kidneys were affected by this medium. Agostine relates a case of poisoning from carbolic acid solution injected frequently into an abscess-cavity. Thomas Smith and others have noted the bad effects of this acid in operations upon children. The author observed albuminuria and temporary suppression of excretion of sulphates in the urine of a young girl after antiseptic ovariotomy. Sonnenburg, Lightfoot, and others have also found that sulphates disappear from urine in similar cases, whereas in the author's patient that excretion did not become dark. Hence carbolic poisoning is not always indicated and exposed by discolouration of the urine, as is generally believed. Keith admits that evil effects may result from prolonged action of spray. hyperpyrexia which follows is due not solely to reaction, but also to carbolic intoxication. The whole merit of Listerism lies not in the supposed good effects of carbolic acid, but in the cleanliness which it promotes. By greatly reducing the strength of the solutions used in operations the author has gained excellent results with absence of pyrexia.

The

The PRESIDENT referred to the local anesthetic effect of carbolic acid.

Mr. KNOWSLEY THORNTON had had considerable experience in the application of Lister's method to ovariotomy. He did not think that anyone had alleged that pyrexia was absent in such cases, except it were Mr. Lawson Tait, who had merely said that it was to be expected. It was very extraordinary not to expect the temperature to rise in ovariotomy. He had had 25 non-antiseptic, and 125 cases of antiseptic ovariotomy. In the former, the average duration of treatment was 26.3 days; in the latter, 20.5 days. In the former, the ice-cap was used in 17 cases; in the latter, in 31 cases. In the 25 cases, it was applied to reduce heat in 12; in the 150 cases, in 14; in the remainder it was applied as a preventive of pyrexia. Perhaps he had used the ice-cap more freely, because he had introduced it at the Samaritan Hospital. He had used it less as he gained faith in Listerism. Dr. Bantock had brought forward only thirty-six cases in which he had performed "Listerian ovariotomy." He (Mr. Thornton) 'believed that failure in the operation would be found to be due to imperfect attention to some part of the antiseptic theory. In the thirty-six cases, some had been dressed, not by the operator, but by the nurses, in the night. Again, in a former paper, Dr. Bantock had referred to the irritant effects of a one-in-twenty solution of carbolic acid; this, however, was no part of Mr. Lister's theory and practice. All were aware that carbolic acid could produce irritation and poisoning; but it was not shown that this explained the unfavourable cases. Suppression of urine had been observed in ovariotomy cases long before carbolic acid was used. When septicemia after ovariotomy was more frequent than now, failure of the kidneys was one of the most frequent causes of death. He had been told that German surgeons were much inclined to attribute to carbolic acid deaths which were really due to septicemia. He could not see on what principle a 1 per cent. solution of carbolic acid was used. If it were not germicide, did it increase the cleanliness of the water? Taking the last six years (1872-77) of Mr. Spencer Wells' hospital operations, done by the extra-peritoneal method and without antiseptics, he found that the mortality was 19.8 per cent.; in six years of Dr. Bantock's practice, by the intra-peritoneal method, it was 17.64 per cent.; and in six years of his own practice, it was 11.25 per cent. For this year, Dr. Bantock, with a modified antiseptic treatment, had a mortality of 12.5 per cent. ; while his own was within 7.5 per cent. In his last 100 cases he (Mr. Thornton) had had a mortality of 7 per cent. in hospital practice; and in private practice he had lost only one case out of twenty-seven. Without Listerism, the mortality in ovariotomy might be reduced to 10 per cent., but not lower.

Mr. LAWSON TAIT said that it seemed impossible for anyone to understand the theory and practice of Listerism. It had been formerly thought that a high temperature and rapid pulse were the characteristics of pyæmia. He thought that one object of Listerism was to prevent surgical fever. If it were not, what was it? He had used solutions of carbolic acid, gradually reducing the strength, till at last he used simple water, and had found that his results were equally satisfactory under the simple dressing. Moreover, the wounds healed more readily when very weak solutions of carbolic acid, or simple water, were used; and his colleague, Dr. Savage, who was an advocate of Lister's method, had

told him that his experience was similar. In one of his cases of ovariotomy (double) the temperature rose to 112°, and remained so nearly fifty hours. He attributed this to the use of carbolic acid. He did not think that the ice-cap was of any use.

Mr. ALBAN DORAN had made post-mortem examinations in forty-one cases of ovarian disease, and had found the kidney normal in only seven. He believed that the mortality after ovariotomy was often due to overlooked renal disease, which would interfere with the elimination of sulphuric acid and of the products of tissue-change.

Mr. SAVORY suggested that diminution of mortality in a surgeon's practice might be due, in great measure, to increased experience.

Mr. SPENCER WELLS said that the mortality in his practice had certainly diminished as his experience had increased; but at last the reduction had come nearly to a standstill, until he began to use antiseptic treatment. Since adopting the antiseptic method in 1878, he had had 131 cases with thirteen deaths, or 10 per cent.; the death-rate being exactly the same as in his last two years of hospital practice without special antiseptic measures. Before he used antiseptics, the results of the intra-peritoneal method had been less favourable than those of the extra-peritoneal; the reverse was now the case. He had never seen a remarkable rise of temperature after antiseptic ovariotomy; it rarely rose above 100°. The wounds healed by the first intention in forty-nine cases out of fifty.

