- Email: [email protected]
REVIEWS FROM THE WEST.
308
tures, is hardly to be qnestioned ; and the knee, but as the operation was the reciprocal influences of the blood on the 17th ult. whilst the and of these organs re-acting ou each performed dite the 20th (only account bears other, thus produce derangements in a complicated manner and COMPOUND I three days subsequently), we shall RATIO." postpone our analysis of it till the pa. A little farther on he says, tient’s recovery is no longer doubtful. " I am convinced, by numerous and Part 2d, contains a review of four varied observations, that those con- I stitutional tendencies to organic con- books, viz. gestion, in which detraction of blood ’, Blunndell’s Physiological Researches, is generally considered essential, arc Latham on the Diseases of the Pefrequently increased by abstinence and inadequate diet, pursued with nitentiary, the express view of prevention, and Pari-y’s Elements of Patholory, and are materially counteracted by those on Colchicum; all of Scudamore means which are unquestionably the best calculated to reproduce the blood which have been long since disposed which has been abstracted, i. e. by a of in the of THE LAXCHT. f°ull supply of nutrient and solid animal In the pages of the Mausoleum remainder food, administered with due regard to the functional capacities of convert- we observe nothing either novel orin. ingit to its proper use." teresting, excepting an article on the We haveonly room for another exEdinburgh School of Medicine, in re,
__
,
-
tract : "
If there is a fever resembling hectic, and associated with cough, dyspiiwa, and pain in the chest resernhling inflammation, which fever is iiiduced and increased by debilitating depletions and abstinence [debilitating starvation], what must be the tiltimate result of pursuing abstinence to
lation to the statutes recently enacted the northern senate. It appears to have been written by one of the
by
Decad, (probably by Jemmy himself,)
we should infer from the vnljar abuse which is lavished on the College of Physicians, who, if they exercise extinguish that fever ?" !!! any unwholesome influence, do it by Speaking of the antiphlogistic plan ancient charter, whilst the DECAN of procedure, he says " whatever are not only the most paltry of innocome of the patient’s constitutional vators, but the most insolent of harpowers, he must be bled, purged, pies that this prolific age has hatched,
sweated, starved, kept completely quiet, cool, motionless, and (the climax comes at last) as near to inanition as possible "!! Bah!
The last of the’original’ commumi-
cations is "case
of plegmasia dolens,
as
REVIEWS FROM THE
Observations connecting pital with
on a
WEST.
the intended Motion for National
Surgical Hos-
the Royal Collegeof Surwhich terminated in sphacehts of ’the in Ireland, addressed to the leg and foot [foot and leg], by Mr. geons Members and Licentiates. By I. T. DAVIES." In this case (which is the ! KIRBY. Dublin, 1825. mearticle of sufficient value to only rit publicity of the original depart- WHEN we first read this Address, ment) the limb was amputated above circulated a few months ago by Mr.
309 KIRBY among his professional friends blish a liberal system of education in in Dublin, we intended to review it Ireland," without being even disat that time, but, on reflection, we cussed ? In order that the reader may thought it better to let it work its own be able fully to appreciate the deep way, unassisted by any aid except its injury which the profession of surgery merits, which wethen presumed were in Ireland has sustained by the failure
sufficiently evident to accomplish the of this measure, we shall place before object of the author. Alas ! we were him a brief outline of the present state no prophets. To judge from those of the Dublin Hospitals, of the Colmotives which ought, rather than those lege as a school of surgery, and of the which do govern human action, of the condition of the majority of its memprobable result of discussion in an as. bers residing in Dublin, and, lastly, sembly secured by law against the con- select such passages from Mr. Kirby’s sequences of the abuse of power, is Address as unfold his plans for the perceive, the surest way to removal of these evils. form In Dublin there are six surgical prospective opinion of any measure, however beneficial its ten- hospitals, containing from fifty to a dency, having to undergo the multi- hundred and fifty beds each, and in farious opposition of passion, preju- neither of these institutions are clinidice, and self-interest. Our experi- cal instructions regularly delivered. ence should have taught us not to cal- This fact requires no comment. To , culate with confidence on corporate each of these hospitals are attached lubricity, "false as dicerb’ oaths." from three to six medical officers. The But we should have been equally de- number of pupils who pay for admisceived, had our anticipations been sion varies from six or seven in the not,
we a
founded
upon this view of the for Mr. Kirby’s proposal question, was defeated neither by the cunning of self-interest, the blindness of passion, nor the obstinacy of prejudice, but by the fatuity of its opponents. even
smaller to about seventy or eighty in the larger hospitals. The fees also differ, according to the number of the
from six guineas a year to eighThese fees are divided equally amongst the surgeons of the establishA more humiliating subject cannot ment which they attend. Many of well be considered than the decision these institutions, it should be recolof the Irish College of Surgeons upon lected, derive their principal support this important question, since upon its from the casual benefactions of the rejection or adoption depended the charitable ; and while the pulpit, the
beds, teen.
in Ire- play-house, and the lottery office land ; and what will be the reader’shave been severally put in requisition surprise when he is informed, that ato increase the funds of these itouses
future advancement of
surgery
many vital in-of refuge, the surgeons, who owe to terests, was contemptuously dismiss-them whatever reputation and suced by a body whose charter defines; cess in practice they may happen to
question, involving
their
duty
in these
so
words,
" To esta-possess,
are
mulcting
the student-
-
310
setting limits tothe acquisition off his connection with these estalish Knowledge—and at the same time.de-ments;,was his time wasted in the franding- the beggar, by appropriatingsterile enjo-yment of a Platonic at. the bounty paid for the inspection off tendance in -soothing the agonies of his sores. What right has a- surgeondisease ; then,, indeed,, and under no .
