THE ARMY MEDICAL DEPARTMENT.

whole two

eruptions

of the two fevers occurred

together-

ber of "a.learned

profession,"

your late

correspondent,

and in

viz., (1) rose-coloured, elevated papulæ—that of typhoid; (2) this capacity I presume I am allowed to sell articles of diet, which may be recommended for infants or invalids, whether a subcutaneous purple mottling of the skin, forming a basis plus petechip, ill-defined, non-elevated, of mulberry-juice hue: they be Laird’s or any one else’s. Such being the case, Mr. the two together forming that of typhus. The rash of typhus is petechial ; that of typhoid, papular. Fresh spots appear during the course of typhoid, each lasting two or three days. Not so in typhus: after the rash is "out" The greater the amount of rash in no fresh crop appears. typhoid the better the prognosis; it is the reverse in typhus. Two-in fact, the—great sources of fallacy in regard to the rashes into which I cannot but think Dr. Bakewell must have sometimes fallen are-first, the error of diagnosing typhus by the purple petechiæ alone, without the mottling; and, secondly, the liability of confounding ilea-bites with purple spots" (typhus). I know most men are offended if you suggest the latter source of error, but it is often by no means an easy matter to know the distinction. Flea-bites are usually welldefined, and exhibit the bite in the centre. This is one of the most common sources of error, amongst students especially. The cases Dr. Bake well saw at Stafford and Scutari (the former coming as they did from the workhouse) were most likely to present such a condition, especially as he was thrown off his guard or "embarrassed by the anomalous character of the cases." Dr. Bakewell does not regard gurgling in the right iliac fossa as of any value. If it be coarse, abundant, and large, it is of no use; but if it be very fine and delicate, assuredly it is an aid to diagnosis. Dr. Chambers appeals to Dr. Watson’s old opinion, as strengthening his own view, and seems to tacitly imply that Dr. Watson still clings to his old opinion, and commits to writing that which he does not believe, merely to oblige others. I am sure that Dr. Watson fully holds with the views promulgated by Dr. Jenner, or he would not have succumbed to and adopted them. I do not agree with Dr. Chambers, that Dr. Watson’’s old opinion was adopted under more propitious auspices than his recent one. The characters of the two fevers are different, though many symptoms are alike in each, because in both pyrexial. Typhoid, the acute ulcerating disease, contrasts with typhus, the congestive and aJyn,1.mic. Differences are seen in the age attaehe d, the duration, mortality, degree of infection, locality, cause, station of life attacked, secondary lesions, &c. &c. As to the treatment, with the exception of the proper administration of wine, beef-tea, &c., it is generally otherwise nil. The two fevers are acute specific diseases, having a definite duration and course, and all we aim at, or can do, is to support the powers till Nature has got rid of the poison : wee have no specific for fever. If Dr. Bakewell has never lost a case, I would mildly suggest that he has seen either very little fever, or few bad cases; for his treatment has nothing special in it, and to the wine, beef-tea, &c., must be credited all the good done. I am, Sir, your obedient servant, WM. TILBURY FOX, Lond. Fox, M. B. Lond Broughton, March, 1858.

MR. MACNEILL AND LAIRD’S "BABY’S FOOD." To the Editor of THE LANCET.

SIR,—My attention hasbeen called to an article in the columns of THE LANCET of last week, in which you have commented most unjustifiably on my conduct. I feel astonished that a journalist of your reputation, of your years, and of your experience, should have so far forgotten himself as to be guilty of misrepresenting an unoffending man, and of holding him up to the contempt of the world in language the most severe that could have been used, without having previously inquired into the circumstances of the case, and without having ascertained that the information upon which he acted was correct. However, as we are perfect strangers to each other, and as I cannot believe that you were actuated by any evil animus towards me, save that of professional zeal in upholding, as you call it, the dignity of a learned profession, I beg to detail the whole circumstances of the case, in order to show that I am innocent of the charge imputed to me, and, having done so, to demand from your justice, not from your sympathy, a full re-

tractation of all you have said about me, and to call upon you to make the amende honorable by publishing this letter in a prominent part of your next issue, and by making such comments upon it as the circumstances may require. The facts are these :-I am a chemist and druggist, living at 28, Princes-terrace, Caledonian-road. I carry on a respectable business, such an one as might be acceptable even to the mem-

