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Mr. ROGERS HARRISON advocated the use of carefully-appliedpressure to the varicose veins.

Dr. ROGERS had seen the plan of Mr. Lee carried into effectin many cases in University College Hospital. Had Mr. Leeseen a strong solution of iodine applied to the varicose veins ?

Dr. SlORDET had seen several cases successfully operated onby Mr. Erichsen on Mr. Lee’s plan.Mr. CANTON had treated a great number of cases with tinc-

ture of iodine most successfully. The iodine was applied tothe surface, and appeared to act by absorbing the products ofinflammation surrounding the vein, and reducing the vessel toits normal calibre.Mr. HIRD had seen, in cases treated by caustic successfully,

other veins become after a time varicosed. There was gene-rally some constitutional defect in persons suffering from vari-cose veins, and, in addition to local treatment, tonics-such asiron, were indicated.Mr. HUNT had seen the disease return frequently after the

veins had been obliterated in various ways. This was, nodoubt, from some constitutional cause. He recommended theuse of the laced stocking in opposition to the elastic stocking;the application of the plaster of ammonium and mercury alongthe course of the vein, with lint and flannel bandages, wereof much service in some of these cases.

n

Dr. RouTH referred many of these cases to accumulations inthe prima vise, and recommended the use of purgatives-suchas the bitartrate of potash in large quantities. The best me-chanical means of support was a pair of tight.fitting drawers.

Mr. Lee having replied, the Society adjourned.

Foreign Department.ANNUAL MEETING OF THE ACADEMY OF MEDICINE, PARIS.

ON the 15th of December last, much animation pervaded thehall where the members of the Academy generally meet, beingthe day fixed for the annual award of prizes, and the deliveryof the accustomed panegyric on a departed member of thelearned society.As to the rewards granted in France for medical investi-

gations and essays on various subjects, we have only to repeatwhat we have stated at various periods before-viz., that suchincitements to exertion in the several branches of medicalscience, are considerably more numerous in France than in ourcountry ; a circumstance which explains the scientific activityof our neighbours, We cannot help remarking, however, thatGreat Britain has, in the al seace of diJ’ect encourzzrgemezat, con-tributed in an admirable manner to the elucidation of medicalquestions, and to the introduction of valuable adjuncts to actualpractice.

It will be interesting to inquire of what nature are the ques-tions upon which the various committees, appointed by theAcademy, did not feel justified in awarding the actual prize ;merely granting sums of money (equal in amount to that offeredfor the prize) as encouragements to authors. In this mannerwe can judge of the weak points amongst onr neighbonrs. Theprizes not awarded were the following :-

1. Prize of .640, given by the Academy: " Settle, by clinicalfacts, the degree of utility of issues, in the treatment of chronicdiseases." "

2. Portal prize of X40 "Point out the organic changesproduced by rheumatism, and indicate the characters by whichthey can be distinguished from the changes occasioned by othercauses. " (No essay was sent in.)

3. Lefevre prize, X72 (triennial) : On Melancholia.4. Barbier prize, X120 : To be given to the discoverer of a

reliable remedy for some disease hitherto considered as incur-able. (No award.)Amongst the prizes actually awarded we find-1. Civrieux prize, .660: On Nervous Vertigo. Dr. Max Simon,

of Aumale (Seine inferieure).2. Capuron prize, X40 On Sudden Death in the Puerperal

State. Dr. Mordret, of Le Mans (Sarthe).5. On Saline Mineral Waters, .640. Drs. Petrequin and

