:

cisterns, and become absorbed by the water, unless the overflow pipe is brought outside the house, and the end left exposed to the air, instead of being carried into the drain :"Regulation 14.-No overflow or waste-pipe other than a 'warning-pipe' shall be attached to any cistern supplied with water by the company, and every such overflow or waste-pipe existing at the time when these regulations come into operation shall be removed, or at the option of the consumer shall be converted into an efficient warning-pipe,' within two calendar months next after the company shall have given to the occupier of, or left at the premises in which such cistern is situate, a notice in writing, requiring such alteration to be made."

THE DIURETIC ACTION OF DIGITALIS.

The

In the Centralblatt for July 4, Dr. Brunton and Mr. Henry Power bring forward reasons founded on some recent experiments of theirs for rejecting the prevalent theory that digitalis increases the flow of urine by raising the blood-pressure in the arterial system. They injected digitalin in considerable doses into the veins of a dog, and drew off its urine by means of a catheter. The injection was followed by great diminution or even total suppression of the flow of urine, while the bloodpressure rose simultaneously. After a time the latter again diminished, with, in some experiments, an immediate increase in the secretion of urine; whereas in others this did not occur until the blood-pressure had fallen below its normal state. In some experiments the rate at which the urine was secreted with a subnormal arterial tension was very considerable. Now, if digitalis owed its diuretic action simply to its power of increasing the blood-pressure, the secretion of urine ought to be considerably increased immediately after the injection, and to diminish pari passu with the blood-pressure. experimental result is, however, exactly the opposite. The authors are therefore inclined to explain the diuretic action of digitalis by assuming that it stimulates the vaso-motor nervous system generally, while it exercises a special action on the vaso-motor nerves of the kidney. From this results a moderate contraction of the vessels of the whole body, with consequent increase of the blood-pressure; while in the kidney the contraction is excessive, and so puts an end to the flow of urine. As soon, however, as the stimulus to the vaso-motor nervous system is removed, the vessels of the kidney relax more quickly and more completely than the systemic vessels, so that the tension of the blood in the glomeruli of the kidney is still above the normal, although that in the general circulation is below it. This theory is further supported by the fact that albumen appears in the urine after the re-establishment of the secretion-just as Hermann has observed it to occur after mechanical obstruction of the circulation in the renal arteries. The authors consider that the action of digitalis may also be due in part to its direct effect on the secreting cells of the kidney, and they are at present investigating this point.

APOMORPHIA AS AN EXPECTORANT.

DR. JURASZ, assistant at the Medical Dispensary at Heidelberg, has found apomorphia in the shape of the hydrochlorate, and administered in doses of one to three milligrammes every two hours, a valuable expectorant in cases of tracheitis and in bronchitis in its various forms. By its use the expectoration is rendered easier and more abundant, to the great relief of the patients, while the physical signs show a corresponding change from dry whistling rhonchus to plentiful moist râles, which gradually disappear. Dr. Jurasz adds a few drops of hydrochloric acid to the mixture in which the apomorphia is dissolved, to prevent the formation of the greenish tint which otherwise occurs, and which deepens the longer the solution is kept. The only ill effect which patients have complained of from the drug is slight nausea after the first dose, but this has disappeared after a second dose.

PARLIAMENTARY.-ADULTERATION OF FOOD-SLAUGHTER-HOUSES BILL-REGISTRATION OF BIRTHS AND DEATHS.

IN the House of Commons, on Friday, July 24, Mr. Sclater-Booth, replying to Sir H. Peek, said, that since receiving the deputation with a view of limiting the prosecutions under the Adulteration Act, he had consulted the Secretary of State, and they were of opinion that it would be unwise to restrict the operation of the law, but he hoped that the local authorities would be extremely careful in instituting prosecutions, especially on the subject of tea adulterations. Mr. Cross, on Tuesday night, gave a similar reply to Mr. Alderman Cotton's inquiry respecting prosecutions for tea adulterations.

In the House of Lords, on Tuesday, the amendments to the Slaughter-houses Bill were agreed to.

In the House of Commons, the Registration of Births and Deaths Bill was read a third time and passed, and the Vaccination Act (1871) Amendment Bill passed through Committee, and was read a third time on Wednesday, July 29.

In the House of Lords, on Thursday, July 30, the Sanitary Laws Amendment Bill was to be read a second time, and the Public Health Bill for Ireland was to pass through Committee. The Slaughter-houses Bill was to be read a third time.

INTERNATIONAL EXHIBITION.

