400

them to flock to the Richmond spare ? If

any of them have a grievous infirmity, orhodily af1:liction, I dare say the governor ofthat immense poor-house might extend itsbenefits to them ; but what they have to doin a work-house, as gymnastic or medicalstudents, I really canrot comprehend.Really, Richmond, you wore out the lashbefore you ventured that last blow ; put upthe whip, then, as it is useless, and be ad-vised by your friend Lennox not to meddlewith it in future ; the heavy whip is aloneformidable, and this-you cannot wield ; the ’,little sixpenny child’s toy you handle, mightstartle by its crack, but cannot injure by itsfall. ’

The motives of this writer, however, Mr.Editor, are worth analysis; he wishes to

defend Mr. Carmichael from what lie consi-ders an unprovoked attack, and, so far, dis-plays his gratitude for the assistance andattention afforded at the Rutland-SquareDispensary; but the gratitude of one willnot gloss over the act of injustice to many,and I think I have made it apparent, not-withstanding the assertions of Richmond,that Mr. Carmlchael’s duty has been neg-lected.Now, Sir, to show the value of your pub-

lication, if alone to one institution, Mr.Carmichael has, unfortunately, laboured an-der a fit of illness for some weeks past, fromwhich he is now only recovering. Duringhis unavoidable absence from the hospital,who has attended the wards for him—Mr.Belton ? No ! Thanks to your pages. Dr.M,Dowel has been appointed in his room,and he, at all events, is vastly superior toRichmond’s well-qualified house-surgeon,to whose instructions the pupils would have.been otherwise consigned. In my remarkson Mr. Carmichael’s conduct, I was infiu.enced by a love of my profession, and by anattention to the welfare of my feilow-

countrymen. The pupils have paid theirmoney on the guarantee of Mr. Carmichael’sname, and he has no right to disappointthem of one iot of instruction—"tibi seris—tibi metis." I may say to tlis gentleman, hisconduct was the text, and my remarks havebeen the lecture ; nor do I think he can feelindebted to Richmond for again bring’inghim before the medical world, in order thathis neglect might be n.o"e fully exposed.Ilis friends are certainly the most needlesscreatures livins. if they perform such odes inhis praise ; odes in which discord and false-hood strive for the mastery. My pen hasliardly been dipped in gall, as Richmondimagines, and for which 1 will excuse him,in the supposition that he labours under anattack of icterus, seeing every thin througha yellow medium ; but it has been directedby truth. Not one syllable of my formerletter can be disproved, and I will go on

with my task, in defending the rights of myfellow-countrymen at an establishment pos-sessed of singular advantages to the student,if they are only secured by attention, and I

may add honesty, in spite of his lashings,which can hardly penetrate the armour 1

before boasted of. " Richmond ! I know

you.I am, Sir,

Your obedient servant,LENNOX.

Dublin, Dec. 13, 1828.LENNOX,

ROYAL INFIRMARY FOR THE DISEASES OFCHILDREN.

To the Editor of THE LANCET.SIR,—We beg the favour of the insertion

of the following reply to the obsorvatiens

respecting the above charity contained inyour 275th Number, and signed " One ofthe Monthly Committee."

Sir, your obedient servants,THE PHYSICIANS AXD SURGEONS OF TIIE

INSTITUTION.

With the author’s remarks on the " phi-lanthropic views" of the lounder of the

charity, we have nothing to do. The pro.fession are capable of forming a correctesti-mate of them. But,

First, as to the alleged instance of neg-lect on our parts, we must remark that, ifthe Member of the Committee had been asanxious to discharge his duty to the charity,as he seems desirous of influencing the pub-lic and professional mind against the medi-cal officers, he would have had the case in

question inquired into at the Committee.Hut not a single instance of neglect, on thenart of the medical officers of the charity,has ever been before this body. As to theinstance in question, the following is an ab.stract of the particulars connected with it,furnished by the house-surgeon, who isa well-educated, experienced, and ablemember or the profession. It should he

kept in recollection, that no patients are

vet received into the wards or’the building." Edward Cole, aged eight months, was

admitted on Tuesday, 21st of October, 1828.As he was brought from a distance, andeuily in the day, I entered him in t’;e

register-book of the Institution, and pre-scribed for him immediately. The cl1ildhad some irritative fcver : the belly wastumid and hard, indicatino mese:.teric ob-struction, and he appealed disposed tJ

rachitis. The gums were much swollen;they were, therefore, lanced. The medi-cines prescribed were, an aperient powderto he taken immediately, hydrarg.cum creta

