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"THE NITRO-PROPIOL TEST FOR SUGAR IN URINE."
882
"CROOK
v.
CROOK AND HORROCKS."
The Welsh Hospital is expected to leave England in about days, Professor Thomas Jones, M.B. Lond, F.R.C.S.Eng., Mr. J. Lynn Thomas, F.R.C.S. Eng., and Mr. R. MillsRoberts, F.R C.S.Edin., will act as surgeons, and Mr. Laming Evans, M.B.Cantab., F.R C.S., late house surgeon, St. Bartholomew’s Hospital, and Mr Herbert Davies, M.B., Ch.B. Vict., senior house surgeon, Stoke-on-Trent Infirmary, Five dressers and nine or ten nurses as assistant surgeons. will complete the staff. The hospital funds now amount to over .66000 and among the subscribers during the past week have been H.M. the Queen 100, H.R.H. the Prince of Wales .E50, and H.R.H. the Duke of York 20.
and
great responsibility of the position. worthy of him, and the siege will prominent place in military history.
ten
was
The part he played hereafter occupy a
FRUIT FOR THE MILITARY HOSPITALS. Haliburton in a letter to the Times says : "...... I have undertaken to send weekly to Netley Hospital a small supply of fresh fruit for the use of the invalids returning from South Africa. Many others, if aware that they might enjoy this privilege, would no doubt gladly avail themselves of such an opportunity of usefulness by sending regular supplies of fruit to the various large military" hospitals scattered throughout the United Kingdom......." It is to be hoped that many others will follow Lady
Lady
Haliburton’s
THE LATE SIR WILLIAM LOCKHART. In the death of the Commander-in-Chief of Her Majesty’s example. forces in India the country and the army have sustained a The total number of conscripts for the French army last great loss, and we cannot refrain from paying a sincere year, says the Army and Navy Gazette, shows a reduction tribute of respect on the part of the British and Indian of nearly 15,000 on that of the previous year. This noticemedical services to his memory. The late Sir William I able has caused some uneasiness. The fundamental Lockhart had a very distinguished career and was a very cause drop of the diminution is doubtless due to the stationary brave man of quite exceptional qualities. He came of a state of the population, but it is also a fact that there has good stock; his uncle was John Gibson Lockhart, the son- been a special The medical examination of cause at work. in-law and biographer of Sir Walter Scott, and Sir William the has been far more severe than for several conscripts Lockhart was himself, apart from his high military reputapast. tion, a man of ability and culture and possessed an ex- years W. Dick, M.B., F.R.C.S. Edin., R.A.M.C. (who is Major cellent knowledge of German. He was very wise in counsel, for Colonel W. F. Stevenson, M.B. Dub., R.A.M.C., acting decided and prompt in action, and eminently honest and as Professor of Military Surgery in the Army Medical School, considerate in his dealings with all-and not least so in the been relieved of the charge of the Surgical Netley), having case of officers of the medical services. Notwithstanding that Division of the Royal Victoria Hospital, Major Birt, R.A.M.C., he was known to have been for a long time in delicate health has been appointed to the office. his death was a surprise and a real grief to all who had the The following gentlemen have been ordered to join the privilege of his acquaintance. He looked as he was, every Army Medical School as surgeons on probation for the Royal inch a soldier-a handsome man of fine physique, to whom Medical Corps :-Mr. H. E. Weston, L.S.A., St. George’s independence, courage, and self-sacrifice were natural and Army Hospital; Mr. J. G. Churton, M.R.C.S. Eng.. L.R.C.P. Lond. ; instinctive. Mr. A. E. Hamerton, M.R.C.S. Eng., L.R.C.P. Lond., Leeds A ROYAL NAVAL MEDICAL RESERVE. School of Medicine. Our contemporary the Army and Navy Bazette contains Royal Army Medical Corps messes have now been estaa communication signed Louis Vintras, M.D., B.Sc., blished in India to which the Government grant 80 and 100 medical officer R.M.S. Orinoco, regarding the value of rupees