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MARKHAM v. ABRAHAMS.
968 indeed, I hope the former reservation would
be of assistance a sufficient
to him. I may add that it would be easy to select
number of
fulfilling
cases
carrying an expectation of I am,
Dr.
Haig’s desideratum-viz.,
life of at least six months.
between them lost 44 lib., the individual losses varying from 2-14 lb. Thus the Cambridge eight lost 433/4 lb. The fact that the crew which won easily in record time actually put on weight as the result of their training, while the losing crew lost more than 3 stones, suggests thac in selecting a crew preference should be given to men who do not need to be trained down. Very significant is the fact that while the losing eight were all rowed out at the end of the race, the only Oxford man to show signs of exhaustion, was one of the two Oxford men who lost weight. I am, Sir, yours faithfully, HARRY CAMPBELL. Wimpole-strect, W., April 2nd, 1911.
Sir, yours faithfully, THOMAS J. HORDER, Physician to the Cancer Hospital, London. 1911.
Harley-street, W., April 3rcl,
THE VACANCY
two between them lost 2 lb., leaving a balance of 4½ lb. to the good for the Oxford men. Of the Cambridge crew, only one man put on weight, and this to the extent only of-4 lb., while the remaining seven
ON THE GENERAL
MEDICAL COUNCIL. To the Editor of THE LANCET.
SIR,-In your admirable notice of the career of the late Dr. L. S. McManus, whose death all will deplore, you state that an election of a Direct Representative will be necessitated to fill the vacancy, but that such election may be postponed until the autumn, so that the four Representatives may be elected simultaneously. I fail to see how this simultaneous election can be effected. By the Medical Act, 1886, each Direct Representative is elected for a period of five years, and it is enacted that should a death vacancy occur as"soon as conveniently may be " after that occurrence the President shall issue his precept to the Branch Council for that part of the United Kingdon in which such Representative was elected, requiring the said Branch Council
MARKHAM
v.
ABRAHAMS.
To the Editor of THE LANCET.
SIR,-It is curious that the writer of your article on the Markham &ngr;. Abrahams case which appeared in THE LANCET of March 25bh last misses the chief and only real conflict of medical opinion at the second trial-namely, the question whether an increase in conicity estimated at 4 D. could or could not occur in about seven months. As to the frequency of conioal cornea, had the writer of the article had access to the shorthand notes of the evidence he would have seen that when questioned on the point I disclaimed the possession of any personal figures. I quoted from the most recent and authoritative estimates with which I am acquainted--viz., those brought forward in a discussion on conical cornea which took place at the French Ophthalmological Society in May, 1899. They are as follows :Holth reports 0 cases in 35,000 eye patients,
a Representative to be elected by the registered practitioners resident in that part of the United Kingdom within 21 days after the receipt of the precept. The remaining Direct Representatives are, for England, Dr. Langley Browne, whose term of office does not expire until Dec. 12th, 1911, and Dr. H. A. Latimer, whose office expires on Jan. lst, 1912. The Scotch Representative,
to cause
medical
Dr. N. P. Walker, also holds office until Jan. 1st, 1912 ; and the Representative for Ireland, Dr. L. Kidd, until Feb. 28th, 1916. Unless, therefore, Dr. Latimer, Dr. Langley Browne, and Dr. Walker resign their offices in the autumn, which no one would reasonably require them to do in the face of a session in November at which they would have the right to be present, and the present vacancy is held over until then, a simultaneous election is impossible. To withhold the election to fill the death vacancy which has occurred until December surely could not be held to be a carrying out of the enactment of 1886, " as it would not be "as soon as conveniently may be" after the date of the vacancy which has taken place. There is no legal or moral authority to force either of the present Representatives to cease to hold office until such As it is automatically determined by effluxion of time. is, we shall be short of a Representative at the May session unless the General Medical Council move quickly in the matter of the new election. Two elections in this year will entail considerable trouble and expense upon the General Medical Council and some inconvenience to the electors, but these must be borne with the usual patience and resignation which are the attributes of medical practitioners generally ; and we must all unite to send in to the Council one worthy to follow in the footsteps of Dr. McManus as a persona grata both to his colleagues and the Council. I am, Sir, yours faithfully, March 31st 1911 A. G. BATEMAN.
