POOR-LAW MEDICAL REFORM.

POOR-LAW MEDICAL REFORM.

359 ward their own interests and those of the whole profession, and during six months. Surely an attendance on lectures, which that at little cost of ...

415KB Sizes 5 Downloads 121 Views

359 ward their own interests and those of the whole profession, and during six months. Surely an attendance on lectures, which that at little cost of time or trouble. Let the medical students qualities for all the English Universities and for the Colleges of at all the different schools in London, Edinburgh, Dublin, Physicians and Surgeons, might, one would think, be considered Glasgow, and Aberdeen, simply sign a declaration that they sufficient for the Naval Medical Service. I am, Sir, yours faithfully, will not enter themselves as candidates for the naval or miliM. R. C. S. October, 1861. tary services until the grievances of the medical officers are redressed, and the battle will be gained. If her Majesty’s WarP. S. -I have written to the Director-General of the Navy rant, as at first published, be only carried out, a career will at Medical Department, representing the facts of the case, and once be opened up to the ambition of young surgeons of good have received a reply to the effect that the regulations must be education and capacity, alike honourable and useful. The adhered to. Secretary for War is willing to aid us, and only requires a little pressure from without to give him a good excuse for setting POOR-LAW MEDICAL REFORM. aside the obstructions of the Horse-Guards. This done, the To the Editor of THE LANCET. Admiralty must follow suit. I am, Sir, yours truly, SIR,-Permit me through your columns to inform the PoorD. I. G. H. October, 1861. law medical officers, more especially of the metropolis, that the Fifth Report from the Select Committee on Poor Relief THE ARMY MEDICAL WARRANT OF 1858. (England) has been issued. It contains the whole of the minutes of evidence of Mr. Griffin of Weymouth, Dr. Rogers To the Editor of THE LANCET. of the Strand Union, and myself. SIR,-There have been of late many and bitter complaints I be permitted to observe, however, that the time and from army medical officers regarding the unjust efforts in high the may circumstances were unfortunate and unfavourable to us. of the and to those officers some of quarters deprive privileges summoned to attend, it was generally believed that part of the relative rank conferred upon them by the Medical Although the Committee would not have time to examine us, or to go at Warrant of 1858. Before the promulgation of that Warrant- all into the medical branch of the inquiry. Certain gentlemen all honoured be its promoters-the names of the army surgeons been delegated by the guardians of the Bristol Union to had were placed in the Army List, at the bottom of the list of evidence on that day, but, owing to their non-arrival in officers of each regiment. Well, Sir, the medical officers could give the medical witnesses were hurriedly called in to be exanot complain, for they had no relative rank; but the publication time, mined. Thus a subject, not only of anxiety and concern to the of the Royal Warrant gave army surgeons relative rank. over three thousand medical gentlemen, but also of vast imParagraph 17 of the Warrant reads as follows :of four millions of the poorer " Such relative rank to carry with it all pnecedence and portance both to the well-being of the country and to the pockets of the ratepayers population to the rank with which it advantages attaching corresponds of the whole kingdom, instead of receiving a complete and (except as regards the presidency of courts-martial, where our searching investigation, was compressed into the few remaining will and pleasure is that the senior combatant officer be always hours of the very last day’s sitting of the Committee. Medical president); and shall regulate the choice of quarters, rates of questions seem as much at a discount in the favour of a Parlialodging-money, servants, forage, fuel and light, or allowances mentary Committee-room, as in that of the body itself of the in their stead, detention and prize money. But when a mediof Commons. The members of the Committee soon cal officer is serving with a regiment or detachment, the officer House tired of Mr. Griffin’s voluminous evidence, which was ulticommanding, though he be junior in rank to such medical mately put in as read. Dr. Rogers and myself had to be con. officer, is entitled to a preference in the choice of quarters." There can be no mistaking the meaning of the above para- tent with the last few minutes of the last hour. My examina. tion did not commence till twenty-five minutes to four. Knowgraph