per mensem respectively where eight or ten officers having competent reserves in all branches of the services. form the mess. The following civil surgeons having arrived at Netley are Dr. Vintras suggests, apropos of the call that has been made on the civil profession to supplement the Army posted as stated: Mr. Marriott to the huts for duty, and Medical Service during the campaign in South Africa, Dr. A. C. Profeit to the surgical division. a that Royal Naval Medical Reserve might be organised with very littfe expense to the State out of the number of medical men who have passed several years of their career in the service of one or another of the mail lines, who are used to the sea, have a knowledge of the medical aspects and hygiene of medical life, who are "Audi alteram partem." experienced in tropical diseases, and thoroughly inured to rapid changes of climate. The idea seems a good one and fits in with that of the Naval Medical Reserve composed of "CROOK v. CROOK AND HORROCKS." officers of the large mail companies. Dr. Vintras asks for To the Editors of THE LANOET. communications from persons in sympathy with such a moveoffer or who have to ment, concerning it, suggestions SiRS,-Will you permit me through your columns to thank to be addressed to him at 19A, Hanover-square, W. all those who have written to me letters of sympathy and congratulation and also to thank Dr. William Duncan and METTIOXED IN DESPATCHES. many others who have expressed a desire to help to defray In a despatch from Lord Methuen on the action at my costs. I quite appreciate the kind motive and am very Magersfontein on Dec. 10th and llth, sent by Lord Roberts grateful, but I prefer that no subscription list should be to the Secretary of State for War, occur the following started on my behalf. passages :I am, Sirs, yours faithfully, "Major O’Donnell, Royal Army Medical Corps, and PETER HORROCKS. Brook street, W., March 19th, 1900. Lieutenant Delap, Royal Army Medical Corps, were indefatigable in attending wounded under fire." Black Watch.-Lieutenant Douglas, Royal Army Medical Corps, "THE NITRO-PROPIOL TEST FOR SUGAR showed great gallantry and devotion, under a very severe fire, IN URINE." in advancing in the open and attending to Captain Gordon To the Editors of THE LANCET. was also who a to wounded ; (Gordon Highlanders), ttending Major Robinson and other wounded men under a fearful SiBS,—In THE LANCET of Feb. 17th there was a notice of fire." Teusch’s Nitro-Propiol Test for sugar which induced me to SIR GEORGE WHITE. i send for a bottle of the tablets in order to compare it with It will be remembered that the gallant defender of Lady- the ordinary method by Fehling’s solution. According to smith in a brief public speech of thanks for the congratula- ’, the directions supplied with the tablets we are told to tions tendered to him after the relief of that garrison i dissolve one tablet in about three drachms of water, add 10 incidentally adverted to the fact that he was at the time drops of the suspected urine, and boil slowly for from three suffering from fever with a temperature of 102° F. Everybody to five minutes. A fine colouration of indigo blue is said to will have learned with regret that Sir George White did not take place if sugar be present, the indigo being deposited when the fluid is allowed to stand. It is at once obvious recover his health so rapidly as could be desired and that he has wisely embarked and is returning to this country where that boiling for from three to five minutes is a disadvantage all, without exception, wish for his speedy recovery. Sir for two reasons : it takes up a good deal of time and it is George White, it is needless to add, went through a most impossible to boil continuously for so long in a test tube trying time during the long siege, and, in addition to the without explosions of steam, so that the process must be hardships and privations he underwent, he had all the care carried out in a flask or capsule. But this is not a serious
Correspondence.
’i
I
THE MIDWIVES BILL.
objection
if the method
were
so
accurate
as
not to need
confirmation.
