A NEW AND IMPROVED CLAMP FOR HÆMORRHOIDS.

401 the great societies refer, and from of the best medical missionaries have hailed. It cannot be too clearly realised, however, that to the piety of its great local physicians and surgeons Edinburgh owes A NEW AND IMPROVED CLAMP FOR HÆMORRHOIDS. the creation and success of the Society. Abercrombie, THE method of crushing piles, instead of dealing with Alison, Handy side, Miller, Coldstream, and Benjamin Bell them by ligature, was an important advance in rectal are classical names in Edinburgh medical history, and they and the question of the best form of clamp has If anyone surgery, were all active promoters of this Divine cause. followed naturally upon the adoption of the operation. doubts the impression for good made on uncivilised or The use of existing instruments during a term of years lad unchristianised nations, he has only to read this book, the inventor of the present clamp to consider, with conthough it by no means exhausts the statement of medical siderable interest, how far the necessities of the operation work done or impression made. One very excellent feature were met by the crushers at present existing, and how of Mr. Lowe’s book is his insistance on the thorough and their shortcomings might be rectified. To surgeons complete training and qualification of those, whether men Benham’s clamp has commended itself by itsmany but at’ power, or women, who go out to do medical missionary work. best it has always appeared a heavy and unwieldy weapon. Their surgical and obstetrical training should be even To others Allingham’&bgr; fenestrated crusher has been acceptmore complete than that of average practitioners, seeing as a distinct improvement, by its greater handiness, as that they have no help in consultation or co-operation able, with the former; but admirable as this undoubtedly with others, as in difficult -cases at home. The rapid compared there are certain points to which exception may fairly be is, progress of this Society is gratifying. In 1861 its income taken-notably, that the pile was .6690; in 1871, .E1311; in 1881, 5508; while during seized by the has to the last decade .15,000 were raised for special objects. be drawn through the fenestrum, There are at present 170 qualified medical missionaries in and that as by necessity a active service at home and abroad, whereas before 1871 only siderable amount of tissue is thirty were in the field. Can London say that she has done brought into the area of the her share in this useful work? The noble and devoted crushing bars, a larger surface Robert Moffat said that a medical missionary was a than is strictly necessary is missionary and a half, or rather a double missionary. Many crushed, and a correspondingly other generous testimonies from clerical colleagues to the large wound remains to be value of medical pioneering in missionary work are given healed. In the hope of overin these pages, which leave no doubt that, as the early these coming objections this ’history of Christianity was associated with great gifts of new clamp was designed, and healing, so its extension is to be. We earnestly commend after much thought and conthis book to the sympathy and attention of our readers. sideration the principle of the familiar " spanner" or "screwHandbook for the Instruction of Attendants on the Insane. hammer" was adopted as a model. Prepared by a Sub-committee of the Medico-Psychological The instrument has been adAssociation. London: Bailliere, Tindall, and Cox. 1885. manufactured by Messrs. Lectures on the Care and Treatment of the Insane, for the mirably and Thompson, of Maw, Son, 17i.itritetion of Attendants and Nurses. By W. C. and whatever M.D. Paramatta. Printed at 1885. Aldersgate-street, WILLIAMSON, Sydney. is found with it by expert fault THE intention of the short manual of sixty pages issued mider the auspices of the Medico-Psychological Association rectal surgeons or the pracis of the most commendable kind, there being no greater titioner at large must be laid to desideratum in the treatment of insanity than well-trained the charge of the inventor, and and instructed attendants. The directions given for nursing not to that of the manufacturers. and general duties are well compiled ; while the information The accompanying woodcut will in regard to the forms of mental disorder and the directions convey a very excellent idea of the modus operandi. It will be - as to the management of the different mental states are also distinctly good. The epitome of anatomy and physiology, seen that the principle of the ’however, with which the handbook begins, is of doubtful lever action has been discarded, value and might confuse rather than instruct. On the whole, and that the crushing power is the handbook is a decided advance on the usual manuals of obtained in a direct line by screw action, as in Allingham’s, rules and instructions in use in asylums. Dr. Williamson’s Lectures are deficient in the amount of with this difference, that whereas instruction and direction given in reference to the special in the latter the lower bar is management of the insane, and are redundant in informa- forced upon the upper, here the tion in regard to the treatment of diseases. They are, how- upper bar is drawn down upon the lower. A slow screw has been adopted, as giving greater power to the operator. ever, satisfactory in bearing testimony to the recognition in It may be contended that greater power is obtained with Australia of the importance of training attendants. the older instrument, but in the opinion of the writer too much stress has been laid upon the power actually AN International Congress of Hydrology and required for the complete destruction of the tissue; and, ’Climatology will be held at Biarritz from Oct. 1st to 8th. moreover, actual experiment has shown, that the present The work of the Congress will be divided into, and papers instrument can be credited with the possession of a posiread on, the three following sections :-Scientific hydrology, while the results obtained increased power, crushing medical hydrology, and climatology. Numerous excursions tively and to warrant been successful have conclusive sufficiently ’nave been arranged, and we are assured that a hospitable reception awaits those who attend the meeting from its the claim advanced for it as an " improved clamp," and as such it is confidently placed at the disposal of the profession. promoters. CHA.RLESJOHN SMITH, CHARLES Two deaths from eating poisonous fungi in mistake Formerly Surgeon to the Farringdon Dispensary. for mushrooms have just occurred at Nottingham. Selborne-road, Brighton, August, 1886.

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