THE AUSTRALIAN WINES.

THE Australian wines make a goodly show in the Exhibition. Many samples of them are shown, some old in bottle; but the stocks, save of a few kinds, are, we believe, still very limited in this country. The production of wines is, comparatively speaking, a new industry in Australia, and this will account for much that is defective in the characters of some of them; but enough has been done to prove that the quantity which may be produced there is almost boundless. In the meantime the grapes are the growth of young vines, and it is just possible that many of the producers may be comparatively ignorant of the methods best suited for their grapes, and so in some instances the result is not so satisfactory as it might be. Many of the wines here shown are exceedingly good, and these also show what due care in selection and in the wine-making process may accomplish. The whole collection is under the care of Mr. Burgoyne, of Old Broad-street, who is also agent for the Australian Vineyard Association, and himself exhibits some excellent wines. One of the best shown by him,} and, indeed, one of the best Australian samples, is a light white wine, called Highercombe, approximating to sherry in flavour, but natural and unfortified. It has a delicate flavour and bouquet, and is very well suited as a dinner wine for those who need something more than the alcohol contained in the lighter class of wines, but who like not the heavy ports and sherries as ordinarily sold. To this lighter class of wines belong two others, the products of Riesling grapes-the one called a Hock, the other a Sauterne. Both of these wines have a remarkably good bouquet, especially the Sauterne, which we esteem the better of the two, though cheaper. This has, however, less body than the Hock, which seems to us rather too young to have developed much character. Another Riesling, the growth of Mr. E. J. Peake, we also mark as very good; its flavour is well developed, and it has a good body. A fourth Riesling, grown by Mr. Gilbert, is exceedingly good as far as flavour is concerned, but lacks body. Yet another good Riesling is that grown by Mr. Foote.

On the whole we fancy the red wines are not so good as the white. Red Highercombe is fairly good, but not so good as the white. Tintara is perhaps the best red wine shown by Mr. Burgoyne. It is a trifle sweetish, but is well suited for an after-dinner wine.

From Victoria only a few samples are sent, but they are very well worth notice. One white wine, styled Ngawend, is excellent. Still better as regards flavour is a white Hermitage grown by Mr. G. de Puray, near Melbourne; its bouquet is not perhaps so delicate as that of Ngawend, but it is of greater alcoholic strength. A red Ivanhoe, grown by Mr. Charles Maplestone, is probably the best of the Victorian red wines,

but it, too, wants age in bottle. A Claret Carbinet, grown by Mr. Charles Braché, is a capital wine.

In short, these specimens are all well worthy of study; they' promise to contribute much to our supplies of good natural wine; and when the processes of production are better understood, and when the wines have had more time to mature, their value will be greatly increased.

ABSTRACT OF THE APOTHECARIES ACT AMENDMENT ACT, 1874.

THE following abstract of the "Apothecaries Act Amendment Act, 1874," has been forwarded to us by the Society of Apothecaries:

The first section enacts that the Act shall be cited as the "Apothecaries Act Amendment Act, 1874."

The second section repeals those provisions of the Apothecaries Act of 1815 which require any member of the Court of Examiners (or any of the five apothecaries to be appointed under that Act for examining assistants to apothecaries) to be a member of the Society of not less than ten years' standing.

The same section repeals those provisions of the Act of 1815 which require candidates for examination for a certificate to practise as an apothecary to have served an apprenticeship of five years.

The third section enables the Society, with the sanction of the Privy Council, to form part of any Conjoint Examining Board to be constituted under the provisions of the Medical Act of 1858.

The fourth section provides for the Society having power in certain cases to strike licentiates off their list.

The fifth section saves any existing rights of women to be admitted to the examination of the Society.

Independent of the power given to the Society to form part of any Conjoint Examining Board, the Act will therefore be found to effect the following important changes :

(1) The Society can for the future select their examiners from the whole medical profession, or from any scientific body instead (as formerly) from a very limited class of the members of the Society.

(2) Apprenticeship is no longer made a necessary condition required of candidates presenting themselves for examination for a certificate to practise as an apothecary.

(3) The Society can strike licentiates off their list on the same grounds as they can be struck off from the Medical Register.

It may be observed, in conclusion, that no new rights are conferred upon women by the fifth section of the Act.

THERAPEUTIC MEMORANDA.

BROMIDE OF POTASSIUM IN TIC.