B
It is well known that the power of reducing cupric oxide is not peculiar to grape sugar but is shared by a good many other substances which are frequently present in sufficient quantities in the urine to cause at any rate a partial reduction of the test solution, so that a method which would be equally delicate and positive in its results and which would stand in no need of confirmation by other means would be a boon to clinical medicine. From this point of view I cannot speak very highly in favour of the new test. A case of diabetes under my care which has improved so much that I the sugar in the urine for a long time has been less than 1 per cent., and estimated by Fehling’s solution gives 0 8 per cent., failed to give any reaction at all On the other hand, the urine with Teusch’s test. I have been examining this morning, which deposits an abundant sediment of cayenne-pepper-like crystals of uric acid, reduced Fehling’s solution partially so as to give a dirty yellow precipitate. After filtering throughi animal charcoal, according to the method advocated byr Sir William Roberts for removing reducing substances3 other than sugar from the urine, the test solution remainedI perfectly clear, bright, and unaltered in colour. I should. say, therefore, that this urine does not contain sugar, butj that the reduction is due to uric acid ; however, after boiling, in a capsule with Teusch’s test a blue film of indigo wasI
883
of carrying light further into the cavity illuminated, far from effecting this object, actually prove disconcerting to the vision by surrounding the dark region investigated with a field of dazzling light. Even supposing that more light is actually carried inwards, which is often doubtful, it must be largely counter-balanced by the reflection backward on to the operator’s eye. And when it is remembered that the first physical essential for examining a field darker than its environment is that the pupil should dilate it is obviously unscientific to counteract this by the inevitable contraction which the reflected light from the speculum induces. This has been realised to a certain extent by the construction of black vulcanite aural and other specula, which are of course useful by assisting dilatation of the pupil. And any surgeon using the black nasal specula I have had constructed for me by Messrs. Mayer and Meltzer will realise the immense gain when contrasted with the ordinary silvered instruments. Extending this principle in the use of intra-laryngeal instruments I have had forceps similarly blackened. The result is of considerable gain when removing minute papillomata from the vocal cords, in which case any condition which prevents contraction of the pupil while examining the relatively dark interior of the larynx must be of essential value. And I believe the gain to the operator is as great here as in examining the nose with blackened specula. Presumably there is no reason why nasal forceps, &c., should not be similarly blackened, though the need is obviously not so great as in operations upon the larynx. Messrs. Mayer and Meltzer have spent much time in discovering a satisfactory method of blackening and, in spite of disappointments, have, I think, succeeded admirably. I am, Sirs, yours faithfully, GREVILLE MACDONALD, M.D. Lond. March 19th, 1900.
object so
deposited upon the capsule. In order to clear up this point I had this urine examinedl by fermentation and with phenyl hydrazin, both of whichi gave a negative result. In this case, then, Teusch’s test is; out of harmony with the results of three methods which are: generally regarded as trustworthy. Therefore it does nott seem to possess any advantage, either in rapidity of application, delicacy, or. accuracy, over Fehling’s solution. I am, Sirs, yours faithfully, "THE CORONERS’ SOCIETY OF ENGLAND March 19th, 1900.
ROBERT SAUNDBY.
AND WALES."