Mr. HOLMES thought that the statistics brought forward showed no decided difference in favour of Lister's method in ovariotomy. He had long ago tried, without success, to master the details of the method, when they were more simple than at present; and he doubted whether anyone understood it in its present form.

Dr. BANTOCK, in replying, said that his results had been as follows:-With 1-in-50 solution, 41 cases with 3 deaths (exhaustion and nephritis); with 1-in-60, 10 cases and 1 death (shock); with 1-in-80, 8 cases to 2 deaths (uræmia and bronchitis); with 1-in-100, 19 cases and 1 death. Patients with disease of the kidney were always unfavourable subjects for operation, and the disease was not always indicated by the state of the urine. In Italy, in the first 100 cases of ovariotomy (of which 4 were done antiseptically) there were 37 deaths; in the second 100, done antiseptically, the mortality was 36. He had not been able to desist from the use of the ice-cap until he had reduced the strength of the carbolic acid solution to 1-in-80. Dr. Bantock further commented on the importance of cleanliness in ovariotomy and in operating on the abdomen.

ASSOCIATION OF SURGEONS PRACTISING DENTAL SURGERY.

WEDNESDAY, DECEMBER 15, 1880.

W. A. N. CATTLIN, F.R.C.S., President, in the Chair.

ON MAXILLARY ABSCESS AND NECROSIS IN CHILDHOOD. MR. EDMUND OWEN read a paper on maxillary abscess and necrosis in childhood, and remarked that the question which he was about to suggest for discussion, for the enlightenment, not only of himself, but also of many other practitioners, was this" Is it right to refuse to extract a carious and aching tooth on account of the acuteness of the periosteal and maxillary inflammation which its presence has excited?" Honestly, he did not know what answer he should get, or he should not have gone through the superfluous performance of coming there that evening for the information. He could assure them that it was a matter on which the knowledge of general surgeons, speaking for others as well as himself, seemed by no means definite, and as it involved pathological and surgical principles of great importance, it would be well if existing haziness could be cleared up by the Fellows of this Society expressing their decided opinion on this question. He was prepared to find that their answers would not be absolute and free of all reserve, though, for his part, he strongly held that the dental surgeon should never refuse to extract a tooth which was the probable cause of acute peri-dental inflammation for the simple reason that the local disturbance was excessive. He now desired the Fellows to accompany him in

imagination to the general out-patient room, and to examine two sufferers, whose cases by analogy had considerable bearing upon the question which this paper proposes. The first case, he said, is that of a little boy, who is in a most miserable condition, with a large bright-red or dusky swelling at the end of his thumb. His mother tells us that he can neither eat nor sleep on account of the pain and throbbing in his hand and arm. When the dressings are removed we see that he is suffering from acute inflammation of the bed of the nail, and we learn that a week or ten days ago the little fellow had his thumb violently squeezed in a doorway. The nail is evidently doomed. It is discoloured and loose, and (attached by one side only) its jagged base and edge are embedded in a bleeding groove of vascular and irritable granulations. The condition of the parts leaves no doubt as to what should be the line of treatment adopted. The nail must be removed so as to set the tissues at rest, and so as to allow of the escape of some unwholesome discharge which is at present partially concealed beneath. As soon as this is done, water-dressings are applied, and cod-liver oil and iron prescribed; and the boy from that time begins to recover health and strength. No treatment which did not include the removal of the nail would have been of avail. The other case is also that of a child. His right leg, from the knee to the ankle, is so full of heat and pain that he is unable to stand upright. Indeed, his condition is one that urgently demands his admission into the wards, and, if possible, instant relief. As we are following him upstairs we learn from his mother, that though hardly a strong boy, he was really never ill till within the last week, and that she attributes all his trouble to the fact that just before the attack he was exposed for some hours to the wet and cold of a snowy day. On examination we find that he has acute periostitis and inflammation of the bone itself, with, probably, some periosteal suppuration. Mr. Owen was sure the Fellows of the Society would agree with him in this, that the proper local treatment consists in making bold and free incisions down upon, and even into, the inflamed bone. And if a bystander asks if we are going to cut into this hot-bed of congested vessels and energetic leucocytes, he may be answered that such treatment is indeed appropriate, inasmuch as it at once relieves the vascular tension and diminishes the chance of the inflammatory vigour determining the death of the adjoining osseous tissue. There was just one other patient the author would yet like to examine; but as he was going to obtain their opinion and advice upon this case shortly, he would (with their permission) examine him by himself. At the first view he had of him he concluded that he had something wrong with his teeth, for his mother had bound up his chin and the lower part of his face with a thick comforter, and with it a decomposing mass of moist linseedmeal. He found the cheek red and swollen, hard and tender; and on getting a peep into the mouth between the jaws, which he could only slightly separate, he found that all the teeth on the bad side were incrusted with a yellow fungusa sure sign that for some time the little patient had been unable to use that side of the mouth for mastication. (In a similar way a stone roller lying idle beneath the damp trees becomes covered with a sickly growth of moss.) By the aid of a better light it was discovered that one of the molars was a little decayed, and that the gum surrounded it with a bright red line. Moreover, on pressing upon the cheek in the swollen part a small quantity of ill-smelling pus welled up between the tooth and gum. He also noticed that near the angle of the jaw was a small opening from which matter was discharging. On asking if the patient had suffered much of late from toothache the mother said, "Yes"; but the child-apprehensive-said, "No." It was learnt that he had neither eaten nor slept of late, and that the cheek, before it began to discharge, was much more swollen than now. On asking the mother how it was that she did not suspect that a bad tooth was the cause of the pain and swelling, she replied that she did not suspect the tooth, but that when she took the boy to the dentist, that gentleman said that he "would not take it out until the inflammation had gone down." Those, she said, were his very words. He also advised her to keep on poulticing the cheek. And now, said Mr. Owen, let us follow out briefly the course that the inflammation, which is started from an inflamed tooth-pulp will take. The local disturbance having caused paralysis of the vaso-motor nerves, the Haversian arteries become crowded and blocked with the red corpuscles. The colourless corpuscles effect their escape together with some of the liquor sanguinis through the thin-walled vessels,

