1640 MEDICAL TRIAL.-WILLIAMS F. BEAUMONT AND DUKE.

by the association, were returned respectively first andsecond on the poll, and all of the four Fellows electedto the Council were more or less in accord with theviews on collegiate politics advocated by the assoc‘ation.The committee had hoped to secure another success thisyear by the return of Mr. A. T. Norton. He was onlytwo votes behind Mr. Morris, who was the fourth on the listof the elected candidates, and who largely owed his successto votes given to him in common wit,h Mr. Norton by mem-bers of the association. An unfortunate mistake as regardsthe date of sending in his application for admission as acandidate at the election has deprived the association of arepresentative, but the views advocated by the associationhave been so generally adopted by the Fellows and enforcedby the Council of the College that this accident is not likelyto interfere with the progress of the cause which the associa-tion has at heart. At the instance of the association and its

representatives the Council of the College has framed rulesfor the conduct of meetings of the Fellows, has agreed tosummon the Fellows regularly twice a year, and has adoptedan amendment of the by-law relating to the issue and collec-tion of voting papers, so as to remove the existing restric-tions. In view of these concessions, for which the Fellowsare indebted to the untiring advocacy of the associa-tion, the members of the association must have sharedin the surprise of the committee at the foundationof a Society of Fellows of the College. After carefulconsideration the committee regards this step as renderingit more desirable than ever to maintain the organisa-tion of the association. The committee regrets to recordthe loss of several members of the association by death,and two or three resignations have been received, butthese losses have been more than repaired by the accession ofnew members. With regard to the finances, the committeehas to report that, owing to special recent expenditure, thereis a small sum owing to the treasurer, and would thereforetake this opportunity of suggesting that all members of theassociation who have not yet paid their subscriptions shoulddo so without delay. The great object of the association isnow to obtain a new charter embodying the recent conces-sions granted by the Council to the Fellows, and such otherreforms as the Fellows, as a body, may deire. When thischarter has been secured the Fellows of the College will

occupy their proper position in the corporation, and theassociation will have done its work. The auditor’s reportwas read and adopted.The following list of officers for 1894-95 was then passed

unanimously :-President : Mr. George Pollock. Vice-Pre-sidents : Mr. T. Holmes and Mr. W. Rivington. Auditor :Mr. A T. Norton. Hon. Secretary : Mr. H. Percy Dunn.Treasurer : Mr. Tweedy. Committee : Mr. W. Allingham,Mr. H. Allingham, Dr. Robert Barnes, Mr. Wickham Barnes,Mr. Brace Claikf, Mr. John Couper, Dr. Ward Cousins, Mr.Alban Doran, Ilr. Gant, Mr. Victor Horsley, Mr. JordanLloyd, Mr. Mayo Robson, Mr. Manley Sims, Dr. C. Steele,Mr. George Jackson, Mr. C. B. Keetley, Mr. George Helm,Mr. J. J. Purnell, and Mr. Vincent Bell.Mr. Norton proposed the following resolution : "That

Mr. Harrison, Mr. Marsh, and Mr. Davies-Colley are deservingof the support of the members of the association at the

College election on July 5th, and that a postcard to this effectbe forwarded by the honorary secretary to each member ofthe association." In the course of his remarks he expressedhis extreme regret at the inconvenience to which he hadsubjected the association by the misapprehension of the legaldate for forwarding his application as an intending candidateto the secretary at the College. The resolution was carriedunanimously, after being seconded by Mr. Potts.

Mr. Holmes then proposed the following resolution infavour of a new charter: "That in the opinion of this

meeting the concei-siocs granted by the Council, and suchother changes as the body of Fellows may desire, should beembodied in a new charter." This resolution was secondedby Mr. Rivington and unanimously carried.The following resolutions were also adopted 1. That the

Association of Fellows of the Royal College of Surgeons ofEngland will welcome the formation of branches of the asso-ciation in large provincial centres. 2. That a compositionsubscription of 10s., in lieu of the annual subscription of2s. 6d., may be paid by any member of the association whoprefers it."A cordial vote of thanks to Mr. Pollock, as chairman and

president of the association, brought the proceedings toa termination.

MEDICAL TRIAL.

THE LEWISHAM LUNACY CASE.WILLIAMS v. BEAUMONT AND DUKE.

