666

analysis proves it to contain the followingsubstances, viz. :-Carbonate of Soda, Mu-riate of Soda, Carbonate of Iron, Carbonateof Lime, Clayey Matter, Silica, and Talk.The Carbonate of Soda, Iron, and Lime, arefound in the greatest proportions.

There is also a little spring of consider-able note at a little distance from the

Pouhou, which has become so from Peterthe Great, in the year 1717, having drunkits waters with advantage. A certificate tothis effect, from the King’s Physician, aDr. Areskea, a Scotchman, is shewn. Theother springs at Spa difler from the two justmentioned only in a slight degree. Oneremarkable circumstance connected withthe springs 11 D Tounelet" is, that duringa north wind they are found to contain morecarbonic acid gas than at any other period.The waters of Spa were known to theRomans. Their principal ingredients are,as I have just stated, carbonic acid, severalsoluble salts, and a considerable quantity ofiron. In cases of debility, cachexia, hæmor-rhagia, hypochondria, hysteria, sterility,and, above all, in convalescence after mostsevere diseases, the exhibition of thesewaters is found to be highly beneficial.The " Waters of Malmedy," a small townnear Spa, are not inferior in their medicinalproperties to those of Spa, indeed it isfound by analysis that they contain a largerquantity of free carbonic acid gas, as wellas of carbonate of iron.

I shall nextproceed to notice the principalmineral springs ° Du Taunus," or, in otherwords, the much-frequented baths whichare supplied from sources taking their

origin in the chain of mountains of thatname. Amongst the number to be noticedare the Baths of Weisbaden, Eus, Schlan-genbad, Soden, Neiderselters, Schwalback,&c. After briefly describing the peculia-rities and properties of each, I shall pass onto Baden-Baden, and say a few words onthe most noted of the mineral springs si-tuated in the Black Forest, and concludewith a notice of Aix-les-Bains, in Savoy, Iand a few of the Swiss mineral waters. ,

ACTION AT STAFFORD

TO RECOVER AMOUNT OF

CLAIM FOR MEDICINES AND ATTENDANCE.

(Abridged from the Staffordshire Advertiser.)MORGAN f. BALLEN AND ANOTHER.

Òr. Sergeant Talfourd stated the plaintiff’scase. Mr. Morgan had carried on the busi-ness of a surgeon and apothecary, at Litch-field, for many years, and had brought thepresent action to obtain remuneration for

professional services rendered to Mrs. Iron-monger, who died, at the age of 86, in May,183.5, the defendants being her executors.

During the last six years of her life, theplaintiff was called upon to attend her almostevery day, sometimes two or three times aday; and his residence being near, she wasin the habit of sending for him at all hours,to ask his advice, not only as to the nie(li-cines she should take, but as to her diet;whether she should take a walk; and theprovisions intended for her table were sentto Mr. Morgan for his opinion as to theirgoodness before she would use them. Healso sent her medicine almost daily, but hewas in the habit of sending it in the shapeof a mixture, for which he charged 3s. 6d.,containing the same quantity as six draughts,for which the usual charge would be 9s. Itwas in respect of these services that the

plaintiff made his claim upon the executors,but which they had resisted. The wholebill amounted to £204 16s. 6d., of which£108 was for attendances for six vears at£18 per annum, and £96 16s. 6d. for medi-cines. The defendants had paid into Court£124 10s., and resisted payment of the fulldemand on the ground that the plaintiff,being a surgeon and apothecary, had noright to charge for his attendances, but onlyfor the medicines. He (the learned Ser-geant) was not aware of any law by whicha medical practitioner in the situation of theplaintiff would be prevented from obtaininga reasonable compensation for his services,by whatever name they might be called. Inthe present case the charge for medicineswas much lower than it would have been ifthe plaintiff had not intended to charge forattendances. It was his practice, in someinstances, not to make a specific charge forhis attendances, but to leave a blank for thesum, to be filled up at the discretion or the

generosity of the parties ; in general hefound he had no reason to regret adoptingthat course, for the parties frequently esti-mated his services at a higher rate than heshould have done. On other occasions itwas otherwise. But in the case of the ex-ecutors it was necessary to make a specificclaim, and he was contident when they hadheard the evidence, the jury would be ofopinion that he was entitled to recover thefull amount of that claim.

