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CONVENTION OF POOR-LAW MEDICAL OFFICERS, THE POOR-LAW BOARD, AND THE GENERAL BOARD OF HEALTH.
191 The which
that of the little girl V—, the particulars of much success; I give no opium with the calomel, which I Mr. Fergusson’s Clinical Lecture, direct to be placed dry on the tongue in five-grain doses* published in your journal in April. At that time she left the every quarter of an hour, until bilious evacuation and secre hospital to go into the country, being able to walk about on tion of urine takes place ; when reaction commencesad-I diminish the doses of calomel, and also the frequency of crutches. Seven months having now elapsed since the proceeding was ministration. I find but little consecutive fever, the patient frequently recovering upon good diet, with alkalies. I do not put in force, I yesterday, in company with my intelligent Mr. Hugman, the author of a late work on " 3forbus give brandy as a remedy in any stage of the disease, knowing Coxarius," visited the child at her home in Greenwich, and the depression which follows the use of so active a stimulant; together with the above-named gentleman, minutely inspected those who have been habituated to the use of spirits, &c., form, of course, an exception. Not desiring to occupy any further her. The following we found to be her condition :The whole length of the extensive cicatrix is in a very firm portion of your valuable journal, I subscribe myself, your humble servant, and healthy state, with the exception of a small portion of the CHARLES MUNDAY, where there is a slight weeping, as one usually sees centre, Medical Officer, West London Union. in scrofulous subjects, after excision of joints, for many months after the operation. The centre of the thigh, when measured, is as large round as the sound one. A false joint OF CHLOROFORM ON THE GENERATIVE has formed. There is perfect flexion and extension of the SYSTEM. thigh upon the pelvis. The power of adduction considerable; To t7te Editor of THE LANCET. the power of rotation outwards slight; as was the case in Mr. White’s and in Mr. Fergusson’s other patients, and as always SiR,--I beg to call the attention of your readers to a curious must necessarily happen, the insertions of the pyriformis fact in connexion with the effect of chloroform upon bees. gemelli and obturators being cut through. Foot neither in- On subjecting a bee-glass to its action, all the working bees verted nor everted. Whole limb shorter than the other by revive from its effects, but almost all the drones do not. These two inches, although considerably more of the bone was re- latter have the organs of generation extended: the few who moved. The patient can plant her toes firmly on the ground were not killed had not their organs so exposed, and they and walk without the assistance of either stick or crutch. Her were very few. This seems to support the idea that this regeneral health is in every respect perfect; she presents, in- markable agent has a special influence upon the organs of geneT am- Sir- yours. &e deed, a happy contrast to the poor miserable creature who was , ration. JOHN PUGHE, M.R.C.S. lying crippled in her bed before the operation. The parents, who had-to use their own expression"beggared themselves in order to get some relief for their CONVENTION OF POOR-LAW MEDICAL OFFICERS, child," and who had seen her sufferings so long, are impressed with a sense of deep and lasting gratitude to that distinguished THE POOR-LAW BOARD, AND THE GENERAL surgeon who, by a proceeding creditable alike to his humanity BOARD OF HEALTH. and skill, has brought health, joy, and comfort, where before To the Editor of THE LANCET. there was nothing but suffering and despair. I send this account of the present condition of the patient, , SIR,—The great interest now taken in the subject of poornot for the purpose of reviving a controversy, where evidently law medical reform, leads the committee to beg the favour of there is now no longer any necessity for it, but for the purpose your publishing the following correspondence:of fairly and honestly laying before the profession the actual (copy.) results of this so much reviled operation, and of showing those ’ the President To of the Poor-Law Board. of them who are fond of looking forward and not retrograding, ’ "44 & 5 William IV., cap. lxxvi. clause 46. And the said that excision of the head of the femur will be attended with those good results which we expected would follow, when it is commissioners may and are hereby empowered, &c.; and when the said commissioners may see occasion, to regulate the undertaken in suitable cases, and with proper care. But it is more especially for the information of Professor amount of salaries payable to such officers, respecting, &c. 10 & 11 Victoria, cap. cix. clause 10. And be it enactedr Syme, and those who may agree with him respecting the bar- , °That all the powers and duties of the poor-law commis&e, and this that I have taken the of barity inutility