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"BLOXHAM v. THE MEDICAL DEFENCE UNION."
"MEDICAL EDUCATION IN AMERICA." and dilatation of the pupil there must also take place that fall of pressure to zero observed by the Glasgow Committee. My suggestion simply is, therefore, that the experiment of the committee ought to be repeated, and preferably by neutral parties, not biased by preconceived opinions. Above all, I would suggest that it should be performed on cats, as they are not liable to the struggling stage as dogs are, and the question could be easily settled in them. For deeper anaesthesia, to show that this fall is then not so Your Indian liable to occur, dogs would be preferable. correspondent ignores the fact that Sir James Simpson, whose teaching was the same as Syme’s, had a death from chloroform, and he has yet to learn that the latest fatality happened only the other day in the hands of their pupil, Mr. Lawson Tait.2One of the rules lately formulated by the Hyderabad Commission re the respiration, and which they regard as of "overwhelming importance," was not derived from the Edinburgh School at all, but was taken from Dr. Snow, who, indeed, was taken to task in the JiJdinb1/’J’flh Medical Journal on the subject. I agree with your correspondent in believing that chloroform will kill in India as well as in England. A fatality lately occurred there in an adult, who got only one drachm of chloroform in four minutes-a case deserving the attention of the Commission. I am, Sirs, yours faithfully, , ROBERT KIRK, M.D. 1891. May 1st, Glasgow, j
1161
"MEDICAL EDUCATION IN AMERICA." To the Editors of THE LANCET.
SiRS,-In THE LANCET of March 17th a correspondent, W. E. R , " writes that’’ the University of Pennsylvania is the only one making it compulsory for students to attend obstetrical cases before graduating." He cites Professor Hirst as his authority. This is an erroneous statement, and one which must be due to a misunderstanding on the part of your correspondent, as Professor Hirst is too well informed to make such a misstatement. The Dean of the University of Pennsylvania writes me that the order requiring students to take obstetrical cases before graduation was passed Oct. 21st, 1889, and the catalogue now announces that students are required to attend one case. The Harvard Medical School has required cases since the fall of 1882, at which time two cases were required. The number has been gradually increased until June, 1890, when the number required was six, which is now the requirement before graduation. I am, Sirs, yours truly, WILLIAM L.
RICHARDSON, Dean.
Harvard University Medical School, Boston, Mass., April 21st, 1894.
" THE USE OF OPIUM IN INDIA." We are informed that the anaesthetic used by Mr. To the Editors of THE LANCET. Lawson Tait in the case alluded to above was not a mixture of two and one of chloroform form, but ’, SiRs,-The result of the inquiry by the Opium Commission part has gone a long way to demonstrate that the number of people ether.-ED. L. of parts who consume opium in India compared with the total popula-
***
chloro-
tion is, after all, very small. All over the world people in their customary stimulants, narcotics, or luxuries "OPERATION FOR CURE OF CLEFT OF indulge of some sort or other. The use of tobacco is the most HARD AND SOFT PALATE." generally diffused, and, on the whole, probably the least harmful habit, although it is not by any means always harmTo the Editors of THE LANCET. and the increased prevalence among small boys, of less, SiBS,—! shall be glad if you will allow me to correct an late, of smoking cigarettes is especially detrimental and inaccurate statement which I made at the last meeting of the to be deprecated-to say nothing of its being often a nuisance Royal Medical and Chirurgical Society. In speaking of my to other people. Alcohol reigns supreme in some countries, operation for uniting cleft of the hard palate by carrying and the results of its abuse are too patent to need any across the gap a triangular flap with a free anterior extremity remark. Compared with the harm produced by alcoholic I said that I had operated in six cases between the ages of the injury caused by the use of opium in India one and two years, and in all with success. On referring to intemperance, seems to be insignificant. The opium eater is not, at any rate, my notes I find that I have operated by this method on only a violent, excited, law-breaking member of society. The prothree patients between the ages of one and two. Of the rest hibition of its use, even were it practicable, would only of my early