Medical Diary of the Week.
1
591 Medical Diary of the Week. Monday, Oct. 24. ST. MARK’S HOSPITAL.-Operations, 2 P.M. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M. METROPOLITAN FREE HOSPITAL.-Operations, 2 p.M. MEDICAL SOCIETY OF LONDON. - 8 P.31. Casual Communications. - Dr. Richardson, " On the Medical Aspects of the Germ Theory." Tuesday, Oct. 25. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10t A.M. . G1IT’S HOSPITAL.-Operations, 1½ P.M. WESTMINSTER HOSPITAL.-Operations, 2 P.M. NATIONAL ORTHOPEDIC HOSPITAL.-Operations, 2 P.M. ROYAL FREE HOSPITAL.-Operations, 2 P.M. Wednesday, Oct. 26. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10i A.M. MIDDLESEX HOSPITAL.-Operations, 1 P.M. Sr. BARTHOLOMEW’S HOSPITAL.-Operations, 11 P.M. ST. THOMAS’S HOSPITAL.-Operations, 1½ P.M. ST. 3iaxr’s HOSPITAL.-Operations, 1¼ P.M. KING’S COLLEGE HOSPITAL.-Operations, 2 P.M. GREAT NORTHERN HOSPITAL.-Operations, 2 p.M. UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 p.M. LONDON HOSPITAL.-Operations, 2 p.M. CANCER HOSPITAL.-Operations, 3 P.M. IIcxrxxiev SOCIETY.-8 p.M. Adjourned Discussion on Mr. Bryant’s paper On Pyæmia." Thursday, Oct. 27. ROYAL LONDON OPHTHALMIC HOSPITAL, -ITOOP.FIBLI)9.-Operations, IOJ A.M. ST. GEORGE’S HOSPITAL.-Operations, 1 P.M. UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M. WEST LONDON HOSPITAL.-Operations, 2 P.M. ROYAL ORTHOP2RDIC HOSPITAL.-Operations, 2 p.M. CENTRAL LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M. Friday, Oct. 28. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 101 A.M. WESTMINSTER OPHTHALMIC HOSPITAL.-Operations, 1 ½ P.M. CENTRAL LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M. QUEKETT MICROSCOPICAL CLUB. 8 P.M. Mr. J. Slade, "On the Micro- scopical Characters of Cannel Coal." CLINICAL SOCIETY OF LONDON.-8 ½ P.M. Dr. Sutton, "On Two Cases of Scurvy."-Mr. Brudenell Carter, "On Cases of Optic Neuritis." Saturday, Oct. 29. ST. THOMAS’S HOSPITAL.-Operations, 9½ A.M. HOSPITAL FOR WOMEN, Soho-square.-Operations, 9½ A.M. ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDs.-Operations, 10 ½ A.M. ROYAL FREE HOSPITAL.-Operations, 2 P.M. ST. BARTHOLOMEW’S HOSPITAL.-Operations, 1 ½ P.M. KING’S COLLEGE HOSPITAL.-Operations, 1 ½ P.M. CHARING-CROSS HOSPITAL.-Operations, 2 P.M. Notes, Short Comments, and Answers to Correspondents. UNSTITCHED PUBLICATIONS. WE have received several complaints about THE LANCET not being stitched as formerly. We are quite aware of the inconvenience and discomfort attending the perusal of an unstitched journal, especially when, as in the case of THE LANCET, it is composed of so many sheets, some of which are liable to become detached, and perchance mislaid. We would gladly have adhered to our old practice; but we have been compelled, of course, to conform in this respect to the new postal regulations. If THE LANCET were stitched, its postage would be according to the pamphlet rate, and cost three-halfpence ; whereas, unstitched, it can be sent anywhere in the United Kingdom for one-halfpenny. We would advise each of our sub- scribers to get his number stitched immediately on its receipt. Dr. Douglas.A. Reid.-We have difficulty in commenting on the case in the absence of a public report. The principle of charging for medicines, as our correspondent does, is one that we had hoped had died out. Certainly the sooner it dies the better. Medicines should be either thrown into the charge for visits, or a mere nominal sum charged for them. The Judge acted very wrongly, we think, in not allowing fees for consultations. Dr. James C. Dickinson’s paper shall have early insertion. OUT-PATIE:NT HOSPITAL REFORM’. To the Editor of THE LANCET. SIR,-Will you be good enough to allow me to acknowledge in your next issue the receipt of the following sums towards the expenses incurred by the Out-patient Hospital Reform Committee:-Dr. H. J. Sanderson, 6s.; Mr. John Scott, 5s.; Dr. A. Grant, 2s. 6d. Allow me also to thank those members of the profession who were preseet at the meeting on the 24th of JrIarch for the proof which their silent reply to my appeal has afforded of their generous appreciation of the labours of their Committee ! May I add that it is expected the expenses will amount to nearly £50, and that I shall be glad to receive any further contributions.