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THE GENERAL MEDICAL COUNCIL AND MEDICAL AID ASSOCIATIONS.
1635 twofold process,
comprising what is termed a receptive and is born helpless ; his physical structures immature," expressive side"(the italics are mine. If language is his mind a blank; but subsequently in response to stimuacquired does it matter whether or not it is a twofold process. lation (use, exercise, experience), he develops enormously I stated that it was acquired, and Dr. Bastian disputed it). both mentally and physically. On consideration it will be Once again let me beg your readers to think in concrete, not seen that nearly all that separates the adult man from the in abstract terms ; let us take the case of a particular word. infant is acquired (i.e., has resulted as a response to stimulaIt appears, then, if I understand my censor right, that an tion, has resulted from exercise and use). For instance, it English child learns—i.e., acquires-the word" picture" the joints of an infant’s limb-e.g., the arm-be locked, as by for instance, but does not learn to say it. The distinction disease, so that the limb cannot be used, it does not develop. is fine but, if Dr. Bastian is right, important. This sound, Again if a man-e.g., a blacksmith-uses his muscles beyond like all others, is produced by the very nice and complex the ordinary he gets an extra development of them, and coordination of a large number of muscles. In other this additional development is said by biologists to be languages the same object is indicated by totally different acquired. But, as we see, the normal" standard of developsounds, each requiring a different coordination of the ment is attained as a response to stimulation, similar in muscles. Are we to understand then that, apart from all kind but less in amount, whence it is plain that the normal experience, from all tentative efforts, from all learning, the degree of development is also acquired. Mentally, as I say, English child is able to make this particular coordination. the infant’s mind is practically a blank. It can instinctively But the word" picture"is not comprised in the French coordinate only a few groups of muscles-e.g., those of in these the language, and therefore the power of making this particular breathing, sucking, defalcating, &c.—and coordination of muscles cannot arise apart from experience coordination is never very delicate. How different is the in the French child; it must, of course, be acquired mind of the adult man with its wonderful power of delicately by him. Nevertheless, the French child, reared in coordinating the different groups of muscles, and with the England, speaks it with as much facility as the vast contents of its memory, and all that arises out of English child, and, if he subsequently learns his memory. native language, speaks that with an English accent. Does Surely then I am right in saying that the faculties of not this prove that language is acquired in its expressive as language and bi-pedal progression are both acquired. Dr. well as its receptive side-i.e., that the power of making Harry Campbell says that the majority of physiologists think quickly and easily all those separate delicate muscular otherwise. But this is not a question of counting heads but coordinations by means of which the many words of a of facts, and the discoverer of a fact is always at first in a language are expressed is acquired-just as the power of minority of one.-I am, Sirs, yours faithfully, G. ARCHDALL REID. making quickly and easily all those separate delicate Southsea, June 1st. an
-
coordinations by
means
of which
we are
enabled to write is
If, as Dr. Bastian maintains, speech is a "deferred primary automatic movement," why does the THE GENERAL MEDICAL COUNCIL AND French child reared in England subsequently speak French MEDICAL AID ASSOCIATIONS. with an English accent ? Dr. Bastian rests his case on two or To the Editors of THE LANCET. three children who apparently began to speak by uttering certain words with singular distinctness. But had these SIRS,-When the subject of Medical Aid Associations children before then been absolutely dumb ? Had they came up for discussion at the May session of the General never before attempted to coordinate their speech Medical Council I tried to show that if the Council took mucles by uttering the usual babbling and inarticulate action it must attack those practitioners connected with sounds that infants make, and which, in the ordinary child, hospitals at which medical aid was given as those practimay be observed to grow in distinctness with practice till at tioners who act as officers to medical aids. To establish this length the child speaks clearly? The case of bi-pedal pro- statement I referred to the gross and sad state of affairs at gression is exactly the same as that of speech. The infant Guy’s Hospital where a patient by paying 3d. per week or 6d. manifestly cannot coordinate its muscles of locomotion at per fortnight (not 6d. per visit be it noted) can obtain, as an birth, and, as I think, very plainly learns to do so. In the out-patient, medical or surgical treatment and medicines.