Ttfr. Major Butler Morgan, examined byMr. Mc Mahon.-I am partner with plain-tiff, in Boar Street, Lichfield. I had beenhis assistant from 1826 to January, 1835.Mrs. Ironmonger died in May, 1835; shelived 300 yards from the plaintiff’s residence;plaintiff attended her professionallv, andsupplied her with medicines from 1821 to1835 ; his attendances for the last six yearswere constant, three or four times a daysometimes ; and the servant came two or

three times a day for directions how hermistress should proceed as to diet and me-dicine; she would only see plaintiff; anduntil lately, when I have answered ques-tions, she would not act upon my answers

667

until she had seen Mr. Morgan ; she gene-rally sent to him at his meal times, in orderto be secure of finding him ; she alwaystook medicine twice a day, generally oftener;she used to send an account every morningof how she passed the night, and receivedinstructions from plaintiff as to how she wasto proceed during the day. The servantwould also come and say,

" My mistresshas had such or such a night; what mayshe have for dinner-a little salmon, or

chicken, or a mutton-chop?" She had oftensent a particular article of food to plaintiff,after it was bought, to see whether it was

good, and to ask how it should be dressed.Mr. Phillips presumed that no charge was

made for the plaintiff’s services as a cook.(A laugh.)Mr. Mc Mahon.—He gave his opinion as

a chemist.Jlr. Phillips.—The chemistry of a leg of

mutton !Plaintiff’s visits were much lengthened

by his being obliged to attend to Mrs. Iron-monger’s domestic troubles; they would oftenlast half-an-hour; the charges were the sameas we should make to the humblest indivi-dual. Plaintiff had many other patients,but none upon whom his attendances wereso frequent or so troublesome ; I think thebill is reasonable, considering there is to bea further charge for attendance. Mr. Mor-gan charges Is. 3d. for a draught; somemedical men charge ls. 6d. ; it is usual withmedical men at Lichfield to charge for theirattendance as well as their medicines.

Cross-examined by Jri,. Phillips.-I havealso brought a joint action against the de-fendant, in which I have charged attend-ances ; I should have charged Mrs. Iron-monger the same sum if she had been aliveas 1 have charged the executors ; the articlesof food brought were, partridges, fish, fowls,rabbits, &c.; it was not a post-mortem ex-amination to ascertain whether they had dieda natural death, but to satisfy the mind ofthe old lady ; I cannot tell how many pa-tients Mr. Morgan might have; as the oldones die off we get new ones. (A laaEgla.)A box of 18 pills is charged 2s.; that is deadcheap.Mr. Sergeant Talfourd.—I hope they were

not Morison’s pills.These bills (several were produced) were

made out to the Rev. Mr. Probyn, for medi-cines and attendance for several years ; hewas not charged so much, as it was con-sidered that he was in bad circumstances.Some of the attendances on Mrs. Ironmongerwere when she was desired not to take medi-cines ; advice as to what she should takefor dinner was charged for ; I consider thatsort of advice of as much value as advice asto what medicine she should take ; whenthe last bill was sent in, £20 was paid forattpndances.Wm. Pott, servant to the plainti9’ from

1831 to 1834. I have generally been to

Mrs. Ironmonger’s eight or nine times aweek. The servant used to come continuallyto know what she might eat—whether she

might have a few turnips to a boiled legof mutton, for instance. It was one person’swork to open the door.Abraham Pass, Wm. Atkins, and Mrs.

Hollier, who lived as servants with plain-till’, gave similar testimony.

Rev. Thos. Levett.-I have employed plain-tiff as my medical adviser; it has been mypractice to pay for attendances as well asmedicines.

