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Dublin last week included 25 of infants under one year ofage, and 21 of persons aged upwards of sixty years ; thedeaths of infants showed a slight further increase uponrecent weekly numbers, while those of elderly personsshowed a marked further decline. Three inquest cases and 2deaths from violence were registered ; and 51, or more thana third, of the deaths occurred in public institutions. Thecauses of 8, or more than 6 per cent., of the deaths in thecity last week were not certified.

THE SERVICES.

ARMY MEDICAL STAFF.

Surgeon-Colonel (local and temporary Surgeon-Major-General) Thomas Walsh to be Surgeon-Major-General, viceP. B. Smith, M.D., retired. Brigade-Surgeon-Lieutenant-Colonel William D. Wilson, M.B., to be Surgeon-Colonel,vice Surgeon-Colonel T. Walsb. Surgeon-Lieutenant-ColonelAnthony L. Brown to be Brigade - Surgeon - Lieutenant-Colonel, vice Brigade- Surgeon - Lieutenant- Colonel W. D.Wilson, M.B. Surgeon-Major Richard C. K. Laffan, fromthe Seconded List, to be Surgeon-Major.

INDJA AND THE INDIAN MEDICAL SERVICE.The Queen’s approval of the following promotions in the

Indian Medical Service appears in the London Gazette of

Aug. 17th :-Bengal Medical Establishment : To be Sur-

geon-Colonel : Brigade- Surgeon - Lieutenant- Colonel ArthurStephen. To be Brigade - Surgeon - Lieutenant - Colonels :Surgeon - Lieutenant - Colonel Francis Cobham Nicholson ;Surgeon - Lieutenant - Colonel Thomas Holbein Handley,C.LE. Bombay Medical Establishment: To be Brigade-Surgeon - Lieutenant-Colonel : Surgeon - Lieutenant - ColonelSelim Myer Salaman, M.D. Her Majesty has also approvedof the retirement from the Service of the undermentionedofficer :—Brigade-Surgeon-Lieutenant-Colonel Robert TempleWright, M.D., Bengal Medical Establishment. The servicesof Surgeon-Lieutenant-Colonel A. S. Reid, Officiating MedicalStorekeeper, Calcutta, have been placed at the disposal ofthe Foreign Department for employment as Officiating Agency-Surgeon in Baghelkhand and Tutor to His Highness theMaharaja of Rewa, for three months. Surgeon-CaptainC. C. Cassidy is appointed to act as Civil Surgeon ofPurnea until further orders.

NAVAL MEDICAL SERVICE.The following appointments are notified :-Fleet - Sur-

geon Edward E. Mahon, C.B., to the Royal Marine Artillery,Eastney. Surgeons : R. A. Fitch, to the Pa,7tti.Ilies H. F.Iliewicz, to the Royal Marine Artillery, Eastney ; JohnGrant, M.B., to the Adventurer; Richard L. Price, M.B., tothe Herald ; J. P. Willis, M.B., to the h’.ep2clse; LawrenceBidwell, to the St. Vincant; John Jei)kij3-,, to Royal Marines,Plymouth ; and John D. Hughes, to the Vivid.

ARMY MEDICAL RESERVE OF OFFICERS.

Surgeon-Lieutenant Thomas Edmund Stuart, 1st EssexVolunteer Artillery (Eastern Division, Royal Artillery), to beSurgeon-Lieutenant.

VOLUNTEER CORPS.

Artillery 1st Worcestershire and Warwickshire : Surgeon-Lieutenant A. F. Clay resigns his commission (datedAug. 22nd, 1894).-Rifle : : 4th Volunteer Battalion, theSouth Wales Borderers : Surgeon-Lieutenant F. E. Paton,M.B., resigns his commission (dated Aug. 22nd, 1894).

DEATHS IN THE SERVICES.

