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THE NEW MEDICAL PRACTITIONERS BILL.
realizing the phenomena of the heart’s action more dis- reader will find evidence of masterly authorship, and an it becomes even still more improbable that the systole acquaintance with the subjects treated, not less masterly than of the ventricle is caused by any kind of stimulation, and of the style. The description of the epileptic paroxysm at pages the blood more particularly. For w hat are the facts ? At the 145-152 is amongst the most graphically written descriptions the the blood rushes arteries into the systole, through coronary The phenocoats of the heart, antl the diastole of the ventricle is attendant of disease which we ever remember to have read. "
On
tinctly,
upon this rush. And after the blood has remained in these mena are struck out with such truthful boldness that the mind coats until it may be supposed to have lost some of its arterial receives, as in a stereoscopic picture, the veritable thing present properties, then the systole returns. These are the simple in its absence. facts ; and thus, if stimulation has to do with the phenomenon Throughout, the argument progresses in accordance with the at all, it is with the diastole and not with the systole. views "It appears, indeed, as if the ventricular diastole were due regarding muscular contraction advanced in the physioto the force with which the blood is into the logical part. Muscular contraction is produced by simple cessapartly injected coronary arteries at the ventricular systole, and partly to the tion of the physical act of certain agents which produce muselongating electro motive effects of the arterial blood upon the cular elongation. Ergo, convulsive action, however manifested, cardiac fibres. It appears also as if the diastole of the ventricles is a sign of a degraded vitality, and the treatment which it were made to continue as long as the blood retained its arterial properties, and that the systole returned when the oxygen was calls for, such treatment as shall bring into play those inby which the body is nourished and sustained. It is not exhausted, and the arterial converted into venous blood, and thus it appears as if the rhythm of the ventricles had a part of probable that a man of such a philosophic turn of mind as our its explanation ; for, according to this view, so long as the author should come forward either with pill, potion, or plaister. proper blood continues to be supplied, and so long as the ven- He does not. " Specifics" he has none to offer, though he gives tricle continues to be capable of responding to it, so long must the systole give rise to the diastole, and the diastole be followed candidly the histories of remedies which have been advised by others, and with an evident lingering towards some few mediby the systole." cines of the " tonic" fraternity. The argument against this view which will be most readily For all further particulars we must direct the reader to the urged is, that the diastole of the ventricles is coincident original work. Our descriptions of it are, by the necessities of with the systole of the auricles, but that auricles and ventricles time and space, imperfect; but we have read it from the are both supplied with blood through the coronary circulation first to the last page with so much pleasure, that we envy the at the same moment and with the same blood. Dr. Radcliffe man who has not read it, the treat he has in store. The book, meets this objection by the supposition that the systole of the as it does with problems, which in our present flickerdealing auricles is not an active muscular contraction, but a falling of the grand forces of life do not readily admit in of the auricular walls upon the sudden withdrawal of blood ing knowledge of demonstration, may, and probably will, lie open for long from the auricles by the diastole of the ventricles. He infers discussion and heavy opposition. But it is just the book which, that the absence of valves at the mouths of the great veins inwill perform the great object of all good dicates the passive character of the auricular systole. To this by eliciting inquiry, works on natural science, the revelation of the laws of Nature view, after careful consideration, and with every deference, we the true translation of their phenomena. must demur. Whoever will watch carefully the action of the by heart when exposed to view will agree with us that the systole of the auricle is no mere collapse; whoever will suspend for a THE NEW MEDICAL PRACTITIONERS BILL. moment the flow of blood through the great veins, and when To the Editor of THE LANCET. the auricle is empty of blood will prick the auricular wall, and SIR,-The Medical Practitioners Act, as amended, is looked see the auricular contraction ; whoever will study the mechanfor anxiously by the profession, and I trust it will not turn ism of the auricles, and will compare their structure and power I fear, if persons claiming as having been out a dead letter. with the amount of work which they have to perform; and in practice prior to 1815 are merely required to sign a declarawhoever will remember the persistence of auricular action after tion, numbers who are now practising illegally, and who have death, must be satisfied that the auricular systole is an act as not a shadow of a claim, will have the effrontery to present before the registrar for that purpose. I trust he purely muscular as the systole of the ventricle or the closure of themselves will be empowered to require something more than the ipre the hand. dixit