system of practical rules that any average woman is competent to apply, but that it involves an acquaintance with, and supplies illustrations of, the whole of medical science and practice. It is connected with every department of medicine and the allied sciences, from the humblest knowledge of remedies to the highest flights of what used to be called transcendental anatomy and physiology.

Many years ago the question was debated, whether the "great pains and perils of childbirth" were not inflicted on woman as a divinely ordained punishment. This question it is not our place to answer. But if they be, it is only one argument the more for alleviating them, as we try to do all other consequences of transgression. It was further held that there was a difference between women and the lower animals, and that women alone undergo "pains and perils," whilst parturient animals accomplish their task in speed and safety. We are glad to see that, in order to solve this question, Leishman introduces the student to the development and structure of the pelvis in the whole of the mammalia. This is as it should be. No branch of physiology or of the healing art can be complete which regards man alone. But we are sorry to see that Leishman starts with an assumption which perpetuates what we venture to think the old error, and which seems to us at variance with the very facts of comparative anatomy which he appeals to. In fact, Leishman follows Osborn and others of the older writers in maintaining that "there exist in the human species conditions which exercise, as compared with the lower animals, a special influence upon the progress and issue of labour. . . . By a comparison of the human race with those of the mammalia which stand nearest to it in the scale, we shall be able to show that the process of childbirth must be more difficult and more obnoxious to serious hindrance than in any even the highest-of the other mammalia." Now, as we have said before, the comparison of the pelves of the whole animal kingdom is a most laudable and useful study; but we venture to think, first, that this comparison of pelves shows the human female to be as well equipped by the Creator for easy parturition as any other female animal whatever; and secondly, as a matter of fact, that the human female, cæteris paribus, does not suffer more in parturition than the female of any other animal; and lastly, that there is no evidence to show that the lower races of mankind-as the negro-pass through childbirth more easily than the higher races.

With regard to the pelvis, let any student walk into the Hunterian Museum, or any good osteological museum, and take a careful survey of this part of the animal framework, and endeavour to make a scale of pelves. In such a scale the simple rudiments--or no rudiments-in the snake or in the cetacea, the imperfect pelves of larks and other birds with slender legs and powerful wings, and the ill-developed pelvis of the mole, will occupy the lower end; whilst the massive pelves of the crocodile, of the ostrich, or dinornis, or other so-called wingless bird, and, above all, of the megatherium or extinct gigantic sloth, will be at the other. Such a survey makes it evident that the size and weight of the pelvis do not depend on general position in the animal kingdom, for chelonia and saurians, as to pelvis, rank above birds. But they depend on one thing, and one only, and that is the size of the lower limbs, the weight they have to bear, and the work they have to do. The best illustration of this is the mole. This animal does the main business of life by the upper limbs; hence these with their vertebral arch are enormously developed in proportion to the legs, which have little to do, and are supported by a dwarfed pelvis. The doctrine that the true relation of the pelvic arch is locomotive or mechanical is well put by Leishman when he says, "The pelvis, in the various groups into which the mammalia have been divided, is formed so as to suit the requirements of the individual. The mode of locomotion, be it leaping, running,

or swimming, is revealed to the anatomist by an examination of the pelvic bones; and in every case it will be seen that the preponderance of ischium, ilium, or pubes is due to the necessity which exists for certain mechanical arrangements, by which alone can the required muscular power be applied to the bony levers. The pelvis is also," continues Leishman, "an efficient support to those organs which are usually contained within it, and especially to those which are connected with the function of generation."

It is quite true that the pelvic arch gives, besides, a support and a localised spot for the cloaca, in its three divisions-fæcal, generative, and urinary, but it is equally true that its real significance is locomotive. In the mole the generative and urinary organs are outside the pelvic cavity, such as it is.

So far, then, the ground is clear. The pelvis is, in its trne conception, the basis of the mechanism of the lower limbs. But yet the obstetrician must look at it from a limited and special point of view, as "the osseous canal through which the product of conception must pass in the act of parturition." And here we venture to repeat what we said above, that the human pelvis, whilst admirably supplying the support of the viscera and the basis of muscular action needed for the erect posture, is yet the most favourably constructed for easy parturition.

Taking the mammalian series generally, the pelvis is a long, narrow, angular passage. Leishman, who teaches that the pelvis of the human female is less favourable for parturition (regarding the pelvis of animals), speaks of the ever watchful provision by nature of means to an end," and describes "the irrefragable evidence afforded that the pelvis is designed with a direct reference to the propagation of the species." This evidence consists in the difference between the male and female pelvis in some animals, but, besides, in "certain modifications of structure which occur on the approach of labour, and clearly prove that nature prepares the parts for their new function." This modification consists in the softening and elongation of the pelvic ligaments, which occurs notably in the guinea-pig and cow, and without which "the difficulties of labour which occasionally arise" in these animals would be much more frequent.

