financial condition of the general medical council for the year ending january, 1861
Embed Size (px)
inability to discover its evils and dangers, it is well to enun-ciate the plain facts of the case. The object of advertising is toattract the especial attention of the general public. The meansof attraction consist in putting forth statements which leadthose who read them to believe that the advertiser is in someway or other superior to his fellows, and therefore a person tobe especially patronized. Where trumpeting is in vogue,the loudest trumpeter has the best chance of being heard.When everybody is saying something to recommend himself,it is necessary to say very startling things to invite notice. Anadvertisement affords no test of a man’s ability, of his truthfulness,or of his honour. It levels rogues, fools, and sages. This is so well
understood, that no one will believe that any honest professionalman is willing to give the rogues and fools the honour of hiscompany, or the advantage of shouldering him on terms ofequality. We all well know the infamous designs, the villan-ous practices, and the degraded character of those pests of theprofession who do most fill the broad sheet with their falseand covertly filthy statements; and we cannot conceive butthat any respectable man must loathe the company and avoidthe precedent. So also with the puffing dentists. We allknow that half the talk about the supply of splendid teethat infinitesimal charges, the infallible cure of decayed andaching stumps, the pseudo-patented systems untruly paradedwith a profusion of other false pretences, are so many lowand lying statements, of which the falsity is perfectly trans-parent to the profession, and known to the framers of theadvertisements, but which are designed to dazzle the unin-formed public. The inherent vice of the system of such
advertising is evident in them. It is a system which leadsnecessarily to false pretences, which involves men in a battleof boasting, which offers the prize to the longest purse andthe boldest and most ingenious liar. This, then, is a system ofwhich we must say that we will have none of it; and who-ever aspires to connexion with our body, or claims our regard,must be clean from its defilement.
SKULLS OF ALL NATIONS.THE systematic study of the measurements of the skull has
been established by the aid of modern anatomists amongst themost valuable resources possessed by ethnological inquirers inthe distinguishing of the varieties of the human race. Thefirst definite rules for the ethnological interpretation of thecranial development we owe to Blumenbach, and subsequently *to the illustrious Retzius, whose divisions of Orac7tycephalicand Dolichocep7talic are still generally adopted. Mr. Busk has
recently attempted to lay down a system of craniometry, inwhich numerical values can be employed in place of words indescribing the proportions of a skull. He proposes thus to de-termine in each case-1. The size of the frontal, parietal, andoccipital regions. 2. The proportions of the skull as regardslength, breadth, height, &e. 3. The degree of prognathismand of occipital projection, and, by inference, the position ofthe foramen magnum. 4. By comparison of measurement ofthe nasal radius, the cranial vertebral axis of Von Baer, andthe maxillary radius, to arrive at some notion of the facialangle.Mr. Busk has also offered suggestions for the adoption of a
uniform method of making drawings of the skull, which wouldthus admit of direct comparison with one another. The im-
portance of these suggestions must be recognised by all cranio-logists. Nothing has more greatly impeded the progress ofethnology than the want of accuracy in the present means ofdetermining and comparing descriptions of cranial characters.By a careful numerical series of measurements uniformly apeplied, and by drawings made always in one defined positionand of one size, the means of satisfactory comparison may beobtained; and it is to be hoped that such a scheme, havingbeen well considered, should be propounded by high authority,and recommended for international use.
A PHYSICIAN THE DISCOVERER OF GUTTA-PERCHA.
THERE is already a long list of benefits which medical inves-tigators have conferred on the world by carrying into otherpursuits than Medicine the scientific knowledge which theyacquire as collateral and adjuvant to a strictly medical train-ing. Geologists, electricians, chemists, and mathematicians-the world owes to the physicians of the last half-century newinstruments, appliances, and discoveries in every departmentof life; the electric telegraph, new planets, the interpretationof hieroglyphics, mining records, and what not. We must addto the list the discovery and introduction of gutta-percha. Welearned recently that it was a medical gelltleman, the late Dr.Montgomery, who, while travelling, observed the manifolduses to which gutta-percha was applied by the Malays, andthought that it might be well adapted for splints and othersurgical appliances. He therefore collected a quantity of it,and sent a specimen to the Society of Arts, for which he.was awarded the gold medal of the Society. His uncle, Mr.Craufurd, says that was all the reward ever received by the-discoverer of this wonderful substance, without which weshould probably never have been able to communicate in five.or ten minutes between St. Petersburg and London. The ex.
ports of gutta-percha amount to between 900 and 1000 tons year, representing a value of £156,000. Dr. Montgomery hasgone from us now, and his reward was indeed scanty. Arecent application, however, to the Board of Control for a cadet-ship for one of his sons was acceded to on the ground of thisdiscovery.