SIR,-Having succeeded twice recently in giving immediate relief in neuralgic headache accompanied by shooting pains in the trifacial nerve, with a sensation "as though the head would split open," I beg to recommend to your readers the simple remedy employed-viz., bromide of potassium in a single dose of twenty grains taken at bedtime. As no inconvenience resulted from this dose, I concluded that it was just exactly sufficient to accomplish the end in view. The dose mentioned in Dr. Meadows' "Prescriber's Companion," 1864, is only from three to ten grains; but I presume the profession were, at the time of its publication, only imperfectly acquainted with the drug in question. My own feeling is always in favour of giving the smallest dose of any drug that is sufficient to give relief. In this case the patient, a girl of about twenty, continues perfectly well. I am, &c., EDWARD HAUGHTON, M.D.

Upper Norwood, S.E., June 18. In certain cases it is not unusual to give even as much as sixty grains for a dose.-ED.

A FEMALE DOCTOR.-Mdlle. Vögtlin, who has been practising medicine at Brugg, has received from the Faculty of Medicine at Zurich the degree of M.D.

SERIOUS CHARGE AGAINST A NUNEATON SURGEON.

Ar the Atherstone Police-court, on Tuesday, Mr. Edwin Peacock, surgeon, of Chilvers Coton, near Nuneaton, was charged with the manslaughter of Ann Woodward, wife of John Woodward, labourer, of Hartshill, on June 19 last. Fortunately for our profession it is not often that such a charge or such evidence is brought before the public. Indeed, in a case like this we hardly feel ourselves justified in abstracting the evidence, but give it as nearly as possible in full. As the case is yet unfinished we abstain from all comment, but only premise that there had been previous to this a coroner's inquest, which, by the weight of medical evidence, ended favourably for Mr. Peacock, but which gave rise to so much dissatisfaction as to cause the Treasury to take up the matter, so that the prosecution is now a Government one. In conclusion, we cannot help thinking that an adjournment to October 9, if convenient for the magistrates and legal gentlemen, is most unjust to Mr. Peacock, over whose head this dreadful accusation hangs, supported by a certain amount of evidence altogether unrebutted. Such a case ought to be settled with all speed.

After an opening statement by the prosecuting counsel,

John Woodward was called, and said he was a labourer, living at Hartshill. His wife died on the morning of June 20. At that time she was forty-three years of age. On Friday night, June 19, she was taken with pains of labour, and he therefore went to fetch Mr. Peacock, who had been engaged to attend her. On returning home about eleven o'clock he found Mr. Peacock there. Whilst Mr. Peacock was upstairs he heard him say to his wife, Lie still, or else I will leave you." She replied, "Then leave me." She had in previous confinements suffered from cramp in the hip. Witness did not go upstairs till the child was born. The child was born about twelve o'clock, and soon after the birth Mr. Peacock called for some brandy, which was supplied. Witness went out to fetch more brandy, and on returning about one o'clock, Mrs. Wilson, one of the women attending deceased, told him that she was dying. He went upstairs then whilst Mr. Peacock was there, as his wife wished to see him. Mr. Peacock then stood by the bedside. His wife said to him when he went up, "That man is the death of me." Mr. Peacock asked her if she was in pain, and she said she was in pain. That would be about half an hour after he fetched the brandy. Before Mr. Peacock left he said that the woman would die in less than an hour. She died about twenty minutes before two o'clock. On the following morning he went to Mr. Peacock's surgery, arriving there about nine o'clock. He went by appointment with Mr. Peacock to get the certificate of death. Mr. Peacock then said he was very sorry for what had happened. He then gave him the certificate. Mr. Peacock said he did not think he had done anything wrong; he had done everything to the best of his judgment. Witness returned home about eleven o'clock, and met Mr. Peacock. He had something in his hand in a rhubarb leaf. Witness followed him to the door. Mrs. Wilson remarked that he was going to take it away, and witness replied that he should not. Peacock said he should take it away. He said that twice. Witness threatened to lock the door, and prevent him taking it away. He then left what he was carrying, washed his hands, and left the house. Witness fetched a policeman, and also Mr. Handford, surgeon, and gave the contents of the rhubarb leaf to him. Had been married twenty-two years, and had had eleven children.

Cross-examined: Mr. Peacock had attended his wife in her two last confinements. He did not know that they were difficult confinements. He lived about three miles from a medical man.