and the protoplasmic contents of the lacunæ and canaliculi take on energetic proliferation. But the sum of the changes to which the nutrition of the maxillary tissue is subjected is not yet complete; at last the intra-vascular pressure becomes unrestrainable, and the walls of the vessels giving way, the bone becomes flooded with sanguineous effusion. Further, healthy nutrition being in these circumstances impossible, a certain portion of the jaw perishes, and becoming surrounded by a more or less complete shell of new osseous tissue, frees itself by a tedious process of linear ulceration, and remains as a sequestrum. Into the question of subsequent operation we need enter no further to-day, than to say that the less the wounding of the skin, and the less the disturbance of the young teeth, as the dead piece of bone is being removed, the better. Whether the sequestrum is to be removed through the mouth, or by way of the sinus which opens near the angle of the jaw, must be determined by the nature of each individual case. The writer then evidently assumes (as he speaks again of the wound being over the angle of the jaw) that it is the inferior maxilla which is the seat of the necrosis, and such is his intention. He is under the impression that necrosis of the superior maxilla is rare compared with that of the inferior, and that for the simple reason that the bony substance of the former is less dense than that of the latter, and is therefore better calculated to suffer from acute inflammation without serious result; and that, moreover, when its elements are engorged with inflammatory products, a certain amount of the strangling pressure is enabled to expend itself harmlessly upon the walls and cavity of the antrum of Highmore. This is, however, a matter well worth discussion from an anatomical point of view; the author confining himself to a statement of the fact, that in his experience necrosis of the superior maxilla in childhood is rare, whilst that of the inferior is not uncommon. Mr. Owen then drew attention once more to the boy into whose acutely inflamed tibia were made those firm incisions but a short while ago. The local bleeding, he said, has now ceased, but it has afforded a complete relief to the vascular and nervous tension, and, freed from pain, the little patient has fallen into a calm sleep. Nor is this the only result. Our energetic treatment has afforded a vent to the effused products, and has saved the compact bony tissue from a fatal flooding. Let us imagine, if we can, that there had already been a sort of vent-peg firmly driven into that inflamed osseous area; how gladly we would have availed ourselves of it to ease the bursting pain in the leg! By prizing or pulling, somehow or other, we would have got it out, and so the parts would have settled down in quiet. And if we had happened to know that that imaginary physiological peg had been the starting-point of all the local mischief and constitutional trouble, we would have effected its removal with vindictive delight. And surely these very conditions have obtained throughout the whole course of that other child's maxillary distress,-each in its proper order. There was the diseased vent-peg (though no imaginary structure), the unsound tooth, wedged into and causing acute inflammation of the maxillary tissue. Probably its prompt extraction would have spared the sufferer much subsequent trouble. Mr. Owen readily admitted that even early in the course of events the jaws may have been rigidly approximated by sympathetic irritation or inflammatory thickenings, so that it became impracticable to apply the forceps to the crown or broken body of the tooth. He could, therefore, well understand that a gentleman whose only other dental instrument was that quaint but desperately powerful tool the "key," might content himself with advising poulticing, or even the application of poppy-head fomentations to the face; but in such cases the most appropriate instrument. was the "elevator," by means of which the tooth could readily be attacked from the outside. He would consequently venture to affirm that whenever a child is brought for dental assistance, the more firmly fixed the jaws, and the greater the inflammation in that certain area, the more imperative is it that the irritating tooth and the vascular tension of the adjacent bone be simultaneously removed. Even if the operation should not be perfectly successful as regards the extraction of the entire tooth, the treatment will have done good. Indeed the local bleeding alone may have sufficed to obtain rest for the parts; whilst if the whole of the tooth be lifted out the tissues will settle down in quiet as happily as did that red and swollen finger-tip, when the removal of the piece of damaged nail was effected. The particular matter, then, in conclusion, upon which he sought information from surgeons practising dental surgery was this:-"Was it right to refuse to extract a carious

and aching tooth because of the acuteness of the periosteal and maxillary inflammation which its presence had excited?'

