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Section XII.-Psychiatry.Lice-President.-C. K. Clarke, M.D., Professor of Psychiatry,

University of Toronto.COlmcil.-T. J. W. Burgess, M.D., F.R.C.S.. Professor of Mental

Diseases, McGill University; W. H. Hattie, M.D., Medical Superin-tendent, Nova Scotia Hospital; Edward Ryan, M.D., Professor ofMental Diseases, Queen’s University, Kingston.

Section XIII.-Dermatology.Co2tncil.-Philip Burnett, M.D., Montreal General Hospital ;

G. G. Campbell, B.Sc., M.D., Lecturer in Medicine and Clinical Medi-cine and in Dermatology, McGill University; David King Smith,M.B., Toronto General Hospital.

Section XIV.-Urology.Council.-Edmund E. King, M.D., Toronto.

Section XV.-Rhinology.T ice-Presicdent.-J. D. Gibb Wishart, B.A, M.D., C.M., Associate

Professor of Laryngology and Rhinology, University of Toronto.

Section XVI.-Otology.Vice-Pl’esiclent.-H. S. Birkett, M.D., Professor of Otology, McGill

University.Section XVIII.-Hygiene

F:ee-P;’M’teK<.&mdash;Charles A. Hodgetts, M.D., C.M., Medical Adviser,Commission of Conservation. Ottawa.

C’OMHC.&mdash;E. M. Simpson, M.D., M.O.H. for the Province of Manitoba.

Section XIX.-Forensic Medicine.COttKe.&mdash;D. B. MacTaggart, M.D., Professor of Medical Juris-

prudence, McGill University.

Section XX.-Naval and Military Medicine.Ft’ce-.P)’Mtf!M.<.&mdash;Colonel Guy Carleton Jones, M.D., C.M., M.R.C.S.,

Director-General, Medical Services, Militia of Canada, Ottawa.CoM?:cx!.&mdash;Lieutenant-Colonel J. T. Fotheringham, lB1.D., Army

Medical Corps, Toronto.

Section XXI&mdash;Tropical Medicine.CO!mcil.-J. L. Todd, B.A., M.D., B.Sc., Associate Professor of

Parasitology, McGill University.

Section XXII.&mdash;Radiology.Cotttzcil.-F. C. Harrison, B.A.. id.B., Assistant in Pharmacology,

University of Toronto, Physician, Toronto Hospital for Incurables.

A GLIMPSE AT OLD-TIME CAMBRIDGE-SHIRE DOCTORS.

THE kind of history that consists merely of recounting anumber of isolated facts is of little profit. It is safe to saythat reconstructive works, such as Becker’s " 6’M " and his" 6%<M"tc," convey a better concrete idea of the actual dailylife in classical times than any amount of the kind of classical

reading which we do as schoolboys. We must learn to view

archaeological remains with the mind’s eye as part of the re-constructed whole. We are led to these reflections by theperusal of a pamphlet by Dr. W. M. Palmer on " Cambridge-shire Doctors in the Olden Time," 1 wherein we are shownthese worthies, not as curiosities in a museum, but ashuman beings, living their lives as professional men in anenvironment superficially so totally unlike, and yet in itsfundamentals so essentially the same as our own.

Some Interesting Details.Dr. Palmer’s paper deals chiefly with the sixteenth and

seventeenth centuries. He brings the dry bones to life bygiving us, after a preliminary excursus on his sources ofinformation, the regulations of early medical practice, andthe various grades of medical practitioners, an interestingand humorous sketch of two village practitioners, respectivelyof the sixteenth and seventeenth centuries, as well as

equally interesting records of certain Cambridge doctors-viz., Walter Lemster, physician (? 1440)-1487 ; John Thomas,surgeon (? 1490)-1545 ; Robert Pickering, physician (a con-temporary of Thomas) ; John Hatcher, M.D. (71512)-1587 ;Thomas Lockyn, M.D., 1528-1591 ; and William Butler,1536-1618.The first important Medical Act, passed in 1511, required,

as regarded country doctors, that no person should practiseas a physician or surgeon in any diocese until he had beenexamined and approved by the Bishop, aided by such expertpersons in those faculties as were convenient. The penaltywas &5, or Z50 of our money, for each month in which hepractised without such licence. A search through the Bishop’s

1 Cambridgeshire Doctors in the Olden Times, 1466-1827. By W. M.Palmer, M.D. Durh. From the Cambridge Antiquarian Society’s Com-munications, vol. xv., 1911.

