for the sake of learning their profession, but with this the governors had no sympathy. They had scarcely reached the idea of looking at the hospital as a great teaching establishment for diffusing knowledge through the kingdom for the benefit of all, and did not recognise that their aid should be given for the promotion of this great object. They were therefore chary of spending a penny which was not directly and evidently required for the patients' benefit. And it was generally a money consideration which stirred up the merits of the question, as, for example, whether some newly invented apparatus was absolutely necessary for the benefit of the patients, or was merely of scientific interest. I well remember that the first microscope used for clinical purposes was supplied by the medical school; that is, its cost came out of the pockets of the teachers. At that time the surgeons brought their own instruments to the hospital for operations and the dressers were obliged to provide themselves with their own dressing-cases. In return these young men who looked after the patients were provided with board and lodging.

In another department with which I was intimately acquainted, I can speak from personal knowledge concerning the different views formerly held by governors and medical staff as to whose duty it was to furnish a post-mortem room for the inspection of the dead. The hospital declared that it would do no more than provide the room; it had very little need of the place, which was only useful to the medical men for scientific purposes, and therefore virtually belonged to the school. This I may mention had nothing to do with the dissecting room devoted to the teaching of anatomy, and which is usually placed far away from the hospital. At that time pathology formed no part of the curriculum laid down by the examining boards; but when it came to be more systematically taught, one of the junior officers was appointed to demonstrate the morbid structures, and this necessitated paid attendants and numerous implements, which put the school to increased expense. It might have been thought that when in those olden days the hospitals had seen such good work turned out as the discoveries by Bright and Baillie, the governors would have seen their way to take charge of this department; but it was declared that they had very little requirement for it, and that it was of use only to those who carried on pathological investigations. When it was pointed out that these examinations often revealed causes of death due to violence, the answer was that these were matters for the coroner and police. At that time, so little did the governors consider that they had any other functions than looking after the comforts of the patients that, when an inspection was made, it was done only at the special request of the surgeon or physician, who filled up a printed form stating that the case was one of great interest, and therefore he requested permission to examine the body. The superintendent then com

municated with the friends and his request was usually granted. This was done in the sole interest of the medical man.

Not many years, however, passed before pathology came to be considered one of the most important branches of medical learning, and the lay authorities saw that they must afford more accommodation for its pursuit. Having interested myself in the subject, I was appealed to by a very active and intelligent governor of one of the largest hospitals in the East of London; as a result the assistantphysician, who was in daily attendance to superintend the autopsies, was awarded 100l. a year. This governor had come to see that it was a duty of the authorities to possess a more accurate and complete account of the causes of death than had ever before been possessed; but this small allowance was not given without the protest of some other governors, who maintained that it was a diversion of the money they had in trust from its rightful purpose. In another hospital at the West End of London a new arrangement was made by the hospital and school dividing the expenses of this department amongst them. It was beginning to be seen that the governors had something more devolving upon them than making the patient comfortable in his bed; that they had a large amount of material in their hands which might be used for the advancement of medical knowledge, and that this should not be allowed to run to waste.

I cannot too strongly enforce the fact upon my readers that in many cases the hospitals are the only places which can supply the information which is so much needed for the public good. Where, may I ask, could the methods of the Listerian treatment have been learned and developed but in a great hospital? The wealthy certainly found the means for supporting the hospital, but it gave them back the value sevenfold. Let me take another example of this. Sir William Jenner, when appointed to the Fever Hospital, was discontented with the term common continued fever,' and was determined to analyse it further. He began by taking careful notes of the cases in the wards, and if the patient died, followed the body into the post-mortem room. Here he spent months, or I might say years, in the most searching examinations of the intestinal canal and other parts, with the discovery that he was dealing probably with two very different diseases under the name of fever, one of them being the highly contagious typhus and the other typhoid or enteric. He himself, I might remark, became the victim of typhus and had a very protracted illness. This knowledge which Jenner obtained was most accurate, and laid the foundation for quite new views of the subject, which became universally adopted and utilised throughout the kingdom. It is only reasonable to suppose that this work of Jenner entailed some slight extra expense, but whether this was defrayed by the doctor or by the institution I do not know. This seems a matter of little moment in comparison with the large

and important result obtained; but on the present occasion it would be very interesting to discover the facts. Judging from opinions which now prevail, it may be assumed that there were those amongst the governors who felt proud that the hospital over which they presided was bearing such good fruit for the benefit of mankind, whilst no doubt there were others who protested against the smallest sum being expended for so-called scientific purposes. However this may be, it is evident that no such investigation could have been carried on in private houses, to say nothing of the advantage of having a number of cases of the same kind brought together in one place, and therefore we all ought to feel a debt of gratitude to the governors for allowing Sir W. Jenner to make these researches. Let us hope that some of the present governors feel a reflected glory when they enter the building, and that a glow of satisfaction comes over them when feeling that they themselves might participate in a similar undertaking. It is impossible to suppose that there are not many amongst the governors of the Queen Square Hospital who have not the same feeling of pride when they consider they are attached to an institution which the medical officers have made one of world-wide renown.