eircnmstances, would he be jus;; tified in accepting a t’ecompencefor
to convert a charitable -institution intoother a source
of ltersonal aggranclisetnent
by what -unaccountable neglect inI his labours. A very considerable re. .’the governors of these places are me-venue must -be the result of this spe. or
dical men tolerated to practise such, cies of taxation- on the laborious stu. vile exactions ? We- were once pre- dent, and how- disgraceful ..thatit sent in one of these houses, when a should be deflected - from its proper . wretch, hottseless and unfriended, object—the support of th&inmates of ; without a shelter but a gateway, or a an hospital, to gratify a voluptuous
psllow but a paving-stone, was ejected gourmand, into the street to perish of want and disease, and in less than half an hour we saw a -few paltry pounds scrupu’ lously, nay, to the toss-up. for an odd shilling, divided amongst the surgeons of this establishment, while a carriage .
while there, are hundreds
of wretches the
pining away of disease-in
garrets and cellars of Dublin, for
want of
a proper house of rffiigeand medical assistance ? We are far fmrn asserting that a student should gain admission into an hospital -without
was waiting outside to receive withiti -payment; we meanno such thing, its gilded pannels one of these toss- but we do fearlessly -assert that the playing speculators in themiserie-s oi amount of the fee should not he fixed " bis,fellow creatures. Is not the emo- by the surgeons of an hospital, or that lument derived from a connection with they should be at liberty to put such an hospital sufficient to appease the money in their pocket, without giving avaricious craving of these pseudo- instructions for it;and that it would philantropists? Vespasian’s urinary be preferable that these fees-should impost was but a faint type of this go to extend the utility of the hospital viler per-centage
ulcers of where they are received, by enabling such institution to admit more patients pauperism, lates of these hospital ernperors with into its wards. By a regulation of this the " delicacies of the season" at kind, two objects might be accom-
on
the
to sate-the luxurious pa-
Morrison’s tavern. Talk to us, indeed, of - quacks, mountebanks, and impostors, what is their mercenary nr delinquency to this traftiic in beggars sores? Did the surgeon give in instruction value for the money which he receives from the pupils ; did he derive :neither pecuniary remuneration nor professional knowledge from
plished—the admission of
a
greater
for medical as° sistance and the extension of the opportunities of the student to inspect disease. In this manner a considerable addition might be made to the funds of the hospitals,,’- since many students who now spend but one year (and we have known many such) out number of
applicants
311
of five, would,
were
the admission fee
moderate rate, spend reduced the whole of that term in an hospital. Thus wonld the student, the hospital, and society, be benefited by such a ’ to
a
regulation. As at present,
what,
seqnenee of
of disease in
arranged ask, is
matters are we
the
con-
given; that weshall reserve for another
opportunity. state few
We
merely intended to
facts to show the reformation in these establishments, and to justify the proposition of erecting some other institatian which might, by its example,
glaring
a
necessity
ot
a
..
the
forestalling product silently modify the existing arrangean hospital mart? It is ments ofthe other hospitals.
Those who have been in the habit, opportunities reading this Journal fnnst- have witnessing practice of an hospital according to met with occasional remarks on the his means: his means may not be am- College of’ Surgeons in Ireland, oft-
simply this ; his
the student must limit
of
the
of
reader who solely for medical instruction would desire, and delivered in a tones, great measure upon extensive obser- perhaps, as contrary to his taste as vation : the want of this must produce they must have been to that of the ignorance, and we need hardly dwell writer. We must again add to this upon its consequences both to the offence by noticing the state of this for the same. reasons, that student, to society, and to the profession, From this vicious concadid the hospitals. tenation of causes a multitude of A library, a musenny and a clinical evils .spring. It cannot be denied we consider as indispensible that young men oftener embrace the to every school of surmedical profession from necessity than or of medicine. The Irish colfrom choice, and that their means to ! lege possesses the twoformer already; arrive at the necessarysources of pro- it only wanted the third to complete fessional information are oftener below its requisites. To the library and muthan above competency. Such being seum the pupils are denied admisthe case, it is ridicnlous that any body far what reason we could never of the under oftnen, raising learn, except that it has been assertpretence raise of our should respectability caste, ed, that when the library was open, the price of information beyond the the pupils stole the books and, plates; student’s pecuniary abilities. A man and that if they were admitted into who,,attends an hospital for five years the Museum, the stairs could not be may be a very ignoraiit, but certainly kept so white, that the preparations he cannot-bea dangerous practitioner. would not exhibit the same rank and These observations may help to give file regularity on the shelves as they the reader some idea of the state of the do at present; and lastly, that the Dublin Hospitals. It is not pretended members -would be liable, to be dishere that an accurate account of theturbed by the noisy intrusions of stuabuses of these institutions , has been.diausly inclined visitors! All these
ple ; his opportunities must be curtailed in proportion ; the science of medicine and surgery depends in a
ener, seeks
perhaps, than the
College, we ’ hospital appendages
gery
sion,
---
312
objections
may
no
doubt be very this we have only to qnote Mr. Kirby very trifling, and Would that he had always spoken so,
true, but they are remind us of the Dutch, who keep one kitchen for show and another for use; except that the College differs from the ostentatious Dutchman, inasmuch as it keeps no utensils at all for common use. As to the students stealing book.’, we do not believe one word of it; servants sometimes steal books in public libraries ; but, admitting the fact to be true, it is as illogical as it