operation, trouble to go some miles out of town, and minutely examine sioners, with, respect to the administration of relief &c., and this patient. If the learned Professor is one who will be con- all other powers and duties now vested in them, shall be vinced at all-and I say this with the greatest respect for his transferred to, and vested in, the commissioners, and shall be exercised by them, under the provisions of this high professional character-he must admit that the results of henceforward &c." this case, together with those before published, silently and act, ’ SIR,—The poor-law board having the power, as evidenced triumphantly proclaim him a vanquished man; and I sincerely " to regulate, when they may see occasion, the amount above, for the that he credit of will Edinburgh surgery, hope, openly retract his written opinions respecting this proceeding. Even of salaries payable to officers respectively," the committee of if he does not think fit to do so publicly, it is to be hoped the convention of poor-law surgeons take leave to memorializethat he will give the pupils of his class, which will re-assemble you, who have already considered the position of poor-law in the forthcoming session, views respecting this operation medical officers, that you may issue such orders as may secureto them in accordance with the extent of their totally different from those they have been accustomed to hear aa payment duties, and the costs incident to the supply of medicines and propounded. I may, in conclusion, state that the above-mentioned case is the maintenance of establishments needful for an efficient adthe more interesting, inasmuch as before Mr. Fergusson ope- ministration of medical relief to the sick poor. Although your memorialists have expressed the opinion rated, the little patient was under the care of a hospital sur- that a board specially constituted for the supervision, control, geon-one who ought to be.well acquainted with, and able to make use of all the resources of his art, (I could mention his and payment of poor-law medical relief, (now extended to name if I chose, and would fearlessly do so if necessary;) and near three millions of her Majesty’s subjects in England and when it was proposed to him to perform the operation for the Wales,) with the whole cost thereof, derived from the conrelief of the patient, he merely laughed at the proposer of solidated fund, would be the best means to secure justice to such an absurdity, as cutting out the head of the thigh-bone in the union surgeons, and the fullest advantage to the sick poor,. they are willing to waive, for the present, this view of the suba living human being, with any prospect of safety or advanject, under a sense of the difficulties which beset its immetage.-I remain, yours obediently, diate introduction. HENRY SMITH. ’ They beg, however, in the most earnest manner, respectfully to submit to you, that an exercise of the authority and SUCCESSFUL TREATMENT OF CHOLERA BY power of the poor-law board, as shown to exist in the citations’ FREQUENTLY REPEATED DOSES OF CALOMEL. from the acts of parliament, would be equal to such a diminuof their admitted grievances as might render their tenure To the Editor of THE LANCET ’ tion of office, and the rigorous performance of their obligations, SIR,—At a time when malignant disease is so prevalent, painful and humiliating to themselves, and, in many ways,. and medical opinions so conflicting, I feel it a duty, holding a less more beneficial to the suffering poor. of and more of public appointment, having opportunities seeing They, therefore, respectfully suggest—1st. That henceforth the disease than practitioners in general, to record the result of * We believe that Dr. my experience, which is decidedly in favour of the practice Ayre has seldom, if ever, given so large a dose at. advocated by Dr. Ayre. I have used a modification of it with such short intervals.—ED. L. case is were
given at full in
friend,
EFFECT
’
-
’
192
saying of the quaint William Cobbett, about John Bull being persecuted by two sets of thieves,--the Whigs on-one side and the Tories on the other. It is gratifying, however, to turn for a moment from this2ndly. That the amount of payment be based on a.calculation of the number of cases attended in-a given district, during dark shadowing, to the light which breaks in from the union. the past three years. That the fixed salaries be arrived at by to which Mr. Vallance, the intrepid advocate of a better determining 6s. 6d. as the average sum to be paid per case system of poor-law medical relief, is the well-tried medical officer. He reports, to the credit of the board of guardians of throughout the country. That the provisions of the medical order in 1842, for extras the West Ham Union, that a sense of justice has impelled be enforced in all unions-; and under all circumstances be them to pay £1per case of cholera to whomsoever the promade binding, except that the operations performed in the fessional attendant may be; and also fifteen per