acquired?
of Sir R. Quain’s daughter, was she never allowed to her legs, and so acquire precision of movement ? Was she never allowed to crawl about, for instance ? Was she The muscles of the upper never placed on her feet? much are less extremity powerful and adapted for locomotion than those of the lower, yet an exceptional man, who had otherwise developed and learned to coordinate them, might at the very first attempt walk on his hands. Thus also might an exceptional child walk at the first attempt on
case
use
her feet, as to Dr. Harry Campbell. Low in the animal scale animal develops fully, mentally and physically, in the absence of all stimulation other than that of sufficient food. In other words, it is a product of heredity pure and simple ; exercise and use is not necessary to the development of its mind and body. Thus we see the caterpillar metamorphosed into the butterfly while hanging quiescent; thus even so high in the scale as the frog, if a tadpole finds its way through a crevice into a small cavity, it will there, if it obtains sufficient food, though it leads a purely vegetative life, develop into a normal frog. But as we ascend in the animal scale we find that this power of developing in the absence of stimulation (of exercise, of use) is gradually lapsed, and replaced by a power (which does not exist low in the scale) of developing in response to stimulation. Compare, for instance, a dragon fly at one end of the scale and man at the other. Physically a dragon fly, in the absence of
Next,
an
stimulation, undergoes extraordinary metamorphoses; mentally it can instinctively coordinate all its muscles, and has besides many other wonderful instincts, but so far as we know it does not change physically in response to stimulation ; mentally it learns and remembers nothing. Even to an animal
so
high
in the scale as a fish has memory been course all that lies within the memory Far different is the case of man. He
denied,2 and of is
acquired. 2
THE LANCET, Jan.
23rd, 1897, p. 257.
This " charity"-if the payors will permit the use of this word-appoints four assistant surgeons and four assistant physicians and pays such practitioners R100 per annum each. During the year ending March 31st, 1895, the out-patients paid £928 and the in-patients .E3985. As this seems a fair commercial speculationbecause I fail to see how it could honestly be called charity-I asked, How many out-patients were refused treatment ? As was to be expected, no answer could be given. Threepenny-a-week patients represent income, and income must be maintained. Hence the present fifteen per cent. charity"hospital business which is now degrading our charities. Then look at the result of this demoralising system. A young practitioner wishing to live and to compete with the practitioners of Guy’s " cuts" their price and charges, not threepence, but one penny per week. Thus we have the various medical aids and their baneful accompaniments. Go a step further down, and we have the private practitioner trying to"cut" the charity prices of Guy’s and of the Medical Aids. He charges threepence and sixpence per visit, not per week. He is sneered by the chief sinners, who all the time use the charity to kill off competitors. My advice to each practitioner isHave nothing to do with clubs, medical aids, or sixpenny fees, and above all shun, as one should shun evil, all penny and threepenny a week hospitals. Mr. Bryant stated at the Council meeting that Guy’s was his hospital and that he "must repudiate in the strongest words he could use the accusations which had just been made against it. Dr. Rentoul was entirely in the wrong, and if he would take five minutes’ trouble he would probably come back next session and apologise for bringing forward such a false accusation." This is strong language for Mr. Bryant. He suggests I should bring forward documents in proof. I gladly do so. May I refer him to the " Annual Report of Guy’s Hospital"for 1895, and will he ask the superintendent of Guy’s to show him a copy of a letter dated ......
1636 Oct. 16th, 1896, which the superintendent kindly sent to me on this very question? My stay upon the Medical Council may be long or it may be short. But if Mr. Bryant thinks for one moment that I deliberately concoct statements to wilfully mislead the that I am going to accept his suggestion Medical Council orto the Council because I have been of "apologising" " guilty " of making a statement true in word and fact, then all I can say is that he has not taken my measure with accuracy.
of provident dispensaries as to the admission of well-to-do persons into the dispensary-in respect to both of which I think he takes a totally wrong view-I will not enter. I feel that the challenge thrown down should not be allowed to remain unanswered, especially since the author states that "the interests of the general medical practitioner have been placed (in the ’Battle of Clubs’) somewhat in opposition to the various means by which medical advice is being obtained." It would appear that it is time they were. I am, Sirs, yours faithfully, ROWLAND HUMPHREYS. Fellows-road, South Hampstead, N.W., June 7th, 1897.
