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In rheumatic fever-which, I think, may be fairly consideredas sympathetic of many co-existing local irritations-I contentmyself-and generally my patients too-with clearing out theprimae viae, aud applying liint, dipped in strong solutions ofopium, or of belladonna, to the seats of pain, covering in thewetted lint with oiled silk, that the soothing effects of warmthand moisture may at the same time be attained. And I havefound the febrile state, the local irritations being subdued,easily controlled by the acetate liquor of ammonia, combinedwith tincture of hyoscyamus and nitrate of potash.In gout, unquestionably, the constitutional state must be

more particularly attended to, especially so far as regards theprophylaxis; and in young and robust people, where rheuma-tism occasionally attacks the heart, I yet think it sometimesnecessary to bleed from the arm. That, however, in thesecases, we might not often, if not always, trust to narcotics, Iam by no means well assured.

I am. Sir. vours resnectfnllv-Liverpool, May, 1849. JOHN COOPER, F.R.C.S.E. &c.

POOR-LAW TRICKERIES.—THE HUDDERSFIELDGUARDIANS AND MR. TATHAM.

GEORGE PHILLIPS.

To the Editor of THE LANCET.SiR,ńI have the honour to enclose you a circular, (in the

name of the committee appointed to collect subscriptions toindemnify Mr. Tatham for the losses he sustained in prosecut-ing his suit against the Huddersfield guardians, an account ofwhich suit appeared in your journal, some twelve months ago,)and I shall feel obliged to you, on public grounds, if you will Icall attention to the matter.

I am, Sir, your obedient servant,... IroN"""""’, ,....,......,

West Parade, Huddersfield, May, I84Q.

We extract the following passages- from the circular, whichwe have elsewhere commented upon :-"In 1847, cases of fever accumulated in the-town of Hudders-

field to a degree that rendered it necessary to open a temporaryfever hospital, for the treatment of these cases alone. Attend-ance on this hospital had not been provided for in Mr.Tatham’scontract with the guardians of the poor; but as soon as it wasopened, Mr. Tatham was specially requested, by the relieving-officer of the district, to attend it. That request Mr. Tathamunhesitatingly complied with. He attended from the openingof the hospital to its close. He had in this hospital 160 casesof infectious fever; 57 other cases of typhus to attend inother parts of the town; and general cases of sickness in ad-dition. Of these 160 cases in the hospital, 77 were removalsfrom other medical districts, by the guardians themselves;and for his attendance at the hospital generally, and for these77 cases in particular, Mr. Tatham claimed compensation ofthe guardians to the amount of 106 3s. 6d. That compen-sation the guardians at first wholly refused. ,

" In this case, Mr. Tatham appealed to the poor-law com-missioners, making them acquainted with the facts; and thecommissioners, in a letter to Mr. Tatham, (a copy of whichthey forwarded to the guardians,) said that ’ it would be in-equitable to hold that Mr. Tatham ought to attend the tem-porary fever hospital under his contract,’ - that if theguardians would consent to award such extra remunerationas was justly due for the extra services he had performed,they [the commissioners] were prepared to consent to thepayment,’-and that if the guardians declined to awardsuch extra payment, it was open to Mr. Tatham to take legalproceedings to enforce his claim, if he was so advised.’ Thatextra remuneration the guardians did decline to grant, andMr. Tatham had to resort to law. After proceedings had beentaken, the guardians appealed to the commissioners to knowif they could legally defend the action out of the funds ofthe Union; and while the commissioners withheld all opinionon the question asked, they recommended that the matterin dispute should be referred to Mr. Austin, the poor-lawinspector, for settlement. That recommendation Mr. Tathamclosed with. His solicitor apprised the guardians that heagreed to do so. That gentleman also repeatedly tried to getthe hearing arranged for, under a proper deed of arbitration,but unsuccessfully. Seven weeks were spent in these fruitlessefforts. The very last meeting of the board, before the expi-ration of term-time, was waited for, before proceedings wererecommenced; and then, when all efforts for a peaceableand amicable settlement had failed, declaration was filed, andthe case proceeded on to trial.

