THE NAVAL MEDICAL SERVICE.

250 to the medical officers places the control of the wages of servants under them. The Army Hospital Corps has also been increased in order to improve the arrangements for the internal service of hospitals under the control of medical officers of the army. It is clear that such control is not meant to refer to Netley, however, for there is now, in addition to the governorship, a new appointment in the shapeof an Assistant-Governor to aid the f orilier officer in the discharge of duties which, in the opinion of most people, have long partaken more of a nominal than real character. To proceed with our analysis, however, we find that the cost of the Director-General’s establishment is estimated This sum includes the magnificent official at =65747. salary, amounting to .81500 per annum, drawn by the Director-General himself ! Law, however, has less to do and gets more for doing it. The solicitor to the War Office has, it appears, the same salary as the Director-General of a very large medical service, and is, moreover, aided by an assistant-solicitor at £ 1000 per annum—.62500 for the two. The number of staff and regimental officers in the department, exclusive of the large contingent serving in India, is estimated as 613 for 1871-72, as against 587 of the present financial year. The number in the inspectorial ranks remains the same; but there is an increase of 7 in the surgeons-major and surgeons, and of ]9 in the rank of assistant-surgeons. Among the savings that have been effected, it may be mentioned that, although about 20,000 men have been added to the strength of the army, the sum for medicines and surgical instruments is .61000 less than formerly; and the weather has so far improved that the vote for meteorological instruments is also reduced .850!

hospitals

ROYAL COLLEGE OF SURGEONS. PROFESSOR ERASMUS WILSON’S LECTURES ON DERMATOLOGY. LECTURE IH.

IN his third lecture Mr. Wilson proceeded to describe the squamous forms of eczema under two chief varieties-viz., pityriasis and psoriasis, two leading features of eczema, hypersemia and disordered formation (exfoliation) of the cuticle, being present in each case. Mr. Wilson explained that the term psoriasis had been applied erroneously to the lepra of the Greeks-our lepra vulgaris; but its application ought to be confined to the squamous phase of ordinary chronic eczema. Before proceeding to describe the secondary changes-which occur as the result of the continual hypersemia in eczema-in the corium, giving rise to induration and hypertrophy of the corium and epidermal textures, Mr. Wilson passed in review the ground which he had already traversed, with the view of showing that the preparations at present in the museum illustrated the fact that there were transitional forms between the several varieties of eczema he had described; and he observed that excema might be said to be not only erythematous, papulous, ichorous, squamous, pustular, &c.,but also divisibleinto two chief types, the moist and the dry. These points were shown by a reference to the models and drawings. Passing on to note eczematous infiltration, thickening, induration, and fission, a series of preparations were exhibited, with a view of dethat would have delighted Joseph Hume,and monstrating-(a) the hypertrophy of the epidermis, which These areasfacts far as the diminished consumption of medicines is often seen as a consequence of eczema, especially about possibly, the palms of the hands and the soles of the feet; (b) hyper- is concerned, the British soldier may be congratulated. It is, trophy of the papillae cutis, described by the French under however, to be regretted that what official ingenuity has been the most misleading title of lichen hypertrophique, the enabled to save in one direction should be lost in another; term lichen, as Mr. Wilson observed, being applicable to for the same page shows that the Governor and Commandant Netley has .6366 per annum, in addition to the half-pay papules formed by the erection and inflammation of the at follicles of the skin; (c) hypertrophy of the fibro-cellular of his rank, and that the Assistant-Commandant gets .6303 tissues in the condition, termed false elephantiasis, but by for aiding and abetting the Governor in discharging duties Mr. Wilson denominated eczema spargosiforme, a variety of the lightness of which may well weigh down the mind of any one man. The total cost of the Military Medical eczema which was termed in America, some years since, School at Netley is .68854 and we are told that the con-erythema papulatum et tuberculatum, to puzzle dermato- tribution of the Indian Government towards the expenses to this until the time, present explanation logists, up of the school is now under consideration. In Vote 13 as to its real nature; (d) hypertrophy of the nails, the so.) we find several items possessing part formed by the matrix being specially affected; and (Works, Buildings, of a sanitary kind. The estimated cost of filling lastly (e) mucous eczema, in which a peculiar secretion interest out upon the skin, forming a crust and up the mill-dam at Portsmouth is .610,000, of which sum was poured .86000 is still required to complete the work. The cost of the a softened and reddened base of integument, over covering Netley Lunatic Hospital is estimated at.Cl8,838, and the presenting much the aspect of mucous membrane. A new favourite seat, however, of this disease is the lip, the sur- amount already voted for it is .825,000. The new barracks face being covered with an irregular light-yellow mask, as at Glasgow are to cost .896,000, .650,000 of which is included it were, of exudative matter, the mucous membrane not in the estimates for 1871-72. The new hospital at Malta is included in the estimates, as well as a sum for providing being ulcerated. water-supply at that station. The sum paid to private asylums for the care and maintenance of military lunatics amounts to .612,000, but the half-pay and pensions have to THE ARMY ESTIMATES. be deducted from this amount, leaving a balance of .65000 THE army estimates have just been laid upon the table to be provided for. It will be remembered that the men the detachment of the Ceylon Rifle Regiment of the House by Mr. Cardwell, and our readers may pro- composing stationed at Labuan suffered terribly in health, and that bably be interested in learning some of the details bearing the mortality from beri-beri and malarious fever was great upon the medical establishments and services and other among them. We perceive that the troops are very wisely to be withdrawn from Labuan, where they will be replaced matters of a sanitary or medical character. by a police force ; this will allow the Ceylon Rifle Corps to be 4 to Vote amounts Imprimis, the increase (Medical Vote) reduced by two companies. to the very modest sum of X800 only. Additional medical officers will, we are informed, be appointed to meet the requirements of troops quartered in detached stations, but THE NAVAL MEDICAL SERVICE. the increased charge is counterbalanced by the absorption of the large number of supernumerary officers in excess WE are happy to announce that the Admiralty have at last year. One of the changes effected in the present esti- last arranged with the War Office that the assistant-surgeons mates ought not to escape attention. The charge for the who shall enter the naval service shall for the future have staff of the office of the Director-General has been trans- the advantages of attending Netley Hospital School, and of ferred from Vote 16 (War Office) to that for medical estab- profiting by the special professional instruction there lishments and services (Vote 4). The Note following pre- afforded. By this act the Admiralty has, we say it advisedly, pares us for some change in hospital administration, with done more to raise the status of the Naval Medical Service the view of dovetailing the functions and defining the than by any order which has been promulgated of late powers of the medical service under the new Control system. years, not excepting even the withdrawal of the cap1!tin-

