POOR-LAW MEDICAL RELIEF.—PETITION OF THE MEDICAL OFFICERS OF THE HUNGERFORD UNION.

672 by exciting forced inspirations from time to application of cold to the face and chest. When patients slept after seeming recovery from asphyxia, it was incumbent on the practitioner most carefully to watch the breathing. Then one exciter of respiration was withdrawn-the will. The patient might relapse, and cease breathing altogether for want of the timely excitement of involuntary respiration. The author instanced atelectasis, of which affection he sketched an outline, as an excellent example of the dependence of the healthy state of the lung on the vigour of the respiratory movements, and referred to an interesting example of it which he himself had lately witnessed. It happened in a girl of eleven, who died of pericarditis. The lungs on inflation resumed their proper colour, texture, and weight. What was the remedy for this affection ? Clearly the excitement of involuntary inspiration, repeated again and again. The remarks were concluded by a reference to that all but exclusively voluntary breathing which was maintained after the division of the vagi nerves. The animal became tired of exertion, the will acted more and more faintly, the blood became less and less oxygenated, and in the end asphyxia was completed. The author related an experiment which he had performed; the results, so far as the affection of the breathing was concerned, were just those described by Legallois. He quite agreed with that distinguished physiologist, Dr. Marshall Hall, in his view of the pneumogastric being the ordinary excitor nerve of respiration, and in what he had said respecting the voluntary breathing when that nerve was divided. He (Mr. Barlow) considered that the state of lung found in animals who died after this experiment, benefit result

time, by

the

resembled that of atelectasis. The

Society adjourned until

the last

Monday in September.

ON THE TREATMENT OF ULCERS BY MECHANICAL PRESSURE.

[REPLY

OF MR. CRITCHETT TO DR.

ARNOTT.]

To the Editor of THE LANCET. the last number of your journal, Dr. Arnott, o: SIR,— In Brighton, has published a letter, the object of which seems t( be to put an end to the claims of two separate aspirants foi originality of invention, by quietly appropriating all priority and merit to himself. How the case may stand with regard to the uterine apparatus I leave to others more conversant witb such matters to determine; I wish to confine myself to the part of Dr. Arnott’s letter, in which he suggests, that second in cases of ulcers of the lower limbs requiring mechanical support, his very simple method, by means of two long Indiarubber tubes, a bladder, and a piece of cloth, is far preferable to the complicated methods recommended either by Mr. Critchett or Mr. Chapman. Here is a remarkable instance of the proneness of man to ride his hobby-horse into a territory where it is at least useless, if not injurious. So anxious is the doctor to substitute his air-pressure for all other means, that he treats as of no moment the fact, that the patient must be kept at rest during his method. Now, considering that one of the principal advantages of mechanical support is, that it allows the sufferer to pursue his usual avocations during the whole time,-a matter of extreme importance to the poor, and, indeed, to almost all,-I think it is rather too bad that the doctor, for the sake of thrusting in his plan, should condemn methods of which he is evidently uninformed or misinformed, both theoretically and practically. I am willing to concede, that Dr. Arnott may have physically rivalled the poet, in "giving to airy nothing a local habitation;" but I would counsel, for the sake of his own reputation and the cause of science, that suitable habitations be chosen for it, and that ulcers of the leg be spared this intrusion. We all remember the story of the famous currier, who, when asked what lie would use for defending the besieged town, recommended leather; in point of suitableness of the means to the end to be accomplished, I think the currier and the doctor are about upon a par. Dr. Arnott suggests, that these contentions for originality on the part of Messrs. Critchett and Chapman (the very existence of which, by the by, I was not previously aware of) are ridiculous; it seems to me that he will probably have the laugh rather against than with him. I have too much confidence in the good sense of the profession and of the public to suppose that they will abandon a method at once simple, effectual, and rapid, and sanctioned by long and repeated experience, and allowing the patient to pursue his ordinary avocations, for the sake of air-pads, which are at least superfluous, inasmuch as every practical surgeon knows that all cases of ulcers of the leg will heal by very simple means, if rest be superadded. I think,

then, that both Mr. Chapman and myself may feel that our professional reputation and our respective methcds of treatment are in no peril if they receive no harder hit than from the

pellet

of Dr.