THE facts of this case may be briefly recapitulated. Mr.Williams recently brought an action against Messers. Beaumontand Duke, the medical officers of the Lewisham Union Work-house, for improper and careless certification of lunacy andillegal detention in the woikhouse. Messrs. Beaumont and

Duke, whose conduct, in an inquiry made by the LocalGovernment Boald into the matter, had been held by thatBoard to be blameless, and so certified in a letter from theBoard to the workhouse authorities, applied for stay of agroundless action. This application was refused by Mr.Justice Kennedy, whose decision, however, was upset onappeal to t.he Divisional Court (composed of Mr. JusticeCollins and Mr. Justice Wills), who dismissed Mr. Williams’action as frivolous and vexatious. On June 18tb, in theCourt of Appeal, before the Master of the Rolls and LordsJustices Kay and A. L. Smith, the appeal of Mr. Williamswas heard from the order of the Divisional Court, dismissingthe action. We have been favoured with a shorthandtranscript of the judgment upholding the decision of theDivisional Court, which we append:-

JUDGMENT.The Master of the Rolls said:-In this case the plaintiff has brought

an action against two medical men on the ground that they had givena ctrtltkate that he was a lunatic, the consequence of which was thathe was detained in a lunatic asylum. In giving that certiticate thathe wds a person who ought to be removed to a lunatic asylum it cannot.be doubted thac they were acting in punuanceof the Lunacy Act,1890_That Act says that for anything done in pursuance of it they shall notbe liable to any civil or criminal proceedings, either on the ground ofwam of jurisdiction or any other ground, if such person has actedin good faith and with reasonable care ; so that the medicalmen in the position of these two defendants are not to have a.

case tried against thtm upon an assertion that their opinion givenas medical men was wrong, so that they may have to enterinto a contest as to their opinion with the opinion of other medicalman. They are not to enter into a contest under which a jury,or the tribunal which has to determine the case, is to say whethertheir opmion was right or wrong, because, assuming it to be wrong,Sllll they are not to be liable to any civil or criminal proceedings if theyacted in good faith and with reasonable care. That is the whole ofthe law. Xow that was only a defence to the action before this sectionof this Act of karliamenu was passed. ’they must have submitted tomeet the action ; they must have pleaded to that action that they actedin good faith and with reasonable care ; but the Act goes further thanthat and gives tnem a further protection. If they did that in such anaction the jury would be bound to find, or the judge to direct judgment,in their favour, but this Act goes further and says that under cer-tain circumstances they shall not be put to that trouble, annoyance,and expense, because it says :

" If any proceedings are taken againstany petson for signing or carrying out, or doing any act with a view tosign or carry out, any such order, report, or certificate " (and that isreally the ground of action in this ca&e, for the plaintiff has no cause.ot action at all unless it be that by reason of that certificate he was.sent to a lunatic asylum) "such proceedings may, upon summatyapplication to the High Court or a judge tueteof, be stayed upon sucbterms as to costs or otherwise as the Court or judge may thmk fit, Uthe Curt or judge is satisfied that there is no reasonable groundfor alleging-what?-not that they were mittaken, but that therehas been want of good faith or reasonable care." Now thiscase falls clearly within the section, where the real cause ofaction is for their signing that certificate. First of all, if itswent to trial and they could prove that they acted in good faithand with reasonable care, the action could not be maintainedagainst them. But, secondly, they have this further protection that, ifthey can satisfy a judge or the Court that th 11 e is no reasonable groundfor alleging want of good fai h or reasonable care, then that Court,or judge may stay the action. Here, the case having been before ajudge at cbambers, he deciined to stay action. It came by appeatbefore the Divisional Court, and they have stayed the action. ’1 heyhave stayed the action because they were satisfied that there was noreasonable ground for alleging want of good faith or reasonable careThe Divisional Court were satisfied there was no ground for it. Nowthere is an appeal to us. What is the question before us orb

the appeal ? The question before us, and the only question, is,"Can we differ from those judges when they said that theywere satisfied?" If we do, we can overrule their decision; ifwe do not, we cannot overrule their decision Wnat is the state ofthe case? Here is a man who sometimes did have a drunken boutwhich lasted for a time. Then the doctors first of all have come to theconclusion that when men do have those drunken bouts it is notuncommon that for a certain time afterwards they are insane. One ofthe forms which that insanity takes is that of melancholia-a well-known form of insanity.Now this man was brought before Dr. Beaumount. Dr. Beaumont

examined t im for an hour dnd a, quarter. He says that he took suchmeans as are in a doctor’s power of inquiring as to the state of bis.physical health and as to the state of his mental health. The man siidto the doctor that he was depressed after these drinking bouts, andthat he had an inclination in his mind to commit suicide. If a man saysthat, and if the doctor then found that he was, according to hisi-ymptoms, suffering from melancholia after a drinking bout, what WdS.tne dostor to ao It is said that the doctor ought to make inquiries.

