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THE RIGHTS OF MILITIA SURGEONS.
the present asylum at Hanwell, and adding thereto an " additional accommodation to the extent of GOO beds for patients, .. at an expense not exceeding X67,300." It is affirmed by Mr. Armstrong that "if the contemplated enlargement of the Hanwell Asylum were carried into effect, the ultimate result would be an extraordinary saving to the county, because the cost of such an enlargement would not be a moiety of the cost of building a new asylum altogether." One of the reasons given for the opinion is, that " one staff of officers would suffice, instead of two." Not long after my appointment to the County Asylum at ,Colney Hatch, in 1850, my then colleague (Dr. Hood) and myself were required to visit the lunatics, male and female, in - confinement at the union-houses throughout the Northern and .Eastern Divisions of the metropolis and in certain of the suburbs; and the knowledge and experience thus gained assured ane that, in spite of all the warm and earnest anticipations to the contrary, the great palace-like erection at the quiet village ’of Colney Hatch, with its 1300 beds, including its sister establishment at Hanwell, would not long continue to accommo.date the pamper lunatics of Middlesex. It required but to look to the past increase of mental disorders amongst the poor, and to consider this in connexion with the increased and increasing population of London and its neighbourhood, to feel assured that the provision of mere commonplace asylums, like Hanwell and Colney-Hatch Asylums, was altogether insufficient to meet the difficulty thus looming in the future;" in other words, that the erection of mere places of confinement and safe custody for the pauper lunatics of Middlesex constituted nothing more nor less than a piece of expediency, and that hardly excusable. You will, Sir, I think, agree with me when I say that there has been wanted in the suburbs of London for a -very long time past, what is now more than ever wanted, - viz., an hospital for the insane poor; an establishment so - contrived and governed as to constitute a place of cure. Such an hospital should receive all the most recent cases, none of which should be sent either to Hanwell or Colney-Hatch Asylums, because neither of these institutions are really adapted to the cw’e of mental derangement. They are both much too large, too cumbrous, too much like the common union-houses, to embrace the details necessary to the cure of the disordered mind. Neither the form of government, the internal arrangements, nor the social and domestic economy, so to speak, of ,either Hanwell or Colney-Hatch Asylums, are adapted for .anything more than the mere common care and safe-custody of their inmates: in a word, these large houses are fit only to receive the incurably mad. If, then, the Middlesex magistrates would escape the enormous cost to the county of finding additional accommodation for something like 5000 lunatics within the next quarter of a century, let them look to the erection of an hospital for the insane poor,-one which shall be so contrived and governed as to embrace all the best and most approved resources of science, and comprehend within itself all the means both of relief and cure of those mentally afflicted. Such an establishment should not contain more than 250 beds, and should be altogether and exclusively an hospital,—i. e., under medical government. Bear in mind, Sir, if you please, that neither of the large asylums named has this advantage. If the recoveries at the Hanwell and Colney-Hatch Asylums realise, as they do, only five per cent. per annum, whilst those at smaller and more favoured establishments of the same kind shew, which is the fact, an average from year to year of from forty to sixty per cent. ,-then, may you consider that I am not without an excuse for thus addressing you. It may occur to you, Sir, that such an establishment as that herein suggested might be rendered additionally serviceable and honourable to our calling if made available as a school of Practical Psychology. But this, to be carried into effect, will demand other interests than those now enlisted in the cause of .asylums and the insane. With many apologies for the length of these remarks, I am. Sir. vour most obedient servant. J. G. DAVEY, M.D.
above-quoted
Sir,
of promotion.
A fortunate man obtains the charge of a civil station in twelve months,. and cnnseqnently draws £500 a year; an unfortunate one is for three or four years without a charge, and only gets X300 a year. Having been an unfortunate man in promotion, and having no friends at head quarters to put me into a good staff appointment, I think my opinion may be considered an unbiassed one. I distinctly say, and I believe, that the very great majority of my brethern will agree with me in saying, that the Service is a very good one, and that if we bad our youth again, we would make the selection we have already done. Any man who has a little private property would act foolishly to come to India. With respect to Presidencies, I prefer Madras, as, although the promotion is worst, the fund is far the best. Bombay is decidedly bad, as every assistant-surgeon in the Bombay Army List is obliged to serve two years on board the Indian navy. One more point : although the Examining Committee at home settle the position of the assistant-surgeons in the " Army List," their places in the Madras Medical Fund (I believe the others are the same) are settled by the date of their arrival in India, so that the senior man in the Army List may, should he stay in England as long as he is allowed by the home authorities, and then come out round the "Cape," be superseded by all the junior of his batch who have had the prudence to leave home sooner, and come out" overland." The annuities are given to applicants by seniority in the Fund List, not the Army List. I remain, faithfully yours, A MADRAS ASSISTANT-SURGEON. Madras, Jan. 18th, 1856.