of the parties concerned. The production of a certificate Moreover, the statement that there are no true valves evidencing that the parties making the claim are of sufficient to the great veins entering the auricles, does not, as we age, and other proof, should be insisted on; and where the opine, answer to the construction which Dr. Radcliffe would practice has been carried on under a partnership, the deed be produced. In the town in which I am put on it. For as the column of blood through the veins is should with a population of 7000, there are eight medical men,-six is a constant and in there always steady pressure progress, and two not. The latter have not received any proonward into the auricle by which the pressure resulting from qualified fessional education whatever; one of them commenced as a the auricular contraction is resisted, while the muscular arrange- chemist, but has now sunk the shop and drives about in his ments around the embouchures of the veins favours the closure phaeton with the greatest song froid, and professes to perform of those embouchures during the contraction. Virtually, there- all the functions of the educated medical practitioner, furnishcertificatps of death &c. to the registrar. These men, by fore, the mouths of the great veins are valved. But while in ing low and disreputable proceedings, have succeeded in obtainthis special point we feel bound to differ with Dr. Radcliffe, ing considerable practice amongst the lower and unthinking we recognise in full the importance of his physiological labours, part of the community. Their malpractices have been well and the necessity of subjecting them to such examination as! known to the profession, and have been fraught with danger shall put them beyond the range of dispute. The novelty of_ to her Majesty’s lieges---several well-attested cases of death his views gives no reason for hesitation in learning them, while having occurred from the same. If this state of things is to be perpetuated, a broad line of distinction must be drawn the radical changes which they suggest have a direct bearing between them and the duly-qualified members of the profeson some of the grandest problems in physiology and pathology. sion; and in the absence of a public prosecutor, medical proWe have already stated that the physiological part of Dr. tection societies will be required to enforce the penalties under I am, Sir, yours truly, Radcliffe’s treatise is but the prelude to another part on the Act. VERITAS. 1858. 26th, July and other Convulsive Affections." ’’ Epilepsy Taking epilepsy as the great type of all convulsive disorders, THE PERILS OF NAVAL MEDICAL SERVICE. - In the and the key to their interpretation, he describes, first, simple late unsuccessful attack upon the "braves " in China by our as epilepsy an ideal type of the epileptiform convulsion, and men, Dr. Tnrnbull, Pt,.N., was unfortunately made prisoner then tremor, simple convulsion, epileptiform convulsion, anc by the enemy, and left in their hands. He was put to death In various passages in this division of the book th< suasm. by them most cruelly, his hands and head being cut off.
fluences
practising,
,
’
120
On
tinctly,
upon this rush. And after the blood has remained in these mena are struck out with such truthful boldness that the mind coats until it may be supposed to have lost some of its arterial receives, as in a stereoscopic picture, the veritable thing present properties, then the systole returns. These are the simple in its absence. facts ; and thus, if stimulation has to do with the phenomenon Throughout, the argument progresses in accordance with the at all, it is with the diastole and not with the systole. views "It appears, indeed, as if the ventricular diastole were due regarding muscular contraction advanced in the physioto the force with which the blood is into the logical part. Muscular contraction is produced by simple cessapartly injected coronary arteries at the ventricular systole, and partly to the tion of the physical act of certain agents which produce muselongating electro motive effects of the arterial blood upon the cular elongation. Ergo, convulsive action, however manifested, cardiac fibres. It appears also as if the diastole of the ventricles is a sign of a degraded vitality, and the treatment which it were made to continue as long as the blood retained its arterial properties, and that the systole returned when the oxygen was calls for, such treatment as shall bring into play those inby which the body is nourished and sustained. It is not exhausted, and the arterial converted into venous blood, and thus it appears as if the rhythm of the ventricles had a part of probable that a man of such a philosophic turn of mind as our its explanation ; for, according to this view, so long as the author should come forward either with pill, potion, or plaister. proper blood continues to be supplied, and so long as the ven- He does not. " Specifics" he has none to offer, though he gives tricle continues to be capable of responding to it, so long must the systole give rise to the diastole, and the diastole be followed candidly the histories of remedies which have been advised by others, and with an evident lingering towards some few mediby the systole." cines of the " tonic" fraternity. The argument against this view which will be most readily For all further particulars we must direct the reader to the urged is, that the diastole of the ventricles is coincident original work. Our descriptions of it are, by the necessities of with the systole of the auricles, but that auricles