492 or ought to be familiar-the sad catalogue of its diseases-the do so as accoucheurs, receiving, as an acknowledged right remedies for :their alleviation—the inexplicable principles by the moiety of the fee, sincerely trusting that the practitioners which the wonderful machine is governed, and the operations of the metropolis generally would act in like manner. of the mental faculties through which reason shines and judgIn accordance with these observations, it was ment elevates, which are strong in health, impaired by disease, Proposed by Mr. ELLIS, seconded by Mr. TUCKER, and carried, and pass away by that debt which all must pay-all this "That it is the unanimous feeling of this meeting, that alsurmounted, he will find his laboursstill in their infancy; the though called upon, from recent exposures, to take up the question most diligent attention and unwearied industry, in the closet of The Division of Midwifery Fees,’ and express an opinion on and at the bed-side, are still necessary to confer the requisite the principles which should guide the profession under the ,foreexperience before lie can apply with due effect the various going circumstances, one object is to establish a friendly branches of his knowledge to the prevention, alleviation, or union among its members, and to call upon them, generally, to cure of disease. If this were done we should not find the pro- co-operate in framing and adopting certain rules and regulafession so degraded as it now is; we should not have the tions which shall be binding on them, and influence their advertising oculists, aurists, dentists, and a host of other prac- proceedings, as a body." titioners, who have portioned out the surfaces, cavities, and by Mr. KENDRICK, seconded by Mr. ELLIS, and organs of the body, for the display of their own ingenuity. carried,-" That all present do consent to attend cases of midMost of the practitioners of the present day seem desirous wifery, when called upon to do so (if at the time not engaged only to administer to the bad tastes of their patients by pleas- in professional duties,) by, or for, any member of the profesing them in their own way; this appears, at least, to be the sion whose name appears in the appended list, on the principle golden secret, and the success of a medical man is more to be mentioned in the foregoing remarks, professing to act in like attributed to his being a nice, kind, sympathizing man, than to manner towards all other practitioners who will unite in the excellence of his mind; he who possesses the greatest share the same object." of impudence and small talk is sure to outdo the physician Proposed by Mr. WILSON, seconded by Mr. LEREW, and whose accomplishments are more strictly sciei-itille; as it is, carried,-" That in cases so attended during the absence of a quacks and quackery, physicians and surgeons, have all their practitioner whose services have been already retained, there supporter, and each pretty nearly an equal share of public shall be an equal division of the fee; but that as it frequently regard. happens that presents are added to what may be regarded as In framing any new Medical Bill, let us hope that this most the usual payment, the amount of fee is not to be considered essential element (a sonnd preliminary education) will be to extend beyond two guineas, nor to be less than one." Proposed by Mr. WiLSON, seconded by Mr. KENDRICK, and strictly enforced, for it will tend far more to raise the members of an honourable profession in the estimation of the public carried,-" That in order to attain an honourable and respectable position for the profession, it is recommended to medical than all the Colleges put together. I am, Sir, your obedient servant, practitioners, generally, to abandon the habit of attendance on H. A. midwifery patients at so small and unreasonable a sum as excepting as an act of charity; but that in declare that agreeing to this resolution the present meeting ! nothing which it contains shall be regarded as interfering with latter part of the third resolution." PROFESSIONAL ETIQUETTE IN THE PRACTICE OF MIDWIFERY. Proposed by Dr. RUSHFORTH, seconded by Mr. TUCKER, and That this meeting be adjourned until the 16th of A PRELIMINARY meeting of medical practitioners was held at carried,-°‘ for the purpose of ascertaining the general feeling of October, on October the residence of one of their number, Thursday, the profession on the subject." 