Eliza Wilson, wife of John Wilson, labourer, of Hartshill, said that on Friday, June 19, she went to attend Mrs. Woodward at her confinement. The husband went for Mr. Peacock, and she remained till he came, about half-past ten. Mr. Peacock ordered deceased to go upstairs with him, and witness followed. After some time had elapsed Peacock ordered witness to fetch his instruments. Witness fetched them. She said,

"Sir, I hope you are not going to use them." He replied, "I shall not unless I am forced to it." He laid the instruments on the table. He came down again for the instruments, and witness again told him she hoped he was not going to use them, as the deceased dreaded them. Mr. Peacock said the child could not be born without them. Saw him take the instruments to the woman, but could not see him use them. The child was born shortly afterwards. He was by the bedside for a long time, but witness could not see what he was doing. He was engaged in this way more than ten minutes, and during that time Mrs. Woodward appeared to be in great pain. Mr. Peacock was very still, and remarked that "it was worse than the baby being born.' Witness took the baby downstairs, and Peacock shouted out, "Where are the scissors ?" As they were not at once given to him, he said, "Good God! where are the scissors?" Witness went upstairs and found him still continuing the operation, and the scissors were lying on the ground. They were the scissors used for ordinary housework. After he had the scissors he said, "The woman will die." He added that the womb had become ruptured. He began to give her brandy just when he began to use scissors. Afterwards he said he should want more. He gave her brandy several times, felt her pulse, and asked her if she was in pain. The husband went for more brandy, and Peacock sent witness after him, telling her, "You follow him, and tell him she will die." Witness did follow him, and on her return to the house she found deceased lying as she had done previously. Witness left the house for a short time, and, hearing deceased shrieking, she returned to the house, and found deceased in great pain, knocking her head about and saying, "I am going as fast as I can; that man has killed me." Soon after that, about twenty minutes before two o'clock, she died. On the following morning, Mr. Peacock came to witness's house, and asked her if she was the woman who was at Woodward's on the previous night. Witness said "Yes," and he said he wanted a word or two with her. He said Mr. Woodward had been to him, and said that the death had been caused through his neglect. Witness said, "Sir, there was that come as should not have come." He said, "Yes, I know that, but it's not my fault." She told him she thought it was very strange for him to empty the vessel, as she had heard he did so.

He said he did it to save the women the trouble. Witness told him a great many persons had been to examine it, and she expected it would be examined by another doctor. He said, "Is it there now?" She said it was, and he asked, " Could you fetch it to me ?" She declined, but agreed to go with him to it. As they were going, he asked if they could go the back way, but she said they could not. Mrs. Clark joined them, and they all went to the privy and recovered the intestines, which he wrapped up in rhubarb leaves and took to the house. Witness whispered to Mr. Woodward that Peacock was going to take them away, and Woodward said he should not take them, and that if he was determined to take them he would fetch the police and put the doctor out.

Cross-examined: Was with deceased at her previous confinement. She then had very hard labour. Defendant attended her, and the instruments were used. It was then that he said the instruments must be used, or the child could not be born. Defendant did all that a doctor could do, so far as she could see. In attempting to deliver deceased, he was quiet and as slow and cautious as he could be. He told her to lie in a certain position, but she wished to have her own way. Defendant kept trying to save her, although he told her she could not live. After Peacock left, she seemed better, and said that she thought she should live.

Re-examined: What defendant did to save deceased was to give her brandy simply. It was between the birth of the child and the use of the scissors that she screamed. After she had brandy she dozed.

She re

Hannah Clark, wife of George Clark, labourer, Hartshill, said she attended Mrs. Woodward's confinement. mained with deceased till the child was born. After the birth of the child she saw defendant cut something in two, and after looking at it he put it into the chamber utensil, and cried out for some brandy. While Mr. Woodward and the previous witness had gone for brandy, defendant took the utensil downstairs to the privy. Witness afterwards saw the intestines in the privy. When defendant brought back the utensil it was empty.

Cross-examined: This was the first confinement in which she had attended deceased. It was true that whilst Mr. Peacock was attending Mrs. Woodward she did not see any

thing at all unreasonable. The doctor seemed to be attending to her, and she thought he did all he could.

