THE REGISTRAR-GENERAL'S REPORTS.

198 too old and obvious to require infatuation the members of the medical profession alone seem to vie with each other in committing breaches of such self-evident truths, to their manifest injury and degradation. Those who practise the divine art of medicine can by its means render services of more value than any other class of men; but so lightly do we esteem those services that we are always ready at the public call to work a fourth part of the most valuable period of our lives absolutely for nothing! By the public we are differently understood. Many are puzzled to know what can induce doctors to work so much for nothingsome that it is merely for experience; others that we run after gratuitous medical appointments in order to obtain private practice : while the most intelligent portion of the public quietly laugh at us, none give us credit for disinterestedness. Laudable as are the efforts of those who have originated the Medical Benevolent College, and great as are the benefits which must eventually accrue from it to the impoverished members of the profession and their families, still I submit, that if the unrewarded services at present rendered by us to the public were but moderately remunerated, there would be little occasion for a medical workhouse. It is not necessary, and God forbid we should, shut our hearts to the sufferings of the poor and destitute ; but while exercising charity in its fullest sense, let it be done with discretion. Let us not, through a mean spirit of rivalry, or a vain wish for popularity, injure both ourselves and our neighbours. Indiscriminate gratuitous advice is a direct injury to our pecuniary interests, more especially to the junior members of the profession ; and it is the high road to pauperism to its recipients. It neither begets us a good name, honour, nor riches; but, on the contrary, we often receive injury, abuse, and embroil ourselves in quarrels with those from whom we expected better treatment. But of all the modes in which gratuitous services are given, the dispensary system, as usually conducted, is the most rankly abused. From considerable experience, I have no hesitation in affirming it to be highly injurious to the character of the workingI classes, wherever they are established, by counteracting their spirit of independence, thereby lowering their self-respect and morals, and unconsciously conducting them to pauperism. Let us explain: a dispensary is supported by some five hundred annual subscribers of from one to five guineas, who are chiefly

begin

at

home,

are

argument; but by

propositions

some

I

of employers of labour, publicans, and shopkeepers. I will not call in question their motives. A workman does not feel fit for his work; he mentions the fact to his master, who at once, without any reference to the man’s circumstances, proffers a recommendation to the dispensary. Of course he is a subscriber of five guineas, and must oblige his workmen. The man earns thirty shillings a week, (a common occurrence,) and has a wife and four children to maintain. He accepts the favour from his master, but has some scruples at first; but he knows his master is a subscriber, and he has a notion that the rates he pays go to the support of dispensaries and such-like places. He goes to the institution, and sees many of his acquaintances there; he appears before the same surgeon he formerly used to pay for his advice. The honorary (?) surgeon recognises his old patient, and is aware of his ability to pay; but as his master is a patient of his also. he does not like, indeed dares not, to refuse to prescribe for him. The other members of his family and relatives soon follow his example. Having found that he can have doctors for nothing, (as he terms it,) his former scruples have now given way; he has broken the first link in the chain; his independence is gone; he has lost the most powerful incentive for exertion. As he gets a little older, and less fit for work, having made no provision for old age, he applies to the parish, and becomes at last a pauper. Who will assert that this man has not been injured by the dispensary? Of another class of recipients is a day-labourer, earning eighteen or twenty shillings a week, without family. He spends along with his better half four or five shillings a week in liquor; the remainder of his earnings is spent in a variety of imHis wife provident ways-at singing saloons, theatres, &c. He immebecomes dyspeptic, and wants medical advice. diately goes to his grocer, or to his friend the landlord of the alehouse, who he knows are subscribers to the dispensary. He at once receives a recommendation. The landlord is too happy to oblige a man who spends so much money at his house, and even the grocer is afraid of losing his custom were he to refuse. The wife appears before the honorary surgeon, or, armed with her recommendation, she sends for him, is prescribed for, and feels indebted to no one. By and by she discovers she is pregnant; but as there is no gratuitous midwifery, and as they are without credit, these same individuals, under the impulse of necessity, become provident for the time, and provide a sufficient sum to pay the expenses of the’confinement.

composed

Such are every-day patients at our so-called medical charities; and unless the profession becomes awakened to a sense of its monstrous injustice, a great portion before long will be found, like Shakespeare’s apothecary, needy in looks, and worn to the bones with unrewarded toil and sharp misery. I trust before we allow the system to conduct us to such an extremity, we shall have been roused into propriety, as drunken men are sometimes stunned into soberness; and while we bestow charity only where it is due, let us retrace our steps, and refuse to take or hold appointments if they are not to be sufficiently remunerated. I am, Sir, your obedient servant, M. D. August, 1853.