regiment
or
THE
HALSTEAD
UNION.
To the Editor of THE LANCET. would be easy to heap " Pelion upon Ossa," in the SIR,—It shape of complaints of the meanness and injustice of Poor-law guardians towards their medical officers. In their "lignite" capacity they do things of which as individuals they would be ashamed. 1 will tell you one. A fortnight after the occurrence of the case which you did me the honour to publish in your number of the 12th inst., I was sent for by the midwife in attendance on the wife of J. E—, a labourer, of Toppesfield. It was her first confinement, and her husband earns ten shillings a week. On my arrival at a miserable cottage, up a vile, dirty lane, I found a young woman in strong puerperal convulsions. I adopted active treatment, and though she was totally insensible upwards of twelve hours, herself and infant both did well. Whilst I was detained at the house, I took the precaution to write a note to a guardian of the parish, close by, telling him that unless. he sent me an order to attend the case I would not remain, for I felt indignant at the board having refused an order for the case previously mentioned. He sent me an order, and as a matter of course I charged £2, it being a case after a
midwife.
Board, not having the power to ignore the "litera of a competent authority, consulted their interest, and, no doubt, their inclination, in cutting the case down to the ordinary fee of 13s. I was detained with this patient all Sunday afternoon, till The
scripta"
late at night. I saw her at five A.M. next morning, made sundry journeys to her, (five miles off,) up a lane it would be dishonest to a life assurance to travel by night, gave the midwife half-a-crown, and for all this "the grave and potent signors" have voted 13.s. It may be said, why not appeal to the Poor-law Board ? and I must here acknowledge that I have done so on many occaand justice has invariably been aiforded me ; still, according to my experience, the result has been unsatisfactory, inasmuch as when a medical officer perseveres and gains his point, he is unpleasantly surprised to find that he has at the same time made many enemies. I am. Sir. vour obedient servant. J. B. BUDGETT.
sions,
THE EAST INDIA MEDICAL SERVICE.
THE RIGHTS OF MILITIA SURGEONS.
of THE LANCET. on the subject of the H.E.I.Co.’s letters SIR,—Numerous Medical Service have appeared ill your columns. All these seem to me to give an incorrect idea to the English reader. It is impossible for me to say how much pay an assistant-surgeon will receive during his first five years, as it is entirely a matter
To the Editor of THE LANCET. confirmation of the leading article in your last SIR,—In number, referring to the position of the militia surgeons on the disembodiment of their respective regiments, I beg, through your pages, to inform my brethren in the service that I have this day received an. official communication Was
To the Editor
496
from the
Department, in answer to a memorial of mine to Lord Panmure on the subject, which states :I am directed by Lord Panmure to acknowledge the receipt of your letter of the 2nd inst., and to acquaint you
GRIEVANCES OF POOR-LAW SURGEONS.
"
that the case of the surgeons of the embodied militia is under consideration.
now
Surgeon Ikin, 4th West York Militia." The-letter referred to contained a fairly-detailed statement of our case, representing our grievances, and requesting from the Government a fair consideration of our claims for compensation, or half-pay, on disembodiment. Something to improve our position I feel confident will now be done, and our best thanks are due to the colonels who waited upon Lord Panmure, and to his lordship for his attention to the case of the militia surgeons. I am. Sir. vour obedient servant. "To
J. I.
IKIN, F.R.C.S.,
4th West York
Regiment of Militia.
MR.