" At the trial, it was not denied, or attempted to be denied,that the work had been performed; it was not alleged, or

attempted to be alleged, that the sum sought as compensationwas excessive; but it was pleaded that there was no writtenorder of the guardians on their resolution-book, directing himto attend the fever hospital; and that therefore he had noclaim for compensation.’ " The facts of the case are these:-The hospital was taken bya portion of the guardians, and a portion of them also in-structed Mr. Tatham to attend. Those guardians reported tothe general body, at their next meeting, what they had done,and its propriety was unanimously acquiesced in. But no entryof that acquiescence was made in the minute-book of theboard. And because this had been neglected at the time, theguardians pleaded their own neglect, and thereby defeated a.just and equitable claim."The facts were laid before a large and influential meeting

of the rate-payers of the township of Huddersfield, on the 1stof May, 1848, when the following resolutions were passed:-" That the overseers should request the poor-law board to

take immediate steps to ascertain the truth of the allegationscontained in their,report, with a view to a speedy remedy ofthe present evils, and a prevention of them in future.’

" That this meeting begs to accord its best thanks to Mr.T. R. Tatham for the manner in which he has maintained theright of the poor to efficient medical relief, in the hour ofdanger and- affliction. And further: that this meeting, sym-pathizing with Mr. Tatham for the extremely hard treatmenthe has experienced at the hands of the guardians of the poor,resolves, that the overseers of the poor memorialize thepoor-law board, in the name of the rate-payers of the Hud§dersfield township, urging that they will be pleased to directthat the guardians of the Huddersfield Union fully recoiu-pense Mr. Tatham for his extra services and great risk of lifeincurred in attending the fever hospital, and also reimbursethe expenses attending the prosecuting his just claim, out ofthe funds in their charge:

This resolution was carried by an overwhelming majority." Twelve months have elapsed since the memorial was sent

up: no other answer than a mere acknowledgment of its re-ceipt has been returned, beyond an intimation, nine monthsago, that the poor-law board were in communication with theguardians on the subject. In fact, it has since been fullyascertained that the poor-law board have no power to directthe guardians to make Mr. Tatham any recompence what-ever.

" Baron Alderson, the presiding judge at the trial, spokeindignantly of the hardship of the case, on finding that apoint of law-viz., that no corporate body can be bound,except by a resolution entered in their own books-interferedwith equity. An entry on the minute-book, however, beingfound, of an offer of X42 having been made to Mr. Tathamafter the legal proceedings had been some time commenced,(which was rejected by his solicitor, as totally inadequate,)his lordship advised the withdrawal of a juror, and the accept-ance of the S42 by the plaintiff, thereby desiring to save Mr.Tatham the expense of the costs on both sides. Havingeffected this arrangement, his lordship showed his sense ofthe injustice of the transaction by remarking:-

" , It will be a disgrace to the town of Huddersfield if theyallow Mr. Tatham to be one shilling out of pocket. A publicsubscription ought to be set on foot, not only to defray thatgentleman’s expenses, but also to compensate him for his ser-vices to the poor, and for the great risk of life he has incurred,in attending to the fever cases. If I were an inhabitant ofHuddersfield, I would readily subscribe to it.’"To prevent that disgrace, the friends of justice are hereby

appealed to. Mr. Tatham has now been in the service of thepublic for a period of six years. Besides the loss of thegreater portion of the sum claimed for hazardous public ser-vices, he has been put to considerably more than £ 200 actualexpense in the prosecution of his suit, and matters connectedwith the subsequent investigation. Indeed, his total ex-penses and losses in this business cannot be estimated at lessthan £ 400.

" Happily, and in a great measure through his instrumen-tality, the workhouse and hospital are in a much better con-dition, and the poor are better attended to."

