GLOUCESTER MEETING. some more protection was, if possible, extended to the qualified practitioner. As regarded this great difficulties existed, but something nevertheless was done in the bill. He thought the bill should be accepted, and an endeavour made to get improvements engrafted on it. A great advantage had arisen from their not having met earlier to consider this measure. At the time it was introduced a great outcry was made against it by those who had overlooked its advantages. Those now present had had an opportunity of considering the bill more carefully and calmly, and were therefore prepared to do it more justice, still it was their duty to endeavour to get it amended and improved, and if they went temperately to Parliament he had no doubt of their being listened to. 471 tained, and not to the details, which may require improvement. He should have been glad had the resolution been expressed even more strongly as regarded the general principles, because he thought the measure was a step, although not one of much immediate good, in the right direction, and must lead, ultimately, to all those advantages which the profession had a right to look forward to. The resolution he had now to propose referred to the details, and to one of the most important of them, namely, that which related to the constitution of the Council of Health. Now if the meeting recollected the small service which the great corporations had rendered to the profession-if they recollected the manner in which diplomas had been given-if they considered how uninterested these corporations had shewn themselves to be in every thing which related to the respectability and advancement of the profession-how little they represented the feelings, and what little regard they paid to the representations made to them in all Mr. Eves, of Cheltenham, said that if the resolution pledged the meeting to support the bill in all its parts, he for one should be obliged to oppose it, on the ground that it threw open the profession to any body who chose ; in fact it was free trade in medicine. He thought that the powers vested in the College of Phy-directions-the profession must rejoice at the prospect sicians and the Apothecaries' Company, although the latter did not prosecute unqualified persons so often as they should have done, were calculated to raise the character of the profession. The terror of penalties hanging over the heads of unqualified practitioners, was always a check. It will be better that we remain as we are, than that we should run the risk of a doubtful change. Mr. Brookes, of Cheltenham, was also of opinion that the bill did not afford sufficient protection. As to the efficiency of the Apothecaries' Company, he could state that about two years ago they instituted proceedings against an unqualified person for practising as a surgeon and druggist. The case arose out of an inquest held on the body of a person who had been treated by the unqualified practitioner. The Company succeeded in getting a verdict against him, and in consequence he was driven from Cheltenham. Mr. Brookes concluded by again giving it as his opinion that the bill ought to give more protection to the qualified practitioner. Mr. Stokes, of Nailsworth, was also of opinion that the protection afforded by the bill was not sufficient; and that the Apothecaries' Act had done good. The Chairman said that he wished it to be understood, that however strongly he approved of the bill, he nevertheless was of opinion that, in some things, it was susceptible of improvement. The resolution was then carried. Mr. Wilton, of Gloucester, in rising to propose the next resolution:-" That while the proposed establishment of a Central Council of Health and Medical Education appears likely to promote the respectability and protect the interests of the Medical Profession, this meeting is of opinion that the constitution of that Council, as laid down in the Government Bill, needs further consideration, more particularly as regards the relative proportion of Councillors to be elected by the profession; and that the measure would be greatly improved by permitting the medical practitioners of the provinces to elect the two representatives whom Sir James Graham has proposed to appoint from the rural districts," expressed a hope that he should not be considered out of order in stating that, in assenting to the resolution just passed, he did so in reference to the general principles which the bill con of being placed in immediate connexion with the Government. When this occurs, representation will not be confined to one section of the profession, but to all branches; physicians, surgeons, apothecaries, all will have equal access in preferring complaints which they may have occasion to make. To the Council of Health will be entrusted the health of the community, and consequently the interests of the profession. It will