as to the question of precedence; yet, Sir, at the present ing that it would be practically impossible to give, in twenty-five moment the medical officers occupy the same position in the the detailed evidence I had prepared, and to read the minutes, of List as did before the the Army they publication Royal documents and facts which had been furnished me in support Warrant, instead of having their names placed properly accord- of the statement by the metropolitan Poor law medical ing to their relative rank. This may appear at first sight to officers (vide THEadopted LANCET of May 18th last), I requested perbe of no importance, but it is of great moment to the medical mission (after answering a few questions) to be allowed to put officers, for the Army List is looked upon as an authority and in the aforesaid statement, as well as an abstract of the views officers treated with to the guide, respect according being embodied therein, with the understanding that my detailed their names in that list. place occupy evidence in support of the same should be taken in the next It may be, and probably is, that army surgeons are not in a session. when the Committee will. I believe. obtain nermission to of sufficient make their position independence complaints heard so as to obtain redress’ but there is a class of officers- to sit again. The statement and abstract therefore appear in this Report of the Committee. the volunteer surgeons-who are in a position of independence, I subsequently also obtained permission to deliver in a and possessing political influence which, if brought to bear memorandum, embracing in detail the views I was prepared to would the medical this upon army question, materially help evidence upon. This memorandum appears as an Apgive officers. I therefore would earnestly urge the volunteer medito the Report. I am sorry, however, to cal officers to assert in every instance their right to proper pendix (No. 2, p. 86) observe that not only have some verbal inaccuracies and some to their relative if rank, and, necessary, faulty arrangement of certain of the paragraphs crept therein, precedence according to carry the matter before Parliament. but owing to an omission in some portions of it, of some sheets I am, Sir. yours, &c., of my manuscript and tables, the sequence of the reading is in A VOLUNTEER SURGEON. October, 1861. some places rendered totally non-apparent, and the sense considerably obscured. This is owing to my not having been furMEDICAL STUDENTS AND THE ROYAL NAVY. nished with proof-sheets of the memorandum during its passage through the press. It appears that, unless the sanction of the To the ECZit09’ of THE LANCET. chairman of the Committee is first obtained, the parliamentary SIR,-Allow me to call attention, through your columns, to printers do not allow proof-sheets for correction. This unforthe singular position in which the students of the London tunately had not been done ; and shortly after the manuscript Schools of Medicine are placed with regard to appointments as memorandum was in the printer’s hands, the Right Hon. Chas. assistant-surgeons in the Royal Navy. The regulations of the P. Villiers had commenced his continental tour, and his sancAdmiralty require certificates of attendance on six months tion was not then obtainable. At page 89 the chief omissions courses of lectures on Materia Medica and Midwifery. Now, occur. The reader will readily surmise that after the paragraph as in none of the London Schools of Medicine are the courses of ending " convenient of access," should follow the " cases " lectures on the above subjects of more than three months’ dura. alluded to; and also that the next paragraph should have comtion, a student who has attended the customary courses of lec- menced with the assertion that " in the metropolis the distance tures, and qualified himself for any of the other English Exa- between the poor and the relieving officer, &c., is, as a rule, not mining Boards and for the Medical Department of the Army, too great." A great quantity of important manuscript (with finds himself at the end of his career debarred from entering many tables) has unfortunately been omitted after the parathe navy unless he can wait until the end of another year in graph in the next column of page 89, which ends with the order to attend the extra courses of lectures. The Scotch words "by the case." 1 here demonstrated the want of unistudents are in a better position, as in the Scotch Universities formity and equality in the salaries (amongst others) of the the lectures on Materia Medica and Midwifery are delivered district medical officers of the three City unions. I also stated

I

.

