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THE MEDICAL INDEX FOR SCOTLAND.
596 engaged to attend Mrs. W in her second accouchement, which she expected about the beginning of March. I was told, that after her first confinement, fourteen months previously, her recovery had not been favourable, and that two or three weeks after her delivery, an attack of mental derangement rendered it necessary to seclude her in Morningside Asylum for a period of three months. Her approaching accouchement was expected by the patient and her friends with no small degree of solicitude. Before resolving on the employment of chloroform when labour should take place, I consulted Dr. Simpson, our distinguished professor of midwifery, who unhesitatingly advised its use. On the 9th of March, labour came on, and under the influence of chloroform it terminated most favourably about three hours after my arrival. Previous to its administration, the patient was in a state of considerable nervous excitement, which speedily subsided. Her convalescence was uninterrupted by a single unfavourable symptom, and up to the present date, after a lapse of more than eight months, she has continued entirely free from any indications of mental derangement. Allow me to remark, that the very general and successful employment of chloroform in surgical and obstetric practice, both here and elsewhere north of the Tweed, excites a strong impression that our professional brethren in the south must either employ a very impure preparation of the medicine, or be very much at fault in their mode of exhibiting it. I am, Sir, your obedient servant,
THE MEDICAL INDEX FOR SCOTLAND.
To the
Editor of THE LANCET.
SIR,—For the satisfaction of all those interested in the of the " Medical Index for Scotland," allow me again ’to request a place in your pages. :success
-
’Since my former communication to you
on
the above sub-
ject, I have much pleasure in being able to state that the work has been welcomed by every member of our body who has been spoken to regarding it, and every day brings a fresh
accession to the number of its supporters. For the information of the proprietors of the London Medical Directory, let me state that the "Medical Index" is to be a work the first of its kind, unlike any other both in its compilation and the results it will produce, and likewise for which no Directory, It will be as as at present published, can be a substitute. true a record of our civil medical staff as the registration books of our several colleges, and will not only give the name and address of every medical man, but will also state the be written showing collegeto which he belongs. Pages how long we have suffered both in reputation and purse from - quackery, and just’because we have never determinedly ,opposed the evil. Let us now, then, change our tactics; let us oppose truth to falsehood; let us put the public in a position to be our judge; and, facts being stubborn things, let the process of quack extermination be resolutely carried out, and soon may we expect to see the last of the race. As to the plan of the " Medical Index," I beg to refer your readers to my paper in your journal of the 6th of October last, and would now further state, that as the work is to be got Xtp without any regard to profit in a pecuniary sense, the price THE ROYAL COLLEGE OF SURGEONS, UNIVER’Will be made as low as possible, so as to bring it within reach SITY OF LONDON, AND THE APOTHECARIES’ of all classes of the community. The compiler of the work SOCIETY. To the Editor of THE LANCET. taking no portion of the receipts derived from the sale of the work, the expense of publishing alone has to be met, and to Council of the of Surgeons having deterSIR,—The preserve the price as wished, and likewise to defray the ex- mined to move in the matterCollege of medical reform, it becomes the the of names of eligibility pense correspondence regarding of that for insertion, it will be necessary that each individual, in send- duty of the profession, and especially of the members to see that the step be taken in the right direction. ing his name, should enclose either one or two postage stamps, College, To secure this, two courses are open-accordi7ag to the qualification he holds. The surplus stamps lst. To call upon the Council to lay their plans before the to be in "Index" in the are expended advertising the provin- members for their approval; or, cial papers of Scotland.-I have the honour to be, Mr. Editor, 2nd. That the members should at once meet in their various Your much obliged and obedient servant. localities, and draw up memorials to the Council, expressing JUSTITIA. what their wants and wishes are. The memorial to the Council should requestPUERPERAL MANIA AND THE EMPLOYMENT OF 1st. Remedy of the injustice done to the members by the CHLOROFORM IN OBSTETRIC PRACTICE. creation of fellows without examination. To the Editor of THE LANCET. This, as it seems to me, cannot be done by creating more but by making those already created pass a proforma SIR,—In a report of an adjourned discussion on chloroform fellows, at the Westminster Medical Society, contained in THE LANCET examination, or throw up their diplomas. 