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742 Medical Diary of the Week. Monday, June 8. St. MARK’S HOSPITAL.-Operations, 9 A.M. and 1l P.M. RoYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10t A.M. METROPOLITAN FREE HOSPITAL.-Operations, 2 p.M. ROYAL COLLEGE OF SURGEONS OF ENGLAND.--4 P.M. Prof. F. Le Gros Clark, " On the Principles of Surgical Diagnosis, especially in reference to Shock and Visceral Lesions." Tuesday, June 9. ROYAL FREE HOSPITAL.-Operations, 9 A.M. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M. GvT’s HOSPITAL.-Operations, It P.M. WESTMINSTER HOSPITAL.-Operations, 2 P.M. NATIONAL ORTHOPÆDIC HOSPITAL.-Operations, 2 P.M. ROYAL INSTITUTION.--3 P.M. Dr. M. Foster, "On the Development of Animals." ETHNOLOGICAL SOCIETY OF LONDON.-8 P.M. "On the Chinese Notation of Time." By Mr. C. B. Wade.-" On the Migration and Historj of Coffee, Tea, Cocoa, &c." By the late Mr. John Crawfurd. ROYAL MEDICAL AND CHIRURGICAL SOCIETY. - 8 P.M. Ballot for Honorary and Ordinary Fellows.-8½ P.M. Mr. John Birkett, " On Sero-Sanguineous Cysts in the Neck and Axilla." Mr. T. Bryant, " On the Torsion of Arteries as a Means of Arresting Haemorrhage." Wednesday, June 10. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M. MIDDLESEX HOSPITAL.-Operations, 1 P.M. t ST. BAMHOLOMBW’8 HOSPITAL.-Operations, Ii P.M. ST. THOMAS’S HOSPITAL.-Operations, 1½ P.M. ST. MARy’S HOSPITAL.-Operations, 1¼ p.M. GREAT NORTHERN HOSPITAL.-Operations, 2 P.M. UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M. LONDON HOSPITAL.-Operations, 2 P.M. OPHTHALMIC HOSPITAL, SOUTHWARK.-Operations, 2 P.M. ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Prof. F. Le Gros Clark, " On the Principles of Surgical Diagnosis, especially in reference to Shock and Visceral Lesions." Thursday, June 11. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations,10½ A.M. CUNTEAL LONDON OPHTHALMIC HOSPITAL.-Operations, 1 P.M. ST. GzoRGE’i3 HOSPITAL.-Operations, 1 P.M. UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M. WEST LONDON HOSPITAL.-Operations, 2 P.M. RoYAL OTHOPÆDIC HOSPITAL.-Operations, 2 P.M. ROYAL INSTITUTION.-3 P.M. Sir John Lubbock, Bart., " On Savages." Friday, June 12. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M. ROYAL FREE HOSPITAL.-Operations, 13 P.M. WESTMINSTER OPHTHALMIC HOSPITAL.—Operations, 1½ P.M. ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Prof. F. Le Gros Clark, " On the Principles of Surgical Diagnosis, especially in reference to Shock and Visceral Lesions." ROYAL INSTITUTION. - 8 P.M. Prof. Frankland, "On the Source of Light in Luminous Flames :’ Saturday, June 13. ST. THOMAS’S HOSPITAL.-Operations, 9½ A.M. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M. ST. BARTHOLOMEW’S HOSPITAL.-Operations, 1½ P.M. KING’S COLLEGE HOSPITAL.-Operations, 1½ P.M. CHARING-OROSS HOSPITAL.-Operations. 2 P.M. ROYAL INSTITUTION.-3 P.M. Sir John Lubbock, Bart., "On Savages." To Correspondents. WORKHOUSE SLOPS. CONSIDERABLE obloquy has been east upon Dr. Markham for his formula for making tea for the sick and aged in the metropolitan workhouses. The public, however, should not be too hard upon him. One ounce of tea to eight pints of water is a great advance upon the formula issued by the Poor-law Board, which consists of one ounce of tea (at any cost per lb.) to fourteen pints of water, a little brown sugar, and no milk. This non- inebriating and doubtfully refreshing beverage was formerly dispensed universally to the aged and sick poor, and is still their fare in the pro- vincial workhouses. Mr. Alexander Stevenson.-The case as stated by our correspondent is an unusual one, and would, no doubt, be of interest if scientifically related. Mr. W. H. Beekett’s question will be fully answered next week. MEDICAL FEES. To the Editor of THE LANCET. SIR,-Will you kindly answer the following queries in the next nnn ber of your journal :- A medical man is retained to attend a lady in her confinement. From un- explained causes she leaves her residence, and engages another doctor to attend her, without letting the first one retained know of her intention. Can the latter recover his fee in a court of law ? Are there any cases recorded, and when and where tried ? Yours faithfully, June 2nd, 1868. SAM. DAY Goss, M.D. *t* The practitioner can recover his fee’under such circumstances. Cases are on record. The plaintiff in one was Dr. Lavies, of Warwick. square. FIBROID PHTHISIS. W. T. B.-The above term is used by Dr. Andrew Clark in a sense peculiar to himself. He confines it to those cases in which the lung, invaded by fibroid tissue, and traversed by dilated or contracted bronchi, contains secondary cheesy deposits which have broken np into cavities. To the lung merely contracted and hardened by fibroid tissue, he gives the name of cirrhosis (Corrigan), or fibroid degeneration (Sutton). The disease is either the local expression of a constitutional state, such as rheumatism, syphilis, and alcoholism; or of a local inflammation of the bronchi, pleura, pericar- dium, or lung. With respect to the literature of fibroid phthisis, in the above sense of the term, we can give our correspondent no other reference than to Dr. Andrew Clark’s case read before the Clinical Society, an abstract of which appeared in our