The PRESIDENT was glad that Mr. Owen had brought under discussion in his practical paper an unskilful kind of practice, which greatly increased human suffering, and was often very injurious to the patient in after-life. It was the erring practice of some to wait until the inflammation subsided, but if the tooth be retained, the swelling, as a rule, rapidly extends to adjoining parts, and sometimes causes necrosis, occasionally infiltration into muscles, restricting the movements of the jaw, and often ending in abscess, which, bursting externally, permanently disfigures the face.

Mr. W. A. N. CATTLIN then brought before the Society a case which happened in his practice some years ago, of a young man, aged nineteen, looking as if suffering from blood-poisoning. The water and drainage of his house were good, and he had never been to sea. The breath was fœtid, but not so bad as that from necrosed bone, and the gums presented a somewhat warty appearance, the larger lobules being of a peculiar blue colour. The upper and lower extremities were studded with patches like ecchymosis, and he had suffered slightly from diarrhoea. No symptoms of purpura hæmorrhagica were seen in the mucous membrane of the mouth or any part of the body, nor did the growths resemble epulis, or ordinary granulations n a congested state. There was no evidence of syphilis. The treatment consisted in a plentiful supply of fresh air, generous mixed diet with four ounces of port wine daily. Full doses of chlorate of potass and decoction of bark were administered, which were subsequently changed for mineral acids and sulphate of iron and quinine. Under the treatment the patient slowly recovered. In all probability this case was one of scurvy brought on by other than the usual causes.

SOCIETY OF MEDICAL OFFICERS OF HEALTH. FRIDAY, DECEMBER 17, 1880.

JOHN SYER BRISTOWE, M.D., President, in the Chair.

THE minutes of the last meeting having been read and confirmed, a discussion arose upon the subject of the notification of infectious disease.

Dr. HARDWICKE remarked that the Town Council at Edinburgh paid £600 last year in small fees to medical men for sending the required information, and they were prepared to pay £1000 for such information at 2s. 6d. per certificate. In Scotland an attempt is being made to carry out the same plan throughout the country.

Dr. CARPENTER remarked that the arrangement in Edinburhh is not working so smoothly as it might, because many medical men are unwilling to supply the information. If the authorities attempt to put on the screw and fine those who decline to certify, they will not succeed in coercive measures. The Council have resolved that the investigation of cases of deaths, uncertified by a medical practitioner, should not devolve on a medical officer of health.

Mr. Kingsell was proposed as an associate, and Dr. Dodsworth, of Chiswick, as an extra-metropolitan member. Dr. Ogle, Dr. Reid, and Dr. Stainthorpe were elected members. ON THE DISSEMINATION OF INFECTIOUS DISEASE BY MILK; WITH SUGGESTIONS FOR ITS MORE EFFECTUAL PREVENTION. Dr. THURSFIELD then read a paper on the above subject, of which we subjoin an abstract:-Having remarked that we ought to see if we cannot prevent the contamination of milk by disease germs, the author proceeded to discuss the practical working of the Contagious Diseases Act, 1878, and the Dairies, Cowsheds, and Milkshops Order of 1879, with a view of considering what measure of protection is afforded by it to the consumer against the risk that by the agency of milk the germs of disease may still be introduced into households. In those districts from which disease has been most frequently imported the risk is in some respects greater than before such legislation. Instead of being placed under the operation of laws relating to the health of mankind, it has been made to occupy a very secondary and subsidiary place amongst the statutes relating to diseases of animals. The statutory duty of enforcing the necessary measures of isolation in outbreaks of such diseases as scarlatina, diphtheria, or typhoid fever in dairies, etc., has been taken

out of the hands of medical officers of health and sanitary inspectors, and placed in the hands of inspectors under the Contagious Diseases (Animals) Act. Of what use is it for urban medical officers of health to influence the various corporate bodies with which they are connected to adopt stringent regulations with reference to milk-shops, etc., in their respective towns if no efficient supervision is exercised in the districts from which the milk is consigned? The carrying out of the provisions of the Legislature has devolved upon officials who are not to be blamed if they have failed to comprehend the importance of, and the method of doing, certain things requiring considerable technical knowledge, but for which they have had no technical training whatever. The executive for carrying out the Contagious Diseases (Animals) Act are invariably police officers. Local authorities have power to appoint other and special inspectors, but, speaking from the results of a very widely extended inquiry, such appointments are found to be most exceptional. The requirements of the Dairies, Cowsheds, and Milkshops Order, 1847, which have to be enforced by inspectors, are, shortly, that every dairy, etc., shall be provided with proper water-supply, and so drained, etc., as to obviate the risk of contamination of milk by means of sewer emanations or in other ways, and that, on the outbreak of any infectious disease amongst the employés, precautions shall be taken to enforce isolation of persons who are infected from milk, "until," to quote the words of the Order, "in each case all danger therefrom of the communication of infection to the milk, or of its contamination, shall have ceased." The sanitary officials of the district are the only persons to whom such duties should be entrusted. The most fertile centres of infection are, as a rule, very slight cases of the disease, unattended by a medical man, and probably called by the mother simply a cold. How can a milk inspector appreciate the significance say, for instance, during the prevalence of diphtheria-of two slight cases of sore throat in one family? If it became necessary to take proceedings with the view of stopping the sale of milk which was presumably infected, the medical officer of health could only do so by calling in the Contagious Diseases (Animals) inspector. In this respect we are worse off, if prompt action is necessary, than before. What is wanted is not so much regulations, as efficient inspection, and, above all, efficient advice under certain exceptional difficulties. Every milk-store should be drained with precision, the water-supply should be free from liability to sewage contamination, and on the outbreak of infectious disease in the families of any of those connected with the dairy, or the milk, the best advice as to isolation should be obtainable. In all of these respects certainly the dairy proprietors would be gainers. The country may not be ripe for the compulsory notification of infectious disease, though the principle of this is already recognised in the case of lodginghouses. Having regard to the respective power for evil of the two places, how much more is it necessary in the case of dairies! Such notification need not, for obvious reasons, involve publicity, but the responsibility of the necessary isolation could only devolve on the medical officer of health.

