THE LONDON AND MANCHESTER INDUSTRIAL ASSURANCE COMPANY.
1
777 colleague and friend, the late G. W. Callender, being the only other known to me) I feel it right to assert that 50 guineas were paid in each year to the surgeon under whom we served, and we received from the hospital 20 or 25 gnineas per annum, with suitable rooms free. The three or four house surgeons had a housekeeper, and we each lived as we could afford. No doubt the hospital authorities made gain out of ns, in addition to our services, by avoiding the payment of inquest fees, they themselves being the parish authorities. The information I derived during my house surgeoncy under the late Mr. E. Stanley and Mr. E. A. Lloyd will ever be remembered with infinite pleasure, and the comparatively small honorarium paid to them will ever be considered a most trivial recognition of friendship. I am, Sirs, your obedient servant, North Cliff, Kidderminster, March 18th, 1895. S. STRETTON. To the Editors of THE LANCET. SIRS,—! still maintain that a man on the junior staff at St. Bartholomew’s Hospital is not much, if at all, more out of pocket than a man on the j anior staff of any other hospital with aschool. Personally, I think that any resident officer ought to have rooms, commons. light, fire, and beer free during his term, and also a small salary to keep him in clothes and tobacco; but this does not alter my opinion as concerning the parallel between St. Bartholomew’s and other hospitals with a school. Personally, too, I should say that the collegiate system ought to be much further carried out. At St. Bartholomew’s certain idiotic restrictions that existed in my time at any rate ought to be done away with-perbaps they have been, and the " College " rebuilt. Perhaps when the long-pending removal of Christ’s Hospital takes place we may see a collegiate establishment attached to the hos- pital on the model of one of the Oxford or Cambridge Colleges; but, with all its faults, St. Bartholomew’s is a fine old place, and it is not seemly for a former resident to draw depreciatory comparisons between it and other hospitals after he has left. I am, Sirs, yours faithfully, AN OLD HOUSE SURGEON OF ST. BARTHOLOMEW’S. March 19th, 1895. *** This correspondence is now closed. -ED. L. THE LONDON AND MANCHESTER INDUS- TRIAL ASSURANCE COMPANY. To the Editors oj THE LANCET. SIRS,-I think there must be many of your readers who will agree with me tha,t something should be done to check the baneful influences that the London and Manchester Assurance Company is exercising towards the degradation of the profession amcngst general practitioners. I suppose there is no legal reason why a medical man should not attend patients for the sum of twopence weekly, including medicine, if that is the amount of the remuneration at which he values his services, although such can hardly be said to raise the profession in the estimation of the public. But when it comes to touts annoying the patients of other practitioners by pestering them to join the society, I say that surely it is time that the bulk of the profession should by some means be able to stop such practices. The General Medical Oouncil would hardly take action, I am afraid, were facts brought before them. The Medical Defence Union has, alas, its hands full with more legitimate work. I, therefore, appeal to the medical press to use its influence to restrain medical men from association with a society of this class. The South-West London Medical Society-to which I have the privilege to belong-lately passed a resolution condemn- ing the practice of charging fees as low as one shilling or eighteenpence. Its members also passed, amongst others, the following by-law: "That no member of the society should solicit private practice either by public advertisement in the newspapers, by placards, by the public distribution of circulars, cards, or handbills, or by soliciting by agents." Other societies have formed similar by-laws. I am, Sirs, your obedient servant, Fulham, S.W., Feb. 25th, 1895. A GENERAL PRACTITIONER. To the Editors ot THE LANCET. SIRS,-Will you kindly give expression of your opinion in your next issue of the above, in accordance with the orthodox views being presently held by leading members of the pro- fession? Should it be supported by medical men upon the principle of a company or aid association running medical business ? Is it a burial club