also be a part of their duty to pres scribe the examinations, and this was also an improvement; and should the measure in any of its parts be found defective, no doubt need be entertained of its being improved. Even on the subject of quackery, should it be found necessary to have recourse to additional powers, it was reasonable to suppose that they would be applied for, and granted. If the profession lost the bill, they would lose also the Council of Health; and where then could they go to? They had worn out those Members of Parliament-never at best very influential—who had advocated their claims in Parliament, and should the present bill be lost, the profession would be the sufferers. Mr. Rumsey, of Gloucester, in seconding the resolution, said that he considered the institution of the Council of Health as most important-by far the most important and beneficial of any reform yet proposed-and he regarded it as the foundation for future measures, more generally approved than other provisions of the present bill had been by some of the profession. He regarded as of great importance the connexion which would be formed with the State. Such a thing had never existed before. The profession had been left to self-government, and what had that self-government done for the profession? He did not wish to press this point, it being so generally admitted that neither the interests nor the respectability of the profession had been promoted under the present system. It must, therefore, be allowed that some other body was required to superintend the management of the medical profession. Much of the advantage to be derived from the measure under discussion depended on the constitution of the Council, and he thought that the mode provided for the appointment of the members was susceptible of improvement. He did not think the provincial members of the pro fession were sufficiently represented. London, Dublin, and Edinburgh were provided for, but he thought that as regarded the English provincial practitioners, they would be practically excluded from any influence in the Council, unless an amendment was made; and he thought that it was the duty of the meeting to suggest such an amendment in the constitution of the Council as would make it more generally acceptable. By this measure, he hoped that an end would be put to the numerous evils which had arisen to the profession from the controul and supervision exercised over them by certain bodies of laymen. For instance, had the Council of Health been in existence when the Poor-law Commission was instituted, its medical functions would probably have been vested in that Council. It was of the greatest importance that the profession should be under chiefly medical management, and not under lay; and this was amply provided for, as it was impossible for the Secretary of State to appoint more than four lay members. There was also another point of importance, and this was the power possesed by the Council of defining all offices which might be called "public situations." This was a power of extensive application, and it may be exercised so as to include attendance on the great mass of the population. In its operation it will include the medical attendance on the poor, in prisons, dispensaries, and hospitals, and it is possible that it may be extended to clubs, and to all those persons who are unable to provide medical relief for themselves, and thus the great body of the people may in time be brought under qualified practitioners. and seconded by Mr. Smith, of Minchinhampton :-"That this meeting would respectfully submit to the consideration of the Government the propriety of such indirect discouragement of illicit practice, as would be effected by abolishing the present obnoxious system of stamped and patent medicines, and by prohibiting, under severe penalties, the advertisement of secret remedies, now carried on to an extent alike injurious to public health and offensive to public decency." Moved by Dr. Collings Robinson, of Cheltenham, and seconded by Mr. Hickes, of Gloucester :-"That a committee be formed, to carry out the objects of this meeting, by preparing a petition to Parliament, founded on the above resolutions, and by requesting the support of the Members of the legislature connected with the county." Moved by Dr. Dick, of Tewkesbury, and seconded by Mr. Copeland, of Cheltenham :-" That the thanks of the meeting be given to the Chairman for the manner in which he had conducted the proceedings. DEVONPORT MEETING. the Medical Profession of the borough of Devonport Dispensary, on Thursday, the 3rd of October, to take The resolution was then put, and carried unani-G. Dansey, Esq:-"That this meeting hails with satis- mously. faction the disposition of the Legislature, to amend the present anomalous state of the medical profession, as shown by the introduction of Sir James Graham's Bill, entitled 'A