HOSPITAL ABUSE.

193 one more foundation like the Charterhouseservice. When, however, the medical officers in question are would be something-we do not mean for the same class aspaid a regular salary, irrespectively of the number of patients Sotton provided for, but for those who have toiled throughthey may have, what will it matter whether rich people or ,life for a small pittance, and who dread, and rightly, the only poor people profit by their services2 Besides, as we workhouse, with its absolute lack of all connoted by thepointed out last week, it is manifestly unfair that medical word "home." officers who live in poor quarters should not be paid more than those who live in wealthy quarters, where there is little or nothing for them to do. We fear the Prefect of Police THE MEDICAL STRIKE IN PARIS. has looked upon this question purely and solely from the THE strike of the medical officers attached to the night financial standpoint, without any consideration, or perhaps service of the eleventh arrondissement of Paris has caused without any knowledge, of its other and indirect conobvious inconvenience to the poor of that populous quarter. sequences. We trust that when these arguments are subFrom motives of humanity Dr. Bellanger and Dr. Hereck mitted to the authorities concerned better and wiser have consented to continue provisionally their service, but measures will be taken. this does not suffice. Thus, last week several persons applied to the police station of the district for medical UNQUALIFIED ASSISTANTS AND THE ROYAL help. The police, on inquiry, however, found that COLLEGE OF PHYSICIANS IN IRELAND. the two medical men were out and engaged attendTHE following resolution has been passed by the Royal ing to other patients, so they had to send away the be muniand no could M. College of Physicians in Ireland :-" That the College Pourest, help given. applicants councillor for the forwarded an district, has energetic condemns the employment of unqualified assistants by any cipal protest to the Prefect of Police, urging that the service of the Licentiates, and instructs their Representative on the should at once be re-established, as the proposed alterations General Medical Council to urge on the Council to suppress The Royal were causing grave injury to the poorer inhabitants of the the practice by every means in their power." in of a has Ireland shown district. According to a report submitted to the Paris College Physicians disposition to its with in their Licentiates contest against modes Municipal Council by M. Edmond Gibert it appears that this sympathise that It does so here. discredit the of profession. practice night medical service cost 141,106 francs (5640) during the it does it It But all can. has scarcely powers of discipline year 1895. It is much appreciated by the population of Paris, over its own Members and Licentiates, and it should but it is now maintained that abuses have arisen. Persons who have means to pay for medical advice are stated to have exhaust them before calling on the General Medical availed themselves of this service. Such abuse, it is true, Council. Men are scored off the Register year after year does not, as in the case of hospital abuse in England, repre- that might have been saved from such a fate by the timely sent a loss to the medical profession, for the medical men are discipline of their own Colleges. paid eight shillings per visit by the municipality, but it is a loss to the ratepayers. The latter are therefore interested in HOSPITAL ABUSE. preventing abuse, whereas if the proposal of the Prefect of A CASE was tried in the Queen’s Bench Division on Police were enforced there would be no check to the abuse. If the medical officers were paid a fixed salary it would not Jan. 12th which is of considerable interest to those who are matter to any one except to the medical men themselves anxious regarding hospital abuse. According to the account how many patients resorted to the night service or whether in the IJaily Teleg’l’apk of Jan. 13th the complainant, who kept these persons were rich or poor. As it is, the payment being three public-houses, received severe bodily injuries. He was per visit, the authorities have every interest to watch and first moved to the house of a medical man close by, and from see that none but the poor avail themselves of the medical there was taken in an ambulance, not to his own residence, officers’ services. It is proposed that the tax collectors as might naturally be expected, but to the West London Hosshould be employed to investigate the cases. They are best pital, where he " underwent an operation." Not only did he informed as to the financial resources of the inhabitants of receive the benefits of the hospital to this extent, but he subsetheir districts, and, in any case, know all those whose rent quently attended as an out-patient for "some time." It is amounts to R20 and upwards, for there is no direct taxation interesting to know that this recipient of the benefits of charity ievied from tenants who pay a rent below .S20. The fact had subsequently to sell his public-houses for the " low that the cost of the service has increased rapidly strengthens price" of IC21, 000, as the takings fell off to the extent of 7a the supposition that abuses have arisen. In 1891 the night week! This case happens to come into court, and accordingly medical service for all Paris cost 110,000 fr. In 1894 it cost stands painted in its full colours. There is scarcely a hospital 27,000 fr., and in 1895, as already stated, 141,106 fr. No less in London which is not thus weekly abused and in the aggrethan 135 medical men are engaged in this service, and it gate the system of gratuitous attendance upon accidents in all calculated that if, instead of.being paid 10 fr. a visit, they classes of society is amounting in London to something like ea’:h received a regular income of 600 fr., this would only a public scandal. While everyone, be he peer or pauper, has - cost 81,000fr. ; but to this it would be necessary to add a right to accept or receive at a hospital first-aid in some the midwifery fees, and therefore the saving on the figure accidents it is only right to point out that as soon as such given ;for the year 1895 would have been.’not 60,000 fr" but patients can be moved they should pass to the care of their Thus if the alteration proposed had been applied own medical advisers and certainly should not attend as ’ Such cases demonstrate a scandalous in 1895 it would have saved <81800 out of a total outlay of "out-patients." :S5640. For a large and wealthy town like Paris, with a mismanagement of charitable funds, which should no population of two and a half million, was it worth while longer be tolerated. Our London hospitals are in a state of disturbing an eminently useful service so as to economise chronic impecuniosity. How can we approach the rich the paltry sum of about Z1800 ? If abuses have arisen these and ask them to bestow their funds to be utilised in this certainly should be prevented, but the alteration proposed manner? Even supposing that the patient gives a handsome will, on the contrary, give every facility for their increase. donation to the funds of the hospital, this does not relieve As it is, we can but repeat that every time a medical man him of the charge of depriving the medical profession of is called up in the night it means eight shillings out of the their just fees. The vast majority of accidents, as fractures rates ; therefore, there are any number of persons interested and the like, could be perfectly well treated by the family in seeing that none but the poor avail themselves of this medical attendant in occasional consultation with a hospital