-Yours obediently, George-street, Hanover-square, October, 1870. ALassn MEADOWS. THE GUARDIANS OI’ THE TIVERTON UNION AND TEBIE MEDICAL OmCES. THE Guardians of the Tiverton Union have just passed a vote of censure upon the medical officer of the workhouse for not having certified an im- becile inmate, of the name of Emma Rendle, as insane, and thus securing her admission to the asylum. Judging from the information we have re- ceived, this censure is altogether undeserved. It appears that Emma Bendle has been an inmate of this workhouse many years, and that no one has ever proposed that she was dangerous either to herself or to any- one around her. She was, unless provoked, horh quiet and harmless; but, like all such persons, she is liable to violent outbursts of passion when hurt or oppressed. About a month ago it was alleged that she was very roughly treated by the porter, who took it upon himself to force her into the hospital without any orders from the master or other superior officer. The medical officer saw the traces of considerable violence, and naturally expressed wish to the master that steps should be taken to prevent a re- currence of similar treatment. The guardiars thereupon required their medical officer to furnish a special report of the case. This report affirmed that she was of weak mind, and that she had little or no control over her temper; that, in consequence of the violent treatment she had received, there had been an explosion of her temper, during which she had broken several panes of glass ; that at the time of the report she had become quiet, and would remain so if she received consistent and non-irritating treatment. This was regarded as a charge against the other officers, and the medical officer, for a confidential statement, is thus made public pro- secutor. The result of the inquiry does not state whether or not improper violence was used, although the evidence was conclusive on this point, but censures the medical officer, as we have already noticed. It is to be regretted that some other medical man was found willing to certify the insanity of the girl without any communication with the medical officer of the workhouse, and, of course, without other evidence than that of the officials, who were probably anxious to be rid of her. If the guardians, in- stead of censuring an officer for the simple performance of his duty, had issued strict orders that no violence should in future be used, they would have given the public a higher opinion of their humanity towards the numerous unfortunate imbeciles who are of necessity confined in work- houses. It is simply monstrous to send such persons to lunatic asylums, where they interfere with the successful treatment of curable cases, and cost twice as much to the ratepayers. P. J. H., (Nottingham.)-Thanks, Our correspondent’s communication is not forgotten. MEDICAL ETIQUETTE. To the Editor of THE LANCET. SIR,-Having read Mr. Mouritz’s disingenuous defence of his breach of professional etiquette, will you kindly allow me to supply a few facts which he suppresses, and some which he misrepresents and distorts. Mr. Mouritz states that on his arrival at the patient’s house, he could find no messenger to send for me. Now, that is a strange statement, considering that the patient is respectable and in good circumstances, and that the neighbourhood in which she resides is thickly populated. He says that, re- turning, he visited the works of Messrs. Pilkington and Hutchinson, and that these works are a considerable distance from my house. True, indi- vidually ; but my house is on the high road between these works, and there- fore Mr. Mouritz necessarily passed it on his way from one works to the other, and, if it suited his dignity better to take a bye-lane, five minutes’ divergence would have sufficed to bring him to my house. He states that he asked whether I proposed a consultation, and that the husband replied, "Never to me, and I was not aware that