Wicherkiewiez about
30 in 120,000 to 150,000"" The figures given above work out at 1 case of conical cornea in 13,000 eye patients. My estimate, therefore, of 1 in 10,000 patients was within the mark, more especially as the source of my information was understood. The writer of your article takes the view that the detection of ’’ even the quite early stages of conical cornea"is a simple matter. Cases by Morax and by Kopff respectively, however, prove the contrary. There is a stage when only an examination of the catoptric images from the surface of the cornea will lead to a correct diagnosis, and that implies the possession of an ophthalmometer or some similar appliance. Later on, of course, the informed use of the ophthalmoscopic mirror is adequate. But the play of the retinoscopic shadows would be difficult for an optician to detect, more especially as he would be working with eyes the pupils of which were not dilated by drugs. At all events (to make a confession), I have at this moment more than one patient under observation in whom I suspect, but cannot assure myself of, the existence of a very early stage of keratoconus. I am, Sir, yours faithfully, SYDNEY STEPHENSON. Welbeck-street, W., March 31st, 1911. ’
TRAINING AND ROWING. To the Editor of THE LANCET. SIR,-A comparison of the effects of training upon the weights of the two University crews who rowed in last
Saturday’s race
,
is of interest :-
Oxford Crew. Cain
T,nqq
I
THE LANTERN TEST FOR COLOUR Cambridge Crew. Gain
BLINDNESS.
Loss
10 the Editor
of THE LANCET.
SIR,-I hardly understand why Mr. Baldwin has written the letter which appears in THE LANCET of to-day. His letter in THE LANCET of 1890 is before me now and is obviously of a later date than the publication of my first papers. He has concluded quite erroneously that my thesis was not of a practical nature. The thesis formed the foundation of my book on colour blindness in the International Scientific Series.-I am, Sir, yours faithfully, ’
.
M will be same
44lb.
that two of the Oxford crew remained the that four between between them gained 771b., lb., and that
seen
weight,
¼lb.
-
I
F. W. EDRIDGE GREEN. Institute of Physiology, University College, Gower-street, W.C., -
--
April 1st, 1911.
be of assistance a sufficient
to him. I may add that it would be easy to select
number of
fulfilling
cases
carrying an expectation of I am,
Dr.
Haig’s desideratum-viz.,
life of at least six months.
between them lost 44 lib., the individual losses varying from 2-14 lb. Thus the Cambridge eight lost 433/4 lb. The fact that the crew which won easily in record time actually put on weight as the result of their training, while the losing crew lost more than 3 stones, suggests thac in selecting a crew preference should be given to men who do not need to be trained down. Very significant is the fact that while the losing eight were all rowed out at the end of the race, the only Oxford man to show signs of exhaustion, was one of the two Oxford men who lost weight. I am, Sir, yours faithfully, HARRY CAMPBELL. Wimpole-strect, W., April 2nd, 1911.
Sir, yours faithfully, THOMAS J. HORDER, Physician to the Cancer Hospital, London. 1911.
Harley-street, W., April 3rcl,
THE VACANCY
two between them lost 2 lb., leaving a balance of 4½ lb. to the good for the Oxford men. Of the Cambridge crew, only one man put on weight, and this to the extent only of-4 lb., while the remaining seven
ON THE GENERAL
MEDICAL COUNCIL. To the Editor of THE LANCET.
SIR,-In your admirable notice of the career of the late Dr. L. S. McManus, whose death all will deplore, you state that an election of a Direct Representative will be necessitated to fill the vacancy, but that such election may be postponed until the autumn, so that the four Representatives may be elected simultaneously. I fail to see how this simultaneous election can be effected. By the Medical Act, 1886, each Direct Representative is elected for a period of five years, and it is enacted that should a death vacancy occur as"soon as conveniently may be " after that occurrence the President shall issue his precept to the Branch Council for that part of the United Kingdon in which such Representative was elected, requiring the said Branch Council
MARKHAM
v.
ABRAHAMS.
To the Editor of THE LANCET.