Mr. Thomas Handford, surgeon, of Atherstone, said he had been in practice for thirty years. On the morning of Saturday, June 20, he was called to Woodward's house, where he was shown a portion of human intestines on a rhubarb leaf. He examined them. There were fully fifteen feet. There was a large portion of the small intestines missing-the greater part of the colon and the cæcum were missing, and the appendix to the cæcum. Fifteen feet would be nearly half of the intestines. They were in one entire piece. He observed the ends of the remaining intestines. They had evidently been cut. On June 21, by direction of the coroner, he made a post-mortem examination of the body of deceased in company with Mr. Nason. There were also present Mr. Hammond (Mr. Nason's partner); Mr. Lawson Tait, of Birmingham; Dr. Jolly, of Birmingham; and Dr. Brown, of Coventry. The three latter gentlemen attended on behalf of Mr. Peacock. A report of the result of the examination was presented to the coroner, and he now produced that in evidence. It was to the effect that the body was found to be welldeveloped. The abdomen and the uterus were much distended, but on examination the latter was found to be entirely uninjured. It contained the afterbirth and a portion of the umbilical cord. There was a rent in the vagina. A portion of the large and small intestines was missing, including the mesentery. It was not a fact that the woman died of rupture of the uterus. He considered that death resulted from the shock to the system, loss of the intestines, and loss of blood, and no doubt the laceration of the vagina. Rupture of the vagina was not necessarily fatal. It did not follow that if the intestines protruded the person would necessarily die. It was absolute and certain death if the continuity of the intestines was broken. The rupture of the vagina might have been caused by the introduction of the forceps or the hand. The vagina being ruptured a certain amount of the intestines would protrude, but he did not think that fifteen feet, or anything like it, would protrude spontaneously. One or two folds might. The fact of the large intestines having protruded led him to believe that force must have been used. If the intestines protruded, the proper way would have been to return them. It was the duty of the surgeon to prevent injury to them. He should not have cut them off. He could not think that it was right for them to be cut, as the result must be death. He should not think it possible for a medical man to mistake the intestines for the afterbirth, although he thought it was done in this instance. About eight inches of the cord was left with the placenta. The ordinary time for the separation of an afterbirth was about five or ten minutes, but if there had been urgent symptoms he should not have waited longer without removing it.

The rup

Cross-examined: In his own practice he did not know of a case where the afterbirth never came away at all. He did not know that he recollected reading of one. His evidence as to the time was simply with regard to ordinary cases. ture was at the upper posterior part of the vagina, where the intestines pressed most. It was a mistake which might be made when Mr. Peacock said it was a rupture of the uterus. Had heard of spontaneous laceration, which might occur apart from the surgical operation. He did not believe the rupture in question could have been caused by internal force. It was possible muscular force, by straining, might cause it in time, but he did not believe it was so in this instance. He did not know of symptoms of laceration. Supposing there were symptoms of laceration, it would be the surgeon's duty to deliver at once. If the intestines had protruded he should not have cut them. He denied that he had said at the inquest, "If I had been present I cannot say what I should have done.' If it was on the depositions he did not say it. He signed the depositions, but they were not read over to him. He should have endeavoured to return the intestines. He did not know that there was any rule to guide a surgeon under the circumstances; but there was no rule to cut them. He should always endeavour to return them.

In answer to the Bench, witness said the cutting off of the intestines destroyed all chance of recovery. The protrusion of the intestines might cause death, but his opinion was that the removal of them accelerated death.

The Court having sat six hours, the case was adjourned, at six o'clock, until October 9, when it will be resumed, at Nuneaton. The adjournment for an extended period was

arranged in order to suit the convenience of the magistrates and the legal gentlemen.

Mr. Peacock, who was in custody, was liberated upon entering into his own recognisances.

Several medical witnesses were in attendance, including Mr. Clay, Mr. Tait, Dr. Jolly, and Mr. Wilders, from Birmingham, and Dr. Brown, of Coventry.

FROM ABROAD.

THE AUTOMATIC MAN.

SINCE the notice concerning this curious case which appeared in our last, we have received the elaborate account of it communicated by Dr. Mesnet, of the St. Antoine Hospital, to the Union Médicale for July 21 and 23, under the title, " Automatism of the Memory and Recollection in Pathological Somnambulism." This enables us to communicate to our readers a few additional particulars and some of the conclusions which an elaborate investigation of the case has led Dr. Mesnet to arrive at.

As we have already stated, the patient, twenty-seven years of age, had a portion of his left parietal carried away by a ball. Shortly afterwards he became insensible, and only recovered consciousness three weeks after, having in the meantime been transported from Sedan to Mayence. He was afterwards sent back to France, and at the end of a year had lost nearly all traces of the hemiplegia of the right side which had followed the accident. Three or four months after the injury, the paroxysms, which have rendered the case remarkable, began to appear, and have continued ever since, although they have varied in the frequency of their occurrence (from fifteen to thirty days) and in their duration (from fifteen to thirty hours). During these four years this man has continued to present two entirely different conditions. In his ordinary state he is sufficiently intelligent, and has gained his living as a clerk and as a singer at concerts; and since he has been in the hospital he has been handy in assisting the other patients. His health, also, is perfectly good.

