already noted in The Lancet, as to Mr Ward, etc. Bedding was daily expected at Scutari from Varna, but did not come, and he had to borrow 200 boards and trestles from the Turkish authorities. It happened just at this time that Lord Redcliffe arrived to inspect the hospital, and observed this want of beds. He took Turkish surgeons into his employ after the battle of the Alma. He sewed sheets together, and filled them with straw, for beds, after the battle of Inkermann. He reported this to Dr Hall. Dr Menzies stated that his own duties were overwhelming-in hospital all day, and frequently up the whole night; plenty of writing also, so that inspection of other hospitals was out of the question. As to clean linen for the hospitals, the purveyor had persons, he said, cleaning it; but after the battle of Inkermann these people would never do anything. Sick arrived in hundreds, and the surgeons were overwhelmed. The Barrack Hospital soon became more filthy; the purveyor lived in the hospital; but the accounts in the public press were all overdrawn. He never saw fæces at all on the floor-this was quite a mistake. He was next examined, or rather cross-examined, as to whether, as the men's pay was stopped while in hospital, they got the value of it in medicine and medical comforts; to which he made the sensible answer, "they all got such supplies as the medical officers considered necessary; but if a patient was labouring under bad inflammation, it would be improper to give him the full value in wine or brandy for which he would ask." One man might have been mistaken for another in some one solitary instance as to the number of his bed; but this was the fault of the purveyor living in the hospital, not the surgeons'; such a thing never came to his knowledge. The Commission of Inquiry came out on the 4th of November; they are going over matters yet. Miss Nightingale proposed to see to the washing, but he told her it was the purveyor's business. During all November we had plenty of medicines; during the entire time he was there he found no deficiency of medicine. The witness was asked several other questions as to the landing of the sick, which was done as well as could be under all the circumstances.

Mr W. H. Flower, surgeon of the 63d Regiment, was examined on the 27th, and corroborated many of the points already published. The strength of his regiment was 980 men. The medicine-chest was left at Varna for want of transport; the opium, though supplied in large quantities, was soon exhausted from the dysentery and diarrhoea amongst the troops; in fact, purgative medicines were left on hand; they never regained their medicines from Varna! His regiment had ten stretchers and two ambulance waggons; the men's "packs" were left on board when they landed in the Crimea, of which they complained very much; but this was a strategic move of Lord Raglan's. After Alma he had sixty sick and wounded a day. Operations were done out of doors," and under every possible disadvantage; even the new hospital tents were supplied rotten, and let in the wet; the sick came in wet; all was damp and dreary. Medicines were deficient at Balaklava. The knapsacks were not given to the men, but it was a "regulation of the service." As to chloroform, he disapproved of Dr Hall's order, and used it.

Dr Menzies was here recalled, and explained some points of no immediate medical interest. He said he employed seven Turkish physicians, and in August thought all was right.

Dr Menzies, Deputy-Inspector-General of Hospitals, was re-examined. He said he had direct charge of the general but not of the barrack hospital. It was Dr M'Gregor's duty to report to witness the state of the hospitals. His reports at times were not satisfactory. He stated that he had not sufficient assistance in the way of orderlies, and witness supplied them as far as he could. Witness never sent away some medical men who came to offer assistance after the Alma. As early as July he wrote to Major Sillery on the offensive state of the barracks and the necessaries. Major Sillery applied to the engineer department, who altered the drains; but they got out of order again, and the evils were never thoroughly remedied. On the arrival of the transports, the

