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ANNUAL MEETING OF THE GRADUATES OF THE UNIVERSITY OF LONDON.
THE NEW POOR-LAW ORDER RESPECTING UNION SURGEONS.
495
and constitute themselves the legal dispensers of ana- ANNUAL MEETING OF THE GRADUATES OF tomical and physiological instruction at a handsome rate per THE UNIVERSITY OF LONDON. No doubt it will be an unlucky discovery for these annum. THE graduates of the University of London held their annual gentlemen, when the efficient means of testing ability by meeting at the Freemasons’ Tavern on May lst, Dr. Birkbeck Nevins, of Liverpool, in the chair. means of examination shall have rendered unnecessary and Mr. SHAEN, honorary secretary, read the following Report supererogatory the " annual course’’-when it shall have been from the committee :" Your committee have this year to record the important lucidly demonstrated that two courses of surgery and three that the Bill prepared under their auspices in the last fact, courses of anatomy are not equivalent to one surgeon. Nor session of Parliament, for placing the medical graduates of the can we think that this discovery is far distant. It is very in- University of London on a footing of perfect equality with those of Oxford and Cambridge in respect of the right to practise teresting to observe how examinations of recent construction, physic, passed both Houses of Parliament, with some slight and even the later forms of some old examining bodies, are alterations, and received the Royal assent on the llth of In their last Report, the committee, in referring modified and remodelled, and all in the direction indicated; to this subject, expressed their anticipation that your Bill how oral examinations have become interchanged with written would meet with no important opposition. In this they were ones; how hours have been extended to days ;-how ana- disappointed. The Bill was stoutly contested in both Houses, and underwent the ordeal of several divisions. In the belief tomical questions have been superseded by anatomical dissec- that the Universities of Oxford and Cambridge had, at all the right to confer a license to practise surgery, the tions ;-how, indeed,-most modern innovation ! the candidate was so framed as to extend such right (if any) to the Unihas even been, in some quarters, expected to examine a veriversity of London. It was, however, stated in Parliament, a to of his sketch a diagnosis table sick man, and disease, if it existed, had fallen into abeyance, and it became necessary to yield to the efforts made to confine the prognosis, and a scheme of treatment. measure to the practice of physic, excluding not only surgery, Still, however, the College stands where it did-immovable, but also pharmacy and midwifery. The committee believe this an ancient land-mark, a tidal monument-demonstrating how be of very small importance, and that the much good ground has been recovered for humanity from the objects of the graduates have been practically and triumphConsidering the small number of Bills of any surges of ancient error. The examination which confers the by private members, which passed in the last honour of its membership presents at this moment the minimum session, the very late period at which the Bill was brought in, of exercise, associated as it is-not happily-with the maximum the strenuous opposition which it received (headed in the House of Lords by the Duke of Argyll, a Cabinet Minister), and the of pay. failure of all previous attempts of every party to modify the existing laws affecting medical practice, your committee cannot but regard the history and progress of your Bill as affordBY issuing the late order for making the office of Union ingan additional and decisive proof that the efforts of the Surgeon a permanent one, the Poor-law Board have conferred graduates have now placed the University in a position from The graduates owe a large The more prominent evils to which it can never be dislodged. a great boon upon the profession. of to the members of both Houses of Parliament, which the medical officer has been for a long period subjected both in and out of the Ministry, by whose votes the measure arose from his position in relation to the guardians. When it was passed ; and especially to Mr. Bell and Mr. Thornely, who suited the purpose of these functionaries, having his appoint- had charge of it in the House of Commons; to Lord Monteagle, acted in a similar capacity in the House of Lords; and to ment in their hands, subject as it was to annual renewal, they Lord Palmerston, who on this occasion lent a cordial and hesitated not to heap upon him every species of injury and effectivesupport as Home Secretary. Special mention must also be made of the services of Professor Foster, which were insult. Even if he appealed in any case to the Poor-law Board freely given to the cause of the graduates. The for protection, and received their approval of his conduct, the Senate voluntarily came forward to aid the progress of the Bill after its introduction, and supported the interests of the Unirevenge on the next day of guardians took care to take versity with vigour and effect. election. "The committee