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half an inch broad. The operations extended over a period ofthree months, and sometimes he had great difficulties to contendagainst.Mr. FRANCIS MASON remarked that the opinion was general

that the withdrawal of fragments by the urethra was attended’with considerable risk. Now, he had seen Mr. Fergusson ex-tract a great many, without any inconvenience or bad resultwhatever.Mr. HART asked Mr. Smith if he could not have crushed the

fragments smaller.Mr. SMITH replied that he could have done so, but as the

patient could not pass his urine, and the bladder would haveto be washed out, be, therefore, purposely broke them into.large fragments to get them out. There was less chance ofdoing mischief, he thought, by removing them with a scoop thanby the syringe.Dr. LEARED made some observations

ON THE USE OF ARSENICAL CIGARETTES AT THE ROYAL

INFIRMARY FOR DISEASES OF THE CHEST,

where cases of asthma were frequent. Each cigarette con-

tained one grain and a half of arsenic, with a little nitre,and he had found the greatest benefit from their use in

many cases, especially in those cases where there was muchnervous spasm.Dr. HABERSHON related the particulars of

TWO CASES OF HICCOUGH,

one chronic, associated with epilepsy, the other preceding theformation of an abscess in the perineum. The first was a man

aged twenty-six, under his care at Guy’s Hospital in Aug. last, arailway porter, who had received several blows on the back andneck, and had been struck on the head with a buffer. Sometime after he was seized with hiccough, more severe on lyingdown ; sleep much disturbed : no affection of lungs or heart.It co7ill be restrained by counting continuously, and it stoppedon his walking about. It was cured by iodide of potassium,given freely, then steel and blistering to the neck. The second ’case was in a m:1.n aged forty-seven, wherein the hiccough pre-ceded the formation of a perineal abscess, and did not finallycease until it had been opened, and was quite healed. Hethought both cases due to some indirect irritation of the pneu.mogastric nerve acting on the spine, and thence reflecting onthe phrenic nerve.Mr. LAWSON remembered seeing a case under the late Dr.

Todd very much like the first described, in the person of ayoung woman, in whom hiccough was present day and night,depending upon some intestinal irritation. He gave a scrupledose of calomel at the commencement, and recovery ensued.

Dr. RouTH thought that cases of hiccough were not so rare asis generally believed. He recollected seeing two very badcases, one in his own practice, and one in University CollegeHospital. Both were treated as in Dr. Habershon’s first case-namely, by blistering in the region of the par vagum nerve. Thisproduced cure in both.

Dr. LEARED related a case of dyspnoea, spinal disease, andhiccough, in which the last was much complained of.

Dr. HABERSHON asked if surgeons had noticed it often.Mr. HENRY SMITH remarked that it was a frequent symptom

in patients about to die.Dr. GIBB exhibited his

LARYNGEAL ECRASEUR,

which he had successfully employed in several cases for the re-moval of polypoid growths from the interior of the larynx. Hedescribed its mechanism, and the mode of its application. Theform and length of the curve of that part of the instrument towhich the loop of wire was attached had been carefully regulated by experiments on the dead subject. He expressed his

’

acknowledgments to Messrs. Weiss and Son, of the Strand, forthe readiness with which they had entered into his plan for theconstruction of what Dr. Gibb called one of the most ingeniousand important instruments that had ever been contrived.

POPULATION OF SPAIN.-For the first time a generalstatistical review of the movement of the population of Spainhas lately been published. According to this, the number ofbirths for the past year was 571,186 ; of deaths, 432,067 ; ofmarriages, 126,893. The statistics fail to give the total of thepopulation ; they only record one birth in 27 inhabitants, onedeath in 33, one marriage in 129 ; according to which the totalnumber of inhabitants would be 15,500,000.

Reviews and Notices of Books.Lectures on Syphilitic and 17accino - Syphilitic Inoculation :

their Prevention, Diagiiosiq, and Treatment. Illustrated byColoured Plates. By HENRY LEr, F.R.C.S., Senior Sur-geon to the Lock Hospital and Asvlum. Second Edition.pp. 335. London : Churchill. 1863.THE title of this book might lead to the supposition that Mr.

Lee is simply offering to the profession a monograph on syphi-litic and vaccino-syphilitic inoculations-a subject, as our

readers know, fully and completely treated in the pages ofthis journal a short time ago by the same author. But thiswould be an erroneous surmise. Mr. Lee has, on the contrary,collected, on a large scale, in these lectures, the facts and argu-ments upon which he founds his pathological and therapeuticalcreed, and discussed, besides the vaccination question, mostof the controverted subjects connected with venereal diseases.We have, therefore, in this book, a kind of manifesto from

the senior surgeon of the Lock Hospital of London. Such awork will naturally be read with the greatest interest by everymember of the profession, as the author’s position gives him, insome degree, the leadership in matters relating to syphilis.Nay, these lectures have a certain historical value. In after

years, the book will be referred to and quoted, just as we nowrefer to or quote from Pearson’s work.

