MEDICAL SICKNESS, ANNUITY, AND LIFE ASSURANCE FRIENDLY SOCIETY.

1889 JOURNALS.

MEDICAL

SICKNESS, ANNUITY, AND

LIFE

Records from General Practice.

ASSURANCE FRIENDLY SOCIETY. By J. KINGSTON BARTON, M.R.C.P. Lond., M.R.C.S. Eng. London: John Bale, Sons, THIS society, which was founded in 1884 with a somewhat and Danielsson. June, 1900. Pp. 84. Price 2s. 6d.-Few multifarious written notes can time to take find programme, has now become, as the result of of, general practitioners a and observations upon, their patients’ cases, and there is no experience, sickness insurance society exclusively so far as doubt that much clinical information is lost thereby. Mr. J. the transaction of new business is concerned. In making this change the directors have, we think, been well advised, Kingston Barton has had the perseverance to keep a record for the accumulation of funds to provide deferred benefits is of a large number of cases during the last 20 years and now an which cannot be carried out. economically on a operation has formed the very praiseworthy intention to publish some small scale, and this society, therefore, has never been in a of them. The first instalment appears in the form of a position to compete favourably with the better sort of life of its work. The periodical and others will be published "from time to time." assurance offices inhasthis department accordingly been closed and is now The first number contains the report of several interesting annuity department being conducted with a view simply to the working out of cases, notably a summary of 50 cases of acute abdominal subsisting contracts. The business of life assurance is affection, including 32 cases of appendicitis and seven of carried on by means of a sort of agency arrangement, by gastric ulcer. There are also some instructive observations which proposals reaching the society are handed on to a on conditions of the teeth-Erosion of the Teeth in Children, particular office, but the connexion between the society and the insurance office is in no sense organic and, indeed, the Ratio and Occurrence of Deficient

of Enamel, Early not, as we understand, close. We think Decay of the Teeth’. The last article in the book is an that a connexion of that sortparticularly cannot be too slight, for it is appropriate one for this time of the year-viz., Holidays, a serious responsibility to advise a man who is proposing to with Notes on the Life-History of the Salmon. Mr. Barton effect an insurance on his life as to the choice of an office, may be congratulated on his publication and we wish it every and the method upon which the society proceeds does not seem to us to involve sufficient discrimination. It is certainly success.

Edinburgh Medical Journal.--The June number opens with a long paper by Dr. Louis Cobbett entitled, " Has Antitoxine reduced the Death-rate from Diphtheria in our Large Towns ? A consideration of the statistics supplied by nine large towns in Great Britain for varying periods of years "

shows that a remarkable fall, both in the diphtheria deathrate and case mortality, has occurred since 1894. Several causes may have contributed to this change, but there appears to be every reason for believing that the most efficient of all Dr. Cobbett was the introduction of diphtheria antitoxin. says that the diphtheria bacillus may remain in a dangerous state for a very long time in the mouths of those who have recovered, so that convalescents can be declared free from infection only after the disappearance of the bacillus has been ascertained, and not at the end of any arbitrarily selected period such as three weeks. Altogether there are five original articles. Scottish Medical and Surgical Jowrnal.-In the June number Professor A. R. Simpson of Edinburgh writes on the application of the steam of boiling water to the endometrium. This may be done in two ways, -either by leading the steam through a fenestrated catheter into the uterine cavity (atmokausis) or by passing into the uterus a non-fenestrated catheter heated by steam which is not allowed to escape into the uterus (zestokausis). In the Edinburgh Royal Infirmary Professor Simpson has used the treatment in 14 cases of endometritis with menorrhagia or metrorrhagia. It was always carried out under chloroform narcosis and was usually continued for 45 seconds. Of the 14 cases 11 were cured and three were improved. In a long paper, entitled "Heredity in Disease," Dr. G. Archdall Reid speculates on some of the far-reaching effects of various maladies, such as the extinction of certain uncivilised populations through the spread of tuberculosis among them after the advent of superior races.