,
well :" Of
Seventy-one members of the resident in Dublin, forty-eight are withont any hospital opportunity; and of thirty-eight licentiates none are connected with any institutions of the kind. Can it be longer maintained that there is no want of hospitals, as far as the college is concerned ? Are these individuals care. less on the subject? I say they are not. Their first ambition is to be concerned with an hospital. To this laudable ambition they devote all the is unjust, upon such a presumption, to interest they can command, and in exclude a hundred b onest men from the pursuit of this desirable object they are content to expend their pecuniary a library because one ruffian may means. They feel the value of an commit a petty theft. Thus are the hospital as an introdnction to public they feel the value of an hos. advantages of the College rendered noticein; the pital acquirement of atiavailing by monopoly, while those al experience, and they dnlvprofession. estimate which might be added are neglect- the claims it ’affords them to ed on the same narrow principles. nage in point of pupils. ’They well know, without a hospital, no man in That it might be placed on a level this conntry has ever taken, or perwith any similar institution in Europe, liaps ever will take, a high station in the profession. They are sensible, the adoption of a morc liberal po- without an hospital where their aplicy, there can be no doubt. The ma- prentices can be educated, they must terials for the study of anatomy and sit down in despair of ever sharing in revenues which enrich the hospital pathology exist in the greatest abun- surgeons of this city, and which first dance. Subjects may be had at ten gave them the means to contend with the difficulties of getting forward in shillings a-head, and thanks to our their profession." noble Premier, LIVERPOOL, as long as The following observations are so it is his pleasure to keep the Irish peaapposite that we need offer no apo· santry on the " antiphlogistic regilogy for their insertion :— men" of feasting npon sempiternal " Now, let me ask, are there lioscan be no of there potatoes, danger pitals enough to accommodate those Mr. TODD and who apply for admission into these a dearth of disease. institutions ? Before the affirmative Lord LIVERPOOL, in their respective can be established, it must be shown avocations, work for the same ends that cancerous diseases are all accom- the one starves the body, the other modated ; that the interesting diseases ot the eye are all accommodated; the mind. that strumons diseases, diseases of In this enviable condition are the the sexnal organs, and a long cataof other diseases, are all accomaffairs of the college situated. The logue modated ; that none are excluded on unen ployed state of the professional which surgery could display its powwith benefit to the suffering part hands, to use a Manufacturing phrase, ers, of the community, and more real imshall be next adverted to. To do provement to the science, than hy a
college
pittro-
by
313
search after things that are curious door of opportunity to those whose andanomalons in practice. Until atl money has enriched us, and whose this is proved, I must hold the nega- claim is strong to every advantage Let us no tive side of the question. After these our funds can diffllse. considerations, can it be said, with longer pursue a system, too long persisted in, of harsh monopoly—a syseven a semblance of truth, that there are no persons to fill the wards of an tem, that by ridicule or unjustifiable additional hospital in this large city ? opposition, aims at the overthrow of Will not a little reflection show, was every individual who attempts an inih accommodation thrice as or dares to carry into praccompre- novation,measure hensive as is proposed, it might any promising to benefit still nsefnlly filled? What has or to extend the science to ad-himself, vanced the character of London snr- which he has devoted his means and the but London talents of his youth. Then, ingery hospitals JOE BURNS, is this true?) Why are the deed, we may assert, that we have Parisian schools so renowned - established a liberal and extensive Whence do we borrow our present of Surgical Education. Our taste for pathological research and) schools educating our students in all pathological science ? Is it from that is elementary, and our hospitals schools, where bodies are dissected, maturing, by early experience, those and surgery taught, without historicwhose principles and practice cannot reference to the diseases whichurged fixed, and may be applied with them to the grave, and without cases uncertainty." illustrative of the principles which the The observations which follow these professor teaches ?Are we still to go on in the old course, sowing for a so excellent that we should feet harvest which we blight in its ripenpleasure in laying them before ) great ing Let us guard against such a us let show to this readers if our limits permitted charge; country, our and to the surgical world, that we We must therefore prowill merit the charter we enjoy. Let ! transcription. to give Mr. Kirby’s financial us prove to those whose timds enrich us—who have raised us to our scheme for the support of the intend.
betice
? (Mr.the system yet be ! are
ceed
prosperity, that participation iu
will
give them a advantages we possess, however they may be acquired. Let us throw open the broad we
the
ed hospital:—
sources "
And first, I shall state the of the college :.
.
Funded snm of 9,5001. ; interest on ditto, about ............ Annual receipts from apprentices, licentiates, members, and
317
expenditure
Leaving a surplus
of the
of
college
2,519 19 1 1,260 17 7
........................
1,259
....................................
He next states the expenditure of the proposed in which these expenses are to be met:-
scheme,
d.
S.
10
2,142 9t
penalties.............................................. Annual
re-
1
6
and the manner _
£ . s. d.
Grant required from the college ..... 6,000 Fund produced by loan from the members and licentiates, ten guineas each, viz. 107 members, 105 licentiates-232...... 2,436 For outfit.. e . , m . s e e s ... , ....
8,436
0
0
0
0
0
( Continued.)