If Mr. Bryant will refer to page 2 of the above annual report he will find that not only are out-patients treated for threepence per week, but that in-patients are treated for from 1 to 3 guineas per week. Practitioners would be also edified if, in his reply, he would state the maximum and THE SUPPLY OF TETANUS ANTITOXIN. minimum fees charged by the Practitioners connected with in or exclusive the or above of 1 To the Editors of THE LANCET. 3 pay patients, Guy’s guineas per week. If he will further refer to the Report of SIRS,—I notice with some interest a case of traumatic the House of Lords on "Metropolitan hospitals," 1892, p. 10, tetanus treated successfully by antitoxin reported in he will find further documentary reference to the sales of THE LANCET of June 5th by Dr. Chalmers. Curiously charity at Guy’s. enough, this case and a similar one, of which the notes were Awaiting his reply, published in THE LANCET of April 10th, 1897, occurred in I am, yours
obediently,
ROBERT R. RENTOUL.
THE NEED OF ORGANISATION IN THE PROFESSION. To the Editors of THE LANCET. have received a pamphlet entitled "The Just SIRS,-I Claims of the Provident Dispensary System" by the secretary of the Provident Medical Association,l and have no doubt but that most other London medical men have had copies sent to them. The pamphlet emphasises strongly the necessity for organisation amongst medical men, and as this formed the subject of a paper I had the honour of reading before the Hunterian Society in 18952 I venture to send you In many a few observations on the pamphlet in question. of his remarks, as contained in the pamphlet in question, I agree very cordially with the writer, but I disagree with him in toto as to the result he arrives at in respect to the fees to be received by medical men attached to provident dispensaries-one of the crucial points. I must premise that I am able to state on the strength of the observations of a patient of mine-observations covering fifty years’ work in a leading builder’s office-that wages have increased within the period I have mentioned some 80 per cent., that about 80 per cent. less work is done, and that the work on the whole is inferior to what it used to be, and that, as we all know, there is a marked tendency amongst this class in the direction of undervaluing (from a monetary point of view) the services of medical men. It is fairly certain that the expenses of living have not increased in the same proportion as wages. Per contra, a medical man cannot, I think, live on less than £400 per annum, with an additional E200 for his trap. If he be properly paid his income, therefore, should amount to at least .B600 per annum. The author of the pamphlet evidently considers that " between 4½d. and 6d. per attendance, whether at the dispensary, the doctor’s surgery, or at the patient’s house," is a fair remuneration. In order to earn an income of .B600 24,000 patients per annum would have to be seen, or at the rate of about 66 per diem all the year round at 6d. each. If he does confinements the additional income so earned will probably allow him to have his Sundays free, but would not pay for holidays. In order to be able to earn this, starting at a far less income at age twenty-three or so, he has to lay down capital and to devote five years to acquiring his
professional knowledge. Does it not emphasise
the necessity for organisation when we are assured by one who ought to know about it that such are the conditions under which we should adduced are want of medical expect to live ? The reasons union and competition with Icharitableorganisations, and not because we know less than we did or do our work less
amongst
us
satisfactorily. Into the fallacies respecting the declarations made by candidates for membership respecting their incomes, the amount of responsibility attaching itself to medical officers 1 A paper read at a special meeting of the Council Organisation Society on Jan. 4th, 1897. 2 Medical Magazine, June, 1895.