’ Such being the case, we of course at once inquire whetherMr. Lee is a mercurialist or the reverse, as rather smart attacks

upon the mercurial treatment of syphilis have of late been

made. The author certainly uses mercury in cases of gene-

ralized syphilis ; but to call him broadly a mercurialist, as wellas all those who do mt reject a mercurial course when required,would be a great mistake. Mr. Lee, although he has success-fully combated some of Ricord’s opinions, views the treatmentof syphilis exactly in the same manner as the French syphilo-grapher. Where the disease seizes, or is likely to seize, uponthe organism, the metal, under some form or other, is given.But the mercury is withheld in the numerous cases which pre-sent the local disease only,-as made patent by a peculiarlymphatic absorption -namely, suppurating bubo (anotherpoint on which Mr. Lee is in perfect harmony with Ricord).Anti-mercurialists are too apt to think or to say that theynever give the metal, and their adversaries always. To themost cursory observer this is an evident misstatement. NeitherRicord nor Mr. Lee nor the well-known specialists of Londonwould have given mercury in the great majority of Friecke’sor Rose’s cases, that are always quoted with such glee by thenon-mercurial school. The great difference between the latterand the school to which the author of the present volumebelongs is, that the former go blindly to work, ignore all dis-tinctions and shades, thrust together all kinds of cases, de-nounce a few instances where mercury has not prevented arelapse, extol other cases in which no secondaries would haveappeared with or without mercury, and quietly settle down toexpectancy.

Mr. Lee is none of such; from his present work, and fromthe valuable contributions which he now and then offers to

societies and the press, we gather that, practically, the LockHospital of London can shake hands with the Hopital du Midiof Paris. We may venture to add that the same harmony nowalso exists in a theoretical point of view. Ricord has acceptedmost of the modifications proposed by a few of his pupils and

by some surgeons out of France, and there is a fair prospect ofan eventual settlement.

I Some questions of priority exist between M. Langlebert, ofParis, and M. Rollet, of Lyons, as to which of these surgeons

first suggested that contamination from secondaries alwaysgives rise to a chancre ; but these differences are small matterswhen compared to the great truths (or hitherto supposed truths)that have been attained.

182

And speaking of priority, we would especially refer to Mr.Lee’s claim as contained in the foot-note to page 30 of the pre-sent work. We quote verbatim:-" The distinction between the two kinds of disease (the sup.

purating chancre and the sore presenting adhesive inflamma-tion), in their mode of origin, was first recognised in 1854. Inmy Pathological and Surgical Observations,’ published in thatyear, the local disease, which commences ith a suppurativeform of inflammation, is described as a distinct and separatemorbid process, from the specific adhesive action which is fol-lowed by constitutional symptoms. That the auto inoculabilityof a chancre was evidence of its non infecting character, wasfirst pointed out by me in the British and Foreign Medico-Ohirurgical Pc.-view for 1856."

Since that period Mr. Lee has continued to use his excellentopportunities in pursuing scientific investigations. His are not

dry collections of facts; but from these and pathological ana-logies the author arrives at certain laws, which give a scientificfooting to his practical conclusions.Mr. Lee has done well to collect in the volume before us his

articles, lectures, and contributions scattered in various ways.The sixteen Lectures, as now presented, form an extremelyvaluable volume, which will be read with much interest, bothby those who for years have been watching Mr. Lee’s laboursin the wide field offered by venereal diseases, and those whohave not had the good fortune to come in contact with theauthor’s published papers on the subject.The first two lectures treat principally of the suppurative e

sore and the chancre presenting adhesive inflammation, togetherwith the distinctions laid down by the author, and now almostgenerally accepted. Respecting syphilitic infection by the latterform of chancre, we would particularly impress upon practi-tioners the following lines of Lecture II. :-" Syphilitic infec-tion of a patient’s system, as far as it can be traced by localsymptoms, commences as a crack, an abrasion, or a pimple.These affections, in the oiin, are often extremely difficult toxecognise. They frequently do not present any characters bywhich they can be distinguished from similar results arisingfrom a variety of accidental causes, and they may be maskedby the coexistence of other venereal complaints." In this lec-ture we find also an application of general pathology to syphilisof a very interesting nature-viz , the disposition to the effu-sion of lymph in the primary and secondary manifestations ofsyphilis. We would, however, ask the author whether thatpeculiar kind of conjunctivitis sometimes observed in secondarysyphilis, the pain in the bones, and the cephalalgia, are due tothe same’ came.

