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MEDICAL FEES AT ASSURANCE OFFICES.
672
hepatic derangement, and a tendency to relapse or to assume angles." The most common forms are, moreover, analyzed remittent character; and, thirdly, those complicated with and fignred. We can recommend this book as well calculated rheumatic symptoms."-p. 58. to fulfil the purposes for which it is designed; and it will This association has not been so clearly shown before; doubtless prove a valuable, as well as inexpensive acquisition, the author, however, finds sufficient justification for placing especially to the mineralogist and geologist. these cases of fever here, in the fact that it was difficult a
thus far from the other form of MEDICAL FEES AT ASSURANCE OFFICES. were the catarrhal symptoms, To the Editor of THE LANCET. to which were superadded the complication just named. So far as the classification could be made, the author disSiR,-As a director of a Life Insurance Office, I take the to you my sentiments and opinion on a subtinguished thirty-one cases of catarrhal fever with abdominal liberty of stating referred to in weekly journal. That the frequently ject complication; of these twenty-two were males, and nine professional medical attendantyour of the person who applies for a females. There were only five deaths in the thirty-one cases. life insurance should receive a fee for giving his evidence as It should be mentioned, that though Dr. Peacock’s conclu- to the state of health of the said person, I entirely assent to; sions are chiefly founded on the cases which, being in the but, in my opinion, every life office has a right to obtain from wards of the hospital, were carefully watched, yet that these the proposed insurer a satisfactory statement of the actual views were extended and confirmed by his observations state of health of that individual, male or female; and the fee due should be paid by the said person, for his or her amongst a large number of out-patients, and amongst private health certificate. Every office, anxious to procure sound individuals. As already stated, the author dwells particularly and satisfactory evidence as to the state of health at the time, on these complications being an element in common with the and the probable future state, has a medical referee, to whom the proposed insurer is referred; and to submit to his inquiry pulmonary affections of the disease. In fact, that when the and examination as to his or her state of health; and the fee morbid poison has entered the system, its effects may be due to the office professional referee is paid by the office. To the form of the when disease; light, constituting simple conclude, my opinion is, that to produce satisfactory evidence severe, they may be shown through these more urgent lesions as to the prudence and safety of the life insurance, the proof the pulmonary or digestive system. Dr. Peacock says,poser should forward adequate information as to the present state and future prospect of the life of the individual at his or we the consider remarkable coincidence when, therefore, in the period of accession, general prevalence, and decline of her expense; and that the life offices, with the view of corrothe several forms of pulmonary, enteric, hepatic, and rheu- borating the accuracy, or ascertaining the inaccuracy or doubtmatic affections-the remittent and typhoid character of the fulness, of the evidence sent by the professional man as to the febrile diseases-the very common occurrence of symptoms present state and future prospect of the life of the proposed referable to the stomach, intestines, and liver, in the cases insurer, are, by prudence and for safety, obliged to refer the with predominant affection of the lungs, and of those of proposed insurer to the professional medical referee of the bronchitis and pneumonia in the abdominal form of the office, and the office, of course, to pay his fee for his examinaI remain. Sir. vour obedient servant. d,isease-and when we further find that these symptoms were tion. L. EVANS, M.D. features not peculiar to the recent influenza alone, but have A Director of the Norwich Life Insurance Office. also, in a greater or less degree, characterized all its former appearances, either in this or other countries-we can scarcely To the Editor of THE LANCET. refrain from acknowledging that these several affections are of keeping alive the sentiments exnot merely coetanous, but correlative, and types and modificaSiR,ŁWith a view tions of one disease, with which they have a common origin." pressed relative to " medical fees at assurance offices," by your numerous correspondents, I forward you the subscribed com-P. 103. munication, and trust you will deem it worthy of publicity Hence we arrive at the medium of your valable journal, not merely as through "The only supposition, therefore, which is applicable to the connected with the interests of our profession, but with being explanation of the phenomena of fever, is that of a delete- those also of assurance offices. terious influence operating upon the nervous system, deranging On the 19th of September, I was requested by Mr. Robert all the vital powers, and so poisoning the blood as to excite a Tucker, secretary to the " Pelican Life Assurance Company," predisposition to local congestion or inflammation in different Lombard-street, on behalf of the directors, and with their 104. organs."