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NOTICE OF A "HOAX."
319 It is not only with the indications above adverted to, that catheterism is employed. I have long viewed the condition of the mucous lining of the naial and Eustachian passage in cases of deafness as closely analogous to a certain morbid condition of the urethral passage. Nobody disputes the value of bougies in rectifying such a departure from the healthy function in the latter, neither will they be disappointed in the judicious use of the Eustachian catheter, with the catgut or whaiebone bougie in the former, class of maladies. I
am,
Savile-row, March,
Sir,
vour very
1550.
obedient serv:mt, JAMES YEARSLEY.
NOTICE OF A "HOAX." To the Editor of THE LANCET. you kindly grant me a corner of your valuable
SIR,—Will to give publicity to a hoax which has been practised upon myself, and (judging from the number of mespace
medical another that which the
officer of this union, attended for me, and did urgency of the case required. I saw her myself the following day ; she was then suffering from haemorrhage, but to a much less extent; premature expulsion had taken place, and ultimately she did well. In your regulations, articles 182 it is provided that in all ordinary cases ..f a puerperal & 183, character, in which the attendance of the medical officer is required, he shall receive a fee not exceeding twenty shillings, but in extraordinary eases, where any especial difficulty may have occurred, he shall be ent tied to two pounds. To prevent any dispute arising out of the difficulty of defining to the satisfaction of the -,:iard;.ii)s what a difficult case really is, a mutual arrangement has long since existed between this board and their iiiel cal officer:., that all puerperal cases shall be charged for, indiscriminately, twenty shillings each. By this agreement, which has now been acted on f.’r many years much dispute has been prevented, though, at the same time, I must remark,
on
probahiy
officers have thereby deprived themselves of nearly the medical half the of fees, which, bv your regulations, they summoned to)
amount one I met at the door of the house I was would otherwise have been entitled to, inasnmch as in this uuion upon many others. My object in making this cowardly jest known to my professional brethren is to warn them, and save midwives are so generally employed, that rarely, except in cases them annoyance. I received, on the 25th inst., a note, stating of urgent difficulty and danger, do poor women require their serthat my professional attendance was required by a lady, whose vices. This, then, being the state of things. I was, I confess, much name was given in full, at her house iu Hyde-park-place an official communication from the clerk of surprised I at seven in the went, West, evening, precisely. though this union,at receiving that the item of twenty shillings contained in s’a:ing, that and several and found greatly inconvenienced, myself others had been victimized. My first thought was to hurry my bill of extras, for attendance on the above-named case, had home as quickly as possible, fearing the rascal who had sent been disallowed. The guardians, as I have since been informed, the note might harass my family during my absence. This through a personal communication with them, believe that your had happily not been the case; and the party must be put regulations do not authorize any extra payment whuteverfor down more as a fool than a knave. At all events, if you will attendance on women in the pregnant stale, under any circumstances have the kinduess to insert this letter, it may have the effect or emergency, prior to the period of seaen months, tit which tirne a of preventing similar tricks being played upon my professional possibility exists of bringing forthlioiny child. I cannot but suppose your meaning has here been misconbrethren. I send my name and address, and remain, strued. It is possible that the term "childbirth," as I have given liespectfully yours, it, may be objected to in the case; but would the substitution of M. D. Feb. 25, 1850.