Bill for the better regulation of Medical Practice throughout the United Kingdom;' and whilst they are ready to admit that the said bill contains much that is calculated to improve the condition of the profession, they cannot refrain from deprecating certain of its enactments." Moved by P. W. Swain, Esq., and seconded by J. Little, Esq. :-"That this bill having proposed to make a high rate of professional education necessary for all registered practitioners, this meeting feels it would be a great injustice to withhold from such practitioners protection against the competition of uneducated individuals, in the removal of all existing restrictions, as contemplated in the said bill." Dr. Disney Thorpe, of Cheltenham, moved the third resolution :-"That as one of the most important features of the bill is the abrogation of existing penalties on unlicensed practitioners, this meeting admits that, in the present state of public opinion, any direct legislative interference with unqualified practitioners would not be unattended with difficulties, but has, nevertheless, reason to believe that these difficulties have been much overrated, and, if fairly met, will not be found to be insuperable; and, therefore that the principle of protection against unqualified pretenders may be more extensively applied than is apparently contemplated by the bill." He did not believe that the strong iron hand of the law brought against quackery would be of the least avail. Lord Bacon said, many years ago, "The weakness and credulity of the multitude often induce them to prefer a Moved by J. May, Esq., and seconded by R. mountebank to a regular physician." There are many Watson, Esq. "That this meeting fully approves medical men who indulge in mysticism, and who may of the principle of forming a Council of Health and be called "quacks of the profession," who just keep Medical Education to provide an efficient and uniform within the profession, and ride roughshod over decorum. standard of qualification for practitioners generally; (Cheers.) If the profession would take every oppor-and to afford assistance to Government and the countunity of explaining to the public the danger of risking try at large in all questions referring to the sanitary themselves with such go-a-head gentlemen, they would conditions of the community-duties which this find the public less anxious to go to the quack.meeting are of opinion would be best performed by Quackery must be put down by instructing the public the intelligent, highly educated, and unbiassed memin whom they are to rely. He referred to what he bers of the profession; they therefore view the consticonsidered the degrading system of medical men tution of the Council, as proposed in the bill, to be attending persons belonging to benefit-clubs at 2s. 6d. highly objectionable." or 3s. 6d. per head. Dr. Gooch, of Stroud, seconded the resolution, which was carried unanimously. Moved by J. Little, Esq., and seconded by J. May, Esq. "That this meeting feeling deeply sensible of the benefits which have resulted from the able admi It was then moved by Dr. Acworth, of Cheltenham, nistration of the Apothecaries' Act, begs to record SHEFFIELD MEETING. its most grateful thanks to the worshipful society, for the manner in which they have raised, mainly by the operation of the restrictive clauses of their act, the education of general practitioners of medicine to its present high standard." Moved by R. J. Laity, Esq., and seconded by W. Cole, Esq.:-" That six of the gentlemen now present be a Committee to embody the foregoing resolutions into a petition, to be presented to the House of Commons. That Sir G. Grey and H. Tuffnell, Esq., be requested to present the same, and to support its prayer, and that the same gentlemen be a standing Committee, to watch the progress of the bill, &c." The thanks of the meeting were then voted to the Editor of The Times; to Mr. Wakley, as Member of Parliament; to the Editors of the Medical Periodicals; and to the Chairman. An account of the proceedings at this meeting was accompanied by the following letter: 473 Moved by Henry Thomas, Esq., and seconded by Hugh Wood, Esq. :-"That, although certain of the provisions of the intended bill are, in the opinion of this meeting, decidedly objectionable, there are others which are deserving of the approbation and support of the profession, such as the connection of the Medical Profession with the State, the registration, and that clause, by which degrees in medicine, conferred without residence and without examination, are not recognized." Moved by Dr. Favell, and seconded by Dr. Shearman :-"That this meeting deeply regrets that by the vague and feeble wording of the 31st clause, full opportunity is given to unqualified persons to take advantage of that part of the first clause, by which all restriction on the practice of physic and surgery is removed, and would