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THE MEDICAL PROFESSION AND LIFE ASSURANCE OFFICES.
46
pints,)
and
measure
out my dose
daily, never exceeding on
application any1 applied accepted; shortly after, patient again
was answered, and whom he had attended. The the died. The office the life to my friend to know if he had not made a mistake in his answer to their first inquiries. My friend
account, and each time fill up the bottle with water, mixed With a little spirit of nutmeg, and by that means I really do not feel the loss. I have lately entirely cured a young lady who had got into the habit of taking two grains of acetate of morphia daily, and, unknown to her, I entrusted the secret of diminishing the dose to her mother, to whom I gave a quart bottle of solution of acetate of morphia, four grains to the ounce, and also gave her some spirit of nutmeg, and directed her, each time she measured out her daughter’s daily dose, to fill it up with spirit-and-water; by this means in three or four
months she was quite cured, and was very much pleased with the result of the deception, as she was perfectly unconscious of any alteration until told.
MEDICCTS.
THE POOR-LAW COMMISSIONERS AND UNION SURGEONS.
To the Editor of TaE LANCET. Sm,-By a general order of the Poor-Law Commissioners, dated July 24, 1847, it is decreed, by Art. 177, that" No salary of any district medical officer shall include the remunerations for operations and services," as named, but that they " shall be paid for by the guardians, according to the rates specified in this article." The Assistant-Commissioner, Mr. Gulston, has been travelling to the various western boards of guardians, to endeavour to persuade them to alter the system hitherto pursued, and has thrown out a bait to quiet the grumbling, ruined (?) farmers and agriculturists, at the expense of the well-doing, lazy, rich, union doctor. Here is the proposal:"The Government feel for the agricultural distress, and therefore will (privately) try to alleviate it. You - the farmers-now have, from the parish rate, to pay the medical officers for accidents, midwifery fees, &c.; now, if you will take a three years’ average you may add that to the salary, of , which we, the Government, pay half from the consolidated ’ fund; so that you will not pay the doctors half as much as you do now." This is greedily swallowed, and it is done. " If any medical officer dare refuse, or even plead, away with him." Sir, a three years’ average is not a fair calculation, as I am ready most easily to demonstrate; and I do hope that you will use your influence to do away with this unjust and hard ordonnance;—unjust.because districtswere taken under certain conditions; hard, because you are not paid in proportion to the work and labour done. There is another grievance which will tell fatally on many poor wretches:-Art. 178 requires the advice of another pro. fessional gentleman, in cases of operation; and now the medical gentleman cannot afford to pay for such, because he receives no fee, and the guardians refuse to pay, so that the medical officer must take the whole responsibility on himself. Art. 181, providing for difficult surgical cases, is also annulled, as is Art. 183. This is the concoction of our precious Poor-Law Board. I could write much more about them, but can say no good of them, therefore leave others to find out, as I have, that they do not scruple to make unfounded charges, and send copies of private letters to boards of guardians. I am. Sir. vour obedient servant. A UNION DOCTOR.
I
THE MEDICAL PROFESSION AND LIFE ASSURANCE OFFICES. THE LONDON LIFE ASSOCIATION. To the Editor QfTHE LANCET. SiR,—I requested Mr. Docker to send me a guinea before I Answered his queries respecting Mr. C-’s health, &c. Since I have not received any reply, I conclude that the " London Life Association" refuse to do justice to medical men, and I hope you will give due publicity of the fact. I am, Sir, yours obediently, EYA11S RIADORE, Lecturer
Harley-street, June,
on
Surgery
at the Hunterian School of Medicine.
1851.
if they had paid proper attention to his answer. This induced them to re-peruse the letter, and on so doing, they acknowledged they had not sufficiently attended to the answer, and the blame rested with themselves. In this case a candid opinion was given, and had the office observed ordinary care, they would have saved their money; but the gentleman received nothing for his opinion. Another party applied at an office to assure his life, where it was necessary to procure a medical opinion. In this case the party did not refer to his usual medical attendant for a statement of particulars of his health, and when he appeared before the directors, a gentleman present detailed particulars of his habits and disposition to disease that induced the Board to decline accepting the life. Some time since, I was asked if I would give a certificate of the health &c. of a patient of mine, but I declined it, as I was well aware that he was strongly disposed to affection of the head, and at the same time a free liver. Many other cases could be brought forward to show the importance of a correct medical opinion in all cases where life is to be assured; and if offices do think they should not pay for them, let them decline asking for them. Again, I am sure I speak for the profession in saying, if medical men are not justified in expecting a fee for a candid opinion of health, habits, &c. of a patient, by which an assurance office is to be guided in accepting or declining a life, let it be withholden from them; but if, on the contrary, they are entitled to it, why should any office attempt to withhold it from them ? I am, Sir, your obedient servant, W. Nix. Savile-row, July, 1851.
