638

MEDICAL ANNOTATIONS.

these touting shops, as t7teRefere,-,! How broken-down trades-

men and publicans ever obtained licences to receive lunaticswithin buildings like those described, is truly most extraor-

dinary ; but it remains for sheriffs, their substitutes, and

others who permitted such transactions, now to answer thatinquiry.

Turning, however, to a more agreeable topic, or another

phase in this most stirring discussion, and which verily impli-cates the humanity of a nation, we would specially notice the

public or chartered lunatic asylums of North Britain, which

present very different aspects from those just delineated. As

already stated, this feature is admitted by the Commissionersin their Report, who doubtless would have found fault hadthere existed any real grounds for complaint or condemnation.But an appeal can also be made to an additional authority,who is equally able to give an opinion on such matters-viz.,Dr. WEBSTER, well known for the Notes which he has, fromtime to time, published in the Psychologica l J ow’nal respectingBritish and Foreign Lunatic Asylums. Fortunately, it so

happened that this physician visited the identical asylums ofScotland nearly at the same period with the Commissioners,and which institutions, he said, deserved commendation in

many essentials, as they have kept pace in the onward anarchof improvement, fully commensurate with modern civilisation;while the fact should always be remembered, that it was in

Scotland where one of the earliest public asylums for receivinglunatics, and the improved treatment of mental diseases, wasfirst founded throughout the United Kingdom. Honour,therefore, is due to the original promoters, as, also, the benevo-lent acting managers, of these most useful institutions, andwhen it is added that such men as Dr. BROWNE at Dumfries,Dr. JAMIESON at Aberdeen, Dr. LIVDSAY at Perth, Dr.

GILCHRIST at Montrose, Dr. WINGETT at Dundee, Dr.

M’INTOSH at Glasgow, and Dr. SKAE at Edinburgh, are nowthe resident superintending medical officers over their re-

spective chartered lunatic establishments, there need be nofear of comparison with analogous institutions, whether inEngland or on the continent. That truth ought, at least, tobe generally known, while the public mind seems impetuouslycarried away by the clamour and just torrent of indignationwhich has been levelled at a very different class of recep-tacles.

Medical Annotations.11 Ne quid llimis,"

SHOULD any seventh son of a seventh son, fate-doomed to

physic, and anxious to work out his destiny with due regardto propriety, endeavour to learn the social restrictions where-with he will have to conform and to acquire a general idea ofwhat is his particular duty to everybody, he will assuredlybe astonished at the result of his researches. He willfind this is a pie in which every one individually has a

finger, whilst society in general nobly consents even to invertits dearest axioms for his particular benefit. He is by turnsthe willing ass, which it is impossible to overload, and the onelabourer who is considered unworthy of his hire. He is the

bridge that cannot be too much abused by those it has carriedover. He is the pitcher which is always to be sent to the well, ’,,and never expected to break. Gossip assumes prescriptiveright to discuss all his doings; from his religion to the tie of his

cravat, from his domestic affairs to his method of treating dis.ease; and Scandal "hints a dislike or hesitates a doubt," with-out imagining that there can be any impertinence or impro-priety in so doing. If he refuse to give freely, without a quidpro quo, that knowledge which is his only means of subsist-ence, he is a churl. If he minister to the sick without bar-

gaining beforehand as to his payment, then every quibblethat the law can afford (and their name is legion) may be re-sorted to for the purpose of upsetting his claims, and be gravelyallowed to weigh against him. We do not mean to assert thatsuch things are of common occurrence. But a case tried lastweek in the Court of Common Pleas at Westminster provesthat they sometimes happen, and illustrates in a startling waythe legal view as to what manner of precautionary proceedings should be adopted by a medical man anxious to ascertainthe probability of his services receiving their just reward.