Court books discovered 15 medical practitioners in the dioceseof Ely in 1640, of whom four were in Cambridge and the restat Brinckley, Chatteris, Chesterton, Coton, Cottenham, Ely,Ickleton, Melbourn, Meldreth, Shudy Camps, and Wisbech,though this list is probably not complete. There were also33 midwives in the county and Isle of Ely. The six recog-nised grades of practitioners appear to have been physicians,surgeons, barber-surgeons, apothecaries, midwives, and bone--setters, of whom the first four had either to take a degree orlicence at one of the universities or to pass through anapprenticeship.

Dr. Palmer appears to doubt the truth of the generalopinion as to the low status of the surgeon of those days,for he says : " Most of the writers on the history of medicinehave been physicians, and they have invariably put theposition of the surgeon as a low one."A Country Praotitioner at the .l!.Jnd of the Sixteenth Cent1lry.Speaking of the real country practitioner, the doctor

living in a country village, with no colleague withinseveral miles, Dr. Palmer tells all he has been able tofind out about one Mr. John Stacey, a predecessor ofhis own in Linton, who first came under his notice throughthe records of a medico-legal case of 1581. A woman

having been indicted before the Bishop’s Court " forincontinency and contingent offences," called in her defenceher doctor, Robert Widdows, of Cambridge, but "eitherDr. Widdows had scruples about divulging professionalsecrets, even in the spiritual court, or did not wantto be cross-examined, or Mrs. Horner hadn’t paid herbill-anyway he wouldn’t give evidence." So she fellback on her husband’s doctor, Mr. John Stacey, of Linton,who attended and gave evidence in support of her character.What the issue of the trial was we are not told, but welearn of Stacey that he was at one time a trusted member ofSir Phillip Paris’s household, who left him the keeping ofhis house in Linton during the nonage of his son Robert.On Robert’s death before attaining his majority, Staceybought a house in Linton and settled in practice. Heseems to have been successful, for in 1592 he paid the fifthhighest amount of taxes in Linton.

Another Co2cntry Dootor (1685).The house of another country doctor, Mr. John Longworthy,

a practitioner in physic and surgery, West Wrattling, a smallcountry village, in 1685, is described as follows :-The house consisted of hall, great and little parlours, closet for drugs

and surgical instruments, kitchen, pantry, and cellar, with fivebedrooms and a garret which was used as a granary. A building withtwo gables and a connecting hall, such as still exist in this county,would fit this description. On entering the hall you would have seentwo gate-legged tables, five joined stools, a grandfather’s clock, and acorner cupboard. The hearth contained a fire-grate, but the floor wascarpetless. In the little parlour was an oval table and six paintedchairs. No carpet and an open hearth. in the great parlour was theonly carpet in the house ; an oval table, probably of walnut, six leatherand two panelled chairs and an open hearth with large cobirons. Asregards the bedrooms, the hall chamber and the great parlour chambercontained fireplaces, which were also open hearths. In the former wasa four-poster bed, a carved oak hutch, three chairs, and a pair ofbellows. In the great parlour bedroom, evidently the best bedroom,was another four-poster with curtains, a chest of drawers, and a,looking-glass, altogether valued at E10, the most expensively furnished roomin the house. The other bedrooms were meanly furnished and withoutfireplaces. One of them is called the manservant’s room, so thedoctor’s groom slept in the house. In the kitchen was a table, withfour chairs and a screen. The value, including roasting apparatus,brass and pewter, was E6 10s. The only eating utensils mentionedbesides this pewter are a case of knives in the pantry and someearthenware.