Syphilization (so-called), Syphilitic Inoculation in Animals,and Lymphatic Absorption, occupy Lectures III. and IV.An excellent sketch of all these subjects has here been offered;and we would call special attention to Mr. Robert de Welz’s(not Wetz) conclusions as to the possibility of inoculating thedisease on animals. Lymphatic absorption is well worked out;but there must, of course, be much conjectural matter on sucha subject.

Lecture V. is taken up by the consideration of DestructiveSyphilitic Iai3a,mmation; Action of Caustics; Serpiginous Sores;and Treatment of Suppurating Syphilitic Sores. Much iufor-mation will be gained by the perusal of this lecture. We may,however, observe, that the author has faith in the action ol

caustics for the period of five days after the application of thepoison (p. 106). This position has become very doubtful ; andit is questioned whether absorption is not more rapid. Rollet,of whom 11r. Lee speaks in high terms, thinks this kind oi

cauterizition useless. As to treatment, we are at issue witlthe author respecting the application of common mercurial ointment to primary sores. We have always found it objectionabhand inefficacious. Aromatic wine has, in our hands, succeededbetter than the ointment just named, and better than tht

dusting with calomel.Lectures VI., VIL, VIII., and IX. are occupied with th<

details connected with the late transmission of syphilis byvaccination: an unfortunate event, on which Mr. Lee, in thesepages, has commented in so masterly a manner.

In Lecture X. we find the much disputed question of inocu-lation with the blood of syphilitic patients discussed in animpartial spirit.

Lectures XI. and XII. treat of the modifications of syphiliticinoculations, either by hereditary transmission of syphilis, orby previous disease. These are valuable lectures, the twelfthespecially, as discussing the great question of the possibility ofa patient contracting the disease more than once.

Lecture XII., on Transmission of Secondary Syphilis, is fullof testimonies and experiments setting the possibility of such

transmission in its true light.The last three lectures, already well known by having beea

published in " Holmes’s Surgery," are descriptive and practical.They present a vivid and accurate picture of the disease, andpoint out the most approved way of combating it. Among thetherapeutical agents, Mr. Lee has a decided predilection forthe calomel vapour bath; and well he may, for it has been ofmuch benefit in many cases, for some of which we can ourselvesvouch.The type is of good size, and clear; the plates are beautifully

finished ; and the book is well got up.We have no doubt that these lectures will not only enhance

the author’s reputation, but lead to great improvements inpractice.

GIBBON VERSUS BUDD.To the Editor of THE LANCET.

SiR,&mdash;Notwithstanding the letter from the defendant’s so-licitor, which appeared in THE LANCET of last week, I adhereto my statement as to the report of this trial ; so far fromgiving the substance of the evidence, it did not state that wit-nesses were called on my behalf. The witnesses I allude towere, the practitioner who at the patient’s desire summonedme to the case, and an assistant from the well known chemists,Messrs. Blake, Sandford., and Blake, who dispensed my pre-scriptions.The evidence for the defence is well and fairly set forth by

Mr. Guillaume; but unfortunately all these witnesses deposed,not only to one but to several negatives, which in law, asin grammar, are apt to neutralize one another.Thus the physician, who by the way was never consulted,

called in, or paid by the patient, but by Mr. Kingsford duringmy absence from town, did not know that I had attended pre-viously, but he also did not know that his patient had beenvisited, during the time of his attendance, by an eminent West-end physician.

Again, Mrs. Pike did not know that my visits were pro-fessional in 1861, but she also did not know that I had everpaid any visits, whether professional or otherwise, in 1860.As to making a yearly account of fees, bad as the practice

is, I sometimes do it, when, as in this case, specially requestedto do so. My fees for attendance in 1860 were punctuallypaid at the end of the year, and I had no reason to anticipatethat they would be disputed at the end of 1861. As to themotives for disputing them, two have been attributed to thedefendant, one by his advocate, the other by his solicitor: atthe trial, it was his sense of duty as executor, which urged himto protect the estate; but now his solicitor, quoting a remarkof the learned judge’s as to the duty to society of contestingunjust claims, proclaims that he was actuated by this generousprinciple. Whether he was moved by a generous concern forthe public or the estate (i.e., his own pocket), I cannot determine;nor do I think Mr. Guillaume is quite justified, because Mr.Baron Bramwell is pleased to say that physicians are not" magicians," and to be a little severe on doctors’ "stuff," anddoctors’ " law," in allusion to the Medical Act, or because hebegins his summing up with a general remark applicable toevery claim, and evidently made in order that the defendantmight not be prejudiced by the fact of his great wealth, insaying what his opinion was as to my particular claim. Hecertainly expressed no opinion, but the gentlemen who wererequired by law to express one gave me a verdict without amoment’s deliberation.-T am- Sir. vonrs f*

SEPTIMUS GIBBON, M.B. Cantab.Finsbury-square, Feb. 1563.