I

To thecall attention,through

toI

360 how the application of these officers of the East London Union for an increase of salary was met at their board by a return,

which was absorbed acted on the kidneys, producing increased quantity of urine, strongly scented with the liquid swallowed. Petroline and paraffin are to be found in every cottage, and accidents of the kind I relate are very likely to occur, so that it may be well worth while knowing whether they contain anymore poisonous than their relatives, turpentine and naohtha. I am. Sir. vours very trulv. JAMES SHEPHERD, M.R.C.S. Swansea, October, 18tH.

quantity an

showing the rate per head, of the sums paid for medical relief on the population of several metropolitan unions and parishes.

This preamble is absolutely necessary to render intelligible the succeeding paragraph, which is, however, a part only ef my illustration of the fallacy of thus computing medical salaries. At page 93 the reader will also detect the absence of a reqnisite preamble to the last paragraph of the first column, commencing "In every case." In the second column there is also entirely omitted before "3. Pauper Lunatics," No. "2,"case in point-viz., Ody versus the Harborough Guardians, as detailed in THE LANCET of January 31st, 1857. The verbal inaccuracies and the faulty arrangement of some of the paragraphs will at once strike the reader without my occupying

thing

THE DEGENERATION OF RACE. To the Editor

of

THE LANCET.

SIR,-I quite agree with Mr. Anderson Smith, that his assertions are in accordance with the authors he mentions, and I can bear testimony to the erroneousness of their statements,