314 £ s. d,
Annual grant rfqnired from the college .................... Fees of pitpils not apprentices, at 15 guineas each, say JOO pupils, this being the probable average which the hospital -would bring, deduced from the present number, which far
500 0, 0
erceeds it 1,706 Four house pupils, at thirty guineas each, for six months 273 Members apprentices, say 100, at three guineas each per ann. 341 Lieentiates’ apprentices, say 80, at six guineas each per ann. 546 Subscribers brought by members and licentiates, say_ ....... 100 ............................................
Total
5 0 5 0 0
0 0 0 0 0
amount.....3,466 10
Deduct for over calculation..............
1,000
0 0 0
2,466
10 0
He then states the expenses for the maintenance of one hundred patients, to meet all contingences, at 201. per patient .....£.2,000 0 0 466 10 0 Leaving a balance of .....
£.2,466 10
0
surgical attendance under his care ; and shall publicly at a specified hour, the pahospital developed in the perform, thological examination of every body it may be permitted to examine, anfollowing terms by Mr. Kirby :a fell record of &uch examinanexing " First it is proposed, that the tion in the registry after the history .. members resident in town shall be of the case. And that at every in. . divided equally into senior and junior spection it shall be required, of the sets, according to their standings— stn geon to transmit to the Museum That from each set- three members Committee of the College such morbid shall be chosen by lot, at a quarterly part;; as premise to iHustrate disease, meeting of the college, as surgical with the name of the individual,the The scheme of
is
at the
°
attendants for three months, who shall
be responsible for the management of the hospital for that period, and who shall be cbliged to report, at the next quarterly meeting of the college, npon all matiers relating to the hospital, and to submit their books of expenditure, &c. to die Court of Censors
and Assistants who, by proposed bye law, will be bound to inspect aid report
on same.
That those
mem-
bers who have served during quarter shal! iict be included iu
cne
and the name of the disease, a numerical reference to the index of the registry. That all ap. of siibscribirsurgeons shall be authorized to attend all public acts the surgical attendants, and that all pupils shall enjoy the same privi. lege. That all members of the college, whether in attendance or not, ,ball be competent to be present at all operations, but that those on!y who are quai terly attendants, shall occapy the area in vhich the operation tabie
age,
with
prentices of
the lots for any .succeeding quarter, until- stands.’ all the members have enjoyed their Such are the outlines of the scheme turn ; but that any member upon Whom the lot may fall shall be comby Mr. Kirby, vihich, in the petent to assign his privilege of at- enlightened corporation of Yorktendance to any other member for the did not even find a voice to limited period. That every attendshaH his ing surgeon deliver, during it support. We pay i[ the willing period, in daily rotation, a clinical lecture; shall preserve a clearrecord tribute of our approbation, not from i n the hospital registry of every case a conviction of its practicability or
I proposed
,
,
street, give
315
.tsaccnracy of conception, but because the attempt in itself was laudable, and because we wish to put on record the contempt and indifference with which this, and every similar body, receives any proposal tending, in the
HOSPITAL REPORTS. GUY’S
HOSPITAL.
of the case of Exostesis. from p. 284. The operation recommended by Sir remotest manner, to disturb their A. COOPER, was this day (June, 4) tranquil enjoyment of an -odious mo- performed in the following. ’way by : The patient was placed: nopoly. Though Mr. Kirby has not Mr. MORGAN his back, and the leg properly upon snfnciently entered -into detail of the supported ; an incision was made expensess of the intended hospital, so through the centre of the tumour, as to satisfy the cautions before they commencing at the upper, and conit quite -to the lower part; would embark in such a speculation, tinuing the integuments were dissected Continuation
,
t °
allowed that his ob- back, and the whole of the tumour ;’’ the* periosteum was sejust, and that many of exposed; parated partly by the knife and the features of his plan might be partly by the finger. The tumour was and a adopted with profit in the existing verysoft, and highly vascular, considerable quantity of blood was institutions- of Dublin . and other lost from a small wmind ii-i the tumour, cities. The great fault of his caused by the first- incision; the hæwas arrested by .pressing scheme seems to be, that the whole morrhage. upon the external iliac artery ; a piece expenses would have fallen on the of lint was applied, and a poulti-ce over the whole. In the evening college, while we presume a consider- put there was considerable irritation, and able assistance, by proper exertion, a good deal of hæmorrhage. He night, but was much might be raised amongst the opulent passed a restless better on the 5th. residing in the country. In thisopi6th. Compldins of a good deal of nion we are strengthened by the pe- pain; is very restless ; pulse quick,. We shall rusal of the last Scotsman newspaper, and tongue ratlier- furred. notice the further progress of this- _ containing an account of the manner case.
yet it
must be
servations
are
’
proposed to erect a similar institu- There has been no operation of imtution in Edinburgh. But Ireland, portance performed this week. thelast of the Nations"-the " tenThe accidents admitted this week nis ball of fortune"—the sport of folly are, two cases of laceration of the scalp, a burn, paraphymosis, ,R sim-and the victim of intolerance, is ever ple fracture of the tibia and fibula, an to remain untaught by experience, injury to the knee, retention of urine, au incised wound of the abdomen, unmoved by example-a petty pro- and a lacerated thigh. vince, where w.orth withers and genins is gagged. Hail ! « land of jobbing," ST. THOMAS’S HOSPITAL. livefor ever! Well may we address you as the Poet did his native soil,--. Case of Plyalism, fromthe absorption " Mantua, viæ miserum, nimium of Mercury in the process of Silvervicina Crem ouæ." ing Mirrors. William Brittain, ætatis 35, was admitted into Henry’s Ward May 12. under the care of Dr. ELLIOTSON, with -.
