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EXETER AND DISTRICT HOSPITAL SATURDAYFUND.-The committee of this fund has recently made theannual awards for 1903, which include £170 to the Devonand Exeter Hospital and £75 each to the Dispensary andEye Infirmary. The sum of £45 was divided among thesmaller medical institutions.

PRESENTATIONS TO MEDICAL PRACTITIONERS.-Dr.Thompson Campbell, who has resigned the office of super-intendent of the Ochil Hills Sanatorium, has been presentedwith a gold-mounted cane and a smoker’s companion. Thearticles bear the inscription: "To Dr. Thompson Campbell,from Friends and Patients at Ochil Sanatorium. 31st August,1903."-An engraved tea-tray and a purse containing £134were presented to Dr. J. B. Montgomery, J.P., at the WestCornwall Infirmary on August 26th. The tray bore thefollowing inscription : I I Presented to James Barclay Mont-gomery, M.D. Glasg., F.R.C P. Lond., in recognition of50 years’ gratuitous services as physician to the WestCornwall Dispensary and Infirmary, 1853-1903."-Mr.Percy Newell, L.R.C.P. and L.R.C.S. Irel., on leavingCrowborough, Sussex, where he had been in practice for12 years, was presented by his numerous friends and patientswith a silver tea and coffee service and an address on vellum.-The staff of the Sheffield Cleansing Departments have pre-sented Dr. John Robertson, medical officer of health, who isleaving Sheffield, with an engraved silver cigarette case.

LITERARY INTELLIGENCE.-Messrs. J. and A.Churchill announce for early publication a new (the sixth)edition of Dr. A. L. Galabin’s "Manual of the Diseases ofWomen." The work has been greatly enlarged and containstwice as many illustrations as in the previous edition-viz.,284. The same firm has also in the press new editions ofDr. H. Jellett’s well-known books on Midwifery and Gyn2a-cology. The latter will be about twice as large as

before and will be fully illustrated.-Messrs. Bailliere,Tindall, and Cox will publish during the next few days"The Health of Armies in the Field," by Surgeon-MajorCaldwell, a record of whose extensive experiences in SouthAfrica, India, and elsewhere should prove useful in futurecampaigns. Also "The After-treatment of Operations," byJ. P. Lockhart Mummery, F.R.C.S. Eng. ; an illustratedhandbook of "Diseases of the Ear," by Richard Lake,F.R.C.S. Eng. ; "Home Nursing," by Dr. Bernard Myers;and a new edition of Mr. Mayo Robson’s ’’ Diseases ofthe Gall-bladder and Bile-ducts." New editions are also inthe press of their Students’ Aid Series in "Surgery,""Physiology," "Chemistry," and "Hygiene."DONATIONS AND BEQUESTS.-Under the will of

Mr. Richard Hawkins of Dublin King Edward’s HospitalFund for London receives a legacy of £10,000 and the Cityof Dublin Hospital and the Hospital for Incurables atDonnybrook will each receive a sum of £5000. Under thesame will £2000 are bequeathed to the Rotunda Hospital,Dublin, and a like sum to the Royal Victoria Eye andEar Hospital.-The late Mr. F. W. G. Moran of Glossopbequeathed £1000 to the Wood’s Hospital, Glossop.-Under the will of Miss Marianne F. Hasker of St. Leonards-on-Sea the following institutions benefit to the extent of£1000 each : the Earlswood Asylum for Idiots, the East SussexInfirmary, and the Cancer Hospital (Brompton). The fol-

lowing hospitals will receive £500 each : St. Mary’s Hos-pital (Paddington), the London Hospital, Charing Cross

Hospital, King’s College Hospital, Chelsea Hospital forWomen, the Royal Hospital for Incurables (Putney),Samaritan Free Hospital for Women and Children (Maryle-bone), and the Hospital for Sick Children (Great Ormond-street).-Under the will of Mr. Walter Evans of DarleyAbbey, Derby, Derbyshire Royal Infirmary receives £1000 ;the Children’s Hospital, Derby, e250 ; the Royal Deaf andDumb Institution, Derby, £500 ; and the Devonshire Hos-pital, Buxton, £250.