His passage into a pathological condition is instantaneous and insensible. His senses become closed to all external impressions, and yet he seems to come and go and to act as if in full possession of his senses and intellect, so that persons unaware of his singular condition would never suspect it from anything which they observed on meeting or passing him. His carriage is easy and his countenance calm, the eyes being wide open, with dilated pupils. There is contraction of the brow and eyelids, with constant nystagmus, and a continuous movement of the jaw. If in a place he knows, he walks about entirely at his ease, while when this is strange to him, and when all kinds of obstacles are placed in his way, he endeavours, by aid of his hands, to gently guide himself through these. He offers no resistance to any movements impressed upon him, so that his direction may be changed or his pace changed, exactly as if he were an automaton. During the paroxysms all the instinctive functions and appetites are accomplished as in the healthy state, and he eats, drinks, smokes, dresses, and undresses at the usual times. These actions Dr. Mesnet is disposed to regard as automatic, the simple result of the habits of his waking hours continued during his sleep, for, on watching him while eating, he is observed to eat with gluttony, and without discernment, scarcely chewing his food, swallowing all that comes to hand without ever seeming satiated. So, also, he drinks whatever is given him, whether wine or nauseous substances, without manifesting any sign of the impressions produced.

The general sensibility of the surface is absolutely extinct, as this may be pricked, pierced, or submitted to the electric pile without any result. The senses of hearing, taste, and smell are entirely abolished, and various external organs may be irritated in any way without any common sensibility being manifested. Sight, also, is no longer influenced by external impressions; but sometimes the patient seems to have a confused perception of brilliant objects. Touch is the only sense that persists, and places the patient in relation with the external world. The whole procedure of the patient manifests the delicacy and subtlety with which this sense is employed.

The first of these paroxysms occurred in 1871, and they were during the year which the wound remained unhealed of

more frequent occurrence, so that the intervals only lasted from five to six days, whereas since that period they have varied from fifteen to thirty days. After some premonitory heaviness of the head, the transition from health to disease takes place almost insensibly in a few minutes, and a conscious and fully responsible being becomes in an instant a blind instrument or automaton, obeying the unconscious activity of his brain, seemingly in the possession of a liberty which he no longer has. All his actions and motions are but the repetition of the habits of his waking hours. One peculiar feature not then found, however, is the development on the part of the patient of a desire for the subtraction and concealment of all objects which come under his hands. This propensity has always been manifested from the first paroxysm; and so irresistible is it, that when objects appertaining to others are not accessible, he conceals his own watch, knife, etc. On awaking from his paroxysm he has not the slightest recollection of what has occurred.

Dr. Mesnet mentions in great detail many examples of the mode in which the sense of touch called forth a whole series of connected actions. Thus, a walking-stick placed in his hand, and mistaken for a musket, called up the recollections of the late campaign and led to his performance of the various acts as if actually engaged in battle. A pen presented to him at once aroused the desire to write, and accordingly he wrote a letter to his general, impressing his claims upon him. It was found that if an impervious object were interposed between his eyes and the paper on which he wrote, the writing became irregular and illegible; and again, when water was placed in the inkstand in place of ink, he perceived the deception, although attributing it to some fault in the pen, which he frequently rubbed on his sleeve. The conclusion to be drawn from these experiments is, that vision here existed, and was necessary for the written expression of the ideas of the patient; but its field was very circumscribed, and was only aroused by the sense of touch, its exercise remaining limited to the objects with which it was brought in relation by this sense. While walking in the garden the patient would make his cigarette, light it, stamp out the lighted match, and smoke-all exactly as if in his ordinary state. But when his tobacco-pouch had been removed, and after he had sought for it in the usual place in the most natural manner, if it were placed before and close to his eyes he never perceived it. Put in his hand, he at once made his cigarette. If while lighting this the match were blown out, it was in vain that another ready lighted one was brought close to the cigar and close to his eyes, for he saw it not, even when it burned his eyelashes. This, again, showed that while the patient saw certain objects he could not see others, the sense of sight being, in fact, closed to all objects external to himself. He saw his own match, but not that which was offered to him.