cases, two were between the ages of two and lead to an increased consumption of alcoholic spirits or three, and a sixth was three years and a quarter old. In each hemp drugs, and the effect of the cheap, vile country spirits on case the flap united well. I am. Sirs. vours trulv. the natives of a hot country like India would simply be N. DAVIES-COLLEY. Harley-street, W., May 2nd, 1891.1. maddening. I do not think any competent and impartial observer can have any doubt on this subject. It seems, too, that it is the exception for opium eaters in India to go on increasing the quantity they consume ; on the contrary, "BLOXHAM v. THE MEDICAL DEFENCE they get accustomed to a certain daily dose, and adhere to it. UNION." No one denies that cases of abuse occur, and it needed no To the Editors of THE LANCET. commission to establish the fact. No doubt people are better SiRS,-Will you allow me to supplement your remarks on without opium, as a rule ; but conditions and circumstances Bloxham v. the Medical Defence Union by a statement of alter cases, and there is, as Sam Slick observed, a great deal the points of law as held by the Lords Justices of Appeal ? of human nature in man, who cannot be made good after a The plaintiff’s counsel submitted three main points-that the pattern and content to relinquish his " pleasant little vices " action of the council of the Union was ultra vires, that their by prohibitory laws. I suspect that the overwhelming amount action in supporting one of the parties rendered them liable of evidence-native and European-produced in India to show for "maintenance,"and that there had not been "due that opium eating and smoking are not the parents of all investigation"as required by the Articles of Association. the horrors and evils ascribed to them was rather a surprise The Lords Justices of Appeal, Lords Justices Lindley, Lopes, to the Commission. As regards the political effect of such and Kay, held : (1) that the action of the Council was Commissions on the native mind it is to be feared that their iiltra vires, on the ground that, it being against natural tendency can only be to weaken the authority of the GovernI am. Sirs. vours faithfullv, justice to attack a man with his own money, the articles, asment of the countrv. AN ANTI-FADDIST. they did not expressly provide for it, must be construed as as the Council disclosed no matter of forbidding it ; (2) that, professional conduct which would give them an interest in the case, they could not resist the imputation of maintenance; LIVERPOOL. and (3) that as the Council had only heard the ex parte statements of Dr. Collie before deciding to support him there had OUR OWN CORRESPONDENT.) (FROM not been due investigation as required by the Articles of Association. Upon the last of these points the Council subThe Assizes. mitted to judgment, in the form as stated in your remarks, of a perpetual injunction like Manchester and Leeds, enjoys the advanrestraining them from expending the funds of the Union in the action of Bloxham tB Collie, with LIVERPOOL, of a fourth assize, which is generally held in May. I am, Sirs, yours truly, payment of all costs. Mr. Justice Day is presiding in the Crown Court, and Old Kent.road, S.E., April 30th, 1894. EDWD. C. BOUSFIELD. it is not six weeks since the last assize there are : although two prisoners charged with murder and about sixty for other 2 Birmingham Daily Post, April 27th, 1894. offences. It is to be feared that crimes of brutal violence are
tage
1161
"MEDICAL EDUCATION IN AMERICA." To the Editors of THE LANCET.
SiRS,-In THE LANCET of March 17th a correspondent, W. E. R , " writes that’’ the University of Pennsylvania is the only one making it compulsory for students to attend obstetrical cases before graduating." He cites Professor Hirst as his authority. This is an erroneous statement, and one which must be due to a misunderstanding on the part of your correspondent, as Professor Hirst is too well informed to make such a misstatement. The Dean of the University of Pennsylvania writes me that the order requiring students to take obstetrical cases before graduation was passed Oct. 21st, 1889, and the catalogue now announces that students are required to attend one case. The Harvard Medical School has required cases since the fall of 1882, at which time two cases were required. The number has been gradually increased until June, 1890, when the number required was six, which is now the requirement before graduation. I am, Sirs, yours truly, WILLIAM L.
RICHARDSON, Dean.
Harvard University Medical School, Boston, Mass., April 21st, 1894.