columns. But concerning fibroid degeneration, discussed under such names as fibro-cartilaginous degeneration (Laennec), metamorphose fibreuse (Cruveilhier), cirrhosis (Corrigan), fibroid phthisis (Laycock), chronic pneumonia (Charcot), and sclerosis (Jaccoud), we are glad to subjoin references to the more important observations:-Williams: Lectures in Med. Times and Gaz., referred to in article on Dilatation of Bronchi in Library of Medicine. Corrigan (Dublin Jour. of Med., vols. 13 and 38): Cirrhosis. Walshe (]fed. Times and Gaz.) : : Clin. Lect., Cirrhosis, Feb., 1856. Charcot: De la Pneumonie Chronique (Paris, 1860). Laycock: -. Notes on Foetid Bronchitis, with references to cases from 1837 (Edinburgh, 1864). Sutton: Fibroid Degeneration (Medico-Chir. Trans., 1864-5) ; an admirable paper. Feltz: Cirrhose Pulmonaire (Gaz. Méd. de Strasbourg, Nos. 2 and 3, 1865); exceedingly valuable. Jaccoud : Leçons de Clinique Médicale (Paris, 1867). WE are compelled to postpone a notice of the Annual Report of the Health Officer of Bombay till next week. A Country Student.-The suggestion will not be lost sight of. UNQUALIFIED ASSISTANTS. To the Editor of THE LANCET. SIR,-I have perused attentively the letter from your correspondent, "Medicus," on the above subject, and perhaps you will allow me to offer a few remarks on the question. I cannot understand why there should be any necessity for making a new diploma; for out of his salary a gentleman may save the whole 01 his hospital fees, if he be but careful. Moreover, the Apothecaries’ Company of London grants a certificate of fitness to act as assistant, and the fact that very few avail themselves of it, as is shown by the pass-lists which appear in THE LANCET, proves that sober, steady gentlemen do not care for it. Now, it will be asked, how can a man earning from £40 to £50 a year save enough to pay for his diploma? We must inquire what expenses a gentleman has who is assistant. None but dressing himself; so he can clearly save from £20 to jB25 a year without cutting himself down very much. Now, situations can be obtained in London where time is allowed to attend lectures, &c.; and as the fees are paid by instalments, a man, now that apprenticeship is abolished for some licensing bodies, may be qualified in four years. I am acquainted with two instances in which this was the way in which the gen- tlemen obtained their qualifications. The fees to the several hospitals, although high-higher, indeed, than they should be,-are not out of propor- tion. For instance, at Charing-cross Hospital the total fee is £70; at West- minster, £75; at Middlesex, due84; at Guy’s, £90; at Bartholomew’s, .695. Again, the fee is not required to be paid in one sum, but by instalments, as £30 the first year, t30 the second, and £10 the third; so that I see no reason why in five years sufficient money should not have been saved to attend all the hospital practice, lectures, &c, and obtain a diploma. Moreover, are there not already a sufficient number of degrees granted by the several exa- mining bodies without instituting a new one ? What would there be to pre- vent men holding a certificate, such as your correspondent suggests, from practising on their own account ? And who shall define what a minor opera- tion is ? ? I have been assured by several agents that unqualified assistants are dying out, and I hope the day is not far distant when practitioners will no longer dispense their own medicines, and the chemist and doctor shall be distinct from one another. When that day comes only can the profession hope to have that respect paid to it as is done abroad-in France, for instance, where no doctor dispenses his medicines. June, 1868. 1 remain, Sir, your obedient servant, R. H. L. June, 1868. R. H. L. To the Editor of THE LANCET. SIRR,-Seeing that you have allowed us, poor unqualified assistants, to dis- cuss our grievances through the medium of your journal, but which I fear are much too many and difficult to enumerate, why not propose some place of meeting in London, and I would be present, and, although out of situa- tion, will gladly subscribe my mite (say one guinea) towards the formation of an Assistants’ Association, which would then protect honest, steady, and in- dustrious assistants from the many dishonest and drunken blackguards which infest most large towns and cities. Yours truly, June, 1868. BETA. THE twelfth half-yearly Report of the Directors of the London and Pro- vincial Turkish Bath Company states that since the opening of the Bath in Jermyn-street, there have been issued 159,339 daily and 1761 periodical tickets. The Company appears to be in fairly flourishing circumstances ; sufficiently so, at any rate, to warrant the contemplated reconstruction of the premises in Jermyn-street in connexion with the Baths. FEMALE MEDICAL C L U B S. To the Editor if THE LANCET. SIR,-I should feel greatly obliged if any of your readers who are the medi- cal officers of private Female Medical Clubs would inform me what would be a fair payment per annum for attendance on the wife and one child of an agricultural labourer, whose wages are equivalent to 10s. per week. I am about to establish such a Club in my neighbourhood. I am, Sir, your obedient servant, June 3rd, 1868. L.R.C.P. Lond.