further space with their enumeration. It will be for the Committee of the Metropolitan Poor-law Medical Officers to determine whether or no it will be advis- and should recommend him to peruse instead " Grant’s Origin able to furnish the parliamentary Poor-law Committee next and Descent of the Gael," "Stewart’s Sketches of the Highsession with these details and facts that have been omitted. landers,"and "Gregory’s History of the Highlands and Isles," Owing to the lateness of the session when the medical evi- where he can learn that Highlanders, more or less, have sucdence was received, it was not considered desirable to present cessively had, since the coalescing of the Caledonian, Pict, to either of the Houses of Legislature the petitions agreed upon Briton, and Scot, an infusion of Danish, Saxon, and Norman at the general meeting of the Metropolitan Poor-law Medical blood. There is an almost pure Saxon race, Gaelic speaking, in Officers on the 10th of May last. These petitions embody the Aberdeenshire; the island of Lewis, Caithness, and Sutherlandstatement (which appears in the aforesaid Appendix) which shires are strongly tinctured by the Dane; while a great extent of Highland territory is owned by Norman chieftains, with was adopted at the meeting at the rooms of the Royal Medical Benevolent College. The petitions are still in circulation for Celtic followers, as we find graphically sketched in "Burton’s of Lord Lovat." What does Mr. Anderson Smith say of signatures, and will be presented at the next session of Parlia- Life the Clan Chattan, who are not certain what name they might ment. I will, in conclusion, take this opportunity of drawing the not admit as one of themselves-they know about thirty, the grave attention of the whole body of the Poor-law medical ubiquitous name Smith being one of them? It was not unofficers to this very important fact. From the remarks of the common, as it might best suit the interests of the party conchairman, made both to Mr. Griffin and myself, it is evident cerned, to assume the mother’ssurname. as the celebrated Rob there is, and tvill be, a very strong endeavour on the part of Roy, who, though a McGregor, styled himself Campbell, and the guardians to obtain the annulling of the permanency of our the present Lord Clyde suppressed his father’s name, which is appointments. It is well known that many of the boards of l1cLiver, for Campbell, the maternal name, to gratify maternal guardians are in opposition to a continuance of the present friends, who could best forward his interests. Myself a native, the descendant of a Norman family 70 0 powers of the board above. Unless, therefore, great care and exertions are used during the recess by the medical officers, we years in the Highlands, always resident, conversant with the may find tha.1 the results of the Committee’s la.broirs will belanguage, familiar with the habits, intimately acquainted with a in which the annual appointment of all the the customs and manners, and practising amongst the Gael, I officers of the union will be thrown in by the Poor-law Board am of opinion my authority should stand as high with the as a " sop in the pan," to mitigate and appease the antagonism medical profession as obscure Holinshed, who spoke Gaelic like of the guardians to the re-obtainment of the protective powers a parrot, judged from appearance, and chronicled from fabulous I am, Sir, your obedient servant, of Gwydyr House. lore; or Macaulay, who deservedly stands as one of the most brilliant writers of the age, yet often proceeds upon data at the ROBT. FOWLER, M.D. Edin., Hon. Secretary to the Cummittee of the Metropolitan best doubtful, often not true; and it is notorious that his Poor-law Medical Officers. accounts of the Highlanders are applicable only to the Sept Bishopsgate-street Without, Oct. 1861. Macaulay found in the Western Isles, but never recognised as a clan bv Highlanders. While the Census shows the actual state of population, it UMBILICAL HÆMORRHAGE. along with other statistics, accounts for the decrease of To the ,Editor of THE LANCET. population in the rural districts of Scotland, and the Highland SIR,-Seeing an account of a case of Umbilical Hœmorrhage, counties more particularly. In the face of these, it is absurd by M. Homolle, quoted in your last impression, I am induced in the extreme to insinuate that the Scotch, much less the to report a very similar one which occurred in my practice Celtic portion of the Scottish population, is stationary. a short time ago. Emigration, depopulation, and centralization have certainly Mrs. S-, about forty-two years of age, the mother of four told upon the rural districts, but they flourish in our colonies. living children, was confined on September 17th. Her labour In the county of Glengarry, Canada, there are 30,000 of the was slow from want of uterine power, and the child, though name McDonald, not to speak of other names, besides the lively and active, was smaller than usual. There was extensive multitudes in British North America generally, Australia, and Zealand. Neither these nor war have interfered with St. fatty degeneration of the placenta and funis. The child got on very well for three or four days, when oozing of blood took Kilda, and it is stationary more so than France, and till within place from the funis (not as yet thrown off) close to the abdo- the memory of man it was the ideal of Mr. Anderson Smith’s A ligature was passed close to the abdominal wall, and representation of the Gael, and still is so, and was also a men. a pledget cf lint, saturated with perchloride of iron, was firmly stranger to religion, education, and civilization. I still affirm pressed to the part, and retained by adhesive plaster round the that Highland chiefs are becoming few from causes similar to The bleeding ceased for some hours ; but afcerwards re- those affecting the aristocracy in general. Although, as a commenced from the same place, and also from the right upper seneral rule. thev do not intermarrv into their own clan. the as a whole, being limited, in course of time, eyelid and behind the left ear. Several dark stains like those families of of ecchymosis also appeared on different parts of the body. like the bourgeoisie of Berne, they have more or less become The child sank from debility, induced by loss of blood, and consanguineous. in the structure No doubt the female has great influence over progeny, and died at the end of six days. The fatty of the placenta was well marked, and I have no doubt was the one fact is worth a thousand theories. The intelligent farmer, direct cause of the malnutrition of the child, and the conse- intent on improving his returns, feeds and rotates the mother earth, and periodically substitutes strange seed. The breeder quent hœmorrhagic diathesis. As I have my pen in hand, I should like to ask some of your of stock also changes the male propagator, substituting an chemical readers, what is the petroline of commerce, and what entire stranger; otherwise both farmer and breeder would see effects might be expected to arise from its internal administra- their stocks deteriorating and running out. By analogy, we tion ? The question is suggested by the fact of my having might infer that inbreeding would produce the same results in been summoned a few nights ago to a woman, who had taken the human species, as it really does, and of which an unpreby mistake about a wineglassful of petroline. Vomiting was judiced mind can, by observation, be fully convinced by speedily induced, but no bad symptoms followed. The smallabundant proof amongst society in general; and notwithstanding

compromise,

,

also,

iNew



body.

chiefs,

change