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SOCIAL SCIENCE ASSOCIATION.
776 ease appeared to attain its maximum, upwards of 60C against whose interests it would be his duty to take patients being under treatment at one time in the hos. action. Dr. Stallard bore testimony to Mr. Chadwick’s invaluable pitals, with a weekly admission of nearly 150 fresh cases, and a total of nearly 2000 patients having passed through the sanitary labours, but felt bound to differ from him on nearly every point. If the Government undertook the appointhospitals up to the end of May. "From this date the disease began to abate, and with ment of local officers they would diminish the responsibility the additional relief afforded after the second week in May of the local authorities, and assume that which they could by the use of the hospital ship Dreadnought, the number of by no possibility fulfil. The effect of electing men exclupatients was so far lessened as to enable the committee, to- sively to public civil service would be to provide either an wards the end of July, to reduce the beds from 620 to 450, introduction for young and inexperienced members of the with a corresponding reduction in the staff; and by the end profession or a refuge for those who had failed in practice. of September the Fever Hospital was emptied of patients, Such men would be more completely the tools of the local and its cleansing and disinfection for the reception of fever authority than those who had a private practice to fall back patients proceeded with. upon, and who had a moral weight in the community-in Scarcely, however, had this been completed, and the hos- fact, a character to lose. He denied entirely that the poor pital prepared for its original purpose, than a fresh outbreak were sacrificed. Medical officers with any regard to their of small-pox towards the end of December, in the southern reputation and interests were compelled to attend to the district, rendered it necessary again to have recourse to pauper before the private patient. The former has no the employment of a portion of the hospital for the treat- one but the Poor-law medical officer to go to. He is the ment of small-pox cases, in order to avoid the necessity of protégé of the whole community. But the private patient sending acute cases on so long a journey as to Hampstead can pay for another attendant, and no one would sympathise with him if he neglected to procure advice from some Hospital. 11 From 31st January, 1871, to the 1st February, 1872, one else. The costliness of a civil medical service would be a total of 3976 patients passed through the hospitals, of a main objection to its adoption, for it is obvious that in
whom 700 or 176 per cent. have died; and, as showing the extent to which the convalescent accommodation provided by the managers was turned to account from the Stockwell Hospitals, it may be mentioned that upwards of 900 convalescents were transferred therefrom. "The daily cost per head for the maintenance and clothing of patients during the half-year ending Lady-day, 1871, was 2s. 22d., and for the maintenance and salaries of officers, &c., during the same period, 2s. ld., but for the half-year ending Michaelmas these charges had been reduced respectively to ls. 2½d, and 10d. per head. "The first, and perhaps most serious, trouble with which the committee have had to contend was the difficultyexperienced at the outset in getting suitable nurses. Doubtless the loathsome nature of the disease, as well as its contagious character, had the effect of deterring the better class of nurses from entering on the work, but as it became known that, owing to the protection afforded by carrying out a careful system of revaccination, the staff of the hospitals enjoyed almost a complete immunity from the disease, very suitable women presented themselves, and the committee have been enabled from time to time so to weed out’the indifferent nurses with whom they at first had to be contented, that they at present possess a staff which will favourably bear comparison with that of any hospital in the country." The committee appear to have had some trouble in officering the Fever Hospital, but it is gratifying to find that they record their entire satisfaction with the way in which the officers of the Small-pox Hospital, Drs. McCann, White, and McKellar, discharged their onerous duties.
SOCIAL SCIENCE ASSOCIATION. ON
Monday evening
a
paper
was
read
by
Edwin Chad-
wick, Esq., C.B., " On the Duties of Medical Officers of Health, and the separation of Private Practice from Public Medical Service." Mr. Chadwick referred all the defects of the Poor-law medical arrangements to the union of public and private practice, and he advocated the employment of a special class of civil medical officers devoting the whole of their time to attendance upon the poor, the prevention of disease, the registration of disease and the causes of death, attendance on prisoners, supervision of factories, He proposed that this class of schools, workshops, &c. civil servants should be appointed by the central government by competitive examination, and that their rate of pay should be fixed on the scale now given to the army surgeons. He strongly denounced the payment of extra fees for midwifery, and said that difficult cases were sure to be more numerous amongst paupers whilst there was attached to them a fee which was of importance to the ill-paid officers. The present system led to actual neglect of the poor which had been concealed from official inspection, and there could be no hope of the private practitioner doing good sanitary work until he was made thoroughly independent of those
many districts it would be a waste of power to have one attendant for the poor and another for the public at large. With regard to the general imperfection of the Poor-law service, he would remind the lecturer that no attempt had been made to inspect or improve it. The whole medical administration had been left to the ignorance and cupidity of boards of guardians, and he would point out that the effect of establishing dispensaries in the metropolis had been to diminish greatly nearly all the evils of which the lecturer complained. With regard to the competence and independence of the medical officer, we must rely upon the general improvement of medical education and the advance of public opinion with regard to sanitary reform. No compulsory system would make things perfect all at once, and the officer who tried to maintain his independence at the cost of cordiality with those with whom he is compelled to act, would find that he was obstructing instead of advancing the progress of sanitary improvement. Mr. Holland, Mr. Fred. Hill, and Mr. Michael, Q.C., all spoke against Mr. Chadwick’s proposals, and letters to the same effect were read from Dr. Druitt and Professor Gairdner of Glasgow, the latter saying that he owed a great part of his sanitary power to the fact that he was able to utilise the experience and influence acquired in the general practice of his profession.
