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recoveries throughout all the great asylums of Englandappears (from Dr. Conolly’s tables) to be about 21 per cent.to the admissions, so that Dr. Skae’s percentage of 43-4 Imust be regarded as exceptionally satisfactory, especiallywhen the nature of the admissions is taken into account,most of them being far gone in mental disease, and many ’,of them hopeless. a Hopeless," however, is a word whichDr. Skae would reduce to a very subordinate position in IIthe medico-psychological vocabulary. Not only do histables confirm the well-known induction that by far the Igreater number of recoveries take place within the first sixmonths of their admission, but they exhibit eight recoveriesafter nearly three years, four under four years, one aftersix, and three after eight, twelve, and thirteen years’ Iresidence in the asylum respectively. Dr. Skae gives in-teresting details as to a case of kleptomania in the person iof an artisan, who suddenly forfeited his previously exemplary Icharacter by stealing three umbrellas from a shop, one of them,a wooden model, serving as their manufacturer’s sign. He Iwas sent to gaol, but after his liberation had to be confined Iin the asylum, where the presence of brain-disease was un- !,mistakably detected in him. Another case, not less inte- ’’,resting, of homicidal impulse, strongly allied in its patho-logy to epilepsy, also appears in Dr. Skae’s report. This

patient, though subject to the aura epileptica, spinalshudder, and other symptoms of undeveloped epilepsy, hasnever had a fit ; but within the last few months has under-gone a peculiar psychological change. He has, nearly everyday, a spectral illusion in the form of a newspaper-an illu-sion at times so vivid that he can read a long paragraph fromthe journal. Dr. Skae is inclined to lay much lighter stressthan has been usual since the days of Prichard on so-calledmoral insanity; and recalls medico-psychology to her propersphere in looking for the causes of emotional disorder oraberration in the patient’s bodily condition or habit. Atthe same time, Dr. Skae omits none of those moral remedieswhich are favourable as adjuvants to the purely medicaltreatment; and finds agreeable and salutary employmentfor his patients, not only in the workshops and saloon ofthe asylum, but in out-door pastimes, literary undertakings,and, above all, in theatrical performances. Now-a-days,when the treatment of the insane is attracting peculiar at-tention, and when innovation threatens to invade much ofthe old traditional working of asylums, Dr. Skae’s report,which exhibits results so much in advance of those visibleelsewhere, will be read with interest and profit. We com-mend it not only to the medico-psychologist, but to the pro -fession and the philanthropic community at large.

THE BOARD OF SUPERVISION FOR THERELIEF OF THE POOR IN SCOTLAND.

THE Twenty-third Annual Report of the above Boardpresents some peculiar points of interest, especially whencontrasted with that which is issued from Gwydyr House.

It would seem strange to us that there should still be 97parishes in which the whole relief is raised by voluntarycontributions ; more strange still that the poor should havethe right of appealing against inadequate relief. Sincethe institution of the Poor Law in Scotland, 13,500 suchappeals have been made, and no less than 3539 have hadthe ground of complaint removed. Mr. Goschen may atleast be thankful that the poor have no such justice done ’’,them here. As no able-bodied persons are allowed relief, itis instructive to observe how large a number of personsare relieved on account of sickness, old age, orphanage, &c.Thus, in a population of 3,000,000, there were relieved104,541 registered or permanent poor, 53,831 casual poor,7000 insane, and as many orphans, and no less than 7359applicants were refused relief. The salaries of medicalofficers are augmented from an annual grant when theterms are certified as satisfactory by the Board of Super-vision. The salaries of the poor-house surgeons vary fromZ’Cd. per head per week on the average number of inmatesto 7td" the average being 2a!. Thus in the Glasgow poor-house, which contains about 1600 inmates, and into thewards of which 3000 sick were admitted in the year, thesalary for medicines and medical attendance is about .81000

per annum. It seems to us, however, that the salaries inEdinburgh are extremely low, as for that large city onlyX543 is paid annually for medical relief. Seeing thatsickness forms so large a portion of Scottish pauperism,and that the Board of Supervisors have charge of thearrangements for vaccination, and the introduction of thePublic Health Act, we cannot but express surprise thatthere should be no medical man upon the Board. Technicalknowledge has been proved to be so necessary for the expo-sure of abuses here, that we hope the Government will takean early opportunity of inquiring whether similar abusesmay not exist in Scotland.

Correspondence.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY:SANITARY REPORTS.

"Audi alteram partem."

To the Editor of THE LANCET.

SiB,—I am sure I shall not request in vain your aidin furtherance of an important public object. Two yearsago, a paragraph in the Annual Report of the Royal Medicaland Chirurgical Society invited the attention of its Fellowsand of the medical profession generally, to the propriety ofpreserving for future reference those Sanitary Reports ofwhich many are now published annually throughout thekingdom. In consequence of this appeal, some valuableadditions have been made to the Society’s collection ofsanitary documents. I refer especially to the entireseries of Reports on the Sanitary Condition of Leicester.The Society, however, does not possess one complete set ofthe Reports of the Metropolitan Medical Officers of Health,or even a single report from the great majority of them.Our appeal now is to all Medical Officers of Health andothers throughout the kingdom for complete sets of Sani-tary Reports, and a regular continuance, as they appearfrom time to time, of these publications, which, if addressedto the Honorary Librarians of the Royal Medical and Chi-rurgical Society, 53, Berners-street, W., will be preservedwith the care which their value and importance, as historicaldocuments, demand.

I am, Sir, your obedient servant,February 29th, 1869. A. P. STEWART.A. P. STEWART.

MEDICAL ASSISTANTS.To the Editor of THE LANCET.

SiB,—I am glad to see THE LANCET take up the questionof assistants, more especially the unqualified.Something must be done to remedy the present working

of both with the profession. Strongly impressed with thenecessity for change, I shall proceed to mention a sugges-tion worthy to be considered by the Medical Council andthe profession generally. Apprenticeships and pupilagesbeing virtually abandoned, and the lamentable want ofcommon practical knowledge exhibited by qualified men(the growth of the schools only), so apparent and serious,it is admitted a remedy is to be searched for, and must befound. In THE LANCET of Jan. 2nd you propose the stu-dent should, after passing over some of his school and hos-pital training (and to form a part of his education), be re-mitted to the duties of ordinary practice with a medicalman, where he would acquaint himself with such mattersof common sense importance not to be acquired elsewhere.This is very good, but inadequate to professional and socialwants, and would only partly meet the difficulty.The question is one of broader basis. Students and

young professional men want every-day experience in

meeting and treating the sick, to learn to understand andfeel their bearings in the surrounding media of a sickroom, and the outer world, among the relatives, friends,and others; to comprehend their feelings, prejudices,wants, and conceptions-constituting the tact of practice.The profession wants recruits and assistants-the former