Dublin Journal of Medical Science.-The original articles in the June number are on Toxins and Antitoxins, by Dr. A. C. O’Sullivan ; on Commercial Pepsin, by Sir Charles A. Cameron; and on the Dublin Method of Effecting the Delivery of the Placenta, by Dr. Henry Jellett. issued before the It contains articles on the Work of Medical Missions in Persia, by Dr. D. W. Carr, of Julfa ; on Overcoming Obstacles in China, by Mr. L. G. Hill, of Pakhoi; and on Opening a Way for the Gospel, by Dr. Mabel Poulter, of Hok-Chiang, South China.

Mercy and

Truth.-The June number

recent outbreak of hostilities in China.

was

not desirable that the entire insurance business of the profession should be turned into one channel, nor is the office which most readily concedes a rebate from its premium rates likely to be the one which will make the best return to It the policy-holder for the premium actually. received. cannot be too often or too impressively pointed out that the secret of good finance in life assurance is the cutting down of all expenditure other than that on benefits to members to the lowest possible percentage of the annual outgo. A rebate from the annual premium may indeed be classed as a benefit when it is made to the policy-holder himself, but it may be doubted whether in fact any benefit in that form is the monetary equivalent of the savings effected by those offices which, eschewing all costly forms of advertisement, are conducted with a view to the benefit alone of the insured members. But it is no part of our purpose to criticise the choice which the society has made of a patron among the life It is with its own proper work of assurance companies. sickness insurance that we are more concerned, and here we have the satisfaction of saying that the seventeenth report recently issued to the members is entirely satisfactory. The members paid in premiums about £11,300, plus 10 per cent.say, £12,430—and received in benefit just over f.13,OOO. The difference is made up for the most part of interest upon the investments standing to the credit of this fund ; for although these investments were drawn upon to answer the bonus distributed to the members in this"Bonus"" year the amount coming from that source was no more than f.250. Such a result is in the highest degree creditable to the management of the society and shows that in this department the members obtain their full money’s worth in the form of benefit. If to the mere balancing of the account we add the priceless boon of an insurance scheme which carries the invalided practitioner over a period of sickness without any heavy demand upon his savings or other resources we see at once that the aid which this society renders is not to be measured by its mere money worth and that the presentation of a satisfactory balancesheet, although indispensable, is the least of the claims which the committee are entitled to put forward for the recognition and gratitude of the profession. The present annual report is accompanied by an actuarial report which does not call for any particular comment.

BRITISH MEDICAL

ASSOCIATION, SOUTH-WESTERN

BRANCH.-The annual meeting of the South-Western Branch of the British Medical Association was held at Torquay on June 20th. Mr. Paul Q. Karkeek read an interesting paper upon Pre-professional Education of the Medical Student. The secretary (Dr. H. W. Webber) stated that the branch A vote of thanks was had now a membership of 358. awarded to the retiring president, Dr. Mark Jackson of Barnstaple. It was decided that the next annual meeting should be held at Devonport and that Mr. G. Thom should be the president-elect. The dinner was held in the evening -

nf-

THE MEDICAL ASPECTS OF THE CHINESE ORISIS.

1890

THE LANCET. :

LONDON: SATURDAY, JUNE 30, 1900. THE crisis in North

China, which is causing us suet of our countrymen, has also a the welfare about anxiety sad side when considered from a humanitarian point of! view. have

The

Chinese, with all their boasted civilisation,

regards the science and art of surgery and the knowledge and practice of medicine not advanced beyond empiricism. They have kept their healing art in the region of magic with its mythical rites and incantations. No savage tribe or unlettered people practises surgery or medicine in a more primitive fashion or invoke the powers of paganism with more zeal or veneration than do the Chinese. as