To the Editor of THE LANCET. one of the most gracious acts, perhaps, to reis not SIR,—It quest an Editor to publish his own unworthiness, or the contrary ; but having read in the last number of THE LANCET a letter signed "Thos. Litchfield,"Icould not withhold my observations in the concurrence and promotion of his views on so just a tribute. I therefore beg you to accept most cordially and respectfully my thanks, in acknowledgment of the debt of gratitude due from the profession to yourself, who at all times, and under all circumstances, have been foremost confessedly to uphold our status, and boldly and fearlessly advance and secure our interests. So universally is this admitted, and so generally felt and acknowledged, that I can but regret and express my astonishment that no public testimonial has been forthcoming, to convince, encourage, and assure you that the medical profession are not less vigilant, less reflective, and less grateful than other bodies. Had I the magician’s wand, or were my opinion and position equal to some in this metropolis, I should endeavour to make my voice heard on so befitting an occasion, and remind our friends" The evil that men do lives after them, The good is oft interred with their bones." As it is, I must be satisfied with reiterating the sentiments of your correspondent, "unless Fortune should be merry, and in this mood bequeath us anything." Why we withhold from "Cæsar the things that are Caisar’s" is unaccountable, and worthy the consideration of a generous and exalted profession. True is it that the manifold engagements which occupy everyday life engross our entire attention, to the exclusion very frequently of important matters; at all events, on the present occasion, I do hope to see practically demonstrated, that by enlarging the understanding, we correct and enlarge the human heart, " and approach nearer to the gods." I am, Sir, very faithfully yours, WM. SETE GILL. Pentonville, April, 1856.
MOVEMENT.
the Poor-law Medical Officers held at Tenit was resolved1st.—That this meeting tenders its best thanks to Mr. Griffin for his exertions in behalf of the Poor-law Medical Officers, and pledges itself to co-operate with him in his endeavours to improve their position. 2nd.-That this meeting considers that the salaries of the Medical Officers ought to be made remunerative for the duties performed; that all operations should be paid for extra; that the minimum fee for midwifery should be £1; and that the Medical Officer of the union-house should be entitled to the same fees for operations performed in the house. 3rd.-That a subscription be entered into for expenses incurred, and that Mr. Newington be requested to forward the; same, with a copy of these resolutions, to Mr. Griffin.
At
a
terden,
meeting of
Signed
"THE LANCET" AND THE MEDICAL PROFESSION.
GRIFFIN’S
on
behalf of the meeting.
JESSE H. NEWINGTON. At a meeting of the Medical Officers of the Devizes union,. the following resolutions were unanimously adopted :1st.—That this meeting, viewing with satisfaction the movement set on foot by Mr. Griffin, for the improvement of the position of the medical officers of the unionsthroughout the kingdom, hereby expresses its willingness to co-operate with him, and generally to support him in the plans which he proposes for the attainment of so desirable an object. 2nd. That Mr. Thomas B. Auster be requested to act as secretary and treasurer, and also to communicate with Mr. Griffin as to the further steps to be taken for the carrying out of his views. 3rd.-That a subscription of 5s. be paid by each officer to the secretary, to be repeated quarterly as long as may be
thought necessary.
4th.-That this meeting is of opinion1st. That the present rates of payment are quite inadequate to the amount of service rendered, and that some system of payment per case is best calculated to effect improvement therein, the question of distance being also duly considered. 2nd. That the list of payment for extras requires to be extended, so as to include all cases requiring more than ordinary labour and responsibility. 3rd. That the establishment of local dispensaries, and the employment of dispensers wherever practicable, would tend to the relief of the medical officers, and the more correct valuation of their services. 5th.-That the foregoing resolutions be sent for insertion to, the leading medical journals. At a meeting of the Medical Officers of the parish of Stoke Damerel, held at the Devonport Dispensary on April 21st, 1856 - present, Messrs. Bennett, Butcher, De Larue, and Rolston,the following resolutions were unanimously agreed to :1st.—That, although the medical officers of this parish have not that cause for dissatisfaction which exists in many places, yet they beg to tender their thanks to Mr. Griffin for the zeal and ability he has displayed in the movement on behalf of
[Our kind correspondent may be assured, that a correct Medical Reform. appreciation of the motives by which our public labours, of Poor-law 2nd.-That this meeting, without pledging itself to details, whatever description, have been dictated and influenced, will approves generally of the principles advocated by Mr. Griffin. ever present to us the most gratifying "testimonial" that it 3rd.-That a subscription of 5s. be paid by each present to would be possible to offer for our acceptance. -ED. L.] defray necessary expenses, and repeated as occasion may require. 4th.--That Mr. De Larue be appointed local secretary. 5th.-That
THE CARMICHAEL PRIZES OF THE ROYAL Griffin, and COLLEGE OF SURGEONS, DUBLIN. To the Editor of THE LANCET. SIR,—The publication of our communication in your worldknown journal has procured an answer respecting the Carmichael Prizes of the Dublin College of Surgeons. The answer given by Dr. Maunsel has quite satisfied us; but till that answer was elicited, we were quite ignorant as to the fate of our essays. We find they had been rejected, which we regret, but we only complain of not being informed of their rejection after two applications. Thanking you very much for rendering us a service, we beg
to subscribe ourselves, Dublin, May, 1856.
