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THE CERTIFICATE SYSTEM—ATTENDANCE OF STUDENTS AT THE GLASGOW INFIRMARY.
PROFESSIONAL
ETIQUETTE.-THE CERTIFICATE SYSTEM.
77
proclaim anatomy, and physiological said, in such a case he would hesitate. I then departed, and and chemical science, and clinical observation, as constitut- left him to reflect on the conduct of a surgeon who dared to uphold his dignity. ing our peculiar claims to public confidence. Is it too much Now I will not say, are such practices respectable; but I to ask of the Legislature that no one be allowed to practise ask, in sadness, are such practices current1 Do they tend to raise medical men in the estimation of the public, or do they medicine, unless he have studied anatomy, physiology, and not facilitate the degradation of the profession ? Is it for the pathology; the structure and functions of the machine, the advantage of patients to disturb their confidence by the disorders of which he would r epair ?-? Is it too much to obtrusive and furtive visits of a stranger in the dead of night!a Or is it honourable to the profession of physic to be merely hope that the public will eventually learn that such know- actuated by the lucrun2 accessell8, forgetful of what is due to the professor of medicine, or even self-respect. ledge is required for such an office ? On the principle " the doctor" propounds, five or six physicians might all arrive on the same errand, and some might
practitioner."
Let
us
feel it awkward to retire without a fee; but Dr. Blundell pocketed his _feliciter° illi cedat.-Yotirs much obliged, MICHAEL K. O’SHEA, M.R.C.S.E.
PROFESSIONAL ETIQUETTE. " Metuone quam fraudem fransus sit."
in-B
I claim your notice in the present Mine is not a private quarrel; it embraces the d,ignity of the profession, the advantage of the public, the THE CERTIFICATE SYSTEM—ATTENDANCE OF safety of patients, and the convenience of practitioners at STUDENTS AT THE GLASGOW INFIRMARY. large. If it were a mere question of obtrusion on a private patient I should not trouble you with my plaint, but the To the Editor of THE LANCET. doctrine enunciated by the party implicated involves the SIR,-Knowing your sincere desire for the reformation of respectability of the entire profession, and the mutual cour- every evil connected with the medical profession, I have taken tesy and gentlemanly bearing which should exist between the liberty of pointing out to you what I imagine to be an physicians and surgeons. The circumstances are these :-For some short time I had erroneous system of procedure regarding the certificates of been in attendance on a young lady on whom the treatment attendance upon the Glasgow Infirmary. After paying the house fee to that institution, the student, of a chemist had been previously inflicted. Her case was before he can obtain a certificate of having attended the hosa,s as could be but one of progressing favourably expected; of two years, must inscribe his her friends (not a member of the family) was desirous that pital for the required period " name in what is called the Infirmary Album," which is open some physician should see my patient: I, of course, assented, for during the last week of every second month in stating, that if they selected a gentleman I should communi- the signature with the month of February, and ending in year, beginning cate with him. On my next visit, the mother of the young that of December, thus making an amount of only six times in was have I to second lady advice; however, indisposed any the year. Now this, in my humble opinion, is no accurate test urged the propriety of gratifying her officious friend. The of the student’s regular attendance upon the hospital during mother then desired that I should write to Dr. Clendinning. It appears that previous to this arrangement, our anxious the time above stated; because, by making himself thoroughly friend sent a message to Dr. Blundell, of Great George-street, acquainted with this regulation, and appearing with the utmost punctuality at the specified periods, a student may obtain Westminster, at eleven o’clock A. M.; but as the doctor did a certificate of having attended the Infirmary for the space of not answer the summons up to six P. M., it was conjectured he may have only appeared at the proper that he objected to come, not receiving intimatioii in the two years, although " the and left the house, to reappear time, signed Album," usual course. When Dr. Blundell’s name was mentioned, I in two months afterwards. I have known this to happen again a note to of Dr. instead him, Clendinning, proposed sending and while the most irregular attenders genebut to my surprise it was announced, at half-past nine o’clock very frequently; receive the best certificates, it sometimes happens, on the rally at night, that the doctor had arrived in compliance with the other hand, that a student, after having attended the hospital morning’s request. I repaired to the patient’s house to ascer- regularly for nearly the whole of the required period, and who and on tain the fact, my entering the room I saw the doctor, has omitted to sign the Album once, (either through perhaps with watch in hand, and busy eye intent, his patient grasped, of the time for signature, or from having been called and all absorbed in thought. I