The consequence of this backwardness in medical education must have appalling results at the present moment, when thousands of Chinese are being wounded partly at the hands of their fellow-countrymen and partly by a foreign foe. And

ignorant fanatics must be punished no medical mind likes to contemplate the idea of neglected surgical injuries. During the Chino-Japanese war the ambulance equipment of the Chinese was rudimentary in the extreme but at the present moment, when undisciplined hordes are being mowed down by Maxims the medical arrangements must be altogether discounted and the condition of the wounded terrible to contemplate. At Tientsin and Hong-Kong schools of medicine have been established for several years past. At Tientsin LI HUNG CHANG, at the instigation of Dr. IRWIN, inaugurated a while these

medical school ment seconded

ten years ago and the British Governmedical officer from the British army, F. S. HEUSTON, to take up the work of the teaching in the institution. LI HUNG

some a

surgery, and the Hong-Kong school especially has been attended with considerable success. The teachers are unpaid ; the medical men in the colony have for 14 years now given their services willingly and gratuitously, but as yet no Government aid has been given to support this eminently useful work. Ambulance work was taught in Formosa by Dr. W. W. MYERS, and in Hong-Kong a bearer section was inaugurated, equipped and maintained by Mr. CANTLIE from amongst the students of the College of Medicine. This bearer section was attached to the Hong. Kong Volunteer Artillery, and has done excellent work. With these exceptions there are no medical schools in China. There are Chinese practitioners in plenty, but their knowledge and practices would afford material for a comic opera rather than for serious consideration. A plaster to mend a fractured leg; a live duck split up and applied to the skin for a poultice; duck’s blood smeared on

temples, face, and neck to relieve fever and headache; and "dragon’s"blood and deer’s horn to cure leprosy are examples of the practice of medicine in China, with which is combined the burning of printed emblems purporting to the

beseech the Evil One to ward off illness and death. The medical missionaries from Great Britain and the United States of America have done a great deal of excellent hos. pital work in China ; but it is perhaps unfortunate that the medical work has been accompanied in almost every instance by religious proselytising. There seems little reason to doubt the fact that the progress of medicine and, what is still more important, the progress of general education and science and even of civilisation, have been thwarted by the fact that the converts are in most instances tinged with conversion to a new religion. The young Chinese trained in medicine are almost all Christians, and the fact is deterrent to the advance of medical science amongst the Chinese. We believe that were science to be taught to the Chinese in a purely secular way Christianity might follow, but it seems impossible to civilise the Chinese by means of Christianity. The Japanese have become civilised of irrespectively Christianity. Encourage secular Western education and especially medical science in China, send Chinamen thus trained into every centre and town of

Surgeon-Major superintending CHANG’S primary idea in establishing the school was to provide medical men trained in Western medicine for service in his army and navy. We use the word "his"army and China, and a leaven will be introduced and a diffusion navy advisedly, for it was only in LI HUNG CHANG’S province of knowledge spread through the length and breadth of of Chihli, of which he was formerly Viceroy, that anything China which will in the near future bring many good like a modern army and navy existed in China. In 1887 a things in its train-among others, we truly believe, a college of medicine for Chinese was opened in Hong-Kong. considerable conversion of Chinamen to Christianity. The school was initiated and its regulations were drawn by Mr. JAMES CANTLIE, and Dr. PATRICK MANSON the first dean. The Viceroy, LI HUNG CHANG, was (and is still) the patron, and in the letter of his acceptance of the position this head and front of Chinese mandarinism, this impersonation of anti-foreign education, wrote that " he hoped that anatomy and chemistry would form a pro. minent part in the training of the students, for he up

was

held these sciences to be the basis of all true medical knowledge." The grasp of knowledge expressed in these words by a man ignorant of science, steeped in Chinese prejudices and old-time mythology, is notable. The Hong-

Kong China

and at

Tientsin

schools

systematic teaching

the only attempts in of modern medicine and

are

WEDNESDAY, June 20th, 1900, should be a memorable day in the history of Newcastle-on-Tyne, for on that day the The men of the north new Infirmary was opened. do nothing by halves. When they work they work, and when the vast and varied industries of the neighbourhood cease they play with equal energy. The laying of the foundation-stone of the new Infirmary-one of the many outcomes of the Diamond Jubilee of QUEEN VICTORIA-by the PRINCE OF WALES was an occasion which called forth all their enthusiasm. The huge works of the district were slosed, and the resources of the North-Eastern Railway