respectfully urge that legally qualified and registered practitioners of medicine and surgery are fully entitled to protection against the practices of unqualified persons, which they would TO THE EDITOR OF THE PROVINCIAL MEDICAL AND suggest ought to be effected by some stringent and SIR, SURGICAL JOURNAL. I have much pleasure in conveying to you the sense of the members of the profession in this borough, of their obligation to you for the very able manner in which you denounce the injustice of certain parts of Sir James Graham's proposed bill, and for your advocacy of the rights of the profession. I have the honour to be, Sir, Devonport, October 8, 1844. SHEFFIELD MEETING. A meeting of the Medical Profession of the borough of Sheffield, and the surrounding district, convened by a previous circular, was held in the Cutler's Hall October 16th, 1844. Dr. Thompson, in the chair. Among those present were-Dr. Favell, Dr. De Bar tolomé, and Dr. Branson, Sheffield; Dr. Benjamin Robinson, Rotherham; Dr. Woollam, Mexborough; Dr. Shearman, Rotherham; Dr. Axe, Sheffield di Messrs. J. Walker, R. Roper, J. T. Porter, and C W. Beckett, Sheffield; Mr. Wm. Askham, Eck ington; Mr. K. Wilson, and Mr. Joseph Law, Sheffield; Mr. John Shaw, Attercliffe; Mr. W. Wilson, Hartlisk; Messrs. Geo. Varah, J. F. Wright, Hugh Wood, Gabriel Reedall, Henry Thomas, Henry Jackson, Wilson Overend, John Haxworth, Henry Boultbee, Joseph S. Waterhouse, and John Nicholson, Shef field; Mr. Jas. Burman, Wath; Messrs. John Deakin, James Ray, Wm. Skinner, W. F. Osborne, William Dawson, and Edward Harrison, Sheffield; Mr. Richardson, Attercliffe. The following resolutions were adopted : Moved by Henry Jackson, Esq., and seconded by Joseph Law, Esq.:-" That this meeting views with satisfaction the attempt now made by Sir James Graham to put an end to the dissensions unfortunately for some time back existing in the Medical Profession, on the subject of Medical Government; and considers that he is fully entitled to the sincere thanks of all its members, for his endeavour to connect so important a branch of the social community of this country with the State, thus enhancing its dignity and extending its efficiency." summary process." Moved by Gabriel Reedall, Esq., and seconded by J. Walker, Esq. "That the following petition to the Commons House of Parliament be adopted and signed by the members of the profession resident in this district : "The humble Petition, &c. &c. "Humbly sheweth, "That your Petitioners witness with great satisfaction the introduction of a bill, intituled 'A Bill for the better regulation of Medical Practice throughout the United Kingdom,' which by its provisions will, in the humble opinion of your Petitioners, conduce to the dignity and interests of the Medical Profession, by connecting it with the State, by favouring an efficient registration of all legally qualified members, and by not recognizing degrees in medicine conferred without residence and without examination. bill does not afford that protection from the irregular "That your Petitioners deeply regret that the intended practices of unlicensed persons, to which all legally qualified practitioners feel they are fully entitled, and humbly pray that your pleased to enact some clause by which such persons shall be more summarily dealt with, and such practices effectually prevented. Honourable House would be "And your Petitioners, as in duty bound, &c. &c." Moved by J. T. Porter, Esq., and seconded by Dr. Shearman: "That the Members of the borough of Sheffield be respectfully requested to present this memorial; and that they, with the Members for the West Riding, be requested to support it in the House of Commons." M. MARTIN DE BARTOLOME, M.D., YORKSHIRE BRANCH MEETING. A meeting of the Yorkshire Branch of the Provincial Medical and Surgical Association has been called for Tuesday, the 29th instant, at Normanton, to take into consideration the Bill of Sir James Graham, for the better regulation of Medical Practice, at which meeting all Members of the Association, residing in Yorkshire, who have not yet joined the Branch, are invited to attend. BRADFORD (YORKSHIRE) MEETING. A general meeting of the Medical Profession of the town and neighbourhood of Bradford, was held on Tuesday, October 1st, to take into consideration the proposed bill of Sir James Graham. Thos. Beaumont, Esq., in the chair. The meeting was addressed by the chairman, and several of the leading members of the profession in the town; and it seemed to be the general feeling that the thanks of the profession are due to Sir James Graham for the trouble and interest he has taken in its behalf, and that the proposed bill as a whole should be thankfully received as a boon. The registration clauses were highly approved of, and it was considered that if the bill passed into a law, it would certainly have the effect of raising the respectability