EDINBURGH.

632 and in the French service. (I was once asked at House, near Edinburgh, for " receiving, detaining, concealing, Paddington why I wanted an officer’s ticket if I wasa sergeant- and harbouring lunatics,"in contravention of the 39th clausemajor?-but the wound to dignity was quite healed by the of the Lunacy Act. The licence for Gilmer House had been remark, on explanation of the slight difference, " We"i’, I taken from Mr. La-wrie ; but, in spite of this, he was charged thought you was an uncommon swell, sergeant-major !") The with the above offence, and found guilty of detaining five proposed distinction by classes" would mark the different lunatics on the premises. A penalty of X25 was inflicted with grades of rank far better than at present. sow we haveassist- expenses, with the alternative of two months’ imprisonment. ant-surgeons, who may be either (relatively) captains or lieu- In the reports of the Commissioners previous to the licence tenants. As regards duty, the duty of surgeon and assistant being withdrawn, frequent and repeated objections were made is exactly the same : both generally divide the hospital wards to the condition of the establishment, and to the state in which between them, though, of course, the junior takes parades, or the patients were kept. On Wednesday evening (the 18th) the Medico-Chirurgical ball-firing, or filling up diets, if the senior pleases; and so he would were he called "surgeon of the fourth class." It is not Society held the first meeting of the forty-third session ; the as with captain and lieutenant, where their place and duty are President, Mr. Spence, senior surgeon to the Royal Infirmary, in the chair. There was a good attendance of the members. quite distinct. In proposing that deputy-inspectors should be purely staff The first paper was a " Report of some Cases of Amputation in officers, and available for executive duty if no longer required which Acupressure was employed,’’ by Dr. Archibald Hamilon the staff, I only leave it open to so employ them ; and I ton, of Carlisle. The paper was communicated, with remarks, have no doubt that any young officer would gladly revert to by Professor Simpson, the introducer of acupressure. In it executive duty sooner than be shelved on half-pay, perhaps for Dr. Hamilton stated that in a certain number of cases the ligayears, as would now be the case after a war of, say, three years’ ture had been used, and in a like number acupressure. It duration. When the Crimean war ended, a long list of " first would appear that the latter method of arresting haemorrhage class staff surgeons," the analogous administratives of that day, had been adopted in cases other than amputation, and with a were placed on half-pay, and glad they were when the coming good result. In a case of wound, for instance, where the artery changes opened to them fall pay, as regimental surgeons. had retracted beyond the surface, but still continued to bleed, Why should not a deputy inspector-general, no longer needed, acupressure had been employed easily and satisfactorily. It go back to his regiment or district, just as a duputy adjutant. had also been resorted to with advantage in a case of aneurism general reduced from the staff, reverts to his corps ? The very where ligature was not advisable. Dr. Simpson, in his remarks, highest duty of a medical officer should be (as Mr. Alexander pointed out the various methods of using this means of stopping maintained) to use his skill for saving life ; and I assert that it haemorrhage. The first method was by introducing the needle requires a much more clever fellow to be a really first-rate through the skin. Where the size of the needle used for this regimental surgeon, than to be a deputy inspector general, as was objected to, he proposed that it should be an ordinary that office is ordinarily dis0harged. No great wisdom is re- sewing one, and entered on the surface of the wound. The quired to forward returns, enforce their punctual transmission, last method was to enter the needle on the surface of the and see that a code of printed rules are strictly complied with. wound below the bleeding vessel; to pass a loop of wire over If, however, Sir James McGrigor’s idea of an inspector’s duty the point, and bring the free ends of the wire round the head, (as given in his admirable autobiography) were carried out, and of the needle. Complete power was thus obtained over the that officer really superintended the practice of all the hospitals vessel; and by withdrawing the needle (which in this a,nd the under him, it would be a different affair, as then, to be efficient, second method is "threaded" with wire) the loop of wire is the inspector must be superiorly qualifieti as a consulting- set free, and can then be easily withdrawn. With regard to physician and surgeon, and so able to command the respect withdrawing the needle, Dr. Simpson remarked that in eleven and confidence of his surgeons. As far us my experience has of the cases of amputation related by Dr. Hamilton in which gone, inspectors do not attempt anything of the kind, and were it had been used, secondary haemorrhage had occurred in one : hardly expected to interfere at all, though the late Regulations this was mentioned because the needle in this case had been withdrawn at a very early period, and it was a question how tell them to do so. The remark, in your observations, that the abolition of long the needle should be kept Mt situ, and whether it was compulsory retirement would lessen promotion must have been advantageous or not to delay its removal. Dr. Simpson also made in foretfutness of my plan, which would insure gradual pointed out how much better it was to have a wound healing rise in rank and pay, quite -irrespective of anything but time and by the first intention, than to keep it open and excite the serviceaplan, in fact, analogous to that of the Indian staff formation of pus by ligatures, which in fact acted as so many corps, and which, by its certainty, would eliminate all the setons. The necessity for a portion of the vessel dying and lottery chances of the present system, on which, as you ob- requiring an exit through the surface of the wound was avoided serve, there may be again (as when I entered the army) by acupressure, for no part of the vessel actually required to undergo gangrenous inflammation. Above all, a great advanassistant-surgeons of twenty years’ service. One thing is certain, if the present state of affairs continues, tage was derived from the adoption of acupressure by surgeons in the country, this measure needing only one pair of hands, the department will fall low indeed. whilst the ligature required two. I am, Sir, your obedient servant, Mr. Spence, the President, was opposed to acupressure, and A DEPUTY INSPECTOR-GENERAL. November, 1863. did not see its great advantages over the ligature ; nor did he consider the ligature subject to the objections which Professor Simpson had brought against it. He had also spoken of the SCOTCH, IRISH, AND PROVINCIAL advantages of metallic sutures in obstetric operations; but the dealt with by the surgeon were of a different and a structures CORRESPONDENCE. our own