cent. (for six house be awarded the same fees allowed to out-door cases. upon the annual amount of the salaries paid to their officers,, as some remuneration for their services as Also, that a special provision be forthwith made to secure a just compensation for the enormous extra labours which are officers of health. If other boards would obey the injunctionentailed upon the union surgeons, through the Board of Health, , of Ancient Writ, " Go, and do thou likewise," there would be under its general powers and regulations, more particularly less cause to trouble you with these details. I have the honour to be, Mr. Editor, during the presence of cholera, or other epidemics. We beg to call your attention to the subjoined copy of a Your very obedient servant. letter recently received from the general Board of Health on CHARLES F. J. LORD, Hon. Sec. the subject. We have-the honour to be, Sir. vours. verv respectfully. DR. CHAMBERS AND DR. SEYMOUR. THOMAS HODGKIN, Chairman. CHARLES F. J. LORD, Hon. Sec. To the Editor of TaE LANCET. SIR,—In reference to a letter which appears in your paper (COPY.) of this day’s date,, (Aug. 11,) bearing Dr. Chambers’s signature, Poor-law Board, Somerset House. in which he re-asserts the truth of his previous statement in 1849. August 1st, THE LANCET of the 9th of June, I may be permitted on my part GENTLEMEN, — I am directed by the Poor-law Board to to reiterate my solemn declaration. acknowledge the receipt of the communication signed by you On my faith as a Christian, and my word of honour as a on behalf of the " Committee of the Convention of Poor-law that I never had any, the most distant connexion gentleman, Medical Officers," and to inform you that the suggestions or knowledge of, any anonymous letters addressed to with, contained in the communication, shall receive the best con- Dr. Chambers or to any other person. sideration. of the board. to all other allegations, I adhere to my stateWith regard The committee are, however, so well acquainted with the ment of the 9th of June. subject of poor-law medical -relief, that it is unnecessary for As to Dr. Chambers’s declaration of his readiness to produce this board to point to it the difficulties which exist to any im- the proofs of his statements, and to confirm them by legal mediate and general alteration or modification of the present I have only to observe, that his not having done so evidence, system. was no fault of mine, and I can assure him that they long ago the suggestion of the committee, (( that a special should since have been before the public if he or his provision be forthwith -made to secure a just compensation for friends long had ever given me the opportunity of compelling their the enormous extra labours which are entailed upon the union production in open court. surgeons through the Board of Health under its general On the contrary, instead of publishing their proofs, Dr. powers and regulations, more particularly during the presence Chambers and his friends first acknowledge, both in writing of cholera and other epidemics," I am directed to state that and most unequivocally in speech, their utter disbelief of my the Poor-law Board arenot empowered to lay down any proconnected with the anonymous letters, while they susspective scale of remuneration for such services, but that of being tain the accusation by insinuations. on of a account extraorreasonable compensation granting I-join with Dr. Chambers in the expression of sincere regret, dinary services is vested in the guardians with the approval that a matter of this nature should have so long engaged- the of this board, by,the proviso to article 172 of the general con- attention of a liberal profession; and I will go a step further’ solidated order, and that such power has already been acted and express my-sorrow that I, a member of that profession,, in instances. several upon only desirous of discharging its anxious duties in tranquillity I am gentlemen, your obedient servant, and good faith, should, behind my back, have been made the, W. G. LUMLEY, Assist. Sec. object of secret inquiries and calumnious imputations by those who were my professional colleagues, and whom I had hitherIt should be observed, ’that no 11, prospective scale of re- to looked upon through a series of years as my private friends. I am, Sir, your obedient servant, muneration" was sought from the poor-law board by the comEDWARD J. SEYMOUR, M.D. mittee. The memorial and application for relief arose less from the, additional labours which an alarming epidemic like the cholera must induce, than from the vexatious returns and THE SUPPLEMENTARY CHARTER OF THE UNIreports of cases for the public advantage, and the liability of VERSITY OF LONDON. the union surgeons, under orders from the General Board of the Editor of THE LANCET. To Health, to examine nuisances,and-report as officers of health. I The provisions of article 172 of the general consolidated SIR,—May beg a brief space in your next number for a order, certainly might be sufficient