sincerely regret that they have not sucinternal reform of the University. Fortunately, the late order will take this arbitrary power ceeded intheaccomplishing the of the last session of Parliament, During concluding part out of the hands of the guardians, and thus not only make the the committee deemed it advisable to direct their efforts mainly medical officer more independent of these petty tyrants, but it to secure the passing of the University of London Medical will tend in every way to the advantage of the profession. It Graduates Bill. They did not, however, omit also to apply to the Home Office upon the subject of the Charter which they will be seen from a letter of Mr. LUMLEY, inserted at page had requested that the law officers of the crown might be 498, that the order alluded to has reference at present only to directed to prepare. No satisfactory answer, however, was received previously to the end of the long vacation. Subsethose Unions which have been formed under the Poor-law quently to this, the incompleteness of the arrangements of the Amendment Act of 1834, and to certain Incorporated Hundreds, ministry, and the general aspect of public affairs, rendered it to act upon the Government with any useful result, which have always acted under the regulations of the Poor-law either by private representation or parliamentary pressure. Commissioners. Giving the Poor-law Board full credit for an When it was understood that the ministerial changes were at was made to Sir George Grey, the Senate earnest desire to place the Union Surgeons of the kingdom in referred the whole question to the Home Office. the position which will enable them to perform their arduous having long ago it The made clear that the long and elaborate letter of duties most completely and satisfactorily, we trust and hope, the 8th of February, 1854, from Lord Burlington, as ChanUniversity, to Lord Palmerston, as Home Secrenot less for the profession itself than for the poor entrusted to cellor of which was in the last Report of your committee, tary, their care, that the Board will shortly issue the new order to had actually been overlooked altogether, and that the present those places in which the relief of the poor is administered Home Secretary believed that he was still waiting for an expression of the viewsof the Senate. To have the settlement of under the provisions of a local act. the question delayed by mistakes of such a character in such a quarter may well tax the patience of the graduates. The APPOINTMENTS.—Mr. William Thomas Fernie, house- committee can only assure them that they will use all the surgeon to the Royal Portsmouth, Portsea, and Gosport Hos- efforts which, in the present position of public affairs, have any pital, has been appointed resident medical officer to the chance of success, to press forward the claims of the graduates, Birmingham Workhouse.-Dr. Smiles has been appointed one either in Parliament or at the Home Office, as circumstances may of the physicians to the St. Pancras Royal General Dispensary. dictate.
lations,
August, 1854, events, Bill
that the right,
modification to secured.
kindantlyintroduced
.
-
debt gratitude who then, as ever,
their
impossible
an end, application reply the
printed
496
is
"The Senate have decided that degrees shall not be conthe prevention of injurious or fatal inflammation from the ferred in public this year; and the committee are informed wound, I am persuaded that it will, ere long, be employed in that for this decisionthere are other reasons besides the want every incision, whether chloroform be inhaled at the same time of suitable accommodation.’ This want ought to be at once or not. Besides, as the anaesthetic power of intense cold will supplied, but if the Senate were desirous of maintaining the not (at least, as hitherto employed) remove the whole of the due position of the University in public estimation, the ob- pain in certain deep operations, I should be glad to have satisstacles to the celebration of the only public ceremonial which factory proof that an adequate dose of chloroform can be justihas ever been instituted by the University would, doubtless, iiably resorted to in these in combination with cold, in order have been overcome as heretofore. that, on every occasion, the anaesthesia may be complete. 11 Mr. Shaen having most liberally tendered his services to Chloroform is now not so often used in minor operations; where the committee as honorary secretary, they need hardly say, cold is not employed, no anaesthetic of any kind is resorted to, have gladly accepted the offer. though the reports alluded to, which I have received from the they " The committee must again repeat their urgent request for country, show that the use of cold for this purpose is now very - assistance and pecuniary support. The policy of the opponents generally diffused. I am much gratified to learn from a surgeon of reform is to weary out the graduates by the passive resist- attached to an hospital in Yorkshire, that congelation has been ar.ce familiar to official persons. It is for the graduates to employed there as an anesthetic previously to the operation for show that they are