THE FELLOWSHIP OF THE COLLEGE OF PHYSICIANS.

1094 THE LUNACY ACTS AMENDMENT BILL. To the Editor

of THE

LANCET. of SIR,—Superintendents Asylums in England, with few exceptions, will endorse Dr. Batty Tuke’s remarks on the absurdity of sending barristers to inspect asylums, and on the necessity for greater supervision by an increase of the number of medical commissioners. Having been superintendent of a large asylum for fourteen years, I may say that I have never in that time seen an occasion or occurrence which in the least called for a legal visitation, or in which the barrister commissioners were of any legal service. I have had experience of visitation by new legal commissioners, including men whom 1 esteem and respect, and they, I believe, would be the first to admit that their inspection of asylums during the early part of their appointment was of no value. I entirely agree with the suggestion of resident district commissioners as the only means by which an individual kncwledge of the vast number of the insane in England can be acquired by supervisors. An increased number of commissioners would exercise a very beneficial influence on the asylum medical service, by .attracting a superior class of medical officers, and the preponderance of the medical element in the commission might idea, which at present appears to be domidepose the legal nant, that " detentionis the great object of asylums, in favour of the belief that treatment" is their essential and most important function. Such changes would greatly advantage the insane, and would tend more than anything else to ,establish public confidence in the Commission and in asylums. I am, Sir, your obedient servant, A MEDICAL SUPERINTENDENT.

ELECTROLYSIS OF STRICTURE OF THE URETHRA. To the Edttor of THE LANCET.

SIR,—My attention was directed to this subject by Mr. Bruce Clarke some months ago, and as I had a large amount of material to work upon, I determined to investigate the effects of the weaker constant currents upon stricture, in order to supplement Dr. Newman, M. Tripier of Paris, and Mr. Clarke’s experiences of the stronger currents upon the same. To my regret, however, I was unavoidably prevented attending the meeting of the Medical and Chirurgical Society when the subject was brought forward, and I venture, therefore, to ask for space for the quota of experience which I had hoped to have furnished to the discussion upon the paper. The question which I sought to answer was this. If stronger currents burn through the cicatrix and leave a scar, which must necessarily contract, would not weaker .currents soften that scar tissue and allow of rapid dilatation ? I took twenty cases of stricture at haphazard, all of them of small calibre, some unpassable, varying as to duration from three to twenty years. I subjected each to the influence of from three to four cells, the sittings lasting ’from fifteen to twenty minutes. With two exceptions, each stream was larger after the sitting, and I could pass a bougie of one size (French gauge) larger than I could before. In two cases the stream was worse. At first I deemed the slight improvement due to the mere pressure of the bulbous electrode against the stricture, but I have since come to the .conclusion that weak currents diminish spasm. Possible danger of reflex shock should be remembered. I quote the only case I have had as yet. Mr. Hichens of Oxford sent me a man with stricture of many years’ standing, who, on the application of three cells, had the severest

THE FELLOWSHIP OF THE COLLEGE OF PHYSICIANS. To the Editor of THE LANCET. SIR,—All must agree in your recommendation that the teachers in our medical schools, alike in the provinces and London, should be preferred at election to the Fellowship; probably some even while only lecturers, without as yet hospital staff appointment. But, on the other hand, length of hospital experience alone, be it only attendance and not practice, should be recognised by the Council as qualifying for nomination. For, at the present time, excellent clinical workers may never have the chance of becoming either lecturer or hospital physician; the latter appointment now being the reserved reward for lecturing. ’ Yet the clinical student is often not less gifted with powers and taste for original research than his lecturer, and should at least have the Fellowship retained for his goal, if only as a stimulant to further clinical pursuit, which ere now has made the pupil teacher to the master. Hope, Williams, and BenceJones, all while in statu pupillari, taught to their chiefs at hospital, on their own patients, a later and more recondite science than those seniors had till then acquired; and two at least of the greatest hospital physicians dating between Baillie and Bright-viz., Drs. Chambers and Latham-gracefully owned the sources of such later knowledge. Discouragement and curtailment of independent clinique, by withholding the Fellowship from it, will degrade such students into less responsible specialism, to the loss of more Their work is now the highest. exact medical science. Indeed, their great prototype won there and then the true blue riband of the race when, after the best of two years in a fever ward, he interpreted a writing till then undeciphered I am, Sir, yours truly, through ages. A MEMBER PRIOR TO 1859. May 31, 1886.

LIVERPOOL.

(From

our own

Correspondent.)

HOSPITAL SATURDAY.

SATURDAY, the 29th ult., was observed as Hospital Saturday, and great efforts have been made this year to promote its success by making working men more familiar with our local medical charities, their financial position, and their claims upon those whom they benefit. It is believed, therefore, that the fund will be augmented this year-a belief which is increased by the recent visit of Her Majesty, the International Exhibition and other collateral causes tending to an improvement in commerce and trade. LIVERPOOL AND THE COUNCIL OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND.

Whilst Birmingham, Leeds, and Manchester have had representatives on the Council of the Royal College of Surgeons in the respective persons of Oliver Pemberton, Wheelhouse, and Lund, Liverpool still remains as it has hitherto been, wholly unrepresented. This circumstance creates, as it very justly may, great dissatisfaction. For many years past Liverpool has possessed in the number and status of its medical practitioners, its medical school, and its hospitals, ample claims for recognition in the Council of the College of Surgeons of England. These claims are now enhanced in the fact that Liverpool possesses a University College in conjunction with the Victoria University of Manchester, while the status of its physicians and surgeons is quite equal to that of other provincial cities, in spite of the disadvan-rigor I have witnessed, terminating in profound collapse. tages which Liverpool has had to contend with in being Ammonia and water rapidly revived him, and he was able younger in its growth. Mr. Reginald Harrison, surgeon to to reach home. Next day I performed internal urethrotomy, the Royal Infirmary and lecturer on Clinical Surgery in the which, curiously enough, was followed by no neurotic dis-- Victoria University, is again coming forward for one of the turbance. One patient returned with a severe urethritis. So vacancies which will shortly occur in the Council. His few months have elapsed since my first case was cured by election would be a gain to the latter, would be extremely .means of a stronger current, that I do not feel justified in popular to most local and many provincial and metropolitan passing an opinion upon it. If the success be honest, then Fellows, and would remove what is now felt to be a slight to we may expect to do good work with other cicatricial conan important medical and surgical community. tractions-e.g., of burns, strictures of the oesophagus, THE THORNTON WARDS OF THE ROYAL INFIRMARY. pylorus, and other tubes.-I remain, Sir, yours truly, In these wards Dr. Wallace performed abdominal section E. HURRY FENWICK. in :one of those desperate cases which abound here, of