2nd. To make application for powers to institute medical as .of Saturday last, Dr. Webster, who, by his own statement, does not practice midwifery, alludes to "three cases which well as surgical examination, making the College the great had come within his cognizance," in which symptoms of head of the professional body, abolishing the Apothecaries’ mania had taken place subsequent to parturition, during Company as a licensing body, and assimilating the profession which chloroform had been exhibited; and these he hastily in the three kingdoms. If the Council refuse to accede to either of these plans, it brings forward as so many instances of " the serious conse- will then be open to the profession to memorialize Sir George sometimes the inhalation of chloroform quences following himpraying Grey, during child-birth." 1st. To abolish the Apothecaries’ Company as a governing Could it be clearly established that the obstetric use of this valuable anmsthetic agent acts, either immediately or re- and licensing body, on account of dereliction of duty in refusing or neglecting to protect the interests of those who have obmotely, as an exciting cause of puerperal mania, it would at ’least furnish a strong objection to its employment, in cases tained their licence. 2nd. To transfer the powers from the Apothecaries’ Comwhere a predisposition to this mental affection might be sus. to the University of London, giving the University also pany in his pected to exist; but as Dr. Murphy justly observes, the power of examination and granting diplomas in surgery, reply, Dr. Webster’s cases would be more valuable as "evi- independently of the College of Surgeons, thereby making it dence of the asserted dangers of chloroform, if puerperal mania did not occur sometimes without the use of that agent." the alma mater of the general practitioners. 3rd. In any and every case to refuse to incorporate a new If Dr. Webster’s knowledge of the three cases in question --could have supplied information on several important points, college of general practitioners. I am, Sir, your obedient servant, as, for example, whether any or all of them were first labours, A MEDICAL REFORMER, M.R.C.S.L. & L.A.C. after former confinements, been I or, if not, whether they had, affected with mental derangement; and if he could have testified as to the purity of the chloroform employed, and the THE ROYAL COLLEGE OF SURGEONS—THE CONmanner in which it was exhibited, a more accurate estimate FERENCE AND MEDICAL REFORM. might then have been formed of the value which ought to be To the Editor of THE LANCET. attached to the cases which he has brought forward as instances of the bad effects of chloroform. SIR,—The College of Surgeons is at present in especial In confirmation of the doubtful character of the evidence favour with you; and if it realizes your expectations, it will furnished by these cases, and still further, of the direct benefit well deserve all you have said of it. For my part, the expeof the employment of chloroform in labour, as a means of rience of past years leads me to put but little faith in the warding off the danger of an attack of puerperal mania, where acts of corporate bodies; and even now, whether I look to the a predisposition to such a seizure was known to exist, I beg council of the College of Surgeons presenting the fellowship to adduce as an example a case which occurred in my practice to its older members, or the National Institute inviting deleupwards of eight months ago. Early in February last, I was gates from all the medico-political associations to combine
might
I
THE MEDICAL INDEX FOR SCOTLAND.
To the
Editor of THE LANCET.
SIR,—For the satisfaction of all those interested in the of the " Medical Index for Scotland," allow me again ’to request a place in your pages. :success
-
’Since my former communication to you
on
the above sub-
ject, I have much pleasure in being able to state that the work has been welcomed by every member of our body who has been spoken to regarding it, and every day brings a fresh
accession to the number of its supporters. For the information of the proprietors of the London Medical Directory, let me state that the "Medical Index" is to be a work the first of its kind, unlike any other both in its compilation and the results it will produce, and likewise for which no Directory, It will be as as at present published, can be a substitute. true a record of our civil medical staff as the registration books of our several colleges, and will not only give the name and address of every medical man, but will also state the be written showing collegeto which he belongs. Pages how long we have suffered both in reputation and purse from - quackery, and just’because we have never determinedly ,opposed the evil. Let us now, then, change our tactics; let us oppose truth to falsehood; let us put the public in a position to be our judge; and, facts being stubborn things, let the process of quack extermination be resolutely carried out, and soon may we expect to see the last of the race. As to the plan of the " Medical Index," I beg to refer your readers to my paper in your journal of the 6th of October last, and would now further state, that as the work is to be got Xtp without any regard to profit in a pecuniary sense, the price THE ROYAL COLLEGE OF SURGEONS, UNIVER’Will be made as low as possible, so as to bring it within reach SITY OF LONDON, AND THE APOTHECARIES’ of all