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in 1847-matters which, in nine cases out of ten, it would beimpossible for the present poor-law officers to answer.

It is almost incredible that the Sanitary Commission shouldhave issued this circular, calling for the performance ofsuch immense labour, without the slightest reference to re-muneration to the poor-law medical officers. Surely the me-dical members of the Commission, Dr. SOUTHWOOD SMITH andMr. OWEN, are not consenting to this attempted impositionupon the time of the hardest-worked members of their profes-sion. We arc loth to set any impediment to the objects ofthe Commission, but we cannot recommend our professionalbrethren to neglect their immediate concerns to fill up theseforms. Work required should be paid for. It is not commonlyhonest in the Sanitary Commission to require such labour from medical men, without at once declaring that it shall be pro-perly remunerated.

WE should be wanting in our duty to the profession, if wedid not direct attention to some portions of the evidence ofDr. GEORGE DupRows before the Parliamentary Committee.The abilities of the Senior Censor of the College of Physicianswe have no wish to call in question, but we do most decidedlycall in question his knowledge of the condition of the pro-fession. Nothing but blindfold ignorance could, we conceive,have led Dr. GEORGE BURROWS to give such a portraiture of" the majority" of the general practitioners of this country, asthat which was contained in his evidence published in THELANCET of last week.

’

" The class of persons who go to the bar, generally speaking,are very differently circumstanced from those who enter intothe profession of medicine. The majority of those who enterinto the profession of medicine enter into what is commonlycalled the lower grade of the profession, and they are personsgenerally of humble means ; their means have not allowedthem to obtain an extended education; their preliminaryeducation has generally been very much neglected, and they.just get as much medical knowledge as will enable them tofill certain public situations, such as surgeons under the poorlaw, or assistant surgeons in the navy, or they commencepractice in a small way. They are compelled by the necessityof the case to seek to gain a livelihood as early as possible :’

Since the celebrated "gease" oration at the College of Sur-geons, the General Practitioners, a body constituting nine-tenths of the profession, have not been so misrepresented andmaligned. For we do not hesitate to say, that the descriptiongiven by Dr. BURROWS is without foundation, and that it ap-

plies to the exceptions rather than to the rule. It is a singularcoincidence that both the Censor and the Hunterian Orator are

of St. Bartholomew’s, the one teacher of medicine, the other ofsurgery, to the " geese" of"humble means," in that hospitaland school, and that they are both of them the sons of generalpractitioners, whose acquirements and position they hold insuch little esteem.

On reference to the evidence, it will be seen that on beingasked a question by Mr. WAKLEY relative to the meaning ofhis first description of the general practitioner, Dr. BuRRowsreaffirmed it, and in his subsequent answer gave his ex-perience of the students of St. Bartholomew’s as the foun-dation for his opinion. We quote his own words :-," I have had very large intercourse with the gentlemen who

practise in our profession as general practitioners, havingbeen for twelve years physician to St. Bartholomew’s Hos-pital, and having many hundreds of them under me in thecourse of those years, and being in constant communicationwith them; and I feel assured that I have only stated thetruth in the answer which I have given to that question."

The description, therefore, in our first quotation, purports tobe descriptive of the young men who have been students atSt. Bartholomew’s. In the old days of ABERNETHY, thestudents of St. Bartholomew’s would not tamely have sub-mitted to such contumely as this. The students’ registra-tion list of the College of Surgeons gives St. Bartholomew’sa high numerical position among the metropolitan schools;it is second or third on the list; but nothing can moretend to the injury of the school, and of the men educatedthere, than such ill-advised remarks as those we have beencommenting upon. The sneer at "surgeons under the poor-law," and " assistant-surgeons in the navy," was particularlyunhappy. Dr. BURROWS owes a retractation of these offensive

assertions to the School of St. Bartholomew’s, and to the greatbody of the general practitioners. Mr. LAWRENCE pitted him-self against the general practitioners, and was forced torecant: Dr. BURRows not only libels them, but he points hisattack against his own hospital and his own school.

GRAVE rumours of change, in a scientific body intimatelyconnected with the medical profession, have been in circula.lation for some time past. In our next we shall be able to re-

duce these airy tongues" to words: for the present we merelyrefer to the prevalent rumours.

SOME DETAILS REGARDING MR. O’CONNELL’SLAST ILLNESS IN FRANCE AND ITALY, ANDTHE POST-MORTEM APPEARANCES.