UNITED KINGDOM POLICE SURGEONS’ ASSOCIA-TION.-At the annual meeting of the members of thisassociation, which was held recently the report of thecouncil was presented. At the date (July 30th) of thelast annual meeting the departmental committee of theHome Office had nearly completed taking evidence andit was hoped that its report would soon be issued. Thecouncil states that it regards the report in many respects asan admirable one. It is satisfactory to notice that thecommittee fully admits the insufficiency of the existing fees

and allowances to medical witnesses, especially those attend-ing sessions or assizes from a distance. It is satisfactoryalso to notice that it recommends the fee of one guinea.for the medical examination of persons in cases of sexualoffences. The council also records with pleasure the greatassistance it has received from the council and officers ofthe British Medical Association in this important matter.The report of the council further states that early in theyear Mr. F. W. Lowndes posted, at his own expense, copiesof last year’s report with a private letter and form of

application for membership to 150 police surgeons whose7names appeared in the last Constabulary Almanack. Healso wrote letters to THE LANCET and the British MedicalJournal, which were duly published, asking all policesurgeons who had not received them and wished to do so tocommunicate with him. The result was very disappointing-and the council reiterates the request given at the end of itslast report that every member should cooperate in trying toobtain the accession to their ranks of police surgeons whoare not members.

Appointments.Sussessful applicants for Vacancies, Secretaries of Public Inatitzstions.

and others possessing information suitable for this column, are-invited to forward to THE LANCET Office, directed to the Sub-Editor, not later than 9 o’clock on the Thursday morning of eachweek, setch information for gratuiton8 publication.

BLACKE, MORETON, has been appointed Deputy Medical to the-Thornbury Workhouse and District.

BROWN, J. WALTER, B.A., M.B., B.Ch., has been appointed MedicalOfficer of Health for the County of Hokianga, New Zealand, andNative Medical Officer for the Hokianga District.

CAYENA&H-MAINWARIN&, W. R., M B., Ch.B. Adel., has been appointedHonorary Assistant Surgeon to the Adelaide Hospital, SouthAustralia.

CROSS, JOHN, M.B., Ch.B. Glasg., has been appointed House Surgeonto the Victoria Infirmary, Glasgow.

DAVIS, EDWARD SANDOM STONE, M.R.C.S., L.S.A., has been appointedDistrict Medical Officer by the St. Austell (Cornwall) Board ofGuardians.

ECCLES, W. McADAM, M.S. Lond., F.R.C.S. Eng., has been appointedJoint Lecturer on Anatomy at St. Bartholomew’s Hospital.

GEOaHEGAN, FRANCIS J.. M.D. Trinity College, Dublin, has beenappointed Resident Medical Officer to the Victoria CentralHospital and Wallasey Dispensary, Liscard, Cheshire.

GILES, W. A., M.B., Ch.M. Edin., has been appointed HonorarySurgeon to the Adelaide Hospital, South Australia.

HAMILTON, A. A., M.B., Ch.B. Dubl., has been appointed HonoraryAssistant Physician to the Adelaide Hospital, South Australia.

HAYWARD, W. T., L.K.Q.C.P. Irel., has been appointed Honorary Phy-sician to the Adelaide Hospital, South Australia.

KiRBY, S. J. J., M.D. Brux., L.R.C.P. Edin" M R.C.S., has been re-appointed Medical Officer of Health of the Hoxne Rural DistrictCouncil. Fressingfield.

MILLEA, WILLIAM C., B.A. R.U.I., L.R.C.P. & S. Edin., has been.appointed Medical Officer, South District of the Poplar Union.

NIESCHE, F. W., M.D. Edin., has been appointed Honorary Physicianto the Adelaide Hospital, South Australia.

NORMAN, R. H., M.D. Lond., B.S., M.R.C.S., L.R.C.P., has beenappointed Anaesthetist to the Tottenham Hospital.

POULTON, B., M.D. Melb., has been appointed Honorary Surgeon to theAdelaide Hospital, South Australia.