-
.
tures, is hardly to be qnestioned ; and the knee, but as the operation was the reciprocal influences of the blood on the 17th ult. whilst the and of these organs re-acting ou each performed dite the 20th (only account bears other, thus produce derangements in a complicated manner and COMPOUND I three days subsequently), we shall RATIO." postpone our analysis of it till the pa. A little farther on he says, tient’s recovery is no longer doubtful. " I am convinced, by numerous and Part 2d, contains a review of four varied observations, that those con- I stitutional tendencies to organic con- books, viz. gestion, in which detraction of blood ’, Blunndell’s Physiological Researches, is generally considered essential, arc Latham on the Diseases of the Pefrequently increased by abstinence and inadequate diet, pursued with nitentiary, the express view of prevention, and Pari-y’s Elements of Patholory, and are materially counteracted by those on Colchicum; all of Scudamore means which are unquestionably the best calculated to reproduce the blood which have been long since disposed which has been abstracted, i. e. by a of in the of THE LAXCHT. f°ull supply of nutrient and solid animal In the pages of the Mausoleum remainder food, administered with due regard to the functional capacities of convert- we observe nothing either novel orin. ingit to its proper use." teresting, excepting an article on the We haveonly room for another exEdinburgh School of Medicine, in re,
__
,
-
tract : "
If there is a fever resembling hectic, and associated with cough, dyspiiwa, and pain in the chest resernhling inflammation, which fever is iiiduced and increased by debilitating depletions and abstinence [debilitating starvation], what must be the tiltimate result of pursuing abstinence to
lation to the statutes recently enacted the northern senate. It appears to have been written by one of the
by
Decad, (probably by Jemmy himself,)
we should infer from the vnljar abuse which is lavished on the College of Physicians, who, if they exercise extinguish that fever ?" !!! any unwholesome influence, do it by Speaking of the antiphlogistic plan ancient charter, whilst the DECAN of procedure, he says " whatever are not only the most paltry of innocome of the patient’s constitutional vators, but the most insolent of harpowers, he must be bled, purged, pies that this prolific age has hatched,
sweated, starved, kept completely quiet, cool, motionless, and (the climax comes at last) as near to inanition as possible "!! Bah!
The last of the’original’ commumi-
cations is "case
of plegmasia dolens,
as
REVIEWS FROM THE
Observations connecting pital with
on a
WEST.
the intended Motion for National
Surgical Hos-
the Royal Collegeof Surwhich terminated in sphacehts of ’the in Ireland, addressed to the leg and foot [foot and leg], by Mr. geons Members and Licentiates. By I. T. DAVIES." In this case (which is the ! KIRBY. Dublin, 1825. mearticle of sufficient value to only rit publicity of the original depart- WHEN we first read this Address, ment) the limb was amputated above circulated a few months ago by Mr.
309 KIRBY among his professional friends blish a liberal system of education in in Dublin, we intended to review it Ireland," without being even disat that time, but, on reflection, we cussed ? In order that the reader may thought it better to let it work its own be able fully to appreciate the deep way, unassisted by any aid except its injury which the profession of surgery merits, which wethen presumed were in Ireland has sustained by the failure
sufficiently evident to accomplish the of this measure, we shall place before object of the author. Alas ! we were him a brief outline of the present state no prophets. To judge from those of the Dublin Hospitals, of the Colmotives which ought, rather than those lege as a school of surgery, and of the which do govern human action, of the condition of the majority of its memprobable result of discussion in an as. bers residing in Dublin, and, lastly, sembly secured by law against the con- select such passages from Mr. Kirby’s sequences of the abuse of power, is Address as unfold his plans for the perceive, the surest way to removal of these evils. form In Dublin there are six surgical prospective opinion of any measure, however beneficial its ten- hospitals, containing from fifty to a dency, having to undergo the multi- hundred and fifty beds each, and in farious opposition of passion, preju- neither of these institutions are clinidice, and self-interest. Our experi- cal instructions regularly delivered. ence should have taught us not to cal- This fact requires no comment. To , culate with confidence on corporate each of these hospitals are attached lubricity, "false as dicerb’ oaths." from three to six medical officers. The But we should have been equally de- number of pupils who pay for admisceived, had our anticipations been sion varies from six or seven in the not,
we a
founded
upon this view of the for Mr. Kirby’s proposal question, was defeated neither by the cunning of self-interest, the blindness of passion, nor the obstinacy of prejudice, but by the fatuity of its opponents. even
smaller to about seventy or eighty in the larger hospitals. The fees also differ, according to the number of the
from six guineas a year to eighThese fees are divided equally amongst the surgeons of the establishA more humiliating subject cannot ment which they attend. Many of well be considered than the decision these institutions, it should be recolof the Irish College of Surgeons upon lected, derive their principal support this important question, since upon its from the casual benefactions of the rejection or adoption depended the charitable ; and while the pulpit, the
beds, teen.
in Ire- play-house, and the lottery office land ; and what will be the reader’shave been severally put in requisition surprise when he is informed, that ato increase the funds of these itouses
future advancement of
surgery
many vital in-of refuge, the surgeons, who owe to terests, was contemptuously dismiss-them whatever reputation and suced by a body whose charter defines; cess in practice they may happen to
question, involving
their
duty
in these
so
words,
" To esta-possess,
are
mulcting
the student-
-
310
setting limits tothe acquisition off his connection with these estalish Knowledge—and at the same time.de-ments;,was his time wasted in the franding- the beggar, by appropriatingsterile enjo-yment of a Platonic at. the bounty paid for the inspection off tendance in -soothing the agonies of his sores. What right has a- surgeondisease ; then,, indeed,, and under no .