Now, the softening of the pelvic ligaments, and separation of the bones, doubtless exist in some parturient women, and give them, in a certain degree, one advantage possessed by the lower animals. But, besides, the human female pelvis, compared with that of apes, is less deep, the symphysis pubis is shorter, and the sub-pubic arch so fully developed, that the difficulties arising from the curve of the pelvic axis, and from the firm floor for the abdominal viscera afforded by the pelvic muscles and ligaments, are more than compensated for. Hence we venture to conclude that, so far as the structure of the pelvis is concerned, parturition is as easy in women as in animals.

In the next place, leaving the osteological museum, and drawing our argument from the bedside, it is notorious that in women who have had one or two children, the child's head may be propelled through the pelvis with one "pain" and one only. Six, eight, or ten hours may have been spent in the dilatation of the os uteri, but that once effected, the whole pelvic canal may be, and often is, cleared in two minutes. So that the well-formed pelvis offers no obstacle to the well-formed head.

Moreover, the clinical examination of parturient animals shows the popular notion of the absolute ease of the process to be a mistake. In days when there were cow-houses in London, we more than once witnessed the parturition of cows, besides that of the other domestic animals; and this we advise the student not to neglect. There is no parturient animal who does not usually show premonitory uneasiness; and during the

expulsive efforts the cow groans, and stands uneasily first on one leg then on the other, to get ease by shifting the posture. Lastly, as regards the alleged facility of parturition in animals and the lower tribes of men, there is, as Leishman well puts it, "a wide field for original investigation." In other words, we know very little about it. What we know of the frequency of vesico-vaginal fistula amongst the coloured women in the United States, and of the cases that come under European practitioners in India and the Colonies, makes us doubt it. (b) Here for the present we must close our remarks on this interesting subject.

MISS JEX-BLAKE v. THE UNIVERSITY OF
EDINBURGH.

WE are told nowadays that the intellect knows not sex, and even the idea that sex can influence or differentiate intellect is repudiated with indignation and scorn. Yet we dare to sus

pect that it is decidedly more difficult to a woman than to a man to understand and appreciate the truthfulness and the force of the saying, "Speech is silvern, but silence is golden"; and we venture to suggest this as the excuse for the letter from Miss Jex-Blake which appeared in the Times of June 20. Allusion having been made in a leader in the Times to the fact that one of the lady-students, “who had rendered herself most conspicuous," had after all failed in the medical examinations at the University of Edinburgh, Mrs. Thorne, a friend and former fellow-student of Miss Jex-Blake's, wrote to the editor, putting the cap on that lady's head, and explaining that she had so entirely devoted her time and energies to the interests of her fellow-students, that the "preparation for her examination became in consequence a secondary consideration," and that hence it was "not surprising that she failed to satisfy the examiners." Miss Jex-Blake, however, altogether repudiates her friend's explanation, and says, "I think it due to myself to state that my preparation for the examination in question was "not made secondary to any other object whatever, but was, on the contrary, as I still believe, thoroughly adequate "; and, further than this, she goes on to say, "my success in answering the papers set was, at any rate, not less than that which had in previous years enabled me, as Mrs. Thorne truly asserts, to obtain a place in the prize-lists (after examinations generally considered more difficult), in every one of the subjects in question." She speaks of her failure only as an alleged failure," and she insinuates, to say the least, that the verdict of the examiners was an unjust one; but "as I found," she says, "that the examiners were practically quite irresponsible except to a court of law, I resolved, after much consideration at the time, to take no steps whatever with a view to my own vindication." We know that that vain and poorer creature man not unfrequently believes, or affects to believe, when he fails to pass an examination, that his failure is due to the incapacity, ignorance, or prejudice of his examiners, but we are grieved to find that the “fairer" sex not only share this weakness, but can be guilty of the much greater weakness of making that weakness public. It could not be expected, we suppose, that Miss Jex-Blake could deign to submit her letter to the judgment of any man before sending it to the Times; but we think that even men who are fighting most earnestly and enthusiastically, not only for the "higher education," but also for the medical education of women, would have pointed out to her the impolicy and injudiciousness of making such a statement public. Miss Jex-Blake has, of course, been answered by the examiners before whom she appeared. It was hardly possible for them, in justice to the University of Edinburgh, to allow her letter to pass without notice. They say "The subjects of examination were