Laird called upon me, and asked

me

to become

one

of his

agents for the sale of his "baby’s food." I consented, gave him my name and address thus, " A. Macneill, Dispensing Chemist, 28, Princes-terrace, Caledonian road, Islington," and in the following week my name was advertised amongst his other agents, and by mistake Surgeon and Accoucheur" sub"

stituted for

That was Mr. Laird’s for I can assure you, Sir, I have no ambition to be called surgeon, and now much less than ever. On reading the objectionable advertisement in the Islington Gazette, I immediately wrote to Mr. Laird that I did not belong to the ’’ profession," and requested him, at once, to have the advertisement corrected, which was accordingly done from that period, now five 01’ six weeks back-. To prove the correctness of my statement, I beg to enclose Messrs. Laird’s letter, also the corrected advertisement, and will now leave the matter in your hands, expecting from your sense of justice that, asyou havebeen instrumental in giving publicity to false reports, you will do everything in yourpower to remove any injurious impression that might be made in consequence on the I am, Sir, your obedient servant, public mind. A. MACNEILL. Pi-inees-tpn-a.ce, Caledoiii-in-road, April, 1858.

mistake,

not

’’ Dispensing

Chemist."

mine ;

" 15, Wharton-street, W.C., April 19th,

18SS.

very sorry indeed to find that the advertisement we inserted in the Islington Guaette of March 13th, 1858, describing you asSurgeon and Accoucheur,’ should have subjected you to any annoyance, especially as the mistake was entirely ours, and corrected at your instance in the following and all succeeding issues of the Gazette. " Expressingour regret for the mistake, in which we wish it to be clearly understood you had not the smallest share,

" SIR,—We

"

We

are

rema,in, Sir, your obedient servants, LAIRD " LAIRD BROTHERS. Br.OTllr,,Rq.

"Mr. A. Macnill."

willingly inserting the above letter, we must yet ‘&mid ot;," observe that we simply commented upon an advertisement that appeared in the Islington Guzette. If that advertisement was incorrect, we were not to blame. It described Mr. jIacneill as a surgeon; and we expressed our opinion that, if lie was a surgeon, his selling canisters of baby’s food was not the business of a member ofa learned profession. If Mr. Macneill be not a surgen, we have no right, of course, to interfere, except to recommend him to be cautious how he allows other persons to aclvertis3 his name for the future.—ED. L. In

THE ARMY MEDICAL DEPARTMENT. To t7te Editor of THE LANCET. of the few surviving Peninsular veterans of the SIR,—One Army Medical Department, departed this life on the 2nd inst., and no less a personage than its late respected chief, Sir James M’Grigor, Bart. A long life and long services closed his eventful career, with honour to himself and family. Those, like me, who have had the pleasure of serving under the late DirectorGeneral cannot but say that he showed no favour to any; but if a medicalofficer did his duty, in whatever part of the world stationed, Sir James M’Grigor was well aware of it, and did not forget him. The object of my remarks is not to pass any eulogium, for this is not required, but merely to observe what Sir James did for the Department, in establishing the valuable museum at Chatham for the advancement of medical science, and that his benevolent mind was ever thoughtful in founding the societies for the benefit of the widows and children of deceased officers. This, I trust, will induce the present chief, Dr. Smith, and medical officers generally, to give some consideration to my

proposals.