eircnmstances, would he be jus;; tified in accepting a t’ecompencefor
to convert a charitable -institution intoother a source
of ltersonal aggranclisetnent
by what -unaccountable neglect inI his labours. A very considerable re. .’the governors of these places are me-venue must -be the result of this spe. or
dical men tolerated to practise such, cies of taxation- on the laborious stu. vile exactions ? We- were once pre- dent, and how- disgraceful ..thatit sent in one of these houses, when a should be deflected - from its proper . wretch, hottseless and unfriended, object—the support of th&inmates of ; without a shelter but a gateway, or a an hospital, to gratify a voluptuous
psllow but a paving-stone, was ejected gourmand, into the street to perish of want and disease, and in less than half an hour we saw a -few paltry pounds scrupu’ lously, nay, to the toss-up. for an odd shilling, divided amongst the surgeons of this establishment, while a carriage .
while there, are hundreds
of wretches the
pining away of disease-in
garrets and cellars of Dublin, for
want of
a proper house of rffiigeand medical assistance ? We are far fmrn asserting that a student should gain admission into an hospital -without
was waiting outside to receive withiti -payment; we meanno such thing, its gilded pannels one of these toss- but we do fearlessly -assert that the playing speculators in themiserie-s oi amount of the fee should not he fixed " bis,fellow creatures. Is not the emo- by the surgeons of an hospital, or that lument derived from a connection with they should be at liberty to put such an hospital sufficient to appease the money in their pocket, without giving avaricious craving of these pseudo- instructions for it;and that it would philantropists? Vespasian’s urinary be preferable that these fees-should impost was but a faint type of this go to extend the utility of the hospital viler per-centage
ulcers of where they are received, by enabling such institution to admit more patients pauperism, lates of these hospital ernperors with into its wards. By a regulation of this the " delicacies of the season" at kind, two objects might be accom-
on
the
to sate-the luxurious pa-
Morrison’s tavern. Talk to us, indeed, of - quacks, mountebanks, and impostors, what is their mercenary nr delinquency to this traftiic in beggars sores? Did the surgeon give in instruction value for the money which he receives from the pupils ; did he derive :neither pecuniary remuneration nor professional knowledge from
plished—the admission of
a
greater
for medical as° sistance and the extension of the opportunities of the student to inspect disease. In this manner a considerable addition might be made to the funds of the hospitals,,’- since many students who now spend but one year (and we have known many such) out number of
applicants
311
of five, would,
were
the admission fee
moderate rate, spend reduced the whole of that term in an hospital. Thus wonld the student, the hospital, and society, be benefited by such a ’ to
a
regulation. As at present,
what,
seqnenee of
of disease in
arranged ask, is
matters are we
the
con-
given; that weshall reserve for another
opportunity. state few
We
merely intended to
facts to show the reformation in these establishments, and to justify the proposition of erecting some other institatian which might, by its example,
glaring
a
necessity
ot
a
..
the
forestalling product silently modify the existing arrangean hospital mart? It is ments ofthe other hospitals.
Those who have been in the habit, opportunities reading this Journal fnnst- have witnessing practice of an hospital according to met with occasional remarks on the his means: his means may not be am- College of’ Surgeons in Ireland, oft-
simply this ; his
the student must limit
of
the
of
reader who solely for medical instruction would desire, and delivered in a tones, great measure upon extensive obser- perhaps, as contrary to his taste as vation : the want of this must produce they must have been to that of the ignorance, and we need hardly dwell writer. We must again add to this upon its consequences both to the offence by noticing the state of this for the same. reasons, that student, to society, and to the profession, From this vicious concadid the hospitals. tenation of causes a multitude of A library, a musenny and a clinical evils .spring. It cannot be denied we consider as indispensible that young men oftener embrace the to every school of surmedical profession from necessity than or of medicine. The Irish colfrom choice, and that their means to ! lege possesses the twoformer already; arrive at the necessarysources of pro- it only wanted the third to complete fessional information are oftener below its requisites. To the library and muthan above competency. Such being seum the pupils are denied admisthe case, it is ridicnlous that any body far what reason we could never of the under oftnen, raising learn, except that it has been assertpretence raise of our should respectability caste, ed, that when the library was open, the price of information beyond the the pupils stole the books and, plates; student’s pecuniary abilities. A man and that if they were admitted into who,,attends an hospital for five years the Museum, the stairs could not be may be a very ignoraiit, but certainly kept so white, that the preparations he cannot-bea dangerous practitioner. would not exhibit the same rank and These observations may help to give file regularity on the shelves as they the reader some idea of the state of the do at present; and lastly, that the Dublin Hospitals. It is not pretended members -would be liable, to be dishere that an accurate account of theturbed by the noisy intrusions of stuabuses of these institutions , has been.diausly inclined visitors! All these
ple ; his opportunities must be curtailed in proportion ; the science of medicine and surgery depends in a
ener, seeks
perhaps, than the
College, we ’ hospital appendages
gery
sion,
---
312
objections
may
no
doubt be very this we have only to qnote Mr. Kirby very trifling, and Would that he had always spoken so,
true, but they are remind us of the Dutch, who keep one kitchen for show and another for use; except that the College differs from the ostentatious Dutchman, inasmuch as it keeps no utensils at all for common use. As to the students stealing book.’, we do not believe one word of it; servants sometimes steal books in public libraries ; but, admitting the fact to be true, it is as illogical as it