" THE USE OF OPIUM IN INDIA." We are informed that the anaesthetic used by Mr. To the Editors of THE LANCET. Lawson Tait in the case alluded to above was not a mixture of two and one of chloroform form, but ’, SiRs,-The result of the inquiry by the Opium Commission part has gone a long way to demonstrate that the number of people ether.-ED. L. of parts who consume opium in India compared with the total popula-
***
chloro-
tion is, after all, very small. All over the world people in their customary stimulants, narcotics, or luxuries "OPERATION FOR CURE OF CLEFT OF indulge of some sort or other. The use of tobacco is the most HARD AND SOFT PALATE." generally diffused, and, on the whole, probably the least harmful habit, although it is not by any means always harmTo the Editors of THE LANCET. and the increased prevalence among small boys, of less, SiBS,—! shall be glad if you will allow me to correct an late, of smoking cigarettes is especially detrimental and inaccurate statement which I made at the last meeting of the to be deprecated-to say nothing of its being often a nuisance Royal Medical and Chirurgical Society. In speaking of my to other people. Alcohol reigns supreme in some countries, operation for uniting cleft of the hard palate by carrying and the results of its abuse are too patent to need any across the gap a triangular flap with a free anterior extremity remark. Compared with the harm produced by alcoholic I said that I had operated in six cases between the ages of the injury caused by the use of opium in India one and two years, and in all with success. On referring to intemperance, seems to be insignificant. The opium eater is not, at any rate, my notes I find that I have operated by this method on only a violent, excited, law-breaking member of society. The prothree patients between the ages of one and two. Of the rest hibition of its use, even were it practicable, would only of my early cases, two were between the ages of two and lead to an increased consumption of alcoholic spirits or three, and a sixth was three years and a quarter old. In each hemp drugs, and the effect of the cheap, vile country spirits on case the flap united well. I am. Sirs. vours trulv. the natives of a hot country like India would simply be N. DAVIES-COLLEY. Harley-street, W., May 2nd, 1891.1. maddening. I do not think any competent and impartial observer can have any doubt on this subject. It seems, too, that it is the exception for opium eaters in India to go on increasing the quantity they consume ; on the contrary, "BLOXHAM v. THE MEDICAL DEFENCE they get accustomed to a certain daily dose, and adhere to it. UNION." No one denies that cases of abuse occur, and it needed no To the Editors of THE LANCET. commission to establish the fact. No doubt people are better SiRS,-Will you allow me to supplement your remarks on without opium, as a rule ; but conditions and circumstances Bloxham v. the Medical Defence Union by a statement of alter cases, and there is, as Sam Slick observed, a great deal the points of law as held by the Lords Justices of Appeal ? of human nature in man, who cannot be made good after a The plaintiff’s counsel submitted three main points-that the pattern and content to relinquish his " pleasant little vices " action of the council of the Union was ultra vires, that their by prohibitory laws. I suspect that the overwhelming amount action in supporting one of the parties rendered them liable of evidence-native and European-produced in India to show for "maintenance,"and that there had not been "due that opium eating and smoking are not the parents of all investigation"as required by the Articles of Association. the horrors and evils ascribed to them was rather a surprise The Lords Justices of Appeal, Lords Justices Lindley, Lopes, to the Commission. As regards the political effect of such and Kay, held : (1) that the action of the Council was Commissions on the native mind it is to be feared that their iiltra vires, on the ground that, it being against natural tendency can only be to weaken the authority of the GovernI am. Sirs. vours faithfullv, justice to attack a man with his own money, the articles, asment of the countrv. AN ANTI-FADDIST. they did not expressly provide for it, must be construed as as the Council disclosed no matter of forbidding it ; (2) that, professional conduct which would give them an interest in the case, they could not resist the imputation of maintenance; LIVERPOOL. and (3) that as the Council had only heard the ex parte statements of Dr. Collie before deciding to support him there had OUR OWN CORRESPONDENT.) (FROM not been due investigation as required by the Articles of Association. Upon the last of these points the Council subThe Assizes. mitted to judgment, in the form as stated in your remarks, of a perpetual injunction like Manchester and Leeds, enjoys the advanrestraining them from expending the funds of the Union in the action of Bloxham tB Collie, with LIVERPOOL, of a fourth assize, which is generally held in May. I am, Sirs, yours truly, payment of all costs. Mr. Justice Day is presiding in the Crown Court, and Old Kent.road, S.E., April 30th, 1894. EDWD. C. BOUSFIELD. it is not six weeks since the last assize there are : although two prisoners charged with murder and about sixty for other 2 Birmingham Daily Post, April 27th, 1894. offences. It is to be feared that crimes of brutal violence are
tage