The pathological condition of this patient cannot be confounded with the state of sleep and dreaming, for the dreamer is not always independent of the action of external influences, many of these being capable of giving or changing the direction of his dream. In this patient one sense alone retained its relations with the exterior, and, as far as this is concerned, impressions of this sense may with him, as with the dreamer, call forth corresponding cerebral action. The dream, too, vanishesspontaneously or on the slightest arousing of the senses; but in this patient the life of relation is suspended to such a point that it becomes impossible to arouse him, whatever efforts be made, and however violent the means employed.

With respect to the medico-legal bearings of the case, Dr. Mesnet observes:-" The disturbance which these functional perversions of the nervous system produce in the exercise of the life of relation, extends not only to the organs of the senses and the intellectual acts properly so called, but also sometimes arouses instinctive excitements, which deliver over their subject, defenceless and deprived of discernment and reason, to the most deplorable impulses. He acts with all the appearance of a liberty which he does not possess, and seems to have combined and prepared certain actions, when, in reality, he has been but a blind instrument, obeying the irresistible impulses of an unconscious will. In each of his paroxysms this patient, dominated by the impulse to steal, possesses himself of every object he can lay his hands on, and conceals them dexterously."

SMALL-POX is very prevalent in Newmarket and neighbourhood.

REVIEWS.

Autobiographical Recollections of the Medical Profession. By. J. F. CLARKE, M.R.C.S. London: Messrs. J. and A. Churchill. 1874. Pp. 537.

THE author of this very interesting work has been long and favourably known to the profession, and with many of its most distinguished members has been in constant intercourse, arising in a great measure from his having been upwards of forty years on the staff of a contemporary, and from his long connexion with medical societies past and present. Enjoying an extensive general practice (for everything appears to be a labour of love with Mr. Clarke), he has found time to produce a delightful gossiping work-just the book to pack up in our portmanteau to read and enjoy in the country excursion so many of us are about to make.

To those of the author's standing it will bring up most pleasing reminiscences, whilst the younger members will be introduced, as it were, to some great and good men, like those described by Pope as "in general the most amiable companions and the best friends, as well as the most learned men I know," -such men, to wit, as Green, Brodie, Lawrence, Astley and Samuel Cooper, Liston, Vincent, Elliotson, Abernethy, Hall, Hodgson, Carlisle, Addison, Holland, etc.,-for with all of these and many more are we again brought in pleasing contact: men of whom the learned but somewhat surly lexicographer Johnson could not but have remarked, as he did of others, that we had all "found in physicians great liberality and dignity of sentiment, very prompt effusion of beneficence and willingness to exert a lucrative art where there is no hope of lucre."

How the members of our profession are too frequently imposed upon by persons well able to pay, Mr. Clarke gives a very amusing illustration as having occurred in the practice of the late Mr. Wardrop, whose opinion could always be obtained without a fee at any time by a needy patient, but who hated to be imposed upon; he disliked shams. Wardrop was in the habit of telling with much glee how he "served out' a "gratuitous" patient who had imposed upon his benevolence. During the time Wardrop was in the habit of giving advice in the morning to the poor, he was one day called out early to see a patient in St. James's-square. On returning to his house he observed an old gentleman, very shabbily dressed, alighting from a carriage with a coronet on the panels. He immediately recognised one of his "gratuitous" patients. He waited, unobserved, until the "old fellow" had turned the corner of Charles-street (where Wardrop resided), and then ascertained that his patient was the Earl of In due course, and in his turn, the Earl was ushered into the presence of the surgeon, who rose from his seat and received the shabby nobleman with the greatest courtesy, and addressed him by his proper name and title. The detected impostor was thunderstruck, and anxious to beat a hasty retreat. But this was not to be allowed. Wardrop upbraided him with his meanness and duplicity, and eventually made him pay a guinea for every visit he had made. The sum thus received was considerable. He never saw the "nobleman" afterwards.

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On the subject of medical incomes we quite agree with Mr. Clarke that they are usually much overrated-an opinion shared by the late Dr. Merriman, of Brook-street, who had as large, perhaps a larger practice than any obstetric physician of the time, and who, in his most prosperous year, never made more than £4000 per annum. Brodie, adds Mr. Clarke, never exceeded £13,000 per annum; and though Sir Astley Cooper is recorded to have made in one year the great sum of £24,000, it was acknowledged by him to be quite an exceptional amount. Abernethy's is mentioned at £10,000, and Liston's at £7000. Dr. Elliotson's income, it is stated, rose in one year from £500 to as many thousands.