FINANCIAL CONDITION OF THE GENERALMEDICAL COUNCIL FOR THE YEAR
ENDING JANUARY, 1861.(FROM A CORRESPONDENT.)
As the General Medical Council will hold their first meetingfor the year on the 27th, it will be well to take a review oftheir financial position and prospects.
In the first year of the Council’s existence they were in the-dark as to the extent of their probable income; and it wasonly when the small number of annual registrations was made.known-a number amounting in 1860 to only 423 for the threekingdoms-that it was revealed to the Council how smallwould be the sum on which they had chiefly to depend. After-
admitting this as an apology for the state of affairs which.calls for animadversion, it is apparent that there must havebeen laxity somewhere in the duty of enforcing registration,because the Apothecaries’ Society of London alone licensed 344practitioners in the year 1860. By the 36th section of the-Medical Act, no person can hold an appointment either in themilitary or naval service or in any hospital or union, or grantlicences, or recover charges, unless he be a registered practi-tioner ; but how far this applies to retired officers, or to prac-titioners who do not seek to hold appointments, or grant certi-ficates, or recover charges, we are not informed in the Act;,and it may be that by such persons the X5 registration fee isevaded. Although this is an evasion of the spirit of the Act,it is within the letter, and therefore, as far as it goes, it may.be regarded by the Council as accounting for the falling off ofexpected numbers.
There are many points in the last Abstract of Income andzExpenditure published by the Council which call for strictinquiry, and which ought to be explained to the medical profes-sion, for whom the Council only act as trustees. It will beremembered that according to the abstract for the year endingJanuary, 1860, the Council expended the enormous sum ofX8165 16s. 7d., with a real annual income of about £3000.Had they continued in this course, they must soon have had to.take advantage of the Attorney-General’s new law regardingbankruptcy, and all the good which the profession had antici-pated from the Medical Act would have been swept away.
Each of the three Branch Councils has funded a portionthe large sums received from the registration of the existiupractitioners in 1859: the English Branch Council, to the ex-
tent of £20,000; the Scotch Branch, £2000; the Irish Brand.63120 8s. 2d. The interest of these sums was to constituitheir permanent income. Now although the English BrancCouncil on the 5th January, 1860--beyond the large expendture of the year-had a balance of £2525 14s. 11d., they alpear to have made no use of it, for nothing is credited by thEnglish Council except the interest on the .620,000; whilsthe thrifty Scotch, with a balance of only X846 lls. 6d. othe same day, manage to carry to the credit side of thaccount nearly £30 as interest on this balance. Is it cre
dible that, with a failing revenue and a short income to meeexpenditure, the treasurers of the English Branch Councicould have left X2525 in their bankers’ hands for twelvemonths without seeking to obtain interest for it? In ExchequeBills they might have obtained a large sum to meet deficiencies, and yet have been able to use the principal when required. The Irish funded the whole of their available balancebut they have damaged the principal by excess of expenditurein the course of the year to the extent of X489 18s. 1Od., irwhich sum they appear to be indebted to the General Council,As to the "Re;ister," it may be remarked, that the
charge for printing the work amounts to the great sum o:
£594 1s. 10d. On the other hand, the sum received for ‘° copiessold," including somesold off as waste paper, is only £6165 17s. 8d. ; showing a loss on the work of £428. The price of the book, iuthe first year, was almost prohibitory; it is still excessive fOIthe less wealthy of the provincial practitioners. As a publicdocument, the Register ought to have been sold by weight,without a cover, like all other public documents published byparliamentary authority. Eighteenpence, or two shillings atmost, would have caused a large sale, possibly even a remune-rative one; but in order to make the work attractive and useful,attention must be given to the " addresses," many of whichremain uncorrected from the commencement of registration. -With regard to the " Pharmacopoeia," I may observe, that
already £1000 have been expended by the Council, and hownear, I may ask, is it to publication? Is it really be-lieved that it will ever arrive at this desired consummation ?Should this ever take place, no profit can ever accrue to theCouncil from its publication, since there has already been ex-pended on it a sum the interest of which would exceed theprobable return from the sale of the work.
Again, how long,, with such excess of expenditure over in-come, may we anticipate as the future existence of the MedicalCouncil ? In less than ten years the funded property will beall absorbed, and then the whole income from registration feeswould not exceed .62000. As the office expenses, togetherwith the registrar’s, exceed the amount, there would be abso-lutely nothing left to remunerate the members of Council, oreven to pay the " travelling expenses and hotel charges" ofthe more distant ones; charges which together in the -year1860.amounted to the enormous sum of X1800 9s.l I may just remark, in passing, that the Council have been
art ’no expense in London for a place of meeting, or even hitherto’for-refreshments, the two Colleges- of Physicians and Surgeonshaving liberally granted, to them the use,of their buildings freeof all. expense.