poor. Even

___

___

45,000 fr.

194 We commend this practice of gratuitous attend- matter, as a whole family must crowd together in upon accidents among the "well-to-do" to the serious one room which answers for all purposes in a consideration of the lay governors of our large hospitals, manner which would not be tolerated in the East-end of with whom lies the power to do their duty and put an end London, and besides there are no educational advantages to a state of things which, as this case sufficiently demon- whatsoever. The collapse of the Nondweni goldnelds (at strates, undoubtedly exists and much weakens the case which place there was until recently a resident surgeon) has sent most of the people there away. This was the only of the hospitals in appealing to the wealthy for funds. place in Zululand which supported a medical man of its own. Since his departure the N’qutu district surgeon easily comSIR JOSEPH LISTER’S PEERAGE. bines the practice there with his official duties, although the

surgeon. ance

WE

able to announce that Sir Joseph Lister raised to the Peerage has selected the title of Lord Lister. It is eminently satisfactory to find that he will still be associated with the name which he has made famous throughout the scientific world and that his identity will not be obscured under some territorial designation. on

are

glad to be

being

HOSPITAL SHIPS. IT is stated that ships for ambulance purposes are to be added to the navy of the United States. Their uses will be found described in the pages of THE LANCET in an interesting paper entitled "Hospital Ships" by Dr. Murray Braidwood published on April 4th, 1896, and illustrated by plans. It is sincerely to be hoped that our naval authorities will turn their attention to this subject. One or two of these ships are really wanted, and there is no reason why our nation should be behindhand.