,
well :" Of
Seventy-one members of the resident in Dublin, forty-eight are withont any hospital opportunity; and of thirty-eight licentiates none are connected with any institutions of the kind. Can it be longer maintained that there is no want of hospitals, as far as the college is concerned ? Are these individuals care. less on the subject? I say they are not. Their first ambition is to be concerned with an hospital. To this laudable ambition they devote all the is unjust, upon such a presumption, to interest they can command, and in exclude a hundred b onest men from the pursuit of this desirable object they are content to expend their pecuniary a library because one ruffian may means. They feel the value of an commit a petty theft. Thus are the hospital as an introdnction to public they feel the value of an hos. advantages of the College rendered noticein; the pital acquirement of atiavailing by monopoly, while those al experience, and they dnlvprofession. estimate which might be added are neglect- the claims it ’affords them to ed on the same narrow principles. nage in point of pupils. ’They well know, without a hospital, no man in That it might be placed on a level this conntry has ever taken, or perwith any similar institution in Europe, liaps ever will take, a high station in the profession. They are sensible, the adoption of a morc liberal po- without an hospital where their aplicy, there can be no doubt. The ma- prentices can be educated, they must terials for the study of anatomy and sit down in despair of ever sharing in revenues which enrich the hospital pathology exist in the greatest abun- surgeons of this city, and which first dance. Subjects may be had at ten gave them the means to contend with the difficulties of getting forward in shillings a-head, and thanks to our their profession." noble Premier, LIVERPOOL, as long as The following observations are so it is his pleasure to keep the Irish peaapposite that we need offer no apo· santry on the " antiphlogistic regilogy for their insertion :— men" of feasting npon sempiternal " Now, let me ask, are there lioscan be no of there potatoes, danger pitals enough to accommodate those Mr. TODD and who apply for admission into these a dearth of disease. institutions ? Before the affirmative Lord LIVERPOOL, in their respective can be established, it must be shown avocations, work for the same ends that cancerous diseases are all accom- the one starves the body, the other modated ; that the interesting diseases ot the eye are all accommodated; the mind. that strumons diseases, diseases of In this enviable condition are the the sexnal organs, and a long cataof other diseases, are all accomaffairs of the college situated. The logue modated ; that none are excluded on unen ployed state of the professional which surgery could display its powwith benefit to the suffering part hands, to use a Manufacturing phrase, ers, of the community, and more real imshall be next adverted to. To do provement to the science, than hy a
college
pittro-
by
313
search after things that are curious door of opportunity to those whose andanomalons in practice. Until atl money has enriched us, and whose this is proved, I must hold the nega- claim is strong to every advantage Let us no tive side of the question. After these our funds can diffllse. considerations, can it be said, with longer pursue a system, too long persisted in, of harsh monopoly—a syseven a semblance of truth, that there are no persons to fill the wards of an tem, that by ridicule or unjustifiable additional hospital in this large city ? opposition, aims at the overthrow of Will not a little reflection show, was every individual who attempts an inih accommodation thrice as or dares to carry into praccompre- novation,measure hensive as is proposed, it might any promising to benefit still nsefnlly filled? What has or to extend the science to ad-himself, vanced the character of London snr- which he has devoted his means and the but London talents of his youth. Then, ingery hospitals JOE BURNS, is this true?) Why are the deed, we may assert, that we have Parisian schools so renowned - established a liberal and extensive Whence do we borrow our present of Surgical Education. Our taste for pathological research and) schools educating our students in all pathological science ? Is it from that is elementary, and our hospitals schools, where bodies are dissected, maturing, by early experience, those and surgery taught, without historicwhose principles and practice cannot reference to the diseases whichurged fixed, and may be applied with them to the grave, and without cases uncertainty." illustrative of the principles which the The observations which follow these professor teaches ?Are we still to go on in the old course, sowing for a so excellent that we should feet harvest which we blight in its ripenpleasure in laying them before ) great ing Let us guard against such a us let show to this readers if our limits permitted charge; country, our and to the surgical world, that we We must therefore prowill merit the charter we enjoy. Let ! transcription. to give Mr. Kirby’s financial us prove to those whose timds enrich us—who have raised us to our scheme for the support of the intend.
betice
? (Mr.the system yet be ! are
ceed
prosperity, that participation iu
will
give them a advantages we possess, however they may be acquired. Let us throw open the broad we
the
ed hospital:—
sources "
And first, I shall state the of the college :.
.
Funded snm of 9,5001. ; interest on ditto, about ............ Annual receipts from apprentices, licentiates, members, and
317
expenditure
Leaving a surplus
of the
of
college
2,519 19 1 1,260 17 7
........................
1,259
....................................
He next states the expenditure of the proposed in which these expenses are to be met:-
scheme,
d.
S.
10
2,142 9t
penalties.............................................. Annual
re-
1
6
and the manner _
£ . s. d.
Grant required from the college ..... 6,000 Fund produced by loan from the members and licentiates, ten guineas each, viz. 107 members, 105 licentiates-232...... 2,436 For outfit.. e . , m . s e e s ... , ....
8,436
0
0
0
0
0
( Continued.)