Of linen there was goodly store, 12 pairs of sheets and fivedozen table napkins (forks were not then in general usein England so that the fingers required constant wiping) ; andthis, Dr. Palmer reminds us, was linen that did not wear outand was often bequeathed in wills. In the cellar were fourhalf-hogsheads of beer and smaller barrels, and there was acider press in the brewhouse. ,His instruments and utensilsfor physic and chirurgery, two stills, one mortar, and a fewold books, ;E4," were of exactly the same value as his linen.Dr. Palmer depicts his subject as probably spending manyhours" grinding dried roots to powder in his mortar, withone eye and ear on the bubbling of the fluid in his still," andshrewdly remarks : "A man who spent hours in the prepara-tion of his physic had more faith in it than some have

nowadays." Mr. Longworthy was also a farmer, as manycountry doctors are to some extent to-day, and his agri-cultural goods amounted to 65 out of a total of <&121.Much quaint information has been collected by Dr. Palmer

750

about the drugs used by a country doctor of the eighteenthcentury. Occasionally possessions to be found in theinventories suggest the spoil of churches. For instance, Dr.Hatcher, of Cambridge (? 1512-1587), possessed, among otherthings, I I a cope of tissue upon green velvet, with a cape andborder of images of needlework," valued at 35s., and anauter cloth of purple velvet with branches 3* yards, 25s."

The Case of a G’ambridgesJtire Vicar.Dr. Palmer concludes his very interesting paper with

"a sad account of a Cambridgeshire vicar of the fifteenthcentury who was dissatisfied with local skill and went toLondon for further advice," which he sought from JohnBrown, warden of the Barber-Surgeons in 1494. Thelatter undertook to do his cure" on the parson, who onhis part undertook to pay ae:I0 (half a year’s stipend ofhis vicarage), half when he could walk without a crutch andhold up his arms so that he might say mass, the other half13 weeks after he was completely whole. But he committedthe mistake, poor simple soul, of signing an obligation ofae:20 to compel him to fulfil his bargain when cured. Afterhe had been more than six months in the city at greatexpense to himself, the surgeon asked for his fee and wasmet with the objection, "But I am in like case as I waswhen first you took me in cure and no better." He refusedto pay and the surgeon ceased to attend.The poor vicar’s expostulation, however, was fruitless,

for the surgeon commenced an action for debt by meansof the obligation against the vicar in the Sheriff’s Court, towhich the vicar put in surety and was prepared to answer.But the wily surgeon knew a trick worth two of letting thecase come to trial, for, in Vicar Dobson’s own words, " Brownnow proceedeth no further in the action, but lets it depend inthe court, to thentente that Dobson should lie styll inLondon to his grete costs and charges unto such tyme as bythat means he shulde be fain to pay Brown ae:5, that hedemandeth for his labour." No more is known about thecase, but as the next appointment to the vicarage ofMelbourn occurred in 1503, the vicar probably lived untilthen. Dr. Palmer closes his paper with the pithy remark," The fame of London specialists must have been dim in thatvillage for many years to come.

"

THE LONDON COUNTY COUNCIL ANDMEDICAL AFFAIRS.

Proposed Extension of the Present System of .LYedioalTreatment.

THE Children’s Care Committee reported to the EducationCommittee of the London County Council on March 6th thatit had approved certain variations in the number of cases

dealt with at the treatment centres controlled by committeesof medical practitioners in Islington, St. Pancras, and

