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Moore wrote, I have to say that in my opinion it was not acase of epilepsy, but of hysterical mania- a case also in whichthere was no doubt as to the cause.

2nd. On the question of cure I must ask you to allow me toquote in extenso my remarks to the young lady’s brother, whichled me to the belief that she was cured.

" By reference to the abstract [that mentioned as taken fromthe case-book] you will see that the facts are as follows :-Your sister, the day after she was operated upon at Mrs. ———’s,had so violent an attack of hysterical mania that it was foundnecessary to remove her to the Home (Jan. 8th). From thedate of her admission she had no maniacal paroxysm, andonly one slight fit Jan. 12th, and an unconscious attack on the15th, and again on the 20th. Up to the date of her leavingthe Home (April 4th) she had not, with these exceptions, theslightest symptom of any fit. I think I was therefore justifiedin saying on March 29th, that she was quite well. She was,during her residence in the Home, visited by ladies of all ranks,and by her late medical attendant, Dr. Wadham Robinson,with all of whom she conversed most rationally, and she wascontinually canvassing for votes for the Clergy Orphan Asylum.[I may here mention that when I first saw her she had all thesymptoms of incipient dementia.] All who saw her werestruck with the marked improvement that took place in hermind, and until I received your note I had leoked on her caseas one of the most gratifying and successful that had yet comeunder my notice."But now, Sir, mark what follows :-" She, however, required

most careful watching, especially at night, and you will re-member that I urged on you the desirability of keeping herunder my supervision for six or twelve months. Had my advicebeen taken, I am strongly disposed to believe that my treat-ment would have resulted in a permanent cure." This offerwas entirely a disinterested one, so far as professional remune-ration was concerned.Those who know the uniform manner in which I have

courted investigation into the truth of my practice at theLondon Surgical Home, will join with me in smiling at Mr.Harris’s concluding quotation.The case was discharged as " cured" it is true, but it has

never been published as such, nor would it ever have beenuntil a much longer interval had elapsed.

I am, Sir, yours obediently, - -.

Connaught-square, June, 1866. I. B. BROWN.

BRAN BISCUITS IN DIABETES.

ARTHUR H. HASSALL, M.D. Lond.

To the Editor of THE LANCET.SIR.,-Dr. Pavy, in the communication inserted in THE

LANCET of the 23rd inst., threw out the suggestion that torre- I,faction of the bran, whereby the insoluble starch becomesconverted into soluble dextrine, might afford t simpler andmore manageable means of freeing the bran from starch thanmy method by dilute sulphuric acid.

This suggestion I have put to a practical test, and foundthat 100 grains or parts of the bran, carefully torrefied at atemperature of 320° Fahr., lost, after being well washed, 24grains or parts of its weight ; that the residue on treatmentwith iodine became almost black : thus furnishing evidence ofthe presence of starch in large quantity, and, on analysis, anamount of glucose corresponding to 22 grains of starch wasobtained. These particulars afford conclusive evidence againstthe process by torrefaction, whereby, although a portion of thestarch may be removed, a considerable quantity is still retainedby the bran.There is, however, a process which I have had in my mind

for some time past, and which recently I have tested prac-tically. It is based upon the conversion of the starch intodextrine through the action of Dictstase. This method of puri-faction is so easy and perfect that it leaves nothing further tobe desired; and the results, so far as the colour and composi-tion of the bran are concerned, are certainly superior to thoseobtained by means of sulphuric acid. Nevertheless, I am ofopinion that, in extreme cases of diabetes, the acid method isto be preferred.

It is necessary, in the interest of those who have the mis-fortune to labour under diabetes, that it should be clearly un-derstood that the analyses given by me of the so-called PureBran and Bran Biscuits were by no means exceptional. Theywere made from samples prepared by one of the most carefulmakers; and I have never yet met with a bran biscuit whichdid not abound in starch, while even those sold at the present

time, no matter where obtained, still contain starch in verylarge amount, turning absolutely black with iodine. I wishit also to be clearly understood that I do not lay the leastblame of this state of things upon the makers; they, I be-lieve, do their best. The radical fault is not with them, butin the process which they adopt, and which they have beentaught to believe was effectual.

I conclude this note with an analysis of Gluten Bread, whichshows how much the amount of starch present in it has beenunderrated, and how unfitted it also is for the use of thediabetic, except in the mildest cases.

I remain, Sir, your obedient servant,ARTHUR H. HASSALL, M.D. Lond.

Wimpole-street, June 26th, 1866.

POOR-LAW MEDICAL REFORM ASSOCIATION.To the Editor of THE LANCET.

SIR,—It would be prudery on my part to pretend ignoranceof the honour intended to be paid me on July 5th, and there-fore permit me space to say I hope the meeting will not beconfined to the donors of the testimonial only, but that allPoor-law medical officers who can spare the time will attend,in order that I may take that opportunity of personally con.sulting them as to the steps they desire to pursue in future inregard to Poor-law medical reform.-Yours, &c.,

RICHARD &EIF’FIK.12, Royal-terrace, Weymouth, June 25th, 1866.

P. S. -The meeting will be held at the Freemasons’ Tavern,Great Queen-street, on Thursday, July 5th, at three P.M. Ifany members of Parliament could honour the meeting withtheir presence they would be enabled to ascertain the feelingsof the profession on the subject of medical relief of the poor.

SURGICAL APPLIANCES AND MINOR SURGERY.MR. ANNANDALE AND MR. HEATH.

To the Editor of THE LANCET.

SIR,—In a review of the little work I lately published underthe title of " Surgical Appliances and Minor Surgery," whichappeared in your journal of June 23rd, you charge me, first,with having written a book which was not required; second,with having followed the plan of Mr. Heath’s book on thesame subject, and borrowed in many instances his very words.

In reply to the first charge, let me state that my object inwriting the work was-

(1) To provide a book on the subject for my pupils; as it iswell known that although in many instances the practice ofthe London and Edinburgh schools is the same, in others itdiffers considerably.

(2) On looking over Mr. Heath’s book, I found that manysubjects which seemed of practical utility were not included.The following subjects, which I have described and in mycases illustrated, are not even referred to in Mr. Heath’s book:Instruments required by a house-surgeon or student; acu-

puncture ; hypodermic injection of sedatives ; application ofleeches; application of cauteries ; application of sulphuricacid; varieties of, and methods of introducing, sutures; appli-cation of drainage tubes ; application of ligatures to tumours;compression of abdominal aorta; application of ice; applica-tion of blisters ; circumcision ; vaccination ; division of thefrænum linguee ; preparation of pathological specimens ; vene-real disease ; imperforate anus and vagina; erythema ; erysi-pelas ; hospital gangrene ; tetanus ; pysemia.; piles ; deliriumtremens ; &c. &c. But a still more urgent claim was suggestedto me by finding that in many points of instruction I did notagree with Mr. Heath, as they were entirely different fromwhat I was accustomed to practise and teach.In regard to the second charge-that of my having appro-

priated expressions in Mr. Heath’s book,-I beg to remark