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twenty-seven years refused the payment of medical fees.

But in a note to the present Report, the Directors draw at-tention to the fact that " A fee of one guinea will in future beallowed by this Society to the medical attendants of personsproposing to assure, in all cases in which the Board of Directorsrequire their advice and information." We have no wish torecall the past, but simply to congratulate the profession uponthis victory over old and long-cherished opinions. But he

must be a bold man who would say that it is not to the exampleoffered by the NEW EQUITABLE, and the hold its principle hastaken upon the profession, that we owe this satisfactoryresult. We only wish the fee had been two guineas insteadof one guinea. In the NEw EQUITABLE, then, the professionhave a lever by which they may compel the non-payingoffices to proceed in the work of just reform and the honestrecognition of medical services.We augur a succession of such Reports as the present in

future years, in which, if possible, still greater triumphs maybe chronicled. We trust the principles of the NEW EQUITABLEmay extend, and that next year we may have to record theadhesion of many more among the older offices to the system of

paying liberal medical fees, and of really consulting the medicalattendants of the assured in all cases. Every man in the pro-fession has this result somewhat in his own power, for it is

only by individual exertion in the most various quarters, that

great results can be obtained. It is only in this way that theinfluence of the medical profession in all matters relating tolife assurance, can be proved; and this influence, it must beremembered, has constantly been jeered at by the offices whotake the lead against the profession. It is by demonstratingthis influence on a large scale, that the recusant directors canbe forced to give way. The publication of such anotherReport as that now issued by the NEw EQUITABLE would besufficient to settle all questions in dispute between the medicalprofession and non-paying life assurance offices.

AFTER sundry delays and hesitations, it is now, we are

assured, been settled definitively between the Government andthe Council of the College of Surgeons, that the Charter, thedraft of which appeared in THE LANCET of Jan. 24th, shall begranted. The whole matter is, in effect, settled for someyears to come. We regret that by this Charter the planof allowing fellows residing in the country to vote at theCouncil elections by papers instead of personal attendance,has not been conceded. To a considerable extent, therefore,the surgeons residing at a distance from the metropolis, havebeen disfranchised.

During the attendance of the deputations in London in 1850,the Council agreed to the plan of voting by papers,but they afterwards came to a new resolution on the sub-ject. By some, this was thought scarcely honourable or juston the part of the Council. Various motives are believed to

have weighed with the Council. The law officers of the

College started difficulties; the " expense of sending voting-papers annually would have been considerable;" a good deal of"trouble" would have been laid on the officers of the College;nobody but the troublesome people of the press cared

about country surgeons having votes at the election of

metropolitan surgeons jnto the Council. After all, the

surgeons in the country, it is said, did not care much about theprivilege they have lost, since few, if any, remonstrances were

sent, either to the Council or to the Secretary of State.And so the country surgeons are virtually disfranchised. Webelieve, after many decisions for and against, the matter wasfinally settled by a majority of one only.For some years to come the College elections will take

place with a certain alteration in the nature of the constituency.All those surgeons in general practice in London who are

eligible, and who consider the letter F, as distinguished fromM, worth ten or fifteen guineas, will, no doubt, become fellows,and vote at the College elections. A few more surgeonsfrom the country will also make their appearance. What

effects may result from these changes, it remains for the

future to show. For ourselves, we think the Council havecommitted a serious mistake. With respect to the asserted

apathy of the country surgeons, we are at a loss to say whoare to blame, but we can scarcely believe that they will bearwith patience the injury which has been inflicted upon them.

