MEDICAL ATTENDANCE ON THE SICK POOR.

803 in the chain of society, yet the practitioner’s principal reliance must be placed on the ixtcrease of his connections and usefulness through their means. The foregoing plan

MEDICAL ATTENDANCE ON THE

SICK POOR.

be as simple and just as the nature of the circumstances concerned will

seems to m to

To ttce Editor

of

THE LANCET.

I beg leave to offer my mite- towards the general fund of plans concerning this important and humane question. 1. The parish officers should submit to view, in a public place or at an open vestry, a list including every pauper in the parish who cannot afford to pay for medical aid in case of sickness. The list to include every individual member of a pauper’s family who is unable to gain a livelihood. 2. Everv pauper or indigent labourer who on the medical list, to have claims a his claims openly heard and discussed once a-year by the parish officers and the parishioners who pay the taxes. 3. After having made the list, the parish should agree with a medical officer to attend every person named in the said list. in case of sickness, for one year, at some fixed price, say fourteenpence per head in the country, and tenlxence per head in the town. If we consider that poor families are generally very numerous, about fourteenpence will come near the mark ; and if midwifery be included in the agreement, an adùitiona] sixpence should be added to each name on

allow; requiring, indeed, several modifications yours

as

to

a

fixed

&c.

I am, Sir,

CORVINIUS.

Corwen, Feb. 8,1836.

MEDICAL ATTENDANCE

ON THE

SICK POOR.

place

-

salary,

respectfully,

To the Editor of rCriLANCET._ has been said in THE LANCET on the mode of procuring medical attendance for the sick poor, and the remuneration of the practitioner, and it has been said so well, that little remains to- be usefully offered. However, a few observations on the subject may not be superfluous. At the same time I take the opportunity of congratulating the profession onthe prospect of the whole mass of absurdities which constitute the laws for regulating (!) medical practice, being brought before Parliament through the medium of the Editor of THE the list. LANCET. 4. The medical candidate should be proThe medical clauses in the Poor-Law posed by the guardians or the parish officers, 1Amendment Act in no respect contemplate f increase in the effectiveness of the mediand be elected by ballot, by those only whoan are on the list of paupers ; by which means (cal profession, and the preservation of the 1 and lives of the poor. the paupers would be less liable to the health abuses of a bad election. The paupers, Even if I approved of the mode on which also, would thus have some claim on their Tmedical men are elected as attendants on doctor’s complacency and attention, as the tthe sick poor, I could find numerous errors voters have on members of Parliament. i the details, but this would be useless; as I in 5. Should sickness occur to persons not (object in toto to the principle of contractnamed in the list, yet who are unable to to t the letting out of medical services to hire a specified period of time, at all hazards, pay for medical attendance, such cases to1for be considered as common cases, not belong-I"come weal come woe." Moreover, it is not 1 to either party, as it implies iu each ing to the agreement, and to be paid for honest I e.x:tra, accordingly, by the parish. This a feeling of distrust. On these grounds I extra payment will meet the miserly designIand my predecessors have at all times reof not placing on the list several who mayfused to be parties to all medical contracts, have a just claim to be there. One suchIand consequently for years have not attended -case would prove the w-isdom of placing a any " parishes." Of course also we have dozen more names on the list. declined any participation in the plan under Supposing a parish to contain fifty pau-the new Act, which therefore does not in pers who receive a weekly allowance, pro- ;any way affect my interests. I hav.e thus, bably there will be two hundred entitled toitoo, avoided the numerous disagreeable cirhave a place on the medical list. If thesecumstances which are so frequently com. are taken at Is. 2d. per head, the sum would plained of in parish medical competition, amount to 111. 13s. 4d.; and if 6d. towardsfrom the eagerness with which medical men midwifery be added, it would amount to have caught at the depreciating otlers of 161. 13s. 4d-, which in a country practice is contracting overseers, jostling and jockeylittle enough. ing each other in the scramble. Indeed, This rate of payment is but very mode- the present degradation of the profession rate, but then the practitioner does not ex- seems to be selt-sought and- self-invited. I do, therefore, on every ground agree pect to fatten by means of poor patients. Although the poor form an important’ part, you in the opixiion that medical men .