neither to be intimidated nor wearied, and hernia, because I cannot doubt that its general adoption for any who feel discouraged by the delays of a struggle unjusti- this purpose will often reuder the operation unnecessary, by its fiably protracted, will do well to consider that the substantial effecting the reduction of the protruded part. The point principally requiring elucidation, is the amount of power of their body has steadily grown year by year, and that their efforts have enabled them to wield a large portion of the injury that has been produced by chloroform carefully adminisinfluence of their university, although they are improperly tered. Are its immediate fatal effects more or less numerous excluded from the recognised position which is their due." than has been supposed, and is its effect on the system useful or injurious as respects recovery from severe operations ? The CHAIRMAN moved that the Report be received. If Professor FOSTER, LL.D., M.A., moved, and Mr. T. S. the amount of danger or injury be little, we must not be deOSLER, LL. B., seconded, a resolution " That the graduates terreci by this from the employment of an agent possessing such will not cease to assert their claims until they have obtained beneficial powers; if it be great, the prevention of pain by chloroform would be a blessing purchased at too high a price. the concession of their rights." There cannot be a doubt that a very imperfect list of the Dr. STORRAR moved, and Dr. STOCKER seconded, a resolution, "That the graduates express their satisfaction at the accidents from chloroform has been published. Several which passing of the University of London Medical Graduates Act, have occurred in hospitals are unknown to the body of the pro.1864, and tender their thanks to those members of both Houses fession, and probably the greater number of those which have of Parliament who have supported that measure, and especially happened in private practice have been concealed. As respects to Mr. Bell, Mr. Thornely, and Lord Monteagle." the latter especially, we have no right to expect that the feelDr. CARR, of Gateshead, LL.D., moved, and Mr. FOWLER, ings of relatives should be hurt by the publication of such misLL. B., seconded, a resolution, "That the graduates regret fortunes, when almost every advantage to medical science that that the Senate has thought it right to suspend the only public can proceed from a knowledge of the circumstance, might, with ceremonial of the University." little trouble to the medical attendant, and no risk to his repu. Mr. WELLS, B.A., and Mr. T. B. BAINES, B.A., moved and tation, be obtained without their being generally known, or .seconded a resolution calling for subscriptions. even without the relatives themselves being made acquainted Mr. J. R. QUAIN, LL.B., moved, and Mr. THOMAS HARRI- with them. During the last year, six deaths from chloroform have been reported as happening in the hospitals of London, SON, B.A., seconded, a vote of thanks to the Chairman. All the resolutions were carried unanimously, and after the but not one in its private practice. Indeed, I think only one .-vote of thanks to the Chairman the meeting separated. fatal case in private life has been reported as occurring in this population of two millions since the introduction of chloroform. Within the last month a private case, occurring near Whitby, has been published, but the circumstances attending it were so peculiar, as to render concealment impossible. In a fatal case which happened only a few days ago in the neighbourhood of Belgrave-square, the circumstances were, in this respect, dif"Audi alteram partem." ferent ; but as they were particularly interesting in a medical point of view, (the chloroform having being extensively applied DO THE ADVANTAGES OF CHLOROFORM AS to a diseased surface,) it is to be hoped that they will not be AN ANÆSTHETIC EXCEED ITS DISADVAN- withheld from the profession. I have accidentally heard of another case in private practice, occurring also within the preTAGES? sent month, in one of the midland counties, where the chloroTo the Editor of THE LANCET. form used in amputation produced a succession of convulsions SIR,-There are several important questions connected with that terminated in death. As only one fatal result has been ,the use of chloroform which it is very desirable should be reported in hospital practice during the same period-viz., that speedily answered, but which can only be satisfactorily answered at the Royal Ophthalmic Hospital, on the 10th instant, the a statement of the results of a varied and extensive expedisproportion may be regarded as a corroboration of the opinion of Dr. Marshall Hall, that accidents from chloroform are more , rience. With a view of gaining information on this subject, I lately likely to occur in private than in public practice, from the ab-took the liberty of addressing a considerable number of surgeons sence of the necessary appliances for resuscitation. The effect of chloroform on the result of severe operations ,possessing much opportunity of witnessing the effects of chloroform ; and the replies with which my applications have been can only be determined