THE MEDICAL BENEVOLENT COLLEGE. To the Editor of THE LANCET. have cause to echo your well-merited eulogy on SiR,—We all our friend Mr. Propert’s for his kindness of heart towards his professional brethren in exerting his energies single-handed to establish a house in the evening of life for deserving but unfortunate members of our profession, together with an opportunity of educating our sons at a moderate outlay; but, Sir, I plainly see that much has yet to be accomplished in raising funds towards the completion of this noble design, as well as for its safer working, and I feel that we have a fit case to make application for a government grant, which I cannot believe would be refused, seeing that we are constantly called on by the public for immediate services for which there is not the shadow of a chance of getting remunerated, and which if we were to withhold, would operate most injuriously on us in our professional connexions. For these, and other reasons, then, I would suggest to the Council of the Medical Benevolent College the propriety of making an early application in the usual way. I am, Sir, faithfully yours, JOSEPH HODGSON. 1, Spital-square, August g, 1853. JOSEPH

THE MEDICAL PROFESSION AND LIFE ASSURANCE OFFICES. To the Editor of THE LANCET. SIR,-I beg to enclose you another specimen of the meanAfter the receipt of No. 1, ness of a Life Assurance Office. I wrote an answer, stating that I would be very happy to give my opinion upon being assured of the usual fee; but, after receiving No. 2,1heard nothing more from the office, and the life of the person was assured without any opinion from me. I remain, Sir, your obedient servant, JOHN JOHN LIDDELL, M.R.C.S.E. M.R.C.S.E Newcastle, August 20, 1853.

No. 1. 61, Grey-street, May 4,

1853.

Sm,—Mr. L. D-,of Pilgrim-street, having made reference to you as his medical attendant, I beg to solicit the

general health, and if you circumstance tending to shorten life or make assurance more than usually hazardous. I am, Sir, yours respectfully, J. Liddell, Esq., Surgeon, Pilgrim-street. M. CUTTWALL. favour of your

are aware

opinion

as

of any disorder

to his

or

No. 2. 61, Grey-street, May 5, 1853. medical examiner, and I have not hitherto been requested by any medical gentleman to pay any fee such as you refer to, seeing that it is only an opinion and not a personal examination we require from you. However, I shall lay your note before our Board, and if they authorize it I shall be most happy to pay it. I am, Sir, yours respectfully, M. CUTTWALL. Mr. Liddell.

SiR,-Dr. Humble is

our

_______________

THE REGISTRAR-GENERAL’S REPORTS. To the Editor of THE LANCET. SiB,—Iread every week with much interest, and no small instruction to myself, the Returns of Births and Deaths in London," and I beg here to tender my thanks to all concerned in this useful periodical statement, especially to Mr. Farr. As an admirer of the Returns, I feel justified in directing the attention of Mr. Farr (if you will kindly give a corner to this note in your widely-spread journal) to some very unsatisfactory passages in the number for the week ending August 13th,

1853, p.

259

:-

199 1. " A

Was the

boy, aged sixteen days,-a deep naavus on the back." operated upon ? was there spontaneous hmmor-

Medical News.

naevus

did the child die from the naevus ? &c. &c. It is plain that adeep naevus on the back" teaches us nothing. 2. " At 110, Penniugton-street, in St. George’s-in-the-East, on the lOth of August, a corn porter, aged sixty-two years, died from " fever, with great prostration, consequent on drinking a large draught of impure water (five days)." This sounds strange, and would require some explanations on the part of the medical attendant. 3." At Circus-row, Greenwich, on the 7th of August, a spinster, aged fifty-six years,-malignant carbuncle (two months), secondary abscesses (one month.)" What is maUgnant carbuncle ? If the affection was what is called carbuncle or anthrax, it was not malignant in the acceptation which surgeons generally attach to this word. 4. " A girl, aged eight weeks,-marasmus after the operation for hare-lip." Shall we look upon this as cause and effect? It is generally supposed that the child sucks better than before the operation. Why thus frighten operators, and not say whether the child was weakly before the surgeon interfered ? I hope these questions of mine will not be thought irrelevant, for I am actuated with a desire to see the " Returns" continue to spread the knowledge of valuable facts among the profession. But no obscurity and doubtful or misleading statements should find their way into so useful a national work.-Yours obediently, A SURGEON. August 19th, 1853.

rhage ?

House

APOTHECARIES’ HALL.—Names of gentlemen who passed their examination in the science and practice of medi-

cine, and

received certificates to

practise

on

Thursday, August 18th, 1853. ALTHAM, WILLIAM, Bentham, Yorkshire. BANKS, WILLIAM ROGER, Birmingham.

LONGTON, EDWARD JOHN, Southport, Lancashire. NEWMAN, WILLIAM JOHN, Sydney. PITTOCK, GEORGE MAYRIS, Deal, Kent. ROLSTON, PETER WILLIAMS, Devonport. TA,YLOR, GEORGE STopi-’oRD, Sheffield.

WILLIAMS, THOMAS MIDDLETON, Wellow,

near

Oberton,

Notts.

ROYAL COLLEGE

OF

SuRGEONS.—The

library

and

of this institution will close on Wednesday next, the former for one month, and the latter for two months, for the necessary cleaning and alterations.

museum

YELLOW FEVER.-It is stated that yellow fever is slowly subsiding in New Orleans, but that its ravages are still frightful, outstripping the mortality of all preceding years.