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(b) See art. "Parturition," by Rigby, and "Pelvis," by John Wood, in Todd's Cyclopædia.

chemistry, botany, and natural history. Her papers were most carefully examined by six examiners (three of whom were professors), and they unanimously agreed that the answers were extremely defective on every subject"; and they add that her papers were perused by one of their colleagues (not a member of the Board of Examiners), and that he was "satisfied that the examiners did no more than their imperative duty." And this is not all. One of the Board of Examiners (Professor Wyville Thompson, the Professor of Natural History) is away with the Challenger scientific expedition, and in his defence a friend of his, "acting under licence," states that in 1872 a friend of Miss Jex-Blake showed to Professor Huxley "what she described as that lady's examination papers," and asked for his opinion of them. Now, Professor Huxley certainly cannot be suspected of entertaining any prejudices hostile to Miss Jex-Blake; but what was his judgment? “He read the natural history paper, and had no hesitation in confirming Professor Wyville Thompson's judgment; and he thought he succeeded in satisfying Miss Jex-Blake's friend that the examination in natural history, at any rate, had been fairly conducted." And most probably he added Ex uno disce omnes, or arguments to that effect. But in vain. Miss Jex-Blake manfully-we beg her pardon, sensibly-kept silence, though no doubt it was pain and grief to her, for two years. But"He that complies against his will

Is of his own opinion still."

In spite of the extreme improbability that a board of examiners had agreed to do her injustice, and in spite of Professor Huxley's judgment, Miss Jex-Blake remained of her own opinion to the contrary, and, stung by the kindly-meant suggestion that she had committed the not uncommon error of over-estimating her fitness for the examination in question, she fell into the far greater, and happily less common, mistake of publishing that opinion to the world in the columns of the Times. We trust for her own sake that Miss Jex-Blake recognises her mistake, regrets it, and will accept its teachings as a part of her "higher education."

NURSES FOR THE SICK POOR.

ON Thursday, last week, two important meetings were held in London for the purpose of training and providing for a body of nurses for the sick poor in London. Even those who have no practical knowledge of the difficulties of treating serious disease in the homes of the labouring classes, can imagine in some degree the value of the presence and help of a well-trained nurse at such times, but all who work in any capacity —as medical men, ministers of religion, or visitors—among our poor know that such assistants would be simply invaluable, and that not only as skilled attendants on the sick, but also as teachers of sanitary measures. One meeting, held at Willis's Rooms, had for its object the establishment of an association, "in accordance with the suggestions of a committee of the Order of St. John of Jerusalem, for training and providing a body of nurses" for the sick poor in London and the provinces. Last year the Council of the Order of St. John of Jerusalem in England formed a committee for the purpose of considering how trained nurses could be provided for the sick poor, and this committee took no little trouble to inquire into the organisation and experience of the various nurse-training institutions in London and the country. The results of their inquiries were considered by the committee and a medical sub-committee, and then a report was published, embodying a précis of the information obtained, certain conclusions drawn from it, and the report of the medical sub-committee, which had been adopted by the General Committee of the Order. Finally, the meeting in question was called for the purpose of obtaining the sympathy and support of the general public for the object the Order have at heart, and resulted in the formation of "The

National Association for Providing Trained Nurses for the Sick Poor." The Association is to establish "a home where nurses in training at the London hospitals, or employed as district nurses, may lodge, and where a register of trained nurses requiring employment may be kept." They propose to invite the co-operation of existing nurse-training institutions, so as "to promote a community of interests and action;" and the Order of St. John hopes eventually not only to provide a large body of trained nurses for the sick poor, but also to establish a scale of rewards for the nurses, according to their merits and period of service, and a system of pensions for old and invalided nurses. The whole scheme is a very wide one, and embraces, besides training in nursing work, an elementary education of an industrial character, and education in "habits of order and discipline, cleanliness, and truthfulness." We need not say that this Association has our warm sympathy and good wishes, for if it succeeds in its work it will do immense good. But looking at the rapidly increasing demands for skilled nurses by those who can pay well for their services, and in hospitals, and the increasing wages that can be commanded for domestic service by the classes from whom nurses for the sick poor must be recruited, most especially by any of them who have been "educated in habits of order and discipline, cleanliness, and truthfulness,"-considering these facts, it is certain that the Association will require very considerable resources to enable it to carry out its objects at all widely and efficiently. We trust that it will succeed in obtaining the sympathy of the general public; and it will, we hope, derive powerful aid from a society formed at the same time, at a meeting held at Grosvenor House. This Society is formed on broadly based rules, "for the purpose of granting annuities to worn-out trained nurses of at least fifteen years' service;" and the Duke of Westminster announced that it "would very likely be amalgamated with the National Association for the Provision of Trained Nurses." The two societies have a grand work of inestimable value before them, and deserve all the help our readers can in any way give them.