Rev. Dr. Harwood.—I reside in Lichfield ;Mrs. Ironmonger had upwards of £400 ayear ; she also owned an inn at Birming-ham. (Cross-examined.)—The plaintiff hasattended me and my family, but I have notpaid him for his " attendances;" I do notrecollect his having sent in any bill.

Mr. Alfred Dukes, surgeon, at Birming-ham. I have been in actual practice 1-) years;my practice has always been to charge formy attendances in addition to medicines.

Mr. Phillips objected to this evidence.The plaintiff, being a surgeon and apothe-cary, could not charge for his attendances.The question had arisen in the case of Townef. Lady Gresley, (3rd Carrington and Payne),before Lord Wynford, Chief Justice of thelying’s Bench ; who held that an apothe-cary might charge for his medicines or hisattendances, hut that he could not chargefor both. In Handey v. Henson, (4th Carring-and Payne), Lord Tenterden had allowedthe plaintiff, a surgeon and apothecary, torecover the full amount of his bill, whichincluded charges for " attendances," but itdid not appear that those attendances werenot in respect of surgical operations, forwhich he would be entitled to charge, sothat the judgment of Lord Wynford was notoverruled by any subsequent decision. If

so, evidence of an usage in Lichfield couldnot give the plaintifl’ a right which he didnot possess by law ; and evidence as topractices at Birmingham, and other placesat a considerable distance, was still more

’ objectionable.Mr. Sergeant Talfour contended that there

was no law or act of parliament to restrain theplaintiff from charging for his attendances;

and if usage to make such charges prevailedin Lichfield, it must be presumed that acontract existed on the part of Mrs. Iron-monger to pay the plaintiff for his attend-ances. The evidence, therefore, was toshow, in the absence of any law, a usagefrom which a contract might be implied.’ The case of Towne v. Lady Gresley was aNisi Pi-ius decision of Lord Wynford, which; had not been confirmed: on the contrary,ithe subsequent case ofHandeyz. Henson wasdirectly the other way, and in that case it

appeared, from a report which he had iti hisi hand, contained in a volume of THE LANCET,

668

edited by Mr. Wakley, that the attendancesfor which the plaintilf recovered were notin respect of surgical operations, but in 1fl.:ordinary business of a surgeon and apothe-cary, and Lord Tenterden considered it tobe a Question for the Jury, what was a rea-sonable compensation lor the services ren-dered by the medical man in each particularcase.

Mr. Phillips, in reply, rea;l some passagesfrom the report in THE LANCET, to shewwhat dependence he thought could be placedupon Mr. Wakley as a legal authority.Mr. Sergeant Tczlaurd said, " You ought

not to attack Mr. Wakley, for you know

you voted for him for Finsbury." ( A laugh.)Mr. Phillips. ° Yes, gentlemen, I voted

for Mr. Wakley, because I was quite surethat he would sit in the House of Commonson the same bench with Sergeant Talfourd,and that they would work together side byside. I think him a very clever man, but Ihave no respect for his opinion upon a pointof law."Mr. Justice LITTLEDALE said he thought

the evidence must be rejected. His opinionwas, that by the general law of the land, asurgeon and apothecary could not charge forhis attendances, and therefore it was not

competent to him to set up any custom pre-vailing in a particular part of the kingdomin contravention of that law. Fifty yearsago probably no question of this kind wouldhave occurred; but of late a practice hadcertainly arisen among this class of medicalpractitioners to make a charge for their ser-vices in addition to the charge for medicines.Still he was of opinion, that that usage, towhatever extent it might prevail, was notsufficient to support a claim for which therewas no authority in law. A surgeon mightcharge for the attendance necessary to Ireybrrrtsurgical operations; but it considered thatura apothecary was sufficiently paid for his supe-rior skill and science, by the extrcz sum whichhe was ulloztwcl to charge for his medicines be-yond the mere value o/’ the drugs, or the sumcharged by a druggist for compounding a physi-cian’s prescription. For instance, a druggistcharged only 8d. for a draught; an apothe-cary charged Is. 6d. ; and as there did notappear to be any statute or decision autho-rising an apothecary to charge for both me-dicines and attendances, he would reject theevidence of any particular usage to thateffect.