with medical aid thrown in at the expense of the profession ? What are the abuses to which it is subject Perhaps some members of the profession, would give their experience upon the latter. I am, Sirs, yours faithfully, March 18th, 1895. _______________ INQUIRER. INQUIRER. MANCHESTER. (FROM OUR OWN CORRESPONDENT.) The Health of Afanchester during the last Quarter of 1894; the Medieal Offlcer’s Report. THE births of 4000 children were registered within the city, and equalled an annual rate of 30 7 per 1000, against 32 4 the corrected average of the December quarters of the> previous three years. Of general sickness treated at the public hospitals and) dispensaries there were 10,137 cases, or 780 per week, being an increase of 238 as compared with the last quarter of 1893 ; 1243 were treated as in-patients, 6718 as out-patients". and 2176 were visited at their own homes. Of infectious. sickness 1025 cases were reported to the medical officer of- health, against 852 in the preceding quarter, and 960 the average number for the fourth quarters of the previous three- years. Severe cases of small-pox were reported during the’ quarter. In the last quarter of 1893 4 cases were reported, in the March quarter of 1894 there were 16, in the Jane- quarter 195, in the September quarter 64, and, as has been seen, there were 7 only in the last quarter of- 1894. In his report for the week ending March 9th Dr. Niven says that no fresh cases of small-pox have occurred here for the last nineteen weeks. Scarlet fever was notified" in 725 cases last quarter, equal to an annual rate of 5-57 per 1000 persons living, against 4’25 in the immediately preceding; quarter and 3’98 the average rate for the fourth quarters of- the years 1891-93. In London the rate was 3 81 last quarter, and in the twelve selected notification towns in this part of- England 4’42. In Halifax it was only 0’39, while in. Warrington it was 9-50. Liverpool and Salford showed rates. of 8 25 and 6’03 respectively. Diphtheria was slightly less. prevalent than usual, 114 cases being reported, the average for the quarter being 130. In North Manchester the" attacks corresponded to an annual rate of 1’50, in South Manchester of 1’03, and in the old unhealthy "township" it only equalled a rate of 0-71. There was le-is enteric fever- than usual, 147 cases beirg reported, against 240 the average for the quarter. They were most numerous in the Manchester township, where the attack-rate equailed 1-34 per 1000, and, fewest in North Manchester, which had a rate of 082, thus. reversing their positions as to diphtheria. Whooping-cough) and measles do not seem to have been excessively prevalent. In the course of the quarter the deaths of 2631 persons were reported, but after making alJowance for the deaths of 70.*’ non-residents this number is r’duced to 2561. This equals, a corrected annual rate of 19 7 per 1000 The average rate- for the fourth quarter fcr the previous three years has been-, 23 6 per 1000, so that last quarter the rate was below the, mean for the quarter by nearly 17 per cent. Here, again:,. the old township maintained its reputation, for the death-- rate was equal to 24’7 per 1000, while in North Manchester it, did not exceed 16 8. Last quarter was marked generally by a low death-rate-e g., in the thirty three great towns of the"- Registrar. General the rate was 17 7 ; in Londcn 16 6 ; and in sixty-seven other large English towns with a population- of about 3,500,000 the death-rate was 167, or 30 below Manchester. In Edinburgh it was 19 6, in Glasgow 21’6, and:. in Dublin 23’5. In rural England and Wales the rate was. only 15 5. Infantile mortality was lower than usual in Manchester.- Measured by the propcrtion of deaths under one year to births. registered, the rate lat qaarter was 162 per 1000, against 17 in the previous quarter, and 180 in the fourth quarter of 1893. North Manchester had the lowest rate, 140, while in the Man- chester township it was 182. But according to Dr. Ashby of. the Children’s Hospital this high rate is much exceeded inr certain areas. In the decline of life, amongst those above the age of sixty... five the death-rate was high. 109 4 per 1000 living at that= age, being equal to 98’4 pi r 1000 in North Manchester, while- in the unhealthy district of the Manchester township it rose: to 134-8.
Transcript of THE LONDON AND MANCHESTER INDUSTRIAL ASSURANCE COMPANY.