The Medical Department of late has been greatly augand at the same time a more definite and creditable position in army rank and pay assigned, especially to the assistant surgeons. I do not stop here; I think the Medical Department should, at any rate, stand upon equality of rank and position with the Royal Engineers. In civil life, as a learned it profession, precedes the latter. " Now what can the officers of the Medical Department of the army do for their own benefit?" They have much within themselves. No body of scientific men have such opportunities of advancingscience generally; they visit all parts of the world.

mented,

invariably

423

candinates may be bought for the same sum, see disease in all its variety of clime, type, and malignity affect- candidates, eight ing mankind; sanitary reports are sent yearly to England from and so on, in proportion to the number of vacancies to be all stations, and no doubt contain valuable information. " Why filled up. Any candidate who can secure the attendance of an not make these treasures public for the profession generally ?" active friend or agent, with his wits about him and his pockets Depend on it they would be appreciated. duly lined, need not be very apprehensive of failure, for the Now let me make the following suggestions :-Army me- longest purse will always prevail; but small indeed will be dical officers are constantly returning home, on leave or duty, the chance of the poor and needy, the friendless orphan, and from all parts of the world; let them be invited to give a public the necessitous widow, and equally small will be the chance of lecture on any subject in their profession they fancy; some like success to the regular subscribers and governors, who support medicine; others, surgery, chemistry, botany, zoology, or other and have supported the charity by their annual contributions, Let those who