inquired
ON THE INCISION OF STRICTURE OF THE URETHRA. To the Editor of THE LANCET. SiR,—Having perused the remarks of M.D., and a Surgeon of Twenty Years’ Standing," in reference to the treatment of permanent stricture of the urethra, in the last number of your excellent journal, permit me to observe that within the last month Professor Syme has operated upon a patient of mine, for impermeable permanent stricture of the urethra, with the
complete, and I would also say, almost incredible, sucfalsifying M.D.’sobservations as to the danger and fatality of that gentleman’s operation. most cess,
During the two winters (those of 1848-49 and 1849-50) I spent in Edinburgh, I several times saw Professor Syme per-
form the operation of which M.D. speaks in so false a manner, and with the greatest success, and therefore persuaded my patient to go and place himself under Professor Syme, which he did on Friday, the 20th ult. During the six or seven weeks he had been under my care, he had had perfect retention of urine three times for many hours. When he first sent for me he had been drinking, but the other two times he had it there was no accounting for it. The last time he had it for about eighteen hours, and had to be bled twice (in a full stream and in the upright position) to the amount of thirtytwo ounces, with potassio-tartrate of antimony and Battley’s solution, and the hot hip-bath, &c., ere he could evacuate the contents of the bladder. He had been dischargpd from the army last November, when several eminent army surgeons in vain endeavoured to pass either bougie or catheter. Yesterday, Sir, the 7th inst., this man arrived at home perfectly cured, to his and my very great delight. The same feeling-a sense of justice-which prompted M.D. to make his remarks on this subject, has also induced me to say what I have; and, in conclusion, I would state that I have the greatest confidence in its propriety, safety, and superiority over any other operation. I am. Sir. yoursvervtruly, trulv. Sir,vours SIDNEY HENSON, L.A.C. & M.R.C.S. Lond. very
COURT OF EXCHEQUER, JULY 1. LEETE V. THE GRESHAM LIFE ASSURANCE SOCIETY.
of THE LANCET. MR. M. CHAMBERS and Mr. HANNEN appeared for the cases SiR,—The following may not be altogether uninte- plaintiff, and Sir F. TIIESIGER and Mr. ATHERTON were counsel resting at this time while assurance offices are endeavouring to for the defendants. obtain medical opinions without remuneration. An office This was an action to recover the sum of X350 upon a policy applied to a friend of mine as to health, habits, &c. of a patient which had been effected in the Gresham Assurance Office upon To the Editor
pints,)
and
measure
out my dose
daily, never exceeding on
application any1 applied accepted; shortly after, patient again
was answered, and whom he had attended. The the died. The office the life to my friend to know if he had not made a mistake in his answer to their first inquiries. My friend
account, and each time fill up the bottle with water, mixed With a little spirit of nutmeg, and by that means I really do not feel the loss. I have lately entirely cured a young lady who had got into the habit of taking two grains of acetate of morphia daily, and, unknown to her, I entrusted the secret of diminishing the dose to her mother, to whom I gave a quart bottle of solution of acetate of morphia, four grains to the ounce, and also gave her some spirit of nutmeg, and directed her, each time she measured out her daughter’s daily dose, to fill it up with spirit-and-water; by this means in three or four
months she was quite cured, and was very much pleased with the result of the deception, as she was perfectly unconscious of any alteration until told.
MEDICCTS.
THE POOR-LAW COMMISSIONERS AND UNION SURGEONS.
To the Editor of TaE LANCET. Sm,-By a general order of the Poor-Law Commissioners, dated July 24, 1847, it is decreed, by Art. 177, that" No salary of any district medical officer shall include the remunerations for operations and services," as named, but that they " shall be paid for by the guardians, according to the rates specified in this article." The Assistant-Commissioner, Mr. Gulston, has been travelling to the various western boards of guardians, to endeavour to persuade them to alter the system hitherto pursued, and has thrown out a bait to quiet the grumbling, ruined (?) farmers and agriculturists, at the expense of the well-doing, lazy, rich, union doctor. Here is the proposal:"The Government feel for the agricultural distress, and therefore will (privately) try to alleviate it. You - the farmers-now have, from the parish rate, to pay the medical officers for accidents, midwifery fees, &c.; now, if you will take a three years’ average you may add that to the salary, of , which we, the Government, pay half from the consolidated ’ fund; so that you will not pay the doctors half as much as you do now." This is greedily swallowed, and it is done. " If any medical officer dare refuse, or even plead, away with him." Sir, a three years’ average is not a fair calculation, as I am ready most easily to demonstrate; and I do hope that you will use your influence to do away with this unjust and hard ordonnance;—unjust.because districtswere taken under certain conditions; hard, because you are not paid in proportion to the work and labour done. There is another grievance which will tell fatally on many poor wretches:-Art. 178 requires the advice of another pro. fessional gentleman, in cases of operation; and now the medical gentleman cannot afford to pay for such, because he receives no fee, and the guardians refuse to pay, so that the medical officer must take the whole responsibility on himself. Art. 181, providing for difficult surgical cases, is also annulled, as is Art. 183. This is the concoction of our precious Poor-Law Board. I could write much more about them, but can say no good of them, therefore leave others to find out, as I have, that they do not scruple to make unfounded charges, and send copies of private letters to boards of guardians. I am. Sir. vour obedient servant. A UNION DOCTOR.