THE WEEK.

TOPICS OF THE DAY.

SIR WILLIAM JENNER, Sir James Paget, Sir William Gull, Dr. Sieveking, Dr. Lowe, and Mr. Prescott Hewett, were among those who had the honour of receiving invitations to the State Ball which was given at Buckingham Palace last week.

It is with much satisfaction that we have seen the announcement in the Gazette of the appointment of Dr. Fayrer as Physician-in-Ordinary to the Duke of Edinburgh. The reward is well merited in every way, and will give satisfaction to a large number of public servants, who will see in Dr. Fayrer's honour a recognition of their own services. Dr. Fayrer's acquaintance with the Duke is not of recent date, for he had the honour of attending his Royal Highness during the greater part of his visit to India.

In the very proper discharge of their duty, the Helmsley Rural Sanitary Authority charged, at the Kirbymoorside Police-court, Mr. Charles Lever, of Malton, with having exposed his apprentice, a youth, while suffering from a dangerous and infectious disease--viz., scarlet fever. The youth, it appeared, was ill, and was sent by his master from Malton to Gilling, and thence to Helmsley, by railway. Medical evidence proved the fever was fully developed and apparent to anyone of ordinary observation. For the defence it was submitted that there was no proof as required by law that the defendant was aware that the youth was suffering from any infectious disease, of which he denied all knowledge, and proved that the boy

was at work that morning and did not then appear unwell. The magistrate said there was a doubt in his mind as to whether the defendant knew the nature of the complaint, and he should give him the benefit and dismiss the summons; but at the same time he considered it was a very proper case for investigation. This decision is scarcely, surely, consistent with the medical testimony brought forward, that "the fever was fully developed and apparent to anyone of ordinary observation." In the conflict of testimony in this case the magistrate had but one course to pursue-to give the supposed offender the benefit of the doubt; but surely such a defence should not be taken as a precedent. Scarlet fever in its premonitory symptoms can scarcely be mistaken by a competent medical practitioner. It was the manifest duty of the defendant in this case to have consulted his medical adviser before removing his apprentice. If sanitary laws are to have any effect their provisions must be strictly carried out, which they certainly were not in this instance.

The Council of the Social Science Association has presented a memorial to the President of the Local Government Board, praying for the periodical publication of an analysis of the air and water of large towns having a high density of population, for the purpose of detecting disease and suggesting what may be needful for the protection of public health and the prevention of the spread of contagious disease.

The joint report recently presented by Mr. Liddle and Dr. C. Meymott Tidy, to the Sanitary Committee of the Commissioners of Sewers of the City of London, upon slaughter-houses in the City, after a careful inspection of each slaughter-house by visits planned to take place at a time when slaughtering was being carried on, and when they were not expected, speaks with authority, distinctness, and confidence on this important subject. After entering with lengthened detail into the sites of the slaughter-houses-twenty-eight in number, their defective arrangements for ventilation, drainage, cleanliness, and water-supply, they are decidedly of opinion that no private slaughter-houses should be allowed in the City of London, and that every effort should be made to bring about the establishment of public abattoirs. They urge cogent reasons why public slaughter-houses would be exceedingly desirable, and at the conclusion of their report they observe that they have no suggestions to offer respecting the improvement of the existing slaughter-houses. The powers of the Local Authority in regulating slaughter-houses are merely imaginary. The slaughter-houses in the City are, in their opinion, without exception altogether unfitted, both by construction and locality, for the purpose; and they most strongly recommend the Committee to take under their consideration the establishment, in appropriate places, of a sufficient number of public slaughter-houses or abattoirs. The marked success that has resulted wherever abattoirs have been erected, fully justifies them in strongly urging this as the only remedy for existing evils. One huge abattoir, as some have suggested, would, they are of opinion, be undesirable; but the establishment of a sufficient number of them would, judging from the experience of authorities gained elsewhere, be a great sanitary improvement, and would benefit all parties concerned, -not merely the public, and especially the poor, by providing them with better and cheaper meat, but the butchers as well. The present opposition of the trade is, they are convinced, dependent on a false prejudice and ignorance of the benefits which will accrue to them, as they have accrued to others, when the private slaughter-houses have given way to the abattoirs.

The report of the Aboo Lawrence School for the year ending March 31 last is of a most gratifying character. The institution was founded by Sir Henry Lawrence. The object of it is to provide for the orphans and other children of soldiers