689

THE LANCET.

London, Saturday, August 29, 1829.

NATIONAL HOSPITALS.

COWARDICE and falsehood are the onlyremaining characteristics of the literary ruf-fians who have endeavoured, by their feeblee8orts, to perpetuate, in the great national

hospitals of this country, a system of hole-and-corner surgery. Having long played thepart of bullies to no other purpose than theamusement of their beholders, they nowwhine under the apprehension of approach-ing danger from the roused indignation ofan insulted profession. The acknowledg-ment of the necessity of reform is extortedfrom the cowards, because they dread theconsequences of avowing a contrary opinioneven to the hundred and fifty fools whom

they still endeavour to deceive. With a

view to lessen our influence with the pro.fession and the public, it has been asserted,with ten thousand other falsehoods, that wehave endeavoured to destroy, and, in greatmeasure, have actually injured, our excel-lent national hospitals. If a constant en.

deavour to procure an honest and judiciousapplication of the funds of those institutionscan be considered an attempt to destroythem, we must plead guilty to the charge ;or, if a constant endeavour to procure for

the miserable occupants of those institutionsa better system of treatment, be consideredan attempt to injure the public, we mustplead guilty to that charge ; or, if an endea-vour to protect medical students from a

shameless system of plunder by those whoûUJht to he their protectors, be considered anar,empt to injure the hospitals, we must herealso plead guilty to thar charge. But at thistime of day, the profession and the publicMed not to be informed either of the direc-

tion or of the effects of the labours of this

Journal, in the great cause of medical reform.We bave been always too much impressedwith a knowledge of the bleasings which our

hospitals hold out to a suffering and impo-verished people, to desire their downfall or

the least diminution of their resources.

Reform in their government, is what we have

sought to obtain ; not the destruction of theinstitutions. We have endeavoured to pu-

rify the stream of charity, and to spare the

public the horror of beholding a river of

blood. That reform in the government ofthese institutions will see its victims, wewell know. That it will effect the destruc-

tion of a certain race, cannot be denied;but that race consists of BATS and corrup-tionists, who fatten upon the vitals of the

poor, and deprive industry and merit of theirdue reward. The mode of election adoptedin these institutions, is worse than can wellbe conceived. Else how comes it, that theiroffices are occupied by neveys and noodles,and, indeed, imbeciles of every grade. The

revenues, however, of the hospitals, as, for

example, those of St. Bartholomew’s, St.

Thomas’s, Guy’s, St. Luke’s, and others,are so enormous,-the prospect of good,though distant, is so certain, from their

immense wealth, that we can tolerate, andsomewhat patiently, even numerous exist.ing evils, in the hope of obtaining morethan commensurate permanent advantages.The assertion, therefore, that we either

are, or ever have been, the enemies of

these hospitals, is false, basely false. Thereare, however, some institutions profess-edly dedicated to charitable purposes, thedestruction of which we should witness

with the greatest delight, for they are nui-sances, alike to the profession and the pub-lic. We of course allude to those pest-houses and puff-shops, infirmaries and dis-

pensaries. We mean not here to include

the infirmaries which ornament the largeprovincial towns, but refer particularly to

Ithe medical charities generated by fraud,and supported by intrigue, which are everyday rising into view in the streets and alliesof this metropolis, like funguses upon hot-beds. These charities, in almost every in-

690 RODERICK MACLEOD.

stance, owe their existence to the ingenuityof some unprincipled quack,-to some fel-low, probably, far less honest, and far lessskilled in his profession, than Dr. Eady, ofwall-chalking notoriety. We have often

stated, that the infirmaries and dispensariesare decoys for the rich, and not charitable

receptacles for the poor. This, of course,has been as often denied by the tools

of corruption, and by none more frequentlythan Doctor RODERICK MACLEOD, DuBand Yellow Goth. This person’s denun-ciations of our attacks on infirmaries and

dispensaries, have been loud and frequent,and his arguments in support of the °’ goodcause " have been bedecked with those

beautiful flowers of rhetoric for which his

writings have so long been celebrated.