of the
Charity
June of last year. In sending up those notes I drew attention to the difficulty of obtaining a supply of antitoxin, and Dr. Chalmers has further emphasised this fact. I wish to point out that so long as the only places at which the antitoxins can be obtained are either Messrs. Allen and Hanburys, Messrs. Burroughs and Wellcome, or other chemists in London, if the want arises on a Saturday after those firms have closed their places of business a delay of forty-eight hours is at present unavoidable. That forty-eight hours may mean a matter of life and death in some cases is indisputable. Surely it is time that a supply of the various antitoxins should be kept by the Public Health Departments in the various large towns throughout the kingdom, so that when required they should be easily obtainable at short notice. I am, Sirs, yours faithfully, ARTHUR H. BUCK, F.R.C.S. June 7th, 1897. Brighton,
MESCAL INTOXICATION. To the Editors of THE LANCET. SIRS,-In my note on the above subject in THE LANCET of June 5th I neglected to mention that I obtained the buttons through Messrs. Potter and Clarke, 60, ArtilleryE., who are able to supply them in small quantities. I am, Sirs, yours truly, -
lane,
Carbis Water, Lelant, Cornwall,
HAVELOCK ELLIS. June 9th, 1896.
THE DIAMOND JUBILEE. To the Editors of THE LANCET.
SIRS,-Your suggestion regarding the publication of an official programme of the proceedings on the 22nd inst., by which all, even the poorest, of Her Majesty’s subjects witnessing the spectacle should be able to identify the various bodies-the troops, colonial corps, and detachments-representing the colonies and dependencies of the British Empire, strikes me as a very wise and excellent idea. The occasion is altogether unique, and the opportunity should not be lost for enabling everybody to realise the geographical extent of the various territories within the sphere of British influence and under the British flag. It would obviously add immensely to the interest of the occasion if those taking part in the procession could be readily identified by the crowds of spectators as the panorama of living pictures passed along. What is wanted is that the power and responsibility of this country, the interdependence of Great and Greater Britain, and all that this implies in the way of the ties-social, commercial, and sympathetic-uniting them with one another, of which the Queen, as the head of the Empire, is the symbol, emblem, and token, should be brought home and impressed upon the imagination of the people. The official guide should be of small and handy size so that its pages could be easily turned over and referred to, and it might also be sufficiently illustrated to fulfil its purpose. It should not cost more than a penny or a halfpenny. It would sell in thousands-possibly millionsand realise a large profit, and the surplus, after the payment
B
comprising what is termed a receptive and is born helpless ; his physical structures immature," expressive side"(the italics are mine. If language is his mind a blank; but subsequently in response to stimuacquired does it matter whether or not it is a twofold process. lation (use, exercise, experience), he develops enormously I stated that it was acquired, and Dr. Bastian disputed it). both mentally and physically. On consideration it will be Once again let me beg your readers to think in concrete, not seen that nearly all that separates the adult man from the in abstract terms ; let us take the case of a particular word. infant is acquired (i.e., has resulted as a response to stimulaIt appears, then, if I understand my censor right, that an tion, has resulted from exercise and use). For instance, it English child learns—i.e., acquires-the word" picture" the joints of an infant’s limb-e.g., the arm-be locked, as by for instance, but does not learn to say it. The distinction disease, so that the limb cannot be used, it does not develop. is fine but, if Dr. Bastian is right, important. This sound, Again if a man-e.g., a blacksmith-uses his muscles beyond like all others, is produced by the very nice and complex the ordinary he gets an extra development of them, and coordination of a large number of muscles. In other this additional development is said by biologists to be languages the same object is indicated by totally different acquired. But, as we see, the normal" standard of developsounds, each requiring a different coordination of the ment is attained as a response to stimulation, similar in muscles. Are we to understand then that, apart from all kind but less in amount, whence it is plain that the normal experience, from all tentative efforts, from all learning, the degree of development is also acquired. Mentally, as I say, English child is able to make this particular coordination. the infant’s mind is practically a blank. It can instinctively But the word" picture"is not comprised in the French coordinate only a few groups of muscles-e.g., those of in these the language, and therefore the power of making this particular breathing, sucking, defalcating, &c.