the royal college of surgeons and the university of london

1
1248 some appropriate manner, and be accompanied by a sub- stantial contribution to the funds of Professor Koch’s Insti- tute of Pathological Investigation ? ’{ I am, Sirs, yours faithfully, Berlin, Nov. 29th, 1890. faithfully, W. BEZLY THORNE. . To the Editors of Ti-iE LANCET. SiRS,-Adverting to Dr. Strahan’s letter which appears in THE LANCET of Nov. 29th, and in the second paragraph thereof, the views expressed regarding the etiology of tuberculosis are so closely allied to the principles on the same subject advanced many years ago by leading Con- tinental pathologists, that I trust I may be pardoned for drawing attention to the fact. At the same time, I am quite aware that men often arrive at similar conclusions, even though it may be at different times. In support of such fact I may say that I remember, when some years ago being called upon to review a medical work, I was about to give expression to such views as are now embodied in Dr. Strahan’s letter, but upon looking up authorities I then became aware that such views might fairly be con- sidered’pathological axioms, in which case I referred to such leading authorities in the following manner :- 11 ...... but we do assign the two causes which we have mentioned-i.e., insanitary influences and the abuse of alcohol-as the chief factors in preparing a fertile ground for all forms of phthisis pulmonalis. This ’misere phy- siologique’ of Bouchardat links us very closely with the theory of Virchow, Koch, and others, that the germ of phthisis is not inherited as that of syphilis may be, but that a certain condition is which but waits, as we assert such noxious influences as are herein cited to have phthisis ’ aroused in all its forms. We do not consider that this view limits us to the idea of spontaneity in the origin of such organism, for is it not possible, and even per- missible, to imagine that, amidst the hosts of pathogenic germs arising from insanitation, some form which can find no fertile ground in the lungs of the healthy may in the effete lung tissue of the miserable find a soil and pabulum, wherein, through some metamorphosis, it becomes revealable subsequently as the tubercle bacillus?" The theory of Professor Bouchardat regarding "physiological misery," though not acceptable in its entirety as the origin of the bacillus in question, is, through the influence of later lights, shaking off a good deal of the adverse criticism that was bestowed upon it, owing to its collateral deductions, and is nov being accepted each day more surely as a funda- mental basis in disease etiology, and is in the fullest sense as acceptable as it is justly extensive in such application. I am, Sirs, yours obediently, Dublin, Dec. 1st, 1890. C. E. MACNAMARA. MYTABRIS FULGURITA AND HYDROPHOBIA IN EGYPT. 1’0 the Editors of THE LANCET. SIRS,-In THE LANCET of Nov. 22od, your Egypt corre- spondent, speaking of cases of hydrophobia in Cairo, said that "one of the arguments in favour of hydrophobia existing occasionally in Egypt is that the natives have a remedy for it dating from the old Arab physicians." And he adds that: "It is a beetle of the cantharides family, which causes the patient to urinate and evacuate blood..." It may be of interest, perhaps, to some of your readers to know that it was after an inquiry made by me in 1876, when I was chief medical officer of health at Lagazoz, that it was ascertained that an insect was used among the Bedouins of the environs of Ismailia as a preservative against and a remedy for hydrophobia ; that this insect belongs to the genus Mytabris, and it was determined, on my request, by the kindness of Professor Adolfo Targioni Tozzetti of Florence, as Mytabris fulgurita reiche; that this insect produces a sort of cystitis, which causes the emission of some sanguineous and fibrinous clots ; and lastly, that the use of this substance is a proof that hydrophobia has for a long time been known in Egypt. I have given a full account of my inquiry in a letter to Professor Targioni, and published by him in the Bullettino Entomologica, anno viii., 1876. I am, Sirs, yours faithfully, Pisa, Italy, Nov. 29th, 1890. P. SONSINO. FEES FOR MEDICAL ATTENDANCE ON THE POLICE. To the Editors of THE LANCET. SIRS,-A meeting of the medical attendants on the police in the county of Kent was held on Friday, Nov. 28th, at Ashford, Dr. George Wilks in the chair. It was resolved unanimously : 1. "That the medical men here present, repre- senting the medical practitioners of Kent who were in the habit of attending the police, do enter their earnest protest against the scale of fees recently propounded by the Standing Joint Committee of Kent. 2. That they consider the scale of fees in use in East Sussex the most satisfactory form of remuneration for attendance on police in Kent-viz., advice and medicine at residence of medical gentleman, a fee of 2s. 6d. visit, advice, and medicine within an area. of one mile from residence, a fee of 3s. 6d. the sum of Is. to be allowed for each additional mile. Fees to be doubled for medical attendance in the night-viz., from 10 P.M. to 7 A.M. ; ; Is. to be allowed for each certificate. Special cases, such as fractures, dislocations, injuries, and operations, to be charged for as in ordinary prac- tice. No additional charge to be made for medicine. Note, mileage can only be charged one way. The allow. ance of double fees at night does not include mileage. 3. That a deputation of three be elected to represent to the Standing Joint Committee the views of this meeting of the practitioners of Kent, and to ask the committee to adopt the code of East Sussex. 4. That the following gentlemen form the deputation : Mr. Thurston, Ashford; Dr. Allan, Tonbridge ; Dr. Hoar, Maidstone. The meeting hopes that any memorials which are being signed may be forwarded without delay to one of the members of the deputation for presentation. The above are the minutes of the meeting of which I sent you notice last week, and of the result of which I promised to inform you.-I am, Sirs, yours faithfully, Maidstone, Nov. 29th, 1890. CHARLES E. HOAR. THE ROYAL COLLEGE OF SURGEONS AND THE UNIVERSITY OF LONDON. To the Editors of THE LANCET. SlRS,-It has come to my knowledge that the Council of the College of Surgeons is now making final negotiations with the Senate of the University of London concerning the proposal to grant a degree under circumstances which cannot but prove prejudicial to the interests of all con- cerned, except the Board of Examiners and Council of the College of Surgeons. It seems to me that the Council of the Association of Fellows of the College ought to be at once summoned to present a remonstrance to both bodies against the conclusion of negotiations till the voice of the Fellows of the College has been heard. I very strongly urge that immediate and strong steps be takan. I am, Sirs, yours faithfully, Dec. 3rd, 1890. LAWSON TAIT. "LANCING ’ASLEEP.’" To the Editors of THE LANCET. SiRS,-My attention has been called to an article in your issue of Nov. 29th, headed "Lancing ’Asleep,’" and as people who are not acquainted with the locality may think that there is a connexion between Lancing College and the grammar school referred to in the paragraph, by which the reputation of this college may suffer, will y ou oblige me by inserting in your next issue the following :-That Lancing College is situated on a chalk hill some 160ft. above the sea, that it is two miles from Lancing-by-the-Sea, and that the college has a drainage system of its own independent of the neighbourhood. The whole of the college drainage system is periodically visited by the medical officer of health, Dr. Kelly, and in September last he certified that he found all the sanitary arrangements in a very satisfactory condition. The buildings which were a grammar school at Lancing-by-the- Sea were wholly unconnected with Lancing College. I am, Sirs, yours very faithfully, HARRY W. MCKENZIE, Head Master. Lancing College, Shoreham, Sussex, : Dec. 2nd, 1890.