We have now, however, a clue to the doc-tor’s zeal, and are indebted for the disco-

very to an advertisement, of which the fol-

lowing extract forms the first part. It ap-

peared in The Times of the 23d ult.-

" Asylum for the Recovery of Health,12, Lisson Grove North, St. Ifaryle-bone,

For the reception of respectable persons oflimited income, who, by paying a small

weekly sum, are provided with medical ad-vice and accommodation superior to thosewhich they can obtain either at their own

houses, or at public hospitals."Although the character of this advertise-

ment indicated some intended hoax, we

thought it our duty to send to Lisson Grove,and make inquiry into the nature of this

extraordinary establishment, if such esta-

blishment there were. Our messenger ac-

cordingly went, and speedily returned, bring-ing with him a neat little pamphlet, entitled" An Account of the Asylum for the Reco-very of Health, supported in part by Volun-

tary Contributions, and in part by moderate

Weekly Payments by the Patients ;" and to

render the title-page complete, the follow-ing is the imprint, " Printed-by the Philan-thropic Society, St. George’s Fields:’ From

this interesting little work, we sball make afew extracts. After describing the situat:cyof the establishment, it proceeds thus :-

" It is a building divided into two sep’rate houses, with separate gardens for t:.e

two sexes. Patients having subscribers

letters, are admitted on Thursdays by tLc

Weekly Board, which meets at one o’clock,The payments at present required of pahutsare-of females, fourteen shillings; of males,seventeen shillings and sixpence ; of cM-dren, ten shillings and sixpence each. Per.sons of either sex having separate rooris,

pay one pound four shillings and sixpenceper week. The governors have been com.

pelled, for the sake of preserving the neces-sary separation, to adopt a regulation, thatsuch servants only be admitted, who shallpay for and occupy separate rooms. Koservants in livery can be admitted."Then follow the names of some lords and

other wiseacres, who, it is stated, are the

patrons, president, and vice-presidents, ofthis excellent charity. Next comes an ad-dress" to the public on what is called the

" design" of the institution, which goes toshow, that after the concern is established," the governors of hospitals may fairly re-fuse all improper objects for gratuitous reolief." Further, it says," In this country, also, there are no doubt

many, who, from a sense of delicacy ac’

quired from a good education, and the habitsof better days, or from honest feelings ofBritish independence, would be averse fromgoing into hospitals, and would rather sub.mit to the effects of severe disease, and towant of needful aid and attendance at home.Should the pressure of afflicting maladies, insome few instances, even overcome that re-

pugnance, the individuals must enter into

such an establishment with a broken spint,and a feeling of degradation that woutdbavea tendency to retard, if not altogether frus-trate every hope of recovery. Females liv.

ing on narrow incomes without domea:c

connexions, and well-educated persons re-duced by the casualties ofhfe, would 6ed msuch an establishment a welcome retrea’,where not only disease might be Mmbat-e,but anxious solicitude and separation fromfriends soothed and consoled, by that Li-u’attention and prompt and various succour.which the unfortunate sufferers could have

691THE ASYLUM OF HEALTH.

sto chance of obtaining at their own dwell-ings. It is also presumed, that the sick

members of the families of many respectableartisans and mechanics, clerks on small sa-laries, apprentices, domestics of the higherclass and of irreproachable character, wouldbe often glad to avail themselves of such aresource ; and the members of friendly andbenevolent societies would find it the most

etigible mode of laying out that money, to,which, during the period of their sickness,they are entitled. For besides lodging anddml, they would have the benefit of expe-rienced nurses, resident medical officers, a

store of medicines purchased and made upunder the inspection of responsible persons,and directed by the advice of men, whoselernla andestablialced character must createa just confidence in their exertions."

After the address, there is, at page 12, aruass of heterogeneous matter, from whichwe extract the two following paragraphs :-" The public will be able to judge of the

description of persons who have been re-lieved by this charity, when it is stated,that several officers of the army and navyhave been admitted, labouring under diseasesbrought on in the discharge of their duty;the wives and widows of officers, their chil-dren, and those of the clergy, governesses,clerks, teachers, small tradesmen, women

subsisting on small annuities, persons de-riving sick allowances from benefit socie-ties, and foreigners, both in civil and mili-

tary life ! ! Surgical operations of great im-portance have been performed with success,which the surgeons would have hesitated tohave undertaken in the crowded wards, and

unquiet circumstances of a public hospital,or with the deficient attendance and accom-modations to be procured in the privatedwellings of the patients."Then we have a " statement of particular

cases;" of course of persons cured, as wefind in the pamphlets of Dr. Lamert, Mr.Williams, Drs. J. and C. Jordan, and manycihers. «’e should not have said cured,’,however, as we find that the subject of

the first case, " a outh twenty years of age,who had been clerk to an attorney in the

country, died of a deep-seated abscess in

the liver." But the patient had experienced

" so much relief from the kindness and at-

tention he bad received, that he made it his

spontaneous request, the evening precedinghis decease, to his friends, never to let a

year pass without contributing a sum of

money to the support of the institution."This is as good for the asylum as a " cure."The other cases related are those of a widow

lady, the child of a medical man, the childof a respectable farmer, the wife of a re-

spectable tradesman, a gentlewoman of goodeducation, a young man of good educationconnected with the press, and a midshipmanin the service of the East India Company.These were all sorely afflicted with" thestone, the sieve, the tortures of the damned,"but nevertheless they were all " cured,"and sent home happy to their friends, pour-ing out blessings upon the charity.