THE LISTON TESTIMONIAL.To the Editor of THE LANCET.

SIR,—Shortly after the death of Liston, a numerous corn-mittee was organized, consisting of many noblemen and gen-tlemen, some of the most eminent members of the profession,and most of the professors in University College, for the pur-

570

pose of raising a tribute to the memory of that great surgeonand a long and splendid list of subscriptions was once advertised in 1The Times. I immediately afterwards paid the sub.scriptions of myself and some friends, but since then I havEnot seen or heard anything more of the matter. Can yO!- inform me, Sir, living as I do in the country, whether it is stilproposed to carry out the original object, or not. If m3memory serves me rightly, the amount subscribed was such asto give every prospect of a sufficiency of funds for the contemplated statue, and I am at a loss to understand why it has noibeen proceeded with. The non-professional members of thEcommittee may think themselves excused in not taking aractive share, (though I believe such is not the case;) but theprofession had a right to expect that the teachers of the college in which he was one of the brightest ornaments, woulcnot show the intense apathy they have done, in allowingeighteen months to elapse without stirring themselves t(

carry out the wishes of the subscribers. I forbear to sa3more, in the hope that some member of the committee ma3be able to explain this apparent neglect of so great a man.

Yours in sorrow,May, 1849. AN OLD PUPIL OF LISTON.

THE FIVE-HUNDRED-POUNDS MEDICAL REFORMFUND.

"To the Editor if THE LANCET.SIR,—It appears essential that the subscribers to the Medi-

cal Reform Fund should meet, to arrange a plan of organiza-tion, and how to act most effectually for the interest of theprofession. Without this, they will do nothing.The question is-Where to meet ? To overcome this diffi-

- eulty, and as a preliminary movement, I propose to them, andto any member of the profession who feels disposed, to meet atmy house, to discuss the subject, on Wednesday, May 30th, atseven P.M. Should this appear feasible and agreeable to mem-bers, I shall be obliged by those who will attend writing mea note to that effect, as soon after reading this as convenient.

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I arm, Sir, yours &c.,

15, Bridge-terrace, Harrow-road, May, 1849. I

Dr. Crisp presents his compliments to the Editor of THE ILANCET, and begs to add his subscription of X2 28. to the‘ Medical Reform Fund."

Parliament-street, May, 1849.

HENRY HANSON DEARSLY,

MEDICAL FEES AT INSURANCE OFFICES.To the Editor of THE LANCET.

SIR,—Being one of those who think the profession at largegreatly indebted to you for your recent notices in regard to-Insurance Offices, and that it now only remains for medicalmen to refuse gratuitous certificates, to induce the public-the insured-to form a fair estimate of the relative securityof those societies, which, on the one hand, obtain the valuablecertificate, by equitable payment, and use it-or, on the other,insure the life on the single interview with their own referee,because they will not pay for better information; I beg tosend you a correspondence with the Secretary of the Provi-dent Clerks’Association; and have the honour to be, Sir, yourobedient servant,

____

CHIRURGUS.

To the Secretary of the Provident Clerks’ Association._ Exeter, March 22.

SIR,—I have received from your agent the usual form ofapplication relative to the health of Mr. -, but without anyfee or intimation that I was to look for one from your Office.I shall not trouble you at length with my observations, as youmust be familiar with the principle the profession is so rapidlyestablishing; but I will merely add, it is no sordid motivewhich induces me to decline giving this or any other certifi-cate ; and that under the circumstances of your particular,Society, I am of opinion that a small honorarium would meetthe requirements of the principle. With every wish for the.success of your institution, I have the honour to be, &c. &c.