—and coordination of muscles cannot arise apart from experience coordination is never very delicate. How different is the in the French child; it must, of course, be acquired mind of the adult man with its wonderful power of delicately by him. Nevertheless, the French child, reared in coordinating the different groups of muscles, and with the England, speaks it with as much facility as the vast contents of its memory, and all that arises out of English child, and, if he subsequently learns his memory. native language, speaks that with an English accent. Does Surely then I am right in saying that the faculties of not this prove that language is acquired in its expressive as language and bi-pedal progression are both acquired. Dr. well as its receptive side-i.e., that the power of making Harry Campbell says that the majority of physiologists think quickly and easily all those separate delicate muscular otherwise. But this is not a question of counting heads but coordinations by means of which the many words of a of facts, and the discoverer of a fact is always at first in a language are expressed is acquired-just as the power of minority of one.-I am, Sirs, yours faithfully, G. ARCHDALL REID. making quickly and easily all those separate delicate Southsea, June 1st. an
-
coordinations by
means
of which
we are
enabled to write is
If, as Dr. Bastian maintains, speech is a "deferred primary automatic movement," why does the THE GENERAL MEDICAL COUNCIL AND French child reared in England subsequently speak French MEDICAL AID ASSOCIATIONS. with an English accent ? Dr. Bastian rests his case on two or To the Editors of THE LANCET. three children who apparently began to speak by uttering certain words with singular distinctness. But had these SIRS,-When the subject of Medical Aid Associations children before then been absolutely dumb ? Had they came up for discussion at the May session of the General never before attempted to coordinate their speech Medical Council I tried to show that if the Council took mucles by uttering the usual babbling and inarticulate action it must attack those practitioners connected with sounds that infants make, and which, in the ordinary child, hospitals at which medical aid was given as those practimay be observed to grow in distinctness with practice till at tioners who act as officers to medical aids. To establish this length the child speaks clearly? The case of bi-pedal pro- statement I referred to the gross and sad state of affairs at gression is exactly the same as that of speech. The infant Guy’s Hospital where a patient by paying 3d. per week or 6d. manifestly cannot coordinate its muscles of locomotion at per fortnight (not 6d. per visit be it noted) can obtain, as an birth, and, as I think, very plainly learns to do so. In the out-patient, medical or surgical treatment and medicines.
acquired?
of Sir R. Quain’s daughter, was she never allowed to her legs, and so acquire precision of movement ? Was she never allowed to crawl about, for instance ? Was she The muscles of the upper never placed on her feet? much are less extremity powerful and adapted for locomotion than those of the lower, yet an exceptional man, who had otherwise developed and learned to coordinate them, might at the very first attempt walk on his hands. Thus also might an exceptional child walk at the first attempt on
case
use
her feet, as to Dr. Harry Campbell. Low in the animal scale animal develops fully, mentally and physically, in the absence of all stimulation other than that of sufficient food. In other words, it is a product of heredity pure and simple ; exercise and use is not necessary to the development of its mind and body. Thus we see the caterpillar metamorphosed into the butterfly while hanging quiescent; thus even so high in the scale as the frog, if a tadpole finds its way through a crevice into a small cavity, it will there, if it obtains sufficient food, though it leads a purely vegetative life, develop into a normal frog. But as we ascend in the animal scale we find that this power of developing in the absence of stimulation (of exercise, of use) is gradually lapsed, and replaced by a power (which does not exist low in the scale) of developing in response to stimulation. Compare, for instance, a dragon fly at one end of the scale and man at the other. Physically a dragon fly, in the absence of
Next,
an
stimulation, undergoes extraordinary metamorphoses; mentally it can instinctively coordinate all its muscles, and has besides many other wonderful instincts, but so far as we know it does not change physically in response to stimulation ; mentally it learns and remembers nothing. Even to an animal
so
high
in the scale as a fish has memory been course all that lies within the memory Far different is the case of man. He
denied,2 and of is
acquired. 2
THE LANCET, Jan.
23rd, 1897, p. 257.
