25
know, better than any other can know by a casual examination, however carefully made, the constitution and habits of his patient; and another, to recommend all their patients of sound constitution desirous of assuring, to do so
informed that he had cut down my bill of zC94s. 6d. to S514s., which munificent award was ordered to be paid by monthly instalments of two pounds each ! I beg you to remember that the defendant is the owner of several houses, and drives about in his gig; and that had the case turned out unsuccessfully, he would doubtless have brought an action against, and have recovered damages from me, which would have been equivalent to the ruin of my professional character. On expressing some surprise to my informant at the court, he assured me (I presume by way of extenuation of the injustice of his chief) that the judge had been assisted in his decision by the medical gentlemen at one of our metropolitan hospitals. Now either these gentlemen were ignorant that the fracture extended into the joint, and of the amount of constitutional irritation which supervened, or they were not. If the former supposition be correct, I contend that they were not justified in pronouncing a judgment at all; and if the latter, I am curious to learn which of them would have treated this case for .652s. 6d., as I rather suspect that the fees of a " pure" would have amounted to at least six times that sum, independently of the chemist’s account for leeches and prescriptions. If my fear of encroaching too much on your valuable space did not preclude all further comment, surely on the facts here detailed it would be superfluous. I am, Sir, your obedient servant, JOHN BROWN. Suffolk-place, Lower Islington, May llth, 1848.
days’ delay, I was
must
those offices which submit to the just demands of a Sir, your obedient servant, J. CuRRIB. P.S.-It appears strange that we should be required to furnish information beyond the physical condition of the proposer, which ought to be procured from a clergyman, or
only in
too generous profession.-I am, Blackburn, May 10, 1848.
minister, or magistrate. #, We have again received several other letters respecting the non-payment of fees by insurance offices. Really the whole question may be compressed within the narrow limits of an inch of type. If the application is made by the office to a medical practitioner, the office is bound by every principle of equity and justice to pay him. If, on the other hand, the application is made to the medical practitioner directly by the party who wants to make the insurance; that party is the one bound to make the payment of the customary fee; but of course, in such a case, the practitioner does not address a secret communication to the office.—ED. L.
INQUEST.—THE BERNCASTLE TESTIMONIAL. To the Editor of TaE LANCET. SIR,—The enclosed list contains the names of all the subscribers to theBerncastle testimonial" up to the present date. If, through your pages, I might be allowed to request those of your readers, whose manifold engagements have not hitherto allowed them to carry their intentions of subscribing into effect, to take an early opportunity of doing so, it would greatly forward the closing of the account. I remain, Sir, your most obedient servant, CHARLES WILSON STEEL. Lewisham, June 27th, 1848. THE CROYDON
MEDICAL FEES AT ASSURANCE OFFICES. To the Editor of THE LANCET. SIR,—The enclosed is an application sent me by the assurance office, to which I forwarded the following reply :" SIR,—As your application has not been accompanied by the usual fee, I must decline answering your queries; and I beg leave to state, that unless such fee be remitted, I shall reto apply to one of those offices which grant commend Mr. remuneration to the medical referee." A few days afterwards, Mr. called upon me with a letter from the office in question, in which it is stated-" The directors are sorry they cannot have the pleasure of remitting him one, (i. e., a fee,) but as the referee is supposed to make his report on behalf of the proposer, they feel obliged invariably to decline paying fees in such cases." Do the directors really suppose us such arrant simpletons as to believe that assurance is not with them a consideration of pounds, shillings, and pence, and that they act solely for the proposer’s benefit ? Does not the character of the queries throughout bear evidence that they are desirous to ascertain whether there exists any reason either to decline the proposal or to demand an enhanced rate of premium, and who employs us confidentially, and requires of us to expose, it may be, the rottenness of the proposer? "Has he ever had any scrofulous affection ?" and his family also. "Has any member of his family died of pulmonary disease. "Has he been, and is he, of sober and temperate habits?" "Is his ordinary manner of living in any way injurious to his health 1" or, in plain English-Is he a drunkard ? Does he go raking, &.c. &c.