Is not this, without exception, one of themost barefaced and impudent humbugs thatwas ever foisted upon the public? Andwhois its physician’! the gentle, the amiable,RODERICK MACLEOD, that worthy man whoobtained " five pounds and a general laugh"in the Court of King’s Bench as a balm for hiswounded reputation. The man who has the

virtue to malign the exposures of quackery,and who has the benevolence to yield hisgreat knowledge gratuitously to an institu-tion where there are 11

separate gardens forthe two sexes, where females are admitted

for a weekly payment of fourteen shillings,where males are admitted for a weekly pay-ment of seventeen shillings and sixpence, andwhere children are admitted for a weeklypayment of ten shillings and sixpence each.

! Where a person of either sex, having a sepa-! rate room, must pay one pound four shillings

and sixpence, and where the worthy gover-nors, for the sake of preserving the ’neces-

sary separation,’ have adopted the resolutionthat such servants only shall be admitted, who

shall pay for and occupy private rooms, andwhere no servants in livery can be admitted."Such is the institution,and such is RODERICKMACLEOD, the man who has frequently

692 COLLEGE AND HOSPITALS.—MIDDLESEX HOSPITAL.

favoured us with the out-pourings of hisvirtuous indignation, against those unfeelingpersons who have alleged that infirmaries

and dispensaries are injurious to the publicand ruinous to the profession.

If these latter institutions generally,where it is professed the poor only are

relieved, are depriving medical practition-ers of the means of obtaining a liveli-

hood, what must be the effect upon medi-

cal practice of the charity under consi-

deration ? For here, respectable persons,who, from "a sense of delicacy," could notthink of entering one of our hospitals,—re-spectable persons, ladies, gentlewomen,clerks, gentlemen of the press, respectablefarmers, the clergy, and officers in the armyand navy, are admitted at a charge of seven-teen shillings and sixpence a week for boardand lodging, with gratuitous medicines andattendance. What, we ask, must be theeffect of such a system as this upon the

interests of medical men ? And yet the

fellow, this dirty DUB, this contemptiblescribbling Scotch DUB, who occupies the

respectable office of physician in this cha-rity, has had the impudence to taunt us onmore than one occasion, with directing ourobservations to the pecuniary interests ofmedical practitioners ! This is a subject uponwhich he may well quake. The professionhas now before it, the true character of, at

least, one of its supporters. Here we shall

quit the subject for the present, as we are

heartily sick of the impostor, and the hum-

bug with which he is connected.

We promised, in a former Number, to

show, that the College of Surgeons cannot

legally exercise the least control over the

proceedings of either the London or pro-vincial hospitals. In considering this ques-tion, it is only necessary to peruse the

charter of the College, and the acts of in-corporation and charters of the hospitals,to be convinced, that the powers of those in-

stitutions are perfectly distinct from eachother. In the acts and charters under

which the hospitals are governed, no men.tion whatever is made of the College of Sur.

geons; and, on the other hand, in the char.

ter under which the College of Surgeons is

governed, not the slightest allusion to anyof the hospitals can be discovered. Xow

the hospitals must be regarded either as

public or as private institutions, and their

governors either have, or they have not,the power to exclude medical students. If

they have a right to exclude students, howcan the College enforce a law requiring theproduction of a certificate which the pupilcan only obtain as a matter of courtesy;and if the governors of the hospitals harenot a. right to prohibit attendance on the

surgical practice of those institutions, thenthe " regulations" of the College are oppos.ed to a right at common law, and cannot beenforced ; and upon this last ground it is

quite clear, that every fee levied for attend-ance is unjustly and illegally imposed. This

disgraceful College, in its passion for plun-der, appears to be utterly regardless of the

opportunities afforded to pupils, except thatof requiring them to pay money to a favour’ed junto. Excluded or not excluded from

the hospitals, no matter-certificates mustbe produced. Aye-certificates from hospi.tals which exclude pupils from their wardsexcept during th1’ee hours in each week;at for example, the Aliddlesex Hospital,where a pupil who pays forty-two guineasto witness the medical and surgical practicefor a period of one year, has the opportuL.tyof walking’ through the wards on Mondays,Wbdcesdays, and Saturdays, from lalf-pasttwelve until half-past one, on which dassand hours the si.c physicians and surgeonsgo through their scientific promenade. Six

physicians and surgeons all visiting differentpatients, and in different wards, probably, at at

the same moment ! Yet the certificates of

this hospital are recognised by the College,while those of our excellent provincial his-

693RHIND ON WORMS.