by careful and extensive iuquiries. The honoured contain many important facts. But as the value of statistical tables relating to this point, which have been pub.these would be much augmented by such an extended return lished in this country and America being of a contradictory as would confirm certain uncontested positions, and show on character, one set showing a great decrease, and the other a which side the evidence from experience preponderates where great increase of mortality since the introduction of chloroform, there is a difference of opinion, may I request that you will new researches are called for. The recent question of the ex.allow me to state to the readers of THE LANCET the particular pediency of usingchloroform after severe gun-shot wounds, and points on which, as it appears to me, information is especially the disapproval of it by the higher medical authorities of the army, has brought this point prominently before the profession. required. I presume to offer myself as the collector of these facts, and In admitting that there may be certain advantages from this the reporter of the truths which may be indicated by them, agent, and particularly that its stimulus may, like that from only because the circumstance of my having introduced into the wine, be useful under certain circumstances, we must not forget practice of medicine an agent possessing anaesthetic powers, has the pernicious effect of the prostration that succeeds this exdrawn my attention in a more than ordinary degree to the sub- citement. But granting that chloroform, as at present administered, is jeet ; but as this very circumstance may possibly be supposed to unfit me for the task by creating a bias in favour of local often fatal, may not means be devised to render it innocuous ? anaesthesia, it is proper that I should anticipate the objection. May it not thus be rendered an exception to all other theraWere congelation proposed only as an anaesthetic, there might peutical agents of the same class ? The principal difference of be a ground for it; but as its principal advantage in operations opinion respecting the mode of exhibitingchloroform at present _
-
Correspondence.
7y
-
_
495
and constitute themselves the legal dispensers of ana- ANNUAL MEETING OF THE GRADUATES OF tomical and physiological instruction at a handsome rate per THE UNIVERSITY OF LONDON. No doubt it will be an unlucky discovery for these annum. THE graduates of the University of London held their annual gentlemen, when the efficient means of testing ability by meeting at the Freemasons’ Tavern on May lst, Dr. Birkbeck Nevins, of Liverpool, in the chair. means of examination shall have rendered unnecessary and Mr. SHAEN, honorary secretary, read the following Report supererogatory the " annual course’’-when it shall have been from the committee :" Your committee have this year to record the important lucidly demonstrated that two courses of surgery and three that the Bill prepared under their auspices in the last fact, courses of anatomy are not equivalent to one surgeon. Nor session of Parliament, for placing the medical graduates of the can we think that this discovery is far distant. It is very in- University of London on a footing of perfect equality with those of Oxford and Cambridge in respect of the right to practise teresting to observe how examinations of recent construction, physic, passed both Houses of Parliament, with some slight and even the later forms of some old examining bodies, are alterations, and received the Royal assent on the llth of In their last Report, the committee, in referring modified and remodelled, and all in the direction indicated; to this subject, expressed their anticipation that your Bill how oral examinations have become interchanged with written would meet with no important opposition. In this they were ones; how hours have been extended to days ;-how ana- disappointed. The Bill was stoutly contested in both Houses, and underwent the ordeal of several divisions. In the belief tomical questions have been superseded by anatomical dissec- that the Universities of Oxford and Cambridge had, at all the right to confer a license to practise surgery, the tions ;-how, indeed,-most modern innovation ! the candidate was so framed as to extend such right (if any) to the Unihas even been, in some quarters, expected to examine a veriversity of London. It was, however, stated in Parliament, a to of his sketch a diagnosis table sick man, and disease, if it existed, had fallen into abeyance, and it became necessary to yield to the efforts made to confine the prognosis, and a scheme of treatment. measure to the practice of physic, excluding not only surgery, Still, however, the College stands where it did-immovable, but also pharmacy and midwifery. The committee believe this an ancient land-mark, a tidal monument-demonstrating how be of very small importance, and that the much good ground has been recovered for humanity from the objects of the graduates have been practically and triumphConsidering the small number of Bills of any surges of ancient error. The examination which confers the by private members, which passed in the last honour