SIR,-It is curious that the writer of your article on the Markham &ngr;. Abrahams case which appeared in THE LANCET of March 25bh last misses the chief and only real conflict of medical opinion at the second trial-namely, the question whether an increase in conicity estimated at 4 D. could or could not occur in about seven months. As to the frequency of conioal cornea, had the writer of the article had access to the shorthand notes of the evidence he would have seen that when questioned on the point I disclaimed the possession of any personal figures. I quoted from the most recent and authoritative estimates with which I am acquainted--viz., those brought forward in a discussion on conical cornea which took place at the French Ophthalmological Society in May, 1899. They are as follows :Holth reports 0 cases in 35,000 eye patients,
a Representative to be elected by the registered practitioners resident in that part of the United Kingdom within 21 days after the receipt of the precept. The remaining Direct Representatives are, for England, Dr. Langley Browne, whose term of office does not expire until Dec. 12th, 1911, and Dr. H. A. Latimer, whose office expires on Jan. lst, 1912. The Scotch Representative,
to cause
medical
Dr. N. P. Walker, also holds office until Jan. 1st, 1912 ; and the Representative for Ireland, Dr. L. Kidd, until Feb. 28th, 1916. Unless, therefore, Dr. Latimer, Dr. Langley Browne, and Dr. Walker resign their offices in the autumn, which no one would reasonably require them to do in the face of a session in November at which they would have the right to be present, and the present vacancy is held over until then, a simultaneous election is impossible. To withhold the election to fill the death vacancy which has occurred until December surely could not be held to be a carrying out of the enactment of 1886, " as it would not be "as soon as conveniently may be" after the date of the vacancy which has taken place. There is no legal or moral authority to force either of the present Representatives to cease to hold office until such As it is automatically determined by effluxion of time. is, we shall be short of a Representative at the May session unless the General Medical Council move quickly in the matter of the new election. Two elections in this year will entail considerable trouble and expense upon the General Medical Council and some inconvenience to the electors, but these must be borne with the usual patience and resignation which are the attributes of medical practitioners generally ; and we must all unite to send in to the Council one worthy to follow in the footsteps of Dr. McManus as a persona grata both to his colleagues and the Council. I am, Sir, yours faithfully, March 31st 1911 A. G. BATEMAN.
Wicherkiewiez about
30 in 120,000 to 150,000"" The figures given above work out at 1 case of conical cornea in 13,000 eye patients. My estimate, therefore, of 1 in 10,000 patients was within the mark, more especially as the source of my information was understood. The writer of your article takes the view that the detection of ’’ even the quite early stages of conical cornea"is a simple matter. Cases by Morax and by Kopff respectively, however, prove the contrary. There is a stage when only an examination of the catoptric images from the surface of the cornea will lead to a correct diagnosis, and that implies the possession of an ophthalmometer or some similar appliance. Later on, of course, the informed use of the ophthalmoscopic mirror is adequate. But the play of the retinoscopic shadows would be difficult for an optician to detect, more especially as he would be working with eyes the pupils of which were not dilated by drugs. At all events (to make a confession), I have at this moment more than one patient under observation in whom I suspect, but cannot assure myself of, the existence of a very early stage of keratoconus. I am, Sir, yours faithfully, SYDNEY STEPHENSON. Welbeck-street, W., March 31st, 1911. ’
TRAINING AND ROWING. To the Editor of THE LANCET. SIR,-A comparison of the effects of training upon the weights of the two University crews who rowed in last
Saturday’s race
,
is of interest :-
Oxford Crew. Cain
T,nqq
I
THE LANTERN TEST FOR COLOUR Cambridge Crew. Gain
BLINDNESS.
Loss
10 the Editor
of THE LANCET.
SIR,-I hardly understand why Mr. Baldwin has written the letter which appears in THE LANCET of to-day. His letter in THE LANCET of 1890 is before me now and is obviously of a later date than the publication of my first papers. He has concluded quite erroneously that my thesis was not of a practical nature. The thesis formed the foundation of my book on colour blindness in the International Scientific Series.-I am, Sir, yours faithfully, ’
.
M will be same
44lb.
that two of the Oxford crew remained the that four between between them gained 771b., lb., and that
seen
weight,
¼lb.
-
I
F. W. EDRIDGE GREEN. Institute of Physiology, University College, Gower-street, W.C., -
--
April 1st, 1911.