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a student in 1859, and qualified in 1864, thus makingthe fourth generation of his family to practise medicine.Shortly after he became resident medical officer toDr. Sibson, for whom he had a lifelong regard, andafterwards was resident medical officer to the LockHospital. Leaving hospital work he went intopractice at Notting Hill, where he remained for 50years, retiring as recently as 1917. He was keenlyinterested in the welfare of his profession, and servedon the medical committee of St. Mary’s Hospitaland also on the medical school committee of thathospital for 13 years, from 1878 to 1891. He wasalso for 27 years on the council of the Medical DefenceUnion. As a member of the council of the RoyalMedical Benevolent Fund and other charitableorganisations for many years he showed a practicalinterest in the medical charities. His experience ofthe happenings in the pre-Listerian days and hisstories of his old hospital days were always of interestto the younger generations of the profession, whoscarcely credit the changes which have occurred inthe practice of medicine and surgery. His knowledgeof the back history of medical professional work wasdirectly derived from his father, who was one of theearly collaborators in the production of THE LANCETunder the Founder.The late Dr. Jordan Roche Lynch married Marian,
daughter of Mr. James Oliver, who survives him,and by whom he had five children, all of whom areliving, one of the sons being Dr. G. Roche Lynch,pathological chemist at St. Mary’s Hospital.
RICHARD JOSEPH TRISTAN, L.R.C.P. & S. EDIN.
BY the death of Dr. R. J. Tristan, on Oct. 25th,Retford loses a well-respected member of the medicalprofession. Dr. Tristan qualified in 1886, and heldthe post of resident midwifery assistant at CoombeHospital, Dublin, before settling in private practice.He went to Retford nearly 40 years ago as assistantto the late Dr. William Pritchard, and his kindnessand geniality brought him wide popularity. Dr.Tristan was a pupil and friend of the late Dr. JosephBell and Sir Henry Littlejohn, and many were thestories he delighted to tell of these men. He was a
vigorous supporter of the National Service League,and took a keen interest in all matters military,having in his youth served in the Sherwood YeomanryCavalry and other corps. During the war he was themedical recruiting officer for Retford and district.He was a well-known member of several Caledoniansocieties. For many years he was a member ofthe medical staff of the Retford Hospital and Dis-pensary, and on his retirement from active work therehe was made honorary consulting physician.
OWING to the prevalence of chicken-pox this yearin Manchester, the Public Health Committee is asking
1for power from the city council to make the disease Icompulsorily notifiable for a period of six months, beginningin January next.
Dr. J. B. Mennell, of St. Thomas’s Hospital, London,on Oct. 22nd opened a new massage department of theRoyal Infirmary, Manchester, and expressed the hope thatthe honorary medical staff would cooperate in the useof the department, which would materially increase theefficiency of the institution.
ROYAL MEDICAL BENEVOLENT FUND GUILD.-Thegolf competition in aid of this Guild, which was open toany woman member of a recognised golf club returning thebest aggregate of five selected cards against bogey (notnecessarily on the same course) between Jan. lst andSept. 30th, 1923, resulted in a tie between Miss W. Doxford(Bromley and Bickley), L.G.U. handicap 7, and Mrs. Wright(Stanmore), L.G.U. handicap 20, with an aggregate of29 holes up on bogey. Ties being decided on the greatestnumber of holes won from bogey on the five cards, MissDoxford wins the silver rose-bowl presented by Sir HughRigby, and Mrs. Wright the prize for competitors withhandicaps over 18. The Guild benefits to the extent of over135, and the committee hope to run a competition onsimilar lines next year.
THE MEDICAL INSURANCE AGENCY.