worst cases were selected for removal to the general hospital. There was no want of sheets, linen, cleanliness, or attention to the sick and wounded after the Alma. A card, bearing each patient's name, was placed over the patient's bed. The sick had three meals a day. Great delay occurred in getting the patients' meals-their dinners especially; and they suffered much in consequence. He had never seen fæces flowing over the privies into the adjoining ante-rooms. Mr Stafford never represented the state of the privies to him. About two-thirds of the deaths from operations in the hospitals arose from amputations of the lower extremities. He was quite satisfied that none of the deaths of the wounded on whom operations had been performed were to be ascribed to the bad sanitary state of the hospital. The position of the French hospital at Constantinople was one of the most healthy in that city, being on elevated ground which overlooked the Golden Horn. The reason that the English hospital was inferior in that respect was, that no better could be procured than that at Scutari. The French had better opportunities of obtaining hospital accommodation, being on the other side of the water. Lord Stratford had visited the hospital twice, and at witness's request the medical officers received him in undress uniform, and not in full uniform, as had been stated; but their being so dressed did not interfere with the discharge of their duties at the hospital. Witness considered Admiral Boxer to be the agent of transports. He always treated witness very well, and was anxious to carry out his wishes as well as he could, except when he landed the sick at improper times, and then witness remonstrated with him, and some improvement took place, but not to the extent that witness wished. The admiral was to blame for not attending to the proper time for landing the sick. He had seen Mr Macdonald, but he (witness) never asked him a question. He did not apply to the Times' fund for assistance, because he did not think there was a necessity to do so. The articles that Mr Macdonald furnished might have been supplied, though not perhaps to the same extent, if they had not previously been purchased by that gentleman at Constantinople. He was not aware that Mr Macdonald applied to him more than once to know if anything was wanted in the hospital, and witness might have told him that nothing was wanted. On Wednesday (March 28th) the Committee sat again, and the examination of Dr Menzies was continued: When he said on the previous day that he "did not know his duties," he meant that his position was anomalous. When Dr Cumming came out, witness considered him his superior officer. Dr Cumming gave directions in the hospital, and witness supposed that Dr Cumming superseded him for the time being, and that he had no right to dispute Dr Cumming's orders. In the strict letter of the law, being himself responsible, he ought not to allow another to do that for which he alone was responsible; but still, witness considered that he should obey Dr Cumming as his superior officer. This was his view, from long military medical experience. Witness questioned the truth of Mr Osborne's statements about the want of tables for operations. Sometimes the operations were performed in the sight of other patients; but some allowance must be made for the state in which the hospitals then were. Men did not die in the hospital of starvation, as Mr Osborne had said. These statements were highly overdrawn. He made the best arrangements he could for the hospital. An officer was specially appointed to see the embarkation of the Russian prisoners for Kululee, and witness was present on the occasion. Witness denied that the Russian prisoners had been insulted in the way described by Mr Osborne. A Russian medical man accompanied them. He was not aware that the Russian prisoners at Kululee slept on bare boards. He did not go there to see the state of their hospital, as his duties at Scutari did not allow him. He believed that the Russian prisoners had bedding, and could not believe it to be true that they slept on bare boards. Mr Wrefford was aged about sixty-three. Mr Wrefford did not satisfy witness. He opposed witness's authority, of which witness complained to Dr A. Smith. Witness would give evidence unqualifiedly contradicting Mr Os