UNIVERSITY

OF

LONDON.——HONOURS.——J.KCOMM/

Physiology : T. Ed. Burton Brown, Exhibition,and Gold Medal, Guy’s Hospital; St. John Edwards, Gold Medal, University College; Clement Williams, Guy’s Hospital; Robert Henry Bartrum, Guy’s Hospital, and John Dewherst Scurrah, University College, equal: William Price Jones, University

and

of Commons.

College; George Mayris Pittock, Guy’s Hospital.—CAe)KM’
CHOLERA

AT

] 9TH.

HAMBURGH.

.

appeared

mistry: T. Ed. Burton Brown, Exhibition and Gold Medal, Guy’s Hospital; Wm. Price Jones, Gold Medal, University College; Joseph Ravenscroft Elsey,Guy’s Hospital, and Jas. Fawcus, University College, equal; Robert Henry Bartrum, and Clement Williams, Guy’s Hospital, equal.-Structural and ASSISTANT-SURGEONS, R.N. Physiological Botany: Thos. Ed. Burton Brown, Gold M;>dal, Mr. MACAULAY presented a petition from the Royal Collegee Guy’s Hospital; Clement Williams, Guy’s Hospital; John of Surgeons, Edinburgh, praying that immediate steps be takeni Dewherst Scurrah, University College; Geo. Mayris Pittock, to improve the condition on ship-board of the assistant-surgeonss Guy’s Hospital. in the Royal Navy. THE MANCHESTER MEDICO-ETHICAL ASSOCIATION METROPOLITAN SEWERS ACT CONTINUATION BILL. AND SIR JA1BIES L. BARDSLEY, M.D.-At a meeting of the ComThis Act, with the borrowing clause expunged, was read a mittee of the Manchester Medico-Ethical Association, held on Thursday. August Ii, 1853, it was moved by R. Allen, Esq., third time, and passed. seconded by T. Mellor, Esq., and unanimously resolved-" That the following congratulatory address be presented to Sir James SATURDAY, AUG. 20TH. L. Bardsley, M.D., President of the Association" :LUNATIC ASYLUMS.

in the public papers. Mr. NELSON said that a despatch from the consul there announced that thirty cases occurred in one day, but said nothing about the mortality. ’

’

-

"

Mr. PELLATT moved for a return of the names of all lunatic asylums, licensed houses, and registered hospitals for the reception of insane persons in England and Wales, the dates of the visits of the Commissioners in Lunacy, the names of the commissioners, and a copy of the report made by each visitor.

Military

and

Naval Intelligence.

MILITARY.-2nd North Durham Militia

Regiment:

John

Bland, gent., to be assistant-surgeon.-Durham Militia Artillery : James Trotter to be surgeon.-2nd Regiment County Warwickshire Militia: Patrick Brown, M.D., to be surgeon. - 54th Regiment of Foot: A vacancy has occurred by the death of Alexander Campbell, surgeon.-21st Foot: Assist.surg. Green has been, according to late accounts, severely and dangerously ill.-Devon Militia Artillery: John Beavis Big-

nell to be surgeon. SICKNESS AND MORTALITY AT BuRMAH.—A letter, dated Prome, states, that hot days, cold nights, fever, ague, and dysentery are decimating H.M. 51st, who have lost 300 men, and have 100 in hospital, while the remainder of that fine regiment, 900 strong, that so lately left Madras, amidst cheers and huzzas, presents a sad picture of disease. They have been almost baked during the hot weather. In the shade the thermometer varied from 17 0° to 112°.

Manchester, Aug. !8,

"SIR,-Her Majesty having been graciously pleased

J853.

confer upon you the honour of Knighthood, the members of the MedicoEthical Association of this city beg to offer you, as President of this Society, their most cordial congratulations on this distinguished recognition of your high professional character and your individual health. " While the association regards this well-merited honour as one done to the entire profession, they cannot fail to applaud the selection of yourself as the person through whom the tribute has been paid-a selection that recognises your eminence as a physician in the largest provincial city in England, and the inheritor of a name that will long be remembered in the profession with respect and admiration. " That you may long live to enjoy the honour which her Majesty has so appropriately conferred upon you, and thus be a living testimony to your junior professional brethren of the practical advantages that attend the possession of intellectual superiority and moral excellence, is the earnest wish of’the members of the Manchester Medico-Ethical Association. Signed on behalf of the Association, , W. W. J. WILSON, l Vice-PresidentS’. J. ROBERTON, ROBERTON,5 D. NOBLE, Treasurer. J. AIKENHEAD, M.D., M.D., to

WILSON,Vice-Presidents.

W. C. WILLIAMSON, W]ILLIANSON, "To Sir James L. Bardsley, M.D., &c."

°’ Hon, Secs. Sees. "’ SlHon.