Of the early history of the journal with which Mr. Clarke was so long and honourably connected, as of its founder and writers, we have a very interesting account. "The appearance of it was received nowhere with more surprise than at the Borough Hospitals of Guy's and St. Thomas's." The author might have added another institution in Lincoln's-inn-fields, at which for a long time it could only gain admittance by stealth; so much was this the case, that the late Mr. Clift, the first Conservator of the Museum, when binding the volumes, had them lettered on the back "The Stiletto," fearing the dreaded true title might be seen by the "great guns," and lead to a severe reprimand, as in the case of a gentleman still holding

office in that institution, who did receive a severe reproof from Sir Anthony Carlisle for presuming to write to or for any journal, "especially the blackguard -" In his "Recollections" Mr. Clarke omits to give what would have been a very interesting account of a scene in the theatre and the violent expulsion, by direction of Sir William Blizard, of the editor from the College by the "Robin Redbreasts," as he terms those stalwart Bow-street runners-nicknamed also "scarlet runners,"-Leadbitter, Gardner, Ruthvin, and Smith; who conducted their crest-fallen prisoner, with dishevelled locks and torn clothes, before the dreaded Sir Richard Birnie at Bow-street Police-office;-a treatment very different from that received not long ago by "the young gentlemen who now wield its thunder," when they met at a "hole-and-corner meeting in a back room in the Strand, in which they privately drew up a certain number of resolutions condemnatory of the College, which, if carried and acted upon, would," Mr. Clarke thinks, "have been ruinous to that institution." With singular modesty he omits all mention of the great share he had in discomfiting the host. The bold front he exhibited on that occasion, backed up by the good feeling of a considerable majority of those present, and the admirable tact and firmness of Mr. Cock, the President, without the aid of the "special constable," effectually disposed of the army of "resoluters."

Those of our readers old enough to remember them, will be struck with the correctness of the pen-and-ink portraits of the many members of the profession with whom the author came in contact: what more photographically correct than his description of Mr. Vincent as "a peculiarly shy man, just above the middle height; he walked quickly and somewhat clumsily, having the appearance and manner of a lawyer's clerk hastening to court, dressed rather shabbily in black." Mr. Clarke thinks he failed to impress his patient, at first certainly, with an idea of his real power; but we think it was Theodore Hook who said that "dear old Vinco" appeared to have eyes at the ends of his fingers, and was so much beloved by the Christ's Hospital boys. Again, speaking of Messrs. Guthrie and White, how true his portraits are "Phrenologically the two men were striking contrasts; White had a largo head, a somewhat heavy overhanging brow, clear, sagacious eyes, bus denoting his indolent proclivities." (Too true.) "Guthrie's head was rather small, but indicative of energy and self-possession. His black piercing eyes were really remarkable. I do not recollect any member of our profession in whom these organs were finer or more characteristic." We remember hearing a well-known American physician say that Guthrie's eyes could look through a stone wall, so bright and piercing were they even to the last. Mr. Clarke is equally correct in his physical and mental delineations of S. and A. Cooper, Hodgson, Wardrop, Keate, Brodie, Dermott, etc. He makes no mention of Mr. Dermott's constant and perhaps most faithful of friendsviz., his large Irish wolf-hound. To some of his faults the author is very charitable; these, he states, were partly due to his erratic mode of teaching, and to the circumstances under which he was placed. Perhaps the author is not aware that to Dermott is due the annual annoyance of the registration required by the Council of the College of Surgeons of all students pursing their hospital studies; as he was very lax in requiring the attendances of his pupils, who, after payment of their fees, were allowed to return to the country to pursue their business, in some cases that of ordinary tradesmen; and then to come back to London at the end of the session to obtain their certificates and the necessary grinds.

Not only of men and events, but of the many past and present societies, anatomical schools, and journals, does Mr. Clarke give us most faithful details, which his readers will peruse with gratification and pleasure. Some of these notices we may perhaps be able to draw attention to on a future occasion, but meanwhile we heartily commend the work as a most interesting and entertaining production.

Contributions to Pathology and Surgery. By CESAR H. HAWKINS, F.R.S., ETC.

MR. CESAR HAWKINS has added another to the many obligations under which he has already placed the profession of which he is so distinguished an ornament, by reprinting in a collected form his many valuable essays and lectures, which have been hitherto scattered through a number of periodicals, and thus comparatively inaccessible. Many of the essays in these volumes have a historical value as records of important steps in the progress of pathology and surgery; but apart