borne's statements that men were miserably dying of starvation, and want of clothes, and medical aid. He had more to do than merely writing reports, he had to go round the hospitals to see that the medical officers did their duty, and to attend all important operations. Witness informed Dr Smith that Mr Wrefford did not carry out his recommendations. Mr Wrefford questioned witness's right to interfere in his office, and when witness consulted him as to some of the sick officers, he turned round and said that witness had nothing to do with it. Witness frequently operated himself at the hospitals, but generally divided the operations with a second-class surgeon. When witness was absent, first-class staff-surgeon Carr attended at the general hospital, and Dr M.Gregor at the barrack hospital. There was not a sufficient number of medical officers, but the patients did not suffer to any considerable extent, as the medical officers, though short in number, did a great deal of work, night and day. Many died in the East after the operations, but that was because they were in so low a state that they would have died without the operations, and the operations were performed merely to give them a chance of life. In a private letter to Dr Hall in December, he stated how the nurses were going on, and that they were very useful in washing the faces and hands of the sick and wounded, and in washing the linen, and attending to their comforts; but that at present their number was too small to enable them to judge of their efficiency. The hospital was then in tolerable order, cleanliness, and comfort ; and Miss Nightingale observed to him that she was surprised at the regularity and comfort that appeared to prevail in every ward in the general hospital. Witness applied to Captain Gordon to have the flooring of the barrack hospital repaired, and Captain Gordon undertook to attend to it. There were 2000 patients in the barrack hospital in November, and the purveyors were supplied with clean linen before Miss Nightingale's arrival. He had not heard that some of the wounded remained for days in the hospital at Scutari with the earth on their wounds which they had got in the field of battle. The returns made to witness of the deaths in the sick transports were numerical, not nominal. In some cases he never received any returns of these deaths at all. Dr Dumbreck, Deputy-Inspector of the Hospitals at Constantinople, said he arrived there on the 15th of April. He established a general hospital at Varna. He did not choose that hospital-it was assigned to him. It was objectionable in many respects. The windows were like pigeon-holes, and the privies were indescribably filthy, and many parts of the hospital were covered with vermin. He remained in charge about a month, and was succeeded by Dr Hall. The food in the hospital and camp, and the bedding in the hospital, were satisfactory. At first, when the regiments began to arrive in Scutari, no purveyor's stores had preceded them there; and what sick there were had food and comforts from the commissariat. The comforts were not such as a purveyor would have supplied. After the battle of the Alma, at which he was present, he saw no want of medicines or surgical appliances, as far as came under his observation. He left the camp before Sebastopol on the 13th of November, up to which time there were no wants amongst the troops which were not supplied; but there was a prospective scarcity of fuel. The green coffee sent out would be certainly prejudicial to health. He sent to the apothecary at Scutari for a fresh supply of opium, and he got it. He believed he applied for 50 lbs., and he got 30 lbs. Of lint, bandages, and things of that kind, there was a superabundance. The army never suffered on that score. Witness saw much in the ambulances to approve of, though some features in the French ambulances might be advantageously engrafted on them. Witness was only thus far responsible for Dr Menzies' appointment: when Dr Hall left Scutari, Dr Menzies was on the spot, and was senior officer in the medical department, and he succeeded Dr Hall as much from being on the spot as from any other consideration. Witness made many suggestions calculated to prevent disease amongst the troops, but they were only very partially adopted; one of them NEW SERIES.-NO. V. MAY 1855. 3 N

was to clothe the army in woollen from September until May. The charge that there was a want of lint, bandages, and medical comforts after the battle of Inkermann, was a calumny. An ample supply had reached the lines the day after the battle. He often visited the Balaklava hospital, and never saw it in the condition described by Mr Stafford. Witness had professionally inspected several transport ships for the sick, especially the Etrunga and the Talavera, both of which were in the best possible order. He had provided 400 mattresses and 2500 palliasses for the sick in these transports; he had intended to have procured more palliasses, but could not get hay to stuff them with. After the battle of Inkermann the bedding in the sick transports failed. Many of the ships were supplied with medical comforts according to lists ordered by witness. He also ordered wine to be placed on board each transport. He visited the hospital tents regularly. The hospital tents were well adapted for summer, but not for winter. Trained nurses (such as Miss Nightiagale had embodied) and trained orderlies were desirable, and in great numbers. The routine services the medical officers had to perform, the accounts they had to keep, and the great amount of writing they had to do, most seriously interfered with the discharge of their medical duties.

Mr Drummond asked witness if that had not been the principal cause of the neglect that had taken place in the medical departments?—Witness replied that he did not admit that any neglect had existed.

The witness considered the maintaining of regimental hospitals in time of peace to operate disadvantageously to the establishment of general hospitals in time of war.- Lancet.

CHLOROFORM IN THE WAR HOSPITALS.-Chloroform was always used, and it appeared to me with the greatest success,-which I attribute a good deal to the practice of using it on a handkerchief held lightly to the face instead of the plan I have seen elsewhere of using some instrument, which, whilst it secured the inhalation of the anaesthetic, excluded too much of the atmospheric air. I assisted at one very painful case, in which a branch of the femoral artery had to be taken up. There were great difficulties about it, so much so that one of the best surgeons there did not seem to me to like to attempt it; it was however done by Dr M'Ilray, assisted by some others. I am afraid to say the length of time the patient was under the influence of chloroform; his head was on my own knee the greater part of the time, and I had to keep up the administration of this inestimable agent; at last they succeeded in getting a ligature round the vessel. I was then left with one of the surgeons to try and recover him from the torpor under which he had, without pain, borne a most severe application of the knife, etc. Our only hope, from the quantity of blood he had lost, was to get some stimulant taken as soon as we could. In vain we tried every means of rousing him-the pulsation of the heart was so weak, his whole appearance such, I had begun to despair. As a last resort, I found out his name, and had him sharply spoken to by it. So strong was the force of habit that he made just sufficient effort to waken to enable us to order him to drink the wine we gave him. Keeping up the saine sharp military tone of voice, we got more and more swallowed, and he soon recovered.Scutari, by the Rev. S. G. Osborne.