he had proposed a consultation to anyone until you hid seen my wife." Does not the word "anyone" in this sentence show, even to those whose notions are "hazy"-much more to a gentleman of such clear conception as Mr. Mouritz,-that I did propose a consultation to some one ? In effect, I proposed the consultation to the pa- tient, her husband not being at home at the time of my visit ; and is there the least likelihood that the wife did not acquaint her husband of my pro- position ? Besides, when I accused 31r. Mouritz at the railway station of seeing &c. my patient in my absence, he replied, "Didn’t you send for me P" and even though Mr. Mouritz had not been told that I proposed a consulta- tion, he knew that I was in attendance; and I should like to know what new interpretation of the rules of medical etiquette he can find to justify him in seeing a patient of mine in my absence, in prescribing for her, and in sending from his own house an eight-ounce mixture, which he calls a draught of chloral hydrate, when at the same time I was giving a mixture containing morphia. Mr. Mouritz’s account of our meeting at the railway station is on a par with his other statements. A gentleman of position and respectability in this locality, who was with me at the station, but stood a half-dozen feet off, saw Mr. Mouritz turn on his heel almost as soon as I commenced to speak with him, and overheard his grunt as he walked off. -Nlr. Mouritz’s conclusion as to the probability of my not having chloral hydrate may be very logical; but I cannot see it. Mr. Mouritx is drawing on his imagina- tion when he asserts that he declined to have any further intercourse with me. The fact is, I declined to meet him in consultation. In regard to that circumstance, which grates so painfully on Mr. Mouritz’s refined and sns- ceptible feelings, as to my not having carbolic acid in my surgery on a par- ticular occasion, I should like to know by what powers of dialectics, by what ingenious sophistry, or by what stretch of the imagination, he can bring that fact to justify him in violating well-established rules of professional etiquette. I am, Sir, your obedient servant, J. M’NAUGHTEN O’KEEFFE, L.R.C.P.E., &e. Widnes, October 17th, 1870. Mr. D. Blackwood, (Halifax.)-Many thanks for the enclosure. So many remedies have been vaunted at different times for small-pox, that we are justified in entertaining a good deal of scepticism in regard to any new agent. Our correspondent might make his offer to some physician in his own neighbourhood, if he can find one willing to try it. Dr. Geo. Buchanan shall receive a private note.
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Transcript of Medical Diary of the Week.
591
Medical Diary of the Week.Monday, Oct. 24.
ST. MARK’S HOSPITAL.-Operations, 2 P.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10½ A.M.METROPOLITAN FREE HOSPITAL.-Operations, 2 p.M.MEDICAL SOCIETY OF LONDON. - 8 P.31. Casual Communications. - Dr.
Richardson, " On the Medical Aspects of the Germ Theory."
Tuesday, Oct. 25.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10t A.M.
. G1IT’S HOSPITAL.-Operations, 1½ P.M.WESTMINSTER HOSPITAL.-Operations, 2 P.M.NATIONAL ORTHOPEDIC HOSPITAL.-Operations, 2 P.M.ROYAL FREE HOSPITAL.-Operations, 2 P.M.
Wednesday, Oct. 26.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 10i A.M.MIDDLESEX HOSPITAL.-Operations, 1 P.M.Sr. BARTHOLOMEW’S HOSPITAL.-Operations, 11 P.M.ST. THOMAS’S HOSPITAL.-Operations, 1½ P.M.ST. 3iaxr’s HOSPITAL.-Operations, 1¼ P.M.KING’S COLLEGE HOSPITAL.-Operations, 2 P.M.GREAT NORTHERN HOSPITAL.-Operations, 2 p.M.UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 p.M.LONDON HOSPITAL.-Operations, 2 p.M.CANCER HOSPITAL.-Operations, 3 P.M.IIcxrxxiev SOCIETY.-8 p.M. Adjourned Discussion on Mr. Bryant’s paperOn Pyæmia."
Thursday, Oct. 27.ROYAL LONDON OPHTHALMIC HOSPITAL, -ITOOP.FIBLI)9.-Operations, IOJ A.M.ST. GEORGE’S HOSPITAL.-Operations, 1 P.M.UNIVERSITY COLLEGE HOSPITAL.-Operations, 2 P.M.WEST LONDON HOSPITAL.-Operations, 2 P.M.ROYAL ORTHOP2RDIC HOSPITAL.-Operations, 2 p.M.CENTRAL LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M.
