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A "NEW" METHOD OF EXCISING THE KNEE-JOINT.
196 THE PROVIDENT PRINCIPLE AND THE MEDICAL PROFESSION.
capabilities, prevails. The second complaint, that of the neglect of commencing chorea, is only a small part of a very and
wide evil. The commencement not only ot chorea, but of all diseases, is neglected in Board schools. No place affords of THE LANCET. an opportunity of studying the different stages in so SIRS,—In condensing into a single paragraph in your thegood of permanent squint than a large infants’ development leading article in THE LANCET of to-day the proposals for Board school. Here, also, children may be seengrowing united action between hospitals, general and special, and out of"rickets, and so on. Most of us will also remember dispensaries, provident or otherwise, in each district of the sad case of the child who died of meningitis a few days stupid. London, contained in my Sturge Prize Essay, you do, I after he had received a blow on the head for being What is rethink, some injustice (quite unintentionally, I am sure) to The remedy for this state of things is obvious. quired is a skilled medical inspection of Board schools. It an idea for which I lay no claim of originality, it having been expressed in both the other successful essays, and is useless to trust, as at present, to the unskilled and preobservations of the teachers. The Board at present possibly in many others of the seventy or eighty which were occupied .not successful The following passage will place the has an expensive organisation for driving children into the schools, but no provision is made to ensure that the children matter before your readers in its true light:" If the managers of hospitals desire, as no doubt they do, so driven in are fit to go to school. It seems incredible that to have their incomes increased in proportion to the needs an institution such as the School Board, whose very of an enormously increased and still increasing London, they existence depends on the value of training, should trust must be prepared to abandon the policy of isolation which their pupils’ health to unskilled hands. I trust that all this leads each institution to appeal for itself alone, and to act will soon be changed; but the change will be brought about only by the calm display of facts, such as appears in Dr. as if unconscious of the presence of other medical charities article.-I am, Sirs, your obedient servant, Sturges’ in its neighbourhood. The union, for certain purposes, of a THOS. GLOVER LYON. of and and in general special hospitals dispensaries group each district of London is to be advocated on many grounds, RELATION OF PHTHISIS TO OVARIAN not the least of which is that it would greatly facilitate the CYSTIC DISEASE. making of effective appeals for funds in a systematic It would also render it easier for the public to manner. To the Editors of THE LANCET. distinguish between useful and useless charities, and for SIRS,—In reference to Dr. Bailey’s case narrated in your hospital managers to compare the different modes of Clinical Notes of last week’s issue, I would, firstly, venture keeping hospital accounts, and of making appeals to the to him on his accurate diagnosis and successpublic, with the object of securing the general adoption of fulcongratulate treatment of a most difficult case, and, secondly, I would what seemed to be the best. It would be almost a necessary him for the information he kindly gives me on the preliminary to the systematic workshop collections advocated thank of the relation between phthisis and ovarian cystic above, as it would render it possible to offer subscribers the point for which I am the more grateful because it is not in disease, united medical institutions of to of the any option going their district. A further step in advance would be the union confirmatory of the common family history of consumption. of these various groups under one council with a central But he mentions a fact which strongly supports the theory I ventured to propound, that ovarian cysts were caused by office." I must not trespass on your space so far as to explain a family tendency to early tissue degeneration. Dr. Bailey what are the " systematic workshop collections" mentioned says "the patient’s parents were first cousins," and how in this passage, but I shall be happy to send a copy of the marriages of consanguinity tend to the enfeeblement of the offspring in a great majority of cases is well known. But I essay to any of your readers interested in the subject. feel still more grateful to Dr. Bailey because many proI am, Sirs, yours faithfully, fessional brethren have most kindly and courteously sent H. NELSON HARDY. me family charts or particulars of cases in which ovarian cysts and phthisis were existent markedly in the same THE MEDICAL REGISTER. family, but hitherto no one has favoured me with notes of To the Editors of THE LANCET. a case occurring in a member of a healthy family. Such, of SIRS,—With reference to my communication as to the course, we know do happen, and I have tried to show the registration of the diploma of Member of the King and importance of knowing why.— Yours faithfully, BEDFORD FENWICK. Queen’s College of Physicians in Ireland, and the degree of Master in Obstetrics of the Universities, which appeared in
To the Editors
--
THE LANCET of Dec. 25th, I have since that time been A "NEW" METHOD OF EXCISING THE engaged in correspondence with the English and Irish Offices KNEE-JOINT. of the Medical Council as to the refusal of the Registrar of To the Editors of THE LANCET. the Branch Medical Council for Ireland to carry out Clause 20 of the Medical Act, 1886. The result is that these qualificaSIRS,—I at the earliest opportunity most frankly acknowtions are now registrable in England, Ireland, and Scotland, ledge that the operation 1 thought to be my own has preand I understand that those already on the Register can viously been suggested and performed by Professor Ollier. I have these additional qualifications appended to their names also tender my sincere thanks to Mr. Keetley for referring me in the Register for 1887 by making application to the to Professor Ollier’s paper in the Revue de Chirurgie, which I had never seen before this day. The merits of the operaRegistrar for Ireland during the next week or ten days. I am, Sirs, yours &c., tion I submit should in fairness be left to future clinical C. FREDK. KNIGHT, M.D. I am, Sirs, yours truly, experience. HERBERT ALLINGHAM. Jan. 19th, 1887.