Medical Diary of the Week

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742

Medical Diary of the Week.Monday, June 8.

St. MARK’S HOSPITAL.-Operations, 9 A.M. and 1l P.M.RoYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10t A.M.METROPOLITAN FREE HOSPITAL.-Operations, 2 p.M.ROYAL COLLEGE OF SURGEONS OF ENGLAND.--4 P.M. Prof. F. Le Gros Clark,

" On the Principles of Surgical Diagnosis, especially in reference to Shockand Visceral Lesions."

Tuesday, June 9.ROYAL FREE HOSPITAL.-Operations, 9 A.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M.GvT’s HOSPITAL.-Operations, It P.M.WESTMINSTER HOSPITAL.-Operations, 2 P.M.NATIONAL ORTHOPÆDIC HOSPITAL.-Operations, 2 P.M.ROYAL INSTITUTION.--3 P.M. Dr. M. Foster, "On the Development of Animals."ETHNOLOGICAL SOCIETY OF LONDON.-8 P.M. "On the Chinese Notation of

Time." By Mr. C. B. Wade.-" On the Migration and Historj of Coffee,Tea, Cocoa, &c." By the late Mr. John Crawfurd.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY. - 8 P.M. Ballot for Honoraryand Ordinary Fellows.-8½ P.M. Mr. John Birkett, " On Sero-SanguineousCysts in the Neck and Axilla." - Mr. T. Bryant, " On the Torsion ofArteries as a Means of Arresting Haemorrhage."

Wednesday, June 10.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M.MIDDLESEX HOSPITAL.-Operations, 1 P.M. t

ST. BAMHOLOMBW’8 HOSPITAL.-Operations, Ii P.M.ST. THOMAS’S HOSPITAL.-Operations, 1½ P.M.ST. MARy’S HOSPITAL.-Operations, 1¼ p.M.GREAT NORTHERN HOSPITAL.-Operations, 2 P.M.UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M.LONDON HOSPITAL.-Operations, 2 P.M.OPHTHALMIC HOSPITAL, SOUTHWARK.-Operations, 2 P.M.ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Prof. F. Le Gros Clark,

" On the Principles of Surgical Diagnosis, especially in reference to Shockand Visceral Lesions."