RUSSELL, JAMES, M.B., Ch.B. Glasg., has been appointed House Surgeonto the Victoria Infirmary, Glasgow.

SMITE, M. STEWART, M.R.C.S., L.R.C.P. Lond., has been appointedAssistant Resident Medical Officer to the London TemperanceHospital.

SWIFT, H., M.D. Cantab., has been appointed Honorary AssistantPhysician to the Adelaide Hospital, South Australia.

SYMONS, M. J., M.D. Edin., has been appointed Honorary OphthalmicSurgeon to the Adelaide Hospital, South Australia.

THOMPSON, JAMES, M.B., B.S. Melb., has been appointed ResidentMedical Officer to the Perth Public Hospital. West Australia.

VERCO, J. C., M.D. Lond., has been appointed Honorary Physician tothe Adelaide Hospital, South Australia.

WATSON. Professor A., M.D. Paris and Gott., F.R.C.S. Edin., has beenappointed Honorary Pathologist to the Adelaide Hospital, SouthAustralia.

WILSON, JAMES, M.B., Ch.B. Glasg., has been appointed House Phy-sician to the Victoria Infirmary, Glasgow.

Vacancies.For !,urther tnformation regarding each vacancy reference should. be

made to the advertisement (see Index).

ADDENBROOKE’S HOSPITAL, Cambridge.-Honorary Assistant Surgeon ;also Assistant House Surgeon. Salary at rate of 0830 per annum,with board, lodging, and washing.

BIRKENHEAD BOROUGH HOSPITAL.-Junior House Surgeon. Salary.E80 per annum, with board and washing.

924

BIRMINGHAM, PARISH OF.- District Medical Officer. Salary £350, risingto £400 per annum.

BRADFORD POOR-LAW UNION (SANATORIUM FOR CONSUMPTIVES),Eastby, near Skipton.-Resident Medical Officer. Salary £100,with rations, apartments, and washing.

BRENTFORD UNION.-Medical Officer and Public Vaccinator. Salary£110 per annum, with fees.

CITY OF LONDON HOSPITAL FOR DISEASES OF THE CHEST, Victoria-park, E.-Physician to Out-patients.

ECCLES AND PATRICROFT HOSPITAL.-House Surgeon, unmarried.Salary £70 per annum, with board and washing.

EVELINA HOSPITAL FOR SICK CHILDREN, Southwark, S.E.--FourClinical Assistants.

,FIFE COUNTY COUNCIL.-Lady Lecturer of Home Nursing and Health.HOSPITAL FOR CONSUMPTION AND DISEASES OF THE CHEST, Brompton.-

Resident House Physicians for six months. Honorarium of JE25.HOSPITAL FOR DISEASES OF THE THROAT, Golden-square.-Anæs-

thetist. Also Senior Clinical Assistant.-JERSEY GENERAL DISPENSARY AND INFIRMARY.-Resident Medical

Officer. Salary £120 a year, with rooms, gas, and attendance.LEICESTER INFIRMARY.-Clinical Clerk for six months. Honorarium

of £10 10s., with board, apartments, and washingLONDON COUNTY ASYLUM, Banstead, Sutton, Surrey.-Junior Assistant

Medical Officer. Salary £150 per annum, with board, apartments,and washing.

MANCHESTER CHILDREN’S HOSPITAL, Pendlebury.-Medical Officer.Salary E180 per annum.

MANCHESTER SOUTHERN AND MATERNITY HOSPITAL.-Resident HouseSurgeon for six months. Salary at rate of £60 per annum, andboard.

’METROPOLITAN HOSPITAL, Kingsland-road, N.E.-Physician ; alsoAssistant Physician.

NEWARK-ON-TRENT HOSPITAL AND DISPENSARY.-House Surgeon, un-married. Salary £80 per annum, with board and lodging.