A MEETING of the Committee of Management of theMedical Insurance Agency was held at the house of theBritish Medical Association on Thursday, Oct. 25th,when, in the absence of Dr. G. E. Haslip owing toindisposition, the chair was taken by Dr. H. A. desVoeux. Other members present were Dr. E. WeaverAdams, Lieut.-Colonel R. H. Elliot, Dr. R. A. Gibbons,Dr. R. Langdon-Down, Sir Dawson Williams, SirSquire Sprigge, and Mr. W. E. Warne. The secretarypresented the audited balance-sheet for the year 1922,together with the chairman’s report thereon. A veryinteresting detailed schedule showed the great andrapid progress made by the Medical Insurance Agencyduring the last eight years. The premium incomeincreased from .612,104: in 1915 to .637,936 in 1922,whilst the commissions, &c., earned rose from 21950in 1915 to 25250 in 1922. For the third year insuccession policies totalling over 2100,000 in sumsassured in respect of life and endowment assurancewere arranged through the medium of the agency,bringing the total sums assured up to Dec. 31st, 1922,under these heads to over .6700,000. Business in fireand accident insurances has increased ; the conveni-ence of paying one premium for all household risksunder a flat rate is apparently much appreciated. Aninterim report by the chairman for the nine monthsended Sept. 30th, 1923, stated that the popularity ofthis comprehensive household contract continued.In spite of a decline in life assurance business experi-enced by all offices, and in spite of the existence of keencompetition, the agency negotiated 62 new life policiesduring the period. One of the advantages-and notthe least-of the Medical Insurance Agency is thatmembers of the profession can obtain from it personaladvice as to the particular kind of policy to meet theindividual’s particular needs. During the annualmeeting at Portsmouth no fewer than 55 interviewstook place, and it was found possible to adjust severaldelicate matters to the satisfaction of the applicant.The amount of business in insuring motor-cars done
by the Agency increased during the year, but bearingin mind the large number of cars now used by membersof the profession it is believed that the amount couldbe further increased. Motor-car insurance is a
specialised business ; accidents are more heavy andfrequent than in almost any other form of insurance,and members of the profession would be well advisedto take advantage of the security offered them toobtain fair and equitable settlements by insuringthrough an agency so strong and influential as theMedical Insurance Agency. The committee has forsome time felt that the benefits already conferred uponthe profession might be increased were it in a positiontb obtain for the person insuring through it adviceon all matters affecting the purchase and use of motor-cars. An arrangements has now been made with thefirm of Mann, Egerton, and Co., Ltd., to advise membersfree of charge, either directly or through the mediumof the Agency, on any problems, difficulties, disputes,or technical matters relating to motor-cars, includingmotor coach-work and accessories ; to give adviceas to the suitability of any particular car for any classof work or type of district; to undertake the periodicalinspection of members’ cars at a moderate fee ; togive expert advice as to the mechanical condition ofmembers’ cars, and the advisability of repairs, and toprepare specifications and estimates for repairs tomechanism or coach-work, or for the manufacture ofspecial bodies to meet particular requirements, andgenerally to place their entire resources at the disposalof members, both in London and throughout thecountry. The firm has been established over 25 years ;it possesses experience, a staff of experts and largeworks at Ipswich, Norwich, and in London (156, NewBond-street, and la, High-road, Kilburn). The firmwill place at the disposal of purchasers of cars, throughthe Medical Insurance Agency, their system of deferredpayment; a purchaser pays 25 per cent. of the valueon delivery and the balance by monthly or quarterly
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instalments as desired. An addition of 2! per cent-to the list price of the car is made to cover interestcharges. The company has a stand (No. 129) in thecoach building annexe of the Olympia Show, and itsrepresentatives will be prepared to give advice free ofcharge to medical men intending to purchase on theadvice of the Medical Insurance Agency. Applicationfor an introduction should be made to the Secretaryof the Agency, 429, Strand, London, W.C. 2.
It appeared from the balance-sheet of the MedicalInsurance Agency for the year 1922 that a sum ofover 22000 had been returned by way of rebates to thoseinsured through the Agency, an increase of 2367 over1921. The surplus carried to the Medical BenevolentFund was slightly larger in 1922 than in the precedingyear, and a sum of 21500 was allotted as follows :to the Royal Medical Benevolent Fund Guild, z630 ;to the Royal Medical Benevolent Fund, JB315 ; to theEpsom College Benevolent Fund, 2210; to the RoyalHospital and Home for Incurables, Putney, 252 10s. ;THE LANCET Editor’s Discretionary Fund for dealingwith emergency cases, 225. A further sum of 2267 10s.was set aside for the fund established by the Agencyto make grants in aid of the education of girls, orphansof medical men, or daughters of unfortunate brethrenwho are precluded by age or ill-health from continuingto practise. Including the contributions now made thetotal sum subscribed to medical charities by theMedical Insurance Agency since 1910 exceeds jBll,500.
THE RECENT SMALL-POX OUTBREAK INLONDON.