To the Editors of THE LANCET. THE MIDWIVES BILL. Hicks’s letter of March 12th, published Braxton SiRS,-Mr. in THE LANCET of March 17th, informs the general body of To the Editors of THE LANCET. the medical profession of an opinion expressed by the aboveSIRS,-Perhaps it may help if I call attention to the fact named society on the questionable duty of the medical practhat the present Midwives Bill is based upon two principles- titioner in attendance being bound to report to the coroner for one that of control and one that of improving the status of his district all deaths other than those arising from natural the midwife. For practical purposes these two principles causes. While convinced that Mr. Braxton Hicks correctly are incompatible, for with improvement in status control of states the opinion of this society, to which he acts as any value is impossible. It is therefore idle to talk of honorary secretary, may I be permitted to point out that the amendments until it is decided upon which principle profession at large are not obliged to abide by any opinion or legislation is to be based. I cannot help congratulat- resolution expressed by this or any other kindred society, but ing the gentlemen of the Obstetrical Society of London by the ruling of the courts of justice on this point? Till suoh They have succeeded in making definite ruling is obtained they can afford to ignore all such upon their success. it to appear before the world that their society is in resolutions. favour of legislation, and, besides their society, both Whilst candidly admitting that no particular class of corporations. They have also hauled into the meshes of persons is mentioned n’hose duty it should be to inform the their net the council of the British Medical Association. coroner (the italics are mine), he proceeds to postulate that As you point out in your issue of March 17th they are really the hypothetical conjectures put forward in " Jervis on backed by a very small number of the profession, as I ascer- Coroners" should be regarded as the law on the subject, tained some years ago. These congratulations I cannot completely ignoring the fact that the pious private accord to the profession as a whole, which has allowed, opinions of that worthy gentleman, unqualified by by its failure to provide an organisation capable of defence,i any definite ruling on the point at issue, do not a few persons to give away the mass. Perhaps the sense rise to the level of authority. Even admitting "Jervis on of danger, which many will not appreciate until it is too late, Coroners " to be correct in stating the law on this pointwill hasten the organisation of the profession. At the i.e., this devolves upon those who are in attendance on duty present moment a study of the history of the Bill will show or about the deceased at the time of death-I fail to see how conclusively that the profession is powerless in the face of such a ruling can affect the medical practitioner in the an organised body, however small and unimportant. The majority of cases which call for an inquest or an inquiry by policy of the corporations is to keep down the general mass the coroner-cases in which no medical practitioner is in of the profession, and a very wise policy, too, from their point immediate attendance on the deceased at the time of death of view. It will require a powerful organisation to cope with or in which the only attendance on or about the deceased them. I am, Sirs, yours faith’ully, commenced after his death. LOVELL DRAGE. Hatfield, March 19th, 1900. The savoury threats held out by the council of this private society of "an indictment at common law for not fully stating the cause of death"may be ignored by all iv7to act in THE MERITS OF BLACK INSTRUMENTS IN good faith. For should any such action be entered, the oitzis of proving" evil intent" and" Tvilful suppression of THE EXAMINATION OF INTERIORS. law the truth" must fall on the plaintiff. p7’op
"CROOK
v.
CROOK AND HORROCKS."
The Welsh Hospital is expected to leave England in about days, Professor Thomas Jones, M.B. Lond, F.R.C.S.Eng., Mr. J. Lynn Thomas, F.R.C.S. Eng., and Mr. R. MillsRoberts, F.R C.S.Edin., will act as surgeons, and Mr. Laming Evans, M.B.Cantab., F.R C.S., late house surgeon, St. Bartholomew’s Hospital, and Mr Herbert Davies, M.B., Ch.B. Vict., senior house surgeon, Stoke-on-Trent Infirmary, Five dressers and nine or ten nurses as assistant surgeons. will complete the staff. The hospital funds now amount to over .66000 and among the subscribers during the past week have been H.M. the Queen 100, H.R.H. the Prince of Wales .E50, and H.R.H. the Duke of York 20.
and
great responsibility of the position. worthy of him, and the siege will prominent place in military history.