dical
men
CORRESPONDENCE WITH THE POOR-LAW COMMISSIONERS. To the Editor of TaE LANCET. STR,—Ibeg to enclose to you the copy of a correspondence recently had with the Central yPuor-Iaw Board, on the subject of claim I made on the guardians of the Weoht’-y Uitioii, for attendance on a case of uterine haemorrhage, accompanied with miscarriage. It is necessary to observe, that considering it as having been a case involving the same amount of trouble and responsibility as one of actual chitjbirth, I cbssed it in my bill of extras as chargeable under that category, with the full impression, grounded on the repeated decisions given in favour of Mr. llayner’s demands against the Eton Union, that any malady consequent on the pregnant state, conjoined with foetal occurring at any period of pregnancy, for which (as in this instance) the attendance of the medical officer may be required, should he considered as a pu rperal malady, and charged for as such. The authorities at Somerset House, however, appear to mainttin a different opinion, and do not evt-n intima’e that I am entitled to the extra remuneration, which, under the circum181, tit stances, and by their own regulations, articles 172& might at all events have reasonably been expected I should be. A tolerable share of private practice has euabled me, for nearly fourteen ears, to hold the office of poor-law surgeon, buoyed up from time to time with the hope and expectation that justice would eventually be meted out to us in some sh.ipe, but, alas! the . 4’ good time" does not come, and many of my professional brethren to sink into their are, I fear, doomed, from age and graves, unrequited even by the much-talked of superannuationi allowance, the mighty and slorious sounds of which come booming from afar.-I am. Sir. your obedient servant. JOHN S. PALMER. Weoblcy, Feb. 27, 1850. a
expulsion,
t
infirmity,
,
’
To the Poor-law
GENTLEMEN,—As
one
r
Comumissioners, Somerset House. of the medical officers of the Weobley
U nioll. I take the liberty of requesting your decision
lowing
case, for attendance
on
on
the
fol-
which, the Board of Guardians
(although they appear to consider I am moral!y en:itled to extra remuneration) are doubtful whether, by your regulations, they
allow it. pauper, residing three mi!es distant from my husband was iii, and in receipt of relief at the residence, time,) in the fifth month of pregnancy, was afflected with uterine hæmorrhage to an alarming extent, tor which my assistance was immediately required. Being from home at the time, Mr. Lomax, are
empowered to Davas, a
Sarah
(whose
the tt-rms abortion, or premature labour, for that of childbirth, red:.:ce the vulue of the service renderered? what, I would ask, has the life or death ot the child to do in regulating the amount of skill and labour requisite to save the lite of the mother, which may possibly be in jeopardy during any period of pregnancy? 1 submit to your consijeration ttie fact that such cases are frequently occurring, fraught with urgent danger, calling for the most prompt, decisive’, and energetic treatment on the part of the medical officer,without which the patient might be lost. Such are not ordinary cases, to be visited at a convenient opportunity, but catts that must be responded to on the instant, either by day or night, be the hour or distance what it may. I beg leave to quote, as some authority, the written opinion of one of the first accoucheurs in Europe on the subject of uterine haemorrhage. He says: ’’ There is no disease to which the practitioner can be called, in which he has greater re,ponsibility than in uterine hæmorrhage; the most prompt and decided means His mu’t be used; the most patient attention must be bestowed. oe n reputation, his peace mind, the life of his patient, are all ut stake!" the cases of ordinary illness attended annually within "!y utstriet, would bring them to 2s. 6d. per case, or thereabout. I think it will be conceded that such a sum is not too much for attendance on the most insignificant malady. Can it then be considered suflicient remuneration for the case in question ? In conclusion, I beg to say, that notwithstanding it may be a question, as to whether cases of abortion and premature labour can be strictly comprehended under the term childbirth, yet, where such cases occur, attended with s)’mptoo’s threatening the life of the patient, eaihng for the instant attention of the medical officer, and subjecting him (it may t.e at any hour) to a very painful and responsible position, involving loss of time, rest, and the exercise of his skill and judgment, during much anxiety of mind, such cfiicer is entitled to expect reasonable compensation, and I believe that by articles 172 & 181, contained in your regulations, the guardians are therein empowered to grant it him. - Respectfully requesting your decision on this matter, I have the honour to be, Gentlemen, your obedient servant, J. S. PALMER. Weobley, Jan. 29,1850.
of
Averaging
Weobley Union, Jan. 29. J850. MY MY LORDS AND GENTLEMEN,—I am directed by the Board of Guardians of this Unio:i to be the medium of transmitting to you the enclosed letter from Mr. Palmer, their medical officer for the Dilwyn district, relative to the board declining to pay him the usual fee as in a case of childbirth, for a case, the board has beeit informed by the pauper herself, was one of miscarriage, and for the board believe they are not empowered by your general
which
am,
Savile-row, March,
Sir,
vour very
1550.
obedient serv:mt, JAMES YEARSLEY.