THE REJECTED CANDIDATES FOR CARMICHAEL PRIZES.
THE
a
copy of these resolutions be forwarded to Mr.
to each of the medical
journals.
At a meeting of the Medical Officers of the Hertford Union, held at Hertford on Saturday, April 26th, 1856, it was resolved
unanimously :-
1st.—That the thanks of this meeting be given to R. Griffin, of Weymouth, for his exertions in the cause of Poor-law Medical Reform. 2nd.-That this meeting pledges itself to support Mr. Griffin in his endeavours to remove the grievances of Union Medical Officers, and hereby agrees to subscribe 10s. each towards the necessary expenses incurred. 3rd.-That this meeting approves generally of the main principles laid down by Mr. Griffin in his circular. L. ARCHER, G. DUNN, T. ODELL. J. WOODHOUSE.
Esq.,
497
above-quoted
Sir,
of promotion.
A fortunate man obtains the charge of a civil station in twelve months,. and cnnseqnently draws £500 a year; an unfortunate one is for three or four years without a charge, and only gets X300 a year. Having been an unfortunate man in promotion, and having no friends at head quarters to put me into a good staff appointment, I think my opinion may be considered an unbiassed one. I distinctly say, and I believe, that the very great majority of my brethern will agree with me in saying, that the Service is a very good one, and that if we bad our youth again, we would make the selection we have already done. Any man who has a little private property would act foolishly to come to India. With respect to Presidencies, I prefer Madras, as, although the promotion is worst, the fund is far the best. Bombay is decidedly bad, as every assistant-surgeon in the Bombay Army List is obliged to serve two years on board the Indian navy. One more point : although the Examining Committee at home settle the position of the assistant-surgeons in the " Army List," their places in the Madras Medical Fund (I believe the others are the same) are settled by the date of their arrival in India, so that the senior man in the Army List may, should he stay in England as long as he is allowed by the home authorities, and then come out round the "Cape," be superseded by all the junior of his batch who have had the prudence to leave home sooner, and come out" overland." The annuities are given to applicants by seniority in the Fund List, not the Army List. I remain, faithfully yours, A MADRAS ASSISTANT-SURGEON. Madras, Jan. 18th, 1856.
regiment
or
THE
HALSTEAD
UNION.
To the Editor of THE LANCET. would be easy to heap " Pelion upon Ossa," in the SIR,—It shape of complaints of the meanness and injustice of Poor-law guardians towards their medical officers. In their "lignite" capacity they do things of which as individuals they would be ashamed. 1 will tell you one. A fortnight after the occurrence of the case which you did me the honour to publish in your number of the 12th inst., I was sent for by the midwife in attendance on the wife of J. E—, a labourer, of Toppesfield. It was her first confinement, and her husband earns ten shillings a week. On my arrival at a miserable cottage, up a vile, dirty lane, I found a young woman in strong puerperal convulsions. I adopted active treatment, and though she was totally insensible upwards of twelve hours, herself and infant both did well. Whilst I was detained at the house, I took the precaution to write a note to a guardian of the parish, close by, telling him that unless. he sent me an order to attend the case I would not remain, for I felt indignant at the board having refused an order for the case previously mentioned. He sent me an order, and as a matter of course I charged £2, it being a case after a
midwife.