Mr. Sergeant Talfourd objected to his lord-s:iip’s decision, and after some discussion itwas arranged that the evidence of the medi-cal gentlemen in attendance from Birming-ham, Walsall, and other places, as to the

practice prevailing with respect to chargingfor attendances, should be considered astendered, and that the plaintiff should be atliberty to present a bill of exceptions, if itshould become material, upon the rejectionof that evidence.

.! With a view to show the reasonablenessof the charges,

Mr. Edgar Ashe Spilsbury was examined.--I am a surgeon and apothecary, at Walsall,9 miles from Lichfield. I have lookedover the plaintiff’s charges, and, havingheard the evidence, I think they are most

reasonable, and for a medical man who hasbeen in practice 40 years, and is obliged tounderstand all the branches of the profes-sion, they are not adequate. I charge 5s.a visit, even to my next door neighbour.Mr. Phillips admitted the reasonableness

of the charges, and therefore it might betaken that ail other evidence would be tothe same ellect as that of iNIr. Spilsbury, andmight be considered as having been given.

This, therefore, was the plaintiff’s case.Mr. C. Phillips then addressed the jury

for the defendant. The Jury had abundantproof in the evidence of Mr. Spilsbury ofthe propriety of the rule laid down by hisLordship,-that medical men should notset up a right to charge what they pleasedby calling some brother practitioners to

prove the{/’ practice, and that it was impos-sible they could charge too much. Mr.Spilsbury was of opinion that the plaintiff’sbill was a great deal too cheap-in fact,actually no remuneration at all. Was any-thing so monstrous ever heard before? Asto the charges for attendances, that questionhas been decided by his Lordship in hisfavour ; but as to the charges for medicines,it was for the Jury to say whether the

plaintiff was not amply remunerated by themoney paid into the Court. Of what sortof items was this bill composed ?-" Thepills, 2s. ;" " The mixture, 3s. 6d.,"—andMr. Spilsbury, without knowing of what -

ingredients they contained, whether cheapor costly, seriously gave his opinion thatthe charge for attendance was unreasonablylow, or even no remuneration at all! Itwas as clear as daylight, from the evidenceof this witness, that the practice of ages,which they were now called upon to over-turn, was correct. Lord Tenterden hadruled that a charge might be made, becausesurgical operations had been performed;and wherever that was the case, there wasa right to charge: wherever a man scaledan eye or set a limb, he had a right to bepaid for his skill. But an apotheeary mustbe looked upon itz the ligl,t of tradesman, acoarzpourrder of drugs, selling his ootls as anyother onuu,-and large indeed were theirprofits—500 per cent., he might say even5,000 per cent. Of these mixtures muchwas water, aqua fontana, he believed theycalled it, a little coloured, and that perhapswas their better portion. Why was this hillreserved till the death of Mrs. Ironmonger?Why that Mr. Morgan might make a chargeto her executors which he would not havedone to her. She would, no doubt, havebeen offended at such a change of system.

669

For it had not before been Mr. Morgan’scustom to charge Mrs. Ironmonger. 20was once given by her as a gratuity to him,a compliment to be paid or witheld at heroption, and the executors, not wishing Mrs.Ironmonger’s memory to sufler, had follow-ed her example, and given the plaintiff:C27 13s. 8d. beyond his charge for medicine.It was a practice for apothecaries to leavea blank against the item of attendance,thereby putting it to the generosity or cir-cumstances of the patient to give what theypleased, and the very practice proved it wasnot a legal claim. But look at the bill ;here was jE92 for medicine, and 110 forvisits. Oh! it was monstrous, and whatwere these visits for ? 1 Here was a rabbit onwhich two or three anxious consultationstook place, till the old lady had taken ashilling’s worth of advice whether she shouldeat a sixpenny rabbit. (Laughter.) Butthis was not all; she was charged for ad-vice whether she might eat turnips withmutton; four visits about the same joint.First," may this leg of mutton be eaten?"- IAdvice, " yes;" one shilling for that ! ’,Second, " how to cook the joint ?"-Advice,"boiled;" one shilling for that! Next, as itwas to be boiled, " might mistress haveturnips with it?"-Advice, "yes, by all