1641CHOLERA—TRANSPORT OF PATIENTS ON TEIE SWISS RAILWAYS.

Sometimes he ought ; but if the case is so clear to a doctor that he doesnot want to make inquires there is no law which.4ays tnat lie is t,o makeinquiries as a matter of course when he is already satisfied. Here thedoctor did take the precaution of making inquiries. The man said thathe had been living with hi, sister-in-law. The doctor sent for thesister-in-law. She appears to have been a respectable, hind-heartedwoman. She says the man had lived with her from February toOctober, which is a fact not denied. She says that wilen he is sober heis a sane man, and he does nothing wrong ; but when he gets drunk,and after he recovers from a drunken fit, then he hashed, wnilsthe waswith her, this same surt of thing ; he has threatened to comm’t suicide.This she told the doctor, and he neard also what was stated by the man,and he examined the man, and upon those facts he cameto the c nelusion that the man wa", at all bveuts fjr the time, insane and mightdo himself a mischief. Tne d jetor thought it his duty to send the manto a lunatic asylum, where thev have the means of treating him, atdwhere, when they have treated him and they feel it safe to let him go,they will let him go. Now this man says that the doctors of the work-house were malicious, they had a spite agaifnt him ; buc this case hasbeen inquired into for twelve days. The doctors have had to run thegauntlet of that inquiry That inquiry has been held, and the resultof that inquiry is an absolute statement by tha impartial person whoinquired, after all the evidence on both sides hed been put beforehim, that the doctors acted with good faith and acted with reasonablecare.

Here, then, you hne two doctors-whose skill, generally speaking, isnot impugned after consultation—coming to th-l." conclusion ; you havean inquiry in which the impartial mudarator or tribunal his come tothe conclusion that tne doctors did act with good faith, and that theyacted with reasonable care. Can we say, aftt th t,t, that he was wrong,and can we say, when the man desires to go on with an action up in thevery same ground and to try this case all over again, that the judgeswere wrong when they said they were sitisfied that there was noground, no w at all events, for his persisting in s tying that these doctorsacted without good faith or that they acted w.thoat reasonable care ?So far from disigreeidg with tnem, 1 think th t no person who heardan impartial statement of that state of things so put before theDivisional Court but must come to the s&ma conclusion, that ihii isonly obstinate persistenre by an obstinate man, who seems to have foryears found fault with everybody and everytmng. He must be satIs-fied that he has no ground for persisting in th-se charges, and thattherefore the learned judges rightly stayeu the action. This appealmust be dismissed.Lord Justi e Kay entirely agreed with the Mabter of the Rolls,

adding that it seemed cleac to him that the doctors aid that which itwas their absolute duty to do, and that they acted with all reasonablecare in this ma’ ter.Lord Justice A. L. Smith wished to add one word only on account of

the difficulty which Mr. Justice Kennedy got himself into by lookingat the different causes of action supposed to be set out, in the state-ment of cliim. It seemed to him (Lord Justice Smith) immaterialwhat the plaintiff sets out in the statement of claim. In his opinionit was the duty of the judge to sed what was ohe suostance of thecause of action which a man has against the defendant before him,and if he comes to the coaclu ion that the action is a p’’. ceeding takenagainst a doctor for ometning done in pursuance of he Act, and notfor something done outside the Ace, then it is his duty to adjudicatewhether there is reas nable ground for alleging want of good faith 01reasonable care. He had cume to the conclusion that if Mr JusticeKennedy had not hampered himself with reading the t-tatement 01

claim, and then, thinking it wis a common law action which he couldnot deal with under thb section, he would not have gone wrong.The appeal was dismissed, with costs.Mr. Herbert Smith (instructed by Mr. Curtis) was connse

for the appellant, and Mr. H. D. Greene, Q.C., M.P., ancMr. Dodd (instructed by Mr. Savage) appeared for the

respondents.

CHOLERA.