if their votes can be swamped by the votes of governors made Me- on the day of election, to serve a particular purpose, and who, and when that purpose is served, will probably never be heard of dical plenty will be found who can do so with credit. When these again. No greater discouragement can be given to charity lectures are decidedly the work of industrious men, let them than the misuse of charitablefunds; and surely that cannot be not be forgotten in professional advancement. There is no said to be a good use which fails to carry out the benevolent royal road to learning, and men rewarded in this way will, I intentions of the donors by failing to secure fair play in the deserve it, and no grumbling can election of objects. The elections should be so arranged and think, consider they honestly " ensue : no interest of general this," or " colonel that," of the conducted as to be above suspicion; and this, I think, is not Guards, to have men kept at home for a few years, and pro- difficult. Let Law 15, which provided that no governor should moted over others, whose bronzed and care-worn features be- vote whose subsciption had not been paid one month before the election, be re-enacted ; let every governor be required to respeak their hard duties. There are many eminent physicians and surgeons in the turn his voting paper, sealed up, to the secretary by a given service who, I think, will be inclined to approve of my sugges- day; and let a general meeting of the governors be called tion, and give a public status to the department. Why keep within a week to open the papers, and, rejecting any the valuable contents of the Military Medical Museum at papers that may have been improperly tampered with, ascerChatham ? Medical officers there are birds of passage, and tain and declare which candidates are elected. There will cannot fully appreciate the wide-world collection. A few then be less opportunity for collusion and barter than the pre. years back a proposal was made to establish a military medical sent system offers. The purchase of votes on the day of elecclub in London by subscription of so many days’ pay. I, for tion to hospital appointments has been found so prejudicial to one, responded to it, but the matter dropped. Now that the the best interests of the charities, by excluding the best practi. department has greatly increased, I think it feasible. The tioners, who will not become purchasers, that in many hospitals advantages that would accrue are obvious. Remove the a law has been introduced to prevent it; and I fear the reo valuable museum from Chatham to London, attach a lecture- moval of this salutary check will be found equally injurious to room, and it would tend more to the advancement of the de- the Royal Medical Benevolent College, by excluding the most partment than anything else. If this cannot be done, annex worthy, because the most necessitous, of the applicants. the collection to that of Hunter at the Royal College of I am, Sir, your obedient servant, EDWARD BARBER, M.R.C.S. Surgeons of England, and distinguish it as the " Military Stamford, April, 1858. Collection." When quartered at Hongkong, I presented many valuable curiosities to the department, especially Chinese oilMEDICAL REFORM — THE STAMP DUTY ON paintings. The latter cost me there over thirtyguineas; but DIPLOMAS. I have heard (I hope it is not true) that these very pictures lie in a lumber-room at Chatham, at the service of the spiders, To the Editor of THE LANCET. unnoticed and uncared for. This should not be. I call the attention of the profession to a point of Lastly, if my proposal of lectures should be thought worthy noSir.,-,May little importance. It is proposed to grant a new charter to of consideration, (remember we have dedicated some to Hunter, the College of Physicians of London, which is to become Harvey, and other great men of "our profession,) dedicate my the Royal Royal College of Physicians of England. In this case as the the deceased to lectures." chief, proposal M’Grigor in the provinces may wish to join it; but many physicians I am, Sir, yours, &c., of them, in common with myself, have had to pay a conmany J. MC Mc G. G. CROFT, M.D., The Grove, Clevedon, Somerset, siderable sum for stamp duty. As a fellow of the Royal ColApril, 185S. Staff-Surgeon, resigned. lege of Physicians of Edinburgh, to which a new charter is also to be granted, I have already paid X25 for stamp duty on my diploma. Is it just or reasonable that on joining another MEDICAL THE ROYAL BENEVOLENT COLCollege of Physicians, in another division of the United KingLEGE AGAIN. dom, I should have to pay this duty a second time ? Now that the medical reform question appears in a fair way To the Editor of THE LANCET. of being settled, I would, through THE LANCET, urge this subSIR,—I address you on a subject of much importance to the less fortunate of our professional brethren, their widows, and ject of stamp duty on the consideration of my brother physicians. I have written to the Hon. W. F. Cowper and to the orphans-viz., the bartering and trafficking for votes at the two members for Sheffield, and I would advise every physician elections of the Royal Medical Benevolent College, and the abuses inseparable from the system of _proxy voting, whereby in the provinces also to urge this point on their own members. the more needy and friendless ’of the candidates are virtually Considering our labours for the public, without fee or reward, in hospitals, dispensaries, &c. &c., I think it would only be deprived of a fair chance of success. I offered some remarks reasonable to remit the stamp duty on all medical diplomas. to the governors last year, which were followed by complaints from Mr. Allison, of Retford, and Mr. Jones, of Beaumaris, At any rate wemust not be called on to pay a second time; the latter of whom shortly afterwards sent to the editor of the for if we have to do so, the advantages of medical reform will British Medical Journal the following extract from a note indeed be questionable. I am, Sir, your obedient servant, addressed to him by Mr. Propert :-" The Council and myself JOHN CHARLES HALL, M.D. Sheffield, April, 1858. are quite of the same opinion as yourself in respect to the mode of voting, and be assured it will be altered before the next

branches of science.

are

willing be invited to do

approval and sanction of the chief of the Army Department presiding; make the matter voluntary,

so, with the

voting

.election."

only notice I have seen of any alteration on the subject of voting was an announcement in December last, that "governors may use their votes for as many candidates as

THE

The

MEDICAL

BILLS.

To the Editor of THE LANCET. When Lord Palmerston, with earnest purpose of SiR, there are vacancies to be filled, or may accumulate them all on bettering the legislation of the country on medical affairs, any one candidate ;" and that "new subscriptions need not be brought the subject before Parliament in 1854, he declared that paid one month before an election in order to enable governors the primary object he sought to establish was uniformity of to vote." No reference was made to proxy voting. The effect education. His vigorous penetration led him at once to seize of these alterations, with the aid of proxy voting, will, I appre- this important principle, and in introducing the subject he used hend, be, to convert the election into a simple question of these words-" That which is wanted is some uniform syspurchase. For example: if there be six vacancies, six votes tem of education, some uniform test of qualification." The may be purchased for a guinea at the time of election, and whole profession assented with one voice to the truth of Lord given immediately for any one candidate; if there be eight declaration, and would have thought it monstrous

424

-

Palmerston’s