of the profession. Several gentlemen spoke strongly in favour of the abolition of the Apothecaries' Company as an examining body; considering it highly derogatory to the profession that a trading company of druggists should have the power of obliging gentlemen, who intend to practice medicine and surgery, to come before them for examination previous to obtaining a license. While the principle of the bill was thus far approved of, a hope was expressed by the meeting that some additional clause would be introduced, to put a check upon quackery. Resolutions to this effect were unanimously agreed to, and a Committee was appointed to communicate with the Members for the borough, and to watch over the progress of the bill. WREXHAM MEETING. On Tuesday, September 24th, at a meeting of the Medical Practitioners residing in Wrexham and the neighbourhood, held at the Dispensary, to take into consideration the best mode of expressing their opinion in the form of a petition to the House of Commons, respecting the Bill introduced by Sir James Graham, for the regulation of the Medical Profession. Mr. Lewis in the chair. It was proposed by Mr. T. T. Griffith, seconded by Mr. E. Williams, and resolved unanimously: "That it is the opinion of this meeting, that the bill introduced into the House of Commons by Sir James Graham, Bart., in its present form, will be injurious to the profession generally, but more especially to that branch denominated general practitioners, by throwing open the practice of medicine and surgery to men wholly unfit to be entrusted with the care of the lives of her Majesty's subjects; and whilst, as members of the professsion they thus feel, they are also deeply impressed with the conviction that the best interests of the public at large are extensively compromised and endangered by the proposed bill. A Petition to the House of Commons was then agreed to; and it was resolved also to forward a copy of the Petition to each of the Members of Parliament for the county and boroughs, with an address respectfully requesting their attention to the subject of the Petition, and their attendance in Parliament to support the prayer of it. NEWCASTLE-UPON-TYNE MEETING. A general meeting of the Medical Profession in the Northern counties will be held at Newcastle-uponTyne, on Wednesday, the 23rd October, 1844, in the Lecture-room of the Literary and Philosophical Society, to consider the Medical Bill of Sir James Graham. The chair will be taken at two p.m., by Members of the Association are Dr. Headlam. earnestly requested to attend, and to engage all qualified practitioners in their neighbourhood to be present. By order of the Council, EDWARD CHARLTON, Hon. Sec. GIBERT ON DISEASES OF THE SKIN. We have much pleasure in informing our readers, and the Medical Profession generally, that Mr. Parker, West Strand, will shortly publish a Translation of M. Gibert's able work on Diseases of the Skin, by Edgar Sheppard, Esq., of Worcester. BOOKS RECEIVED. Guy's Hospital Reports. No. IV. October, 1844. London: Highley. 8vo. Annals of Medicine. No. 1. Sir James Graham's Bill repudiated. By John Thomson, M.D., Lecturer on the Practice of Physic, Edinburgh, &c. London: Highley, 1844. 8vo., pp. 48. On the Colour and Structure presented by Corpora Lutea in the Early Stage; and Correspondence with Dr. Lee regarding a disputed Case of this kind. By Robert Paterson, M.D., &c., Leith. (From the Edinburgh Medical and Surgical Journal, No. 161.) 8vo. pp. 10, plate. A Manual of Elementary Chemistry, Theoretical and Practical. By George Fownes, Ph. D., Chemical Lecturer in the Middlesex Hospital Medical School, &c. London: Churchill. 1844. Fscap. 8vo., pp. 566, Engravings. Memoir on the Sex of the Child, as a Cause of Difficulty and Danger in Human Parturition. By J. Y. Simpson, M.D., F.R.S.E., Professor of Midwifery in the University of Edinburgh, &c. &c. (From the Edinburgh Medical and Surgical Journal.) Edinburgh: 1844. 8vo., pp. 55. Treatise on Inflammation as a Process of Abnormal Nutrition. By John Hughes Bennett, M.D., F.R.S.E., Fellow of the Royal College of Physicians; Pathologist to the Royal Infirmary; Physician to the Fever Hospital, Edinburgh, &c. Edinburgh: Machlachlan, Stewart, and Co., &c. 1844. 8vo., pp. 80. Plate. An Account of some Experiments Illustrative of the Mode of Formation of Dissecting Aneurisms. By Thomas B. Peacock, M.D., &c. (From the London and Edinburgh Monthly Journal of Medical Science.) 1843. 