—p. respectful compliments, to favour the board by answering, as Neither is this influence thus restricted. Various other early as convenient, queries relating to the present and diseases participate in this depressing influence, and the mor- general state of health, (as well as other questions usually submitted by such boards,) of Mr. and Mrs. -, as being their tality of many of them is increased. medical atttendant. My reply was, that unless a " fee" was We shall not dwell on the very practical chapter which in- forthcoming, I had resolved not to comply with their request. cludes the treatment of the disease and its numerous com- Should there be a fee, I would with pleasure answer their plications, neither have we space to enter more fully than we several queries. I received no answer, but on visiting the have just done, on the more theoretical discussion on the parties to whom the assurance related, they informed me that nature and causes of the disease which follows. Suffice it to the day after my reply to the secretary of the company, they received a notice that they had been accepted, and the assusay, that if the one fails to announce a specific, or the other rances were to be effected forthwith. No medical certificate to assign a positive source from whence the disease proceeds, whatever has been given by me (their only medical attendant) relative to the health of the lJOJ.L narties OJJ"IVyç above alluded to. Now they both contain much valuable information. Our high opinion of the author and his production may be I have merely to add that the company will most undoubtedly inferred from the preceding remarks. We know of no work have to reproach themselves with their hazardous proceedings ; for I know of many circumstances which will tend to which contains a more complete description of the disease, shorten the days of -, aud consequently render an insurance and its complications. on that life more than usually precarious. How easily might have obviated such a risk! The medical referees of the several assurance companies are remunerated for their time An Elementary Treatise on Crystallography. By M. V. REG- and talents, and why should not the medical attendant of the with Wood H. Illustrated London: NAULT. about to insure, and who is called upon as a medical party Bailliere. 1848. 12mo, pp. 70. referee by the assurance company ? Surely one medical man THE object of this small treatise is well stated in the preface is as much deserving of remuneration for services given as -viz., to supply the present " scanty amount of information another. Medical men should one and all join heart and upon the crystalline forms of bodies contained in even the hand in refusing to answer any queries put to them by assuand without entering rance companies unless they have their fee. By adopting such larger treatises on chemistry; a measure, assurance companies will be brought to a proper upon the more difficult and mathematical parts of the science, sense of their duty. to give a clear insight into the principles of the classification I am, Sir, your obedient servant, of crystals, and to describe the mode of measuring their F. G. BROXHOLM, Islington, Dec. its. BSOXHOLM, M.R.C.S.E. & L.S.A.
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hepatic derangement, and a tendency to relapse or to assume angles." The most common forms are, moreover, analyzed remittent character; and, thirdly, those complicated with and fignred. We can recommend this book as well calculated rheumatic symptoms."-p. 58. to fulfil the purposes for which it is designed; and it will This association has not been so clearly shown before; doubtless prove a valuable, as well as inexpensive acquisition, the author, however, finds sufficient justification for placing especially to the mineralogist and geologist. these cases of fever here, in the fact that it was difficult a
thus far from the other form of MEDICAL FEES AT ASSURANCE OFFICES. were the catarrhal symptoms, To the Editor of THE LANCET. to which were superadded the complication just named. So far as the classification could be made, the author disSiR,-As a director of a Life Insurance Office, I take the to you my sentiments and opinion on a subtinguished thirty-one cases of catarrhal fever with abdominal liberty of stating referred to in weekly journal. That the frequently ject complication; of these twenty-two were males, and nine professional medical attendantyour of the person who applies for a females. There were only five deaths in the thirty-one cases. life insurance should receive a fee for giving his evidence as It should be mentioned, that though Dr. Peacock’s conclu- to the state of health of the said person, I entirely assent to; sions are chiefly founded on the cases which, being in the but, in my opinion, every life office has a right to obtain from wards of the hospital, were carefully watched, yet that these the proposed insurer a satisfactory statement of the actual views were extended and confirmed by his observations state of health of that individual, male or female; and the fee due should be paid by the said person, for his or her amongst a large number of out-patients, and amongst private health certificate. Every office, anxious to procure sound individuals. As already stated, the author dwells particularly and satisfactory evidence as to the state of health at the time, on these complications being an element in common with the and the probable future state, has a medical referee, to whom the proposed insurer is referred; and to submit to his inquiry pulmonary affections of the disease. In fact, that when the and examination as to his or her state of health; and the fee morbid poison has entered the system, its effects may be due to the office professional referee is paid by the office. To the form of the when disease; light, constituting simple conclude, my opinion is, that to produce satisfactory evidence severe, they may be shown through these more urgent lesions as to the prudence and safety of the life insurance, the proof the pulmonary or digestive system. Dr. Peacock says,poser should forward adequate information as to the present state