-and yet all thison behalf of the proposer !" What assurance directors must have ! Kind, generous souls indeed, to require the proposer to pay for, it may be, his own condemnation ; or, if the medical referee will only furnish them with such information, which they have the assurance " to request" gratis, they declare they will never tell the proposer ’ aught about it. It is high time the profession should arouse to action; more ’, than enough has already been written and said on the subject; but without a unanimous determination on their part, assurance offices will still continue to impose upon their generosity, for they have been so long accustomed to receive such reports gratuitously, that they now demand them as a matter of right. K I am desired to request" that you will furnish our directors with such information as may induce the proposer to dispense with your services in all time to come. NATIONAL VACCINE INSTITUTION. All applications should invariably emanate from the office, OF THE LAST REPORT FROM THE NATIONAL VACCINE INSTICOPY and never from the proposer, who is moreover required to TUTION TO HER MAJESTY’S SECRETARY OF STATE FOR THE HOME pay his guinea for a document which may entirely frustrate DEPARTMENT. the object he has in view-besides, it places the referee in a [ABSTRACT.]] -very delicate position with his patient. It ought, therefore, National Vaccine Establishment, April 24th, 1848. to be adopted as a rule by the profession at large, that in no To the Right Hon. Sir George Grey, Bart. ,Case should any application ever be allowed from the pro’poser, even though he should be willing to pay the fee. This SIR,—Nothing has occurred since our last Report to dimiwould, in my opinion, be our means of settling the question, nish our confidence in the protective influence of vaccination. as assurers are perfectly aware that the medical attendant Through the liberality of the Government, we have been able -
-
,
26 to establish four new stations in populous districts, to which such a boon had not been previously given. Foreign States have, as usual, made heavy demands upon the institution for vaccine lymph on the efficacy of which dependence might be placed, naturally believing that the country in which such a discovery was made would feel a just pride in ensuring its successful and general application. Sardinia was supplied last year. By a request through the Foreign Office, a very large supply of lymph has been forwarded to the proto-medico of the hospitals in Moldavia, the lymph at present in use in that country having, it is stated, lost its protective influence. Nor have the claims of our own colonies diminished; and although vaccine lymph had repeatedly been sent to Bathurst on the Gambia, it failed until last year, when we received the gratifying intelligence, from a resident medical officer, of its having succeeded in two cases for the first time since the establishment of the colony. During the last year, 168,489 charges of lymph have been distributed, in answer to a correspondence, foreign and domestic, amounting to 6930 letters, in the form either of applications for lymph, or of communications on the protective influeuce and progress of vaccination. We have authentic reports of 85,434 cases vaccinated in the provinces from our supplies of lymph, in addition to 10,403 in London. The former is but an imperfect estimate of our usefulness, and bears but a small proportion to the means supplied, owing to the want of attention in the public to the repeated requests made for faithful returns, and over which we have no control.—We have, &-c... John Ayrton Paris, M.D., (Signed) President of the Royal College of Physicians.
Professor Goodsir to the chair of anatomy. Why is this ? In almost every other class in that school prizes are given. It is said that Mr. Goodsir (by the way, a very able anatomist and kind teacher) argues that the giving of prizes is injurious to the interests of the student, inasmucli’as that a student, when studying for a certain prize, has his attention totally absorbed by that particular branch; and consequently other branches of his studies are neglected. Now, assuming the validity of this argument, (which, I think, highly questionable,) and bearing in mind that anatomy is the true basis of all medical knowledge, would the institution of prizes in the anatomical de. partment of that school not be advantageous if they were but to act as a counteraction to this supposed evil-to say nothing of the incentive they would afford to many to be studious ? There were upwards of three hundred students in the anatomical classes last session, in which, I think, a few prizes might have been afforded. Bat it is not for the intrinsic value of the prize for which the student strives, but for the honour of its attainment; consequently, were the prizes but nominal they would be as efficacious. Another object of complaint is, that there is no class ex. aminations in anatomy! The advantages arising from class examinations are sufficiently obvious; therefore it will not be necessary for me to adduce any arguments in their favour. But, in conclusion, I will mention one, which is, that they incite many students to study, in order to cut a decent figure in the examinations, who might otherwise be indolent. Holywell House, June,
tS48.
medical News.
Benjamin Travers,
President of the Royal College of Surgeons.
John
Clendinning, M.D.,
Senior Censor of the Royal College of Physicians.
C.
Hue, M.D., Registrar.
THE PAYMENT OF SURGEON-SUPERINTENDENTS ON BOARD OF EMIGRATION SHIPS. To the Editor of THE LANCET.