ten
was
The part he played hereafter occupy a
FRUIT FOR THE MILITARY HOSPITALS. Haliburton in a letter to the Times says : "...... I have undertaken to send weekly to Netley Hospital a small supply of fresh fruit for the use of the invalids returning from South Africa. Many others, if aware that they might enjoy this privilege, would no doubt gladly avail themselves of such an opportunity of usefulness by sending regular supplies of fruit to the various large military" hospitals scattered throughout the United Kingdom......." It is to be hoped that many others will follow Lady
Lady
Haliburton’s
THE LATE SIR WILLIAM LOCKHART. In the death of the Commander-in-Chief of Her Majesty’s example. forces in India the country and the army have sustained a The total number of conscripts for the French army last great loss, and we cannot refrain from paying a sincere year, says the Army and Navy Gazette, shows a reduction tribute of respect on the part of the British and Indian of nearly 15,000 on that of the previous year. This noticemedical services to his memory. The late Sir William I able has caused some uneasiness. The fundamental Lockhart had a very distinguished career and was a very cause drop of the diminution is doubtless due to the stationary brave man of quite exceptional qualities. He came of a state of the population, but it is also a fact that there has good stock; his uncle was John Gibson Lockhart, the son- been a special The medical examination of cause at work. in-law and biographer of Sir Walter Scott, and Sir William the has been far more severe than for several conscripts Lockhart was himself, apart from his high military reputapast. tion, a man of ability and culture and possessed an ex- years W. Dick, M.B., F.R.C.S. Edin., R.A.M.C. (who is Major cellent knowledge of German. He was very wise in counsel, for Colonel W. F. Stevenson, M.B. Dub., R.A.M.C., acting decided and prompt in action, and eminently honest and as Professor of Military Surgery in the Army Medical School, considerate in his dealings with all-and not least so in the been relieved of the charge of the Surgical Netley), having case of officers of the medical services. Notwithstanding that Division of the Royal Victoria Hospital, Major Birt, R.A.M.C., he was known to have been for a long time in delicate health has been appointed to the office. his death was a surprise and a real grief to all who had the The following gentlemen have been ordered to join the privilege of his acquaintance. He looked as he was, every Army Medical School as surgeons on probation for the Royal inch a soldier-a handsome man of fine physique, to whom Medical Corps :-Mr. H. E. Weston, L.S.A., St. George’s independence, courage, and self-sacrifice were natural and Army Hospital; Mr. J. G. Churton, M.R.C.S. Eng.. L.R.C.P. Lond. ; instinctive. Mr. A. E. Hamerton, M.R.C.S. Eng., L.R.C.P. Lond., Leeds A ROYAL NAVAL MEDICAL RESERVE. School of Medicine. Our contemporary the Army and Navy Bazette contains Royal Army Medical Corps messes have now been estaa communication signed Louis Vintras, M.D., B.Sc., blished in India to which the Government grant 80 and 100 medical officer R.M.S. Orinoco, regarding the value of rupees per mensem respectively where eight or ten officers having competent reserves in all branches of the services. form the mess. The following civil surgeons having arrived at Netley are Dr. Vintras suggests, apropos of the call that has been made on the civil profession to supplement the Army posted as stated: Mr. Marriott to the huts for duty, and Medical Service during the campaign in South Africa, Dr. A. C. Profeit to the surgical division. a that Royal Naval Medical Reserve might be organised with very littfe expense to the State out of the number of medical men who have passed several years of their career in the service of one or another of the mail lines, who are used to the sea, have a knowledge of the medical aspects and hygiene of medical life, who are "Audi alteram partem." experienced in tropical diseases, and thoroughly inured to rapid changes of climate. The idea seems a good one and fits in with that of the Naval Medical Reserve composed of "CROOK v. CROOK AND HORROCKS." officers of the large mail companies. Dr. Vintras asks for To the Editors of THE LANOET. communications from persons in sympathy with such a moveoffer or who have to ment, concerning it, suggestions SiRS,-Will you permit me through your columns to thank to be addressed to him at 19A, Hanover-square, W. all those who have written to me letters of sympathy and congratulation and also to thank Dr. William Duncan and METTIOXED IN DESPATCHES. many others who have expressed a desire to help to defray In a despatch from Lord Methuen on the action at my costs. I quite appreciate the kind motive and am very Magersfontein on Dec. 10th and llth, sent by Lord Roberts grateful, but I prefer that no subscription list should be to the Secretary of State for War, occur the following started on my behalf. passages :I am, Sirs, yours faithfully, "Major O’Donnell, Royal Army Medical Corps, and PETER HORROCKS. Brook street, W., March 19th, 1900. Lieutenant Delap, Royal Army Medical Corps, were indefatigable in attending wounded under fire." Black Watch.