and future prospect of the life of the individual at his or we the consider remarkable coincidence when, therefore, in the period of accession, general prevalence, and decline of her expense; and that the life offices, with the view of corrothe several forms of pulmonary, enteric, hepatic, and rheu- borating the accuracy, or ascertaining the inaccuracy or doubtmatic affections-the remittent and typhoid character of the fulness, of the evidence sent by the professional man as to the febrile diseases-the very common occurrence of symptoms present state and future prospect of the life of the proposed referable to the stomach, intestines, and liver, in the cases insurer, are, by prudence and for safety, obliged to refer the with predominant affection of the lungs, and of those of proposed insurer to the professional medical referee of the bronchitis and pneumonia in the abdominal form of the office, and the office, of course, to pay his fee for his examinaI remain. Sir. vour obedient servant. d,isease-and when we further find that these symptoms were tion. L. EVANS, M.D. features not peculiar to the recent influenza alone, but have A Director of the Norwich Life Insurance Office. also, in a greater or less degree, characterized all its former appearances, either in this or other countries-we can scarcely To the Editor of THE LANCET. refrain from acknowledging that these several affections are of keeping alive the sentiments exnot merely coetanous, but correlative, and types and modificaSiR,ŁWith a view tions of one disease, with which they have a common origin." pressed relative to " medical fees at assurance offices," by your numerous correspondents, I forward you the subscribed com-P. 103. munication, and trust you will deem it worthy of publicity Hence we arrive at the medium of your valable journal, not merely as through "The only supposition, therefore, which is applicable to the connected with the interests of our profession, but with being explanation of the phenomena of fever, is that of a delete- those also of assurance offices. terious influence operating upon the nervous system, deranging On the 19th of September, I was requested by Mr. Robert all the vital powers, and so poisoning the blood as to excite a Tucker, secretary to the " Pelican Life Assurance Company," predisposition to local congestion or inflammation in different Lombard-street, on behalf of the directors, and with their 104. organs."—p. respectful compliments, to favour the board by answering, as Neither is this influence thus restricted. Various other early as convenient, queries relating to the present and diseases participate in this depressing influence, and the mor- general state of health, (as well as other questions usually submitted by such boards,) of Mr. and Mrs. -, as being their tality of many of them is increased. medical atttendant. My reply was, that unless a " fee" was We shall not dwell on the very practical chapter which in- forthcoming, I had resolved not to comply with their request. cludes the treatment of the disease and its numerous com- Should there be a fee, I would with pleasure answer their plications, neither have we space to enter more fully than we several queries. I received no answer, but on visiting the have just done, on the more theoretical discussion on the parties to whom the assurance related, they informed me that nature and causes of the disease which follows. Suffice it to the day after my reply to the secretary of the company, they received a notice that they had been accepted, and the assusay, that if the one fails to announce a specific, or the other rances were to be effected forthwith. No medical certificate to assign a positive source from whence the disease proceeds, whatever has been given by me (their only medical attendant) relative to the health of the lJOJ.L narties OJJ"IVyç above alluded to. Now they both contain much valuable information. Our high opinion of the author and his production may be I have merely to add that the company will most undoubtedly inferred from the preceding remarks. We know of no work have to reproach themselves with their hazardous proceedings ; for I know of many circumstances which will tend to which contains a more complete description of the disease, shorten the days of -, aud consequently render an insurance and its complications. on that life more than usually precarious. How easily might have obviated such a risk! The medical referees of the several assurance companies are remunerated for their time An Elementary Treatise on Crystallography. By M. V. REG- and talents, and why should not the medical attendant of the with Wood H. Illustrated London: NAULT. about to insure, and who is called upon as a medical party Bailliere. 1848. 12mo, pp. 70. referee by the assurance company ? Surely one medical man THE object of this small treatise is well stated in the preface is as much deserving of remuneration for services given as -viz., to supply the present " scanty amount of information another. Medical men should one and all join heart and upon the crystalline forms of bodies contained in even the hand in refusing to answer any queries put to them by assuand without entering rance companies unless they have their fee. By adopting such larger treatises on chemistry; a measure, assurance companies will be brought to a proper upon the more difficult and mathematical parts of the science, sense of their duty. to give a clear insight into the principles of the classification I am, Sir, your obedient servant, of crystals, and to describe the mode of measuring their F. G. BROXHOLM, Islington, Dec. its. BSOXHOLM, M.R.C.S.E. & L.S.A.
to
the
separate them
disease,
so
even
characteristic
.
.LV.La.V.LYv
they
Engravings.
....
w
B.I1..Lv J.J.IÇUJ.LJ..L
V.L
B,iJ.J.v
vies
n.u u
w.