Arnott’s airgun. .

I remain, your obedient servant, GEORGE CRITCHETT. Finsbury square, June, 1849.

MEDICAL FEES AT ASSURANCE OFFICES. To the Editor of THE LANCET. the SIR,—On subject of payment of medical men by life assurance societies for information required, and on which their profits are based, there ought only to be one opinion. The pocket of the ordinary medical attendant is the proper channel to direct their fees for professional information respecting the health and habits of any particular person. Reference to a medical man not acquainted with the habits, general condition, &c., of a person, and who has to find out all essentials, by hurried questioning, at a time when any adverse circumstance is likelv to be suppressed, can only be looked upon as a form, I will not say " more honoured in the breach than the performance;" but only observe, that information so received can only be looked upon as second in importance to that obtained from the family medical attendant. Here’s a question to answer any body of men without a fee. Is temperate in his or her habits of eating and drinkingHow any assurance society can have the bold effrontery to make such a demand upon any one whom they never saw in their lives, and especially a professional man whom they have no idea of feeing, but expect to receive it with tacit obedience; such obedience as is demanded of a witness on oath before a court of law,—can only be looked upon as one of the gross things of this world-an indelicacy which makes a man stare with amazement, and go away wondering at the vulgar impudence of some people. I send you the following brief correspondence, to use at your discretion; and if my remarks meet with your approbation, they are much at your service. Please add my name to the "Five-Hundred-Pounds Medical Reform Fund" for £1 —I am. Sir. vours obedientlvWILLIAM Lowther street, Carlisle, 1849.

REEVES, Surgeon &c.

SIR,-An application has been made to me to-answer certain As I am the questions relative to the life insurance of ordinary medical attendant, and as your office will receive from me the most particular information regarding the health &c. of -, I wish to know whether any fee is allowed by -.

your office for such information.

ltlost of the

assurance

offices

acknowledge the propriety of granting such a fee. I am,

Sir, your obedient servant,

WILLIAM REEVES.

To Mr. Lidderdale.

sun Lue Assurance

.society, .a pru, tS4g.

SIR,—In reply to your note of the lst inst., I beg to inform you that it is not the practice of this Society to pay fees to the medical attendant of the life proposed for insurance, it being incumbent on all persons whose lives may be proposed, to produce evidence, at their own expense, that their lives are

eligible for insurance.-I

am.

To William Reeves, Esq.

Sir. C.

vour

H.

obedient servant.

LIDDERDALE, Actuary.

POOR-LAW MEDICAL RELIEF.—PETITION OF THE MEDICAL OFFICERS OF THE HUNGERFORD UNION. THE medical officers of the Hungerford Union have forwarded (for presentation to the Right Honourable the House of Com-

mons)

to T. H. S. Sotheron, Esq., member for North Wilts, a similar to that of the Bury Poorlaw Union, published

petition

in a late number of THE LANCET. The Hungerford petition has been signed byDAVID KENNARD, Surgeon, Lambourn district. JOHN GALE HILLIER, (late Union Surgeon,) Lambourn. JOHN LIDDERDALE, Surgeon, Kintbury district. H. H. P. MAJOR, Hungerford district. RICHARD DAVIS, M.D., Ramsbury district. RICHARD H. BARKER, (late Union Surgeon,)

Hungerford.

JAMES LIDDERDALE, Surgeon, Great Bedwin district.

These medical officers express a hope that the advice of the Poor-law Medical Committee, to petition, as circulated in THE LANCET, may be still more generally followed, so as to command the attention of Parliament.