THE necessity of a Medical College, on the plan proposedby Mr. PROPERT, becomes more especially apparent when somestriking case of distress is presented to our notice. A shorttime since, the melancholy death of Mr. CuMMiNG, surgeon, ofBuxton, and his son, by drowning, was recorded in THELANCET. A widow and seven children lived to lament his

loss. Those children have now to mourn over the

death of their other parent, who has died suddenly, on herjourney from Buxton to Berwick-upon-Tweed. Had the

Medical College been in existence, no more fitting objects forits bounty than these poor orphans could possibly have beenfound. Entirely dependent upon his professional exertions,Mr. CUMMING1 had made no provision for his family, and theyare thus left destitute. A subscription has been enteredinto at Buxton, and a sum of money raised for the orphans,but by no means sufficient to render them an effective and

permanent benefit. The subscription list has lately ap-

peared in this journal; earnestly do we hope that membersof our profession will contribute to it, and, whilst doing so,bear in mind, that had the Medical College been in existence,such a lamentable case as that of Mr. Cumming’s childrenwould have met with the assistance which its nature so

urgently requires.

THE NEW EQUITABLE LIFE ASSURANCECOMPANY.

THE REPORT OF THE DIRECTORS,Read at the First General Meeting of the Policy and Shareholders,

held at the Offices of the Company, West Strand, CharingCross, London, on Friday, the 27th day of February, 1852.

j THE Directors of the NEW EDITABLE LIFE ASSURANCECOMPANY entertain the liveliest feelings of gratification onsubmitting the first annual Report to the consideration of thepolicy and shareholders of the Company.Those who have watched the progress of events connected

with life assurance, must have observed the general tendencyof modern offices to appeal for support to distinct classes andinterests of the community, and through them to society atlarge. Almost all the more successful offices established inrecent years have proceeded upon that plan. The Directorsof the NEW EQUITABLE, at the commencement of their under-taking, were deeply impressed with the belief that the influenceof the MEDICAL PROFESSION in the promotion of the great socialduty of life assurance, had never been brought properly and

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fully into operation. Yet the tables of mortality and of the to act as agents. To this duty the Directors now propose toduration of human life, upon which all the averages and rates address themselves, and by its efficient performance, theyof life assurance are based, were the results of the labours of expect largely to augment the prosperity of the Company.medical iuquirers; and it is, and ever must be, the medical The Directors have had under their consideration the pro-evidence in individual cases, which can alone afford sound priety of appointing local boards, according to the provisionsdata for the acceptance of life assurance responsibilities. of the deed of settlement; but they have deferred this subject

Life assurance societies, when first established, were chiefly for the present, on account of the expense that would neces-in the nature of philanthropic associations, and medical gen- sarily be incurred by such establishments.tlemen gave their services without reward for the promotion There is one circumstance that especially proves the excel-of the beneficent and provident objects. They did this when lence of the ruling principle in transacting the business ofgrave and sober men looked on such societies as profane this Company-namely, that of attaching the greatest im-attempts to subvert the intentions of God’s providence, and portance to the medical testimony in individual cases, as thewhen learned divines preached against them as wicked and only safe information for determining the rates of premiumimpious schemes. at which proposals for assurances should be effected. Con-But in process of time the life assurance interest reckoned sidering the ages of the parties assured in the NEW EQUiT-

its millions upon millions sterling, and physicians and surgeons ABLE, it has been calculated that, according to the averagevery properly refused to place their gratuitous services on a mortality, some deaths might have been expected among thelarge scale at the command of boards of directors, who carried policy holders during the year. But not one death amongst theon the business of life assurance on the principles of ordinary assured has occurred up to the present time. This gratifyingcommercial speculations. The demands of medical practitioners circumstance is stated by the Directors in connexion with thefor a just consideration were for a long time pertinaciously re- carefully-framed and admirable medical reports which theyfused and misrepresented; and feeling the injustice acutely, have received,and also with the fact, that nearly in all instancesthe Medical Profession became little disposed to promote the the MEDICAL ATTENDANTS of the proposers for assurance have

objects of such institutions. From these causes the great and been consulted by the DIRECTORS as the MEDICAL ADVISERS OFundoubted influence of the members of the Medical Profession THE COMPANY. In the future career of this Company, thewith regard to the social working of life assurance transac- DIRECTORS hope to be enabled to ascertain the nature of riskstions, remained unstimulated and unexercised. on lives with so much accuracy as to acquire the reputation ofThe Directors of the NEw EQUITABLE bslieved that by adopt- carrying on the safest life, assurance business in the kingdom.