SIR,—So much

with

804

rely only on themselves and the legislature for redress under the numerous evils arising from the present anomalous and un. just laws. As for the poor! may God help them. If the Malthusian doctrine be good, commend them to the tender mercies of enwho confide them lightened commissioners, to the care of " American" practitioners, sans must

MEDICAL

To the

CORONERS.

Editor.—SIR, As you desire

informed of the medical

coroners

to he

residing in

vicinity of the numerous readers of THE I beg leave to state that the coroner for the county of Merioneth, is EDWARD WILLIAMS, Esq., of Bala, surgeon. In the "catheter," sans "horse," sans everything. next county to this, the county of Deubigh, With regard to remuneration, I think the there is also a medical coroner, R.;NiCHOLS, following mode would be advantageous. In Esq., snrgeon, of Ruthin. Thus it would cases beyond a certain distance (a mile?) seem that we are wiser in Wales than they should be charged. For the are in England,-two at least of its counties a mileage case itself, whether in town or country, having chosen their coroner from among the a charge should be made in the ratio members of the medical profession. 1 am, of its duration,—a certain sum per day, Sir, your obedient humble servant, JOHN WILLIAMS. gradually diminishing after the first three Corwen, Feb. 8, 1836. days. Thus for a continued chronic case

there would be

smaller rate of pay, and iu of shorter duration, when more time and trouble are bestowed, the rate of remuneration would be somewhat an

acute

the

LANCET,

a

case

Mr. SMITH’S INDENTURES

—Sir,—In

- To the Editor.

inquiry made in greater. the last number of your journal, by the Under such arrangements the poor might author of the letter signed INVESTIGATOR," apply to whom they pleased, each practi- I hasten to furnish him with a statement of tioner at certain periods giving in (as di- the simple facts. About half an hour before iected under the new Act) the names of my examination terrninated, the Clerk of those patients who have been under his the Court gave me my indenture of apprencare, with an account of the nature and dura- ticeship, which I placed by my side, when tion of their disorders. I am, Sir, yours the examiner who was sitting opposite to obediently, me, whose name I have not the l,leasure of A COUNTRY PRACTITIONER. knowing, took it up and looked at it. The Cirencester, Feb. 9, 1836. rest of the proceeding has already been answer to an

"

made known. Now if this mode of probe irregular, which the author of the letter in question considers it to be, I am only performing a proper duty in stating POOR-LAW AMENDMENT ACT. the facts, in order that a similar proceeding may be prevented in future. You will oblige me by inserting this note in the pages To the Editor of THE LANCET. of your very excellent journal. I remain, SIR,—The following statement will prove Sir, your obedient servant, the hardship of my case under the PoorTHOMAS SMITH. law Amendment Act. Three years ago I 1, Jewin-crescent. engaged in a practice of sixty years’ standing, which comprised the medical attendance on five parishes in my immediate To the Editor.—SIR I belr to state. neighbourhood, but which five parishes will through the medium that I not give me sufficient interest to obtain the have no knowledge or coiieerit with certain attendance on the poor in the district, iu individuals who have taken the liberty to consequence of the sudden introduction of affix my name to a preparation of Sarsapathe men Poor-law medical Comstrange by printing it on the stamp,-as demissioners. I shall not be able to retain rilla, by at clared, least, in certain advertisements. even the one parish in which I reside. The Nor have as 1 find it is asserted, anything I, consequence will be, the entire destruction to do with sarsaparilla, or any medicinal preof my practice, the committal of a dead paration whatsoever. Permit me also to robbery on my property, with the prospect state that legal measures will immediately of starvation to the sufferer. The Guardians, be commenced in order to obtain redress after allowing a certain sum for a certain for this most unjustifiable freedom, orforgery, number of attendants, should, at least, di- as it might be designated. 1 am, perhaps vide that sum amongst the established mediSir, most respectfully, your most obedient cal men, allowing them to remain undis-I JOFIN HANCOCK. JOHN servant, I transmit you my name and turbed. Feb. 1836. Commercial-road, address privately, and am, Sir, your obedient

ceeding

of your journal,

servant, A SUFFOLK PRACTITIONER.