POPLAR UNION.-Medical Officer. Salary £130 per annum..ST. MARY’S HOSPITAL FOR SICK CHILDREN, Plaistow, E.-Resident

Medical Officer, unmarried. Salary at rate of B100 per annum,with board, residence, and laundry. Also Assistant ResidentMedical Officer, unmarried, for six months. Salary at rate of £80per annum, with board, residence, and laundry.

JST. PAUL’S HOSPITAL FOR SKIN AND GENITO-URINARY ÐISEASES, RedLion-square, W.C.-Honorary Assistant Surgeon.

’SAMABITAN FREE HOSPITAL, Marylebone-road, N.W.-ClinicalAssistants.

.SEAMEN’S HOSPITAL SOCIETY, Greenwich, S.E.-House Physician forthe " Dreadnought" Hospital, Greenwich. Salary ;E65 per annum,with board, residence, and washing. Also Junior Resident MedicalOfficer. Salary £40 per annum, with board, residence, and wash-ing. Also House Surgeon for the Branch Hospital, Royal Victoriaand Albert Docks, E. Salary £50 per annum, with board, residence,and washing.

SOUTHAMPTON INCORPORATION WORKHOUSE INFIRMARY, ShirleyWarren.-Resident Assistant Medical Officer.-Salary £120 perannum, increasing to .E150, with apartments, rations, washing, andattendance.

WARWICK COUNTY ASYLUM, Hatton, near Warwick.-Third AssistantMedical Officer, unmarried. Salary £130 a year, with board, lodging,and washing.

WESTON-SUPER-MARE.-House Surgeon, unmarried. Salary £100 perannum, with board and residence. ,

’YORK DISPENSARY.-Resident Medical Officer, unmarried. Salary dE120 .a year, with board, lodging, and attendance.

The Chief Inspector of Factories, Home Office, S.W., gives notice of a ]

vacancy as Certifying Surgeon under the Factory Act at Bury St. ,

Edmunds, in the oounty of Suffolk.

Births, Marriages, and Deaths.BIRTHS.

LAMB.-On Sept. 16th, at Church-street, Crewkerne, the wife of J. H-Lamb, M.B., of a daughter.

MISKIN.-On Sept. 19th, at Kennington-road, S.E., the wife of ErnestMiskin, M.B. Lond., of a son, prematurely born; survived its birthone hour.

W ATKINs.-On the 16th inst., at Stone-Legh, Newton-le-Willows, Lanes.,the wife of Harold E. Watkins, M.R.C.S. Eng., of twin sons.

MARRIAGES. BENNETT-HENDERSON.-On Sept. 12th, at St. John’s-wood Presby-

terian Church, Norman Godfrey Bennett, M.A., M.B., B C. Cantab.,L.D.S. Eng., to Maida Mabel, second daughter of John Henderson.

BRIGHTMORE-PHILIPS.-On Sept. 16th, at St. Gabriel’s, Hulme, HarrySterdale Brightmore, M.B., to Alice Marie Stella, second daughterof John Philips.

LAWSON-NEW.-On Sept. 19th, at Marylebone parish church, by theRev. Canon Barker, Frederick J. Lawson, M.R.C.S., to Ethel F.New, daughter of G. W. New, M.R.C.S., of Harrington-square,N. W.

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N.B.-A fee oJ 5s. is charged for the insertion of Notices of Births,Marriages, and Deaths.

Notes, Short Comments, and Answersto Correspondents.

A QUESTION OF HOSPITAL DISCIPLINE.To the Editors of THE LANCET.

SIRS,-We, the undersigned, beg to thank you for the trouble youhave taken to investigate our case and also for your valuable expressionof opinion. We do not know whether you will care to be troubled withthis matter any further, but as the case appears to have created muchgeneral interest we think it only fa’r to ourselves to explain severalpoints which are still not quite clear.

1. The stump was healed with the exception of a small sinus leadingdown to bare bone and was not in urgent need of treatment beyondsimple dressings. The treatment for several weeks past had been towait and the suggested future treatment was also to wait until the boneshould separate as a sequestrum.

