"ROTHELN: A POINT OF DIAGNOSIS."

951 first five weeks of the current quarter the death-rate in the city averaged 27’5 per 1000; the mean rate during the same period did not exceed 19’0 in London and 186 in Edinburgh. The 188 deaths in Dublin last week showed an increase of 23 upon the number in the previous week, and included 14 which were referred to the principal zymotic diseases, against 16, 8, and 13 in the preceding three weeks; 7 resulted from whooping-cough, 4 from diphtheria, 2 from diarrhoea, 1 from "fever(typhus, enteric, or simple), and not one either from small-pox, measles, or scarlet fever. These 14 deaths were equal to an annual rate of 2’1 per 1000, the rates from the same diseases being 2’1 in London and 3’3 in Edinburgh. The fatal cases of whooping-cough, which had been 4 and 5 in the previous The 4 deaths referred two weeks, rose last week to 7. to diphtheria also exceeded the numbers in recent weeks, and raised the number of fatal cases of this disease recorded in the past five weeks to 8, whereas only one was registered in the first quarter of this year. Seven inquest cases and 7 deaths from violence were registered. The deaths both of infants and of elderly persons exceeded the numbers returned in recent weeks. More than a quarter of the deaths were registered in public institutions. The causes of 20, or nearly 11 per cent., of the deaths registered during the week were

Correspondence. "

Audi alteram

partem."

THE SCHOOL BUILDINGS OF WILLIAM HUNTER. To the Editor of THE LANCET. is not long since you recorded the demolition of SIB,—It

John Hunter’s house at Earl’s Court. In a few daysthe whole of the school buildings" built by William Hunter in 1768 in Great Windmill-street-which you allowed me to describe in THE LANCET of Sept. 27th, 1884-will be removed to make way for the new thoroughfare from Piccadilly to Holborn. Yesterday I was in the Museum, which I first entered as a student some years ago. That room, the theatre, and dissecting-room will soon be only a matter of history. These buildings were used as a school until 1835. Here taught William Hunter, Hewson, Cruickshank, Baillie, Wilson, Brodie, Charles Be11, Herbert Mayo, and Cassar Hawkins. For three years after the majority of the teachers migrated to St. George’s Hospital in 1830, and Mayo to King’s not certified. College in 1831. Mr. Gregory Smith, who died a few weeks ago, lectured for three years subsequently; he was the head of the school in Little Windmill-street. The dwelling-house, now a foreign cafe, still remains; it was built at the same time THE SERVICES. as the schools. Here William Hunter lived and died. He was succeeded by Dr. Baillie, who lived in it until 1799, THE Queen has been pleased to give and grant unto Arthur James Wharry, Esq., Surgeon-Major in the Egyptian when he resigned as physician to St. George’s Hospital, and to live in Lower Grosvenor-street, where he died in Army, Her Majesty’s Royal licence and permission that he went 1823. Mr. Wilson was the last connected with the school Class of the and wear the the Fourth of may accept Insignia Order of the Aledjidieh, which His Highness the Khedive of who lived in the house. This neighbourhood had long been a medical centre. Sir John Shadwe11, physician to three Egypt, authorised by His Imperial Majesty the Sultan, has many years, been pleased to confer upon him in recognition of his services sovereigns, lived in Great Windmill-street and died there in Dr. Willis, who attended the whilst actually and entirely employed beyond Her Majesty’s children of James II, 1747. when Duke of York, lived in St. Mardominions with the Egyptian Army. and died there in 1675. Dr. Denman lived in tin’s-lane, WAR OFFICE.-Army Medical Staff: Deputy SurgeonDenman-) street, and delivered lectures on General William Henry Muschamp is granted retired pay, Queen- (now in his own house for many years. I should be with the honorary rank of Surgeon-General ; Surgeon-Major midwifery to be informed where John Hunter lived after his William Elgee, half-pay, is granted retired pay, with the glad to return England in 1763, until he succeeded his brother honorary rank of Briga.de Surgeon; Surgeon-Major and in Jermyn-street in 1768. I have heard that it was in Honorary Brigade Surgeon Owen William George, M.D., has Golden-square, but I can nowhere find any record of it. been permitted to commute his retired pay. I am. Sir. vours trulv. ADMIRALTY.