2d, 1845, at which were present :—Mr. Cocke, of HowlandSince the 16th, more than fifty gentlemen have signed their street, in the Chair; Mr. Tucker, Berners-street; Mr. Wilson, Gentlemen wishing Great Portland-street; Mr. Kendriek, Manchester-street; Mr. names in approbation of the movement. to append their signatures to a document framed in accordance Ellis, Howland-street; Mr. Lerew, Upper Norton-street ; Dr. with the resolutions, or to obtain information as to the future Rushforth, Howland-street ;—when there was submitted to their consideration the inconvenient circumstances which proceedings of those who have already united to carrv them attend the want of an honourable and just arrangement into effect, can do so, by applying to Mr. George VTilson, the Hon. Secretary, 100, Great Portland-street, amongst accoucheurs with respect to midwifery fees, when it Surgeon, Cavendish-square. from that or absence accident, ill-health, home, happens occurs at the precise moment at which their presence is most needed by patients in child-bed, and a second practitioner is MEDICAL FACTS, REMARKS, AND requested to attend. On such occasions, it was considered to be neither just that the former should lose the payment which CRITICISMS. he may have expected to receive, nor that the labours of the In the present second practitioner should go unrewarded. uncertain state of the matter, however high the notions of ’ TnE DEBRIS FURBISHED BY PAVEMENTS.—It is stated by Mr. honour which characterize most medical men, circumstances Thorn, a contractor, that the mud on a Macadamised road is frequently arise which it is almost impossible to meet without three times as much as on ordinary pavement; whilst the some misunderstanding or unpleasant feeling intruding between accumulation on a wooden road is not more than one-third of the parties. Some recent events of this nature had occurred that on pavement. Mr. Whitworth, the inventor of the main that neighbourhood manifesting highly derogatory con- chine for cleansing streets, and which has been for some time duct, most destructive of the respect that is due to medical used in a few districts in London, and generally in Manchester, men as a body. It seemed imperatively necessary, therefore, states that at Manchester, he has agreed to sweep the streets to take some steps which, by mutuai6agreement, would set at twice as often as under the old system, and at saving to the town test this vexata questio; tle passing, for instance, of certain of £500 per annum. Some idea of theeniciencyofthisplan, which resolutions, tending to establish a general rule, according to is applicable to every kind of street surface, may be formed from which a division of fees could in future be made in such cases. the fact, that whilst a man can on the average sweep not more Every gentleman who had paid attention to the subject must than 1500 square yards daily, the machine worked by one be aware that such a proceeding would have a very beneficial horse, sweeps from 16,000 to 24,000 square yards per diem. The effect on the communications of medical men with each other economy of labour on the whole is so great, that one machine in practice, and become a guarantee of good faith and reliance will do the work of 36 men. IVlr,1Vhitworth states that he is enon aid to be given and accepted when difficult circumstances, gaged in preparing a hand-sweeping machine for courts and of the kind mentioned, arose. Some general arrangements of alleys, an amelioration which, if properly carried out by the this nature had been long needed; esteem and confidence in authorities, will be an unspeakable benefit.—Med. Chir. -7?ev. Oct. CHEAP WATER CLOSETS.—The noxious exhalations from open each other would be induced by an honourable understanding respecting the fulfilment of friendly obligations, when cesspools situated close to houses are a cause of disease, and emergencies in the lying-in room occurred; removing the have induced the Commissioners of towns to recommend that, stigma cast upon the profession, that it displayed no more in all new houses, it be made compulsory on landlords to procohesion than a " rope of sand," and improving the opinion vide proper necessaries for the accommodation of the inmates. entertained by the public respecting the kind bearing of trust, however, that in the progress of improvement effectmedical men towards each other. Accordingly, several ive water-closets will be generally substituted. It has been practitioners had attached their signatures to an agreement proved by a gentleman who has paid considerable attention to to render every assistance to each other when called upon to the subject (Mr. Austin), that a self-acting water-closet can be