The story of the trial ran thus : Mr. Atkyns, a general prac-titioner, was called upon to attend the three children of awoman named Pearce, who was apparently living decentlyand domestically with her husband. Having cured the chil-dren of an attack of scarlatina, he subsequently attended themother through two confinements ; and the welcome had

scarcely been given to the last little stranger, when anotherand very unwelcome stranger (somewhat in the position of thehero in Kotzebue’s play of that name) made his entrance onthe scene. Then it was discovered that the father of thelast two children was only the paramour of the woman, andthat her original husband, the father of the children first

attended, had been absent for years in Australia. He it waswho now suddenly reappeared, claimed from their mother hisown children (those preserved to him by the care of Mr.

Atkyns), and discarded his frail rib. The surgeon sent to himhis unpaid account for attendance on the children during theirillness, omitting all mention of claims for his other services;was finally compelled to bring an action to recover the amount,and obtained a verdict in his favour. It was proved on thetrial that the absent Menelaus never denied the three children

to be his, allowed his fickle Helen a sum sufficient for their

ordinary support whilst he was away, and at once claimedtheir guardianship on his return. Now, as the woman, how-ever deep was the dye of her own sins, did not give the chil-dren scarlatina, and could not pay for their cure out of whatwas acknowledged as only just enough to provide them withnecessaries, therefore the verdict returned by the jury seemsbut just and reasonable in a common-sense view. However, acommon-sense view and a Common-Pleas view are essentiallydifferent matters. For the case being again opened in thatcourt, the Chief Justice decided against the surgeon, andreversed the decision of the jury, on the ground that the’’ wife, who was left in this country by the defendant, enteredinto an adulterous connexion with another person, who assumedher husband’s name, and the plaintiff, a medical practitioner,supplied attendance and medicines to her. He was of opinionthat there was no authority on the part of the wife to bind thehusband in this case."We need hardly mention that the children of the husband

had no connexion whatever with the alleged adultery, nor canwe see how their position was influenced by it. However, thefiat of the law, delivered by one of its highest dignitaries, hasgone forth, and the conclusions to which this judgment leadsare rather startling. For it is hereby defined to be the duty ofa medical man, who wishes to avoid law-suits and obtain his

fees, to inquire (when summoned to children urgently ill)whether the mother be married to the individual representingher husband, to inspect her marriage certificate, ascertain thedate of her husband’s departure when absent, and the time ofbirth of the children, who will probably be dead before he hasacquired the information which alone, according to the latestlegal authority, will give him the least chance of obtainingfrom anyone the most moderate remuneration for his services.

639

AT a meeting of the French Academy three weeks ago, Of course the rest of the medical officers protested, as wasM. Elie de Beaumont announced his wish to lay before the their duty, against an innovation so injurious to the interests of’savans there congregated a series of discoveries, which, if he the institution, and so detrimental to the welfare of the

will only make good his promises, might lead us to hope that pataents. The Board therefore called on Dr. Horner to resign.so ingenious a gentleman could even render the profession Then came a fourth letter, entirely at variance with the formerassistance which at present seems unattainable. The novelties ones, and notifying his refusal. And so all the ceremony of a

he announces to the Academy comprise-a method of repro- special meeting had to be gone through, to consider the matter.

ducing animal life, a complete solution of the problem of aerial The tone of the speakers thereat was one of sorrow and pity :navigation, a project for a universal language, and the dis- sorrow that a gentleman whom they respected should, so late in

covery of the cause and nature of, and an infallible cure for, life, have exposed himself to the humiliation that drew forth

cholera. their pity. Dr. Horner was himself present at the meeting,It is possible that the discoverer who thus sets at defiance and had to swallow many a bitter pill from out-speaking, truth-

the decision that t fL11 men, anxious for the interests of the institution. Finally,e eClSLOn