The report of the Public Health Committee of the LondonCounty Council on the recent small-pox outbreak in Londonmakes interesting reading. It appears that altogether therewere 18 cases-two terminating fatally-of which 11 occurredin the County of London and 7 in extra-metropolitandistricts. Attention was first directed to the appearance ofsmall-pox in London on Sept. 7th, the patient being a girlemployed as a chambermaid at a central London hotel.During the course of her duties at the hotel she had waitedupon a lady visitor from Spain, who, in the absence of medicaladvice, was thought to be suffering from influenza, withspots attributed by her to fish poisoning. This woman leftthe hotel on August 19th and efforts were immediately madeto trace her movements and destination. Before she wasultimately discovered on Sept. 10th at an address in an out-county suburb, two cases presented themselves whichapparently were the result of contact with her. One patientwas employed in the vicinity of the hotel where she hadstayed and the other was actually employed at the hotel.When finally she was located, the local medical officer ofhealth, on visiting the address, discovered an adult relativesuffering from a severe attack of small-pox, and ascertainedthat the lady herself was out shopping in the West End ofLondon. On her return she was found to be recovering froma mild attack of small-pox. On the same day another casewas discovered in London, the patient being a relative whohad been in contact with her. During the later period of herconvalescence, before she was removed to hospital on
Sept. 10th, this lady was visiting, shopping, &c.Ten further cases afterwards occurred. Three apparently
had no connexion with the original source of infection, butfour were presumed to have been infected by the man whoworked in the vicinity of the lady’s hotel. Of the remainingthree, one was a man employed by a laundry firm in washingsoiled linen from the hotel, and the other two were adultswho had occupied at different times the room at the hotelin London previously occupied by the Spanish visitor. ThePublic Health Committee of the Council conclude : " Themedical officers of health in the various local areas had theassistance of the Council’s experts in diagnosis, Dr. W.McConnel Wanklyn and Dr. J. A. H. Brincker, and tookprompt measures to arrest spread of the disease, including thevaccination and observation of contacts. Vaccinations andrevaccinations by public vaccinators of school-children inthe schools directly or indirectly connected with the outbreakhave also been carried out through the medium of the Council’sdivisional medical officers acting in cooperation with theboard of guardians. Only one child of school age (anunvaccinated boy of 12 years) contracted the disease. As aresult of the energetic measures taken the outbreak of small-pox in London was localised." Of the 18 cases which occurred,12 patients whose ages ranged between 23 and 79 years hadnot been vaccinated since infancy, and of these 1 died ;5 between the ages of 12 and 50 years were unvaccinated,and of these 1 died. One patient had been vaccinated inthe army in 1914, and suffered a very mild attack.
Medical News.ROYAL COLLEGE OF PHYSICIANS OF LONDON.-An
ordinary Comitia of the College was held on Oct. 25th,the chair being taken by Sir Humphry D. Rolleston, thePresident. It was reported by the Censors’ Board that Mr.George Dawson Stilwell had been appointed Jenks scholar.The following candidates were admitted to the Membershipof the College : Drs. C. K. J. Hamilton, D. Hunter, D. G.Leys, W. T. Nelson, D. Nicholson, E. 0. A. Singer, and K. H.Tallerman. Licences to practise physic was granted to 168candidates (including 33 women) who have passed the FinalExamination in Medicine, Surgery, and Midwifery of theConjoint Board, and have complied with the by-laws of theCollege. The following are the names and medical schoolsof the successful candidates :-W. L. Ackerman, London ; J. C. Ainsworth-Davis, Cambridge