This " charity"-if the payors will permit the use of this word-appoints four assistant surgeons and four assistant physicians and pays such practitioners R100 per annum each. During the year ending March 31st, 1895, the out-patients paid £928 and the in-patients .E3985. As this seems a fair commercial speculationbecause I fail to see how it could honestly be called charity-I asked, How many out-patients were refused treatment ? As was to be expected, no answer could be given. Threepenny-a-week patients represent income, and income must be maintained. Hence the present fifteen per cent. charity"hospital business which is now degrading our charities. Then look at the result of this demoralising system. A young practitioner wishing to live and to compete with the practitioners of Guy’s " cuts" their price and charges, not threepence, but one penny per week. Thus we have the various medical aids and their baneful accompaniments. Go a step further down, and we have the private practitioner trying to"cut" the charity prices of Guy’s and of the Medical Aids. He charges threepence and sixpence per visit, not per week. He is sneered by the chief sinners, who all the time use the charity to kill off competitors. My advice to each practitioner isHave nothing to do with clubs, medical aids, or sixpenny fees, and above all shun, as one should shun evil, all penny and threepenny a week hospitals. Mr. Bryant stated at the Council meeting that Guy’s was his hospital and that he "must repudiate in the strongest words he could use the accusations which had just been made against it. Dr. Rentoul was entirely in the wrong, and if he would take five minutes’ trouble he would probably come back next session and apologise for bringing forward such a false accusation." This is strong language for Mr. Bryant. He suggests I should bring forward documents in proof. I gladly do so. May I refer him to the " Annual Report of Guy’s Hospital"for 1895, and will he ask the superintendent of Guy’s to show him a copy of a letter dated ......
1636 Oct. 16th, 1896, which the superintendent kindly sent to me on this very question? My stay upon the Medical Council may be long or it may be short. But if Mr. Bryant thinks for one moment that I deliberately concoct statements to wilfully mislead the that I am going to accept his suggestion Medical Council orto the Council because I have been of "apologising" " guilty " of making a statement true in word and fact, then all I can say is that he has not taken my measure with accuracy.
of provident dispensaries as to the admission of well-to-do persons into the dispensary-in respect to both of which I think he takes a totally wrong view-I will not enter. I feel that the challenge thrown down should not be allowed to remain unanswered, especially since the author states that "the interests of the general medical practitioner have been placed (in the ’Battle of Clubs’) somewhat in opposition to the various means by which medical advice is being obtained." It would appear that it is time they were. I am, Sirs, yours faithfully, ROWLAND HUMPHREYS. Fellows-road, South Hampstead, N.W., June 7th, 1897.
If Mr. Bryant will refer to page 2 of the above annual report he will find that not only are out-patients treated for threepence per week, but that in-patients are treated for from 1 to 3 guineas per week. Practitioners would be also edified if, in his reply, he would state the maximum and THE SUPPLY OF TETANUS ANTITOXIN. minimum fees charged by the Practitioners connected with in or exclusive the or above of 1 To the Editors of THE LANCET. 3 pay patients, Guy’s guineas per week. If he will further refer to the Report of SIRS,—I notice with some interest a case of traumatic the House of Lords on "Metropolitan hospitals," 1892, p. 10, tetanus treated successfully by antitoxin reported in he will find further documentary reference to the sales of THE LANCET of June 5th by Dr. Chalmers. Curiously charity at Guy’s. enough, this case and a similar one, of which the notes were Awaiting his reply, published in THE LANCET of April 10th, 1897, occurred in I am, yours
obediently,
ROBERT R. RENTOUL.