to provide adequate re- few remarks on the subject of the supplementary charter just muneration to medical officers; but experience has proved, granted to, or inflicted upon, the University of London. The publication of this charter entire in the last number of over and over again, that merely permissive clauses will not reach the existing evil, admitted by all concerned to be very THE LANCET will have the effect of removing a serious misapprehension from the minds of many that this was the charter great. The answer from the General Board of Health in reply-to sought for by the graduates’ committee. The committee will the committee, appeared in your number of July the 21st; it have occasion, in a report which will shortly be presented to throws the onus of providing for the medical officer upon the the graduates, to offer some observations on this supplementary poor-law board; this board politely hand the case over to the charter, and the mode in which it has been obtained. I will boards of guardians. Mr. Mitchell’s experience may be con- only here mention, that the committee had no opportunity sidered an average sample of the mode in which these func- afforded them by the parties to this measure, of expressing tionaries will deal with applications for advanced payment to either their approval or disapprobation of what I will venture medical officers. " Mr. Mitchell had been the medical officer to characterize as a very doubtful boon to the University or to the parish of Lambeth for eighteen years. Three halfpence , the cause of education. It will readily be seen, on perusal of this document, that it per cholera case whether occurring. night or day! tie made equitable propositions to the board, but the Lambeth guar- is simply a piece of patchwork, intended to supply one of the dians paid no attention; in consequence he sent in his re- very numerous defects of the original charter. It empowers the senate, in the first place, to admit certain persons as cansignation, which was accepted!" the union surgeons thus bandied about from one didates for degrees who were excluded by the interpretation board to another, and as a body redressed by none, the simple put upon the old charter. In the second place it empowers adage of " a fall between two stools" occurs to the mind; and the senate to exercise a new function altogether-that of giving
poor-law board should, by a special order, direct that all appointments of medical officers be as durable as their good conduct and- capability and willingness to continue therein. the
even a
months) medical
’
As regards
_.
-
Seeing
that of the little girl V—, the particulars of much success; I give no opium with the calomel, which I Mr. Fergusson’s Clinical Lecture, direct to be placed dry on the tongue in five-grain doses* published in your journal in April. At that time she left the every quarter of an hour, until bilious evacuation and secre hospital to go into the country, being able to walk about on tion of urine takes place ; when reaction commencesad-I diminish the doses of calomel, and also the frequency of crutches. Seven months having now elapsed since the proceeding was ministration. I find but little consecutive fever, the patient frequently recovering upon good diet, with alkalies. I do not put in force, I yesterday, in company with my intelligent Mr. Hugman, the author of a late work on " 3forbus give brandy as a remedy in any stage of the disease, knowing Coxarius," visited the child at her home in Greenwich, and the depression which follows the use of so active a stimulant; together with the above-named gentleman, minutely inspected those who have been habituated to the use of spirits, &c., form, of course, an exception. Not desiring to occupy any further her. The following we found to be her condition :The whole length of the extensive cicatrix is in a very firm portion of your valuable journal, I subscribe myself, your humble servant, and healthy state, with the exception of a small portion of the CHARLES MUNDAY, where there is a slight weeping, as one usually sees centre, Medical Officer, West London Union. in scrofulous subjects, after excision of joints, for many months after the operation. The centre of the thigh, when measured, is as large round as the sound one. A false joint OF CHLOROFORM ON THE GENERATIVE has formed. There is perfect flexion and extension of the SYSTEM. thigh upon the pelvis. The power of adduction considerable; To t7te Editor of THE LANCET. the power of rotation outwards slight; as was the case in Mr. White’s and in Mr. Fergusson’s other patients, and as always SiR,--I beg to call the attention of your readers to a curious must necessarily happen, the insertions of the pyriformis fact in connexion with the effect of chloroform upon bees. gemelli and obturators being cut through. Foot neither in- On subjecting a bee-glass to its action, all the working bees verted nor everted. Whole limb shorter than the other by revive from its effects, but almost all the drones do not. These two