3rd. It often happens that when a remedy or mode of treatment of importance has been introduced by one unknown to the profession, it has been adopted by some leading man, and in many cases the originator is entirely lost sight of.

势

After carefully considering all the circumstances, I determined to defer making the remedies and their method of application public, until such time as I should be recognised as the originator of them; and I am glad to say that I think this time has already come, and that I can now publish my plan; for the approbation of many medical gentlemen, and the gratitude of a multitude of cured patients have now placed it on such a broad basis of facts (and I hold that facts are everything in medicine), that it cannot well be either plagiarized, or the credit due to me disputed.

For the past year and a half my consulting rooms have been open every Tuesday to the Medical Profession, for the purpose of exhibiting to them my method of treatment, and I am proud to say that during this period over one hundred members of the profession some of them the leading and most justly celebrated in the country-have visited me, and nearly all of them have spoken of it in the highest terms, and have treated me with the greatest

liberality and politeness. I was, however, somewhat surprised to find in the Lancet of February 14th an article written by a gentleman who had been a constant visitor during a period of six months to my rooms, who had seen my treatment in all its stages, and who had been profuse in his expressions of admiration, in which my method (except the material used) is described, but in which paper he forgot to mention me or his visits to my rooms; but as the controversy between him and the gentlemen connected with him in his first efforts has enlightened the profession upon this point, I shall leave it for them to judge the matter.

I have also heard that some of my visitors, taking advantage of my confidence, succeeded in carrying away some of my remedies; but even a hospital analysis failed to detect the vegetable portion of them: this I am also willing to leave to the liberal and highminded of the British profession, confident, from what I have seen of them, of the soundness of their judgment.

Some time since I received a communication from the Board of Governors of the Middlesex Hospital, asking me upon what terms I would make a trial of my method of treatment in the cancer wards of that charity, and after due reflection I proposed to them

certain conditions, which were recommended by the liberal Medical Committee, and at once unanimously and without reserve accepted by the Board.

My first applications were made to patients in the Hospital on the 22nd of January last, with what success may be learned by reading the following report of the Surgical Staff, made March 18th, 1857:

THE undersigned, being the Surgical Staff of the Middlesex Hospital, have much pleasure in complying with Dr. Fell's request that they should furnish him with a report upon his treatment of certain cases of cancer under their charge in the Middlesex Hospital.

They have learned with great satisfaction that Dr. Fell's object in obtaining this report is, that he may embody it in a work now on the eve of publication, in which he intends to disclose the peculiarities of his method of treatment to the profession.

Before proceeding further, the undersigned consider it due to themselves, to their professional brethren, and to Dr. Fell, to state the general terms upon which, in compliance with the desire of the benevolent founder of the Cancer Establishment of the Middlesex Hospital, the Medical Committee felt it their duty to recommend to the executive authorities, that that gentleman should be allowed to pursue his plan of treatment under their superintendence in the wards.

The terms were proposed by Dr. Fell, and were to the

1st. That Dr. Fell should, in confidence, communicate to the Surgical Staff the nature of the remedies employed by him, the method of their preparation, and the mode of using them.

2nd. That twenty-five cases should be subjected by him to treatment during a period of eight months.

3rd. That Dr. Fell should pledge himself to publish the full particulars of his system of treatment within a period of six months; and that in case of his failing to do so, that duty should be undertaken by themselves.

The undersigned have great pleasure in now stating that Dr. Fell has fulfilled the obligation contracted by him frankly and without reserve; and whilst they regret that the limited period which has elapsed since the treatment in the hospital was commenced (January 22nd) prevents their coming to any positive conclusions upon certain points of great importance, they have yet no hesitation in stating their unanimous opinion

I. That Dr. Fell's mode of treatment is in entire accordance with known principles of surgery, is ingenious, safe, and easy of application by well-instructed surgeons.

II. That it may be employed in all cases in which surgeons use the knife, and in many others in which no prudent person would recommend a cutting operation.

III. That Dr. Fell confines himself to the enucleation of the tumours merely; and, in the case of the breast, does not remove the entire gland, as is commonly considered

necessary in the excision of mammary cancers in this

country.

IV. That it is a great advantage attending this mode of treatment that the patients are not confined to bed or to the house; but that, on the contrary, they are able to obtain the benefit of exercise in the open air. In some instances their health has manifestly improved during the treatment.

V. That the patient being exempt from the immediate hazards of a cutting operation, such as exhaustion and hæmorrhage, and being able to pursue the treatment without confinement to bed, they appear little prone to such constitutional affections as erysipelas and pyæmia.

VI. That the enucleation of the diseased mass is succeeded by a healthy granulating and cicatrizing surface. From the inspection of Dr. Fell's private cases of longer duration than those in the hospital, the undersigned have had opportunities of observing that healthy cicatrices are eventually formed.

VII. That all the patients have suffered pain during the treatment; some have spoken lightly of their sensations, others have complained much. No one, however, has sustained that acuteness and severity of pain which characterises the action of caustics, as ordinarily employed; and it has been observed that the pain which has been felt has usually been referred, not to the tumour itself, but to parts at some distance from it, as, in the case of the mamma, to the shoulder and arm.

VIII. That, although the treatment is less expeditious than that usually resorted to, yet, taking account of the