In the debate which followed, Mr. JACOB complained that the local authorities have allowed the Order in Council for the control of dairies and milkshops to be almost a dead letter. In a very perfunctory fashion the police-officer will make occasional visits for the purpose of ordering lime-whiting of the sheds and stalls, while nothing is done to improve the ventilation, drainage, etc., of the shed. By the energy of Dr. Carpenter and other Surrey magistrates, the Quarter Sessions district have arranged for the appointment of inspectors. Dr. Pryce Jones and himself have been appointed to undertake this work in part of Surrey, and the dairymen are duly apprised of the requirements of the Privy Council.

Dr. CARPENTER remarked that the Surrey magistrates, being anxious to carry out the Order in Council, had obtained copies of the bye-laws on cowsheds, etc., as published by the Society, and had modified them slightly. These less stringent regulations were printed and circulated among the farmers, etc. All sheds built since the Order in Council was published have been carefully inspected. If the inspection of cowsheds for the existence of pleuro-pneumonia, etc., was put in the hands of the medical officer of health, the present method of unlimited slaughter without any attempt to remedy the cause would be put an end to.

Mr. WYNTER BLYTH considered that fresh legislation was not required, because when in Devonshire he always inspected Cowsheds. The medical officer of health should study

epizootic diseases so as to give prompt instructions for isolation. The public ought to require from the trade germ-proof milk, every pint having been boiled.

Dr. TRIPE said that the local authority have no power to consider the effect of cowsheds as centres for infecting the surrounding neighbourhood, nor to superintend the sanitary condition of parts outside the sheds.

Dr. ROBINSON thought it derogatory to a medical officer of health to accept the appointment of inspector under the Act. Dr. DUDFIELD remarked that if the Order in Council were properly understood no regulations would be required. Rural officers of health should be associated with their urban brethren for the purposes of the Act, so as to medically superintend the milk traffic from first to last.

Dr. THURSFIELD, in his reply, said that there is nothing which concerns the prevention of disease that the medical officer of health should be above doing. He concluded by moving"That, in the opinion of this Society, it is desirable, having regard to the more effectual prevention of the spread of zymotic disease by the agency of milk, that the special sanitary supervision and inspection of cowsheds, dairies, and milkshops should be entrusted by the local authorities to the medical officers of health and the sanitary inspectors of the respective districts."

NEW INVENTIONS AND IMPROVEMENTS.

THORNTON'S T-SHAPED COMPRESSING FORCEPS. THE forceps represented in the accompanying engraving were designed by Mr. Knowsley Thornton as a modification of Mr. Spencer Wells' pressure forceps, and are intended to seize and compress the edges of the divided

KROHNE & SESEMANN.LONDON

uterine tissues in flap operations for the removal of uterine fibroids. They will also be found very useful for temporarily restraining the hæmorrhage along the edges of large surfaces of adherent omentum in ovariotomy. They are made in two different sizes by Messrs. Krohne and Sesemann, London.

WATFORD UNION.-We are glad to learn that the Local Government Board have approved of the proposed increase in Dr. Brett's salaries as Medical Officer to the Workhouse and District of Watford, so that, from the 25th ult., such salaries will be £70 and £100, instead of £55 and £70 as before.

UNIVERSITY OF DUBLIN.-At the Michaelmas Term Winter Commencements, held in the Examination Hall of Trinity College on Wednesday, December 15, 1880, the following degrees in Medicine and Surgery, and licence in Medicine, were conferred by the University Caput :

Baccalaurei in Chirurgia.-Henricus Lewis Clare, Stuart Davis, Gulielmus Spear Gordon, Johannes Carolus Martin, Johannes Michael Nicolls. Baccalaurei in Medicina.-Austin Cockle, Stuart Davis, Johannes Galbraith, Johannes Mason, Johannes Carolus Martin, Johannes Michael Nicolls, Georgius de Joncourt Patterson, Georgius Scriven. Magister in Chirurgia.-Gulielmus Cox Neville.

Doctores in Medicina.-Georgius Augustus Bluett, Franciscus Carolus M'Nalty, Gulielmus Cox Neville.

Licentiatus in Medicina.-Gulielmus Smyth.

ROYAL COLLEGE OF PHYSICIANS OF LONDON.-The following gentlemen were admitted Licentiates on December 30, 1880:

Allen, Thomas William James, University Hospital, W.C.
Bathe, Anthony John, 3, Whittington-villas, Ñ.

Bull, George Coulson Robins, 15, London street, Paddington, W.
Carpenter, Arthur Bristowe, Duppas House, Croydon.