" One only science can one genius fit, he tendered his resignation. It was accepted, and the meet-So wide is art, so narrow human wit," ing, which his own act had unnecessarily caused to be sum-

moned for his mortification, separated.having satisfactorily executed the small order above detailed, may The recital bears its own moral. The vacillation apparentbe induced to undertake the more arduous task of framing a in the letters we have described-the strange statement, madeMedical Bill that shall please everybody. This would have to by Dr. Horner at the meeting, that he did not know whatinclude a scrupulous recognition of everybody’s vested interests, charges were to be brought against him-the perversion, at anwith a careful adjustment that shall give to each corporation age when opinions are firmly settled or pitiably unsettled, to athe freshest of the loaves and the finest of the fishes. It must

system now being fast deserted by its followers, even as ratsalso evince a delicate regard for the feelings of members of leave a sinking ship-all these things, whilst affording someParliament who patronize quacks, or are interested in the sale clue for an explanation of the change in Dr. Horner’s views,of patent medicines. It might also include some slight notice may fittingly serve as warning for others to avoid the shoalsof the general interests of the profession at large. But as this and quicksands whereon he has wrecked the professionalis a point which has scarcely been deemed worthy of mention repute that so many laborious years had been spent in ac-in the Battle of the Bills, that has now been fighting for some amrino’months, it might be too much to expect even an " Admirable --

Crichton" to take cognisance of a matter so trifling in com- "

parison with the private interests of University professors, and THE Z)M?7m County Advert8el’, recently inserted a letterof College Councils with desperately sharp eyes for the main from Dr. Larquier of Lausanne, which whimsically reminds uschance. of the account given by some African travellers who discovered

- a native prince, with his retinue of two naked negroes, seateclbeneath a tree, and whose first question to them was, "Do

LAST week there was enacted at Hull a very sad scene- they talk much about me in JEurope ?" Our provincial con-the committee of the infirmary in that town meeting to accept temporary inserted, some weeks ago, a communication in refer-the resignation of their senior physician, and if need were, ence to a certain Dr. B-d, who vehemently complained ofto dismiss him from a post which he has filled for many the treatment he had received whilst endeavouring to obtainyears. We deeply regret that so deplorable an instance of the necessary qualification for entering on practice in the Can-vacillating weakness, and of indecision more pitiable even than ton de Vaud. The law of the canton requires that all candi-bold perversion of judgment, should have been afforded by one dates desirous of practising, whether native or foreign, shouldwho once held so good a position in the ranks of the profession undergo an examination; making honourable exception, how-as Dr. Horner, late senior physician to the Hull General In- ever, in favour of those holding foreign diplomas and at allfirmary, and once Vice-President of the Provincial Medical distinguished in the profession. Dr. B-d determined toAssociation; now a confirmed follower and disciple of that mise- forego this advantage, and to stand the test of an examination.rable impostor, who, having failed to succeed with a quack He was rejected because, according to his own statement, heremedy he named Pnoeum, (consisting only of borax,) invented refused "to submit to the absurd doctrines of the examiners."a system which referred nearly all the ills that flesh is heir to, Dr. Larquier, who is one of the surgeons to the hospital atto the existence of itch, and called this exceedingly rational Lausanne, denies this assertion, stating that the candidate

system of medicine, Homceopathy. Hear it, ye delicate damsels (whom he recognises under his flimsily-disguised name) wasaddicted to globulism, and out of whose pockets are cajoled thG rejected because he stated, in answer to a question about thesustaining guineas! Hahnemann, the discoverer of homoeopathy, preparation of calomel, that "English physicians did not pre-the arch-deity of your sugar-of-milk temple of Hygeia has pare it, but were satisfied with what was sold at the shops."gravely declared that your reception of his doctrine is tanta- He also"states that on being questioned as to the value ofmount to a confession of belief in his axiom, that " common emetics, the Doctor answered that " the only emetic he everitch is the only real fundamental cause and producer of innu- troubled himself with was mustard." The letter of the worthymerable forms of disease, nervous debility, hysteria, barren- Swiss doctor is not dictated in a good spirit, nor does it doness, impotence, convulsions of all sorts," &c.-(Organon, much credit to the board of examiners; but if his authoritativep. 183.) assertions are true, the rejection of the candidate was quiteOn the 23rd of last April, Dr. Horner wrote to the committee justifiable.