"SCHOOL-MADE
CHOREA."
of THE LANCET. a two ago acted for twelve months SIRS,—Having year or as honorary correspondent to one of the largest Board schools in London, I have read with much interest in THE LANCET of last week Dr. Sturges’ contribution and the leading article upon the subject of school-made chorea. Dr. Sturges clearly makes out two points. First, that by neglect of the temperament of children chorea is sometimes caused by themere distress of uncongenial work. Secondly, that when chorea has just begun in a child it often remains unnoticed, and so becomes much exaggerated by school work. The remedy for the first grievance will, I am afraid, remain far distant so long as the present system of forcing children through certain standards, irrespective of their inclination To tlte Editors
DEGREES FOR LONDON MEDICAL STUDENTS. To the Editors of THE LANCET. SIRS,—With regard to your paragraph in THE LANCET of Jan. 15th, stating that the students of St. Mary’s Hospital were the first to express a collective opinion on the scheme of the conjoint Colleges for granting an M.D. degree, I think it is only right to say that on Nov. 25tb, 1885, at a meeting of the University College Medical Society, attended by over one hundred students, Dr. Thomas Barlow being in the chair, an almost identical resolution to that approved by the students of St. Mary’s Hospital was passed, after a long and animated discussion.—Yours truly. J. WALTER B S., President, Univ. Col. Medical Society.
CARR, M.B.,
capabilities, prevails. The second complaint, that of the neglect of commencing chorea, is only a small part of a very and
wide evil. The commencement not only ot chorea, but of all diseases, is neglected in Board schools. No place affords of THE LANCET. an opportunity of studying the different stages in so SIRS,—In condensing into a single paragraph in your thegood of permanent squint than a large infants’ development leading article in THE LANCET of to-day the proposals for Board school. Here, also, children may be seengrowing united action between hospitals, general and special, and out of"rickets, and so on. Most of us will also remember dispensaries, provident or otherwise, in each district of the sad case of the child who died of meningitis a few days stupid. London, contained in my Sturge Prize Essay, you do, I after he had received a blow on the head for being What is rethink, some injustice (quite unintentionally, I am sure) to The remedy for this state of things is obvious. quired is a skilled medical inspection of Board schools. It an idea for which I lay no claim of originality, it having been expressed in both the other successful essays, and is useless to trust, as at present, to the unskilled and preobservations of the teachers. The Board at present possibly in many others of the seventy or eighty which were occupied .not successful The following passage will place the has an expensive organisation for driving children into the schools, but no provision is made to ensure that the children matter before your readers in its true light:" If the managers of hospitals desire, as no doubt they do, so driven in are fit to go to school. It seems incredible that to have their incomes increased in proportion to the needs an institution such as the School Board, whose very of an enormously increased and still increasing London, they existence depends on the value of training, should trust must be prepared to abandon the policy of isolation which their pupils’ health to unskilled hands. I trust that all this leads each institution to appeal for itself alone, and to act will soon be changed; but the change will be brought about only by the calm display of facts, such as appears in Dr. as if unconscious of the presence of other medical charities article.-I am, Sirs, your obedient servant, Sturges’ in its neighbourhood. The union, for certain purposes, of a THOS. GLOVER LYON. of and and in general special hospitals dispensaries group each district of London is to be advocated on many grounds, RELATION OF PHTHISIS TO OVARIAN not the least of which is that it would greatly facilitate the CYSTIC DISEASE. making of effective appeals for funds in a systematic It would also render it easier for the public to manner. To the Editors of THE LANCET. distinguish between useful and useless charities, and for SIRS,—In reference to Dr. Bailey’s case narrated in your hospital managers to compare the different modes of Clinical Notes of last week’s issue, I would, firstly, venture keeping hospital accounts, and of making appeals to the to him on his accurate diagnosis and successpublic, with the object of securing the general adoption of fulcongratulate treatment of a