THE NEED OF ORGANISATION IN THE PROFESSION. To the Editors of THE LANCET. have received a pamphlet entitled "The Just SIRS,-I Claims of the Provident Dispensary System" by the secretary of the Provident Medical Association,l and have no doubt but that most other London medical men have had copies sent to them. The pamphlet emphasises strongly the necessity for organisation amongst medical men, and as this formed the subject of a paper I had the honour of reading before the Hunterian Society in 18952 I venture to send you In many a few observations on the pamphlet in question. of his remarks, as contained in the pamphlet in question, I agree very cordially with the writer, but I disagree with him in toto as to the result he arrives at in respect to the fees to be received by medical men attached to provident dispensaries-one of the crucial points. I must premise that I am able to state on the strength of the observations of a patient of mine-observations covering fifty years’ work in a leading builder’s office-that wages have increased within the period I have mentioned some 80 per cent., that about 80 per cent. less work is done, and that the work on the whole is inferior to what it used to be, and that, as we all know, there is a marked tendency amongst this class in the direction of undervaluing (from a monetary point of view) the services of medical men. It is fairly certain that the expenses of living have not increased in the same proportion as wages. Per contra, a medical man cannot, I think, live on less than £400 per annum, with an additional E200 for his trap. If he be properly paid his income, therefore, should amount to at least .B600 per annum. The author of the pamphlet evidently considers that " between 4½d. and 6d. per attendance, whether at the dispensary, the doctor’s surgery, or at the patient’s house," is a fair remuneration. In order to earn an income of .B600 24,000 patients per annum would have to be seen, or at the rate of about 66 per diem all the year round at 6d. each. If he does confinements the additional income so earned will probably allow him to have his Sundays free, but would not pay for holidays. In order to be able to earn this, starting at a far less income at age twenty-three or so, he has to lay down capital and to devote five years to acquiring his
professional knowledge. Does it not emphasise
the necessity for organisation when we are assured by one who ought to know about it that such are the conditions under which we should adduced are want of medical expect to live ? The reasons union and competition with Icharitableorganisations, and not because we know less than we did or do our work less
amongst
us
satisfactorily. Into the fallacies respecting the declarations made by candidates for membership respecting their incomes, the amount of responsibility attaching itself to medical officers 1 A paper read at a special meeting of the Council Organisation Society on Jan. 4th, 1897. 2 Medical Magazine, June, 1895.
of the
Charity
June of last year. In sending up those notes I drew attention to the difficulty of obtaining a supply of antitoxin, and Dr. Chalmers has further emphasised this fact. I wish to point out that so long as the only places at which the antitoxins can be obtained are either Messrs. Allen and Hanburys, Messrs. Burroughs and Wellcome, or other chemists in London, if the want arises on a Saturday after those firms have closed their places of business a delay of forty-eight hours is at present unavoidable. That forty-eight hours may mean a matter of life and death in some cases is indisputable. Surely it is time that a supply of the various antitoxins should be kept by the Public Health Departments in the various large towns throughout the kingdom, so that when required they should be easily obtainable at short notice. I am, Sirs, yours faithfully, ARTHUR H. BUCK, F.R.C.S. June 7th, 1897. Brighton,
MESCAL INTOXICATION. To the Editors of THE LANCET. SIRS,-In my note on the above subject in THE LANCET of June 5th I neglected to mention that I obtained the buttons through Messrs. Potter and Clarke, 60, ArtilleryE., who are able to supply them in small quantities. I am, Sirs, yours truly, -
lane,
Carbis Water, Lelant, Cornwall,
HAVELOCK ELLIS. June 9th, 1896.
THE DIAMOND JUBILEE. To the Editors of THE LANCET.
SIRS,-Your suggestion regarding the publication of an official programme of the proceedings on the 22nd inst., by which all, even the poorest, of Her Majesty’s subjects witnessing the spectacle should be able to identify the various bodies-the troops, colonial corps, and detachments-representing the colonies and dependencies of the British Empire, strikes me as a very wise and excellent idea. The occasion is altogether unique, and the opportunity should not be lost for enabling everybody to realise the geographical extent of the various territories within the sphere of British influence and under the British flag. It would obviously add immensely to the interest of the occasion if those taking part in the procession could be readily identified by the crowds of spectators as the panorama of living pictures passed along. What is wanted is that the power and responsibility of this country, the interdependence of Great and Greater Britain, and all that this implies in the way of the ties-social, commercial, and sympathetic-uniting them with one another, of which the Queen, as the head of the Empire, is the symbol, emblem, and token, should be brought home and impressed upon the imagination of the people. The official guide should be of small and handy size so that its pages could be easily turned over and referred to, and it might also be sufficiently illustrated to fulfil its purpose. It should not cost more than a penny or a halfpenny. It would sell in thousands-possibly millionsand realise a large profit, and the surplus, after the payment
B