startled his consciousness ignorance suddenly by private affairs,) is, on this account, most by presuming that I met Dr. Blundell. He assented, and away denied his certificate of attendance. These reperemptorily greeted my presence with a sinister smile. I asked if he had marks have suggested themselves to me solely on account of known that I was in previous attendance. He answered, within the past week, witnessed a most glaring in"we don’t enter into the discussion of that subject." I then, having, stance of the latter description ; and I trust, that in order to in his hearing, inquired of the lady, who stood by him, if she the eyes of the profession more fully to this evil system, could satisiy my former interrogatory. She stated that the open the editor of THE LANCET will pardon this encroachment upon doctor was made acquainted with mv attendance. This the his columns, and give insertion to these imperfect observadoctor did not then deny. I immediately retired from the tions. sick chamber to an adjoining parlour. In some short time l A PUPIL OF THE GLASGOW RoYAL IxriRMABY. was joined by the doctor, who, in answer to my demand for Glasgow, July, lStõ. an explanation of how he came to be there, said, with expanded chest, and body erect,-" Sir, I’ll tell you the rule that guides FATAL HÆMORRHAGE FROM LANCING THE physicians, and shall give you my reasons. I consider that when a physician is sent for he is in duty bound to attend, for GUM IN AN INFANT. the safety of the public, and the advantage of the patient." I To the Editor of Tiaiz LANCET. objected, "What! if the safety of the public and the advantage of the patient was previously consulted by having a medical SiR,—In continuation of the case of "Fatal Haemorrhage man in attendance " He answered, " It makes no difference, from a Free Incision of the Gum," related in your number for " you medical men might amongst ourselves I inter- July 4th, I should feel obliged by the insertion of the following rupted, and required an explanation of the word, " yourselves," facts:-On the Tuesday following the death of that child on the stating that my understanding was too obtuse to recognise Sunday, it was intended to bury it; but the people of the its meaning. The doctor failed to enlighten me, but con- village-the public-demanded that an inquest should be tinued, " Physicians are bound to protect themselves against held. In consequence of this outcry, the constable was sent you medical men; that the latter might, in their medical to Mr. Hall, Coroner, at Uppingham, who, when he had societies, say they did not like this or that one, and refuse to heard the particulars of the case, said there was no need for call him in; and that physicians should protect themselves an inquest. The day after this opinion was delivered, Ir. against such injustice, and obey every call, in their own Jones, by his own request, met three other medical men defence, though he acknowledged the danger to be only a (viz., Dr. Hopkinson, Mr. Atley, of Stanford, and Mr. Leet, possible contingency." I told him I resigned the patient into of Thrapstone) at Cottesmore. They went all together into his hands; that I would not (at his solicitation) enter into the the room where the child lay dead ;two of the four passed young lady’s case with him; that he might send his prescrip- each the tip of his little finger into the child’s mouth, and tion to a chemist, for I would not compound it. I also asked then endeavoured to explain away to the parents a cause of him if he would act so with a Fellow of the College of Phy- death to them (the parents) so evident. A statement was sicians. He evaded an answer. I pressed him. He then then made to the clergyman by the four, that it was their
MR.
stance.
EDITOR,—May
I
ETIQUETTE.-THE CERTIFICATE SYSTEM.
77
proclaim anatomy, and physiological said, in such a case he would hesitate. I then departed, and and chemical science, and clinical observation, as constitut- left him to reflect on the conduct of a surgeon who dared to uphold his dignity. ing our peculiar claims to public confidence. Is it too much Now I will not say, are such practices respectable; but I to ask of the Legislature that no one be allowed to practise ask, in sadness, are such practices current1 Do they tend to raise medical men in the estimation of the public, or do they medicine, unless he have studied anatomy, physiology, and not facilitate the degradation of the profession ? Is it for the pathology; the structure and functions of the machine, the advantage of patients to disturb their confidence by the disorders of which he would r epair ?-? Is it too much to obtrusive and furtive visits of a stranger in the dead of night!a Or is it honourable to the profession of physic to be merely hope that the public will eventually learn that such know- actuated by the lucrun2 accessell8, forgetful of what is due to the professor of medicine, or even self-respect. ledge is required for such an office ? On the principle " the doctor" propounds, five or six physicians might all arrive on the same errand, and some might
practitioner."
Let
us
feel it awkward to retire without a fee; but Dr. Blundell pocketed his _feliciter° illi cedat.-Yotirs much obliged, MICHAEL K. O’SHEA, M.R.C.S.E.
PROFESSIONAL ETIQUETTE. " Metuone quam fraudem fransus sit."