There has yet to be made known to us, I fear, a largeexpenditure in law proceedings. In nearly all the causes orprosecutions in which the Council have engaged they have beenfound in the wrong, and have of necessity been left to paythe .costs.
I here for the present take leave of this unbusinesslike.Council. As it is now constituted, there appears, little hopethat it will surmount its threatened difficulties, or serve anybeneficial purpose to the medical profession.
- THE AUSTRALIAN MUSEUM.- It appears from theSeventh Annual Report of the Trustees, that this museum isprogressing most favourably, and that there is a greater needthan ever for the increased accommodation which has been’sooften demanded. It is intended to resume the system. com-,menced by Mr. Pittard, M. R.. C. S. Eng., the curator, of givingperiodical courses of lectures as soon as the classification andaxrangement of specimens are sufficiently advanced. Thetrustees express their satisfaction at having observed the regu-lar attendance of a number of young men for the -purpose ofavailing themselves of the means of self-culture which areaffortied by this institution. £10,000 have since been wotedby the Assembly for the enlargement of the building. ;
Correspondence."Audi alteram partem."
DR. CHAMBERS’ LECTUREON
GONORRHŒA AND IMAGINARY SPERMA-TORRHŒA.
e To the Editor of THE LANCET.
- SIR,-In your journal of last week you publish a ClinicalLecture, given at St. Mary’s Hospital by T. K. Chambers,
g M.D., in which I am prominently brought forward as the
r cause of death in the case of Mr. S-, I therefore trust that- you will, as an act of justice to me, publish verbatim my reply.
On March 26th of this year I received a letter from Mr.S-, of which the following is a copy :-" SIR,-Would you please inform me if the operation for the
removal of a congenital phimosis would entail any relaxation, from business, and if so, how long, and what would be your
charge for the operation, and the cure, if necessary, of a sper-; matorrhœa, also the most convenient time, and oblige,
" Yours, &c.," Dr. Dawson." " J. S.
To this letter I sent the following answer :-15, Finsbury-circus, London, March 27th, 1861.
" SIR,-The removal of a congenital phimosis would requireyou to remain quiet for a few hours only. My charge for theoperation is a guinea. In all probability the removal of thedefect from which you are suffering would be all that is requi-site to cure your spermatorrhoea-. My fee is a guinea a visit:I never undertake to cure patients.for a definite sum, and myhours for consultation are from half-past ten o’clock to half-past.one, except on Sundays, when I am not in London at all.
" Yours faithfully,"R. DAWSON.
The patient called upon me in April, suffering from con.genital phimosis and irritation of the neck of the bladder. Thephimosis I removed; but the irritation still continuing, I re-commended the introduction of a sound twice a week, withthe view of blunting the morbid sensibility of the urethra.The patient did not call so frequently as I wished, which Iattributed to his want of means, and I therefore proposed andsubsequently attended him without any pecuniary remuneration.I continued to pass the instrument twice a week until the coldweather in May. The urine then became suddenly turbid, andupon analysis I found it contained phosphate of lime. I analyzedit again on May 16th, not having then seen the patient for aweek, and I found it contained pus. On that occasion I drewoff the urine, which I found was ammoniacal, and orderedsedative enemas, iron, and warm hip-baths three times a day.On May 17th I received a letter from the patient, saying thathe was not better. I therefore requested Dr. Venables, whoseauthority in urinary affections- is undisputed, to meet me inconsultation., The patient told us he was then better, having en-joyed a.beef-steak. His mother at that time informed us thathis father suffered from a similar attack at the same age, anddied from a disease of the bladder in his forty-second year.The medicine previously ordered was continued, Dr. Venables.suggesting, in addition, to give buchu and hydrochloric acid.Notwithstanding the patient informed us he had passed asmuch urine as he drank fluid, we agreed to pass the catheter, and I drew off a large quantity of alkaline urine, which wasevidently keeping up the irritation in the bladder. It was alsoarranged that the urine should be drawn off at regular in-tervals. ’
At this juncture Dr. Chambers was announced, and I was’informed, for-the first time, that Mr. S was employed byhim in making some physiological experiments, and in analysis:of urine, which latter accounts for his being in possession ofmy work on that subject, for he never received it from me, asDr. Chambers’statement suggests. Why had not Dr. Chambersthe candour in his Clinical Lecture, instead of calling him a"private patient," to say that he was his assistant; and in-stead of asserting that he himself was sent for to visit the case,to state that he called, as he informed Dr. Venables and my-self, simply to inquire why Mr. S- was not at his work ?I gave Dr. Chambers the history of the case. He asked me if .
I had cauterized the urethra; and not content with my asser-