-Lieutenant Douglas, Royal Army Medical Corps, "THE NITRO-PROPIOL TEST FOR SUGAR showed great gallantry and devotion, under a very severe fire, IN URINE." in advancing in the open and attending to Captain Gordon To the Editors of THE LANCET. was also who a to wounded ; (Gordon Highlanders), ttending Major Robinson and other wounded men under a fearful SiBS,—In THE LANCET of Feb. 17th there was a notice of fire." Teusch’s Nitro-Propiol Test for sugar which induced me to SIR GEORGE WHITE. i send for a bottle of the tablets in order to compare it with It will be remembered that the gallant defender of Lady- the ordinary method by Fehling’s solution. According to smith in a brief public speech of thanks for the congratula- ’, the directions supplied with the tablets we are told to tions tendered to him after the relief of that garrison i dissolve one tablet in about three drachms of water, add 10 incidentally adverted to the fact that he was at the time drops of the suspected urine, and boil slowly for from three suffering from fever with a temperature of 102° F. Everybody to five minutes. A fine colouration of indigo blue is said to will have learned with regret that Sir George White did not take place if sugar be present, the indigo being deposited when the fluid is allowed to stand. It is at once obvious recover his health so rapidly as could be desired and that he has wisely embarked and is returning to this country where that boiling for from three to five minutes is a disadvantage all, without exception, wish for his speedy recovery. Sir for two reasons : it takes up a good deal of time and it is George White, it is needless to add, went through a most impossible to boil continuously for so long in a test tube trying time during the long siege, and, in addition to the without explosions of steam, so that the process must be hardships and privations he underwent, he had all the care carried out in a flask or capsule. But this is not a serious
Correspondence.
’i
I
THE MIDWIVES BILL.
objection
if the method
were
so
accurate
as
not to need
confirmation.
B
It is well known that the power of reducing cupric oxide is not peculiar to grape sugar but is shared by a good many other substances which are frequently present in sufficient quantities in the urine to cause at any rate a partial reduction of the test solution, so that a method which would be equally delicate and positive in its results and which would stand in no need of confirmation by other means would be a boon to clinical medicine. From this point of view I cannot speak very highly in favour of the new test. A case of diabetes under my care which has improved so much that I the sugar in the urine for a long time has been less than 1 per cent., and estimated by Fehling’s solution gives 0 8 per cent., failed to give any reaction at all On the other hand, the urine with Teusch’s test. I have been examining this morning, which deposits an abundant sediment of cayenne-pepper-like crystals of uric acid, reduced Fehling’s solution partially so as to give a dirty yellow precipitate. After filtering throughi animal charcoal, according to the method advocated byr Sir William Roberts for removing reducing substances3 other than sugar from the urine, the test solution remainedI perfectly clear, bright, and unaltered in colour. I should. say, therefore, that this urine does not contain sugar, butj that the reduction is due to uric acid ; however, after boiling, in a capsule with Teusch’s test a blue film of indigo wasI
883
of carrying light further into the cavity illuminated, far from effecting this object, actually prove disconcerting to the vision by surrounding the dark region investigated with a field of dazzling light. Even supposing that more light is actually carried inwards, which is often doubtful, it must be largely counter-balanced by the reflection backward on to the operator’s eye. And when it is remembered that the first physical essential for examining a field darker than its environment is that the pupil should dilate it is obviously unscientific to counteract this by the inevitable contraction which the reflected light from the speculum induces. This has been realised to a certain extent by the construction of black vulcanite aural and other specula, which are of course useful by assisting dilatation of the pupil. And any surgeon using the black nasal specula I have had constructed for me by Messrs. Mayer and Meltzer will realise the immense gain when contrasted with the ordinary silvered instruments. Extending this principle in the use of intra-laryngeal instruments I have had forceps similarly blackened. The result is of considerable gain when removing minute papillomata from the vocal cords, in which case any condition which prevents contraction of the pupil while examining the relatively dark interior of the larynx must be of essential value. And I believe the gain to the operator is as great here as in examining the nose with blackened specula. Presumably there is no reason why nasal forceps, &c., should not be similarly blackened, though the need is obviously not so great as in operations upon the larynx. Messrs. Mayer and Meltzer have spent much time in discovering a satisfactory method of blackening and, in spite of disappointments, have, I think, succeeded admirably. I am, Sirs, yours faithfully, GREVILLE MACDONALD, M.D. Lond. March 19th, 1900.