I

j,

The transfer of the

management of

all services within

theI superintendents from the naval

hospitals.

We fear that it

251 is too late for this most satisfactory arrangement to affect the entry of assistant-surgeons at the coming examination, but there can be no doubt that it will produce a most beneficial effect upon the state of feeling in the medical schools of this country quoad the navy. The Admiralty and the Director-General are both to be congratulated on the result of their labours ; and the War Office authorities also merit a word of approbation for the liberal manner in which they have met the overtures from the sister service. Dr. James Wingate Johnston, retired Inspector-General of Hospitals and Fleets, who has been awarded the good service pension in the place of Dr. John Wilson, deceased, entered the Naval Medical Service as assistant-surgeon in 1825, and after serving in that capacity for upwards of six years on the North American and Home Stations, and on particular service, was promoted to the rank of surgeon in 1832, in which capacity he served with great credit on the North American, West Indian, South American, Pacific, and Home Stations, and also in charge of two convict-ships. He was promoted to the rank of Deputy Inspector-General in 1847, and was employed as Deputy Inspector-General of the fleet under the command of the Earl Dundonald on the North American and West Indian Stations, and subsequently in the same capacity, for nearly four years, at z, Jamaica Hospital, during the prevalence of cholera and yellow fever, and afterwards at the Royal Naval Hospitals ’ at Deal, Chatham, and Greenwich. He was promoted to the rank of Inspector-General in 1864, and his name was placed on the retired list in November, 1868. Dr. Johnston has been awarded Sir Gilbert Blane’s Gold Medal, and is Honorary Surgeon to the Queen.

Correspondence. "Audi alteram

partem."