NOTICE OF A "HOAX." To the Editor of THE LANCET. you kindly grant me a corner of your valuable
SIR,—Will to give publicity to a hoax which has been practised upon myself, and (judging from the number of mespace
medical another that which the
officer of this union, attended for me, and did urgency of the case required. I saw her myself the following day ; she was then suffering from haemorrhage, but to a much less extent; premature expulsion had taken place, and ultimately she did well. In your regulations, articles 182 it is provided that in all ordinary cases ..f a puerperal & 183, character, in which the attendance of the medical officer is required, he shall receive a fee not exceeding twenty shillings, but in extraordinary eases, where any especial difficulty may have occurred, he shall be ent tied to two pounds. To prevent any dispute arising out of the difficulty of defining to the satisfaction of the -,:iard;.ii)s what a difficult case really is, a mutual arrangement has long since existed between this board and their iiiel cal officer:., that all puerperal cases shall be charged for, indiscriminately, twenty shillings each. By this agreement, which has now been acted on f.’r many years much dispute has been prevented, though, at the same time, I must remark,
on
probahiy
officers have thereby deprived themselves of nearly the medical half the of fees, which, bv your regulations, they summoned to)
amount one I met at the door of the house I was would otherwise have been entitled to, inasnmch as in this uuion upon many others. My object in making this cowardly jest known to my professional brethren is to warn them, and save midwives are so generally employed, that rarely, except in cases them annoyance. I received, on the 25th inst., a note, stating of urgent difficulty and danger, do poor women require their serthat my professional attendance was required by a lady, whose vices. This, then, being the state of things. I was, I confess, much name was given in full, at her house iu Hyde-park-place an official communication from the clerk of surprised I at seven in the went, West, evening, precisely. though this union,at receiving that the item of twenty shillings contained in s’a:ing, that and several and found greatly inconvenienced, myself others had been victimized. My first thought was to hurry my bill of extras, for attendance on the above-named case, had home as quickly as possible, fearing the rascal who had sent been disallowed. The guardians, as I have since been informed, the note might harass my family during my absence. This through a personal communication with them, believe that your had happily not been the case; and the party must be put regulations do not authorize any extra payment whuteverfor down more as a fool than a knave. At all events, if you will attendance on women in the pregnant stale, under any circumstances have the kinduess to insert this letter, it may have the effect or emergency, prior to the period of seaen months, tit which tirne a of preventing similar tricks being played upon my professional possibility exists of bringing forthlioiny child. I cannot but suppose your meaning has here been misconbrethren. I send my name and address, and remain, strued. It is possible that the term "childbirth," as I have given liespectfully yours, it, may be objected to in the case; but would the substitution of M. D. Feb. 25, 1850.