THE following account was recently read at the Société Medi-cale d’Emulation, of Lyons, by Dr. LACOUR:-

Mr. O’Connell had, very early in life, been subject tohaemorrhoids; they continued discharging for a long time,butproduced no great inconvenience. However, tired of them,he allowed an English physician to stop them two years ago.From that very time began all the head symptoms. Advisedto travel, Mr. O’Connell arrived in Paris in March, 1847, wherehe saw Professor Chomel, and his countryman, Dr. Oliffe.They both gave their opinion, and ascribed the diminishedappetite, the unsteady gait, and the failing intellect, to a slowcerebral congestion. These physicians advised mere hygienicmeans-namely, light food, relaxation, and travelling. Theweather having set in very severe, he was not able to reachLyons before twelve days had elapsed. Professor Bonnetfound him there in the following state: Face very much in-jected ; contracted pupils; small pulse, but regular; heart’saction normal; intense bronchitis; dulness on percussion, withmucous and sibilant rates on the right side; undisturbed vesi-cular murmur on the left; complete anorexia ; abdominalpains ; obstinate constipation ; intelligence unaffected, butloss of mental activity, with despondency; extreme weakness;difficulty of motion in the arms, of which the right was con-stantly trembling, the hand being quite cold, as well as theleft foot; progression slow and interrupted; face thin; coun-tenance sad; downcast look; attitude bent and broken. Dr.Bonnet gave very little hope; his diagnosis was a slow cere-bral congestion, and tendency to ramollissement, with pul-monary catarrh. He advised amusement, a tonic diet, and areestablishment of the hæmorrhoidal discharge, by means ofaloes, both in pills and suppositories. Against the pulmonicaffection he prescribed antimonials.Mr. O’Connell left Lyons on the 22nd of April, in a very dan-

gerous state ; Dr. Lacour accompanied him. He improvedgradually until the party reached Genoa, where, after twodays, pretty satisfactorily passed, a violent headach came on,speech became unusually quick, and the movements spasmo-dically rapid. On a consultation on the 10th of May, thepatient was in the following state: diarrhœa, somnolency, in-jection of face, headach, slight delirium, impeded speech, fulland strong pulse, dorsal decubitus. Leeches to the perinæum,and five doses of calomel, of two grains each, one to be takenevery hour. The next day, slight improvement, and freshapplication of leeches. But soon after, a change for the worsetook place, speech became more embarrassed, and deglutition

difficult. The physicians, fearing for an impairment of the

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intellect, prescribed a slight venesection. In the nightviolent delirium came on ; and the next day, life recededgradually whilst the patient gave an attentive ear to the

prayers read for him. He expired at nine o’clock at night.The following were the principal alterations noticed on a

post-mortem examination:-Dura mater unchanged; the twolayers of the arachnoid connected together by adhesionsmuch resembling those of the pleura, but less resisting. The

pia mater was adhering to many anfractuosities, so that severalconvolutions of the brain were glued together. This membranewas very vascular in its whole extent. The cerebral matterhad preserved a tolerable degree of firmness. The pia matercould easily be raised off, except on the anterior lobe of theright hemisphere, where it carried a thick stratum of cerebralmatter along with it. A space which might have containeda walnut was transformed into a greyish, thick fluid, in themidst of which there was a little blood. The cerebral matteraround this softened part reassumed its normal firmness.There was a high degree of congestion in all the other partsof the brain, just as if it had been thickly sprinkled withblood. Congestion and adhesions in the left lung ; heartsound; ossifications on the aorta. Thus, then, ramolissementof the brain was the disease from which Mr. O’Connell hadsuffered during the two years previous to his death, whichproduced the uncertain gait and failing intellect, and towhich the fatal termination was entirely attributable.

MEETING OF POOR-LAW UNION SURGEONS ATROTHERHAM.

JOSEPH HATFIELD TURNER, Chairman.

AT a meeting of the medical officers of the RotherhamUnion, on Friday, the 12th instant, the following resolutionswere unanimously agreed to:-Proposed by Mr. BLYTHMAN, seconded by Mr. WiLKiNSON,-

"Resolved, That this meeting considers that the salaries ofthe poor-law union surgeons throughout the country are notcommensurate with the duties they have to perform."Proposed by Mr. WADE, seconded by Mr. STONE,-" Re-

solved, That the medical officers of this union approve of theefforts now making by the Convention of Poor-law UnionSurgeons, and express their determination to support themuntil redress be obtained."Proposed by Mr. FLOWER, seconded by Mr. HARDWICKE,-

"Resolved, That a subscription of five shillings each be for-warded to T.P. Healey, Esq., the Secretary of the Convention."Proposed by Mr. WILKINSON, seconded by Mr. HARDWiCKE,

- " Resolved, That this meeting strongly objects to the pay-ment of the medical officers by the case."Proposed by Mr. WiLKINSON, seconded by Mr. WANE,-

That Mr. Blythman be requested to take the office of Secre-tary, and to communicate with the Secretary of the Poor-lawUnion Convention.’’

Correspondence.DR. TODD ON CONFUSION OF IDEAS.