Friday, Oct. 28.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDS.-Operations, 101 A.M.WESTMINSTER OPHTHALMIC HOSPITAL.-Operations, 1 ½ P.M.CENTRAL LONDON OPHTHALMIC HOSPITAL.-Operations, 2 P.M.QUEKETT MICROSCOPICAL CLUB. - 8 P.M. Mr. J. Slade, "On the Micro-
scopical Characters of Cannel Coal."CLINICAL SOCIETY OF LONDON.-8 ½ P.M. Dr. Sutton, "On Two Cases of
Scurvy."-Mr. Brudenell Carter, "On Cases of Optic Neuritis."
Saturday, Oct. 29.ST. THOMAS’S HOSPITAL.-Operations, 9½ A.M.HOSPITAL FOR WOMEN, Soho-square.-Operations, 9½ A.M.ROYAL LONDON OPHTHALMIC HOSPITAL, MOORFIELDs.-Operations, 10 ½ A.M.ROYAL FREE HOSPITAL.-Operations, 2 P.M.ST. BARTHOLOMEW’S HOSPITAL.-Operations, 1 ½ P.M.KING’S COLLEGE HOSPITAL.-Operations, 1 ½ P.M.CHARING-CROSS HOSPITAL.-Operations, 2 P.M.
Notes, Short Comments, and Answers to
Correspondents.UNSTITCHED PUBLICATIONS.
WE have received several complaints about THE LANCET not being stitchedas formerly. We are quite aware of the inconvenience and discomfortattending the perusal of an unstitched journal, especially when, as in thecase of THE LANCET, it is composed of so many sheets, some of whichare liable to become detached, and perchance mislaid. We would gladlyhave adhered to our old practice; but we have been compelled, of course,to conform in this respect to the new postal regulations. If THE LANCETwere stitched, its postage would be according to the pamphlet rate, andcost three-halfpence ; whereas, unstitched, it can be sent anywhere in theUnited Kingdom for one-halfpenny. We would advise each of our sub-scribers to get his number stitched immediately on its receipt.
Dr. Douglas.A. Reid.-We have difficulty in commenting on the case in theabsence of a public report. The principle of charging for medicines, asour correspondent does, is one that we had hoped had died out. Certainlythe sooner it dies the better. Medicines should be either thrown into the
charge for visits, or a mere nominal sum charged for them. The Judgeacted very wrongly, we think, in not allowing fees for consultations.
Dr. James C. Dickinson’s paper shall have early insertion.
OUT-PATIE:NT HOSPITAL REFORM’.To the Editor of THE LANCET.
SIR,-Will you be good enough to allow me to acknowledge in your nextissue the receipt of the following sums towards the expenses incurred bythe Out-patient Hospital Reform Committee:-Dr. H. J. Sanderson, 6s.;Mr. John Scott, 5s.; Dr. A. Grant, 2s. 6d. Allow me also to thank thosemembers of the profession who were preseet at the meeting on the 24th ofJrIarch for the proof which their silent reply to my appeal has afforded oftheir generous appreciation of the labours of their Committee ! May I addthat it is expected the expenses will amount to nearly £50, and that I shallbe glad to receive any further contributions.-Yours obediently,
George-street, Hanover-square, October, 1870. ALassn MEADOWS.
THE GUARDIANS OI’ THE TIVERTON UNION AND TEBIEMEDICAL OmCES.
THE Guardians of the Tiverton Union have just passed a vote of censureupon the medical officer of the workhouse for not having certified an im-becile inmate, of the name of Emma Rendle, as insane, and thus securingher admission to the asylum. Judging from the information we have re-ceived, this censure is altogether undeserved. It appears that EmmaBendle has been an inmate of this workhouse many years, and that noone has ever proposed that she was dangerous either to herself or to any-one around her. She was, unless provoked, horh quiet and harmless; but,like all such persons, she is liable to violent outbursts of passion whenhurt or oppressed. About a month ago it was alleged that she was veryroughly treated by the porter, who took it upon himself to force her intothe hospital without any orders from the master or other superior officer.The medical officer saw the traces of considerable violence, and naturallyexpressed wish to the master that steps should be taken to prevent a re-currence of similar treatment. The guardiars thereupon required theirmedical officer to furnish a special report of the case. This report affirmedthat she was of weak mind, and that she had little or no control over hertemper; that, in consequence of the violent treatment she had received,there had been an explosion of her temper, during which she had brokenseveral panes of glass ; that at the time of the report she had becomequiet, and would remain so if she received consistent and non-irritatingtreatment. This was regarded as a charge against the other officers, andthe medical officer, for a confidential statement, is thus made public pro-secutor. The result of the inquiry does not state whether or not improperviolence was used, although the evidence was conclusive on this point,but censures the medical officer, as we have already noticed. It is to be
regretted that some other medical man was found willing to certify theinsanity of the girl without any communication with the medical officer ofthe workhouse, and, of course, without other evidence than that of theofficials, who were probably anxious to be rid of her. If the guardians, in-stead of censuring an officer for the simple performance of his duty, hadissued strict orders that no violence should in future be used, they wouldhave given the public a higher opinion of their humanity towards thenumerous unfortunate imbeciles who are of necessity confined in work-houses. It is simply monstrous to send such persons to lunatic asylums,where they interfere with the successful treatment of curable cases, andcost twice as much to the ratepayers.