Surgeon-General Miah William Murphy (retired), whosedeath is announced at the age of eighty, was appointedassistant surgeon in 1842. He took part in the BurmesEWar of 1852-53, and acted at Donabew as staff-surgeor(medal and clasp for Pegu), where he was wounded.Surgeon - General John Henry Orr, C.B., M.D., I.M.S.,

Retired List, Hon. Surgeon to the Queen, died at South.bourne-on-Sea recently at the age ot eighty. He enterecthe Madras Army in 1837, and from 1842 to 1862 wa:employed in the service of the Nizam of Hyderabad, takingpart in the Malwa Campaign of 1857. From 1863 to 1865 h<was Deputy-Inspector-General of Hospitals with the NagporEForce, and retired in 1871 as Inspector-General of Hospital;on the Madras Medical Establishment.

SURGEON-MAJOR JOHN FREDERICK MCCREA, V.C.Surgeon-Major McCrea, whose death we regret to have t(

announce, was born at Fort George, Madras, were his fatherwas sta.tioned, in 1854. He received his medical education atGuy’s Hospital, and soon after qualifying was appointed CivilSurgeon to Her Majesty’s Forces at the Cape during the time ofthe Zalu War in 1879. In the following year he took part inthe Basauto War, and it was in this campaign that his con-spicuous bravery won him the Victoria Cross. With theassistance of Captain Buxton of the Mafeteng Contingent,Surgeon-Major (then Surgeon) McCrea, after the Burgherswere forced to retire, went out under a heavy fire and con-veyed a wounded Burgher to the shelter of a large ant-heap,and having placed him in a position of safety returned to theambulance for a stretcher. Whilst carrying the stretcher tothe wcunded man he received a bullet wound in the breast,but notwithstanding the severity of the injury the gallantofficer continued to fetch in more wcunded and to attend totheir sufferingp.

MEDICAL EXAMINATION OF MILITARY CANDIDATES.

According to the reply recently given by Mr. Woodall inthe House of Commons on behalf of the Secretary of Statefor War, we are glad to notice that a full statement of thephysical condition required of candidates for the army hasbeen prepared by the authorities, and may be obtained bycandidates on application to the War Office, by which it isbelieved that any qualified surgeon will be able to informcandidates whether they are likely to pass the medicalexamination. This appears to us to be a common-senseand practical method of proceeding, and it is in accord-ance with a suggestion previously made in THE LANCET tothat effect. Next week in our "Students’ Number" wepropose to publish the text of the regulations with referenceto the medical examination of candidates.

THE ARMY MEDICAL STAFF EXAMINATION.The following is a list of successful candidates for com.

missions in the Medical Staff of Her Majesty’s Army at therecent examination in London :&mdash;

Names. Marks. Names. Marks.Howel!, II. A. L....... 2445 Profeit, C. W....... 2075Lawson, D.......... 2270 Whitehead, J. H....... 2013

E Harrison. W. J....... 2260 Tomlinson, N. P....... 1999. Steel, E. B......... 2178 Kiddle, F....... 1986, Perry, S. J. C. P....... 2168 Murison, J. A....... 1978

Haddon, H. E....... 2088 Heaton, A. S....... 1940

c The Army and Navy Gazette states, and it corroboratesE what we have already announced, that it is very probablethat Surgeon-General Bradshaw, Principal Medical Officerwith Her Majesty’s Forces in India, will be granted an

- extension of his appointment for two years, from Dec. 5th, next, the date on which he should ordinarily retire. This. extension is believed to be recommended from home.

Correspondence.

THE CHELSEA HOSPITAL FOR WOMEN.

" Audi alteram partem."

To the Editors of THE LANCET.SIRS,&mdash;When the late staff of the Chelsea Hospital for

Women placed their resignation in the hands of the board ofmanagement they did so as they felt it the most honourablecourse to pursue after the publication of a report in whichthe censure was grave but was not apportioned to anyparticular members. In seeking re-election as individualmembers each understood that he would stand or fall on hisown personal work at the hospital, and that if he were notincluded in the common blame his position would be justifiedbefore the public and the profession by the fact of his re-election. As the board of management have failed to takethis view of the situation and leave it open to inference thatwe were not re-elected owing to our work being involved inthe report, we submit as a fact that the committee of inquirydid not include us in the censure of the report. We feelsure the committee of inquiry will not deny this and wechallenge the board of management to disprove it. Weappend statistics of our operative work at the hospital during1893. and bes to remain. Sirs. yours trulv.