Pitals are virtually excluded. The College ofSurgeons having no power to enforce attend-ance on the hospitals, it has no power to

enforce the production of certificates. The

infamy of recognising certificates from a

hospital where pupils have no opportunityof acquiring the least knowledge of their

profession, is peculiar to, and worthy of, thisCollege. The six physicians and surgeons,as we have already stated, attend from half-past twelve to half-past one on Mondays,Wednesdays, and Saturdays. Now a pupil Ican only attend one surgeon or physicianat a time; hence he loses five-sixths of

the practice, even in the hour when his in-structor visits the hospital. But, it will be

said, after the surgeons have left, he can re-main in the wards to inspect the books, andexamine the patients at his leisure ! Can

he? Here is the answer, which we have

taken from over the mantlepiece in the hallof the hospital."The attention of the pupils of this

hospital is particularly called to the ESTA-

BLISHED I.AWS of this institution, whichdirect that No PUPIL Br ADMITTED in the

WARDS of the hospital, BUT AT THE STATEDHOURS OF VISITIVG BY IIIE OFFICERS of the

establishment," (from half-past twelve to

IJalf-past one on Mondays, Wednesdays, andSaturdays;) and that no pupil or dresser beALLOWED to REMIA IN in the hospital afterthe usual businpss (the visit, recollect, fromhalf-past twelve to half-past one) of the dayis 6oished.

" The pupils of the years 1827 and 1828,are desired to be prepared to produce theircards of admission as pupils, should they becalled upon to do so.

" ALEX. SIIFDDEN, Secretary."

The last paragraph, it will be seen, con-

tains a sort of threat, in order to preventstudents from obtaining more than the hun-dred and fifty-six hours allowed for runningdud scampering through the wards, and forwhich they may hare paid forty-two guineas.Sa months’ attendance at this hospital isdetmed by the worthy College equivalent toan attendance of four years upon the sur-

gical practice of any of the large provincialhospitals, where the students have the un-restrained privilege of attending the bed-sides of the sick, from eight in the morninguntil the setting of the sun. When will the

profession rid itself of the intolerable incu.bus by which it has been 20 long oppressedand degraded?

A Treatise on the Nature and Cure of In-testinal Worms of the Human Body :arranged according to the Classification ofRudolphi and Bremser, and containingthe most approved Methods of Treatment.By WILLIAM RHIND, Surgeon, M.R.M.Soc. Ed. Illustrated by Six Plates. Edin-burgh, Oliver. 1829, pp. 152 ; 8vo.

A Treatise on the Nature and Cure of In-testinal Worms of the Hunzun Body, ;arranged according to the Classification ofRudolphi and Bremser, and containingthe most approved Methods of Treatment.By WjLLiAM RHIND, Surgeon, M.R.M.Soc. Ed. Illustrated by Six Plates. Edin-burgh, Oliver. 1829, pp. 152 ; 8vo.

Au accurate treatise on the subject of intes-tinal worms, has long been a desideratum inEnglish medical literature. Dr. Hooper, inthe year 1799, wrote in the London MedicalTransactions, an excellent paper on the nvespecies of worms which are found in the ali-mentary canal of the human body; but he

confines himself entirely to a description of £the external appearances and anatomical

structures, without regarding their history,symptoms, and method of cure ; and he

makes no mention whatever of the various

species which inhabit the other cavities andtextures of the body.

’ Dr. Bradley published, in 1813, a smalltreatise on worms, which was an incom-plete copy of Dr. Hooper’s paper, with theaddition of a fewmeagre directions for their -cure.

,

Dr. Chamberlin’s monograph, publishedin 1784, is written for the sole purpose ofrecommending the dolichos pruriens as a

cure for taenia, &c. To fill up the gap whichhas been so long felt to exist, Mr. Rhindcompiled this work, and he has chiefly doneso from the writings of Rudolphi, Bremser,and Hooper. To Rudolphi he is indebtedfor the classification, and for the genericand specific descriptions. From Bremserlie has derived that ample information onthe symptoms and treatment which the in-

dustry and extensive practice of that meri-torious physician enabled him to afford tohis readers. He has adopted the anata-