ing a plan founded on justice and liberality towards the profes- The Directors have the satisfaction of stating that a sufficientsion, an immense field hitherto uncultivated would be opened number of shares has been disposed of to cover the pl’obablefor philanthropic and prudential operations. The position liabilities of the Company; and they may further add, that athus discovered and examined they have attempted to occupy, majority of the shares which have been issued are held byand abundant are the reasons which render the results members of the Medical Profession. It has not been thoughtpre-eminently satisfactory. necessary to hasten the indiscriminate disposal of shares, asThe extent and character of the business already transacted applications for their allotment continue to be received weekly,

by the NEw EQUITABLE Company have exceeded the most the object of the Directors having been to distribute as widelysanguine expectations of its founder, and zealous advocates. as possible the shares of the Company amongst the medicalFrom the 31st of January, 1851, the date of the complete and other respectable classes of the community. In this objectregistration of the Company, to the 31st of January, 1852, they believe that perfect success will be attained. Nothinginclusive, no less than Four hundred and forty-eight pro- can show more convincingly the confidence of the Professionposals were received and entertained by the Directors. in this Company than the large number of Policies and SharesOut of this number of proposals Three hundred and fifty-five that are held by Medical Practitioners.policies were completed, and the remaining ninety-three have The Directors have referred with pleasure to their recogni-been either declined, or are not yet completed. The sum tion of the value of medical opinions in considering proposalsassured on the Three hundred and fiftyjive policies issued for life assurance. The practice of acting upon such opinionsby the Company is One Hundneed and Sixty-eight Thousand is not merely a benefit conferred upon the medical professionSeven Hui2dred and Sixty-fve Pounds. The premiums on the -it is also an important element in the stability of the NEWpolicies thus effected amount to Six Thousand and Twenty-five EQUITABLE as a public institution. The Directors have taken

pounds two shillings and seven-pence per annum; the average an enlarged view of this question. If more than the averageamount of the policies being nearly Five hundred pounds. number of lives per annum lapse in an assurance office throughThese facts afford matter for earnest congratulation to the the want of proper medical evidence, who are the sufferers?

Directors, the shareholders, and the assured. If the extent Clearly the holders of the policies and shares. Undoubtedlyof the operations of the NEW EQUITABLE, during the past year, the greatest obstacle to the accumulation of profits is thebe compared with those of other companies, it will be seen practice of accepting the lives of unhealthy persons at healthythat there are very few of the oldest life offices, even of the rates. The Directors know from their own experience thatfirst class, which have transacted an equal amount of business. the lives of hopelessly diseased individuals have been unsus-It is demonstrated by the balance-sheets of offices in the best pectingly assured at healthy rates, at the offices of companiesrepute, as published from time to time, that after ten, twenty, which had either neglected or refused to apply for the bestor even thirty years of experience and consolidation, many of testimony-namely, that of the Medical Attendants of the,them have not equalled, in the year just ended, the infant Proposers. Thus, as a corollary to the injustice inflicted uponlabours of the NEW EQUITABLE. It is worthy of remark that medical practitioners, the policy and shareholders of suchthe business of this office has been steady and progressive from companies find, when too late, that their interests have beenits commencement to the present time, thus affording the exposed to unnecessary and enormous risks and’losses.best ground for believing that the NEW EQUITABLE has already If medical testimony be the first, the best, the safest, thattaken a permanent position amongst the most successful of the can be furnished in effecting life assurance policies, why is itlife offices in this country. declined ? Prejudice or ignorance must supply the answer.