"

EDINBURGH.

(FROM THE

OUR SPECIAL

municipal elections in

CORRESPONDENT.)

city weTe made at the comThe medical interest is tolerably

this

mencement of this month.

well represented. The Junior Bailie, a ing to the alderman in English civic

Alexander, Surgeon,

a

most

dignitary correspondbodies, is Mr. J. T. energetic promoter of sanitary

science. Amoagsc the Councillors, there are two members of the profession-Dr. Win. Buchanan, and Mr. P. Miller, Surgeon. There is good reason to hope, therefore, that the medical welfare of the city and the interests of the profession are likely to be well looked after at the Council Board. The first infliction of a penalty under the Lunacy Act took place on the 10Gh instant, in a prosecution instituted by the Lunacy Board against Mr. A. T. Lawrie, living at Gilmer

varied nature, and the character of the tissues had much to do with suppuration after operation. He thought the proportion of secondary haemorrhage-one in eleven cases mentioned by Dr. Hamilton-was large, for in upwards of two hundred primary amputations performed by himself he had only had two instances of haemorrhage. Dr. Handyside, who has adopted successfully the use of acupressure, spoke in favour of its advantages from personal experience. and also alluded to the favour with which the system was being received in Paris by some distinguished surgeons, one of whom spoke highly of it as being likely to prove a most valuable means in the treatment of aneurism. The next paper was a "Notice of Gingival Diphtheritis in Lying in Women," by Dr. Matthews Dunoan. From the description of the cases, they were considered by Dr. Moir, Prof. Simpson, &c., to be cases of aphthae, such as are not rarely met with-a view which was most indignantly objected to by Dr. Duncan, who was not likely to mistake aphthae for diphtheria, and said that it was not usual in cases of the former to be able to tear off considerable portions of diphtheritic membrane from the gums, which was reproduced next day. In the cases de-