ST. THOMAS’S HOSPITAL OLD STUDENTS’ BIENNIAL FESTIVAL. ON Tuesday evening, May 28th, a large number of old and present students dined together at the Cannon-street Hotel, the chair being taken by Dr. Risdon Bennett. After the conclusion of the dinner, which was admirably served, and which was enlivened by the band of the Coldstream Guards, the Chairman proposed The Queen and the Royal Family." To the toast of The Hospital of St. Thomas" Sir Francis Hicks responded, and expressed his anxiety to promote the welfare of the school as well as the hospital. The Chairman next proposed 11 The School of St. Thomas’s Hospital, past, present, and future." He was listened to with marked attention, and his speech was frequently interrupted with applause. He was particularly well received when he dwelt upon the importance of clinical instruction, and the advisability of students becoming acquainted with the minor subjects of professional studies before coming to the hospital. Mr. Gibson responded °‘ for the Past" in a speech which created considerable amusement. " For the Present," the Dean, Dr. Peacock, replied ; and " for the Future," Mr. Mac Cormac made an excellent and most humorous speech. Mr. Le Gros Clark received a complete ovation when he rose to propose the health of the chairman. He referred in feeling terms to the friendship which had existed for so many years between himself and the chairman, and urged "
-
"
whom 700 or 176 per cent. have died; and, as showing the extent to which the convalescent accommodation provided by the managers was turned to account from the Stockwell Hospitals, it may be mentioned that upwards of 900 convalescents were transferred therefrom. "The daily cost per head for the maintenance and clothing of patients during the half-year ending Lady-day, 1871, was 2s. 22d., and for the maintenance and salaries of officers, &c., during the same period, 2s. ld., but for the half-year ending Michaelmas these charges had been reduced respectively to ls. 2½d, and 10d. per head. "The first, and perhaps most serious, trouble with which the committee have had to contend was the difficultyexperienced at the outset in getting suitable nurses. Doubtless the loathsome nature of the disease, as well as its contagious character, had the effect of deterring the better class of nurses from entering on the work, but as it became known that, owing to the protection afforded by carrying out a careful system of revaccination, the staff of the hospitals enjoyed almost a complete immunity from the disease, very suitable women presented themselves, and the committee have been enabled from time to time so to weed out’the indifferent nurses with whom they at first had to be contented, that they at present possess a staff which will favourably bear comparison with that of any hospital in the country." The committee appear to have had some trouble in officering the Fever Hospital, but it is gratifying to find that they record their entire satisfaction with the way in which the officers of the Small-pox Hospital, Drs. McCann, White, and McKellar, discharged their onerous duties.
SOCIAL SCIENCE ASSOCIATION. ON
Monday evening
a
paper
was
read
by
Edwin Chad-
wick, Esq., C.B., " On the Duties of Medical Officers of Health, and the separation of Private Practice from Public Medical Service." Mr. Chadwick referred all the defects of the Poor-law medical arrangements to the union of public and private practice, and he advocated the employment of a special class of civil medical officers devoting the whole of their time to attendance upon the poor, the prevention of disease, the registration of disease and the causes of death, attendance on prisoners, supervision of factories, He proposed that this class of schools, workshops, &c. civil servants should be appointed by the central government by competitive examination, and that their rate of pay should be fixed on the scale now given to the army surgeons. He strongly denounced the payment of extra fees for midwifery, and said that difficult cases were sure to be more numerous amongst paupers whilst there was attached to them a fee which was of importance to the ill-paid officers. The present system led to actual neglect of the poor which had been concealed from official inspection, and there could be no hope of the private practitioner doing good sanitary work until he was made thoroughly independent of those
many districts it would be a waste of power to have one attendant for the poor and another for the public at large. With regard to the general imperfection of the Poor-law service, he would remind the lecturer that no attempt had been made to inspect or improve it. The whole medical administration had been left to the ignorance and cupidity of boards of guardians, and he would point out that the effect of establishing dispensaries in the metropolis had been to diminish greatly nearly all the evils of which the lecturer complained. With regard to the competence and independence of the medical officer, we must rely upon the general improvement of medical education and the advance of public opinion with regard to sanitary reform. No compulsory system would make things perfect all at once, and the officer who tried to maintain his independence at the cost of cordiality with those with whom he is compelled to act, would find that he was obstructing instead of advancing the progress of sanitary improvement. Mr. Holland, Mr. Fred. Hill, and Mr. Michael, Q.C., all spoke against Mr. Chadwick’s proposals, and letters to the same effect were read from Dr. Druitt and Professor Gairdner of Glasgow, the latter saying that he owed a great part of his sanitary power to the fact that he was able to utilise the experience and influence acquired in the general practice of his profession.
ST. THOMAS’S HOSPITAL OLD STUDENTS’ BIENNIAL FESTIVAL. ON Tuesday evening, May 28th, a large number of old and present students dined together at the Cannon-street Hotel, the chair being taken by Dr. Risdon Bennett. After the conclusion of the dinner, which was admirably served, and which was enlivened by the band of the Coldstream Guards, the Chairman proposed The Queen and the Royal Family." To the toast of The Hospital of St. Thomas" Sir Francis Hicks responded, and expressed his anxiety to promote the welfare of the school as well as the hospital. The Chairman next proposed 11 The School of St. Thomas’s Hospital, past, present, and future." He was listened to with marked attention, and his speech was frequently interrupted with applause. He was particularly well received when he dwelt upon the importance of clinical instruction, and the advisability of students becoming acquainted with the minor subjects of professional studies before coming to the hospital. Mr. Gibson responded °‘ for the Past" in a speech which created considerable amusement. " For the Present," the Dean, Dr. Peacock, replied ; and " for the Future," Mr. Mac Cormac made an excellent and most humorous speech. Mr. Le Gros Clark received a complete ovation when he rose to propose the health of the chairman. He referred in feeling terms to the friendship which had existed for so many years between himself and the chairman, and urged "
-
"