314 £ s. d,
Annual grant rfqnired from the college .................... Fees of pitpils not apprentices, at 15 guineas each, say JOO pupils, this being the probable average which the hospital -would bring, deduced from the present number, which far
500 0, 0
erceeds it 1,706 Four house pupils, at thirty guineas each, for six months 273 Members apprentices, say 100, at three guineas each per ann. 341 Lieentiates’ apprentices, say 80, at six guineas each per ann. 546 Subscribers brought by members and licentiates, say_ ....... 100 ............................................
Total
5 0 5 0 0
0 0 0 0 0
amount.....3,466 10
Deduct for over calculation..............
1,000
0 0 0
2,466
10 0
He then states the expenses for the maintenance of one hundred patients, to meet all contingences, at 201. per patient .....£.2,000 0 0 466 10 0 Leaving a balance of .....
£.2,466 10
0
surgical attendance under his care ; and shall publicly at a specified hour, the pahospital developed in the perform, thological examination of every body it may be permitted to examine, anfollowing terms by Mr. Kirby :a fell record of &uch examinanexing " First it is proposed, that the tion in the registry after the history .. members resident in town shall be of the case. And that at every in. . divided equally into senior and junior spection it shall be required, of the sets, according to their standings— stn geon to transmit to the Museum That from each set- three members Committee of the College such morbid shall be chosen by lot, at a quarterly part;; as premise to iHustrate disease, meeting of the college, as surgical with the name of the individual,the The scheme of
is
at the
°
attendants for three months, who shall
be responsible for the management of the hospital for that period, and who shall be cbliged to report, at the next quarterly meeting of the college, npon all matiers relating to the hospital, and to submit their books of expenditure, &c. to die Court of Censors
and Assistants who, by proposed bye law, will be bound to inspect aid report
on same.
That those
mem-
bers who have served during quarter shal! iict be included iu
cne
and the name of the disease, a numerical reference to the index of the registry. That all ap. of siibscribirsurgeons shall be authorized to attend all public acts the surgical attendants, and that all pupils shall enjoy the same privi. lege. That all members of the college, whether in attendance or not, ,ball be competent to be present at all operations, but that those on!y who are quai terly attendants, shall occapy the area in vhich the operation tabie
age,
with
prentices of
the lots for any .succeeding quarter, until- stands.’ all the members have enjoyed their Such are the outlines of the scheme turn ; but that any member upon Whom the lot may fall shall be comby Mr. Kirby, vihich, in the petent to assign his privilege of at- enlightened corporation of Yorktendance to any other member for the did not even find a voice to limited period. That every attendshaH his ing surgeon deliver, during it support. We pay i[ the willing period, in daily rotation, a clinical lecture; shall preserve a clearrecord tribute of our approbation, not from i n the hospital registry of every case a conviction of its practicability or
I proposed
,
,
street, give
315
.tsaccnracy of conception, but because the attempt in itself was laudable, and because we wish to put on record the contempt and indifference with which this, and every similar body, receives any proposal tending, in the
HOSPITAL REPORTS. GUY’S
HOSPITAL.
of the case of Exostesis. from p. 284. The operation recommended by Sir remotest manner, to disturb their A. COOPER, was this day (June, 4) tranquil enjoyment of an -odious mo- performed in the following. ’way by : The patient was placed: nopoly. Though Mr. Kirby has not Mr. MORGAN his back, and the leg properly upon snfnciently entered -into detail of the supported ; an incision was made expensess of the intended hospital, so through the centre of the tumour, as to satisfy the cautions before they commencing at the upper, and conit quite -to the lower part; would embark in such a speculation, tinuing the integuments were dissected Continuation
,
t °
allowed that his ob- back, and the whole of the tumour ;’’ the* periosteum was sejust, and that many of exposed; parated partly by the knife and the features of his plan might be partly by the finger. The tumour was and a adopted with profit in the existing verysoft, and highly vascular, considerable quantity of blood was institutions- of Dublin . and other lost from a small wmind ii-i the tumour, cities. The great fault of his caused by the first- incision; the hæwas arrested by .pressing scheme seems to be, that the whole morrhage. upon the external iliac artery ; a piece expenses would have fallen on the of lint was applied, and a poulti-ce over the whole. In the evening college, while we presume a consider- put there was considerable irritation, and able assistance, by proper exertion, a good deal of hæmorrhage. He night, but was much might be raised amongst the opulent passed a restless better on the 5th. residing in the country. In thisopi6th. Compldins of a good deal of nion we are strengthened by the pe- pain; is very restless ; pulse quick,. We shall rusal of the last Scotsman newspaper, and tongue ratlier- furred. notice the further progress of this- _ containing an account of the manner case.
yet it
must be
servations
are
’
proposed to erect a similar institu- There has been no operation of imtution in Edinburgh. But Ireland, portance performed this week. thelast of the Nations"-the " tenThe accidents admitted this week nis ball of fortune"—the sport of folly are, two cases of laceration of the scalp, a burn, paraphymosis, ,R sim-and the victim of intolerance, is ever ple fracture of the tibia and fibula, an to remain untaught by experience, injury to the knee, retention of urine, au incised wound of the abdomen, unmoved by example-a petty pro- and a lacerated thigh. vince, where w.orth withers and genins is gagged. Hail ! « land of jobbing," ST. THOMAS’S HOSPITAL. livefor ever! Well may we address you as the Poet did his native soil,--. Case of Plyalism, fromthe absorption " Mantua, viæ miserum, nimium of Mercury in the process of Silvervicina Crem ouæ." ing Mirrors. William Brittain, ætatis 35, was admitted into Henry’s Ward May 12. under the care of Dr. ELLIOTSON, with -.
-
.