Grayling, Arthur, Forest Hill, S.E.

Harvey, Sidney Frederic, 9, Catherina-terrace, Lansdowne-road, S.W. Macdowall, Cameron Joseph Francis Stewart, 32, Osnaburgh-st., N.W.

Maynard, Foster Fowler Martin, St. Andrew's Park, Hastings.

Mills, Thomas Wesley, M.D. McGill, 116, Murray-street, N.

Patten, Charles Arthur, Marpool House, Ealing, W.

Pearce, Walter, 62, Oxford-terrace, Edgware road, W.

Phillipps, William Alfred, Longton-grove, S.E.

Renshaw, Israel James Edward, Sale, Manchester.
Wilkinson, Frank Tichborne, 6, Dean-street, S.E.

ROYAL COLLEGE OF SURGEONS OF ENGLAND.-The following gentlemen passed their Primary Examination in Anatomy and Physiology at a meeting of the Board of Examiners on the 5th inst., and when eligible will be admitted to the Pass Examination, viz. :—

Burke, William H., student of the Dublin School.
Cunningham, Albert G., of the Bristol School.
Dill, J. F. Gordon, of the Cambridge School.
Groom, Harry, of the Cambridge School.
Kelly, Thomas, of the McGill School, Toronto.
Paxton, Edward, of the Manchester School.
Pearse, Frank, of Guy's Hospital.

Powell, Joseph Harry, of the Bristol School.
Rushbrooke, Thomas, of the Cambridge School.
Slater, Charles, of the Cambridge School.
Thompson, Charles W., of the Leeds School.
Whittaker, Joseph, of the Manchester School.
Wood, H. Simpson, of the Melbourne School.

Eleven candidates were rejected, including one who had an additional three months.

APPOINTMENTS.

DOBSON, A., L.R.C.S., L.R.C.P.-Re-appointed Medical Officer for the
West District of the Holbeck Union.
WALTER, WILLIAM, M.A., M.D. Dublin.-Honorary Surgeon to St.
Mary's Hospital for the Diseases of Women and Children, Manchester,
vice R. Heslop, M.R.C.S., appointed Consulting Surgeon.

NAVAL, MILITARY, ETC., APPOINTMENTS. ADMIRALTY.-Surgeon William Henry Colahan, M.D., has been promoted to the rank of Staff-Surgeon in her Majesty's Fleet, with seniority of December 28, 1830.

BIRTHS.

BUCK-On January 2, at Walrond House, George-street, Ryde, Isle of
Wight, the wife of T. A. Buck, M.B., of a son, stillborn.
COLENSO.-On November 28, 1880, at Durban, Nata', the wife of Robert
J. Colenso, M.B. Oxon., M.R.C.S. Eng., of a son.

CONSTABLE.-On January 2, at 127, Kennington-park-road, the wife of
Joseph J. Caffry Constable, M.D., of a son.

HOLLAND.-On December 27, 1880, at 56, Maida-vale, W., the wife of J. Holland, M.D., of a daughter.

KISCH.-On December 31, 1880, at 3, Sutherland-gardens, Maida-vale, the wife of Albert Kisch, M.R.C.S., of twin sons.

RANDELL.-On January 2, at 22, Vanbrugh-park, Blackheath, the wife of E. B. Randell, M.R.Č.S., L.D.S., of a daughter.

MARRIAGES.

BARLOW-DALMAHOY.-On December 30, 1880, lat Edinburgh, Thomas
Barlow, M.D., F.R.C.P., to Ada Helen, daughter of the late Patrick
Dalmanoy, Esq., Writer to the Signet, Edinburgh.
BEDFORD-DRAKEFORD.-On December 29, 1880, at Sydenham, Walter
George Augustus Bedford, M.B., M.R.C.S., of the Army Medical
Department, to Adelaide, eldest daughter of Rev. D. J. Drakeford, M.A.,
of Elm-grove, Sydenham.

CARMICHAEL-BRIDGET-HAWES.-On December 29, 1880, at Redcliffe, square, Daniel Macrae Carmichael, M.B., M.C., of Portree, N.B., to Hannah Sarah, daughter of the late Mrs. Bridget-Hawes, of Priorygrove, South Kensington.

GAMBLE-SHIPLEY.-On December 28, 1880, at Eastgate, Lincoln, Ernest G. Langwith Gamble, L.R.C.P., M.R.C.S., to Emmeline, youngest daughter of G. H. Shipley, Esq., of Lindum House, Lincoln. HASELFOOT-COWEN.-On January 1, at St. Helier, Jersey, Frederick K. H. Haselfoot, Esq., of the Inner Temple, barrister-at-law, to Rose Agnes, eldest daughter of Surgeon-General H. L. Cowen, H.P. Army Medical Department.

HAYWARD-MACKENZIE.-On December 30, 1880, at Manchester, Thos. Ernest Hayward, M.B., F.R.C.S., of Haydock, Lancashire, to Catharine, only daughter of Melville Mackenzie, Esq., of Edinburgh. MILL-HEPBURN.-On December 31, 1880, at Calcutta, James Forrest, son of C. J. Mill, L.R.C.S., of Kirriemuir, to Helen Monro, eldest daughter of the late David Hepburn, Esq., of Hackney, London. RICHARDSON-SLEEMAN.-On January 1, at Portsmouth, Charles Sidney Richardson, L.K.Q.C.P., of Appleby Magna, to Marian Louise, eldest daughter of R. H. Sleeman, Esq., Inspector of Machinery, R.N. (Hongkong), Lingdale, Southsea."

