306 local remedies? THE is not contagious, it belongs to what the author If the disease, being chronic, believes to be a taneous affections, and designates very natural group of cutagious chronic diseases of the skin." None of "non-conthese, he considers, are local, but all-dependent upon a constitutional cause, and he believes that this cause is much the same in every variety of the large group in question; the varieties depending upon accidental circumstances of age, climate, and idiosyncrasy. This opinion he supported with the fact that they all yield to the same remedy. He had found that arsenic, judiciously administered, is a uniformly successful remedy for all these affections-as much a specific for them as quinine is for ague. The arsenic should be given in doses of from three to five minims of the liq. arsenical three or four times a day, regulating the quantity and the frequency of the doses so as to keep up a slight action upon the conjunctiva, and, with this Indication of its effect, should be persevered in for some time after the affection has disappeared. It should be borne in mind that arsenic is a cumulative medicine, not one of those of which the system becomes more and more tolerant the longer they which prevents its injurious effect on the stomach. It should be given after the food, The author then proceeded to read a number of brief accounts of cases in which arsenic was administered for the cure of "chronic non-contagious skin diseases" with uniform success; in several of these the effect of the arsenic was strikingly evidenced by the exacerbation of the eruption when when the medicine was accidentally omitted for a few days during the progress of the cure. cases were one of lichen, one of prurigo pudendi muliebris, one of prurigo scroti, one of prurigo forThese micans, two of lepra, three of psoriasis, one of urticaria, and one of purpura; with regard to the case of purpura, he hinted that the cure might probably are taken. MEDICAL TIMES. PHARMACEUTICAL SOCIETY, JAN. 13. proficiency in organic chemistry. Sugar." of Ether in Surgical Operations," at the same time exhibiting his inhaling apparatus. Mr. Squire read a paper "On the Inhalation instrument resembles in form a Nooth's apparatus: a sponge wetted with ether being placed in the upper part, the vapour descends to the bottom, whence it is conveyed to the mouth by This tached. The tube contains a valve to prevent the return of air into the vessel, and, by a a flexible tube, to which a mouthpiece is atsimple contrivance-a ferrule placed near the mouthpiece with one perforation, the supply of vapour can be regulated at the will of the operator, enabling the surgeon to give the whole of his attention to the patient. Mr. Squire explained that various reasons might be given for the apparent failure in producing insensibility, in the experiment by Mr. Liston in the amputairrespective of the merits of the instrument, as tion of the forearm, where the precaution was not taken to prevent the ingress of free atmospheric air to the lungs through the nose, which is essential the failure, without the mention of these circumstances, the merits of the apparatus had been In consequence of the publication of unjustly called in question, as the omission is much depended on the willingness of the patient equally fatal to the production of stupor in the use of every apparatus. He considered that much more easily when that is inhaled freely. He had found in some cases that one minute to receive the vapour, as the effect was produced the patients in these cases were in health, and was sufficient time for the effect to show itself; Mr. Rhodes was astonished to hear the author where coma was brought on by the use of this express himself so decidedly against iodide of po-means, the patients are equally unable to give breathed freely. It would be found in all cases tassium; he had often seen its exhibition attended any account of the length of time which they with marked good effect in syphilitic eruptions. Mr. Eade remarked that iodide of potassium has hour. He had observed that, when unwashed very marked effect in curing syphilitic periostitis, ether was used, the lungs were often irritated, have lost-some thinking it an age; others, an which warrants a presumption of its efficacy in other syphilitic affections. but this was avoided by washing. have been due to the tonic effect of arsenic on the capillaries, rather than to its specific virtue in skin disease. Mr. Pittard observed that the fact of a remedy curing syphilis in one tissue furnishes no presumption of its efficacy in curing it in other tissues; because, though iodide of potassium has very marked influence in syphilitic periostitis, it is not of the slightest use in syphilitic iritis, and, vice versa, mercury cures syphilitic iritis, whilst it makes syphilitic periostitis worse. decided opinion as to the effect of iodide of potasHe could not give a sium in syphilitic eruption, but he had great confi dence in mercury. Mr. Wood questioned the expediency of giving arsenic for many skin diseases; he thought the author had underrated the dangerous nature of that remedy. He once saw arsenic given for pityriasis, in doses of four drops of the liq., increased to five drops, to a girl; as soon as the conjunctiva became affected, she got extremely ill; left off the medicine and recovered; resumed it; was again taken ill suddenly, and