Board, not having the power to ignore the "litera of a competent authority, consulted their interest, and, no doubt, their inclination, in cutting the case down to the ordinary fee of 13s. I was detained with this patient all Sunday afternoon, till The
scripta"
late at night. I saw her at five A.M. next morning, made sundry journeys to her, (five miles off,) up a lane it would be dishonest to a life assurance to travel by night, gave the midwife half-a-crown, and for all this "the grave and potent signors" have voted 13.s. It may be said, why not appeal to the Poor-law Board ? and I must here acknowledge that I have done so on many occaand justice has invariably been aiforded me ; still, according to my experience, the result has been unsatisfactory, inasmuch as when a medical officer perseveres and gains his point, he is unpleasantly surprised to find that he has at the same time made many enemies. I am. Sir. vour obedient servant. J. B. BUDGETT.
sions,
THE EAST INDIA MEDICAL SERVICE.
THE RIGHTS OF MILITIA SURGEONS.
of THE LANCET. on the subject of the H.E.I.Co.’s letters SIR,—Numerous Medical Service have appeared ill your columns. All these seem to me to give an incorrect idea to the English reader. It is impossible for me to say how much pay an assistant-surgeon will receive during his first five years, as it is entirely a matter
To the Editor of THE LANCET. confirmation of the leading article in your last SIR,—In number, referring to the position of the militia surgeons on the disembodiment of their respective regiments, I beg, through your pages, to inform my brethren in the service that I have this day received an. official communication Was
To the Editor
496
from the
Department, in answer to a memorial of mine to Lord Panmure on the subject, which states :I am directed by Lord Panmure to acknowledge the receipt of your letter of the 2nd inst., and to acquaint you
GRIEVANCES OF POOR-LAW SURGEONS.
"
that the case of the surgeons of the embodied militia is under consideration.
now
Surgeon Ikin, 4th West York Militia." The-letter referred to contained a fairly-detailed statement of our case, representing our grievances, and requesting from the Government a fair consideration of our claims for compensation, or half-pay, on disembodiment. Something to improve our position I feel confident will now be done, and our best thanks are due to the colonels who waited upon Lord Panmure, and to his lordship for his attention to the case of the militia surgeons. I am. Sir. vour obedient servant. "To
J. I.
IKIN, F.R.C.S.,
4th West York
Regiment of Militia.
MR.
To the Editor of THE LANCET. one of the most gracious acts, perhaps, to reis not SIR,—It quest an Editor to publish his own unworthiness, or the contrary ; but having read in the last number of THE LANCET a letter signed "Thos. Litchfield,"Icould not withhold my observations in the concurrence and promotion of his views on so just a tribute. I therefore beg you to accept most cordially and respectfully my thanks, in acknowledgment of the debt of gratitude due from the profession to yourself, who at all times, and under all circumstances, have been foremost confessedly to uphold our status, and boldly and fearlessly advance and secure our interests. So universally is this admitted, and so generally felt and acknowledged, that I can but regret and express my astonishment that no public testimonial has been forthcoming, to convince, encourage, and assure you that the medical profession are not less vigilant, less reflective, and less grateful than other bodies. Had I the magician’s wand, or were my opinion and position equal to some in this metropolis, I should endeavour to make my voice heard on so befitting an occasion, and remind our friends" The evil that men do lives after them, The good is oft interred with their bones." As it is, I must be satisfied with reiterating the sentiments of your correspondent, "unless Fortune should be merry, and in this mood bequeath us anything." Why we withhold from "Cæsar the things that are Caisar’s" is unaccountable, and worthy the consideration of a generous and exalted profession. True is it that the manifold engagements which occupy everyday life engross our entire attention, to the exclusion very frequently of important matters; at all events, on the present occasion, I do hope to see practically demonstrated, that by enlarging the understanding, we correct and enlarge the human heart, " and approach nearer to the gods." I am, Sir, very faithfully yours, WM. SETE GILL. Pentonville, April, 1856.