—In accordance with the provisions of Her CHARLES HAWKINS. Majesty’s Order in Council of December 30th, 1884, Surgeon John Jennings has been placed on the retired list of "ROTHELN: A POINT OF DIAGNOSIS." his rank. To the Editor of THE LANCET. The following appointment has been made :-Surgeon Percy E. Maitland to the Lion. SIR,—Having just passed through an attack of the above INFANTRY MILITIA.—3rd Battalion, the Sherwood Foresters complaint, perhaps it would be interesting to your readers (Derbyshire Regiment): Surgeon W. A. Walker is granted the to have an account of it, especially as it confirms the statehonorary rank of Surgeon-Major. of in ment Dr. Glover issue of the 24th ult. as to the your YEOMANRY CAVALRY (Dorset).-Surgeon G. W. Daniell of some of the cervical is granted the honorary rank of Surgeon-Major. implication glands previously to the ARTILLERY VOLUNTEERS.—1st Dorsetshire: The following appearance of the rash. officer is transferred from the 1st Hampshire Artillery VolunOn Tuesday, March 23rd, I visited a young patient who teer Corps, on its division into two corps-viz., Acting Sur- had the disease in a mild form, and having seen her only the geon P. W. G. Nunn, to be Acting Surgeon.-2nd Sussex: once, can accurately give the incubation period in my own The following officers to be transferred from the 1st Sussex case-viz., seven days. On the following Thursday (March Artillery Volunteer Corps, on its division into two corps- 25th) I felt a stiffness at the angle of the jaw on both sides, fiz., Surgeon R. V. Skinner, to be Surgeon; Acting Surgeon and, having a case of mumps at the time, I laughingly said to a H. Colgate, M.D., and Acting Surgeon H. Habgood, M.D., to friend that I hoped I was not going to have mumps, little be Acting Surgeons.-3rd Lancashire: John Joseph Neville, thinking at the time that I was in for another infectious disorder. The stiffness continued, and on Friday, the 26tb, Gent., to be Acting Surgeon. RIFLE VOLUNTEERS.—4th Lancashire : John Alexander I noticed that two or three of the glands on both sides were Mackenzie. Gent., M.B., to be Acting Surgeon; Surgeon swollen and tender. This stiffness about the neck and William Hoyle resigns his commission.-24th Midd1esex : tenderness of the glands continued until the rash made it’s Acting Surgeon H. M. Crookshank resigns his appointment.- appearance. On Tuesday evening, March 30th, I felt rather 2nd Perthshire (the Perthshire Highland): Acting Surgeon out of sorts, and had considerable aching of the eyes. I passed John Mackay, M.B., to be Surgeon; Acting Surgeon Peter a fair night, and was able to do my work the next day, McCa11um resigns his appointment.-2nd Volunteer Battalion, though feeling it an exertion. The aching of the eyes the Princess of Wales’s Own (Yorkshire Regiment) : Surgeon increased, so about midday I took a dose of quinine, thinking J.W. Taylor, M.D., is granted the honorary rank of Surgeon- it was neuralgic, but without relief. At 7 P.M. I had a Major.—1st Volunteer Battalion, Princess Charlotte of Wales’s distinct rigor, and at 7.30 went to bed feeling very unwell, the < Royal Berkshire Regiment) : Surgeon and Honorary Sur- pain in the eyes being very intense and shooting to the back geon—Major W. R. H. Barker resigns his commission; also is of the head ; I was also very hot and feverish. After passing permitted to retain his rank, and to continue to wear the a very restless night, I was astonished to find myself with a uniform of the Battalion on his retirement.—1st Dumfries : rash on the face, neck, and shoulders, which rapidly spread Thomas Davidson, Gent., M.B., to be Acting Surgeon.—18th over the whole surface of the body except the hands and feet; Lancashire (Liverpool Irish): Surgeon J. Finegan, M.D., is the pain of the eyes was not relieved by the appearance of the rash. Next morning, Friday, April 2nd, the rash was granted the honorary rank of Surgeon-Major.