died. The eruption in this case was much bettered, but he considered it far better that many skin diseases, which are often merely very trifling inconveniences, should be left uncured, than that they should be cured at the risk of the patient's life. to success. ratus made under the suggestion of Dr. Boot Mr. its indiscriminate use, cited the opinion of Mr. pended on the effectual exclusion of free atmo- paratus which he had constructed, having the Tracey had found by use that all had answered vapour was described by a member, being a different construction from the preceding, conMr. J. C. Clendon exhibited an apparatus of sisting of a glass cylinder, into which is infrom ether, placed in a funnel at the top of the tube. The inhaling tube is provided with stopserted a tube for the supply of vapour obtained cock and valves, and is, like the ether and air tube, inserted in the top. It will be seen that the action of this apparatus depends not on the weight of the vapour, but on Mr. Clendon remarked that the comatose state of ether, and instanced the case of a young man of Guy's Hospital, who for a quarter of an its elasticity. would not always be induced by the inhalation hour on two occasions inhaled so freely that the ether vapour expelled impregnated the atmolowed. For two days he completely lost the use sphere of the whole house, but no insensibility was produced. Another effect, however, folapparatus could be contrived which would be successful in all cases; it was well known that of his memory. He was not of opinion that any opium, spirits, and other powerful stimulants, Mr. Webb and Dr. Arlidge also joined in thebe expected that this would be the case with sometimes produced effects differing from those discussion. ordinarily found to follow this use, and it might this vapour. He cautioned the meeting against Mr. Griffith had seen arsenic given in very numerous cases, and had never witnessed anything so alarming in its effects as occurred in the case mentioned by Mr Wood. Was Mr. Wood sure that the patient had not taken over doses? Mr. Wood said that he should have added that the patient was suddenly seized with symptoms of poisoning by arsenic, but actually died in a fit resembling epilepsy, to which she was subject, soon after. ether, and that the washing is intended to remove the same, but that pure sulphuric ether does not The Chairman explained, in answer to a question, that alcohol is often combined with the require it. stated that the effect depended in some degree into the lungs without an admixture of atmo- obstacles to free inhalation. at half-past eleven. TO CORRESPONDENTS. THE MEDICAL TIMES is the only Medical Journal published at its mon Office, and which is free from the control of all Booksellers and Publishers. Gentlemen may procure it by an order on any Newsman or Bookseller, or it will be sent direct from the Office of the Medical Times to Annual Subscribers sending by a Post-office order, directed James Angerstein Carfrae, or an order on some party in town, One Guinea IN ADVANCE, which will free them for twelve months. Half-yearly Subscription, 13s.; Quarterly, 68, 6d. No number of the Medical Times can be forwarded, except to gentlemen paying in ad vance. A HANDSOME PORTFOLIO for holding the "MB- A Constant Reader cannot certainly be indicted humbug," as in doing so we should render our- A Medical Student, Bristol.-We should recommend Keightley's" History of England," "History of Greece" in the Library of Useful Knowledge, Goldsmith's "History of Rome," any work on Geography, Crank's "Arithmetic," Lathom's "English Grammar." We should further recommend the student to obtain the "University Calendar," and ascertain by its means exactly what is required in the Matriculation Examination. A Provincial Medical Student will find the information he requires in the present number of our journal. name. 1. A British surgeon-apothecary is a name Several Correspondents must accept our apology for THE SATURDAY, JANUARY 16, 1847. "The Lord hath created medicines out of the earth; and and to the individual character and relative situation of the more important internal organs. In the dissections now made, the student should consider the bearings they may have upon his practical obligations hereafter. He should bear in mind that he now becomes an anatomist, that in future days he may be a surgeon-that he now studies the right disposition of parts, that he may subsequently discover when those parts are wrong that he now learns the character of healthy organism, that in future he may know whether it be morbid, directly that it is presented to him. It is a great error of the student, and not an uncommon one, to pride MEDICAL TIMES. himself rather in being an excellent anatomist, than in being able to well apply his anatomy. In this respect he stands in similitude to the classical scholar, who is so familiar with dead languages that he has no knowledge of the right use and beauty of a living one, though it may be that the very employment of this is the learning in this, but there is very indifferent means whereby he has to live. There may be wisdom in it. We have known a man fully competent by theoretical and practical knowledge, by reading and assiduous dissection, to describe every muscle of the body, individually and relatively, and knowing well every ligament and the uses of it, in the several joints, yet be quite unable to discover