THE OUT-PATIENT ABUSE AT HOSPITALS.

67 THE OUT-PATIENT ABUSE AT HOSPITALS. To the Editor of TilE LANCET. from Mr. Hodgson, on the abuse of public letter SIR,—A hospitals, was inserted in the last number of TnE LANCET. No doubt, abuse exists; but how is it to be prevented ? The authorities of the London Ophthalmic Hospital, Moorfields, have several times altered the heading of their out-patients’ tickets, with the view of shaming such persons as might be suspected of imposing on the charity. The heading used to stand thus:-" Open for the reception of patients daily." Afterwards the word " indioentwas inserted before " patients:" then the word was printed in larger type than the rest of the sentence, and for several years past-"really indigenthas been adopted. The plan suggested by Mr. Hodgson, that no patient should be admitted to the hospital without a certificate from a clergyman or medical man, that the applicant is a proper object for gratuitous relief, would altogether exclude the most destitute class of persons—foreigners, poor Jews, poor Irish, who know nothing of London parsons or doctors. As regards certificates from medical men, it has, unfortunately, been now and then discovered that a patient, able to pay, has been sent to the hospital, by his 0r her medica l man, who hoped in this way to et an opinion on a doubtful case, without the risk of losing his patient, which calling in another practitioner might have occasioned. Quis custodiet custodes? Another writer suggests the strict questioning of applicants by the medical officers of the institution. This would be imposing a disagreeable duty on those gentlemen, who, it would be said, are personally interested in making patients pay: and unless the questioning were really strict, external appearance and dress might be taken as tests of ability to give a fee, and thus a great hardship would be inflicted on those persons, such as clerks, dressmakers, and others, to whom a good appearance is so much stock in trade, and absolutely necessary to procure them a livelihood, while at the same time they are truly indigent, and fit objects of charitable Your obedient servant, relief.

Edinburgh:

and when

we

consider its great trade and

com-

accidents take place there for every one in the old canny metropolis of the East. Your correspondent might have with proprietv used a few capital letters in writing, but probably he was in the old frog feeling at the time, and may be excused. The curriculum of the Faculty is so much greater than some other places of old note, I am half afraid some have wished to be examined there, and have been sent to the left about. I am, vours. &c. merce, there is need for

a

good school, as probably ten

A LICENTIATE.

NAVAL ASSISTANT SURGEONS. To the Editor of THE LANCET. SIR,—Insertion for the following remarks will much oblige, AN ASSISTANT-SURGEON, R.N. About two months since, I called on the medical officers of American frigate at this place, deeming it my duty to keep up friendly relations with those who are so closely connected

an

with us by language, habits, and origin. After having examined the sick-bay and its arrangements, also the very liberal supply of medicines and rnedicalnecessaries for the use of the sick, all which are far superior to what is allowed by our Admiralty,—I then inquired what was the position of the assistant-surgeons in that service, and heard, with much pleasure, that they were all made wardroom officers about four years ago. This boon was the result of a spirited system of agitation, which they had carried on for Their modus operandi was detailed to some years previous. me by one of the assistant-surgeons on board, and resembled very closely that which we are carrying on at present-viz., they first petitioned the Admiralty and government, but met with nothing better than evasion or cold denial. They then adopted a plan, which is worthy of being imitated by us. They admonished all the young medical men on shore, who had any idea of entering the navy, what they must expect if they did so. This intimation had the desired effect. No canA GOVERNOR. didates could be procured for the office of assistant-surgeon, London, Jan. 4, 1850, and the ships could not put to sea without them. The authoTHE FACULTY OF PHYSICIANS AND SURGEONS, rities showed their good sense, by sacrificing their prejudices to the good of the state, and assistant-surgeons at once had GLASGOW. simple justice done to their claims. To the Editor of THE LANCET. One important fact has marked this happy change in the SIR,—In the last number of THE LANCET, its readers are position of our transatlantic brethren—i. e., not the slightest favoured with a letter from a member (as he savs) of a difficulty was ever experienced in supplyin them with cabins, Royal College of Surgeons north of the Tweed, and by it we servants, and a seat at the ward-room table. We trust this learn that the Faculty of Physicians and Surgeons of Glasgow lesson will not be lost on our bigoted Admiralty; if they will are applying to Parliament for an alteration and amendment not do us justice, and tleat soon, let us follow the example set of their charter. before us; nay, let us go beyond it; let us employ a medical I cannot guess at the reason of this application, as they agent, to travel through every part of Great Britain and already have a Royal Charter, and which is ratified by Act of Ireland, to obtain the signatures of all the qualified practiParliament. However, I feel exceedingly for the writer of tioners, in every city, town, and village, to petitions, to be the letter, as he seems to be in extreme distress of mind; for forwarded by their respective representatives to parliament. which melancholy condition he assigns reasons, which I beg Three hundred such petitions, signed by 30,000 men of high leave to notice in brevity. The first reason is, that he and respectability and literary attainments, will soon procure us many of his brethren think that no diploma should be held that justice which, contrary to an Order in Council of 1804, legal unless it come from him and his brethren. Hector had and never withdrawn, has been fraudulently withheld to the no brothers that I read of. present time. In conclusion, Mr. Editor, allow me to assure you of what 2ndly. As his mental sufferings increase, he talks of being annoyed that those holding the paltry diploma of the Faculty we can never forget, the never to-be-cancelled debt of gratihave the same privileges as lie and his brethren, at least in tude due to you for your able and untiring advocacy of our Scotland. I would add—and why not? claims. M. D. 3rdly. Here comes on a fit of astonishment at the East Naples, 18t9. India Company taking the Glasgow diploma. The men holding these diplomas seem to have no existence. THE ASSURANCE OFFICES AND THE MEDICAL 4thly. In an intense agony he cries out to you, by the way PROFESSION. of question-Can these evils be remedied ? Editor of THE LANCET. the To Now, a pleasing circumstance occurs. We see the attack subsiding; for he seems to have the faith to trust, that the SIR,—You have frequently, with so much ability and success, Bill about to be brought by you into Parliament will effec- urged the justness of the claim made by medical men on life assurance companies for their opinions for the purpose of tively put a stop to all these unqualified practitioners. Now, permit me to tell your worthy correspondent, that I effecting policies, that I am induced to send you the following hold one of these hated diplomas, and have done so for forty statement, in the hope it may tend to stir up my professional years; and moreover, I would not consider myself disquali- brethren (as you so well express it) " to be true to themselves fied to practise medicine and surgery though I was deprived and each other, and resolved to maintain their just rights of the diploma, unless by some improper act or acts of my upon the matter." The Metropolitan Life Assurance Society, own. No. 5, Princes Street, Bank, sent me, on the llth of October, The Faculty are a large and learned body, and efficient the usual form of questions respecting the past and present medical men; besides, many of them are teachers of medi- state of health of a patient of mine, requesting me to fill it cine ; and the School of Medicine in Glasgow is a rising up. I wrote immediately, declining to give the required inschool, and must rise with the city in which it is, for Glasgow formation without first receiving the proper fee. I informed contains nearly three times the number of inhabitants of my patient of his position, and explained the cause to him, _____