and ventricles time and space, imperfect; but we have read it from the are both supplied with blood through the coronary circulation first to the last page with so much pleasure, that we envy the at the same moment and with the same blood. Dr. Radcliffe man who has not read it, the treat he has in store. The book, meets this objection by the supposition that the systole of the as it does with problems, which in our present flickerdealing auricles is not an active muscular contraction, but a falling of the grand forces of life do not readily admit in of the auricular walls upon the sudden withdrawal of blood ing knowledge of demonstration, may, and probably will, lie open for long from the auricles by the diastole of the ventricles. He infers discussion and heavy opposition. But it is just the book which, that the absence of valves at the mouths of the great veins inwill perform the great object of all good dicates the passive character of the auricular systole. To this by eliciting inquiry, works on natural science, the revelation of the laws of Nature view, after careful consideration, and with every deference, we the true translation of their phenomena. must demur. Whoever will watch carefully the action of the by heart when exposed to view will agree with us that the systole of the auricle is no mere collapse; whoever will suspend for a THE NEW MEDICAL PRACTITIONERS BILL. moment the flow of blood through the great veins, and when To the Editor of THE LANCET. the auricle is empty of blood will prick the auricular wall, and SIR,-The Medical Practitioners Act, as amended, is looked see the auricular contraction ; whoever will study the mechanfor anxiously by the profession, and I trust it will not turn ism of the auricles, and will compare their structure and power I fear, if persons claiming as having been out a dead letter. with the amount of work which they have to perform; and in practice prior to 1815 are merely required to sign a declarawhoever will remember the persistence of auricular action after tion, numbers who are now practising illegally, and who have death, must be satisfied that the auricular systole is an act as not a shadow of a claim, will have the effrontery to present before the registrar for that purpose. I trust he purely muscular as the systole of the ventricle or the closure of themselves will be empowered to require something more than the ipre the hand. dixit of the parties concerned. The production of a certificate Moreover, the statement that there are no true valves evidencing that the parties making the claim are of sufficient to the great veins entering the auricles, does not, as we age, and other proof, should be insisted on; and where the opine, answer to the construction which Dr. Radcliffe would practice has been carried on under a partnership, the deed be produced. In the town in which I am put on it. For as the column of blood through the veins is should with a population of 7000, there are eight medical men,-six is a constant and in there always steady pressure progress, and two not. The latter have not received any proonward into the auricle by which the pressure resulting from qualified fessional education whatever; one of them commenced as a the auricular contraction is resisted, while the muscular arrange- chemist, but has now sunk the shop and drives about in his ments around the embouchures of the veins favours the closure phaeton with the greatest song froid, and professes to perform of those embouchures during the contraction. Virtually, there- all the functions of the educated medical practitioner, furnishcertificatps of death &c. to the registrar. These men, by fore, the mouths of the great veins are valved. But while in ing low and disreputable proceedings, have succeeded in obtainthis special point we feel bound to differ with Dr. Radcliffe, ing considerable practice amongst the lower and unthinking we recognise in full the importance of his physiological labours, part of the community. Their malpractices have been well and the necessity of subjecting them to such examination as! known to the profession, and have been fraught with danger shall put them beyond the range of dispute. The novelty of_ to her Majesty’s lieges---several well-attested cases of death his views gives no reason for hesitation in learning them, while having occurred from the same. If this state of things is to be perpetuated, a broad line of distinction must be drawn the radical changes which they suggest have a direct bearing between them and the duly-qualified members of the profeson some of the grandest problems in physiology and pathology. sion; and in the absence of a public prosecutor, medical proWe have already stated that the physiological part of Dr. tection societies will be required to enforce the penalties under I am, Sir, yours truly, Radcliffe’s treatise is but the prelude to another part on the Act. VERITAS. 1858. 26th, July and other Convulsive Affections." ’’ Epilepsy Taking epilepsy as the great type of all convulsive disorders, THE PERILS OF NAVAL MEDICAL SERVICE. - In the and the key to their interpretation, he describes, first, simple late unsuccessful attack upon the "braves " in China by our as epilepsy an ideal type of the epileptiform convulsion, and men, Dr. Tnrnbull, Pt,.N., was unfortunately made prisoner then tremor, simple convulsion, epileptiform convulsion, anc by the enemy, and left in their hands. He was put to death In various passages in this division of the book th< suasm. by them most cruelly, his hands and head being cut off.
fluences
practising,
,
’
120