To t7te E(litor of THE LANCET.SIR,-Dr. Todd observes, (" Encyclopædia of Anatomy and

Physiology," vol. iii. p. 721, Z,) after quoting the followingparagraph from Dr. Marshall Hall-viz.,

" It is impossible to adduce specimens of more completeconfusion than these, in which voluntary acts, and the actionsof the heart, stomaelt, and intestines,-functions of the cerebraland of the ganglionic systems respectively,-are arranged withcertain reflex experimental facts, and very obvious sympatheticactions, which really belong to the true spinal system"-"I have carefully examined the passages quoted from Pro-

chaska by Dr. Hall, and I confess myself unable to discoverany of that complete confusion’ to which he alludes."The truth is, things are only or best perceived by contrast,

and there is such confusion in Dr. Todd’s own mind, that Iam not surprised to find that he can detect none in that ofProchaska.But let me set the matter before your readers. Prochaska

says,-quoting, Sir, from your own pages,-" As, therefore, theprincipal function of the sensorium commune consists in thereflexion of sensorial into motor impressions, it is to be ob-served that this reflexion takes place whether the mind beconscious or unconscious of it. (!) The motion of the heart, (!)of the stomach, ( ! !) and of the intestines ( ! ! !) certainly in norespect depend on the consciousness of the mind; but as no

muscular motion can be excited, unless a stimulus applied tothe sensorial nerves passes by a certain reflexion to the motornerves, and excites contraction of the muscles, so it is certainthat the reflexion of impressions proper for inducing thesemotions, if they take place in the sensorium commune, takeplace without the consciousness of the mind. But it is askedwhether these impressions ascend to the sensorium commune,to be reflected, or whether, without making this circuit, theyare reflected by the ganglia, whence these parts have manynerves. More on this point hereafter. But that the re-

flexions of sensorial into motor impressions take place in thesensorium commune, we learn from certain actions in apoplecticpatients, in whom all consciousness is destroyed; for theyhave a strong pulse, (!) breathe, and even raise the hand tothe part affected ( ! !) unconsciously."*

’

Here are heart, stomach, intestine, all associated with realreflex action. I will not imagine any reader-except Dr.Todd-unable to " discover any of that complete confusion towhich he (Dr. Hall) alludes."But Dr. Todd himself observes, (p. T22, A, § 12,) " Examplesof reflex acts of this kind are found in sneezing, in the wink=

ing of the eye when the finger is suddenly directed close to it,in the violent cough produced by a particle of food or a dropof water passing into the traclzea," not perceiving that he,like Prochaska, confounds an effect of emotion with actionsreally reflex; for "the winking of the eye," under such circumstances, is an effect of emotion.But such as are Unzer and Prochaska, it is entirely to Dr.

Marshall Hall, as I have already said, that we are indebtedfor their works themselves. Were they known to our phy-siologists before the appearance of Dr. Hall’s labours ? Is it

not owing to these labours that they-have been disinterred, asit were, from the dust of library shelves, and commented andre-commented on by Drs. Forbes, Todd, &e. themselves ? Willany one pretend to say that to their works we owe Dr. Hall’s,and to deny that to Dr. Hall’s we owe a knowledge of theirs ?

In conclusion, allow me to ask Dr. Todd, or Dr. Forbes, orany one of their legion, as all example, whether one singlereally reflex function is mentioned and explained by Pro-chaska? And whether Dr. M. Hall does not enumerate, andexplain, and tabulate, placing before the eye and the mind’seye, ALL these functions, forming a grand CLASS of the functionsof ingestion and of egestion, as excito-motor ila their nature,reflex in their form, &c. &c., and a vast deal more not to befound in Prochaska ? Here I take my stand for the present.Let Dr. Todd answer it.-I ant, Sir, your obedient servant,Nov. 1847. AMICUS VERITATIS ET HONORIS.

CYCLOPÆDIA OF ANATOMY AND PHYSIOLOGY../0 the Editor of THE LANCET.

SIR,-It is new above twelve long years since I first becamea subscriber to the "Cyclopaedia of Anatomy and Physiology,"edited by Dr. Robert B. Todd, in the full conviction that agentleman of his standing in the profession would fulfil thepromise contained in the conditions (which, amongst otherthings, stated that the work would be completed in abouttwenty parts) printed on the wrapper, accompanied by anotice when the next part would appear; these said conditionsdisappeared from the wrapper after the twelfth part, and thenotice from the wrapper of the twenty-first part, -when thework was commencing to exceed the limits at first spoken of.I beg to send you a list of the dates of each part, to show youhow the profession have been trifled ’with:-

1835. Part 1, June; 2, August; 3, OctoLc-r; 4, December.-1836. Part 5, March; 6, May; 7, July; 8, September.-1837.Part 9, January; 10, June; 11, August; 12, October.-1838.Part 13, February; 14, and one part in a wrapper of 1835.-1839. Part 15, January; 16, February; 17, J--il3,; 18, October.- 1840. Part 19, July; 20, September.-1841. Part 21, April,22, November.-1842. Part 23, April; 24, July.-1843. None.- 1844. Part. 25, January; 26, November.-1845. None.-1846. Part 27, March.-1847. Part 28, April; 29, October.

Thus, you see, that only in the first year has the promisebeen kept. In part fifteen, January, 1839, is a slight regretexpressed for the part being so long in making its appear-ance, and another is again offered in part nineteen, July 1840, for the non-appearance of that part, the last one having beenpublished in October, 1839, from which date the work pro-gressed at the rate of two parts per annum for three years;when in part twenty-five, January, 1844, appears a very longapology for there not having been a part published sinceJuly, 1842, and promising that the work shall be completed

* Sic.