P. J. H., (Nottingham.)-Thanks, Our correspondent’s communication isnot forgotten.
MEDICAL ETIQUETTE.To the Editor of THE LANCET.
SIR,-Having read Mr. Mouritz’s disingenuous defence of his breach ofprofessional etiquette, will you kindly allow me to supply a few facts whichhe suppresses, and some which he misrepresents and distorts.Mr. Mouritz states that on his arrival at the patient’s house, he could find
no messenger to send for me. Now, that is a strange statement, consideringthat the patient is respectable and in good circumstances, and that theneighbourhood in which she resides is thickly populated. He says that, re-turning, he visited the works of Messrs. Pilkington and Hutchinson, andthat these works are a considerable distance from my house. True, indi-vidually ; but my house is on the high road between these works, and there-fore Mr. Mouritz necessarily passed it on his way from one works to theother, and, if it suited his dignity better to take a bye-lane, five minutes’divergence would have sufficed to bring him to my house. He states that heasked whether I proposed a consultation, and that the husband replied,"Never to me, and I was not aware that he had proposed a consultation toanyone until you hid seen my wife." Does not the word "anyone" in thissentence show, even to those whose notions are "hazy"-much more to agentleman of such clear conception as Mr. Mouritz,-that I did propose aconsultation to some one ? In effect, I proposed the consultation to the pa-tient, her husband not being at home at the time of my visit ; and is therethe least likelihood that the wife did not acquaint her husband of my pro-position ? Besides, when I accused 31r. Mouritz at the railway station ofseeing &c. my patient in my absence, he replied, "Didn’t you send for me P"and even though Mr. Mouritz had not been told that I proposed a consulta-tion, he knew that I was in attendance; and I should like to know whatnew interpretation of the rules of medical etiquette he can find to justifyhim in seeing a patient of mine in my absence, in prescribing for her, and insending from his own house an eight-ounce mixture, which he calls a draughtof chloral hydrate, when at the same time I was giving a mixture containingmorphia. Mr. Mouritz’s account of our meeting at the railway station is ona par with his other statements. A gentleman of position and respectabilityin this locality, who was with me at the station, but stood a half-dozen feetoff, saw Mr. Mouritz turn on his heel almost as soon as I commenced tospeak with him, and overheard his grunt as he walked off. -Nlr. Mouritz’sconclusion as to the probability of my not having chloral hydrate may bevery logical; but I cannot see it. Mr. Mouritx is drawing on his imagina-tion when he asserts that he declined to have any further intercourse withme. The fact is, I declined to meet him in consultation. In regard to thatcircumstance, which grates so painfully on Mr. Mouritz’s refined and sns-ceptible feelings, as to my not having carbolic acid in my surgery on a par-ticular occasion, I should like to know by what powers of dialectics, by whatingenious sophistry, or by what stretch of the imagination, he can bringthat fact to justify him in violating well-established rules of professionaletiquette. I am, Sir, your obedient servant,
J. M’NAUGHTEN O’KEEFFE, L.R.C.P.E., &e.Widnes, October 17th, 1870.
Mr. D. Blackwood, (Halifax.)-Many thanks for the enclosure. So manyremedies have been vaunted at different times for small-pox, that we arejustified in entertaining a good deal of scepticism in regard to any newagent. Our correspondent might make his offer to some physician in hisown neighbourhood, if he can find one willing to try it.
Dr. Geo. Buchanan shall receive a private note.