633 scribed there were extensive patches of diphtheritic membrane our local prints. The hospital in question is avowedly secwhich did not extend from the parts first affected, and were tarian, and its authorities have adopted as one of their fundanot accompanied by any marked constitutional symptoms, nor mental rules, that under no pretext whatever shall a RomanWere did the cases require any other than mild alterative treatment. Catholic clergyman be admitted within its portals. The meeting closed with the narration of " A Case of Dropsy Roman-Catholic patients denied admission as well as their associated with Cardiac Disease," which had been benefited in clergymen, the rule could be justified ; but as their rules now a most marked and rapid manner by the inhalation of oil of stand, it appears a very extreme measure to deprive them of juniper. The case was narrated by Dr. Benj. Bell, President the services of their clergy at the very time they most require of the Royal College of Surgeons, who had tried the treatment them, and this in a country where such extreme importance is at the suggestion of Prof. Simpson. The method was to dis- attached by the members of that persuasion to the rites and solve half a drachm of the oil in a tumblerful of hot water, ceremonies of their church. The facts of the case are briefly the patient inhaling the steam four or five times, with occa- these :—A poor Roman-Catholic patient, some time an inmate sional repetitions. Prof. Simpson remarked that the practice of the hospital in question, required the performance of an He recommended it several years ago, and had operation hazardous in its results ; and, previous to undergoing was not new. often used it with success. it, requested to receive at the hands of his priest the sacraIf the succeeding meetings be as interesting as the first, the ments of his church. No relaxation of the rule, however, could forty-third is likely to prove a most successful session to the be permitted, and he had actually to be carried out of the hosSociety. pital into the street to have the desired interview with his There are two students’ medical societies connected with our clergyman. Were such an occurrence to have happened under - medical school-the Royal Medical and the Hunterian. The the régime of King Bomba, surprise would be a mild term for latter inaugurated the session on Friday evening (the 20th), the feeling that would seize our minds; but to happen in what Dr. Handyside, the President, in the chair. Dr. Warburton we boast as being the second city in her most Christian Majesty’s Begbie read the introductory paper, the subject of his disser- empire, requires for us to credit it proof strong almost as that tation being " The Life and Labours of John Hunter, and the of Holy Writ. If this rule is to remain amongst the ordinances Benefits which his Genius and Study had conferred on Medical of this hospital, let another eqnally stringent be placed in Science." juxtaposition with it-that no Roman-Catholic patient be adI observe with pleasure that THE LANCET of the 14th inst. mitted, and then all cause of complaint will be removed, and has commenced an investigation into the adulterations of drugs our city for the future will be exempt from such disgraceful Could you but extend your inves- scenes of intolerance. It is no excuse to allege that our Romanas sold in the metropolis. tigations to this city I doubt not you would find that the Catholic poor are aware of such a regulation. Accidents will spiritus cetheris nitrici sold is not quite what it ought to be. I occur, and in the emergency recourse will be had to the nearest understand that methylated spirit is largely used. The whole- hospital for relief. Few patients enter the wards of an hospital sale price of spiritus cetheris nitrici made with it is 9d., and under the impression that they are to die ; so that even if that from pure spirit of 850 0specific gravity is 3s. per lb. The acquainted with this regulation, they avail themselves of the spirit sold by.our best shops at 5d. the ounce must give a hand- relief that the hospital affords, in the hope that the separation from their clergy will after all be but temporary. But their some profit. Writing of adulterations recalls the fact that but the other case assumes a graver aspect: death is imminent, and the poor day a dealer in a respectable position in Glasgow was fined ignorant creature for the first time awakes to the fearful doom X25 for selling as coffee a mixture of 80 per cent. chicory and he has so inconsiderately invoked upon his own head. This 20 per cent. mustard husks. Another sample contained equal should not be. Either refuse admission to Roman Catholics, or, proportions of chicory and coffee, and 15 per cent. of mustard if admitted, afford them