of its membership presents at this moment the minimum session, the very late period at which the Bill was brought in, of exercise, associated as it is-not happily-with the maximum the strenuous opposition which it received (headed in the House of Lords by the Duke of Argyll, a Cabinet Minister), and the of pay. failure of all previous attempts of every party to modify the existing laws affecting medical practice, your committee cannot but regard the history and progress of your Bill as affordBY issuing the late order for making the office of Union ingan additional and decisive proof that the efforts of the Surgeon a permanent one, the Poor-law Board have conferred graduates have now placed the University in a position from The graduates owe a large The more prominent evils to which it can never be dislodged. a great boon upon the profession. of to the members of both Houses of Parliament, which the medical officer has been for a long period subjected both in and out of the Ministry, by whose votes the measure arose from his position in relation to the guardians. When it was passed ; and especially to Mr. Bell and Mr. Thornely, who suited the purpose of these functionaries, having his appoint- had charge of it in the House of Commons; to Lord Monteagle, acted in a similar capacity in the House of Lords; and to ment in their hands, subject as it was to annual renewal, they Lord Palmerston, who on this occasion lent a cordial and hesitated not to heap upon him every species of injury and effectivesupport as Home Secretary. Special mention must also be made of the services of Professor Foster, which were insult. Even if he appealed in any case to the Poor-law Board freely given to the cause of the graduates. The for protection, and received their approval of his conduct, the Senate voluntarily came forward to aid the progress of the Bill after its introduction, and supported the interests of the Unirevenge on the next day of guardians took care to take versity with vigour and effect. election. "The committee sincerely regret that they have not sucinternal reform of the University. Fortunately, the late order will take this arbitrary power ceeded intheaccomplishing the of the last session of Parliament, During concluding part out of the hands of the guardians, and thus not only make the the committee deemed it advisable to direct their efforts mainly medical officer more independent of these petty tyrants, but it to secure the passing of the University of London Medical will tend in every way to the advantage of the profession. It Graduates Bill. They did not, however, omit also to apply to the Home Office upon the subject of the Charter which they will be seen from a letter of Mr. LUMLEY, inserted at page had requested that the law officers of the crown might be 498, that the order alluded to has reference at present only to directed to prepare. No satisfactory answer, however, was received previously to the end of the long vacation. Subsethose Unions which have been formed under the Poor-law quently to this, the incompleteness of the arrangements of the Amendment Act of 1834, and to certain Incorporated Hundreds, ministry, and the general aspect of public affairs, rendered it to act upon the Government with any useful result, which have always acted under the regulations of the Poor-law either by private representation or parliamentary pressure. Commissioners. Giving the Poor-law Board full credit for an When it was understood that the ministerial changes were at was made to Sir George Grey, the Senate earnest desire to place the Union Surgeons of the kingdom in referred the whole question to the Home Office. the position which will enable them to perform their arduous having long ago it The made clear that the long and elaborate letter of duties most completely and satisfactorily, we trust and hope, the 8th of February, 1854, from Lord Burlington, as ChanUniversity, to Lord Palmerston, as Home Secrenot less for the profession itself than for the poor entrusted to cellor of which was in the last Report of your committee, tary, their care, that the Board will shortly issue the new order to had actually been overlooked altogether, and that the present those places in which the relief of the poor is administered Home Secretary believed that he was still waiting for an expression of the viewsof the Senate. To have the settlement of under the provisions of a local act. the question delayed by mistakes of such a character in such a quarter may well tax the patience of the graduates. The APPOINTMENTS.—Mr. William Thomas Fernie, house- committee can only assure them that they will use all the surgeon to the Royal Portsmouth, Portsea, and Gosport Hos- efforts which, in the present position of public affairs, have any pital, has been appointed resident medical officer to the chance of success, to press forward the claims of the graduates, Birmingham Workhouse.-Dr. Smiles has been appointed one either in Parliament or at the Home Office, as circumstances may of the physicians to the St. Pancras Royal General Dispensary. dictate.
lations,
August, 1854, events, Bill
that the right,
modification to secured.
kindantlyintroduced
.
