HOUSE SURGEONS OF THE LONDON HOSPITALS.
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periodical pnblications at home andabroad." A week before the expira-tioa of the days of grace, Dr.GRE-GORY remitted to the Committee amincing of the grievances from theManagers, which was of course re-jected with contempt, and it was notDlttil the last evening that a surreu-der at discretion was made. Thusended, Mr. Editor, (and we had noLANCET to advocate our cause,) an at-tempt to treat the student*) of medi-cine in the University of Edinburghn an unjl1st and tyrannical manner.Here, as in all other instances, thestudents were backed by the 1tofes-sors ; their interests, they conceive,are the same, and they afways act inunison; this is not the case in London,it would appear, but I think that the
pupils might at least be treated likegentlemen, although it may not be car-ried to the almost levelling length thatit is done in Edinburgh.-It is the fa-shion of the day to scoff at the medicalschool in the north ; but, With all itsfaults, in vain can a rival be pointedout ; no where are such independentand intelligent students to be found ; -,there is no pinning of faith to thegown of individual teachers. I haveknown many who had previously stu-died many years in London say, thatthey never learned to think fLr themselves until theywent to Edinburgh ;this is, indeed, the iorte of the Uni-versity, and justly entitles it to thehigh name it holds, and will for eversecure a vast number of illuminatifrom every quarter of the globe.
Yours,M. D. EDINENSIS.
London, Aug.23.M. D. EDINENSIS.
HOUSE SURGEONS OF THELONDON HOSPITALS.
To the Edefor of THE LANCET. !
SIR,Permit me to address yonupon a subject loudly calling for theinterference of the Governors of theLondon Hospitals generally, namely,the appointment of the HOUSE SUR-GEONS. It is notorions, that any man,however ignorant of his prefesbion, ordull in his natural abilities, by becom-ing a perpetual pupil, ib considered
fully competent to the arduous dutiesof the office in question, when it comesto his turn. Knowing the importanceand responsibility of the situation, andat the same time being aware of themany instances of gross ignorance andneglect that are constantly occurringin the Metropolitan Hospitals, (for Iexcept none of them) ; are they not(the Surgeons) highly culpable in notendeavouring, by some means or other,to put a stop to a system that mustultimately be productive of disgrace,if not ot rntn, to those institutions ?Now, Sir, to remedy this evil, I wouldsuggest that the six senior- claimantsshould be examined (if not alreadymembers of the College of Surgeons),and that person should be deemedeligible who has made the greatestprogress in anatomy and surgery. Iti.s not in the nature of things that astripling, a mere boy, very often withlittle more in his head than a fond re-membrance of his school antics, can,in the conrse of (in some instances)a few months, be fit to nndertake acharge, which at all timea, whetherin public or private practice, requiresa certain tact that is only obtained bypractice and observation. On theother hand, I do not mean to say thata House Surgeon can be expected tobe a thoroughly experienced surgeon;undoubtedly not; hilt I rfrtaintv think
that a person filling such a situationthat a person filling such a situationeught to have a good foundation laid,as ar as anatomy and the commoncase--, in surgery go. I have heard iturged, and that, too, by men whocught to know better, that it is notnecessary for a House Surgeon toknow more than any other pupil,because he is entirely guided by theSurgeons. Now the absurdity of sucha remark is too evident to need refu-tation. Does it not fiequently fall tothe lot of a House Surgeon to applythe taxis, to reduce a dislocation ofthe jaw, or thumb, and twenty otherminor, but very important operations.When myself a pupil, I have morethan once witnessed the irreparablemischiet that has been produced bythe ignorance and want ot anatomicalknowledge displayed in an attempt toreduce a hernia. I might mentionmany instances of irreparable injuryto patients from the ignorance of
I House Surgeons, but shall at preseut
forbear troubling you farther tlian toexpress my hope that we shall, erelong, by the timely application of yourinvaluable LANCET, see a stop pnttoall the abnses ofthe London hospi-tals, one of the greatest of which thesubject of my present communicationmay be considered.
A MEMBER OF THE COLLEGEOF SURGEONS.
Sept 1, 1825.
To tile Editor of THE LANCET.
SIR,The case of aneurism relatedin the last number of THE LANCET,is one of the many in Middlesex Hos-pital, as well as other Institutions, inwhich individual gratification and ad-vantage superseded every other con-sideration. How long the Governorsof Middlesex Hospital will remain in-different to the uue interest of theCharity is not for me to determine,bnt a more gross violation of theirlaws and regulations, for the purposeof procuring a preparation for Mr.BELLS new Museum, is not upon re-cord. I shall be glad to be informed,whether. in the event of the Surgeousof an Institution finding that theirpractice upon investigation has beenthe object of censure, are entitled toa8mit patients without hope of benefit,for the purpose of making prepara-tions, and whether such preparationsbeing sold, the Hospital is not entitledto part of the sum received for thesame.
Mr. BELLs interest in the Hospitalhas frequently been exemplified in amanner not creditable to his veracity;but the circumstance of his havinggone to Scotland, wituout leavmg aperson willing to perform a capi-tal operation, is rather surprising.That such is the case at the presenttime, no one will ba inclined to doubtwho are acquainted with the namesof JOE BURNS and JOHN SHAW, or, asthey are termed, the senior and juniorJoss. A patient was placed underthe care of the latter gentleman sometime ago, he agreed to submit to theoperation of lithotomy, and for someweeks has repeatedly requested youngJOE to perform the operation, but nopersuasion can induce him to attemptsuch an operation, until his brother.in-law returns. I trust, Sir, you will
continae to exert yew talents in thecause of humanity, and thereby eBa-bte the juniors of tire - profession toform -an estiniate of men who, indiffe-rent to the interest of fheir fellowcreatures, perform operations for thepdrpose of exhibiting their mechanical- powers, regardless of the time whensuch operatiom onght to be performed.
I am, Sir,A PUPIL OF MIDDLESEX HOSPITAL.
Sept. 5, 1825.
Chronic Tumour of the Breast.There is, perhaps, no class of dis-
eases so perplexing, or in which s&mtrch difficulty is experienced, in ar-riving at a correct diagnosis, as intumours of the breast at their firstcommencement; take, for example,the following case, and we cah onlyconceive it to be that practical tactwhich is not communicable by words,and therefore dies with its possessor,which could enable Sir A. COOPER todecide that the tumour in questionwas not of a scirrhons nature.The patient is a woman about 49
years of age, of healthy appearance,dark complexion, and of spare habit ;she has been the mother of two chil-
dren, and her menstrual dischargehas not yet ceased. She states, thatshe first perceived a small knob inthe breast about five months since,which has gone on gradually iucreas-ing, without any lancinating pain, butwith occasional uneasiness, and moreespeciallv at the periods of menstrn-ation. The tnmonr in the breast is ofabout the size of the palm of the hand;it is flat and has an uneven lobulatedfeel, as if it were formed of a seriesof conglomerate glands, firmly com-pacted together ; the edges are irre-gutar, or tuberculated, and it has astony hardness. The greater part ofthe tumour is situated above the nip-pte, and is perfectly moveable, notconnected with the parts below, andonly connected with the integuments