and St. Bart.’s ; R. H. Amm, Cape Town and Guy’s ;R. S. Andcrson, St. Bart.’s ; F. G. A. Armson, Birmingham ;1. Atkin, St. Bart.’s ; W. Balendra, Ceylon and London ;Rose Baranov, Univ. Coll. ; P. E. Bardsley, Cambridgeand St. Thomas’s ; J. S. Benzecry, Univ. Coll. ; E. M.Bergheim, Middlesex; Dora M. Berry, Royal Free ; E. J.Blackaby, St. Bart.’s ; Margery G. Blackie, Royal Free ;L. G. Blair, Edinburgh and London ; W. L. Blakemore,Birmingham; D. R. Blunn, London; A. J. Boase, St.Thomas’s ; Hilda A. Bond, Univ. Coll. ; E. G. Bradbeer,Bristol ; R. T. Brain, London ; A. Broido, Guy’s ;C. 0. S. B. Brooke. St. Bart.’s ; Georgie G. Brown, Aberdeenand Charing Cross ; J. W. Brown, Middlesex ; Mary Buck,Royal Free ; B. H. Burns, Cambridge and St. George’s ;Lily C. Butler and Kathleen F. Butterfield, Royal Free ;F. B. Byrom, London ; C. M. Carruthers, Kingston andLondon ; H. K. Christie, Otago ; D. H. Cockell, St. Bart.’s ;M. Cohen. ]3irminL-Iiqm - B A. r’nlfR r!HTf)iff anr) WMt-minster ; A. B. Cooper, St. Bart.’s ; R. Cove-Smith,Cambridge and King’s Coll. ; I. S. Cristol, Leeds ; G. J.Crosby, Cambridge and Univ. Coll. ; D. T. Davies, Cardiff ;I. G. Davies, Cardiff and St. Ba,rt.’s; T. D. Deighton,St. Bart.’s ; Margaret B. M. Dewhurst, St. Mary’s ;D. Diamond, St. Bart.’s ; V. W. Dix, Cambridge andLondon; A. F. Doyle, St. Thomas’s; Doris L. Durie,Univ. Coll. ; Hilda R. Dutton, Bristol; N. L. B. V. Eckhou,Cape and Guy’s ; L. C. J. Edwards, Melbourne and London ;P. Ellman, Manchester; G. S. W. Evans, St. Bart.’s ;W. M. Evans, Univ. Coll. ; J. L. Farquharson and S.Farquharson, St. Thomas’s; R. B. Fawkes, Cambridgeand Guy’s ; H. G. Goldwater, Cambridge and Middlesex ;T. S. Goodwin, Cambridge and St. Bart.’s ; F. M. Gore,Birmingham ; L. J. Green, Westminster ; J. V. Grifnths,Cambridge and Durham; P. D. Griffiths and C. J. P.Grosvenor, Cambridge and St. Bart.’s ; C. C. Halliwell,Cambridge and St. Thomas’s ; A. Harbour, St. George’s ;H. E. Harris, St. Bart.’s ; Doris I. Harston, Royal Free andLondon ; G. T. Henderson, Cambridge and Guy’s ; K. W.Heritage, London ; G. Hochschild, Cape and St. Thomas’s ;Frances A. Hogben, Manchester; E. Holmes, Leeds ;J. W. Hope-Simpson, Cambridge and St. Thomas’s ;Madge W. Hubble, King’s Coll. ; D. F. Hutchinson,Cardiff and St. Thomas’s ; L. I. Hyder, King’s Coll.;C. Iszatt, London ; C. Ive, Guy’s ; E. C. James, Cardiff ;A. H. Johns, Cambridge and St. Bart.’s ; C. E. Keast,Guy’s ; Karin L. E. Kellgren, Royal Free ; G. B. Kirkland,Guy’s ; C. de Winton Kitcat and R. A. E. Klaber, St.Bart.’s; E. H. Koerner, Oxford and Guy’s ; P. E. M.Lanier, Middlesex ; Miriam A. Lawson, Royal Free ; J. J.Lewinstein, Guy’s ; R. H. Little, St. Thomas’s; A. A.Lucas, Madras and Edinburgh; A. R. Macdonald andG. B. McMichael, St. Bart.’s ; Margaret D. Mason, London ;G. B. Matthews, Charing Cross ; G. A. Metcalfe, Cambridgeand St. Thomas’s ; H. D. N. Miller, Cambridge and King’sColl. ; G. 0. Mitchell and P. M. Moffatt, Guy’s ; C. 1. N.Morgan, Cardiff and St. Bart.’s ; 0. G. Morris, Guy’s ;N. Moulson, St. Bart.’s ; Jeannette F. L. Murray, Capeand St. Mary’s ; F. W. G. Nash, Middlesex; F. N.Newell-Roberts, Guy’s; M. F. Nicholls, Cambridge andSt. George’s; J. R. Nicholson-Lailey, Bristol; MurielL. M. Northcote, Royal Free ; P. H. O’Donovan and R. J.Oliver, London; Mary E. Ormsby, Royal Free ; JeanOrr-Ewing, Oxford and St. Mary’s ; Amy M. Parkinson,Charing Cross ; J. Parrish, St. Bart.’s ; T. W. Preston,King’s Coll. ; C. A. Probert, Guy’s ; R. J. V. Pulvertaft,Cambridge and St. Thomas’s ; P. G. D. Quinet, Birming-ham ; K. Rai, Lahore and Middlesex; W. A. Rankin,Edinburgh and Westminster ; J. 0. M. Rees and R. D.Reid, St. Bart.’s ; W. L. Roberts, Cambridge and Univ.Coll. ; H. A. Robertson, Oxford and King’s Coll. ; N. L. D.Robertson, King’s Coll. ; Sybil H. G. Robinson, London ;T. Robson, Cardiff and St. Thomas’s; D. J. Rose, St.Bart.’s; Marjorie Rushbrooke, Birmingham; Z. Salama,Cairo and Birmingham : F. H. Scotson, Manchester ; J.Scott, St. Bart.’s ; H. M. Shelley, Sheffield ; A. E. Sherwell,Bristol; Mary M. Sillito, Royal Free ; Lucy C. Simpson,St. Mary’s ; A. J. D. Smith, St. Bart.’s ; N. R. Smith,St. Thomas’s ; L. V. Snowman, Cambridge and St. lIary’s ; -,A. C. Sommerville, King’s Coll. ; M. Stieber, Westminster;R. M. L. Still, Guy’s ; F. 0. T. Strange, King’s Coll. ;E. R. S. Sweeney, Bombay and St. Mary’s ; Annie Svden-ham, Royal Free ; F. C. M. Taylor, Charing Cross ; H,Taylor, Bristol; R.. C. Taylor, Univ. Coll. ; L. M. Teuten,Cambridge and St. Mary’s ; B.M.Toop, London ; A. Turner.St. Mary’s; H. F. Turney, Oxford and St. Thomas’s ;