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think the new Medical Act will do more harm to the medicalprofession in England than any Act that has ever been passed,and it will undoubtedly lower the status of every member ofthe profession, and the overcrowding will be increased. Ihave written to two members of Parliament in reference tothe registration of foreign diplomas. One of them replied asfollows : °‘ It is notorious that foreign diplomas may be hadon easy terms, and it is unfair to class them as equal to ourown." The other member answered my letter thus :-" I ascertained that the leading members of the medicalprofession do not object to these being registered providedthis is done in a separate list, so that there may be no con-fusion between British and foreign diplomas." The holdersof foreign diplomas will not care for this so long as they cantell the public that they are on the Medical Register, and as tothe opinion of the leading members of the profession/MedicalBills do not affect them as they do the mass of the profession,the general practitioners; and every Bill brought in oughtto be on behalf of the profession ; and although in the newMedical Bill the general practitioners have gained fiverepresentatives, they have paid too dearly for it in allowingforeign diplomas to be registered. I have no personalinterest in this matter, as I have been a good many years inthe profession, and have realised a competency, and have agood social and professional position; but for the sake of therising young members of the profession who have been re-quired to pass severe examinations, and who have to contendwith an overcrowded profession, I do not see that theyshould be still further overweighted by admitting foreigndiplomas, and I advise them to be up and doing, and inter-view their member of Parliament, and ask him to use hisinfluence to repeal the clause bearing on foreign diplomas.

I am, Sir, yours truly,A GRADUATE OF A SCOTCH UNIVERSITY.

(Possessor of three English and three ScotchAugust 30th. diplomas, all of them registered.)

A GRADUATE OF A SCOTCH UNIVERSITY.(Possessor of three English and three Scotch

diplomas, all of them registered.)

To the Editor of THE LANCET.SIR,—Your correspondent, "An M.D., of New York," in

contrasting an American degree with the M.D. Brussels,asks which is the more reliable qualification. I unhesitat-

ingly say the M.D. Brussels ; for, according to the rules ofthe Brussel’s University, none but qualified practitioners areadmitted to its examinations. This in itself is a guaranteethat all candidates for its degree are men who have spentat least four years at a recognised medical school, and havesuccessfully undergone the various examinations at someone or other licensing board and evinced their fitness topractise prior to their degree examination. When I addthat out of these picked and qualified men at least from 30to 50 per cent. are invariably rejected, it goes without

saying that the lame, the halt, and the failures of other uni-versities and corporations, who are apt to knock from doorto door until they find an indulgent alma mater, have no placewhatever here. Men selected and approved by a searchingexamination from amongst already British qualified prac-titioners, whose very qualifications bespeak a certain amountof knowledge and training, can only secure the degree, forM.D. Brussels not only implies a higher examination, but aBritish qualification as well. Can "An M.D. of New York"claim as much for an Ameiican degree ?

I am, Sir, yours faithfully,Aug. 28th, 1886. AN M.D. OF BRUSSELS.AN M.D. OF BRUSSELS.

THE INCUBATION PERIOD AND DURATION OFINFECTIOUSNESS OF DIPHTHERIA.

To the Editor of THE LANCET.SIR,— Your correspondent, Dr. Pearse, is mistaken in

saying that "no observations seem to be recorded" as to theincubation period of diphtheria. In a paper contributed byme in 1878 to the St. George’s Hospital Reports (vol.ix., p. 711)are recorded three cases in which an attack of diphtheriafollowed a single exposure to a source of infection; in onethe incubation period was two days, in a second four days,and in the third :6.ve days. In that same paper are alsorecorded eight other cases in which the exposure to possibleinfection had not been limited to a single occasion, so thatonly the outside limit of the incubation period could be de-termined ; in none of these eight cases did the interval

between the first exposure and the attack exceed a week,being in three cases two days, and in single cases one, three,five, six, and seven days severally. In one other case therewas reason to believe that the incubation period was at leasteleven days.In the same paper will be found several observations as to

the duration of infectiousness of diphtheria-that is, as to thetime during which a person who has had diphtheria iscapable of communicating the disease to others, and theseobservations appear to me to show conclusively that theinfectiousness attaches to a patient for a much longer periodthan three weeks, which is the term assigned to it by Dr.Pearse. I am, Sir, yours obediently,

WILLIAM OGLE.Gordon-street, Gordon-square, Aug. 31st, 1886.