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Page 1: THE ROYAL COLLEGE OF SURGEONS AND THE UNIVERSITY OF LONDON

1248

some appropriate manner, and be accompanied by a sub-stantial contribution to the funds of Professor Koch’s Insti-tute of Pathological Investigation ? ’{

I am, Sirs, yours faithfully,Berlin, Nov. 29th, 1890.

faithfully,

W. BEZLY THORNE.

. To the Editors of Ti-iE LANCET.

SiRS,-Adverting to Dr. Strahan’s letter which appearsin THE LANCET of Nov. 29th, and in the second paragraphthereof, the views expressed regarding the etiology oftuberculosis are so closely allied to the principles on thesame subject advanced many years ago by leading Con-tinental pathologists, that I trust I may be pardoned fordrawing attention to the fact. At the same time, I amquite aware that men often arrive at similar conclusions,even though it may be at different times. In support ofsuch fact I may say that I remember, when some yearsago being called upon to review a medical work, I was aboutto give expression to such views as are now embodied inDr. Strahan’s letter, but upon looking up authorities Ithen became aware that such views might fairly be con-sidered’pathological axioms, in which case I referred tosuch leading authorities in the following manner :-

11 ...... but we do assign the two causes which we havementioned-i.e., insanitary influences and the abuse ofalcohol-as the chief factors in preparing a fertile groundfor all forms of phthisis pulmonalis. This ’misere phy-siologique’ of Bouchardat links us very closely with thetheory of Virchow, Koch, and others, that the germ ofphthisis is not inherited as that of syphilis may be, butthat a certain condition is which but waits, as we

assert such noxious influences as are herein cited to havephthisis ’ aroused in all its forms. We do not considerthat this view limits us to the idea of spontaneity in theorigin of such organism, for is it not possible, and even per-missible, to imagine that, amidst the hosts of pathogenicgerms arising from insanitation, some form which can findno fertile ground in the lungs of the healthy may in theeffete lung tissue of the miserable find a soil and pabulum,wherein, through some metamorphosis, it becomes revealablesubsequently as the tubercle bacillus?" The theory ofProfessor Bouchardat regarding "physiological misery,"though not acceptable in its entirety as the origin of thebacillus in question, is, through the influence of laterlights, shaking off a good deal of the adverse criticism thatwas bestowed upon it, owing to its collateral deductions,and is nov being accepted each day more surely as a funda-mental basis in disease etiology, and is in the fullest senseas acceptable as it is justly extensive in such application.

I am, Sirs, yours obediently,Dublin, Dec. 1st, 1890. C. E. MACNAMARA.

MYTABRIS FULGURITA AND HYDROPHOBIAIN EGYPT.