the consolation of their religion. This husks. A third sample had a trace of coffee, 15 per cent. of latter would be the better course ; for, in my opinion, an hosmustard husks, and the rest chicory. Another dealer in coffee pital, above all charities, should know no creed or sect. was fined zC5 for a similar offence, but pleaded that he was In my letter of the 10th instant, I mentioned to you that a quite ignorant that the coffee was adulterated. From this we deputation from the Irish Medical Association waited upon may be alto wed to conclude that, in Glasgow, the more ignorant Sir Robert Peel to bring, through him, under the notice of a dealer is, the less chance is there of his being punished ; and Government, what by the profession universally throughout that not to know the nature of the article he sells, is a plea for Ireland are felt to be grievous injustices and shortcomings in his selling adulterated goods. the Irish Medical Charities Act. Some of these apply with Rilinh11rQ"h- Nov_ 24th 1863 such equal force to the profession on your side of the Channel as on ours that I submit them for perusal and consideration. First comes the question of superannuation. As the law DUBLIN. now exists, a man may spend a long and weary lifetime in the service of the sick poor upon a salary barely sufficient to pro(FROM OUR OWN CORRESPONDENT.) cure for him the absolute necessaries of life, in a district so wretched as to make a fee indeed a rara avis. Old age and of the ON Saturday evening last the twenty-sixth session and still must he make a semblance of Dublin Obstetrical Society was inaugurated by an opening decrepitude creep on, the duties of his office, as without its salary no redischarging address delivered by the outgoing president, Dr. Beatty, for- source is left him save the almshol1se; for in this department of merly professor of midwifery in the College of Surgeons. The the public service no provision is made for a retiring allowSociety met in what is termed the Pillar-room of the Rotunda; ance. Thus two parties are injured : the worn out old man, and a crowd of distinguished visitors and members were at- forced to toil when past his labour; and the sick poor, who, cannot get the attention which their tracterl together, in anticipation of a rich intellectual treat to under such circumstances, cases demand. And yet in no other department of the public be afforded them by the discourse of the accomplished lecturer, service is there such an unceasing demand on his time as in the - an anticipation in which no one present was disappointed. case of the medical man engaged in the discharge of dispensary Dr. Beatty selected for his theme Ovariotomy, and gave a most duties ; at any hour of the day and night he is at the beck and instructive and interesting lecture on this very important sub- call of any one of his dispensary committee ; and numerous inject. Having prefaced his remarks by an enumeration of all deed are the instances where, after a ride of some ten or twelve the papers that had been read before the Society in the pre- miles, he finds the case of some trivial nature. Still there vious session, he proceeded to give a sliceiiiet yet accurate is no provision made for his retirement after years of service, analysis of the several cases that have been the subjects of the or when broken up by work or disease. Another just cause operation at which he was himself present. He next exhibited of complaint, and one indeed, in my opinion, trenching on the the various instruments used in its performance, and wound spirit of the British Constitution, is the manner in which charges up a most admirable discourse by calling on the present mem- against the medical officer for any cause are conducted. An bers of the Society to uphold, during the next quarter of the inspector is sent down, the case is investigated, and a report century, the character that had been won for it in the last. He forwarded to the Poor-law Commission ers, founded, it is to be then, amidst loud applause, resigned the chair to the recently presumed, upon the evidence adduced ; but this the accused elected President, Dr. Denham, the present accomplished never is permitted to see or read, and the decision of the ComMaster of the Lying-in Hospital, in whose hands your reader s missioners is final. So that a medical man not only may be, may rest assured the interests of the Society will suffer no but has been in repeated instances, dis-missed from his situation damage. upon a report which he has never been allowed to examine, A very unpleasant story, in which is mixed up the name of and which, so far as he knows, may contain a highly-coloured, one of our metropolitan hospitals, has made its appearance in perhaps a distorted and ex-parte, statement of his case, which,