SIR,—As the only real channel for medical abuses, I beg tc call your attention to the handsome remuneration offered by government to well-educated gentlemen, to take charge oi emigrants going out to Australia. How does this matter stand with regard to the most unfortunate, best worked, and worst paid profession, or calling, or trade, in the kingdom. First; one gets a free passage out, worth nothing, as Australia is not a colony adapted to a medical man as a medical man, Secondly, ten shillings per caput landed alive. Few of these emigrant vessels are 500 tons burthen; but allowing all to be so, and that they are full, and that they carry out their full complement-300, that gives £150 for the voyage: subtract from that the outfit necessary for a gentleman, cabin furniture and clothes, at least £70; passage home, (one man in fifty may be brought home free,) at the lowest £40; and if he has to buy his own medicines and instruments, £25 more at the least. So, on squaring accounts for a twelve-months’ voyage, he has the splendid sum of £15 for his use on shore, and to support himself waiting for a ship in Australia; and this, supposing he gets the largest size going out. Now, in the name of an insulted profession, is not this worth calling the attention of the House toThere is one remedy: the navy wants surgeons and cannot get them, but the emigrant-ships want them too.-With respect, I am, Sir, yours, C. P.S.-I am aware that all that is paid for each emigrant is X15 per head; but that is for a pauper one, herding in the fore-part of the vessel. UNIVERSITY OF EDINBURGH.—UTILITY OF SCHOLASTIC PRIZES. To the Editor of T]aE LANCET. SIR,—Knowing that you are ever an advocate of the in-
terests of the student,I trust that you will insert the following in a forthcoming number of your excellent journal, which will much oblige, Yours, most respectfully,
Civis.
____
I studied at the University of Edinburgh last session, and astonished to find, that in the anatomical department there were no prizes given, nor has been, since the election of was
APOTHECARIES’ HALL.—Names of gentlemen who passed their examination in the science and practice of medicine, and received certificates to practise, on Thursday, June 22nd, 1848:-Joseph Alfred Tapson, St. German’s, Cornwall; John Hendley; Frederic Hodson, Goole, Yorkshire; Samuel Elevin Brand ; Joseph Nash, Eden-bridge, Kent ; John Thomas Arlidge; Joseph Adolphus, Jamaica. REDUCTION OF A LUXATED THUMB BY MEANS OF A KEY.—M. ALABOISSETTE describes, in L’ Union IITedicale, a case of luxation of the thumb, which he reduced by using the ring of a key as a fulcrum, according to the advice given by M. Vidal (de Cassis) in his " Treatise on Surgery." The steps were the following:-The surgeon took a key, the stem of which was surmounted by a pretty wide ring, and introduced the thumb into the latter, so that the stem of the key was perpendicular to the external aspect of the thumb; the upper part of the ring lay on the superior and dorsal extremity of the phalanx, the lower part of the same ring resting on its inferior and anterior extremity. A tilting effort was then made with the key, which tended to exaggerate the displacement, in effecting, however, a certain degree of extension. The extremity of the thumb was then suddenly flexed and drawn forward, and the reduction was complete. No sign of the accident but alittle swelling was visible a week afterwards, and the patient was working, as previously, in the capacity of a weaver. THE MEDICAL AND SURGICAL INSTITUTE OF GLASGOW,3 meeting of which has been recently held, was established in the autumn of the year 1847. Patron, Sir B. C. Brodie, Bart.; honorary presidents, Dr. A. Buchanan, professor of the institutes of medicine in the University of Glasgow, and Dr. ill. S. Buchanan, professor of anatomy in the Andersonian UniGlasgow; vice-presidents, Dr. R. D. Thomson, professor of practical chemistry in the University of Glasgow, and Dr. A. Anderson, professor of the practice of physic in the Andersonian University. Honorary members are elected from gentlemen distinguished for professional and general information, and corresponding members from such ordinary members as have ceased to reside in Glasgow. To become an ordinary member, the candidate must have studied medicine, by classes or otherwise, for at least six months, and be recommended by a member, and approved of by three-fourths of the Society. The members of the Glasgow Medical Society, under certain limitations, generously presented to the Institute a portion of their library. The essays read before the Society during the past session have been on delirium tremens; cases of inguinal hernia, and fracture of the neck of£ the femur; on the cellular theory; inflammation; on the mesial operation for lithotomy, as proposed by Dr. A. Buchanan, and performed by him in the Glasgow Royal Infirmary; on the urine in diabetes; on phagedsenic ulceration; on the coagulation of the blood; apoplexy; the superiority of man
versity,