supplied and fixed complete for 50 shillings; and when we find any ordinary chair and every reader of books will find it to be a that all which is required for draining houses, together with a very agreeable and comfortable companion. It is the invention of constant and unlimited supply of water, can be secured for a Mr. Howell of St. Paul’s Church-yard. EXCESSIVE CROWDING.—Mr. Farr had adduced a small porweekly payment of 24¼d. per family, we may anticipate that the above, or some similar contrivance, will be introduced even into tion of the East of London, containing a population in the the poorest tenements, especially when it is recollected that the ratio of 243,000 inhabitants to a square mile, as the greatest expenses of cleansing and maintaining privies, and the cost of a density attained in the heart of English cities; but, according .miserable supply of water, exceed the weekly estimate above to Dr. Duncan, there is actually a district in Liverpool ° conquoted.—Med. Chir. Rev. Oct. taining about 12,000 inhabitants crowded together on a surface * THE PRACTICE OF RE-VACCINATION.—Every medical man of 105,000 square yards, which gives a ratio of 460,000 inhabimust be aware that the propriety or necessity of this practice tants to the geographical square mile; and if we confine the has excited much attention of late, although its investigation calculation to a smaller portion of this district, but still comhas been unaccountably neglected by the profession in this prising a population of 8,000 (on 49,000 square yards), we shall country. To us there seems no one valid objection to urge find the inhabitants packed together in the proportion of against it. It has been said, indeed, that such adoption would 657,963 to the square mile." In Nottingham, which is hemmed unsettle the public mind in its faith in vaccination. Nor need in by fields belonging to the freemen, it is stated by Mr. this be regretted. The most fatal condition of the public mind, Hawksley that 4,200 people dwell in a square of 220 yards on and from which much evil has already sprung, is apathy. Let the side (46,400 square yards), and that the average area to public attention be fairly aroused, the merits of vaccination each inhabitant throughout the town, including the streets, is will then undergo renewed discussion, and its more general about 18 square yards.—Med. Chir. Rev., Oct. adoption must be the result. It is especially to Prussia and EXPENSE OF UNHEALTHY CUSTOMS.—The pecuniary penalties Wurtemburg that we are indebted for the experiment of re- inflicted on the community by the excessive mortality and sickness In the former country, of vaccination upon a large scale. now prevailing, and removable by sanitary measures, are enormous. 216,289 re-vaccinations during 1833-7, there were 84,516 success- According to Dr. Playfair, in the one county of Lancashire, alone, ful ; and of 44,000 in the latter country, 20,000 succeeded. Fre- £5,000,000 per annum are sacrificed in consequence of the attacks quently, too, cases which failed on a first trial succeeded on a of preventible disease! It is also desirable to state, that the subsequent one. The precise proportion of successful cases has greater number of ameliorations so demanded would in ,varied from 31 to 45 or 46 per cent.-the period between the themselves be actuary economical. urgently Thus it has been calculated, of 10 and 30 found that most certain of Of success. ages being by one of the most experienced engineers, that an improved and course, no one infers thaf the success of re-vaccination implies a unlimited supply of water may be provided at one-sixth part of liability to small-pox in an equal number of cases. The the cost of the existing and defective system. Such a supply would in hands in the of also successful operation fact, Heim, proved further tend to animmense saving in the loss by fire, for it has in 32 per cent. of persons who hadalready had the small-pox- been ascertained in some of the great cities in the United a proportion infinitely greater than that in which small-pox States, that the cost of insurance has actually been reduced 25 occurs a second time. But, although we are unable to state the per cent. in consequence of a high pressure being kept up in exact proportion of the vaccinated persons, in whom re-vacci- the mains. By a judicious application of that refuse matter, nation succeeded at the rate of 34 per cent., who would other- which in other greattowns, after contaminating the air is reckwise have acquired small-pox on exposure, yet experience has land around Edinburgh has been made to return wasted, lessly that this have been shown considerable; whereas, among ’, an annual rent of £30, .640, and even Z50 an acre; whilst, in might the many thousands who have undergone re-vaccination in I, the vicinity of Milan, meadows irrigated by the sewerage water Prussia and Wurtemburg, an example of the occurrence of i of that city, which in London isallowed to flow into the Thames, here and there been has observed. Moreovcr, are rendered small-pox only so fertile that they are mowed in November, in the case of an epidemic breaking out, it has been found, in March and April for stable feeding; in June, July, January, various localities, that immediate re-vaccination has arrested its and August, they yield three crops of hay, and again in Sepcourse—individ$uals in whom the operation proved successful tember they furnish an abundant pasture for cattle.