-
debt gratitude who then, as ever,
their
impossible
an end, application reply the
printed
496
is
"The Senate have decided that degrees shall not be conthe prevention of injurious or fatal inflammation from the ferred in public this year; and the committee are informed wound, I am persuaded that it will, ere long, be employed in that for this decisionthere are other reasons besides the want every incision, whether chloroform be inhaled at the same time of suitable accommodation.’ This want ought to be at once or not. Besides, as the anaesthetic power of intense cold will supplied, but if the Senate were desirous of maintaining the not (at least, as hitherto employed) remove the whole of the due position of the University in public estimation, the ob- pain in certain deep operations, I should be glad to have satisstacles to the celebration of the only public ceremonial which factory proof that an adequate dose of chloroform can be justihas ever been instituted by the University would, doubtless, iiably resorted to in these in combination with cold, in order have been overcome as heretofore. that, on every occasion, the anaesthesia may be complete. 11 Mr. Shaen having most liberally tendered his services to Chloroform is now not so often used in minor operations; where the committee as honorary secretary, they need hardly say, cold is not employed, no anaesthetic of any kind is resorted to, have gladly accepted the offer. though the reports alluded to, which I have received from the they " The committee must again repeat their urgent request for country, show that the use of cold for this purpose is now very - assistance and pecuniary support. The policy of the opponents generally diffused. I am much gratified to learn from a surgeon of reform is to weary out the graduates by the passive resist- attached to an hospital in Yorkshire, that congelation has been ar.ce familiar to official persons. It is for the graduates to employed there as an anesthetic previously to the operation for show that they are neither to be intimidated nor wearied, and hernia, because I cannot doubt that its general adoption for any who feel discouraged by the delays of a struggle unjusti- this purpose will often reuder the operation unnecessary, by its fiably protracted, will do well to consider that the substantial effecting the reduction of the protruded part. The point principally requiring elucidation, is the amount of power of their body has steadily grown year by year, and that their efforts have enabled them to wield a large portion of the injury that has been produced by chloroform carefully adminisinfluence of their university, although they are improperly tered. Are its immediate fatal effects more or less numerous excluded from the recognised position which is their due." than has been supposed, and is its effect on the system useful or injurious as respects recovery from severe operations ? The CHAIRMAN moved that the Report be received. If Professor FOSTER, LL.D., M.A., moved, and Mr. T. S. the amount of danger or injury be little, we must not be deOSLER, LL. B., seconded, a resolution " That the graduates terreci by this from the employment of an agent possessing such will not cease to assert their claims until they have obtained beneficial powers; if it be great, the prevention of pain by chloroform would be a blessing purchased at too high a price. the concession of their rights." There cannot be a doubt that a very imperfect list of the Dr. STORRAR moved, and Dr. STOCKER seconded, a resolution, "That the graduates express their satisfaction at the accidents from chloroform has been published. Several which passing of the University of London Medical Graduates Act, have occurred in hospitals are unknown to the body of the pro.1864, and tender their thanks to those members of both Houses fession, and probably the greater number of those which have of Parliament who have supported that measure, and especially happened in private practice have been concealed. As respects to Mr. Bell, Mr. Thornely, and Lord Monteagle." the latter especially, we have no right to expect that the feelDr. CARR, of Gateshead, LL.D., moved, and Mr. FOWLER, ings of relatives should be hurt by the publication of such misLL. B., seconded, a resolution, "That the graduates regret fortunes, when almost every advantage to medical science that that the Senate has thought it right to suspend the only public can proceed from a knowledge of the circumstance, might, with ceremonial of the University." little trouble to the medical attendant, and no risk to his repu. Mr. WELLS, B.A., and Mr. T. B. BAINES, B.A., moved and tation, be obtained without their being generally known, or .seconded a resolution calling for subscriptions. even without the relatives themselves being made acquainted Mr. J. R. QUAIN, LL.B., moved, and Mr. THOMAS HARRI- with them. During the last year, six deaths from chloroform have been reported as happening in the hospitals of London, SON, B.A., seconded, a vote of thanks to the Chairman. All the resolutions were carried unanimously, and after the but not one in its private practice. Indeed, I think only one .