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THE RESPONSIBILITIES OF THE EMPLOYER.
THE RESPONSIBILITIES OF THE EMPLOYER.
638
branch of the radial artery and the posterior carpal and if compelled to ndopt that course resign en bloc, and, as branch of the ulnar. One can readily understand that if the has been proved in Liverpool, successwould follow in time, posterior carpal branch of the radial, which comes off exactly and the hospital .’-ecretary, promoter, and lav committee over, and runs transversely across, the seat of Colles’ frac- would very soon ca,ve in and Dndtheir own level. The ture, were pressed on, or, may be, obliterated, these four general practitioners would resume their practic:tl appreciafinger-nails would be deprived of half their blood-supply tion and remunerative confidence in the hospital specialist, until a compensatory supply from the ulnar artery bad there would be employment for hundreds more of our proThe reason the thumb escaped is: fession, the people would cease to be demoralised, and the become established. because the dorsalis pollicis branch of the radial, which subscribing public would not be defrauded as they are at supplies the thumb-nail, comes off a good two inches lowerpresent, and part of the money now expended on those who down, quite clear of the fracture. A glance at Fig. 221 can afford to pay for advice and medicine could be given to in " Gray’s Anatomy" will make this explanation clear, andl help other deserving charities. I for one am much indebted to Dr. Davison for clearing up) I am, Sirs, your obedient setvant, MEDICAL PRACTITIONER. a matter which, for lack of clinical evidence of this kind, has London, Aug 19th, been erroneously attributed to the nervous system when in (reality it is due to a disturbance in the circulatory system. I am, Sirs, your obedient servant, MANCHESTER. THOMAS D. SAVILL, M.D. Lond. Upper Berkeley-street, Aug. 22nd, 1836. OWN CORRESPONDENT.) OUR (FROM
carpal
.
1896.
-
THE RESPONSIBILITIES OF THE
EMPLOYER. of THE LANCET. SIRS,—I would feel obliged if you or any of your numerous readers could give me information on the following point. A medical man keeps an unqualified chemist to dispense his own prescriptions only (no retail). Would such chemist or the medical man be liable to prosecution should a prescription dispensed by the former be found on analysis to contain a scheduled poison?-I am, Sirs, yours faithfully. To the Editors
ECOSSAIS, M.B. is allowed to prescribe all remedies, .scheduled or unscheduled. The qualifications of his dispenser do not enter into the question. The medical man is responsible entirely. His dispenser merely does as he is told by word of mouth or written formula. He should not be employed by the medical man unless he is competent to
man
HOSPITAL ABUSE. To the Editors of THE LANCET. SIRS,-Having decided to examine this subject I visited regularly for the past few months the out-patient departments of several London general and special hospitals. I found (1) that the majority of the patients attended for
ordinary ailments-viz., minor accidents, bruises, ulcers, .abscesses, indigestion, constipation, coughs, and uterine discharges, &c. ; (2) that about two out of every six patients could pay the smart
fee charged by many of the who abound in almost every
required reduced
general practitioners
- district and who keep comfortable, well-equipped surgeries ; (3) that in both sets of hospitals it was absolutely scandalous to treat several of the patients so superior were they in ’dress, genuine jewellery, &c. ; and (4) many of the patients .asked for medicine "for a fortnight " or for " three weeks," .as they were going for a holiday to the " seaside." I spoke to several of the surgeons and physicians the
of the abuse prevalent, when they but pointed out that so desirous were the secretary and lay committee of the hospital to treat the largest number of out-patients, they, the staff, could not decline to do so unless they were prepared to resign their appointments. I now beg to offer the following suggestion, which might be adopted in some form to put a stop to this monstrous fraud that is being carried on under the garb of charity. The hospital secretary and hospital promoter and lay committee have had their unfettered turn, and they have, to use a mild term, failed. Let those professional gentlemen who hold hospital appointments, and those who aspire to hold such positions, combine and form an association to enable them to act individually and collectively ; let them, when, for instance, they see fit, recommend improvements in the medical department of their respective hospitals, and decline to treat any patient whom they consider ineligible and then stand the consequences. Should any member be called on to resign for so - declining the entire medical staff should at once threaten on
all
subject deplored it,