1’0 the Editors of THE LANCET.

SIRS,-In THE LANCET of Nov. 22od, your Egypt corre-spondent, speaking of cases of hydrophobia in Cairo, saidthat "one of the arguments in favour of hydrophobiaexisting occasionally in Egypt is that the natives have aremedy for it dating from the old Arab physicians." Andhe adds that: "It is a beetle of the cantharides family,which causes the patient to urinate and evacuate blood..."It may be of interest, perhaps, to some of your readers toknow that it was after an inquiry made by me in 1876, whenI was chief medical officer of health at Lagazoz, that it wasascertained that an insect was used among the Bedouins ofthe environs of Ismailia as a preservative against and aremedy for hydrophobia ; that this insect belongs to thegenus Mytabris, and it was determined, on my request, bythe kindness of Professor Adolfo Targioni Tozzetti ofFlorence, as Mytabris fulgurita reiche; that this insectproduces a sort of cystitis, which causes the emission ofsome sanguineous and fibrinous clots ; and lastly, that theuse of this substance is a proof that hydrophobia has for along time been known in Egypt.

I have given a full account of my inquiry in a letter toProfessor Targioni, and published by him in the BullettinoEntomologica, anno viii., 1876.

I am, Sirs, yours faithfully,Pisa, Italy, Nov. 29th, 1890. P. SONSINO.

FEES FOR MEDICAL ATTENDANCE ON THEPOLICE.

To the Editors of THE LANCET.SIRS,-A meeting of the medical attendants on the police

in the county of Kent was held on Friday, Nov. 28th, atAshford, Dr. George Wilks in the chair. It was resolvedunanimously : 1. "That the medical men here present, repre-senting the medical practitioners of Kent who were in thehabit of attending the police, do enter their earnest protestagainst the scale of fees recently propounded by theStanding Joint Committee of Kent. 2. That they considerthe scale of fees in use in East Sussex the most satisfactoryform of remuneration for attendance on police in Kent-viz.,advice and medicine at residence of medical gentleman, afee of 2s. 6d. visit, advice, and medicine within an area.of one mile from residence, a fee of 3s. 6d. the sum of Is.to be allowed for each additional mile. Fees to be doubledfor medical attendance in the night-viz., from 10 P.M.to 7 A.M. ; ; Is. to be allowed for each certificate.Special cases, such as fractures, dislocations, injuries,and operations, to be charged for as in ordinary prac-tice. No additional charge to be made for medicine.Note, mileage can only be charged one way. The allow.ance of double fees at night does not include mileage.3. That a deputation of three be elected to represent to theStanding Joint Committee the views of this meeting of thepractitioners of Kent, and to ask the committee to adoptthe code of East Sussex. 4. That the following gentlemenform the deputation : Mr. Thurston, Ashford; Dr. Allan,Tonbridge ; Dr. Hoar, Maidstone. The meeting hopes thatany memorials which are being signed may be forwardedwithout delay to one of the members of the deputation forpresentation.The above are the minutes of the meeting of which I sent

you notice last week, and of the result of which I promisedto inform you.-I am, Sirs, yours faithfully,

-- .

Maidstone, Nov. 29th, 1890. CHARLES E. HOAR.

THE ROYAL COLLEGE OF SURGEONS ANDTHE UNIVERSITY OF LONDON.

To the Editors of THE LANCET.

SlRS,-It has come to my knowledge that the Council ofthe College of Surgeons is now making final negotiationswith the Senate of the University of London concerning theproposal to grant a degree under circumstances whichcannot but prove prejudicial to the interests of all con-cerned, except the Board of Examiners and Council of theCollege of Surgeons. It seems to me that the Council ofthe Association of Fellows of the College ought to be atonce summoned to present a remonstrance to both bodiesagainst the conclusion of negotiations till the voice of theFellows of the College has been heard. I very strongly urgethat immediate and strong steps be takan.

I am, Sirs, yours faithfully,Dec. 3rd, 1890. LAWSON TAIT.

"LANCING ’ASLEEP.’"To the Editors of THE LANCET.

SiRS,-My attention has been called to an article in yourissue of Nov. 29th, headed "Lancing ’Asleep,’" and aspeople who are not acquainted with the locality may thinkthat there is a connexion between Lancing College and thegrammar school referred to in the paragraph, by which thereputation of this college may suffer, will y ou oblige me byinserting in your next issue the following :-That LancingCollege is situated on a chalk hill some 160ft. above thesea, that it is two miles from Lancing-by-the-Sea, and thatthe college has a drainage system of its own independent ofthe neighbourhood.The whole of the college drainage system is periodically

visited by the medical officer of health, Dr. Kelly, and inSeptember last he certified that he found all the sanitaryarrangements in a very satisfactory condition. Thebuildings which were a grammar school at Lancing-by-the-Sea were wholly unconnected with Lancing College.

I am, Sirs, yours very faithfully,HARRY W. MCKENZIE, Head Master.

Lancing College, Shoreham, Sussex, :Dec. 2nd, 1890.