a luxation, or to reduce it after it had been pointed out to him. All this was for the want of seeing the appropriation of the anatomical knowledge he was gathering-of seeing that that very anatomy was only a means to an end. In like manner we have known a man pride himself upon being the cleanest dissector in the room, and, in truth, he could lay bare a muscle better than any scalpelist we ever saw, yet he knew less of the muscles than any man who dissected near him. The fact was, he thought more of picking up scraps of cellular tissue, and leaving a bare structure prettily exposed for an artist, than of studying what that structure was-what were its attachments, relations, and uses. Justus. We have great cause to regret that circum- his handkerchief with it, and inhaling the vapour. Aspecies of intoxication was produced, accompanied by movements and gestures which excited the merriment of the bystanders. We have seen precisely the effects of the inhalation of nitrous oxide produced by the inhalation of the vapour from a common bladder. A Correspondent writes," I saw in your last week's paper the account before the Vice-Chancellor of Brown against the Medical Times.' Are you aware that they (the "Medical Gazette") extracted from your journal a case of poisoning by aconite, forwarded by Mr. Sayle, of Lynn? It appears to me a hard case that they are to do with impunity what they deny your right to do." [The inconsistency of the procedure is its least enormity.-ED.] Mr. Winstone, of Bouverie-street, and Mr. Eden, of M.D. and other Correspondents.-We really can- education, and his protest against it on the score Last session, after a chapter or two of preface, valedictory to those that were gone, or going, from the ranks of studentship-congratulatory to those who were rejoining the said ranks, and introductory to such as were coming amongst them for the first time: after all these things, and sundry others, we proceeded with special words of admonition! These chiefly bore reference to the practical study of anatomy and chemistry, additionally to which we said a few words, in the summer, about botany. These things were intended to apply to the first year's student, to whose notice we especially commended them. Regarding this student as now in the second year of his probation, it is to him that our attention and advice are further to be directed. If laboratory chemistry were not attended to in the previous summer, it is, perhaps, well pursued during the present session, inasmuch as it will not encroach upon the duties of the forthcoming summer (which should comprise medical jurisprudence and midwifery), and will aid an important study just now to be pursued, viz., materia medica. Anatomy, in the dissectingroom we mean, is still, of course, to be continued: for every winter of the student's career should have a specific portion of it devoted to this most necessary branch of duty. Demonstrations and dissections should be prosecuted just now, attention being particularly directed to the joints liable to luxation, to the parts of hernia, to the precise spots for taking up arteries, Dissecting, like learning the import of words, is of little value unless it extend beyond this, know a dictionary by heart, yet be a wretched and apply itself as we have said. A man may composer of language. We must not descant further on this head, for our motto has reference to materia medica. This is one of the most important departments of the profession, and yet, strange to say, is one of the most frequently neglected. Every man says it is so dull—and no man can see anything in it until he has to make a demand upon its services, and then, for the first time, he finds there is much more in it than he ever gave it credit for. Botany is liked by one man, and another, because it leads to pleasant walks and murmuring rills, and the picking of pretty flowers, and breathing fresh air, and hearing the birds sing: in all of which things there is a dash of pleasantry that is not wholly prosaic. Chemistry is liked by another, because it is a science that has some precision and power in it; it is a great organ in the hands of the active world; it is capable of good and evil, and has made many a man's fortune; moreover, there is a significance about it that impresses unable to do! To those of our young readers, to whom the story may be novel, it may be amusing to know that a physician once wrote running thusa prescription R. Infusi sennæ, 3vij. Tinct. ejusdem, 3j. beholders or investigators with an awe of its vided he would tell him the dose, which he was consequence. Practice of physic is a favourite with another, because it is the “very head and front of" professional importance, and gives dignity to whomsoever may be its agent. Surgery, with another, is paramount, for he may love blood and the instruments of it, and sweeping off a man's limb, or slitting up any other portion of him, is everything in the eyes of the embryo pure surgeon, who loves the glitter of the knife and the gash it makes, fat more than the paltry medicinal means that may save all this splendid show and derided suffering. Midwifery finds favour in the eyes of another, who thinks it his highest honour to be an arbitrator between Nature and her sternest agony. Medical jurisprudence is preferred by another, for it is made up of varieties, scraps of consequence derived from law and physic, and perhaps may