ROPER-HOFFMANN.-On December 28, 1880, at Eardisley, Alfred Francis Roper, M.A., of Keble College, Oxford, to Isabel May, third daughter of Octavius W. Hoffmann, M.R.C.S., of Eardisley, Herefordshire. STRACHAN-JOHNSON.-On December 6, 1880, at Calcutta, William Strachan, Esq., to Annie, eldest daughter of David Johnson, M.D., of Manor House, Earl's Court, South Kensington.

SUMNER-MALCHER.-On December 7, 1880, at Pará, Brazil, George Harlowe Sumner, A.L.C. E., eldest surviving son of W. A. Sumner, M.R.C.S., of Wellington-road, St. John's-wood, London, to Joanna Maria, youngest daughter of Lieut.-Col. Joao Diogo Clementi Malcher, of Pará, North Brazil.

DEATHS.

BUCK, JOHN, M.R.C.S., at the County Lunatic Asylum, Leicester, on December 29, aged 64.

EVANS, GEORGE HARRISON, M.B., F.R.C.S., of Chad-road, Edgbaston, at Rome, on December 31, 1880, in his 36th year.

PRENTICE, ALFRED, M.D., at 34, Campbell-road, Bow, on December 29, 1880, in his 76th year.

PUDDICOMBE, EDITH MORGAN, daughter of John Morgan Puddicombe, F.R.C.S., at South Town, Dartmouth, on December 30, 1880, aged 36. NEYLAN, Dr. JOHN DESMOND, M.R.C.S., L.S.A., of County Clare, Ireland, at Bowral, Sydney, New South Wales, on November 10, 1880, in his 30th year.

WHITE, WILLIAM ALEXANDER, M.D., F.R.C.S., Deputy Surgeon-General retired, Army Medical Department, at 9, Duncan-street, Newington, Edinburgh, on December 29, 1880.

WHYTE, CHARLES, Inspector-General Army Hospitals, at Clifton, Bristol, on January 2, aged 85.

VACANCIES.

BURTON-ON-TRENT UNION.-Medical Officer and Public Vaccinator. Applications, stating age and qualifications, accompanied by three recent testimonials (endorsed Medical Officer), to be sent to Mr. Alfred Coxon, Clerk, Union Offices, Burton-on-Trent, not later than 10 a.m. on Monday, January 10.

LONDON LOCK HOSPITAL, MALE AND OUT-PATIENT DEPARTMENT, 91, DEANSTREET, SOHO, W.-House-Surgeon. Applications, with testimonials, to be sent to D. Harvie, Esq., Secretary, on or before January 15. TAUNTON UNION.-Medical Officer. Candidates must be duly qualified. Applications, stating age and previous employment, together with testimonials of recent date, to be sent to Mr. H. C. Trenchard, Clerk, Union Offices, Taunton, before January 10.

WEST LONDON HOSPITAL, HAMMERSMITH, W.-Assistant-Surgeon. Candidates must be fellows of one of the Royal Colleges of Surgeons of England, Edinburgh, or Dublin, and not practising midwifery or pharmacy. Applications and testimonials to be sent to R. J. Gilbert, Esq., Secretary, on or before January 8.

WOLVERHAMPTON FRIENDLY SOCIETIES' MEDICAL ASSOCIATION.-Resident Medical Officer. Candidates must be members of one of the Royal Colleges of Surgeons in the United Kingdom, and registered under the Medical Act. Applications (stating salary required), with diplomas and original testimonials of recent date, to be endorsed "Medical Officer," and forwarded to F. Blower, Esq., Chairman of Committee, Town Hall Hotel, North-street, Wolverhampton, not later than February 1.

UNION AND PAROCHIAL MEDICAL SERVICE.

The area of each district is stated in acres. The population is computed according to the census of 1871.

RESIGNATIONS.

Chesterton Union. Mr. C. E. Walker has resigned the Third District: area 14,667; population 4107; salary £50 per annum.

Leeds Union.-Mr. Dawson has resigned the office of Medical Superintendent of the Workhouse Infirmary: salary £300 per annum.

Maldon Union-Mr. John Betts has resigned the Maldon District: area 10,669; population 3257; salary £85 per annum.

Samford Union.-The Stratford District is vacant by the resignation of Mr. T. D'Oyly Pain: area 3149; population 1044; salary £81 10s. Woodstock Union.-The First District is vacant by the resignation of Mr. Arthur Herbert Orpen: area 4683; population 2483; salary £40 per annum. APPOINTMENTS.

Docking Union.-Alan Reeve Manby, M.R.C.S. Eng., L.S.A. Lond., to the Rudham District.

Newport Pagnell Union.-George A. D. Mahon, M.R.C.S. Eng., L.S.A., to the Eighth District.

Penistone Union.-Duncan A. Macgregor, M.B., C.M., to the Denby District.