classes of the community. The compiler of the work SOCIETY. To the Editor of THE LANCET. taking no portion of the receipts derived from the sale of the work, the expense of publishing alone has to be met, and to Council of the of Surgeons having deterSIR,—The preserve the price as wished, and likewise to defray the ex- mined to move in the matterCollege of medical reform, it becomes the the of names of eligibility pense correspondence regarding of that for insertion, it will be necessary that each individual, in send- duty of the profession, and especially of the members to see that the step be taken in the right direction. ing his name, should enclose either one or two postage stamps, College, To secure this, two courses are open-accordi7ag to the qualification he holds. The surplus stamps lst. To call upon the Council to lay their plans before the to be in "Index" in the are expended advertising the provin- members for their approval; or, cial papers of Scotland.-I have the honour to be, Mr. Editor, 2nd. That the members should at once meet in their various Your much obliged and obedient servant. localities, and draw up memorials to the Council, expressing JUSTITIA. what their wants and wishes are. The memorial to the Council should requestPUERPERAL MANIA AND THE EMPLOYMENT OF 1st. Remedy of the injustice done to the members by the CHLOROFORM IN OBSTETRIC PRACTICE. creation of fellows without examination. To the Editor of THE LANCET. This, as it seems to me, cannot be done by creating more but by making those already created pass a proforma SIR,—In a report of an adjourned discussion on chloroform fellows, at the Westminster Medical Society, contained in THE LANCET examination, or throw up their diplomas. 2nd. To make application for powers to institute medical as .of Saturday last, Dr. Webster, who, by his own statement, does not practice midwifery, alludes to "three cases which well as surgical examination, making the College the great had come within his cognizance," in which symptoms of head of the professional body, abolishing the Apothecaries’ mania had taken place subsequent to parturition, during Company as a licensing body, and assimilating the profession which chloroform had been exhibited; and these he hastily in the three kingdoms. If the Council refuse to accede to either of these plans, it brings forward as so many instances of " the serious conse- will then be open to the profession to memorialize Sir George sometimes the inhalation of chloroform quences following himpraying Grey, during child-birth." 1st. To abolish the Apothecaries’ Company as a governing Could it be clearly established that the obstetric use of this valuable anmsthetic agent acts, either immediately or re- and licensing body, on account of dereliction of duty in refusing or neglecting to protect the interests of those who have obmotely, as an exciting cause of puerperal mania, it would at ’least furnish a strong objection to its employment, in cases tained their licence. 2nd. To transfer the powers from the Apothecaries’ Comwhere a predisposition to this mental affection might be sus. to the University of London, giving the University also pany in his pected to exist; but as Dr. Murphy justly observes, the power of examination and granting diplomas in surgery, reply, Dr. Webster’s cases would be more valuable as "evi- independently of the College of Surgeons, thereby making it dence of the asserted dangers of chloroform, if puerperal mania did not occur sometimes without the use of that agent." the alma mater of the general practitioners. 3rd. In any and every case to refuse to incorporate a new If Dr. Webster’s knowledge of the three cases in question --could have supplied information on several important points, college of general practitioners. I am, Sir, your obedient servant, as, for example, whether any or all of them were first labours, A MEDICAL REFORMER, M.R.C.S.L. & L.A.C. after former confinements, been I or, if not, whether they had, affected with mental derangement; and if he could have testified as to the purity of the chloroform employed, and the THE ROYAL COLLEGE OF SURGEONS—THE CONmanner in which it was exhibited, a more accurate estimate FERENCE AND MEDICAL REFORM. might then have been formed of the value which ought to be To the Editor of THE LANCET. attached to the cases which he has brought forward as instances of the bad effects of chloroform. SIR,—The College of Surgeons is at present in especial In confirmation of the doubtful character of the evidence favour with you; and if it realizes your expectations, it will furnished by these cases, and still further, of the direct benefit well deserve all you have said of it. For my part, the expeof the employment of chloroform in labour, as a means of rience of past years leads me to put but little faith in the warding off the danger of an attack of puerperal mania, where acts of corporate bodies; and even now, whether I look to the a predisposition to such a seizure was known to exist, I beg council of the College of Surgeons presenting the fellowship to adduce as an example a case which occurred in my practice to its older members, or the National Institute inviting deleupwards of eight months ago. Early in February last, I was gates from all the medico-political associations to combine
might
I