if referred by the the treatment. Mr. Clay’s formula was used and the Chian turpentine examiners to the further study of Anatomy and Physiology the extra months employed in this work are usually lost to was supplied by Messrs. Southall and Co. All the hospital the time properly spent in the wards of the hospital. I cases were observed from time to time by one of my believe that not less than eighty per cent. of the general colleagues.-I am, Sir, your obedient servant, J. HICKINBOTHAM, M.D., M.R.C.P., F.R.C.S. ED., practitioners scattered throughout England (many of them Women. Physician to the Birmingham and Midland Hospital for Women would support having sons about to enter at our Mr. Marshall’s scheme, and if so they should exert all their legitimate influence to secure the reform in the medical cur- EXCISION OF OBSTRUCTION AT THE NECK riculum of our students which he so strongly advocates. OF THE BLADDER. Yours faithfully, To the Editor of THE LANCET. C. MACNAMARA. June 14th. matter of concern at present between Mr. SIR,-The only To the Editor of THE LANCET. Teevan and me is not what he did not say, but what he did SiR,-Your leading article on Mr. Marshall’s proposal to say in his Lettsomian Lectures. He fails to meet my alleinstitute an examination at the end of the first year’s gation that Mercier’s operation is abandoned in Paris by medical study has elicited various opinions on each side of the leading surgeons there as useless and dangerous ; and the question. The writers have each more or less reason, he does not offer any explanation of the extraordinary stateand valid reason, on the side they advocate. But it seems to ment which I called in question, that there are "hundreds me, that the plan of dissection practised at most of the of men now aliveto whom Mercier has restored the faculty of schools (at least si I am told), of attempting to make a free and natural micturition." I hope I may not in vain student dissect all the minute vessels and nerves in his first assure Mr. Teevan that I alone am responsible for calling. attempt at dissection, has something to do with putting the attention to his statements.-I am, Sir, yours, &c., mind of an average student in a muddle. Surely the plan G. BUCKSTON 13L CIiST01 BROWNE. Wimpole-street, June 14th, 1880. some

hospitals)

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