Tamworth Union.-Thomas Buxton, M.R.C.S. Eng., to the Kingsbury and Faseley Districts.

Operations at the Metropolitan Free, 2 p.m.; St. Mark's Hospital for Diseases of the Rectum, 2 p.m.; Royal London Ophthalmic, 11 a.m.; Royal Westminster Ophthalmic, 14 p.m.

ODONTOLOGICAL SOCIETY, 8 p.m. Annual General Meeting and Election of Officers; Curator, Librarian, and Treasurers' Report. President's Valedictory Address. Mr. G. Wallis will show Mr. Lennox Browne's Adaptation of the Lime Light. Casual Communications.

MEDICAL SOCIETY OF LONDON, 8; p.m. Sir Joseph Fayrer, "On Tropical Dysentery and Diarrhoea." (Lettsomian Lecture.)

11. Tuesday.

Operations at Guy's, 14 p.m.; Westminster, 2 p.m.; Royal London Ophthalmic, 11 a.m.; Royal Westminster Ophthalmic, 14 p.m.; West London, 8 p.m.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY, 8 p.m. Mr. Knowsley Thornton, "On One Hundred and Seventy-two Antiseptic Abdominal Sections, with Remarks on the Causes of Death in the Fatal Cases." Mr. Frederick Treves, "On a Case Illustrating the Condition of Large Arteries after Ligature, under Antiseptic and Non-Antiseptic Measures." Mr. Henry Lee, "On Radical Cure of Varicocele." Mr. Jeremiah M'Carthy, "On Aneurism of Axillary Artery treated by Antiseptic Ligature of Third Part of Subclavian Artery."

12. Wednesday.

Operations at University College, 2 p.m.; St. Mary's, 1 p.m.; Middlesex, 1 p.m.; London, 2 p.m.; St. Bartholomew's, 1 p.m.; Great Northern, 2 p.m.; Samaritan, 2 p.m.; King's College (by Mr. Lister), 2 p.m.; Royal London Ophthalmic, 11 a.m.; Royal Westminster Ophthalmic, 1 p.m.; St. Thomas's, 1 p.m.; St. Peter's Hospital for Stone, 2 p.m.; National Orthopedic, Great Portland-street, 10 a.m.

HUNTERIAN SOCIETY (London Institution) (Council Meeting, 7), 8 p.m. Mr. Jonathan Hutchinson, "On the Clinical Importance of Recognising the Pre-cancerous Stage of Cancer."

OBSTETRICAL SOCIETY, 8 p.m. Specimens will be shown by Dr. Chambers, Mr. Doran, Dr. Hoggan, and others. Papers: Dr. Thomas Chambers, "On Complete Extirpation of the Uterus with both Ovaries; Recovery." Dr. W. R. Rogers, "On a Case of Chronic Complete Inversion of the Uterus successfully treated by Sustained Elastic Pressure." Matthews Duncan," On Delivery in a Case of Double Uterus." And other Communications.

Dr.

ROYAL MICROSCOPICAL SOCIETY, 8 p.m. Prof. P. Martin Duncan, "On Three Microspongiado belonging to the Hexactinellids from the Deep Sea." Mr. G. Shadbolt, "On the Aperture Question.' Prof. E. Abbe, "On the True Conditions of Stereoscopic and Pseudoscopic Effect in Microscopical Vision." Mr. A. D. Michael, "On a Species of Acarus believed to be Unrecorded."

13. Thursday.

Operations at St. George's, 1 p.m.; Central London Ophthalmic, 1 p.m.; Royal Orthopedic, 2 p.m.; University College, 2 p.m.; Royal London Ophthalmic, 11a.m.; Royal Westminster Ophthalmic, 14 p.m.; Hospital for Diseases of the Throat, 2 p.m.; Hospital for Women, 2 p.m.; Charing-cross, 2 p.m.; London, 2 p.m.; North-West London, 24 p.m. OPHTHALMOLOGICAL SOCIETY, 8 p.m. Mr. Higgens, "On Hypo Scleral Cyclotomy." Dr. W. A. Brailey, "On a Rare Form of Muscular Asthenopia." Mr. Hulke, "On Ophthalmoplegia Interna." Dr. A. D. Davidson and Mr. Fitzgerald (Dublin), “On Cases of Detachment of the Retina in Albuminuric Retinitis." Living specimens must attend at eight o'clock.

14. Friday.

Operations at Central London Ophthalmic, 2 p.m.; Royal London Ophthalmic, 11 a.m.; South London Ophthalmic, 2 p.m.; Royal Westminster Ophthalmic, 14 p.m.; St. George's (ophthalmic operations), 1† p.m.; Guy's, 14 p.m.; St. Thomas's (ophthalmic operations), 2 p.m. QUEKETT MICROSCOPICAL CLUB (University College), 7 p.m. Conversation and Exhibition of Objects.

CLINICAL SOCIETY, 8 p.m. Annual Meeting for Election of Officers. Report on the Treatment of Hip Disease, with Special Reference to the Operation of Excision. Mr. Croft, "On a Case of Traumatic Hydronephrosis." Dr. R. H. Lloyd, "On Two Cases of Myxoedema." Dr. Sutherland, "On a Case of Chronic Vomiting, in which no Food except Koumiss was taken for sixteen months."