777
colleague and friend, the late G. W. Callender, being theonly other known to me) I feel it right to assert that 50
guineas were paid in each year to the surgeon under whomwe served, and we received from the hospital 20 or 25
gnineas per annum, with suitable rooms free. The three orfour house surgeons had a housekeeper, and we each livedas we could afford. No doubt the hospital authorities madegain out of ns, in addition to our services, by avoiding thepayment of inquest fees, they themselves being the parishauthorities. The information I derived during my housesurgeoncy under the late Mr. E. Stanley and Mr. E. A. Lloydwill ever be remembered with infinite pleasure, and the
comparatively small honorarium paid to them will ever beconsidered a most trivial recognition of friendship.
I am, Sirs, your obedient servant,North Cliff, Kidderminster, March 18th, 1895. S. STRETTON.
To the Editors of THE LANCET.SIRS,—! still maintain that a man on the junior staff at
St. Bartholomew’s Hospital is not much, if at all, more out ofpocket than a man on the j anior staff of any other hospital withaschool. Personally, I think that any resident officer ought tohave rooms, commons. light, fire, and beer free during histerm, and also a small salary to keep him in clothes andtobacco; but this does not alter my opinion as concerningthe parallel between St. Bartholomew’s and other hospitalswith a school. Personally, too, I should say that thecollegiate system ought to be much further carried out.At St. Bartholomew’s certain idiotic restrictions that existedin my time at any rate ought to be done away with-perbapsthey have been, and the " College " rebuilt. Perhaps whenthe long-pending removal of Christ’s Hospital takes placewe may see a collegiate establishment attached to the hos-pital on the model of one of the Oxford or CambridgeColleges; but, with all its faults, St. Bartholomew’s is a fineold place, and it is not seemly for a former resident to drawdepreciatory comparisons between it and other hospitalsafter he has left. I am, Sirs, yours faithfully,
AN OLD HOUSE SURGEON OF ST. BARTHOLOMEW’S.March 19th, 1895.
*** This correspondence is now closed. -ED. L.
THE LONDON AND MANCHESTER INDUS-TRIAL ASSURANCE COMPANY.
To the Editors oj THE LANCET.
SIRS,-I think there must be many of your readers whowill agree with me tha,t something should be done to checkthe baneful influences that the London and ManchesterAssurance Company is exercising towards the degradation ofthe profession amcngst general practitioners. I supposethere is no legal reason why a medical man should not attendpatients for the sum of twopence weekly, including medicine,if that is the amount of the remuneration at which he valueshis services, although such can hardly be said to raise theprofession in the estimation of the public. But when itcomes to touts annoying the patients of other practitionersby pestering them to join the society, I say that surelyit is time that the bulk of the profession should by somemeans be able to stop such practices. The General MedicalOouncil would hardly take action, I am afraid, were factsbrought before them. The Medical Defence Union has,alas, its hands full with more legitimate work. I, therefore,appeal to the medical press to use its influence to restrainmedical men from association with a society of this class.The South-West London Medical Society-to which I havethe privilege to belong-lately passed a resolution condemn-ing the practice of charging fees as low as one shilling oreighteenpence. Its members also passed, amongst others,the following by-law: "That no member of the societyshould solicit private practice either by public advertisementin the newspapers, by placards, by the public distributionof circulars, cards, or handbills, or by soliciting by agents."Other societies have formed similar by-laws.
I am, Sirs, your obedient servant,Fulham, S.W., Feb. 25th, 1895. A GENERAL PRACTITIONER.
To the Editors ot THE LANCET.
SIRS,-Will you kindly give expression of your opinion inyour next issue of the above, in accordance with the orthodoxviews being presently held by leading members of the pro-fession? Should it be supported by medical men upon the
principle of a company or aid association running medicalbusiness ? Is it a burial club with medical aid thrown in atthe expense of the profession ? What are the abuses towhich it is subject Perhaps some members of the profession,would give their experience upon the latter.