of the Hull Infirmary, stating that his medical opinions had As far as this individual case is concerned it is not of muchundergone an entire change, and asking to have two wards importance. If the whole Canton of Vaud suddenly disap-in the institution placed under homoeopathic charge, and that peared from the face of the earth it would scarcely create sucha dispenser to match should be provided. In case of refusal, an excitement as that caused by a large London fire. But it,he intimated a fear that he should feel called on to resign. is of interest as directing attention to a subject on which weNext week he wrote another letter, withdrawing the former possess very little correct information; namely, the restrictionscommunication, and definitely stating that he should resign if under which English medical men are permitted to enter’his demand was not complied with. On the same day came a practice in the different countries of Europe.third letter, withdrawing the second, and substituting the

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original document.

640

MEDICO-PARLIAMENTARY.

Thursday, June llth,-Six petitions presented for redress ofthe wrongs of Union medical officers. Five in favour of Mr.

Headlam’s Bill; and two for Lord Elcho’s. Mr. Davison askedfor a return from the coroners of the accidental deaths thathave occurred in Ireland from the construction of railways andpublic works.

Friday, June 12<7t.&mdash;Ten more petitions praying for redressof the grievances of Poor-law medical officers. Six petitionsin support of Mr. Headlam’s Medical Bill. Sir G. Grey pro-mised to introduce the Board of Health Bill on Monday.Whilst discussing the authority under which a new workhousehad been ordered to be built at Preston, Mr. Drummond anim-adverted on the miserable parsimony displayed by boards ofguardians, especially towards medical men, whose allowances,he said, " were reduced to so low a sum that it was utterlyimpossible for those gentlemen to attend properly to the dutiesof their position upon such terms; and everybody accustomedto attend these boards must have noticed that when physicwas prescribed to a sick man in the workhouse the guardianshad no objection to it, but when wine or other nourishmentwas ordered they usually rose against it." "

Sir Benjamin Hall explained, in reference to the late im-

provements in the park, that the first suggestion to remedythe filthy condition of the water in the lakes came to him froma deputation of medical men.

Lord John Manners boasted that when he was President of theBoard of Works, similar representations had been made to himby a medical deputation; but he had " looked into the matter,"

"

and had done nothing. His lordship had once a pretty tastefor writing feeble rhymes. Whether it was his " poet’s eye ina -fine frenzy rolling" that he employed to look into the matterhe did not explain. Sir B. Hall, luckily for the health andwelfare of Londoners, takes more reliable means of arriving ata just judgment. - &mdash; -

The civil service estimates, moved by Mr. Wilson, again in-cluded the vote of .619,000 for the maintenance of the Dublinhospitals, whilst not a farthing is contributed by Governmentto the support of similar institutions in Edinburgh or London.

Monday June 15th.-::B1r. Headlam’s Bill : seven petitions inits favour; one in support of Lord Elcho’s. Forty-one petitionsfor redress of wrongs of Poor-law medical officers.Board of Health Bill again deferred till Thursday.Mr. Fagan called attention to the laws concerning medical

charities and relief of the poor in Ireland. Owing to theimproved condition of that country, workhouses constructedto accommodate 300,000 now contain only 50,000 paupers, one-third of whom are sick. He proposed to convert the unoccu-pied space into infirmaries for the sick poor, instead of buildingnew hospitals; the medical attendants being fairly remune-rated.Mr. H. Herbert, Secretary for Ireland, objected to this very

sensible proposition, and tried to insinuate a doubt as to its

utility, instead of boldly stating the fact that Government hasits hands too full to attend to any new business.

Mr. Fagan withdrew his motion for a committee on the

subiect.

Correspondence.

POOR-LAW MEDICAL REFORM ASSOCIATION.

"Audi alteram partem."

To the Editor of THE LANCET.