meet with an exaltation, some solitary now and then, before the pompous self-sufficient chair of a petty magistrate, or in the more orthodox precincts of a judge and jury. Amongst all these, materia medica is forgotten you never fiud a voluntary champion in its cause. Students dislike it utterly, and yet, when they become practitioners, they have more to do with it than with anything else. In fact they never can move without it-it is next to impossible that they can be called to any case which does not involve the services of materia medica. And, inasmuch as it is one of the most commonly demanded subjects of information, so is an ignorance of it one of the most serious failures that can happen to the practitioner. It is no trifling matter to mistake a drug, or to mistake the dose of it. Many a life has been sacrificed by the perchloride being substituted for the protochloride of mercury-corrosive sublimate for calomel. Scheele's prussic acid, and the diluted acid of the pharmacopoeia, have more than once been confounded, and a victim has been the consequence. Morphia has been given for opium, and strychnia for nux vomica, and the result may be inferred. We remember, in our own pupillage, a man being asked the dose of bitartrate of potass, and he said "about half a grain." He was then asked the dose of elaterium, and he replied, "about half an ounce." He was properly rejected at once: yet this man was a good anatomist. He was excellent in the dissecting room; at the bedside he might have poisoned his first patient! enough, but he was foiled at the second, for he The apprentice read the first line easily could not find a bottle labelled tinct. ejusdem throughout the whole surgery. In despair he scouted every street in the neighbourhood containing a druggist's shop, but everywhere meeting with the risible reply that they did not keep tincture of ejusdem! In our own experience we once met with a somewhat similar case that might have proved fatal. shortly confined, and suffering from constipaA lady, tion and afterpains, was ordered two or three draughts of castor oil, an ounce each, with twenty drops of laudanum, the order being haustus pro re nata. The pupil translated the latinity for a thing new-born, and, imagining that this must be the child, ordered it to take a draught now and then! Of course, if it had taken one, there would have been no need for a repetition of the dose. mistakes and mischiefs, consequent upon an The experience of the profession is full of ignorance of materia medica and pharmacy. These things may seem dull enough to the student, but he should remember that their main value is their application—and he should remember, also, that this will be the chief business of his professional life. Often, on the instant, he will be required to prescribe this or that, and sad will be his dilemma if he fail in his duty or faultily perform it. It often hapnity of atonement. Once done, the mischief is pens that a slip, thus made, leaves no opportutoo frequently ever done. ing materia medica is during studentship, when The only available occasion of rightly studyits details are theoretically given in the classroom, and daily corroborated in the practice of the hospital. To these two sources the student ought scrupulously to look. fail him—but if he fail them, he may mourn They will never their loss ever after. We earnestly commend this subject, and these remarks, to the notice of our young friends. ON THE PROPER CONSTITUTION OF A COUNCIL OF HEALTH. COMMISSIONS, committees, and councils, for an infinite variety of purposes, are things of daily occurrence in this busy age. Many of Besides doing actual harm, a practitioner, ignorant of materia medica, may make himself very ridiculous in consultation. Some years ago, ourselves had occasion to suggest at a "meeting" the propriety of altering a prescription which consisted of tonics and a stimu-them lant, as its author said, and which said tonics and stimulant were compounded of sulphate of iron, sulphate of quinine, carbonate of ammonia, and water! We know an instance of a consultation between a very sensible man and a very silly one, when the former advised a stimulating plan, which the latter assented to, at the same time strongly recommending an outlandish form of ether. The superior said he had had no experience of it, but should he happy to try it on the other's suggestion, pro from their inquiries; and, being of a very exare purely abortive; no results flow pensive character, are rather a burden than a benefit to the nation. utility of the Health of Towns Commission, We cannot deny the whose report we have read with considerable attention; it contains a vast amount of information on the causes of disease in large towns, and a collection of the opinions of the highest authorities as to the means to be used for their removal. Unfortunately the report occupies four moderate-sized octavo volumes, and is not, for that reason, adapted for general circulation; nor can it be expected that the ignorance of even the educated classes would be much enlightened by so bulky a document, even were the report extensively circulated among them, containing, as it does, much matter from which most persons would turn away with disgust. Were it not for this reason, such questions as those we append to the we should be of opinion that the diffusion of present article would be a work of supererogation. The