8vo.,pp. 8. TO CORRESPONDENTS. Communications have been received from Mr. H. W. Livett; a Subscriber; T. P. F.; Mr. S. A. Philbrick; G. M.; and Mr. T. Sandwith. The notice of the Chichester Meeting came too late for insertion this week. PROVINCIAL MEDICAL & SURGICAL JOURNAL. CLINICAL LECTURES ON DISLOCATIONS, | but the violence and mischief done to the joint may be CASE I. William Robinson, aged 50, was admitted into the BY HENRY HANCOCK, Esq., Surgeon to the Hospital. London Hospital, under the care of Mr. Thompson, on LECTURE VI. the 6th of December, 1760, having been injured by the sudden recoil of a wheel he was working in twisting a rope. On examination, his shoulder was found to be dislocated, and attempts were made to reduce it, but without success. He caught cold, with fever, and died on the 24th of the same month, having been eighteen days in the hospital. The shoulder was examined, and presented the following appearances :The deltoid muscle was very much stretched, the coraco-brachialis but slightly so, whilst the short head of the biceps, with which you know this latter is connected at its origin, was relaxed. The long head of the biceps, instead of retaining its natural position, made a large curvature, and thus being violently stretched and distorted, occasioned an insurmountable FATHOLOGY OF DISLOCATions of the SHOULDER. It is only of late years that surgeons have endeavoured, by dissection, to throw any light upon this very important branch of our subject. We search the writings of the older surgeons, but we search in vain for any account of the state of parts produced by this accident, the true character of which was naturally involved in mystery sufficient to account for the erroneous opinions entertained by our forefathers as to the real nature and character of the mischief incurred. The first published account of a dissection of a dislocation of the humerus downwards, is that by Mr. Henry Thompson, one of the surgeons of the London Hos-flexion of the forearm. The deltoid, pectoralis, coracopital, in the year 1761, related in the second volume of the "Medical Observations and Enquiries," and since this period but comparatively few dissections of recent cases have been recorded; indeed, to the shame or misfortune of surgeons, Mr. Thompson maintained the honour for more than fifty years of being the only individual who had published a case of this description. Within the last thirty years, however, more has been written on the subject. Sir Astley Cooper, Dr. Hunter, and Mr. Crampton, have each given us the benefit of their experience, and related cases and dissections of great value, as tending to remove the un certainty in which we must otherwise have remained. It will be necessary that I should detain you for a short time while I relate some of the most important of the cases recorded, whence you will be able to judge how useless it is to endeavour to make out a general rule from one, or even a few cases. Much has been said and written of the causes of obstacles to reduction in this form of dislocation, one surgeon considering it one thing, another something else, and each following or recommending a line of practice based on his par-attachment was uninjured. On examining the bone a ticular theory; but this is wrong, the best surgeon being he who, unshackled by any one theory, is enabled to call to mind what has been met with in cases similar to his own, and is hence prepared to meet with, and meeting with, may be enabled to obviate and sur-the bony attachments of the supra and infra-spinatus mount any difficulties which may arise. You will find I am borne out in this observation after we have studied these cases. The same symptoms and signs may be present, the same difficulty of reduction may occur, No. 31, October 30, 1844; brachialis, short head of the biceps, latissimus dorsi, and teres major muscles, having been removed from their attachments at the humerus and scapula, afforded a view of the tendinous expansion of the supra and infraspinatus muscles, spread upon the anterior part of the capsular ligament, which seemed to be in a state of great tension, but that of the teres minor was relaxed, whilst the arm hung down by the side. Under this aponeurosis several fragments of bone were observed blended with a fleshy mass, which united at its lower part with an exostosis that had shot out from the body of the humerus. The head of the humerus was broken, and found lodged on the inside of the neck of the scapula, at the root of the coracoid process, between the subscapularis and serratus magnus muscles. The blood-vessels and nerves lay on the inner and forepart of the head of the humerus, but were in nowise compressed by it. The capsular ligament had been completely torn from the whole circumference of the neck of the humerus, no remains being left but a few fringes, denoting its place of attachment. Its scapular loss of substance was discovered, extending in length about two inches downwards, and in breadth taking in the portion of the bone that lies between the insertion of the subscapularis and teres minor muscles, so that muscles were destroyed. The tendons of the teres minor and subscapularis were torn from the greater and lesser tubercles, but a few fibres remained attached to the periosteum, and thus embraced the neck of the |