SiR,&mdash;I shall feel obliged for space to inform the poor-lawmedical officers that all the reports of our late meeting werecirculated agreeably to the new postal regulations, which re-quire 1 d. only to be paid for each packet under four ounces, andthat the petition to Parliament, though written and enclosed

with the report, is treated as printed matter. T mention thiscircumstance as I regret to find a great many medical officershave been surcharged 2 1" through the ignorance or cupidity ofthe local post-masters, who could not, or would not, understandthat an envelope, with the ends cut open, is the same as a pieceof paper wrapped round the report. Previous to their trans-mission, I enclosed a specimen of the documents to the GeneralPost-office, and was informed that 1l. would free them, theovercharged twopences are all recoverable. Since our meetingon the 28th ultimo, thirty-six unions, then on the black list,have joined the Association, and I have accounts of 125 peti-tions already presented to Parliament in support of our generalpetition, and others are going in daily.-I am, Sir, &c.,

RICHARD GRIFFIN.12, Royal-terrace, Weymouth, June 16th, 1857.

RICHARD GRIFFIN.

POOR-LAW MEDICAL RELIEF.! To the Editor of THE LANCET.

SiR,-In these days, those whose complaints do not appearin The ’7’!’mes are supposed not to have any urgent claims on thepublic interest; yet no cause has, both inherently and on publicgrounds, a stronger claim to attention than the common one ofunion medical officers and of the poor committed to their care,for the outrageous advantage taken of the necessities of ourprofession in its present crowded state necessarily extendsitself in cruel deprivations to vast numbers of our patients.

Those who receive medical relief as paupers in this countryamount to about five millions, a large proportion of whom getno other than medical relief, which, on the strength of unioncontracts, is granted by parish authorities with the greatestfacility. Now, five millions of the strong arm of the country,to say nothing of some thousands of medical men, who oughtto be allowed to be honest and to cultivate science, deservesome share of public attention. Be good enough to see howthe matter stands; and, to be brief, let me state a case which,allowing for an excessive irregularity that ought not to existin a national system, still scarcely forms an average type ofour complaint, for few instances are better and many worse.My weekly medical return averages about 50 cases of patients,

residing at a mean distance of three miles and a quarter frommy residence. This number does not include casual applicantsagainst trifling ailments, but 50 cases requiring regular treat-ment, and some of them of course of the most urgent anddangerous character; and not a little irksome are those manycases of feigned illness whereby the poor have learned to 2vorkthe Poor-law to their pecuniary advantage. But as medicalrelief is at first remote from pecuniary relief, there is a some-what superabundant facility, and so far a progressive increasein the number of those who at length draw on the Poor-lawrevenue. This number fluctuates certainly in healthy andunhealthy, clement and inclement, cheap and dear. seasons;but in the mean, the draw upon the revenue very naturallygoes on increasing beyond the increase of population. Thechief cause is this : guardians have contracts with their medicalofficers, and on the strength of those contracts medical ordersare dispensed with the utmost liberality, and a man is made apauper on the most distant contingency. Without saying thatmedical aid should be given niggardly, it is still evident thathe who on the first occasion gets medical relief, on the secondoccasion gets pecuniary relief also, and that without his cir-cumstances having really become worse; for orders being givenby parish authorities, who almost never have seen the caseabout which they write, a vast amount of unnecessary andtherefore of galling labour is inflicted on the medical officer.Why, then, should not that officer have the satisfaction of re-cording his work by entering the names of all he has attendedin the weekly return of paupers for relief? Besides this,medical orders being given loosely, and not standing, as theyalways should, as something like a faithful index to the case, area very fertile cause of that fcltal neglect the fabled shepherd ex-perienced when he cried " Wolf ! wolf !" after many deceptions.

I will presently suggest a safe and not in the least excessiveremedy against all this, and for making the poor rely whenthey can on their own resources ; they will never be energeticnor honest until they do. But first allow me to state the officialcondition of Poor-law medical officers, who are the abused pivotupon which Poor-law relief entirely turns. The law does notallow a bit of bread nor bit of flannel without a medical visitand testimony; hence our trouble, necessary and unnecessary.We, therefore, who preside over the lives and sanitary comfortsof five millions, and over a large amount of public revenue, havea riht to justice and consideration. Where is the man whowill say we get them? and if we do not, neither paupers nor