for

952

height, the face swollen, conjunctivæ injected, and selection to the fellowship of the older Members, the length throat, soft palate, and gums puffed and sore; the hard of whose hospital experience, as well as entrance to the Colpalate was also very rough to the tongue and tender, and I feel lege, may measure within a decade of his own, and most of confident I had the same rash in my mouth and throat as I had whom were Members before the youngest of the recently externally. On Saturday the rash was fast fading, the aching elected Fellows had been born. Be it understood, however, of the eyes had diminished, and the stiffness of the neck had no fault is found with the early elections, but it is felt to bedisappeared; and on the following Monday I got up for a desirable as well as equitable, since the College has ceased short time, though feeling very shaky; it was on that day to be merely metropolitan and become national, that its at its

the

that I first noticed desquamation taking place Nothing remains to be said except that I made I am Sir, yours faithfully. valescence.

on a

the face.

rapid

status of fellowship should be placed within the reach of industry and integrity after a reasonable term of memberI am, Sir, yours truly, ship.

con-

W. STROVER.

May 10th,

A MEMBER

1886.

PRIOR TO

1859.

AMENDMENT OF THE PENAL CLAUSES.

"AFTER-CARE " OF MENTAL CONVALESCENTS.

To the Editor of THE LANCET.

To the Editor of THE LANCET. SIR,—Your previous kindness in calling attention in your columns to the need of " after-care" on behalf of many poor and friendless mental convalescents induces me to trouble you with another brief communication. In succession to Lord Shaftesbury, who took much interest in the subject of " after-care," and attended several successive anniversaries of the Association, Lord Brabazon has accepted the office of President. Several well-known physicians, specially experienced in the treatment of mental maladies., have evinced personal interest in a project for fostering the convalescence of persons recovering from these disorders. It is intended, when the amount of funds permit the undertaking, to open a "home," both for the reception of a few convalescents and also as a centre of the Society’s operations. Lord Shaftesbury expressed an opinion that such a homeNo existing convalescent home (among was necessary. more than 200) professes to receive persons recovering from general mental derangements. Many homes, by their rules,, exclude this class of convalescents from the benefits which they provide for persons convalescing from ordinary maladies. It should be borne in mind that there are more than 60,000 patients (of whom the majority are women) in county asylums and kindred institutions. Many are physically as well as mentally invalided, requiring, on leaving asylums, " after-care" at least equally as much as convalescents from ordinary hospitals. Contributions would be received by Dr. Clay Shaw, hon. treasurer, Banstead, Sutton, Surrey; or by the Union Bank of London, Argyll-place, W. I would gladly reply to any communication.

SIR,—The following clause in the Medical Amendment Act of 1884 has unfortunately been omitted in the present Act :" On and after the said appointed day, if any person who is not a registered medical practitioner, and who practises or professes to practise, or publishes his name as practising medicine or surgery for gain, or who receives any payment for practising medicine or surgery-(a) uses the designation of or represents himself to be a physician, surgeon, doctor, or apothecary; or (b) uses any designation or description denoting that he is qualified by law to practise medicine, surgery, or midwifery,-he shall, on summary conviction, be liable to a penalty not exceeding twenty pounds." It is too much to expect at present the passing of a law to prevent unqualified persons practising either medicine or surgery; indeed it is doubtful whether such a law will ever be passed; but it is not too much to expect, or indeed to demand, that legally qualified members of the medical profession shall have their titles protected by law. At present a quack can assume any title that he may feel disposed to adopt, provided that he does not pretend to be registered, and the burden of disproof, often well-nigh impossible, lies upon those who take action thereon. By the insertion of the above clause this assumption is rendered impossible. It is intended to bring the subject before Sir Lyon Playfair (and other members of Parliament who have expressed themselves favourable to this clause) before the Bill reaches the committee stage, on Monday, the 17th inst., and if necessary petition the House of Lords in favour of the clause. All members of the profession who are in favour of its insertion will greatly assist if they will signify their acquiescence to me without delay either by post-card or letter. 1 am Sir. vours &c.. ARTHUR WIGLESWORTH. ** *

We

entirely sympathise with

I

am

Cir

yours

friilv

H. HAWKINS, Hon. Sec. ,

* * We heartily wish this very useful and prise success.-ED. L.

humane enter-

the purpose of those

who have drawn the above clause. Mr. Wiglesworth is chairman of the Liverpool Medical Defence Association, and speaks on the strength of much experience of the weak points in the clauses of the present Act. A Bill with a similar object is already before the House, introduced by Mr. John Morgan Howard, member for the Dulwich division of Camberwell. This Bill further contains a clause meant

dispensaries which purport to be conducted by registered practitioners and are worked chiefly by unqualified assistants. This is a great evil, and needs more stringent legislation than we either have or are likely to get. The clause of Mr. Howard’s Bill is perhaps a little too sweeping, but it is in the right direction. Practitioners who approve of the clause to which attention is drawn by Mr. Wiglesworth will do well to signify their approval by post-card to to suppress

him.-ED. L. ROYAL COLLEGE OF PHYSICIANS. To the Editor of THE LANCET. election this year of Fellows to the College of SIR,-The Physicians disappoints those who had hoped for an extension of it on a generous scale to the older Members. Your kindness allowed of attention being drawn to this proposition as early as last October, but possibly then too late to affect the recent election. If so, the sexennium of our present President might at its close be gracefully signalised by liberal

NORTHERN

(From

COUNTIES NOTES,

our own

Correspondent.)

SUNDERLAND INFIRMARY.

THE spring meeting of the North of England Branch of the British Medical Association having been held at Roker (a pleasant watering-place in the vicinity of Sunderland) on the 21st ult., the Honorary Medical Staff of the Sunderland Infirmary invited the members to the infirmary, and entertained them to luncheon. Between eighty and ninety members availed themselves of the invitation and inspected the infirmary, which contains accommodation for 150 beds, and was much admired. The new wing has now been two and was built in accordance with opened nearly years, the most advanced ideas of hospital construction, and cost £10,700. The admissions of patients is untrammelled by any subscriber’s recommendation, and a small sub-committee sits to see that improper persons are not admitted. This change from ticket to free admission has now been tried for eight years, has worked admirably, and has had the special effect of bringing to the infirmary acute medical cases. There is. another feature that might be mentioned in connexion with the Sunderland Infirmary-namely, that for the last fourteen years it has been nursed by the sisters from the Protestant Deaconesses’ Training Hospital, Tottenham, and the unanimous feeling of the Committee of Management and of the medical officers is that the nursing and management of the