I
THE MEDICAL PROFESSION AND LIFE ASSURANCE OFFICES. THE LONDON LIFE ASSOCIATION. To the Editor QfTHE LANCET. SiR,—I requested Mr. Docker to send me a guinea before I Answered his queries respecting Mr. C-’s health, &c. Since I have not received any reply, I conclude that the " London Life Association" refuse to do justice to medical men, and I hope you will give due publicity of the fact. I am, Sir, yours obediently, EYA11S RIADORE, Lecturer
Harley-street, June,
on
Surgery
at the Hunterian School of Medicine.
1851.
if they had paid proper attention to his answer. This induced them to re-peruse the letter, and on so doing, they acknowledged they had not sufficiently attended to the answer, and the blame rested with themselves. In this case a candid opinion was given, and had the office observed ordinary care, they would have saved their money; but the gentleman received nothing for his opinion. Another party applied at an office to assure his life, where it was necessary to procure a medical opinion. In this case the party did not refer to his usual medical attendant for a statement of particulars of his health, and when he appeared before the directors, a gentleman present detailed particulars of his habits and disposition to disease that induced the Board to decline accepting the life. Some time since, I was asked if I would give a certificate of the health &c. of a patient of mine, but I declined it, as I was well aware that he was strongly disposed to affection of the head, and at the same time a free liver. Many other cases could be brought forward to show the importance of a correct medical opinion in all cases where life is to be assured; and if offices do think they should not pay for them, let them decline asking for them. Again, I am sure I speak for the profession in saying, if medical men are not justified in expecting a fee for a candid opinion of health, habits, &c. of a patient, by which an assurance office is to be guided in accepting or declining a life, let it be withholden from them; but if, on the contrary, they are entitled to it, why should any office attempt to withhold it from them ? I am, Sir, your obedient servant, W. Nix. Savile-row, July, 1851.
inquired
ON THE INCISION OF STRICTURE OF THE URETHRA. To the Editor of THE LANCET. SiR,—Having perused the remarks of M.D., and a Surgeon of Twenty Years’ Standing," in reference to the treatment of permanent stricture of the urethra, in the last number of your excellent journal, permit me to observe that within the last month Professor Syme has operated upon a patient of mine, for impermeable permanent stricture of the urethra, with the
complete, and I would also say, almost incredible, sucfalsifying M.D.’sobservations as to the danger and fatality of that gentleman’s operation. most cess,
During the two winters (those of 1848-49 and 1849-50) I spent in Edinburgh, I several times saw Professor Syme per-
form the operation of which M.D. speaks in so false a manner, and with the greatest success, and therefore persuaded my patient to go and place himself under Professor Syme, which he did on Friday, the 20th ult. During the six or seven weeks he had been under my care, he had had perfect retention of urine three times for many hours. When he first sent for me he had been drinking, but the other two times he had it there was no accounting for it. The last time he had it for about eighteen hours, and had to be bled twice (in a full stream and in the upright position) to the amount of thirtytwo ounces, with potassio-tartrate of antimony and Battley’s solution, and the hot hip-bath, &c., ere he could evacuate the contents of the bladder. He had been dischargpd from the army last November, when several eminent army surgeons in vain endeavoured to pass either bougie or catheter. Yesterday, Sir, the 7th inst., this man arrived at home perfectly cured, to his and my very great delight. The same feeling-a sense of justice-which prompted M.D. to make his remarks on this subject, has also induced me to say what I have; and, in conclusion, I would state that I have the greatest confidence in its propriety, safety, and superiority over any other operation. I am. Sir. yoursvervtruly, trulv. Sir,vours SIDNEY HENSON, L.A.C. & M.R.C.S. Lond. very
COURT OF EXCHEQUER, JULY 1. LEETE V. THE GRESHAM LIFE ASSURANCE SOCIETY.
of THE LANCET. MR. M. CHAMBERS and Mr. HANNEN appeared for the cases SiR,—The following may not be altogether uninte- plaintiff, and Sir F. TIIESIGER and Mr. ATHERTON were counsel resting at this time while assurance offices are endeavouring to for the defendants. obtain medical opinions without remuneration. An office This was an action to recover the sum of X350 upon a policy applied to a friend of mine as to health, habits, &c. of a patient which had been effected in the Gresham Assurance Office upon To the Editor