MEDICAL APPOINTMENTS IN THE EAST.-Dr Robert D. Lyons of Dublin has been appointed to the important scientific duty of investigating the pathological conditions of the diseases which are now making such havoc among our men in the East. Dr Lyons is already on his way to Scutari.

Dr William Aitken, Demonstrator of Anatomy in the University, and Pathologist to the Royal Infirmary, Glasgow, has been appointed assistantcommissioner at the hospitals on the shores of the Black Sea.

NEW REGULATIONS FOR THE MILITARY HOSPITALS AT SCUTARI.-The representations of the Council of Health, in respect to the improper mode of burial

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practised at our military hospitals, has been attended with the best results. Drs Sutherland and Gavin, and Mr Rawlinson, have determined that no burial should take place but at the distance of 100 yards from the walls enclosing the general hospital. But one range of bodies, with an intervening space of 12 inches, is to be placed in a trench; the trench to be at least of the depth of 6 feet from the surface. A layer of coal dust to be laid in lieu of quick lime over the bodies, and all interments to take place in future in the morning early, or evening, and not during the heat of the day. In respect to the ground already used up, a stratum of moist coal dust is to be thrown over it, and it must be pressed down, levelled, and scattered with grass seed.

TURKISH CONTINGENT.-Dr Macpherson, chief medical officer of the corps, has lately visited Edinburgh for the purpose of securing surgical volunteers. The terms offered were as follows:-25s a day for surgeons who must be under thirty-two years of age; 15s a day for assistant surgeons with diplomas to rank at first as first-class dressers; and 10s 6d a day for dressers in their second or third years of study, who have dressed in an infirmary, to rank as second-class dressers. To proceed to Constantinople without delay. Pay to commence on day of appointment. Free rations. Free passage out and back. Fifty-one days' pay in advance. Twelve of these various grades were required. For the inferior dresserships, however, there were 40 applicants, of whom thirteen were selected, and the full complement of surgeons was at once obtained. A few appointments for the assistant-surgeon-ships were still vacant when Dr Macpherson left town, but these were in prospect of being filled up.

LUNATIC ASYLUMS IN SCOTLAND.

The Queen has been pleased to direct letters patent to be passed under the seal appointed by the Treaty of Union to be kept and made use of in place of the Great Seal of Scotland, appointing Samuel Gaskell, Esq., Fellow of the Royal College of Surgeons; William George Campbell, Esq., Barrister-at-Law; Alex. Earle Monteith, Esq., Advocate, Sheriff of the Shire of Fife; and James Coxe, Esq., Doctor of Medicine; to be her Majesty's Commissioners for the purpose of Inquiring into the state of the Lunatic Asylums in Scotland, and also into the present state of the law respecting Lunatics and Lunatic Asylums in that part of the United Kingdom.-London Gazette, April 10.

We trust that the inquiries of this commission may lead to the provision of Public asylums for all the pauper lunatics of Scotland. By the act 4 and 5 Vic. c. 60, it was enacted that all parish paupers should be sent to a public hospital or asylum, unless under special circumstances and cause shown, the Sheriff of the county should permit any case to be sent to a private or licensed madhouse. The poor-law act, however, subsequently passed, which rendered it imperative on all parishes to send their pauper lunatics "to some establishment legally qualified to receive them," appears to have rendered the clause referred to in the former act inoperative to a great extent. In the first place, it multiplied the cases requiring to be sent to asylums so much that the existing public asylums could no longer receive them; and, in the second place, it seems to have been understood by the parochial authorities and Board of Supervision as a virtual abrogation of the clause giving a preference to public asylums. The consequence has been that during the last ten years a great number of private asylums have sprung up in Scotland, which compete eagerly with the public hospitals and with each other-sending their circulars to all the parochial boards of the country offering to take their pauper lunatics at the lowest possible rates of board. It is much to be feared that this competition has been fostered by the urgent desire of parochial boards to keep down the assessments for the poor; and that the pauper insane have, from motives of economy, been consigned to houses where they are deprived of nearly all the