Aug. 22nd, 1894.VINCENT DICKINSON.J. A. SHAW-MACKENZIE.

* The statistics were appended, but we regret that, at

463"THE BIR.11 INGHAM EYE HOSPITAL."

any rate in this issue, we have been unable to find space forthem.-ED. L.

-

To the Editors of THE LAXCET.

SrRs,-In consequence of the comments which have

recently been made in the medical press upon the silence ofthe late medical staff of the Chelsea Hospital for Womenwith regard to the report of the committee of inquiry, wefeel it our duty to make a personal explanation. We havenot hitherto felt at liberty to act individually, for while wewere members of the late staff we felt that joint action wasalone admissible. We are now free from this obligation, andas our positions are identical we submit the following jointstatement :-1. At the end of 1893, when the hospital wasclosed, we had been on the staff for five and a half months,our duties being charge of out-patients and pathological workrespectively. 2. As there was no recognised medical com-mittee we had no voice at all in the management of thehospital. 3. We had no beds in the hospital, and suchoperations (mostly minor) as we performed in the temporaryabsence of our colleagues were unattended by mortality orsepticaemia. 4. Oar work was not called in question by thecommittee of inquiry. 5. The association of the deaths fromsepticaemia with the sanitary conditions of the hospital wasnot at the time obvious, and even now may be considered amatter of opinion. There was, therefore, nothing to lead usto call attention to the matter.

Hitherto no one, from the medical officer of health to thecommittee of inquiry, has ventured to apportion blame foranything that has been faulty. We have so far borne theimputation of common blame. The censure implied in thereport of the committee of inquiry allowed us no alternativebesides either disclaiming responsibility at once or resigningwith our colleagues. We chose the latter, because it seemedto us the more loyal and honourable course. We now feelthat we are at liberty to explain and that justice to ourselvesdemands that we should publicly state that we had no per-Bonal share of responsibility in the matter.

It seems to us that our position has been further justifiedby the fact that we have been re-elected to the staff of thehospital.-We are. Sirs. vours faithfullv.

Aug. 21st, 1894.

ARTHUR E. GILES, M.D., M.R.C.P.;T W. EDEN, M.D., M.R.C.P.,

Physicians to Out-patients, Chelsea Hospitalfor Women.

To t7ie Editors of THE LANCET.

SIRS.&mdash;Letters having been published by certain of myformer colleagues in a contemporary, I now feel at liberty,and in a measure obliged, to publish the details of mywork. Had I had the prescience of these gentlemen Imight have foreseen that personal interests must some-

times be placed before considerations of common good, andhave realised that others might not hold the views I haveheld-that conjoint work should be conjointly recorded.So far as I and the profession generally are concerned,I hope to be in a position very soon to state the whole factsof my operative work at the hospital since I joined the staffin 1891. During 1893 an exceptionally low mortality attendedthe work of some of the staff, an exceptionally high mortalitythat of others. Each man must now speak for himself.Personally, I have no wish to deal with other than my ownwork, and when the board of management furnish me withmy full records, which I have asked for, I trust you willfavour me by accepting an abstract, so that facts maydemonstrate what word, written or spoken, may have mis-represented. I am. Sirs. vours faithfullv.

LEITH NAPIER, M.D., M.R.C.P.Grosvenor-street, W., Aug. 18th, 1894.

"THE ETHICS OF HOSPITALS."To the Editor of THE LANCET.