I am, Sirs, yours faithfully,March 18th, 1895.
_______________
INQUIRER.INQUIRER.
MANCHESTER.(FROM OUR OWN CORRESPONDENT.)
The Health of Afanchester during the last Quarter of 1894;the Medieal Offlcer’s Report.
THE births of 4000 children were registered within thecity, and equalled an annual rate of 30 7 per 1000, against32 4 the corrected average of the December quarters of the>previous three years.
Of general sickness treated at the public hospitals and)dispensaries there were 10,137 cases, or 780 per week,being an increase of 238 as compared with the last quarter of1893 ; 1243 were treated as in-patients, 6718 as out-patients".and 2176 were visited at their own homes. Of infectious.sickness 1025 cases were reported to the medical officer of-health, against 852 in the preceding quarter, and 960 theaverage number for the fourth quarters of the previous three-years. Severe cases of small-pox were reported during the’quarter. In the last quarter of 1893 4 cases were reported,in the March quarter of 1894 there were 16, in the Jane-quarter 195, in the September quarter 64, and, as hasbeen seen, there were 7 only in the last quarter of-1894. In his report for the week ending March 9th Dr.Niven says that no fresh cases of small-pox have occurredhere for the last nineteen weeks. Scarlet fever was notified"in 725 cases last quarter, equal to an annual rate of 5-57 per1000 persons living, against 4’25 in the immediately preceding;quarter and 3’98 the average rate for the fourth quarters of-the years 1891-93. In London the rate was 3 81 last quarter,and in the twelve selected notification towns in this part of-England 4’42. In Halifax it was only 0’39, while in.Warrington it was 9-50. Liverpool and Salford showed rates.of 8 25 and 6’03 respectively. Diphtheria was slightly less.prevalent than usual, 114 cases being reported, the averagefor the quarter being 130. In North Manchester the"attacks corresponded to an annual rate of 1’50, in SouthManchester of 1’03, and in the old unhealthy "township"it only equalled a rate of 0-71. There was le-is enteric fever-than usual, 147 cases beirg reported, against 240 the averagefor the quarter. They were most numerous in the Manchestertownship, where the attack-rate equailed 1-34 per 1000, and,fewest in North Manchester, which had a rate of 082, thus.reversing their positions as to diphtheria. Whooping-cough)and measles do not seem to have been excessively prevalent.In the course of the quarter the deaths of 2631 persons werereported, but after making alJowance for the deaths of 70.*’non-residents this number is r’duced to 2561. This equals,a corrected annual rate of 19 7 per 1000 The average rate-for the fourth quarter fcr the previous three years has been-,23 6 per 1000, so that last quarter the rate was below the,mean for the quarter by nearly 17 per cent. Here, again:,.the old township maintained its reputation, for the death--rate was equal to 24’7 per 1000, while in North Manchester it,did not exceed 16 8. Last quarter was marked generally bya low death-rate-e g., in the thirty three great towns of the"-Registrar. General the rate was 17 7 ; in Londcn 16 6 ; andin sixty-seven other large English towns with a population-of about 3,500,000 the death-rate was 167, or 30 belowManchester. In Edinburgh it was 19 6, in Glasgow 21’6, and:.in Dublin 23’5. In rural England and Wales the rate was.only 15 5.
Infantile mortality was lower than usual in Manchester.-Measured by the propcrtion of deaths under one year to births.registered, the rate lat qaarter was 162 per 1000, against 17in the previous quarter, and 180 in the fourth quarter of 1893.North Manchester had the lowest rate, 140, while in the Man-chester township it was 182. But according to Dr. Ashby of.the Children’s Hospital this high rate is much exceeded inrcertain areas.
In the decline of life, amongst those above the age of sixty...five the death-rate was high. 109 4 per 1000 living at that=age, being equal to 98’4 pi r 1000 in North Manchester, while-in the unhealthy district of the Manchester township it rose:to 134-8.