Some years ago a very fatal malady was observed at Bradford, which soon began to be known as the Woolsorter's Disease. This was due to blood-poisoning owing to the introduction of a parasite attached to the foreign skins. About the same time there appeared a fatal form of boil amongst the tanners or fellmongers at Bermondsey. When these cases went to a neighbouring hospital they underwent a rigid examination in the medical school laboratory, with the result that they were found to be due to a parasite of the same nature as was met with in the Woolsorter's Disease. This suggested the appropriate remedies and external treatment, resulting in the cure of most subsequent cases. I believe the hospital incurred no expense on account of this necessary investigation. It would be interesting to know how any hospital would act under like circumstances if no medical school had been attached.

I must also add that the ordinary pathological work of the hospital, which is only partly paid for by the governors, brings with it often an amount of information which nowhere else could be obtained. A very loathsome disease, which already had received the notice of the British Government owing to its ravages in India and elsewhere, has many victims dying in the London hospitals. This disease became a few years ago the subject of a much more intimate examination than had ever been undertaken before, when it was found that various parts of the interior of the body were affected as well as those of the exterior. The external manifestations had been known for centuries, but, from the absence of a thorough postmortem examination, the extent of the mischief on the internal organs of the body was unknown, notably the damage to the brain

and the liver. Associated with the changes found in these organs there had been present hepatic and cerebral affections, such as epilepsy and paralysis. This discovery suggested the same remedies for these disorders as had been found most efficient in the more commonly recognised symptoms, and their use was followed by the most astonishing result. Patients with the severest forms of epilepsy were now cured; those lying hopelessly ill with paralysis were raised from a bed of apparent death, and many a man with supposed cancer of the liver was absolutely cured. All this immensity of good has come out of a careful examination of those who had died of these loathsome diseases. This could only have been effected by seizing the opportunities which the hospitals offer.

With such flagrant instances before them it seems extraordinary to find some governors of hospitals declare that, although these institutions are the only places where it is possible for this most important knowledge to be obtained, they have no concern in the matter, and are opposed to the outlay of a farthing of the funds, which ought to be devoted solely for the care and comforts of the individual patient. They say that they have no public responsibility beyond this. I apprehend that in cases of death from suspected poisoning, where there was no professor to undertake an analysis, the governors would be within their rights to throw the responsibility upon the police or other external authorities.

As at the present time means are being adopted by an anti-scientific clique to put a stop to all physiological and pathological inquiry, by making more stringent the laws which already control research, I may take this opportunity of informing my readers, as few are acquainted with the fact, that the complete study of anatomy is also hampered by Acts of Parliament. If England were isolated and had no connection with the Continent it would be impossible for the medical student to learn his profession. The provisions of the Anatomy Act, which has worked well as a whole, require that no body can be dissected unless by the sanction of the Government inspector, and also that it must be buried in a public cemetery at the end of a month or thereabouts; this is also certified by the inspector and the returns are sent to the Secretary of State. In consequence of this enactment it is impossible to take away all the bones in order to frame a skeleton. Consequently no skeleton has been made in this country for many years. Those found in our museums are either old or have been imported from abroad. As the first lesson the student has to take is in osteology, it is necessary for the museum to be provided with skeletons and separate bones; consequently they have to be brought from abroad. It was my duty for several years to pay a heavy annual bill to a person who traded in such articles in Paris. It is satisfactory to know that there is no marked difference between the bones of French men and women and those of our own

countrymen, and therefore no fear of any ill arising from this restrictive Act.

I cannot, however, refrain from remarking that the position our country takes in the progress of the arts and sciences requires our most serious consideration. We are constantly hearing of our inferiority in manufactures and in artistic articles; we therefore require rather official support than the introduction of any measures which might retard their progress. In this light it is serious to contemplate the possibility of any further legislative enactment to retard the study of anatomy and physiology, already hampered by two distinct Acts of Parliament preventing their full development and practical efficiency.

SAMUEL WILKS.