Tram Servants and their Meals. IF the drivers and conductors of the trams now to be seen in every large town throughout the country are act treated with greaterconsideration than they are in Manchester their lot is not to be envied. Here their hours are lcng-sixteen hours a day, it is said-without any arrangements for getting a meal anywhere but in the trams. Some correspondence has been going on in the Manchester Guardian which shows that whatever the Manchester Carriage Company may feel, it is left for sympathetic passengers to bring the matter forward. It is a common sight on the last journey from town to the suturbs before the dinner-time-not dinner hour-to see a poor woman or a little girl bring a can of tea, with a basin wrapped in :1 cloth, to the car for the driver or the guard. As they near the stables, if the passengers are few, "the guard turns up one of the cushions, seats himself with his back to the passengers, and begins his dinner." When the terminus is reached it is the driver’s turn, so he comes inside, goes up usually to the other end of the car, and eats his dinner, while his wife, with a child or two, waits to take home the can and the basin. Nominally I believe fifteen minutes are allowed for this purpose, but generally five minutes have to suffice. "Very often the guard drives while the driver finishes eating at a rate that would kill anyone else." This takes place twice every day. It is a proceeding not only devoid of all comfort for the men, but disagreeable to the passengers from the "dinnery"smell left in the tram. Even if the directors have no thought for the men, one would have supposed that self-interest, as to which they are usually alive, would have led them to make arrangements to save the passengers from a spectacle which excites pity and from smells that are obnoxious. This hurry-scurry cramming of their food is not good for the digestion of these men, and yet, as a rule, they are most civil and obliging. Imagine the scenes that would have occurred if poor, dyspeptic Carlyle had been a tramconductor under such a régime. The Manchester Guardian in a leading article speaks of it as a "public scandal " and says: "These men, who cannot be spared for half an hour in the middle of the day, are working long hours at a waga of, say, some 20s. to 24s. a week. This is scarcely what one would expect in the administration of a wealthy and prosperous company." It is directed by men, some of whom pass for philanthropists, and illustrates in an unpleasant manner the deterioration of conscience when it becomes "corporate," for it is not to be supposed that individually any one of them would inflict cruelties of such a character on any dweller in their own households. But, as one of the correspondents, Dr. Rideal, says, "The Tramway men themselves, not being skilled labourers, are not in a position to make their own terms with the company." There is
a
Sanitary Museum for ManeAeqttr. good prospect that before long Manchester will
be provided with a sanitary museum where all interested in the health of the city, either generally or as regards the condition of their own dwellings, may have object lessons in sanitary requirements and applianees. An important deputation waited the other day on the Manchester Technical Instruction Committee, "with a view to the provision of accommodation in the Technical School for a sanitary museum, and to offer on behalf of the Plumbers’ Council as a nucleus the prize work in connexion with the competition which is now being organisecl." It consisted
638
branch of the radial artery and the posterior carpal and if compelled to ndopt that course resign en bloc, and, as branch of the ulnar. One can readily understand that if the has been proved in Liverpool, successwould follow in time, posterior carpal branch of the radial, which comes off exactly and the hospital .’-ecretary, promoter, and lav committee over, and runs transversely across, the seat of Colles’ frac- would very soon ca,ve in and Dndtheir own level. The ture, were pressed on, or, may be, obliterated, these four general practitioners would resume their practic:tl appreciafinger-nails would be deprived of half their blood-supply tion and remunerative confidence in the hospital specialist, until a compensatory supply from the ulnar artery bad there would be employment for hundreds more of our proThe reason the thumb escaped is: fession, the people would cease to be demoralised, and the become established. because the dorsalis pollicis branch of the radial, which subscribing public would not be defrauded as they are at supplies the thumb-nail, comes off a good two inches lowerpresent, and part of the money now expended on those who down, quite clear of the fracture. A glance at Fig. 221 can afford to pay for advice and medicine could be given to in " Gray’s Anatomy" will make this explanation clear, andl help other deserving charities. I for one am much indebted to Dr. Davison for clearing up) I am, Sirs, your obedient setvant, MEDICAL PRACTITIONER. a matter which, for lack of clinical evidence of this kind, has London, Aug 19th, been erroneously attributed to the nervous system when in (reality it is due to a disturbance in the circulatory system. I am, Sirs, your obedient servant, MANCHESTER. THOMAS D. SAVILL, M.D. Lond. Upper Berkeley-street, Aug. 22nd, 1836. OWN CORRESPONDENT.) OUR (FROM
carpal
.
1896.