To the Editor of THE LANCET.SIR,—Dr, Pearse fixes the incubation period of diph-

theria at fourteen days. Two years ago I had twocases under my care, in which I found it to be two

days only after exposure to the poison. Other prac- titioners will no doubt be able to calculate the periodin cases they have treated. The treatment I have foundmost efficacious in cases of this nature is that by thebiniodide of mercury in solution of potassic iodide, followed,on disappearance of the membranous effusion, by steel andchlorate of potash. Thus: Solution of bichloride of mer-cury, one ounce; iodide of potassium, half a drachm;citrate of ammoniated iron, one drachm; chloric ether, twodrachms; water to eight ounces. One tablespoonful everytwo hours. 1 am, Sir, your obedient servant,Clayton-Ie-Moors, Aug. 29th, 1886. C. R. ILLINGWORTH, M.D.

To the Editor of THE LANCET.SIR,—In your issue of August 28th two cases are

cited in which the incubation period of diphtheria wouldappear to have been about forty-eight hours. In connexionwith the same subject I send you a note recorded about threeyears ago :-

F. B--, one of a numerous family, had a very severeattack of diphtheria. The other children were at once

removed, and on the patient’s recovery the house was

well fumigated by the burning of sulphur, and, in

addition, there was much washing with carbolic acid. Therooms were also repapered and whitewashed. The patientwas sent away, and after he had been absent for twenty-five days three children of the same family were allowed toreturn. On the eighth day after their return I was calledto the house, and found two out of the three with well-marked diphtheritic patches on the throat. They hadremained quite well until the previous day.

I am, Sir, faithfully yours,East Grinstead, Aug. 30th, 1886. JOHN MAGRATH, M.D.

WILLIAM OGLE.

C. R. ILLINGWORTH, M.D.

JOHN MAGRATH, M.D.

EDINBURGH.

(From our own (Correspondent.)

POST-GRADUATE COURSE IN EDINBURGH.

IN a former notice of this course of demonstrations oneor two particulars were omitted which have since becomemore definitely known. In consequence of a statement oftheir opinion to that effect, it has been decided to adopt.the view of the managers of the Royal Infirmary, that nofee should be expected from those who attend the course.Another item of some importance is, that the demonstrationsare to be thrown open to all practitioners of medicine, andare not to be confined to graduates of the Edinburgh school,as was at one time in contemplation. In addition to thethirteen clinical and practical courses already alluded to inprevious notices, arrangements have now been madefor a complete series of demonstrations in bacteriology.These demonstrations, six in number, will be held in thepathological department at the new University Build-

ings, under the auspices of Professor Greenfield, and will beof as practical a nature as can be made consistent with afairly exhaustive treatment of the subject. A large number

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of inquiries as to the arrangements of the classes have beenalready received, and numerous intimations of their inten-tion to be present, from medical practitioners at a distance.The committee, however, are anxious that all who intend totake part in the course should communicate their intentionas soon as possible to one or other of the secretaries--Dr.Muirhead and Professor Chiene (Charlotte-square), so thatadequate arrangements for their reception may be completed.

THE CITY FEVER HOSPITAL.

After a prolonged period of waiting, the Town Councilhave at length resolved to give effeet to the repeatedrecommendations of the city medical officer of healthand vote a reasonable sum as an honorarium to thevisiting physician to the City Fever Hospital. Thisdecision has been rapidly followed by the appointment of awell-known Edinburgh physician to the vacant post.Dr. W. Allan Jamieson has accepted the post, and his

appointment is one that will give general satisfactionhere; and especially so as Dr. Jamieson has in his develop-ment of the Dermatological Department of the RoyalInfirmary proved himself an able clinical teacher, and istherefore one who may be looked to as a clear exponent ofdiseased conditions, who will not lose opportunities of im-parting instruction as soon as the authorities recognise theabsolute necessity of opening their fever wards for thepurposes of clinical teaching.Edinburgh, Aug. 31set. __

IRELAND.

(From our own Correspondent.)

THE Chair of Surgery in the Queen’s College, Belfast, hasbecome vacant, and applications for the post must be for-warded to the Under-Secretary at Dublin Castle not laterthan the 7th inst.

THE EPIDEMIC OF FEVER IN HARE ISLAND.

The patients attacked with typhus are doing well, butfrom a report of Dr. Hadden, dated Aug. 21st, it appearsthat another woman has contracted the disease, and hasbeen admitted to hospital. One of the nursing sisters alsohas caught the infection, and has been removed to Skib-bereen. The notice of motion given by one of the guardiansof Skibbereen Union, that a medical man should reside onthe island, has been withdrawn, as the proposed arrange-ment could not be carried out.

ROYAL UNIVERSITY OF IRELAND.