401

every night, and the diaphoretic mixtureevery three hours. Seeing no immediatedanger in the ease, sufficient medicines tolast till Saturday were given, on which daythe mother was-told to attend. She came,however, on the Friday, and I prescribedfor the child, as she had come out of the

regular order of attendance. I found theblood oozing slightly from the gum ; thechief disease existing in the child’s consti.tution general1y, and in the abdominal vis-cera in particular. An active styptic wasordered to the gum, with the necessarydirections, and aperients and astringenttonics piescribed. The mother returned

again on Saturday, (one of the days in theregular order of her attendance,) when thephysician of that day saw the child.Blood, or rather bloody water, continued toooze from the gum. Petechiæ had now ap-peared on the body, and the mother wasmade acquainted with the danger. Themuriated tincture of iron was directed to be

constantly applied to the gum; and nitricacid, with Cascarilla bark, were prescribedinternally. I saw no more of either themother or child."With reference to the long paragraph of

puerile declamation in which the author in-dulges against the medical officers of the In-stitution, it is unnecessary for them to makeany remark. It is only where he refers toalleged facts or circumstances, that he re-quires to be noticed.

2. He alludes to the tearing out of a leafin the house-visitors’ book. Th;s occurredsome years ago, under circumstances of mis-

conception on the parts both of a medicalofficer and house-visitor ; but, as the mat-ter was explained at the following meetingof the Committee, and long before the writerof the letter had tlle honour of being oneof that body, it could in no way promote theinterests of the charity now to refer to it.

3. The author of the letter next alludesto a motion carried in the Committee, re-specting a book, in which they wish themedical officers to sign their names, with

the day and date of their attendance, andthe time of their arrival at, and departurefrom, the institution. This the medicalofficers, without a single exception, haverefused to comply with. The motion was

brought forward by the author of the letter,and was treated by them with the respectit deserved. It should be remarked, thatproper register-books of patients, with thediseases, &c., are always kept at the Insti-tution ; and the medical officers preservefull details of the more important cases. ,

4. "’e have nothing to do with the direct-ing or providing for the accommodation orcomforts of the patients ; this rests with theCommittee themselves. It surely cannotbe expected that, in addition to gratuitous

attendance, we are to furnish a -room and

provide it with coals, when it is the dutyof the Committee themselves to do so ; und,where one dispenser oniy is kept, a numbercf patients cannot always be provided withtheir medicines in a short time. The phy-sicians and surgeons are in no way the causeof the delay the patients experience in ob-taining their medicines.We have now adverted to all that re-

quires notice in the Committee-man’s letter;and we have no hesitation in stating, that ithas been written in opposition to, or with-out the knowledge of, the body of which heis a member. In conclusion, we unhesi-tatingly declare, that, with the exceptionof periods of illness, our attendance has beenuniformly regular ; and, whilst we have en-deavoured to advance the medical reputa-tion of the Institution, we have avoidedcompromising our own character by acts

which, however they be veiled by the glossof benevolence or philanthropy, ate neithercompatible with professional duties nor pro-fessional respectability.

Infirmary, 8th Dec. 1828.

UNION OF BONE.

F. WILSON.

To the Editor of THE LANNCET.

SIR,—The following I consider a beauti-ful instance of the union of bone by the firstintention. Should you think it worthy a

place in your valuable journal, I shall behappy in having had the opportunity ofcommunicating it.

Your obedient servant,F. WILSON.

Bourn, Lincolnshire, Nov. 10th, 1828.Oct. 14th, J. Cawthorn, a labouring man,

was feeding a patent chaff-cutting machine ;but his foot slipping, his left hand came incontact with one of the blades, which com-pletely divided the middle finger from itsextremity to the base of the second pha-lanx, the bones being equally divided. On

presenting it to be dressed, the wound ap-peared very wide, the upper portion beingmuch elevated. Strips of plaster were im-mediately applied, and the two parts broughtinto close contact. A bandage was appliedrather firmly over the plaster, and the fingerallowed to remain for two days withoutdressing, no inflammation supervening.On the l6th, the wound seemed to be firmlyuniting, and the plasters were renewed. ’On the 18th, there appeared a little ten-

dency to separation, owing to his havingused his hand ; but a small compress of lint

restored the connexion, and from that timeit rapidly united. On the 9th of Novem-Lber, the union was completely restored,: and the finger firm and sound.