most difficult case, and, secondly, I would what seemed to be the best. It would be almost a necessary him for the information he kindly gives me on the preliminary to the systematic workshop collections advocated thank of the relation between phthisis and ovarian cystic above, as it would render it possible to offer subscribers the point for which I am the more grateful because it is not in disease, united medical institutions of to of the any option going their district. A further step in advance would be the union confirmatory of the common family history of consumption. of these various groups under one council with a central But he mentions a fact which strongly supports the theory I ventured to propound, that ovarian cysts were caused by office." I must not trespass on your space so far as to explain a family tendency to early tissue degeneration. Dr. Bailey what are the " systematic workshop collections" mentioned says "the patient’s parents were first cousins," and how in this passage, but I shall be happy to send a copy of the marriages of consanguinity tend to the enfeeblement of the offspring in a great majority of cases is well known. But I essay to any of your readers interested in the subject. feel still more grateful to Dr. Bailey because many proI am, Sirs, yours faithfully, fessional brethren have most kindly and courteously sent H. NELSON HARDY. me family charts or particulars of cases in which ovarian cysts and phthisis were existent markedly in the same THE MEDICAL REGISTER. family, but hitherto no one has favoured me with notes of To the Editors of THE LANCET. a case occurring in a member of a healthy family. Such, of SIRS,—With reference to my communication as to the course, we know do happen, and I have tried to show the registration of the diploma of Member of the King and importance of knowing why.— Yours faithfully, BEDFORD FENWICK. Queen’s College of Physicians in Ireland, and the degree of Master in Obstetrics of the Universities, which appeared in
To the Editors
--
THE LANCET of Dec. 25th, I have since that time been A "NEW" METHOD OF EXCISING THE engaged in correspondence with the English and Irish Offices KNEE-JOINT. of the Medical Council as to the refusal of the Registrar of To the Editors of THE LANCET. the Branch Medical Council for Ireland to carry out Clause 20 of the Medical Act, 1886. The result is that these qualificaSIRS,—I at the earliest opportunity most frankly acknowtions are now registrable in England, Ireland, and Scotland, ledge that the operation 1 thought to be my own has preand I understand that those already on the Register can viously been suggested and performed by Professor Ollier. I have these additional qualifications appended to their names also tender my sincere thanks to Mr. Keetley for referring me in the Register for 1887 by making application to the to Professor Ollier’s paper in the Revue de Chirurgie, which I had never seen before this day. The merits of the operaRegistrar for Ireland during the next week or ten days. I am, Sirs, yours &c., tion I submit should in fairness be left to future clinical C. FREDK. KNIGHT, M.D. I am, Sirs, yours truly, experience. HERBERT ALLINGHAM. Jan. 19th, 1887.
"SCHOOL-MADE
CHOREA."
of THE LANCET. a two ago acted for twelve months SIRS,—Having year or as honorary correspondent to one of the largest Board schools in London, I have read with much interest in THE LANCET of last week Dr. Sturges’ contribution and the leading article upon the subject of school-made chorea. Dr. Sturges clearly makes out two points. First, that by neglect of the temperament of children chorea is sometimes caused by themere distress of uncongenial work. Secondly, that when chorea has just begun in a child it often remains unnoticed, and so becomes much exaggerated by school work. The remedy for the first grievance will, I am afraid, remain far distant so long as the present system of forcing children through certain standards, irrespective of their inclination To tlte Editors
DEGREES FOR LONDON MEDICAL STUDENTS. To the Editors of THE LANCET. SIRS,—With regard to your paragraph in THE LANCET of Jan. 15th, stating that the students of St. Mary’s Hospital were the first to express a collective opinion on the scheme of the conjoint Colleges for granting an M.D. degree, I think it is only right to say that on Nov. 25tb, 1885, at a meeting of the University College Medical Society, attended by over one hundred students, Dr. Thomas Barlow being in the chair, an almost identical resolution to that approved by the students of St. Mary’s Hospital was passed, after a long and animated discussion.—Yours truly. J. WALTER B S., President, Univ. Col. Medical Society.
CARR, M.B.,