SlRS,&mdash;Your leading article on this subject in THE LANCETof Aug. llth is one to which little or no exception can betaken : but there are two sentences which are capable ofmisunderstanding, and with your permission I should like toenter a protest against any reading which may be applied tothem. "The third great ethic is to omit no antisepticprecaution....... But over and above all this is the con-scientious use, even in details, of the great antisepticsystem which has revolutionised surgery." There are manywho will read your use of the word ’’antiseptic " as being limited to the employment of chemical means for the !

destruction of germs, and against this possible misunder-standing I desire to protest, as your remarks are based onthe performance of the great operations of abdominalsurgery, and the record-breakers in this department are

those who exclude all such details from their practice. Ifyour word is to be taken to mean what is now generallyknown as " aseptic " precautions, then it includes much morethan dangerous chemicals. It includes recommendationsbegun by Howard, emphasised by Semmelweis, preached bySimpson, and practised most successfully by many of thepresent day, including Your obedient servant,Birmingham, Aug. 15th, 1894. LAWSON TAIT.

" CASE OF CONGENITAL SYPHILIS ; INFEC-TION OF MOTHER BY CHILD.

To the Editors of THE LANCET.

SiRS,&mdash;absence from London has prevented me fromreplying sooner to Dr. George Ogilvie’s second letter on mycase. His objection to the title of my paper as "mis-leading " is surely somewhat fanciful, as on its correctnesslies the crux of the whole question at issue. Dr. Ogilvie, too,complains that I have not dealt completely with his objec-tions to my interpretations of the case. To have done sowould have been to have taken up an undue amount of yourspace, and his complaint may be met with one of mine-thathe has not met any of the arguments with which I attemptedto explain away some of the acknowledged points of weak-ness in the family history. It may be that some of myassertions about the manifestations of acquired syphilisin infants are rather "based on belief than on clinicalobservation." My personal experience of this rare acci-dent is limited to seven or eight undoubted examplesof the complaint. Had I chosen, however, to add manycases, as others have done, where inoculation in infantswas alleged to have occurred through the agency ofvaccination without any satisfactory proof or history ofprimary sore, this number would have been considerably in-creased. Without the inclusion of such unsatisfactory cases,is Dr. Ogilvie prepared to state that the experience of

any authority, however eminent, is sufficiently extensive tojustify the peremptory rejection of some of the conclusions Ihave drawn ? Moreover, I consider the opinion of the autho-rities I have quoted as equally weighty as that of thosementioned by Dr. Ogilvie. I fully admit the relevancy of thequotations from Fournier and am prepared to agree withthem to a high degree ; in the case at issue, however, it wasnot a question of one or several "special symptoms " thatwere concerned in the determining whether it was one ofacquired or inherited syphilis. The infant presented almostevery sign of inherited syphilis ; there was a satisfactorynegative history of a primary sore and an absence ofany symptom that ingenuity could pervert into one

of the acquired complaint. Had it not been forthe infection of the mother, the case would have beenaccepted as an ordinary one of congenital syphilis, in spiteof the unsatisfactory family history on this score. Thisbeing so, I feel justified in regarding it as such, and see noreason for going out of the way to classify it as an exampleof the acquired variety. I regret I am unable to furnishDr. Ogilvie with any satisfactory account of the two casesreferred to in my former letter. The one occurred in thepractice of a medical man who was too busy for note-taking,and all I learnt about it was from hearsay evidence. Theother was seen some years ago by a late eminent syphilo-logist, who took the same view of it as Dr. Ogilvieapparently does of my case and pronounced it one of

acquired syphilis, but for reasons that were unexplainableand unsatisfactory to my friend, himself an acknowledgedauthority on children’s diseases. Since it has drawn two

interesting letters from Dr. Ogilvie emphasising some of theless known points of infantile syphilis, I cannot regret thepublication of my case, although, as I said, I had no certainhope of convincing the majority of the profession of myviews regarding it. I am. Sirs. vours faithfullv.

Upper Berkeley-street, W., Aug. 18th, 1894. J. A. COUTTS.

" THE BIRMINGHAM EYE HOSPITAL."To the Editors of THE LANCET.

SIRs,-In THE LANCET of Aug. 18th last your Birminghamcorrespondent states that the above hospital will containsixty-five beds when the new block is added. Will you kindlystate that this is a mistake. The hospital at present contains