Hitherto, numerous agents for the NEW EQUITABLE have If, on the other hand, testimony of so valuable a character benot been appointed. The Directors were anxious, before received and acted upon as the very basis of the transaction,appointing agents on a large scale, that their plans should be on what principle of justice is the medical practitioner, bymatured, and some progress made in the business of the office, whom it is rendered, to be denied an adequate remuneration ?with a view to obtain ultimately the best class of persons , The Directors of the NEW EQUITABLE confidently believe

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that the system they have adopted, of recognising and con-sulting the medical referees of proposers for assurance, as theMEDICAL ADVISERS OF THE COMPANY, will at no distant day befollowed by all respectable and successful life assurarce com-panies, to the great advantage of the Medical Profession, andto the still greater advantage of their policy-holders and thepublic.If the power at the disposal of the Medical Profession be

energetically exercised, this great and good victory will bespeedily achieved. To that power the Directors of the NEW

EQUITABLE emphatically appeal. They also make a not lessearnest appeal to the policy and shareholders for their strenuousand unremitting support and exertions, with a view to obtainfor the NEW EQUITABLE Life Assurance Company an unrivalledcareer of utility and success.

(Signed,)February 26th, 1852. ROBERT LEE, M.D., Chairman.

RETIREMENT AND ELECTION OF DIRECTORS.

The following gentlemen retire from the direction by rota-tion, and are eligible and candidates for re-election:—Thomas Wakley, Esq., M.P. Tyler Smith, Esq., M.D.George Beaman, Esq. I Thomas Bevan Jones, Esq.

RETIREMENT AND ELECTION OF AUDITORS.

The retiring auditors and candidates for re-election are :-R. H. Parkinson, Esq. I

C. R. Rowland, Esq.W. B. Mitcalfe, Esq. f E. Weston, Esq.

In consequence of the extent of the business transactions ofthe Company, the Directors have been compelled to seek forlarger offices, and they have the satisfaction of stating thatthey have taken, on advantageous terms, the extensive

premises lately in the occupation of the GREAT WESTERNRAILWAY COMPANY, situated at No. 449, West Strand, adjoiningthe Electric Telegraph Office. In this capacious establish-ment the business of the Company will be transacted on and I.after the 25th day of the ensuing month of March.The SHAREHOLDERS are informed that interest at the rate of

- of five per cent. per annum is now receivable at the officeupon the paid-up capital of the Company.

I

Medical Societies.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.

TUESDAY, FEBRUARY 10, 1852.—MR. HODGSON, PRESIDENT.

CASE OF SCIRRHUS OF THE RECTUM: FORMATION OF AN ARTI-FICIAL ANUS. By JOHN ADAM, Esq., Surgeon to theLondon Hospital.

The patient was a lady, thirty-five years of age, the motherof children. She had for a considerable time complained ofgreat difficulty in passing her motions. This was accomp.ishedwith pain and much straining, and she was the subject ofhaemorrhoids. She was hereditarily predisposed to cancer.About a year ago, a surgeon pronounced her case one ofcancer of the rectum, with ulceration. The bowels were con-stipated nine days, and the usual purgatives were administered,and scruple doses of calomel, without effect. Her sicknesswas allayed by opium and sucking ice. The rectum-tube couldnot be passed above four inches. Scirrhous rectum, veryhigh up, was presumed to be the cause of the obstruction.Metallic mercury to the extent of two pounds, was given, asmall quantity of which passed soon after. The operationwas performed according to Mr. Luke’s method, (see his casein the last number of the Society’s Transactions.) The de-

scending colon and sigmoid flexure were undistended. In thecourse of a few hours, a large quantity of fluid faaces passed,and the relief was complete. She continued to progressfavourably, and since the operation has been better than shehad been for some years. Occasionally a small quantity offseces pass per anum, but it is nearly all discharged by thewound; there is also occasionally a small quantity of bloody’mucus passing per anum. A light truss is used to restrain

the constant passage of the fxces, and there is a distincttendency to pass them twice daily. A large quantity of themercury passed by the wound soon after the operation, but avery considerable quantity was retained until a short timeago, and it then passed per anum. The patient was slightlysalivated, apparently from the calomel, the mercury being un-altered.