truth is, that full and complete answers to all these questions are contained in the report we have already noticed. ་ ་་ T MIGA general importance, such But the agitation of any question of as the preser vation of the health of the people, rereiterated answers; that they should be put and quires that the same questions should receive answered again and again, until, by the circulation of the answers in a brief form, by leading articles in the periodical press, by pamphlets, and other similar means, the public mind is fully awakened to the extent of the evil. We in the agitation of some recent questions have seen that such a process was successful of national importance. Taking these circumstances into consideration, we think that the mode of procedure adopted by the Health of London Association will prove of great national benefit; for the results of its inquiries will be equally applicable to the condition of other towns besides the metropolis. We, therefore, call upon all our metropolitan medical brethren to reply as fully as they are able to the questions proposed, and to give as much information concerning their own particular localities as may be in their power. But we are fearful that the measures founded many former measures, prove in some degree a on the different sanitary reports will, like job. We are fearful that the test of efficiency and that thus the whole scheme will prove a dewill not be that of knowledge, but of influence; cided failure. When Sir J. Graham brought in a bill for the regulation of the medical profession, it was in contemplation to found, at the same time, a Council of Health; and this was intended to consist of the "crême de la crême" of the profession. It was more than whispered that the redoubtable baronet, Sir B. Brodie, was intended to be its head; that the other members of the council would consist of the more influential members of the Colleges of Physicians and Surgeons; and that a part of the duty of this to the Legislature for the regulation of the board would be to present recommendations public health. whether either of the gentlemen who, had Now, we very much doubt this bill become the law of the land, might have been chosen councillors, would have ever paid any marked attention to hygiene; and we very compelled to commence this portion of their strongly suspect that they would have been studies after they had received the appointment of councillors of health. This looks very much like what is called in the country putting the cart before the horse. But this is a very o mon result of modern appointments: the parties appointed learn their duties after having entered on their office. Probably these very com sapient men would have proposed one or two gentlemen who had really paid attention to the subject as subordinate members of the council, for the purpose of affording the requisite information; and thus the clumsy contrivance would have been enabled to move, though with slow and halting steps. The crême de la crême of the profession would have absorbed the best salaries; they would have feathered their nests very comfortably at the expense of the less influential, but really more useful and important, portion of the council, who would have been graciously permitted to take the leavings of their betters, There is no doubt we do need a good and efficient Council of Health, composed of men who have the object at heart, and who possess a full knowledge of the subject. One important feature in the construction of such a council is this :-Its members must be well paid, and so well paid as to render other employment unnecessary for their respectable maintenance; and they must be compelled, when taking the offices, to abandon all other pursuits, and devote their whole time to the duties of their office. If our unwise parsimony dictate an insufficient salary for such important offices, the work will be badly performed, and the council will prove worse than useless, because it will lead the public into a false security. 2 That a well-constituted Council of Health is really required needs no proof. We are all aware that any piece of machinery requires a central, intelligent directing power, without which good results cannot follow. We shall take this matter for granted, and now give the general plan of what we consider to be the true constitution of an efficient council. But before entering on the plan a short digression may be permitted. It is a well-known fact, daily disclosed by the public papers, that the crime of poisoning is largely on the increase in England, and that it very commonly escapes detection; so that it is probable that murders of this description are of weekly, if not daily, occurrence. As so atrocious a crime is becoming a common one, examinations for the detection of poison are, necessarily, much more numerous, and the institution of medical jurists becomes proportionally necessary. Without disparaging the knowledge or education of the medical profession, we do not hesitate to say that very few practitioners are capable of performing the chemical operations necessary for the detection of a poison with sufficient accuracy. We will explain ourselves. Chemistry is not an essential, but simply an auxiliary, science to medicine and surgery; some knowledge of it is necessary, but a profound and practical acquaintance with the details of the science would occupy more time and attention than