Thursday, June 11.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations,10½ A.M.CUNTEAL LONDON OPHTHALMIC HOSPITAL.-Operations, 1 P.M.ST. GzoRGE’i3 HOSPITAL.-Operations, 1 P.M.UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M.WEST LONDON HOSPITAL.-Operations, 2 P.M.RoYAL OTHOPÆDIC HOSPITAL.-Operations, 2 P.M.ROYAL INSTITUTION.-3 P.M. Sir John Lubbock, Bart., " On Savages."

Friday, June 12.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M.ROYAL FREE HOSPITAL.-Operations, 13 P.M.WESTMINSTER OPHTHALMIC HOSPITAL.—Operations, 1½ P.M.ROYAL COLLEGE OF SURGEONS OF ENGLAND.-4 P.M. Prof. F. Le Gros Clark,

" On the Principles of Surgical Diagnosis, especially in reference to Shockand Visceral Lesions."

ROYAL INSTITUTION. - 8 P.M. Prof. Frankland, "On the Source of Light inLuminous Flames :’

Saturday, June 13.ST. THOMAS’S HOSPITAL.-Operations, 9½ A.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M.ST. BARTHOLOMEW’S HOSPITAL.-Operations, 1½ P.M.KING’S COLLEGE HOSPITAL.-Operations, 1½ P.M.CHARING-OROSS HOSPITAL.-Operations. 2 P.M.ROYAL INSTITUTION.-3 P.M. Sir John Lubbock, Bart., "On Savages."

To Correspondents.WORKHOUSE SLOPS.

CONSIDERABLE obloquy has been east upon Dr. Markham for his formula formaking tea for the sick and aged in the metropolitan workhouses. The

public, however, should not be too hard upon him. One ounce of tea toeight pints of water is a great advance upon the formula issued by thePoor-law Board, which consists of one ounce of tea (at any cost per lb.) tofourteen pints of water, a little brown sugar, and no milk. This non-

inebriating and doubtfully refreshing beverage was formerly dispenseduniversally to the aged and sick poor, and is still their fare in the pro-vincial workhouses.

Mr. Alexander Stevenson.-The case as stated by our correspondent is anunusual one, and would, no doubt, be of interest if scientifically related.

Mr. W. H. Beekett’s question will be fully answered next week.

MEDICAL FEES.To the Editor of THE LANCET.

SIR,-Will you kindly answer the following queries in the next nnn ber ofyour journal :-A medical man is retained to attend a lady in her confinement. From un-

explained causes she leaves her residence, and engages another doctor toattend her, without letting the first one retained know of her intention. Canthe latter recover his fee in a court of law ? Are there any cases recorded,and when and where tried ? Yours faithfully,June 2nd, 1868. SAM. DAY Goss, M.D.

*t* The practitioner can recover his fee’under such circumstances. Casesare on record. The plaintiff in one was Dr. Lavies, of Warwick. square.

FIBROID PHTHISIS.W. T. B.-The above term is used by Dr. Andrew Clark in a sense peculiarto himself. He confines it to those cases in which the lung, invaded byfibroid tissue, and traversed by dilated or contracted bronchi, containssecondary cheesy deposits which have broken np into cavities. To the lungmerely contracted and hardened by fibroid tissue, he gives the name ofcirrhosis (Corrigan), or fibroid degeneration (Sutton). The disease is eitherthe local expression of a constitutional state, such as rheumatism, syphilis,and alcoholism; or of a local inflammation of the bronchi, pleura, pericar-dium, or lung. With respect to the literature of fibroid phthisis, in theabove sense of the term, we can give our correspondent no other referencethan to Dr. Andrew Clark’s case read before the Clinical Society, an abstractof which appeared in our columns. But concerning fibroid degeneration,discussed under such names as fibro-cartilaginous degeneration (Laennec),metamorphose fibreuse (Cruveilhier), cirrhosis (Corrigan), fibroid phthisis(Laycock), chronic pneumonia (Charcot), and sclerosis (Jaccoud), we areglad to subjoin references to the more important observations:-Williams:Lectures in Med. Times and Gaz., referred to in article on Dilatation ofBronchi in Library of Medicine. Corrigan (Dublin Jour. of Med., vols. 13and 38): Cirrhosis. Walshe (]fed. Times and Gaz.) : : Clin. Lect., Cirrhosis,Feb., 1856. Charcot: De la Pneumonie Chronique (Paris, 1860). Laycock: -.Notes on Foetid Bronchitis, with references to cases from 1837 (Edinburgh,1864). Sutton: Fibroid Degeneration (Medico-Chir. Trans., 1864-5) ; anadmirable paper. Feltz: Cirrhose Pulmonaire (Gaz. Méd. de Strasbourg,Nos. 2 and 3, 1865); exceedingly valuable. Jaccoud : Leçons de CliniqueMédicale (Paris, 1867).