-vote of thanks to the Chairman the meeting separated. fatal case in private life has been reported as occurring in this population of two millions since the introduction of chloroform. Within the last month a private case, occurring near Whitby, has been published, but the circumstances attending it were so peculiar, as to render concealment impossible. In a fatal case which happened only a few days ago in the neighbourhood of Belgrave-square, the circumstances were, in this respect, dif"Audi alteram partem." ferent ; but as they were particularly interesting in a medical point of view, (the chloroform having being extensively applied DO THE ADVANTAGES OF CHLOROFORM AS to a diseased surface,) it is to be hoped that they will not be AN ANÆSTHETIC EXCEED ITS DISADVAN- withheld from the profession. I have accidentally heard of another case in private practice, occurring also within the preTAGES? sent month, in one of the midland counties, where the chloroTo the Editor of THE LANCET. form used in amputation produced a succession of convulsions SIR,-There are several important questions connected with that terminated in death. As only one fatal result has been ,the use of chloroform which it is very desirable should be reported in hospital practice during the same period-viz., that speedily answered, but which can only be satisfactorily answered at the Royal Ophthalmic Hospital, on the 10th instant, the a statement of the results of a varied and extensive expedisproportion may be regarded as a corroboration of the opinion of Dr. Marshall Hall, that accidents from chloroform are more , rience. With a view of gaining information on this subject, I lately likely to occur in private than in public practice, from the ab-took the liberty of addressing a considerable number of surgeons sence of the necessary appliances for resuscitation. The effect of chloroform on the result of severe operations ,possessing much opportunity of witnessing the effects of chloroform ; and the replies with which my applications have been can only be determined by careful and extensive iuquiries. The honoured contain many important facts. But as the value of statistical tables relating to this point, which have been pub.these would be much augmented by such an extended return lished in this country and America being of a contradictory as would confirm certain uncontested positions, and show on character, one set showing a great decrease, and the other a which side the evidence from experience preponderates where great increase of mortality since the introduction of chloroform, there is a difference of opinion, may I request that you will new researches are called for. The recent question of the ex.allow me to state to the readers of THE LANCET the particular pediency of usingchloroform after severe gun-shot wounds, and points on which, as it appears to me, information is especially the disapproval of it by the higher medical authorities of the army, has brought this point prominently before the profession. required. I presume to offer myself as the collector of these facts, and In admitting that there may be certain advantages from this the reporter of the truths which may be indicated by them, agent, and particularly that its stimulus may, like that from only because the circumstance of my having introduced into the wine, be useful under certain circumstances, we must not forget practice of medicine an agent possessing anaesthetic powers, has the pernicious effect of the prostration that succeeds this exdrawn my attention in a more than ordinary degree to the sub- citement. But granting that chloroform, as at present administered, is jeet ; but as this very circumstance may possibly be supposed to unfit me for the task by creating a bias in favour of local often fatal, may not means be devised to render it innocuous ? anaesthesia, it is proper that I should anticipate the objection. May it not thus be rendered an exception to all other theraWere congelation proposed only as an anaesthetic, there might peutical agents of the same class ? The principal difference of be a ground for it; but as its principal advantage in operations opinion respecting the mode of exhibitingchloroform at present _
-
Correspondence.
7y
-
_