can be given by y the majority of medical students, with justice to the more direct object of their pursuits. Medical students, therefore, do not pay any marked attention to that science, unless impelled to do so by their own peculiar taste. How, then, is it possible that they should be fitted to undertake one of the most delicate and difficult of chemical questions-the detection of minute traces of a deleterious substance? The usual and the safest practice followed by medical practitioners is, to place the parts supposed to contain the poison in the hands of some acknowledged chemist for examination. It has long been our intention to propose the appointment of a certain number of what we should term medical jurists, whose duty it should be to examine all cases in which foul play was suspected; that all viscera of persons suspected to have been poisoned should be sent to them, and to them alone, for examination; and that such examinations only should be legal. These gentlemen, thus officially delegated as medical jurists, should not confine their attention to cases of poisoning, but extend their investigation to all other cases involving medical questions. Two medical jurists might be appointed for each circuit, whose duty it should be to accompany the judges through the different circuits. They ought to receive a sufficient salary to enable them to live in a style which becomes their position. The medical jurists, thus appointed, would constitute, when assembled, the Supreme Council of Health, to whose judgment all questions of medical jurisprudence, whether sanitary or not, would be presented for decision with a perfect and well-grounded confidence that they would undergo a sufficient examination; and the decisions of the council would thereby acquire a character which could not be equally obtained by any other means. The medical jurists, indeed, being appointed in the same manner as the judges, would be bound by their oath of office to undertake no other employment, but to give up their whole time to the duties of the office. In travelling the circuits they would be enabled to investigate the state of each town in the circuit, and present to the notice of the judge any nuisances they might observe. But a better arrangement might be made, if local officers of health were appointed. The medical jurists might then receive the reports of the local officers, and, should any particular circumstance demand a personal inspection, such inspection might be made while the jurists were in the immediate vicinity. Thus much time and trouble would be saved, and due attention would be given; the impartiality of their reports and decisions would command equal confidence. It has been suggested in the preceding paragraph, that the Supreme Council of Health should be constituted by the assembled medical jurists. These gentlemen, following the judges in their circuits, would necessarily meet in London during each term, and thus ample time and opportunity would be afforded for the meetings of the council. At these meetings all the more important questions and reports would be fully examined and discussed, and calm and impartial reports or decisions would result. There are many and important collateral advantages to be derived from such a constitution of a Council of Health. We will content ourselves, for the present, with the notice of one only, as we should far outrun the limits of a leading article were we to indulge in a full examination of so important a question. We can It has been a common and oft-repeated remark, that members of our profession, even the most highly gifted, have cut but a sorry figure in courts of justice; that their evidence has been of a contradictory or vague description; and that medical testimony does not obtain the credit which is freely accorded to that of men far below the members of our profession in education and intellect. What cause can be assigned for so lamentable a circumstance a state of things so derogatory to the dignity of medical science? That we, who are in the daily habit of conducting the most complicated and delicate investigations, of balancing conflicting evidence, of cross-examining our patients, and, finally, of performing the part of judges in deciding on the evidence placed before us, should be so incapable of furnishing satisfactory evidence when acting as witnesses in a court of justice, seems to be an inexplicable and anomalous circumstance to non-professional auditors. But, when we examine the circumstances more attentively, we have no difficulty in arriving at the true causes of this failure in medical testimony. Two chief causes of failure may be assigned: want of confidence, and the amount of uncertainty which must always attach to a science of observation such as medicine. not feel surprised that medical practitioners succeed so badly in the witness-box, when we reflect that they are comparatively rarely placed in that position. A practitioner may, and often does, pass through a long professional life without being called as a witness in any important trial, before one of the higher tribunals. Now, it cannot be expected that a man who has so little practice in giving evidence will do so with becoming firmness and coolness. He is teased by the opposing counsel, becomes flurried, is put off his guard, and commits some sad mistake, which is, of course, immediately wrested by the opposite party to