inches, although considerably more of the bone was re- latter have the organs of generation extended: the few who moved. The patient can plant her toes firmly on the ground were not killed had not their organs so exposed, and they and walk without the assistance of either stick or crutch. Her were very few. This seems to support the idea that this regeneral health is in every respect perfect; she presents, in- markable agent has a special influence upon the organs of geneT am- Sir- yours. &e deed, a happy contrast to the poor miserable creature who was , ration. JOHN PUGHE, M.R.C.S. lying crippled in her bed before the operation. The parents, who had-to use their own expression"beggared themselves in order to get some relief for their CONVENTION OF POOR-LAW MEDICAL OFFICERS, child," and who had seen her sufferings so long, are impressed with a sense of deep and lasting gratitude to that distinguished THE POOR-LAW BOARD, AND THE GENERAL surgeon who, by a proceeding creditable alike to his humanity BOARD OF HEALTH. and skill, has brought health, joy, and comfort, where before To the Editor of THE LANCET. there was nothing but suffering and despair. I send this account of the present condition of the patient, , SIR,—The great interest now taken in the subject of poornot for the purpose of reviving a controversy, where evidently law medical reform, leads the committee to beg the favour of there is now no longer any necessity for it, but for the purpose your publishing the following correspondence:of fairly and honestly laying before the profession the actual (copy.) results of this so much reviled operation, and of showing those ’ the President To of the Poor-Law Board. of them who are fond of looking forward and not retrograding, ’ "44 & 5 William IV., cap. lxxvi. clause 46. And the said that excision of the head of the femur will be attended with those good results which we expected would follow, when it is commissioners may and are hereby empowered, &c.; and when the said commissioners may see occasion, to regulate the undertaken in suitable cases, and with proper care. But it is more especially for the information of Professor amount of salaries payable to such officers, respecting, &c. 10 & 11 Victoria, cap. cix. clause 10. And be it enactedr Syme, and those who may agree with him respecting the bar- , °That all the powers and duties of the poor-law commis&e, and this that I have taken the of barity inutility operation, trouble to go some miles out of town, and minutely examine sioners, with, respect to the administration of relief &c., and this patient. If the learned Professor is one who will be con- all other powers and duties now vested in them, shall be vinced at all-and I say this with the greatest respect for his transferred to, and vested in, the commissioners, and shall be exercised by them, under the provisions of this high professional character-he must admit that the results of henceforward &c." this case, together with those before published, silently and act, ’ SIR,—The poor-law board having the power, as evidenced triumphantly proclaim him a vanquished man; and I sincerely " to regulate, when they may see occasion, the amount above, for the that he credit of will Edinburgh surgery, hope, openly retract his written opinions respecting this proceeding. Even of salaries payable to officers respectively," the committee of if he does not think fit to do so publicly, it is to be hoped the convention of poor-law surgeons take leave to memorializethat he will give the pupils of his class, which will re-assemble you, who have already considered the position of poor-law in the forthcoming session, views respecting this operation medical officers, that you may issue such orders as may secureto them in accordance with the extent of their totally different from those they have been accustomed to hear aa payment duties, and the costs incident to the supply of medicines and propounded. I may, in conclusion, state that the above-mentioned case is the maintenance of establishments needful for an efficient adthe more interesting, inasmuch as before Mr. Fergusson ope- ministration of medical relief to the sick poor. Although your memorialists have expressed the opinion rated, the little patient was under the care of a hospital sur- that a board specially constituted for the supervision, control, geon-one who ought to be.well acquainted with, and able to make use of all the resources of his art, (I could mention his and payment of poor-law medical relief, (now extended to name if I chose, and would fearlessly do so if necessary;) and near three millions of her Majesty’s subjects in England and when it was proposed to him to perform the operation for the Wales,) with the whole cost thereof, derived from the conrelief of the patient, he merely laughed at the proposer of solidated fund, would be the best means to secure justice to such an absurdity, as cutting out the head of the thigh-bone in the union surgeons, and the fullest advantage to the sick poor,. they are willing to waive, for the present, this view of the suba living human being, with any prospect of safety or advanject, under a sense of the difficulties which beset its immetage.