dical
men
CORRESPONDENCE WITH THE POOR-LAW COMMISSIONERS. To the Editor of TaE LANCET. STR,—Ibeg to enclose to you the copy of a correspondence recently had with the Central yPuor-Iaw Board, on the subject of claim I made on the guardians of the Weoht’-y Uitioii, for attendance on a case of uterine haemorrhage, accompanied with miscarriage. It is necessary to observe, that considering it as having been a case involving the same amount of trouble and responsibility as one of actual chitjbirth, I cbssed it in my bill of extras as chargeable under that category, with the full impression, grounded on the repeated decisions given in favour of Mr. llayner’s demands against the Eton Union, that any malady consequent on the pregnant state, conjoined with foetal occurring at any period of pregnancy, for which (as in this instance) the attendance of the medical officer may be required, should he considered as a pu rperal malady, and charged for as such. The authorities at Somerset House, however, appear to mainttin a different opinion, and do not evt-n intima’e that I am entitled to the extra remuneration, which, under the circum181, tit stances, and by their own regulations, articles 172& might at all events have reasonably been expected I should be. A tolerable share of private practice has euabled me, for nearly fourteen ears, to hold the office of poor-law surgeon, buoyed up from time to time with the hope and expectation that justice would eventually be meted out to us in some sh.ipe, but, alas! the . 4’ good time" does not come, and many of my professional brethren to sink into their are, I fear, doomed, from age and graves, unrequited even by the much-talked of superannuationi allowance, the mighty and slorious sounds of which come booming from afar.-I am. Sir. your obedient servant. JOHN S. PALMER. Weoblcy, Feb. 27, 1850. a
expulsion,
t
infirmity,
,
’
To the Poor-law
GENTLEMEN,—As
one
r
Comumissioners, Somerset House. of the medical officers of the Weobley
U nioll. I take the liberty of requesting your decision
lowing
case, for attendance
on
on
the
fol-
which, the Board of Guardians
(although they appear to consider I am moral!y en:itled to extra remuneration) are doubtful whether, by your regulations, they
allow it. pauper, residing three mi!es distant from my husband was iii, and in receipt of relief at the residence, time,) in the fifth month of pregnancy, was afflected with uterine hæmorrhage to an alarming extent, tor which my assistance was immediately required. Being from home at the time, Mr. Lomax, are
empowered to Davas, a
Sarah
(whose
the tt-rms abortion, or premature labour, for that of childbirth, red:.:ce the vulue of the service renderered? what, I would ask, has the life or death ot the child to do in regulating the amount of skill and labour requisite to save the lite of the mother, which may possibly be in jeopardy during any period of pregnancy? 1 submit to your consijeration ttie fact that such cases are frequently occurring, fraught with urgent danger, calling for the most prompt, decisive’, and energetic treatment on the part of the medical officer,without which the patient might be lost. Such are not ordinary cases, to be visited at a convenient opportunity, but catts that must be responded to on the instant, either by day or night, be the hour or distance what it may. I beg leave to quote, as some authority, the written opinion of one of the first accoucheurs in Europe on the subject of uterine haemorrhage. He says: ’’ There is no disease to which the practitioner can be called, in which he has greater re,ponsibility than in uterine hæmorrhage; the most prompt and decided means His mu’t be used; the most patient attention must be bestowed. oe n reputation, his peace mind, the life of his patient, are all ut stake!" the cases of ordinary illness attended annually within "!y utstriet, would bring them to 2s. 6d. per case, or thereabout. I think it will be conceded that such a sum is not too much for attendance on the most insignificant malady. Can it then be considered suflicient remuneration for the case in question ? In conclusion, I beg to say, that notwithstanding it may be a question, as to whether cases of abortion and premature labour can be strictly comprehended under the term childbirth, yet, where such cases occur, attended with s)’mptoo’s threatening the life of the patient, eaihng for the instant attention of the medical officer, and subjecting him (it may t.e at any hour) to a very painful and responsible position, involving loss of time, rest, and the exercise of his skill and judgment, during much anxiety of mind, such cfiicer is entitled to expect reasonable compensation, and I believe that by articles 172 & 181, contained in your regulations, the guardians are therein empowered to grant it him. - Respectfully requesting your decision on this matter, I have the honour to be, Gentlemen, your obedient servant, J. S. PALMER. Weobley, Jan. 29,1850.
of
Averaging
Weobley Union, Jan. 29. J850. MY MY LORDS AND GENTLEMEN,—I am directed by the Board of Guardians of this Unio:i to be the medium of transmitting to you the enclosed letter from Mr. Palmer, their medical officer for the Dilwyn district, relative to the board declining to pay him the usual fee as in a case of childbirth, for a case, the board has beeit informed by the pauper herself, was one of miscarriage, and for the board believe they are not empowered by your general
which