The Senate will, at its meeting in October, consider theappointment of one Fellow in the department of Medicine.The salary will be S100 a year, provided always that if anymedical Fellow shall hold any fellowship or professorship inany other university, or college, he shall receive only suchsum, not exceeding £100 yearly, as with the salary of theother fellowship or professorship shall amount to .64:00 perannum. The office is tenable for seven years, and the Senateappoint by open voting. As regards the duties to be per-formed, every medical Fellow holds his fellowship uponcondition that he shall act as an examiner at the medicalexaminations of the University, and shall be bound, in con-junction with any other persons whom the Senate may add,to conduct the medical examinations of the Universitywithout further payment, save for expenses. It is probablethat the contest for a member of the Senate, in the vacancycaused by the decease of Mr. Curtis, will mainly lie betweenDr. Whitla, and Major Fitzgerald, a distinguished graduateof the University.

STROKESTOWN DISPENSARY.

In consequence of the sudden death of Dr. Murray, anelection for a medical officer took place last week, andDr. Duffy was appointed by a majority of votes. So greatwas the excitement in connexion with the election that theauthorities considered it advisable to draft a number ofextra police into the town from Athlone and other places.

LUNACY IN IRELAND.

The report for 1884 was not issued until February last,but the inspectors of lunatic asylums in Ireland on thisoccasion have published their report for 1885 with greaterpunctuality. A total of 14,279 persons were registered

as being mentally affected at the beginning of last year ;in the course of which, in addition to 9687 being locatedin district asylums, 2850 cases were admitted. Of theselatter, 2240 were cases of first attack, and 610 relapses.From the proportion of recoveries on the daily average ofpatients, it would appear that about eighteen individuals inevery 100 were directly benefited in a curative or ameliora-tive point of view from district asylum treatment; but ifestimated on the basis of admissions, at about 53 per cent.The deaths numbered 856, and were somewhat lower thanthose which occurred in the previous year; four of thesewere suicidal. The inspectors justly refer to the inadequatepay and allowances granted to the subordinate residentstaffs attached to district asylums, and they are of opinionthat their position admits of a more liberal consideration,taking into account the irksome, responsible, and not in-frequently dangerous occupations in which they are un-ceasingly engaged. The cost of supporting district asylumslast year was £216,799 17s. 4d., or at the rate of .821 19s. 5d.per inmate, being a decrease of 1:1 Is. 6d. per head ascompared with the previous year. In poorhouses, 3733persons, composed of lunatics, aged, utterly demented andtranquil, were located last year. Latterly, at some unionboards, a strong feeling has been expressed that theinsane of all denominations should be transferred todistrict asylums-a scheme which, if carried out, wouldentail a large outlay on new buildings, or on extensiveadditions to the existing ones, independent of an increasedlocal taxation and a fresh call on the Government rate inaid. Some years ago it was proposed to erect large pro-vincial receptacles for idiots, epileptics, and dementedlunatics, but the project was abandoned from the likelihoodof its failure. In the inspectors’ report they state theirobjection to these depots, as, independent of the outlayfor their construction, the number of counties and citiesattached to them would cause much embarrassment in theirworking, with continuous and unavoidable expenses andinconveniences consequent upon the conveyance and returnof patients at the desire of their friends to and from remote -localities, distant perhaps 100 or 130 miles. The full estab-lishment cost of each for 800 or 1000 inmates might bereasonably estimated at from .625,000 to .630,000.

Dublin, Aug. 31st. _________________

MEDICAL NOTES IN PARLIAMENT.

The Tentilation of the House.IN the House of Commons on the 26th ult., Air. Plunket,

n reply to Mr. R. Cooke, said the Committee on the Ventila-;ion of the House had been reappointed, and had held itsirst meeting. He was authorised to state that they weresatisfied with the recommendations in the second report ofhe previous select committee. These recommendationswould be carried out with as little delay as possible, and hehoped the works would be completed before the reassemblingof Parliament.

The proposed Small-pox Hospital.On the 27th ult. Mr. Pickersgill, who had given notice to

ask the President of the Local Government Board whetherhe had received protests from several metropolitan boardsof guardians against the proposal of the MetropolitanAsylums Board to erect a permanent small-pox hospital atGore Farm, Darenth, at an estimated cost to the ratepayersof S116,000; whether he was aware that it was proposed tohold a conference of the metropolitan guardians at an earlydate to consider the question; and whether he would with-hold the assent of the Local Government Board to the pro-posed expenditure, at all events until this conference hadbeen held,- said he had now been informed that the LocalGovernment Board had refused its assent. He wished toknow if that was correct. In reply, Mr. Ritchie stated thatit’was quite correct.

The Metropolitan Asylums Board.On the 30th ult., in reply to Mr. Pickersgill, Mr. Ritchie

stated that it is the fact that the accommodation providedfor imbecile children by the Metropolitan Asylums Board isat present insufficient for the needs of the metropolis. Themanagers are now, however, extending the schools for im-becile children at Darenth, and he understood that thebuildings will be completed this summer. It is expected