AN ACCOUNT OF Two CASES OF INTESTINAL OBSTRUCTION, INWHICH THE OPERATION FOR THE FORMATION OF AN ARTIFICIALANUS WAS PERFORMED: ONE IN THE ASCENDING, THE OTHERIN THE DESCENDING COLON. By W. J. CLEMENT, Esq.,F.R.C.S., Shrewsbury.CASE 1.—The author visited, on the 8th of October, 1841, a

married woman, aged forty-seven years, who was sufferingfrom obstruction of the bowels of fourteen days’ duration,accompanied by great distention of the abdomen, hiccough,incessant vomiting, which during the last two days had becomefaecal; the countenance was anxious; the pulse small, rapid,and fluttering. It appeared that for the previous seven or eightyears the patient had suffered from habitual constipation, andhad required the constant use of drastic purgatives. The abdo-men was tympanitic on percussion everywhere except on theright inguinal and iliac regions, where it was dull. It was evident,from the fact that several pints of fluid could be injected intothe colon, that the obstruction was not in its descending por-tion. On the 10th, the symptoms having undergone no abate-ment, and the patient’s state being evidently hopeless unlessrelief could be obtained by operation, it was proposed bythe author, and performed on the same day. The patient wasplaced on her belly; the incision was made midway betweenthe last rib and the crest of the ilium, extending from closeto the spinal column to a line cutting the anterior superiorspinous process of the ilium perpendicularly. The colon wasfound to be distended. It was secured by a couple of ligaturespassed through its coats; and a vertical incision being madeinto it, a large quantity of liquid faeces escaped, together withmuch flatus. Immediate relief was obtained; the unfavourablesymptoms ceased; the fmces were passed more or less freelythrough the wound, and at the end ot six weeks the patientwas able to walk a mile. About this time the dischargethrough the artificial anus became gradually less; at the endof seven weeks vomiting and colicky pains returned, butceased after the expulsion of a mass of plum-stones, when afree exit for the faeces was again established. The patientlived for more than three years after the operation, enjoyingtolerable health, and able to walk a considerable distance,and to attend to her domestic affairs. Aperient medicineswere taken regularly, and the passage of fæces was pretty free.Plum-stones were passed at intervals; the total number col-lected was 116. The patient’s health declined for some monthsbefore her death, the appetite decreasing, the strengthfailing, and emaciation progressing. On examination, a verycomplete stricture was found to exist in the transverse colon,which would not admit even the passage of a bristle. It wasabout a quarter of an inch in length. The coats of the bowelat this point were of a dense, white, cartilaginous structure.The muscular coat of the caecum and ascending colon wasmuch thickened, and there was great distention of the gutbehind the stricture. No traces of inflammatory action wereto be found in the peritonsea.1 cavity, with the exception ofthree membranous bands, which extended in a lateral direc-tion, connecting the lower part-of the ilium with the csecumand ascending colon.CASE 2.—The driver of a mail coach, a stout muscular man,

aged forty-three, consulted the author in January, 1847,suffering from constipation and external piles. In the monthof March the constipation had become more obstinate, and thepatient was obliged to give up his occupation. The symptomswere relieved by cupping on the loins, calomel, and otherpurgatives. On the second of April, rigors, which had occurredonce during the month of March, returned, and were followedby vomiting, which continued for two or three days. Exami-nation of the rectum showed the existence of a stricture aboutsix inches from the anus. The attempt to pass rectum bougiesof the smallest size failed. An elastic-gum urethra bougiepassed the obstruction, and upon withdrawing it, liquid faecesand flatus were voided. This operation caused great eonsti-tutional disturbance, rendering bloodletting, leeches, andcalomel and opium, necessary. The discharge from thebowels was very slight; the vomiting recurred frequently. Onthe 12th of May, three small fleshy bodies, with a little fæcu-lent matter, were voided. No faeces passed from the rectumsubsequently. During the remainder of the month of May thepatient suffered greatly from hiccough, vomiting, and most