MOVEMENT.
the Poor-law Medical Officers held at Tenit was resolved1st.—That this meeting tenders its best thanks to Mr. Griffin for his exertions in behalf of the Poor-law Medical Officers, and pledges itself to co-operate with him in his endeavours to improve their position. 2nd.-That this meeting considers that the salaries of the Medical Officers ought to be made remunerative for the duties performed; that all operations should be paid for extra; that the minimum fee for midwifery should be £1; and that the Medical Officer of the union-house should be entitled to the same fees for operations performed in the house. 3rd.-That a subscription be entered into for expenses incurred, and that Mr. Newington be requested to forward the; same, with a copy of these resolutions, to Mr. Griffin.
At
a
terden,
meeting of
Signed
"THE LANCET" AND THE MEDICAL PROFESSION.
GRIFFIN’S
on
behalf of the meeting.
JESSE H. NEWINGTON. At a meeting of the Medical Officers of the Devizes union,. the following resolutions were unanimously adopted :1st.—That this meeting, viewing with satisfaction the movement set on foot by Mr. Griffin, for the improvement of the position of the medical officers of the unionsthroughout the kingdom, hereby expresses its willingness to co-operate with him, and generally to support him in the plans which he proposes for the attainment of so desirable an object. 2nd. That Mr. Thomas B. Auster be requested to act as secretary and treasurer, and also to communicate with Mr. Griffin as to the further steps to be taken for the carrying out of his views. 3rd.-That a subscription of 5s. be paid by each officer to the secretary, to be repeated quarterly as long as may be
thought necessary.
4th.-That this meeting is of opinion1st. That the present rates of payment are quite inadequate to the amount of service rendered, and that some system of payment per case is best calculated to effect improvement therein, the question of distance being also duly considered. 2nd. That the list of payment for extras requires to be extended, so as to include all cases requiring more than ordinary labour and responsibility. 3rd. That the establishment of local dispensaries, and the employment of dispensers wherever practicable, would tend to the relief of the medical officers, and the more correct valuation of their services. 5th.-That the foregoing resolutions be sent for insertion to, the leading medical journals. At a meeting of the Medical Officers of the parish of Stoke Damerel, held at the Devonport Dispensary on April 21st, 1856 - present, Messrs. Bennett, Butcher, De Larue, and Rolston,the following resolutions were unanimously agreed to :1st.—That, although the medical officers of this parish have not that cause for dissatisfaction which exists in many places, yet they beg to tender their thanks to Mr. Griffin for the zeal and ability he has displayed in the movement on behalf of
[Our kind correspondent may be assured, that a correct Medical Reform. appreciation of the motives by which our public labours, of Poor-law 2nd.-That this meeting, without pledging itself to details, whatever description, have been dictated and influenced, will approves generally of the principles advocated by Mr. Griffin. ever present to us the most gratifying "testimonial" that it 3rd.-That a subscription of 5s. be paid by each present to would be possible to offer for our acceptance. -ED. L.] defray necessary expenses, and repeated as occasion may require. 4th.--That Mr. De Larue be appointed local secretary. 5th.-That
THE CARMICHAEL PRIZES OF THE ROYAL Griffin, and COLLEGE OF SURGEONS, DUBLIN. To the Editor of THE LANCET. SIR,—The publication of our communication in your worldknown journal has procured an answer respecting the Carmichael Prizes of the Dublin College of Surgeons. The answer given by Dr. Maunsel has quite satisfied us; but till that answer was elicited, we were quite ignorant as to the fate of our essays. We find they had been rejected, which we regret, but we only complain of not being informed of their rejection after two applications. Thanking you very much for rendering us a service, we beg
to subscribe ourselves, Dublin, May, 1856.
THE REJECTED CANDIDATES FOR CARMICHAEL PRIZES.
THE
a
copy of these resolutions be forwarded to Mr.
to each of the medical
journals.
At a meeting of the Medical Officers of the Hertford Union, held at Hertford on Saturday, April 26th, 1856, it was resolved
unanimously :-
1st.—That the thanks of this meeting be given to R. Griffin, of Weymouth, for his exertions in the cause of Poor-law Medical Reform. 2nd.-That this meeting pledges itself to support Mr. Griffin in his endeavours to remove the grievances of Union Medical Officers, and hereby agrees to subscribe 10s. each towards the necessary expenses incurred. 3rd.-That this meeting approves generally of the main principles laid down by Mr. Griffin in his circular. L. ARCHER, G. DUNN, T. ODELL. J. WOODHOUSE.
Esq.,
497