-I remain, yours obediently, diate introduction. HENRY SMITH. ’ They beg, however, in the most earnest manner, respectfully to submit to you, that an exercise of the authority and SUCCESSFUL TREATMENT OF CHOLERA BY power of the poor-law board, as shown to exist in the citations’ FREQUENTLY REPEATED DOSES OF CALOMEL. from the acts of parliament, would be equal to such a diminuof their admitted grievances as might render their tenure To the Editor of THE LANCET ’ tion of office, and the rigorous performance of their obligations, SIR,—At a time when malignant disease is so prevalent, painful and humiliating to themselves, and, in many ways,. and medical opinions so conflicting, I feel it a duty, holding a less more beneficial to the suffering poor. of and more of public appointment, having opportunities seeing They, therefore, respectfully suggest—1st. That henceforth the disease than practitioners in general, to record the result of * We believe that Dr. my experience, which is decidedly in favour of the practice Ayre has seldom, if ever, given so large a dose at. advocated by Dr. Ayre. I have used a modification of it with such short intervals.—ED. L. case is were
given at full in
friend,
EFFECT
’
-
’
192
saying of the quaint William Cobbett, about John Bull being persecuted by two sets of thieves,--the Whigs on-one side and the Tories on the other. It is gratifying, however, to turn for a moment from this2ndly. That the amount of payment be based on a.calculation of the number of cases attended in-a given district, during dark shadowing, to the light which breaks in from the union. the past three years. That the fixed salaries be arrived at by to which Mr. Vallance, the intrepid advocate of a better determining 6s. 6d. as the average sum to be paid per case system of poor-law medical relief, is the well-tried medical officer. He reports, to the credit of the board of guardians of throughout the country. That the provisions of the medical order in 1842, for extras the West Ham Union, that a sense of justice has impelled be enforced in all unions-; and under all circumstances be them to pay £1per case of cholera to whomsoever the promade binding, except that the operations performed in the fessional attendant may be; and also fifteen per cent. (for six house be awarded the same fees allowed to out-door cases. upon the annual amount of the salaries paid to their officers,, as some remuneration for their services as Also, that a special provision be forthwith made to secure a just compensation for the enormous extra labours which are officers of health. If other boards would obey the injunctionentailed upon the union surgeons, through the Board of Health, , of Ancient Writ, " Go, and do thou likewise," there would be under its general powers and regulations, more particularly less cause to trouble you with these details. I have the honour to be, Mr. Editor, during the presence of cholera, or other epidemics. We beg to call your attention to the subjoined copy of a Your very obedient servant. letter recently received from the general Board of Health on CHARLES F. J. LORD, Hon. Sec. the subject. We have-the honour to be, Sir. vours. verv respectfully. DR. CHAMBERS AND DR. SEYMOUR. THOMAS HODGKIN, Chairman. CHARLES F. J. LORD, Hon. Sec. To the Editor of TaE LANCET. SIR,—In reference to a letter which appears in your paper (COPY.) of this day’s date,, (Aug. 11,) bearing Dr. Chambers’s signature, Poor-law Board, Somerset House. in which he re-asserts the truth of his previous statement in 1849. August 1st, THE LANCET of the 9th of June, I may be permitted on my part GENTLEMEN, — I am directed by the Poor-law Board to to reiterate my solemn declaration. acknowledge the receipt of the communication signed by you On my faith as a Christian, and my word of honour as a on behalf of the " Committee of the Convention of Poor-law that I never had any, the most distant connexion gentleman, Medical Officers," and to inform you that the suggestions or knowledge of, any anonymous letters addressed to with, contained in the communication, shall receive the best con- Dr. Chambers or to any other person. sideration. of the board. to all other allegations, I adhere to my stateWith regard The committee are, however, so well acquainted with the ment of the 9th of June. subject of poor-law medical -relief, that it is unnecessary for As to Dr. Chambers’s declaration of his readiness to produce this board to point to it the difficulties which exist to any im- the proofs of his statements, and to confirm them by legal mediate and general alteration or modification of the present I have only to observe, that his not having done so evidence, system. was no fault of mine, and I can assure him that they long ago the suggestion of the committee, (( that a special should since have been before the public if he or his provision