THE absence of any recent intelligence about cholera is

of happy augury as far as it goes. It implies, at any rate,that the disease is dormant or, as it may be termed, hyber-nating. Although it is satisfactory to hear nothing of anyfresh epidemic manifestations of cholera at the presenttime, we cannot, of course, feel assured that this absenceaffords any guarantee that nothing of the kind will appearlater. The reports which have been published as tothe existence of cholera at Jemeppe, Lear Liège, havebeen authoritatively contradicted. From intelligence pub-lished in the Standard it would appear that the disease atJemeppe is not A,iatic cholera, although an epidemicresembling cholera in some of its features is stated to havebeen prevailing there for some months past. Attogethersixty cases and fifreen deaths have been returned since thedisease first made its appearance.We may remark that the Indian papers continue their

observations regarding cholera and the pilgrim traffic. TheTimes of India, for example, in commentmg upon a recentreport of the Health Office for Bombay relating to the RedSea pilgrim traffic, contends that all the evidence goes toprove that India was not responsible for a single case of

imported cholera during the sevei e epidemic which occurredduring last year’s Hedjaz. The disease had been prevailing

for some weeks at Mecca and other inland holy cities,where the mortahty reached a thousand a day, and ithadalso been very prevalent along the Red Sea coast forthree or four months previously. In spite of this there was aterrible state of unpreparedness, as is well known, on thepart of the Turkish authorities, and the most elementaryprinciples of sanitation were neglected. The pilgrims fromIndia, alleged to have carried the disease to Jeddah, wereconveyed in a large steamer, and had been minutelyinspected before embarkation. They had no cholera atthat time or during the voyage, and were healthy at theirdisembarkation at Camaran ; and it was not until eight daysafter they had left the ship, and had been exposed to all theinsanitary conditions they encountered on shore, that cholerabroke out among them. So far from India being, under existingcircumstances, a danger to Europe through pilgrim traffic, itis contended by the Indian authorities that India is herselfin danger from Jeddah and Camaran. The precautions alreadyinvariably taken at Bombay for preventing the export of choleraare, in reality, those suggested at the late International Sani-tary Conference at Paris, as regards, for example, medicalinspection, the provision of a medical officer for the ships,and the prevention of pilgrims embarking in excess of thenumbers laid down by law. It appears that the baggagetaken by the pilgrims on shipboard often gives rise to a,

difficulty in regard to the proper appropriation of space forthe third class pilgrim passengers. The scale allowed is

only nine superficial and fifty-four cubic feet per adultpassenger. Any overcrowding on shipboard should, no doubt,be carefully guarded against. The difficulty is that anyincreased allowance in this direction is provided at the

expense of the pilgrims, which might, in the case of manypoor Mussulmans, be prohibitory of their effecting the Haj atall. Still, we concur with our Indian contemporary in tbirjkmgthat Dr. MacCartie’s recommendation to limit the sale ofthird-class pilgrim tickets to the exact number which theship measures should be adopted.As regards cholera in India, we may advert to the keen

interest which seems to be taken in Professor Ha.Rkine’&inoculations against that disease. We have already calledattention to this subject. Up to the present time some 25,000persons have quite spontaneously availed themselves of theoperation. If a trial is to be given to this system for a

’ sufficient time and on such a scale as to become a reallyadequate test of its protective efficacy or otherwise againstcholera (as recommended by Dr. W. J. Simpson, the health

officer of Calcutta) India no doubt offers the best field for

carrying out the experiment. The results have so far beenencouraging, but it would be altogether premature to form

1 any opinion about Professor Haffkine’s protective method at

1 | present.

THE TRANSPORT OF PATIENTS ON THESWISS RAILWAYS.

LAUDABLY solicitous to promote the convenience of thetravelling public-especially of those who are labouringunder illnesses which disqualify them from the usual modesof transit-the Swiss Railway Union has been in communica-tion with the "Verkehrsvereine " (Commercial Associations)of the country, with a view to facilitate the conveyance ofthe invalid or the wounded along the lines. It has con-sidered several proposed improvements on the means alreadyin use for such conveyance, and has subjected them to aseries of thorough practical tests in as many trial-trips. Theconclusions to which it has come, in accord with the V er-kebrsvereine," are the following, subject, of course, to modi-ncatior, should experience suggest any further changes forthe better :-

1. In summer, so long as the carriages can dispense withheating apparatus, the transport of the sick or woundedshall be effected as heretofore in covered goods waggonswithout any further arrangement, on the understanding thatno addtcional luggage or load shall be taken in.

2. During the " Heizoeriode," (that is, when heating appa-ratus is in use), patients may have at their disposal singlecompartments of third-class carriages, in which stretchers orbeds for invalids can be conveniently employed The meansof fitting up these latter is available at the chief stations.On special request, fortified by medical certificate, even

during the ’’ Heiz periode,’’ the transport of patients in goods.I waggons shall be conceded.