Socquet, of Lyons.A prize diferreil is the following :4. Argenteuil prize (sexennial), £ 480 : For Improvements

in the Treatment of Stricture of the Urethra. 1’tvezaty essay shave been sent in ; the committee cannot finish their labourstill December, 1858.To the official vaccinators, to medical men appointed to

watch and report upon epidemics, and to the inspectors of

watering establishments, numerous prizes, as well as gold andsilver medals, have likewise been awarded.At the conclusion of the report on prizes, M. F. Dubois, the

secretary of the Academy, read the panegyric of Magendie.This panegyric turned out to be a very severe critical examina-tion of the professional life of the great physiologist; and sopointed were the strictures, that a relation of Magendie hasthought it his duty to publish, in the different medical papersof France, an indignant letter on the subject.In his exordium, M. Dubois says, after having acknowledged

that Magendie revived experimental physiology, I shall beobliged to speak of Magendie as professor at the College ofFrance, and of the kind of teaching he carried on in that insti-tution ; also of his doctrines, or rather complete absence of

I doctrines, upon which absence he prided himself. I shall beobliged to mention how great was his dislike for every kind ofreasoning, and his contempt for the assistance of a reflectingmind in scientific pursuits. I shall be obliged to bring Magendiebefore you as physician to the Salpêtrière and the H6tel Dieu,and show you into what strange scepticism, and also completeinefficiency, his exclusive attention to the physical phenomenaof life at last made him fall." And fully did the orator keep his word, following the subject

of his panegyric through the whole of a long career, principallyfilled by experamental researches in physiology. The picturehas the defect of one-sidedness, since hardly any of the incon-testably useful results of Magendie’s labours are dwelt upon.

Incidentally, M. Dubois mentioned two anecdotes referringto the United States and to this country. The first alludes toa Pennsylvanian quaker, who publicly reproached Magendie, inhis own lecture-room at Paris, with his (to the quaker’s mind)unjustiiiablecrueltyto animals. The second relates to Magendie’svisit to this country, and to the attack made in the House ofCommons against the vivisections practised in London by theFrench physiologist.M. Dubois is extremely careful to do full justice to Sir

Charles Bell respecting the latter’s beautiful discovery of thedifferent properties of the anterior and posterior roots of thespinal nerves, and reduces to very little the light thrown byMagendie on the functions of the cranial nerves by his well-known intra-cranial sections performed in 1824, carefully men-tioning that Fodere, in 1822, had already performed the samekind of sections. Altogether, we have, in M. Dubois’ discourse,the partial verdict of a vitalist on a physiologist perhaps a littletoo much rivetted by the merely physical phenomena of life.

Correspondence.

SPECIAL HOSPITALS.

"Audi alteram Mrtem."

To the Editor of THE LANCET.

SIR,—The public and the profession have, during the lastthirty years been indebted to THE LANCET for the exposureand correction of many an abuse. This debt will be increasedtwo-fold if you can succeed in checking the monstrous Andgrowing evil of the multiplication of " special hospitals" for thetreatment of almost every medical and surgical ailment.

That hospitals specially devoted to the reception and treat-ment of patients suffering from certain forms of disease are re-quired every one will readily admit, and the only question isto what complaints should they be confined. It may, I think,be answered, that they should be limited to the reception ofpatients labouring under diseases that require either a greateramount of special skill in their management than men engagedin the general practice of the profession can be expected to at-tain, or to cases that are usually excluded from the wards ofgeneral hospitals. Thus, the peculiar delicacy of manipulationrequired in operations upon the eyes; the complexity of theapparatus necessary for the treatment of deformities of thelimbs, and the exclusion of patients labouring under phthisis orsmall-pox from many general hospitals, more than justified theestablishment of such institutions as the Ophthalmic, the Ortho-paedic, the Consumption and Small-pox Hospitals-institutionsthat, from their magnitude, their utility, and the character oftheir officers, are an honour to the profession and to the country.But what reason can justify the establishment of special in-

stitutions for the treatment of fistula, of diseases of women, orof urinary complaints?-a hospital for stone, stricture, bladder