be forthwith -made to secure a just compensation for friends long had ever given me the opportunity of compelling their the enormous extra labours which are entailed upon the union production in open court. surgeons through the Board of Health under its general On the contrary, instead of publishing their proofs, Dr. powers and regulations, more particularly during the presence Chambers and his friends first acknowledge, both in writing of cholera and other epidemics," I am directed to state that and most unequivocally in speech, their utter disbelief of my the Poor-law Board arenot empowered to lay down any proconnected with the anonymous letters, while they susspective scale of remuneration for such services, but that of being tain the accusation by insinuations. on of a account extraorreasonable compensation granting I-join with Dr. Chambers in the expression of sincere regret, dinary services is vested in the guardians with the approval that a matter of this nature should have so long engaged- the of this board, by,the proviso to article 172 of the general con- attention of a liberal profession; and I will go a step further’ solidated order, and that such power has already been acted and express my-sorrow that I, a member of that profession,, in instances. several upon only desirous of discharging its anxious duties in tranquillity I am gentlemen, your obedient servant, and good faith, should, behind my back, have been made the, W. G. LUMLEY, Assist. Sec. object of secret inquiries and calumnious imputations by those who were my professional colleagues, and whom I had hitherIt should be observed, ’that no 11, prospective scale of re- to looked upon through a series of years as my private friends. I am, Sir, your obedient servant, muneration" was sought from the poor-law board by the comEDWARD J. SEYMOUR, M.D. mittee. The memorial and application for relief arose less from the, additional labours which an alarming epidemic like the cholera must induce, than from the vexatious returns and THE SUPPLEMENTARY CHARTER OF THE UNIreports of cases for the public advantage, and the liability of VERSITY OF LONDON. the union surgeons, under orders from the General Board of the Editor of THE LANCET. To Health, to examine nuisances,and-report as officers of health. I The provisions of article 172 of the general consolidated SIR,—May beg a brief space in your next number for a order, certainly might be sufficient to provide adequate re- few remarks on the subject of the supplementary charter just muneration to medical officers; but experience has proved, granted to, or inflicted upon, the University of London. The publication of this charter entire in the last number of over and over again, that merely permissive clauses will not reach the existing evil, admitted by all concerned to be very THE LANCET will have the effect of removing a serious misapprehension from the minds of many that this was the charter great. The answer from the General Board of Health in reply-to sought for by the graduates’ committee. The committee will the committee, appeared in your number of July the 21st; it have occasion, in a report which will shortly be presented to throws the onus of providing for the medical officer upon the the graduates, to offer some observations on this supplementary poor-law board; this board politely hand the case over to the charter, and the mode in which it has been obtained. I will boards of guardians. Mr. Mitchell’s experience may be con- only here mention, that the committee had no opportunity sidered an average sample of the mode in which these func- afforded them by the parties to this measure, of expressing tionaries will deal with applications for advanced payment to either their approval or disapprobation of what I will venture medical officers. " Mr. Mitchell had been the medical officer to characterize as a very doubtful boon to the University or to the parish of Lambeth for eighteen years. Three halfpence , the cause of education. It will readily be seen, on perusal of this document, that it per cholera case whether occurring. night or day! tie made equitable propositions to the board, but the Lambeth guar- is simply a piece of patchwork, intended to supply one of the dians paid no attention; in consequence he sent in his re- very numerous defects of the original charter. It empowers the senate, in the first place, to admit certain persons as cansignation, which was accepted!" the union surgeons thus bandied about from one didates for degrees who were excluded by the interpretation board to another, and as a body redressed by none, the simple put upon the old charter. In the second place it empowers adage of " a fall between two stools" occurs to the mind; and the senate to exercise a new function altogether-that of giving
poor-law board should, by a special order, direct that all appointments of medical officers be as durable as their good conduct and- capability and willingness to continue therein. the
even a
months) medical
’
As regards
_.
-
Seeing