-
THE RESPONSIBILITIES OF THE
EMPLOYER. of THE LANCET. SIRS,—I would feel obliged if you or any of your numerous readers could give me information on the following point. A medical man keeps an unqualified chemist to dispense his own prescriptions only (no retail). Would such chemist or the medical man be liable to prosecution should a prescription dispensed by the former be found on analysis to contain a scheduled poison?-I am, Sirs, yours faithfully. To the Editors
ECOSSAIS, M.B. is allowed to prescribe all remedies, .scheduled or unscheduled. The qualifications of his dispenser do not enter into the question. The medical man is responsible entirely. His dispenser merely does as he is told by word of mouth or written formula. He should not be employed by the medical man unless he is competent to
man
HOSPITAL ABUSE. To the Editors of THE LANCET. SIRS,-Having decided to examine this subject I visited regularly for the past few months the out-patient departments of several London general and special hospitals. I found (1) that the majority of the patients attended for
ordinary ailments-viz., minor accidents, bruises, ulcers, .abscesses, indigestion, constipation, coughs, and uterine discharges, &c. ; (2) that about two out of every six patients could pay the smart
fee charged by many of the who abound in almost every
required reduced
general practitioners
- district and who keep comfortable, well-equipped surgeries ; (3) that in both sets of hospitals it was absolutely scandalous to treat several of the patients so superior were they in ’dress, genuine jewellery, &c. ; and (4) many of the patients .asked for medicine "for a fortnight " or for " three weeks," .as they were going for a holiday to the " seaside." I spoke to several of the surgeons and physicians the
of the abuse prevalent, when they but pointed out that so desirous were the secretary and lay committee of the hospital to treat the largest number of out-patients, they, the staff, could not decline to do so unless they were prepared to resign their appointments. I now beg to offer the following suggestion, which might be adopted in some form to put a stop to this monstrous fraud that is being carried on under the garb of charity. The hospital secretary and hospital promoter and lay committee have had their unfettered turn, and they have, to use a mild term, failed. Let those professional gentlemen who hold hospital appointments, and those who aspire to hold such positions, combine and form an association to enable them to act individually and collectively ; let them, when, for instance, they see fit, recommend improvements in the medical department of their respective hospitals, and decline to treat any patient whom they consider ineligible and then stand the consequences. Should any member be called on to resign for so - declining the entire medical staff should at once threaten on
all
subject deplored it,
Tram Servants and their Meals. IF the drivers and conductors of the trams now to be seen in every large town throughout the country are act treated with greaterconsideration than they are in Manchester their lot is not to be envied. Here their hours are lcng-sixteen hours a day, it is said-without any arrangements for getting a meal anywhere but in the trams. Some correspondence has been going on in the Manchester Guardian which shows that whatever the Manchester Carriage Company may feel, it is left for sympathetic passengers to bring the matter forward. It is a common sight on the last journey from town to the suturbs before the dinner-time-not dinner hour-to see a poor woman or a little girl bring a can of tea, with a basin wrapped in :1 cloth, to the car for the driver or the guard. As they near the stables, if the passengers are few, "the guard turns up one of the cushions, seats himself with his back to the passengers, and begins his dinner." When the terminus is reached it is the driver’s turn, so he comes inside, goes up usually to the other end of the car, and eats his dinner, while his wife, with a child or two, waits to take home the can and the basin. Nominally I believe fifteen minutes are allowed for this purpose, but generally five minutes have to suffice. "Very often the guard drives while the driver finishes eating at a rate that would kill anyone else." This takes place twice every day. It is a proceeding not only devoid of all comfort for the men, but disagreeable to the passengers from the "dinnery"smell left in the tram. Even if the directors have no thought for the men, one would have supposed that self-interest, as to which they are usually alive, would have led them to make arrangements to save the passengers from a spectacle which excites pity and from smells that are obnoxious. This hurry-scurry cramming of their food is not good for the digestion of these men, and yet, as a rule, they are most civil and obliging. Imagine the scenes that would have occurred if poor, dyspeptic Carlyle had been a tramconductor under such a régime. The Manchester Guardian in a leading article speaks of it as a "public scandal " and says: "These men, who cannot be spared for half an hour in the middle of the day, are working long hours at a waga of, say, some 20s. to 24s. a week. This is scarcely what one would expect in the administration of a wealthy and prosperous company." It is directed by men, some of whom pass for philanthropists, and illustrates in an unpleasant manner the deterioration of conscience when it becomes "corporate," for it is not to be supposed that individually any one of them would inflict cruelties of such a character on any dweller in their own households. But, as one of the correspondents, Dr. Rideal, says, "The Tramway men themselves, not being skilled labourers, are not in a position to make their own terms with the company." There is
a
Sanitary Museum for ManeAeqttr. good prospect that before long Manchester will
be provided with a sanitary museum where all interested in the health of the city, either generally or as regards the condition of their own dwellings, may have object lessons in sanitary requirements and applianees. An important deputation waited the other day on the Manchester Technical Instruction Committee, "with a view to the provision of accommodation in the Technical School for a sanitary museum, and to offer on behalf of the Plumbers’ Council as a nucleus the prize work in connexion with the competition which is now being organisecl." It consisted