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and prostate disease being generally understood in surgicalcircles to be in an embryonic state, to be developed-with afull staff, already self-elected-in all probability in the courseof the next season. It cannot be pretended that, as in the caseof consumption and small-pox, the doors of our general hos-pitals are closed against patients suffering from these commoncomplaints. On the contrary, they are usually sought out, andvery readily admitted by hospital surgeons. Nor will it, Ipresume, be contended that the introduction of a catheter, oran operation for fistula or piles requires so large an amount ofspecial surgical skill that the ordinary run of surgeons cannotdo justice to such important cases. Why, Sir, there is not asimpler and easier class of operations in the whole range of sur-gical practice than those required for rectal diseases, often de-manding less skill than does the extraction of a tooth; and yetthe public are led to suppose that it is only at St. Mark’s thatsurgeons are in this respect up to the mark ! So with regardto diseases of women and urinary affections, cannot everyaccoucheur treat the one, and every hospital surgeon the other ?and what necessity can there be to inveigle patients to specialinstitutions, when in every hospital in London there is a ma-ternity charity in full operation, and in most of them surgicalbeds unoccupied for want of funds ?The real reason for the establishment of such institutions is

not that the profession requires them, or that they are calledfor by any defect in our already existing hospitals, but it liesdeeper than this : it is that they may benefit directly and pecu-niarily their professional originators by leading the public tobelieve that they, and they only, are the men who are com-petent to treat the " speciality" that the particular hospitalprofesses to relieve. In this way the whole profession islowered in the eyes of "the public, and its competency to treatcertain common diseases called into question, in order that thefew men who are connected with these institutions may obtaina monopoly of practice, each in his own special department.

There cannot be the least doubt in the mind of any one whois acquainted with the state of the medical profession in London,that the special institutions to which I allude, have been, orare about to be established, for the direct personal advantage ofthe individuals connected with them

But, Sir, the evil, damaging as it is to the general body ofthe profession, does not rest here. You have in last week’sLANCET most ably shown how the establishment and multipli-cation of such special institutions diverts funds from the generalhospitals, and wastes the money subscribed for the support ofthe specialists by an enormous expenditure on the non-profes-sional staff, which is maintained by each. There is, however,an evil connected with such institutions even of greater mag-nitude than this-viz., their interference with the means ofaffording proper clinical instruction to the pupils of our generalhospitals. In order that the metropolitan schools of medicinebe maintained in a proper state of efficiency, it is absolutelynecessary that as large a number as possible of varied casesshould be brought under the observation of the pupils. Theestablishment of special hospitals interferes most seriously withthe supply of cases of many forms of disease to the general hos-pitals connected with the medical schools, and if their continuedand almost indefinite increase be not checked, the clinicalteachers will be left with little else than cases of dyspepsia,fractures, and sore legs, to illustrate their lectures; and whocan say how soon some enterprising practitioners, in emulationof the rectum doctors, or the would-be urinary specialists, maydeprive them even of these scanty supplies, by taking thestomach, when in difficulties, or the bones, when broken, undertheir special care ?Whether we regard special hospitals as established to benefit

certain individuals at the expense of the rest of the profession;as diverting the funds from, and thus crippling, the utility ofour general hospitals; or as absorbing patients, and thus limit-ing the means of clinical instruction at our schools of medicine,they should, save in certain exceptional cases, be discoun-tenanced by the profession, as damaging to its dignity, to itsresources, and to its advancement. Finally, should a publicneed for the institution of a special hospital ever be manifested,let the appointment be thrown open to the profession; let thembe conferred on the best men that can be found ; and let nonominations to office be parcelled out amongst the originatorsof the jcb before even the embryo institution " has a localhabitation and a name."-I am, Sir, your obedient servant,December, 1857. A LONDON SURGEON.

** The writer of the above letter is a distinguished hospitalsurgeon, and teacher of surgery. His opinions on the subjectare entitled to grave consideration.-SuB-ED. L.

ON THE TEACHING OF SURGERY IN EDIN-BURGH, AND MR. MILLER’S POSITION INTHE HOSPITAL.