his own advantage. The fault, then, in a large number of instances, does not lie so much in the want of knowledge or capacity of the medical practitioner, as in his want of confidence and practice in giving evidence. Now, this would not be the case with the medical jurist; he would be frequently placed in the witness-box, would become familiar with the mode of examination, and would acquire that confidence and experience the absence of which we have already pointed out as the great difficulty with which the practitioner has to contend. The ordinary limits of a leader have been somewhat overstepped in this article, but the subject is far from exhausted, and we shall take a fitting opportunity of recurring to it, and of detailing the proceedings of the Health of Towns Association in some future number. In the meantime we print below the questions we have already noticed, as about to be circulated among the members of our profession. 1. Have you observed sickness and disease to arise from badly-constructed and ill-ventilated dwellings, from imperfect sewage, and from bad cleansing of the streets, courts, and alleys? 2. Have the poor power to remedy these evils? 3. Are there any nuisances existing, or are there any offensive trades carried on, in your locality, such as tallow-boiling, slaughtering of cattle, pigstyes, the burning and boiling of animal or vegetable matter, &c. ? 4. In your neighbourhood are there any noxious or offensive chemical works, especially lead, colour, mercurial, and water-gilding factories? 5. If so, have you found them injuriously affect ing the health of those engaged in them, or of the neighbourhood? 6. Would it be advantageous to the public that an inspector of nuisances and a public officer of health should be appointed? 7. Do you approve of the establishment of a council of health to watch over the sanitary condition of cities and towns, with power to rectify all those evils which are removable, and which are prejudicial to health? 8. In the evidence collected on the sanitary condition of the labouring classes by the Poor-law Commissioners, and by the Government Health of Towns Commission, it is therein stated that it would be a pecuniary saving to the rate-payers to remedy, at the parish expense, the insufficient drainage, the bad cleansing, and the imperfect ventilation of houses, workshops, and public buildings, inasmuch as sickness, and the evils attendant thereon, entail heavy burdens on the public, not only through voluntary institutions, such as hospitals, dispensaries, &c., but add to the increase of poor-rates. Do you agree in this opinion? 9. Are all the houses and streets in your neighbourhood provided with sewers and drains? 10. Are there any open drains or sewers, and if any, are you aware of any case of disease having arisen from their effluvia? 11. Should the sewers and drains be covered over? 12. No general survey as to levels of the metro polis has as yet been made as a necessary preliminary for efficient drainage. Do you think that such a step should be immediately undertaken by competent persons legally appointed? 13. It is recommended by the Health of Towns Commission, as well as by the Select Committee of the House of Commons, appointed April 30, 1846, to examine the application for local acts, &c.,that all waterworks, all works for drainage of towns, for sewage, and for paving, should be placed under one administrative body. Does your opinion coincide with these recommendations? 14. Are you of opinion that new legislative measures are required, applicable to all towns and populous districts, for the introduction and maintenance, not only of an efficient and economical system of house drainage, sewage, paving, and cleansing, but also for the provision of an ample supply of water for public and private purposes? 15. Are there any cesspools and privies in the poorer neighbourhoods, full, and suffered to overflow? 16. Are they productive of sickness among the inhabitants? 17. State what cases of disease you have known to arise from this cause. 18. Have the houses of the poor separate privies, or are the inmates compelled to use a common one, indiscriminately as to the sexes? 19. Are uncleanly and indecent habits created by the want of separate privies? 20. Is it practicable to introduce a water-closet into each house? If so, would it produce more decent and cleanly habits, and a better state of health? 21. Do not the public suffer in their health and comfort, and is not decency outraged from the want of public water-closets and urinals in large cities and towns? 22. Are the poor adequately supplied with water? 23. What accommodation have they for keeping the water, and what is its general condition? 24. Is the charge for it reasonable? 25. Does its scarcity conduce to uncleanliness and ill health, and are the comforts of the poor greatly abridged in consequence? 26. Is it not the duty of the Legislature to provide an abundant supply of water, and to protect the poor from high and unreasonable charges? 27. Would not a constant supply of water to the public at large, and to the poor in particular, at 29. Are the present water companies sufficiently 30. Is sufficient attention paid to the ventilation of workshops and houses occupied by the poor in your district? 31. Is the neglect of it productive of demoralization, such as drunkenness, &c. ? 