—Med. and those in whom it failed equally resisting the disease.—Med. Chir. Ibev., Oct. C’har. Rev. Oct. DURATION OF LIFE.—The general state of health in a town may be inferred from the mortuary tables, but, in order to apply APOTHECARIES’ HALL, LONDON. this test, it is necessary to premise that the mean duration of life Names of Gentlemen who have obtained Certificates of Qualification to for the whole of England in 1841 was 41 years, and the mean practise as Apothecaries, on Thursday, Oct. 23,184-> : Richard Fernandez in death 29 of the the at The cause difference blattlaesv signiage years. Freeborn, Oxford; Hinchliffe, Dewsbury; Bertie Pardo fication of these terms is not generally understood. The follow- Matthews, Oxfordshire ; Arthur Charles Copeman, Cottishal!, Norfolk; ing is an explanatory passage from the Fifth Annual Report of the William Guille Dalgairns, Guernsey; Thomas Francis: Welchpool. Registrar-General of Births and Deaths : —" The duration of life in England is 41 years; if the population were stationary, the CORRESPONDENTS. mean age of those who died would be 41 years, and 1 in 41 would die every year. The population has however increased We have received the following note from lMr. Nunn, of East Bergholt, 1’41 per cent. annually during the last 40 years; and we find Sunblk :—" I shall be greatly obliged if you will add my name to those enfranchisement in the Royal College of Surgeons, that the mean age of the persons who died in the vear 1841 in- who wish to obtain I have, by this post, written in to a separate incorporation. stead of being 41 is 29 years; while 1 in 46 of the population to preference the Secretaries of the Hanover-square Association, to direct that my died."—Med. Chir .Rev., Oct. name be withdrawn from the National Association of (general Practias I feel greatly disappointed at the course that has been pursued DEATH OF SIR MATTHEW TIERNEY.—This eminent physician, tioners, with regard to it." who was one of the oldest inhabitants of Brighton, died vesterday A Subscriber, ab origine is referred to the Iterulation.r of the College, in THE LANCET, for Sept. 27th. last. Any additional information might be (Tuesday) morning, at his residence, Pavilion-parade, Brighton, obtained application, by letter, to the Secretary of the College ; after a short illness arising from an attack of the gout. The the courseonwedirect should have to adopt ourselves. deceased was physician in ordinary to George IV., whose personal The Essay of Dr. G. JV. Garlick is too long for insertion in our columns of the propositions which are made in it having already friendship he had the honour to enjoy for a great number of years, a great number and also to William IV. and the Royal household when in been, again and again, fully discussed in the Medical Journals. It might find publicity in the form of a pamphlet, if the author be indifferent on Brighton. He was born in November 1776, and was consequently the subjects of expense and remuneration. in his 69th year. In 1808 he married a daughter of the late Mr. Mr Wiliam Turnbull.—Probably any measure which may be passed will not afect the interests of our Correspondents, in the respect menof had he no issue. Henry Jones, Bloomsbury-square, by whom He was created a baronet in 1818, and obtained a second patent tioned in his note of Sept. 29th. A. B. would render himself liable to the penalty, were he to reside, and in 1834, with remainder to his brother, Mr. Edward Tierney, of practise any department of the profession, within five miles. a solicitor for Ireland. The Crown Mr. Poorley’s case of glanders shall be inserted ; as also shall that of Fitzwilliam-street, Dublin, deceased was appointed a Knight Commander of the Royal Dr..Sundwith, of Hnll. The of Dr. Sfiaclzearth and Dr. Megginson shall be Guelphic Order of Hanover on the 7th of May, 1831.—Daily insertedcommunications next week. The letter of Mr. J. L. Ieza was received too late for publication last Paper. THE PATENT READING EASEL—This is a very useful and in- week. Mr. George Todd’s paper on Ascit2s shall be inserted as soon as possiblegenious invention and is admirably adapted for its intended pur- V,recan recommend to J. A. -tf. Mr. Erasmus Wilson’s Treatise on inof is Skin Diseases, and the Translations of Cazenave and Gibert, without The whilst pose. practice le4ining upon tables, readmg Dr. Willis’ translation of Bayen is a. valuable work, and jurious to health and tends greatly to detract from the proper illustrations. by plates. form of the chest and interfere with the healthy functions of the accompanied The letter, signed A Stude$nt of the C’ol?eye csnd a Sufferer, from Birheart and lungs. This little instrument admits of being, applied to mingham, shall be inserted next wt.ek.