WE are compelled to postpone a notice of the Annual Report of the HealthOfficer of Bombay till next week.

A Country Student.-The suggestion will not be lost sight of.

UNQUALIFIED ASSISTANTS.To the Editor of THE LANCET.

SIR,-I have perused attentively the letter from your correspondent,"Medicus," on the above subject, and perhaps you will allow me to offer afew remarks on the question.

I cannot understand why there should be any necessity for making a newdiploma; for out of his salary a gentleman may save the whole 01 his hospitalfees, if he be but careful. Moreover, the Apothecaries’ Company of Londongrants a certificate of fitness to act as assistant, and the fact that very fewavail themselves of it, as is shown by the pass-lists which appear in THELANCET, proves that sober, steady gentlemen do not care for it. Now, itwill be asked, how can a man earning from £40 to £50 a year save enough topay for his diploma? We must inquire what expenses a gentleman has whois assistant. None but dressing himself; so he can clearly save from £20to jB25 a year without cutting himself down very much. Now, situationscan be obtained in London where time is allowed to attend lectures, &c.;and as the fees are paid by instalments, a man, now that apprenticeship isabolished for some licensing bodies, may be qualified in four years. I amacquainted with two instances in which this was the way in which the gen-tlemen obtained their qualifications. The fees to the several hospitals,although high-higher, indeed, than they should be,-are not out of propor-tion. For instance, at Charing-cross Hospital the total fee is £70; at West-minster, £75; at Middlesex, due84; at Guy’s, £90; at Bartholomew’s, .695.Again, the fee is not required to be paid in one sum, but by instalments, as£30 the first year, t30 the second, and £10 the third; so that I see no reasonwhy in five years sufficient money should not have been saved to attend allthe hospital practice, lectures, &c, and obtain a diploma. Moreover, arethere not already a sufficient number of degrees granted by the several exa-mining bodies without instituting a new one ? What would there be to pre-vent men holding a certificate, such as your correspondent suggests, frompractising on their own account ? And who shall define what a minor opera-tion is ? ?

I have been assured by several agents that unqualified assistants are dyingout, and I hope the day is not far distant when practitioners will no longerdispense their own medicines, and the chemist and doctor shall be distinctfrom one another. When that day comes only can the profession hope tohave that respect paid to it as is done abroad-in France, for instance, where no doctor dispenses his medicines.

June, 1868. 1 remain, Sir, your obedient servant,

R. H. L.June, 1868. R. H. L.To the Editor of THE LANCET.

SIRR,-Seeing that you have allowed us, poor unqualified assistants, to dis-cuss our grievances through the medium of your journal, but which I fearare much too many and difficult to enumerate, why not propose some placeof meeting in London, and I would be present, and, although out of situa-tion, will gladly subscribe my mite (say one guinea) towards the formation ofan Assistants’ Association, which would then protect honest, steady, and in-dustrious assistants from the many dishonest and drunken blackguardswhich infest most large towns and cities. Yours truly,

June, 1868. BETA.

THE twelfth half-yearly Report of the Directors of the London and Pro-vincial Turkish Bath Company states that since the opening of the Bathin Jermyn-street, there have been issued 159,339 daily and 1761 periodicaltickets. The Company appears to be in fairly flourishing circumstances ;sufficiently so, at any rate, to warrant the contemplated reconstruction ofthe premises in Jermyn-street in connexion with the Baths.

FEMALE MEDICAL C L U B S.To the Editor if THE LANCET.

SIR,-I should feel greatly obliged if any of your readers who are the medi-cal officers of private Female Medical Clubs would inform me what would bea fair payment per annum for attendance on the wife and one child of anagricultural labourer, whose wages are equivalent to 10s. per week. I amabout to establish such a Club in my neighbourhood.

I am, Sir, your obedient servant,June 3rd, 1868. L.R.C.P. Lond.