ARMY MEDICAL ADMINISTRATION.

240 should be the sole administrator for the sick. All hospitals should be placed under the immediate control of the medical officer, who should be responsible for the appointment and discharge of every other officer employed about the sick, "Audi alteram partem." except the chaplain. Wise and economical administration should be made a ground of promotion; and there is no CLINICAL SURGERY IN THE UNIVERSITY OF doubt that a great reduction could, under these circumstances, be made in the army of purveyors, clerks, EDINBURGH. sergeants, corporals, sentries, and orderlies now engaged, To the Edit07’ of THE LANCET. but nct, as it appears to me, half employed, about the Sis,—As Mr. Syme has ingeniously made it appear that sick; whilst the whole military element, directors, captains might be dismissed, since he denies my statements., while in truth he confirms them, of orderlies, paymasters, &c., divide authority, and increase the probability of they only allow me to sayinefficiency and abuse. Secondly, it is imperatively neces1st. With regard to physiological instruments being toys sary that the relation between the Medical Department, the and injurious to medical education, Mr. Syme made no ex- War Office, the Horse Guards, and the Engineers, in respect ceptions when he uttered that remarkable statement. But to sanitary duties, be at once defined and simplified. In it is satisfactory now to learn that the value of two of theory, and according to the regulations, the regimental them-viz., the microscope and the ophthalmoscope-is at medical officer is responsible for the sanitary state of the length admitted by him. barracks and the regiment to which he is appointed. The 2nd. As to experiments upon living animals, Mr. Syme various inspectors are also sanitary officers according to says they are warranted for scientific investigation. Why,.their rank and jurisdiction, and the Director-General is, of then, did he interfere with the scientific investigations in- course, the chief. But what are the facts ?In reality, the stituted by the Br. tish Medical Association, to determine regimental officer is treated as a mere nonentity; he is not the action of mercury on the liver, and thereby throw a even a member of the Sanitary Committee ; and I could give large amount of unnecessary trouble and annoyance upon a score of instances where reports of the grossest defects the Committee ? have been made from year to year without the least result. 3rd. As to clinical surgery, the question is not what Mr.I Nor is the inspector in a more worthy position. He, too, Syme thinks useful, or what change has taken place in his i makes from time to time an elaborate sanitary report ; but lectures. I never referred to these topics, but to the fact1 whilst be is writing in the office of the hospital over which that he is probably the only clinical professor in the world I he has there may be a Sanitary Committee, entirely charge, who does not visit his patients in the hospital with his composed of combatant officers, going round his wards, and students, and afford them the opportunity of watching the making sanitary observations, without either his knowledge effects and results of his practice. I fear that in England or consent. The Director-General is in nearly the same this is scarcely credited, and that the profession are slow to position, and is a sanitary officer in name and not in deed. believe that in Edinburgh the University authorities permit In the heat of the Crimean war, when sanitary science was such a procedure. But such is the case; and if his pupils scarcely so much appreciated as at present, there was, do not complain of it to him, they certainly do so to others. perhaps, ample excuse for the appointment of an indeThe efforts made by the Medical Faculty to see that hos- pendent Sanitary Commission, with a civil medical adviser, pital visits with the students should be made by Mr. Syme civil engineer, &c.; and to the members of that Commission have been counteracted by the influence he exercised over the soldier, no doubt, owes a deep debt of gratitude. But the seven gentlemen who formerly constituted the Univer- the necessity for external advice of this kind has passed sity Court. It only remains, therefore, to make the facts away. The army now contains a number of medical officers public, so that professional opinion, through a free medical who possess knowledge and experience on sanitary questions press may be exercised in correcting so great an abuse in of the very highest order, and who are fully competent to medical education. advise the Minister for War and the Commander-in-Chief Sir William Jenner is reported to have said, in his address on all such questions. It is quite time that the anomalous to the Teachers’ Association, "Iet the licensing bodies and expensive which now interposes between the machinery make the student attend the wards of an hospital, and Medical Department and the other branches of the then, with rare exceptions, he will leave with a fair executive should be abolished, and that the Directoramount of clinical knowledge."’ But what hope would General should be regarded as the sole sanitary authority, there be of such judicious advice being followed, if Mr. and brought into direct communication with those whose Syme’s system of teaching became general, or his peculiar duty it is to accept his advice when not inconsistent with view as to bedside instruction being" a miserable clap-trap the exigency in which the army may be placed, nor with the and sham " were adopted by the Medical Council ? interest in a pecuniary point of view. public I am, Sir, your obedient servant, I remain, Sir, your obedient servant, J. HUGHES HUSHES BENNETT. &e. J. H. STALLARD, Feb. 1869. STALLABD, M.B., &c. Glenflnlas-street, Edinburgh, February 6th, 1869.

Correspondence.

I

ARMY MEDICAL ADMINISTRATION.

GENERAL HOSPITALS AND SPECIAL

DEPARTMENTS. THE LANCET. To the Editor of THE LANCET. I barrack of the course inspections Szx, During my have been most courteously assisted by army medical officers SiR,-As the mention made of St. Bartholomew’s in your of every rank. Under their guidance I have visited all the leader of Saturday last, referring to the subject started in hospitals, and have been made acquainted with the system the now famous article in The Times of Jan. 30th, contains of administration therein pursued. Although not strictly an enumeration of certain special departments, which leaves within my province, as your Commissioner, it might possibly the reader to infer that they are not only in existence, but be expected that I should offer some opinion upon the con- efficiently carried out, it is of great importance that the stitution, relationship, and duties of the Army Medical public and the profession should be correctly informed, in Department, the more so as the subject is one of peculiar order that the force of their opinion may compel the iminterest at the present moment, when changes are in conmediate adoption of a system in every respect consonant templation which have for their object greater economy in time of peace and more expansibility in the event of war. The with the high standard of modern science. Indeed, it can subject is, however, so large and difficult, that I feel great hardly be doubted that, werethe Royal President of that diffidence in expressing any opinion, particularly in reference hospital not now abroad, one word from Mm would be sufto the vexed question as to the relative advantages of staff ncient at once to init-iat6 this desirable’ reform. -Iwill, and regimental systems. I cannot refrain, however, from therefore, endeavour to trace - in --ii6 -few words as possible certain anomalies that be expensive observing might swept away at once, not only without loss, but with positive the history of special treatment and instruction -at this advantage to the public service. First, the medical officer otherwise incomparable institution. To the Editor

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