Provident Clerks, Association, March 24, 1849.SIR,—I have received your esteemed favour, and thank you

for the kind wishes you have expressed for the prosperity ofthis Association. Our directors admit, that in all cases ofassurance a fee should be given for the medical report, therebypaying the proper tribute to the faculty; but they do not con-t3ider they ought to pay for that information which the person

proposing to insure his life is bound to furnish. In all townswhere we have an agency, a medical referee is appointed, whois paid for every person whom he examines; but the board ofmanagement has always declined to remunerate the medicaladviser of the party wishing to effect an insurance with thisOffice.-Yours &c. P. N. BYRNE, Secretary.To -, Esq., Surgeon, Exeter.

-

Exeter, March 25.

SIR,—I am in receipt of your polite note, which you mustbe fully aware blinks the question the profession is deter-mined to raise. I can only refer you, in your assumedignorance of the question at issue, to recent leaders in THELANCET, where you will see the names of those Societieswhich the profession is bound to support; and beg you toadvise your Exeter agent to submit Mr. -’s application atonce to your referee, if you think such course calculated tobenefit your Association. If, on the other hand, you seek tomake mischief between myself and my patient, then a courseof open hostility is all that is left me in self-defence.To the Secretary &c. Yours &C., .

(The application, I am given to understand, was accepted.)

MEDICAL CLUBS IN THE ISLE OF WIGHT.To t7te Editor of THE LANCET.

I am sorry to say that I am a witness to a disgraceful systemof medical club-practice. There is a medical man residingin Newport, Isle of Wight, who has now been in practiceabout six years. When he first left the hospital, andbefore any one could possibly judge of his professionalacquirements, he instantly, in the face of all the medicalmen of the town, started these cheap medical clubs, which arenearly a dozen in number. One would suppose the patientsvalued their money more than their lives. I am not alludingto want of skill on the part of the " club doctor," but the utterimpossibility, even with an assistant, to give them that attend-ance they stand in need of. There is scarcely a farmer ortradesman who is not in these three-shilling (per year) clubs.There are fourteen or fifteen medical men in Newport who,as Ihave stated before, had these, now club people," once as theirprivate patients, making a difference of some hundreds ofpounds less in their receipts per annum. If the clubs hadbeen limited to the labouring classes, earning from ten totwelve shillings per week, who would not be entitled to anyallowance from the parish in illness, and yet are not able topay a medical bill, it would have been no more than fair, butin this instance the large farmers and respectable trades-men of the neighbourhood have most disgracefully joined.One would suppose education, time, and knowledge, oflittle value, if it can be afforded to retail them all out at socheap a rate. I am of opinion that all similar cases should bemade public in your valuable journal.

I am, Sir, your obedient servant,A GENERAL PRACTITIONER,

Newport, Isle of Wight, 1849. ONE OF THE MANY INJURED.

A CASE FOR A COURT-MEDICAL.To the Editor of THE LANCET.

SIR,—Feeling assured of your impartiality as a judge on theconduct of professional men towards each other, I take theliberty of troubling you with an account of the treatment Ihave lately experienced from a brother practitioner, whomI should have expected to set an example of etiquette andstrict professional conduct, instead of adding personal insultto a breach of both these, under which I cannot remain silent.I will therefore state particulars, and leave you, and thereaders of your widely-circulated journal, to decide.

I attended Mrs. - in her confinement, on Saturday, Feb.17th, 1849. She was progressing very favourably, up to Feb.24th, when she was attacked with pleurisy of the right side,and subacute inflammation of the large lobe of liver. Not-.withstanding the active treatment employed, effusion tookplace in the right pleura. The husband became alarmed, andhe asked me if I had any objection to meet another medicalman, to which I replied, that I would meet any one he mightwish. W. Birch, Esq., a highly-respected and able practi-tioner, residing at Barton-under-Needwood, was accordinglysent for, on Monday, March 5th, and arrived early the follow-ing morning. Mr. Birch confirmed my opinion of the case,and ordered the treatment I was adopting to be persevered in.On this day, March 6th, I heard accidentally that Mr. Chap-man, a gentleman practising in this town, had seen my pattest