CAN THE DEAD CONVEY INFECTION ? To the Edito’ of THE LANCET. SiR,—The letter of Dr. S. Wilbs presses upon the consideration of the profession a subject of great importance, and I trust it will lead to a general expression of opinion, which may set at rest the question, involving, as I believe it does, points of deep interest. I can truly say that Dr. Wilks’s letter, emanating from so high an authority, has completely upset all my previous views. For twenty years I have laboured to impress upon people, often at the cost of giving serious offence, the paramount importance of more than usual early interment of persons dying of contagious diseases, under the impression that the extra risk of infection was very great. For the most part, my labours in this direction have been ineffectual, and I have often mourned over the sight of the corpse of a person who has died of scarlatina or measles lying in the same house, and frequently the same room, with living beings for three or four days. My experience has been derived in very great measure from my official position as medical officer to large Union districts, and too often in connexion with cottages in which sanitary arrangements have been most defective. Of course, private practice has also afforded me many opportunities, and here the length of time between death and interment has generally been longer ; yet I am compelled honestly to admit that, in spite of solemn protestations against such practices, I cannot recall to my mind a single instance in which there was any good ground for supposing that the dead body did the mischief antici-

feelings for the sake of propriety-to bury the dead out of the sight of the living. But there is another point for consideration. We all know the general feeling that the corpse of a person dead of contagious disease should not be carried into the church, and frequently we have witnessed the bitter grief of the survivors at the supposed slight to the memory of the deceased. And although no manner of good whatever can result from the custom of carrying a corpse within the sacred building, yet at such times friends are peculiarly sensitive and ill-fitted to consider the prejudices of other

persons ; and when, as is so often the case, it occurs to our poor brethren, and the remains of their dead are barred out, the case is considered specially grievous, and comparisons are drawn between the different treatment of the poor and the rich. What medical man of feeling has not been called on to soothe the irritation felt in such a case. It matters little to say that bearers have been taken ill after funerals of this kind. We must first take into consideration the effect of fear produced by the disagreeable smell occasionally exuding from the body through a badly made coffin, predisposing to take infection from the various sources which are always at hand in the case of epidemic contagious diseases, and we are well aware that this smell is frequently noticed in persons who have died of non-contagious diseases. And now to come to the pathological question. I presume Dr. Wilks entertains the idea that (to take scarlatina for example) with the death of the body tha instantaneous destruction of the vital germs thrown off by the skin would also take place ; and it must be admitted that this is a Dr. Wilks has given the valuable rational supposition. testimony of negative, and I think he may fairly call for positive evidence (if obtainable) that the specific disease has ever been communicated by a dissection wound-e.g., that scarlatina has ever thus produced scarlatina or variola, &c.; in fact, we want proof that any other than the ordinary results of inoculation of the veins generated in the body by post-mortem changes have ever occurred. My own experience does not enable me to give any opinion on the matter. I am, Sir, your obedient servant, JOHN EWENS, L.R.C.P. Cerne Abbas, Feb. 7th, 1871.

THE EMPLOYMENT OF MERCURY

IN HEPATIC

DISEASES.

of THE LANCET. SIR,-As it must be obvious to your readers that the To the Editor

scientific question as to the employment of mercury in diseases has nothing to do with the unfounded charges and continued misconceptions of Dr. Rutherford, I must decline any further controversy with that gentleman, as being utterly useless in elucidating a point of medical practice. I have proved that I never attacked the medical department of the army as he alleged, but, instead of accepting my explanation, he repeats the offensive statement, adding "or ’word to that effect," comment upon which is unne-

hepatic

cessary. I have no objection, however, to argue this question with Dr. Maclean so long as no personalities are introduced into the discussion. When I state that thousands of soldiers have been treated for hepatic diseases with mercury, and that many of these have had their healths thereby injured, I put forth a proposition I am ready to defend. But when I am asked who so treated them, and because they may have been army surgeons, it is alleged I insult those gentlemen, I repudiate such a statement as contrary to common sense and to the spirit of free criticism which is so necessary in every teacher who refers to the history of the

pated. Although, for many reasons, I consider early interment, as a, rule, desirable, yet it will occur to your readers that sometimes serious inconvenience must result, especially in the past. ,,If," says Dr. Maclean, "the man, Nicholas H-, was country, where decent mourning cannot be always provided at a day’s notice. Friends at a distance cannot attend, and foolish enough to rub himself with the mercurial ointment the feelings of the husband, wife, parent, or child are often twice or thrice a day, as he is said to have done, it would rudely violated by the importunity of those around to account for the signs of mercurial action observed by Dr. hastily dispose of the body of the dearly-loved one ; yet, Bennett, without a shadow of blame attaching to anyone believing in the ordinarily received opinion, duty impera- here." Exactly so. I never attached blame to anyone, tively called upon medical men, as conservators as well as and that I did do so results only from the exaggerated and views of Dr. Rutherford. But that the man, as a restorers (under God’s blessing) of health, to set aside

heated