object so
deposited upon the capsule. In order to clear up this point I had this urine examinedl by fermentation and with phenyl hydrazin, both of whichi gave a negative result. In this case, then, Teusch’s test is; out of harmony with the results of three methods which are: generally regarded as trustworthy. Therefore it does nott seem to possess any advantage, either in rapidity of application, delicacy, or. accuracy, over Fehling’s solution. I am, Sirs, yours faithfully, "THE CORONERS’ SOCIETY OF ENGLAND March 19th, 1900.
ROBERT SAUNDBY.
AND WALES."
To the Editors of THE LANCET. THE MIDWIVES BILL. Hicks’s letter of March 12th, published Braxton SiRS,-Mr. in THE LANCET of March 17th, informs the general body of To the Editors of THE LANCET. the medical profession of an opinion expressed by the aboveSIRS,-Perhaps it may help if I call attention to the fact named society on the questionable duty of the medical practhat the present Midwives Bill is based upon two principles- titioner in attendance being bound to report to the coroner for one that of control and one that of improving the status of his district all deaths other than those arising from natural the midwife. For practical purposes these two principles causes. While convinced that Mr. Braxton Hicks correctly are incompatible, for with improvement in status control of states the opinion of this society, to which he acts as any value is impossible. It is therefore idle to talk of honorary secretary, may I be permitted to point out that the amendments until it is decided upon which principle profession at large are not obliged to abide by any opinion or legislation is to be based. I cannot help congratulat- resolution expressed by this or any other kindred society, but ing the gentlemen of the Obstetrical Society of London by the ruling of the courts of justice on this point? Till suoh They have succeeded in making definite ruling is obtained they can afford to ignore all such upon their success. it to appear before the world that their society is in resolutions. favour of legislation, and, besides their society, both Whilst candidly admitting that no particular class of corporations. They have also hauled into the meshes of persons is mentioned n’hose duty it should be to inform the their net the council of the British Medical Association. coroner (the italics are mine), he proceeds to postulate that As you point out in your issue of March 17th they are really the hypothetical conjectures put forward in " Jervis on backed by a very small number of the profession, as I ascer- Coroners" should be regarded as the law on the subject, tained some years ago. These congratulations I cannot completely ignoring the fact that the pious private accord to the profession as a whole, which has allowed, opinions of that worthy gentleman, unqualified by by its failure to provide an organisation capable of defence,i any definite ruling on the point at issue, do not a few persons to give away the mass. Perhaps the sense rise to the level of authority. Even admitting "Jervis on of danger, which many will not appreciate until it is too late, Coroners " to be correct in stating the law on this pointwill hasten the organisation of the profession. At the i.e., this devolves upon those who are in attendance on duty present moment a study of the history of the Bill will show or about the deceased at the time of death-I fail to see how conclusively that the profession is powerless in the face of such a ruling can affect the medical practitioner in the an organised body, however small and unimportant. The majority of cases which call for an inquest or an inquiry by policy of the corporations is to keep down the general mass the coroner-cases in which no medical practitioner is in of the profession, and a very wise policy, too, from their point immediate attendance on the deceased at the time of death of view. It will require a powerful organisation to cope with or in which the only attendance on or about the deceased them. I am, Sirs, yours faith’ully, commenced after his death. LOVELL DRAGE. Hatfield, March 19th, 1900. The savoury threats held out by the council of this private society of "an indictment at common law for not fully stating the cause of death"may be ignored by all iv7to act in THE MERITS OF BLACK INSTRUMENTS IN good faith. For should any such action be entered, the oitzis of proving" evil intent" and" Tvilful suppression of THE EXAMINATION OF INTERIORS. law the truth" must fall on the plaintiff. p7’op