2. It is not a fact that Mr. Messiter was not aware that the man hadbeen repeatedly insubordinate, as Mr. Messiter saw one of us (Mr.Hadley) two days after he had telephoned ordering the patient’s re-admission at once. He (Mr. Messiter) then asked whether the patienthad been re-admitted and Mr. Hadley answered, "No, he has not pre-sented himself," and then asked, "Mr. Messiter, are you aware thatthis patient has been repeatedly and persistently insubordinateever since his admission last May, a period of over four months," towhich Mr. Messiter replied: " Yes, I am perfectly well aware." Mr.

Hadley did not then make any further comment upon the patient’s re-admission as he thought that as the patient had not come back and twodays had elapsed since he was directed by Mr. Messiter to do so, probablyhe would not dare to present himself again and that would be the end ofthe matter, thus rendering it unnecessary, at that time, to refuse totake him in hand again and to create with Mr. Messiter any ill-feelingperhaps unnecessarily. [N.B. The whole of the above was reported byMr. Hadley to the board, Mr. Messiter being present and confirmingit.] The fact of the man’s re-admission was never mentioned betweenMr. Messiter and Mr. Hadley, for neither of us again saw Mr. Messiterbetween the time of the patient’s re-admission and the meeting of theboard, at which Mr. Messiter was present, but one of us (Mr. Hadley)did at once report the fact of the man’s re-admssion to the hospitalvisitors, who were also members of the board.

3. The man did not at the last moment refuse to leave the hospitalbut was given four or five hours to make up his mind, and on a formeroccasion had refused to leave but was then given another chance.

4. The refusal to treat this man did not imply mhumanity as he wasable to walk about without inconvenience upon crutches and couldhave been treated as an out-patient at another institution, even closerto his own home than the Guest Hospital, which has no out-patientdepartment of its own.

5. The fact that the condition of the man’s stump was not urgentlyrequiring treatment was pointed out to the board and Mr. Messiter,although present, did not disagree. Wa said that if the board wished tokeep the man in the hospital we felt our positions would be untenable.To Mr. Messiter’s proposition accepting our resignations and that theman be sent out we were allowed to reply, " No, if you wish the patientto remain we will go out at once." Although the board knew that itwas our intention to go at once yet it directed the secretary to order thepatient to leave the hospital the following day. The patient refused toremain and went the same day. We quite agree with you that ourcase would have been better, or looked better, if we had not been

quite so hasty in leaving the same day but stayed perhaps three orfour davs until we knew a locum-tenent had been obtained to fill ourplaces, although we knew that should any emergency arise there wasmore than one medical man in the district willing, as they had done onformer occasions, to render medical assistance with very little delay.

6. Mr. Messiter also alludes to differences of opinion between himselfand Mr. Hadley. We think that this, in justice to us, as he intro-duces it into the case, requires explanation, especially as the differenceof opinion did not arise from causes arising in connexion with thetreatment of patients or the duties of house surgeons as one mightinfer, but also upon questions of hospital etiquette on discipline.

-

Mr. Messiter almost invariably refused to allma the nurses to send forthe medical resident staff when he came to pay his official visits to thewards and left instructions with respect to alterations or fresh treat-ment which he wished carried out with the nurses to deliver to us,although we were not being detained by other honorary surgeonswhen he was paying his visits. Mr. Hadley asked him if he wouldmind asking one of us to accompany him round the wards as he likedto do so and preferred to take instructions as to treatment, &c., from

himself, as he (Mr. Hadley) was afraid that there was a great danger ofhis having the messages improperly conveyed to him by nurses, notof course wilfully, but simply because they did not understand therationale and raison d’etre of the messages they were delivering, andalso he (Mr. Hadley) often wished to tell him matters concerning theprogress and, perhaps, fresh symptoms in a patient which he (Mr.Hadley) seldom was given an opportunity of doing. As a result of

Mr. Hadley’s request he promised that in future he would endeavourto fall in with his wishes. This, however, he only did for a few times,but did not continue to do so, hence the cause of our differences.

We are, Sirs, yours truly,

Sept. 21st, 1903.ERNEST C. HADLEY, Shilton, near Coventry.

C. ItoLLES2or, Gloucester Infirmary.