To the Editor of THE LANCET.SIR, -In answer to "M. D.," in your journal of the 19th:

December, I must observe that his notions are somewhat pecu.liar. How anyone can say, " In every other medical schoolthe teaching of surgery is held to be of importance; here,seemingly, it is not;" and at the same time pretend to be seek-ing in vain after surgical knowledge, when Mr. Syme’s wardscontain at least eighty beds, and he lectures twice a week cli-nically (not in the " seemingly," London sense, but with thesubject before him, referring to the features of the case aspresented at the moment of speaking), I do not understand.Either your correspondent, knowing the facts I mention, hasmade a maliciously ignorant sneer at the Edinburgh school, or,not knowing anything whatever about the arrangements inEdinburgh, is therefore unfitted to make comparisons betweenit and " every other medical school." I strongly suspect" M.D." ’s knowledge of "every other medical school" is aboutas great as his acquaintance with the surgical clinic of Edin-burgh. For my part, I maintain that an honest and impartialexamination of the Edinburgh arrangements will show that inGreat Britain, at least, there is no other school of clinical sur---

gery. Let it be understood what I mean by clinical teaching.I am not a graduate of Edinburgh, or in anyway connectedwith it; I have not, like "M.D.," had opportunities of com-paring it with "every other medical school;" but I havestudied at Paris and Berlin, and there only have 1 seen any-thing like Mr. Syme’s clinic. M.M. Nélaton and Langenbeckare the teachers I mean; and I ask any London man if wehave anything in London to compare with Langenbeck’s clinic ?’Nelaton’s, Langenbeck’s, and Syme’s are the only three ’’ re-gular clinics" I know, and I use the word entirely in the sensethey do, attaching the strict sense of the word to it. I am

perfectly aware how many more men there are in Paris whocan and do give a "clinic," truly so called; but where to go,in London, to see a clinic, such as it is understood at the chiefmedical schools of the continent and in Edinburgh, I do notknow, and shall feel obliged if you, Sir, can afford me, as a.stranger, any information on the subject.Now, Sir, with reference to Mr. Miller’s grievance: I have-

been compelled to put it aside till now, in consequence of thenecessity I feel of showinghow absurd is’’ M. D." ’s charge againstthe medical school in Edinburgh. That the professor of surgery-should, ex officio, be an acting surgeon to the hospital, no one-denies. Mr. Miller is so. Where, then, is the grievance ? Agreater than Miller was content with twelve beds--Scarpa.How does " M.D." propose to give Mr. Miller more accommo-dation ? Does he mean to diminish Mr. Syme’s accommoda-tion ? With all respect to Mr. Miller’s claims, I think mostwill agree with me that it would be an unmitigated evil for theteaching of surgery if Mr. Syme’s field were reduced. Suchwould be the answer of the students on the spot. Then thereremains the accommodation granted to the Extra- AcademicalSchool: is it fair that they should part with some of theirbeds? I think so, but that is a matter of arrangement innowise connected with the 9,61e surgery plays in Edinburghmedical education. The fact is, it is impossible to do more thanis done in the present state of the funds of the hospital. Thattwelve beds are better than none Mr. Miller believes : that heshould have more is desirable; but in bringing it about, onemust set to it with a little more knowledge of the hospital than"M.D." has. I can see no hardship in shutting the wardswhen Mr. Miller is not in the active exercise of his functionsas professor. "M.D." says he cannot teach with twelve bedsonly. I doubt that; but am certain he cannot teach whenthere is no one to be taught, as in the vacation. So long asMr. Miller lectures, he is charged with a service. Where isthe hardship, then, when the reason for his being attached tothe hospital no longer exists ?

Yours faithfully,Brompton, Dec. 1857.

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IMPARTIAL.

PREMONITORY DIARRHŒA IN CHOLERA.To the Editor of THE LANCET.

SIR,—In THE LANCET of December 19th I observed a letterfrom Dr. Macloughlin, in answer to a previous communicationby Dr. Elliot on the subject of premonitory diarrhoea in casesof cholera. I have not seen Dr. Elliot’s article, and thereforethe remarks I am about to offer may probably have been anti-