32. It is proved that the want of ventilation is a prolific source of disease, such as fever, consumption, scrofula, &c., among the inhabitants. Do you think that public means should be adopted for promoting a proper system of ventilation in all edifices for public assemblage and resort, especially those for the education of youth? 33. It is likewise proved by the evidence taken by the Health of Towns Commission, that overcrowding in common lodging-houses in poor neighbourhoods is a prolific source of disease and demoralization. Are you of opinion that such lodging houses should be placed under inspection and control? 34. Do you think that in the construction of dwellings for the poor, provision for the efficient admission of light (especially solar light) and air should be enforced? 35. Do you think it would be desirable to give power to parishes, or to the local administrative bodies, to raise money to purchase property for the purpose of opening thoroughfares whereby both light and air would be more freely admitted into the abodes of the poor? 36. Can you suggest any plan reconcileable with 39. Are the habits of the people as to cleanliness 41. Are those courts which are private property 43. If the public thoroughfares were skilfully 44. Is not interment in towns frequently at tended with desecration of the dead, as well as with 45. Are not the quantities of smoke generated in 46. Ought not the Legislature to make every possible exertion to abate this nuisance? 47. The Legislature having passed an act to authorize municipal authorities and vestries to establish baths and wash-houses for the poor at very low rates of payment, are you of opinion that they should be brought into use in your locality without delay? 48. Would you recommend baths being introduced into parish and union workhouses and hospitals, not as a remedial measure only, but to promote the health and cleanliness of the inmates? 49. Do you think that habits of uncleanliness are productive of demoralization? 50. Should it not be an object of the Legislature to encourage the spirit of commercial enterprise in the execution of the measures for sanitary improve ment? 51. If the expense for sanitary improvements should be charged upon properties, and be distributed over a term of years coequal with the probable duration of the works, and if a special rate of small amount be levied upon the occupiers until the capital and interest shall have been repaid, do you think the burden would be felt by the people? PAINLESS SURGICAL OPERATIONS. The investigation of the new method of rendering surgical operations painless, rather increases than diminishes in interest, both among medical men and the public, who, having now become acquainted with its safe application, followed by pleasing and satisfactory results, have also been crowding our hospitals to witness the operations. KING'S COLLEGE HOSPITAL presented an unusual amount of interest, by the numbers that arrived to witness three operations performed by Mr. Fergusson. The first case was that of a woman, who had been operated on previously for an abscess in ano. When brought into the theatre, she insisted upon having her sleeping draught as in the first operation. On this occasion the operation was for fistula, and she was obliged to lie on her side. The inhalation was employed, but the effect was not so rapid, nor was it so satisfactory, as on the former occasion; and on recovering, and being asked after the operation what had been her sensations, she stated she had felt more pain than in the last operation. The management of this patient appeared to us to be under the control and direction of Dr. Forbes. The second case was that of a young man who had four or five venereal warts on the inside of the prepuce. The patient was placed in an upright position; the vapour was in this instance administered by Mr. Robinson, and the word given to the operator when to begin after two or three minutes. The operation commenced and the warts removed; during the first part of the operation a slight reflex action of the muscles took place; but on the recovery of the patient, and on being questioned by Mr. Fergusson and Dr. Forbes, he was unaware that the operation had been performed. The third case, a man who had also been previously operated on for stricture, was brought in to have a catheter passed. Dr. Forbes appeared to manage this case as the first. After inhaling the vapour for seven minutes the catheter was passed, and he evidently showed symptoms of pain, which he afterwards stated to be the fact. In the former operation no pain was felt. We cannot see the propriety or good judgment in the authorities permitting any person present, unconnected with the hospital (and only invited as a spectator to witness the results), to interfere in any way. The patient should be left entirely to the care of the operator and the party who administers the vapour. It reminds us of the old adage, "too many cooks spoil the broth." WESTMINSTER HOSPITAL. A large number of medical men, the nobility attendance to witness the results of two operaand gentry, supporters of the institution, were in tions by Mr. Hale Thompson. On this occasion Mr. Robinson administered the vapour in both cases. A woman who had three very large venereal warts on the labia was first operated on. She was affected in four or five minutes; the word given to the operator, "Patient ready!" and the operation of removal quickly performed. On re |