in-B
I claim your notice in the present Mine is not a private quarrel; it embraces the d,ignity of the profession, the advantage of the public, the THE CERTIFICATE SYSTEM—ATTENDANCE OF safety of patients, and the convenience of practitioners at STUDENTS AT THE GLASGOW INFIRMARY. large. If it were a mere question of obtrusion on a private patient I should not trouble you with my plaint, but the To the Editor of THE LANCET. doctrine enunciated by the party implicated involves the SIR,-Knowing your sincere desire for the reformation of respectability of the entire profession, and the mutual cour- every evil connected with the medical profession, I have taken tesy and gentlemanly bearing which should exist between the liberty of pointing out to you what I imagine to be an physicians and surgeons. The circumstances are these :-For some short time I had erroneous system of procedure regarding the certificates of been in attendance on a young lady on whom the treatment attendance upon the Glasgow Infirmary. After paying the house fee to that institution, the student, of a chemist had been previously inflicted. Her case was before he can obtain a certificate of having attended the hosa,s as could be but one of progressing favourably expected; of two years, must inscribe his her friends (not a member of the family) was desirous that pital for the required period " name in what is called the Infirmary Album," which is open some physician should see my patient: I, of course, assented, for during the last week of every second month in stating, that if they selected a gentleman I should communi- the signature with the month of February, and ending in year, beginning cate with him. On my next visit, the mother of the young that of December, thus making an amount of only six times in was have I to second lady advice; however, indisposed any the year. Now this, in my humble opinion, is no accurate test urged the propriety of gratifying her officious friend. The of the student’s regular attendance upon the hospital during mother then desired that I should write to Dr. Clendinning. It appears that previous to this arrangement, our anxious the time above stated; because, by making himself thoroughly friend sent a message to Dr. Blundell, of Great George-street, acquainted with this regulation, and appearing with the utmost punctuality at the specified periods, a student may obtain Westminster, at eleven o’clock A. M.; but as the doctor did a certificate of having attended the Infirmary for the space of not answer the summons up to six P. M., it was conjectured he may have only appeared at the proper that he objected to come, not receiving intimatioii in the two years, although " the and left the house, to reappear time, signed Album," usual course. When Dr. Blundell’s name was mentioned, I in two months afterwards. I have known this to happen again a note to of Dr. instead him, Clendinning, proposed sending and while the most irregular attenders genebut to my surprise it was announced, at half-past nine o’clock very frequently; receive the best certificates, it sometimes happens, on the rally at night, that the doctor had arrived in compliance with the other hand, that a student, after having attended the hospital morning’s request. I repaired to the patient’s house to ascer- regularly for nearly the whole of the required period, and who and on tain the fact, my entering the room I saw the doctor, has omitted to sign the Album once, (either through perhaps with watch in hand, and busy eye intent, his patient grasped, of the time for signature, or from having been called and all absorbed in thought. I startled his consciousness ignorance suddenly by private affairs,) is, on this account, most by presuming that I met Dr. Blundell. He assented, and away denied his certificate of attendance. These reperemptorily greeted my presence with a sinister smile. I asked if he had marks have suggested themselves to me solely on account of known that I was in previous attendance. He answered, within the past week, witnessed a most glaring in"we don’t enter into the discussion of that subject." I then, having, stance of the latter description ; and I trust, that in order to in his hearing, inquired of the lady, who stood by him, if she the eyes of the profession more fully to this evil system, could satisiy my former interrogatory. She stated that the open the editor of THE LANCET will pardon this encroachment upon doctor was made acquainted with mv attendance. This the his columns, and give insertion to these imperfect observadoctor did not then deny. I immediately retired from the tions. sick chamber to an adjoining parlour. In some short time l A PUPIL OF THE GLASGOW RoYAL IxriRMABY. was joined by the doctor, who, in answer to my demand for Glasgow, July, lStõ. an explanation of how he came to be there, said, with expanded chest, and body erect,-" Sir, I’ll tell you the rule that guides FATAL HÆMORRHAGE FROM LANCING THE physicians, and shall give you my reasons. I consider that when a physician is sent for he is in duty bound to attend, for GUM IN AN INFANT. the safety of the public, and the advantage of the patient." I To the Editor of Tiaiz LANCET. objected, "What! if the safety of the public and the advantage of the patient was previously consulted by having a medical SiR,—In continuation of the case of "Fatal Haemorrhage man in attendance " He answered, " It makes no difference, from a Free Incision of the Gum," related in your number for " you medical men might amongst ourselves I inter- July 4th, I should feel obliged by the insertion of the following rupted, and required an explanation of the word, " yourselves," facts:-On the Tuesday following the death of that child on the stating that my understanding was too obtuse to recognise Sunday, it was intended to bury it; but the people of the its meaning. The doctor failed to enlighten me, but con- village-the public-demanded that an inquest should be tinued, " Physicians are bound to protect themselves against held. In consequence of this outcry, the constable was sent you medical men; that the latter might, in their medical to Mr. Hall, Coroner, at Uppingham, who, when he had societies, say they did not like this or that one, and refuse to heard the particulars of the case, said there was no need for call him in; and that physicians should protect themselves an inquest. The day after this opinion was delivered, Ir. against such injustice, and obey every call, in their own Jones, by his own request, met three other medical men defence, though he acknowledged the danger to be only a (viz., Dr. Hopkinson, Mr. Atley, of Stanford, and Mr. Leet, possible contingency." I told him I resigned the patient into of Thrapstone) at Cottesmore. They went all together into his hands; that I would not (at his solicitation) enter into the the room where the child lay dead ;two of the four passed young lady’s case with him; that he might send his prescrip- each the tip of his little finger into the child’s mouth, and tion to a chemist, for I would not compound it. I also asked then endeavoured to explain away to the parents a cause of him if he would act so with a Fellow of the College of Phy- death to them (the parents) so evident. A statement was sicians. He evaded an answer. I pressed him. He then then made to the clergyman by the four, that it was their
MR.
stance.
EDITOR,—May
I