MEDICAL PRACTICE IN ZULULAND. A GENTLEMAN who has recently accepted a Government medical appointment in Zululand has written to us as follows :-" Medical practice in Zululand, like all Gaul, is divided into three parts-that by the district surgeons (of whom there are five), that by the Kaffir doctors, and, of course, that by the ubiquitous quack. The two former have to obtain from the Government a licence to practise, for which each alike pays a guinea a year. The district surgeons get a salary of Z200 per annum and extras, with permission to practise if they take out the licence. The practice and extras amount to about £ 30 a year, as told to me by one of them, who, however, supplements his income by acting as a missionary, and some have f.50 a year for conducting a dispensary, at which they must attend all natives at a uniform fee of one shilling. The shilling goes to the Government, which supplies the necessary medicines; the district surgeon, however, is expected to provide surgical instruments. The dispensary system does away with all chance of native practice, which before its institution used to yield a fair income, as the natives cannot see why they should pay more than ls. for private attendance when they can have attendance and medicine at the surgery for that sum. The termextras’ means a travelling allowance per mile, outside a six-mile radius, of Is. out and 6d. return, to obtain which the practitioner has to keep one or two horses and a groom and must frequently sleep at Kaffir stores, where the charges are from 5s. to 7s. 6d. a night for his horse, 2s. 6d. for his bed, and 2s. 6d. for each meal. This item is therefore a source of loss rather than of profit. No allowance is made for evidence in courts of justice, for inquests, or for post-mortem examinations. The white population, including the military, numbered until recently about 700. I do not think that at present it exceeds 500, and the military surgeon at Eshowe takes what private practice he can obtain. No houses are provided by Government, and the district surgeon must build a hut, sleep in a tent, or provide a dwelling-place as best he can. This in the case of a bachelor and a young man (and no other should be appointed to these posts) is not of such consequence ; but for an elderly man, a married man, or, above all, one with children, it becomes a serious

places are thirteen miles apart. The cost of living in Zululand-principally on account of the very high rate of freight by rail through Natal and by bullock waggon in Zululand, as well as through the mealie famine, the locusts, and the rinderpest in other parts of South Africais extremely high, in addition to which the Government salaries are very disproportionate to necessary expenditure and much below what is usually paid by others. Tradesmen even, carpenters, and blacksmiths can get from B28 to .E30 a month-horseshoes cost 10s.a set. Even young fellows under twenty are drawing salaries of from B15 to .635 a month at the mines, without any trade or profession whatsoever. The quacks seem to go on the even tenor of their way here as elsewhere and do a roaring trade, not only at extracting teeth at 1s. each, but at bone-setting, surgery, and the practice of medicine generally, uninterfered with by the Government. Taking one consideration with another the life of a district surgeon in Zululand is, like the policeman’s, , not a happy one."’" two

--

THE PRESIDENCY OF QUEEN’S

COLLEGE, CORK.

of Queen’s College, Cork, which is now lie between Sir Rowland Blennerhassett, is said to vacant, Professor Corby, and Mr. Starkie. To our mind Professor Corby’s claims completely outweigh those of the other two gentlemen. He is a graduate of the College and at present holds an important Professorship therein-that of Midwifery. He is a man of learning and culture outside the profession, and the esteem in which he is held by his colleagues is shown by the fact that he has been four times elected to the council of the College. This intimate connexion with the College is the finest testimonial that a candidate could possess to his fitness for the vacant Presidency; but in addition to it Professor Corby would represent the body of the College in a way that neither of the other claimants could hope to do. Three-quarters of the students at Queen’s College, Cork, hope to enter the medical profession, so that it is very fitting that the President should belong to that profession. If the Presidency had been held on many occasions, or for many years, by a medical man we would willingly admit that a layman might for many reasons be an advisable choice. But this is not the case. It is the turn for a medical man, and a medical man would be a grateful selection to an enormous majority of the graduates and students of the College. THE

Presidency

A QUACK AND HIS VICTIM.

As truly as the earth requires its atmosphere, so the knave requires for success in his duplicity the company of ignorant and foolish neighbours. So long as he can find these he will flourish in some degree, and so long must they If at last there comes an awakenserve and suffer for him. one can be blamed who pities neither him nor ing hardly them. It is with no deep feeling of regret that anyone endowed with ordinary honesty and good sense will regard the fate of one who was thus duped by a heartless impostor i& the name of medical service. The case was tried afew days since at the Burnley Quarter Sessions. The plaintiff, a carter. had been induced to part with over L12 to a travelling " specialist before he discovered, on seeking the advice of two medical practitioners, that he was himself a fairly healthy