means;" there was another shilling gone.Then, "what part might mistress eat 1"-Advice, " any part she liked !" and downwent another shilling for that. (Loudlaughter.) And so the charge attending aleg of mutton was double its fee simplebefore it reached this poor lady’s table.Then, at night, came a brace of ruddy mut-ton chops, and " might mistress eat thosefor supper ?" 11 Oh, yes :" and down went anadditional shilling to the day’s bill for that.Thus, " eat till you’re ready to burst,"and then, " nothing but my pills can emptyyou." (Loud laughter.) ) They had chargedfor 500 stomachic mixtures, and yet hislearned friend never ventured to ask thenature of the old lady’s complaint, becausehe knew there was none but old age. Theplaintiff would be amply repaid for suchservices if he received nothing. Mr. Phil-lips concluded by calling upon the Jury notto sanction this attempt of apothecaries tocharge for their advice, and thus placethemselves, per sttltem, iza the situation ofphysicians, without being possessed (if the neces-sary qualifications. He also submitted thatthe plaintiff was over-paid by the moneypaid into court.Mr. Justice LITTLEDALE, in summing up,

repeated his former observations as to theright of apothecaries to charge for advice aswell as medicines, which, he said, was aquestion of great importance to the medicalprofession, and the public in general, andwould be decided by the Court above, if itshould be thought necessary to bring it Ull-der their consideration. His opinion was;

very strongly, that they had no such rightby law; and as to the usage in Lichfield, orits neighbourhood, it was not admissible inevidence, inasmuch as the profession of anapothecary was subject to the same rules inall parts of the kingdom. Certain tradesmight be regulated by the custom of theplaces in which they were carried on—for

instance, the manufacture of muslins, andso on ; but the medical profession was re-gulated by the common law, and by acts ofparliament applicable to the whole king-dom. At the same time the plaintiff wasentitled to an adequate remuneration, and itwas for the jury to say whether he had madeout his claim to the full amount. His at-tendances upon this old lady were, indeed,unremitting; a great deal of his time hadbeen occupied, and he had been put to greattrouble, and probably some expense, in

giving his advice, not only upon her state ofhealth, but as to matters which did not

always fall within the province of a medicalman to advise upon; and for these services,as well as for the supply of medicines, theplaintiff was undoubtedly entitled to a rea-sonable compensation. Supposing him tobe entitled to charge for attendances at all,£18 per annum, being at the rate of a shil-ling a day, was certainly as moderate ascould be expected.The Jury consulted, and having inspected

another bill of the plaintiff, in which therewas no charge for attendances, (but a blankto be filled up by the party,) they found averdict for the plaintiff for £80 6s. Od., beingthe difference between the amount of thebill and the money paid into Court. The

plaintiff therefore has recovered the wholesum claimed, subject to the question of law.

CORONER’S INQUEST,ENDING IN A VERDICT OF

MANSLAUGHTER AGAINST AN ACCOFCHEUR.

(Abridged from the Sheffield Iris of July 19th.)

AN inquest was held on July 8th, and, byadjournment to the 15th and 16th, at Hirst,before Mr. Badger, Coroner, at the TownHall, on the body of Isabella Turner, whohad died in child-bed, while under the careof Mr. Spilling, surgeon, of Ecclesfield.Mr. Palfreyman appeared on behalf of Mr.Spilling.Mary Mawe, of Pitsmoor.—On Tuesday

evening, the 5th of July, I went to StephenTurner’s, of Hirst, to attend his wife inher confinement. It was near 10 o’clockwhen I arrived. About a quarter to 11,Mr. Spilling came. Five minutes after, Iwas taken ill, went down stairs, and wentup again at about five o’clock. I saw Mr.Spilling pulling at Mrs. Turner; his handswere the colour of my gown. I ran down