Hackney. An offer had been considered from a voluntarycommittee, not wholly composed of medical practitioners,to establish an additional centre in Poplar for treatmenton five afternoons a week upon the conditions proposedin respect of other centres. The committee had approvedof arrangements with this local committee for twelve months,the number of children to be dealt with being 880 sufferingfrom eye defects and 1320 suffering from ear, nose, and throatailments. The Metropolitan Hospital, Kingsland-road, wasprepared to undertake the treatment of 500 eye cases and500 ear, nose, and throat cases a year upon the terms usuallyoffered by the Council, and the Care Committee had agreedto the inclusion of this hospital in the medical treatmentscheme as likely to be of assistance in meeting the needs ofHaggerston and South Islington. The Committee had also

accepted an offer by the authorities of St. Cecilia’s Home,Commercial-road, Stepney, to arrange for the cleansing ofverminous children and for the medical treatment of ailingchildren. Treatment would be provided for 440 cases and itwould be given in two inter-communicating rooms. Adoctor would attend on one half day a week; his salarywould be paid by the Council. The cost if 440 cases weretreated for ear, nose, and throat ailments not requiringoperations and for external eye diseases would be .E104 ayear.

In connexion with the foregoing the Care Committee drew

attention to the steps taken by the Council since the autumnof 1911 (in accordance with the promise to the Board ofEducation), with a view to coordinating medical inspectionand treatment, and to securing the efficiency of the treatmentcentres. Under newly proposed arrangements the followingprovisions were included: (1) The local committees had

agreed that the doctors themselves who performed thework (instead of as heretofore their qualifications only)should be subject to the approval of the Council ; (2) arrange-ments for the attendance of a lay officer or a nurse to

supply information to school care committees as to thenature of treatment ordered by the doctors were now in

operation at all the existing centres, and it was proposed toextend them to suggested centres ; (3) the school doctors andthe doctors at the centres would exchange information ; and(4) the adoption of the proposals now made would give theCouncil experience of providing treatment at three types ofcentre-namely, at hospitals, at centres established by localpractitioners, and at centres provided by committees whichwere not composed of medical practitioners. The com-

mittee felt that the Board of Education should be informedof these points, and also of the experiment approved at theend of 1911 and put into force on March lst this year, in theEast-end of London, in carrying out medical inspection byfull-time officers under the supervision of a divisional medicalofficer, who would work in close cooperation with the Council’sofficers at the treatment centres. The Board should be askedto sanction the establishment of the proposed additionalcentres as a matter of urgency, inasmuch as there was specialneed for the treatment of children in the districts whichwould be served by the centres. A comprehensive report onthe work of medical treatment in London generally would besubmitted in October next. The total expenditure involvedin the present proposals was f’.3565 a year for treatment and.E475 in the first year for apparatus.The Education Committee directed that a letter in these

terms be sent to the Board of Education.

Playground Classes.

The Board of Education, while commenting favourably onthe improved arrangements for medical supervision recentlyintroduced into playground classes, has made certain

suggestions to the London County Council with a view tobringing about further improvements. These were submittedto the Council on Feb. 20th. In classes in which all thechildren are definitely chosen on the ground of delicacy ofhealth the Board thought it was desirable that every childshould be subjected to systematic medical inspection as earlyin the session as practicable, and that all initial and subse-quent records made by medical officers should be dated. Inclasses in which the influences needed were mainly pre-ventive the Board thought that the medical examinationshould be conducted on more uniform lines than at present.While some examinations were thorough, others appeared toomit such important details as the chest and lungs, othersagain included merely such items as could be gathered fromsimply looking at the child, while in some of the schoolsmedical supervision of every kind was omitted. Thatthere was need for inspection of the more thoroughkind was obvious from the serious cases of defectthat occurred in certain of the classes, the scholarsof which had been subjected to medical inspection. Itwas important that the results of routine medical inspec-tion should be re-entered on playground class records (aswas done in some cases) in order that the open-air classmight be better utilised as a means of following up thosecases most likely to benefit under its influence. " Control "

measurements might be more generally instituted in classesof the kind referred to, and they should have special refer-ence to height, weight, and haemoglobin content. TheBoard pointed out that the open-air class was an experimentlikely to yield results useful to the whole country, and itwas important, therefore, that its usefulness should rest onscientific bases of the kind to be obtained bv means of

,

" control " measurements. -

L The Council decided to ask the medical officer to meet thesuggestions of the Board as far as possible.

The Council also resolved to ask the Board of Education toY, approve the formal appointment of Dr. W. H. Hamer fors the purpose of certifying defective or epileptic children

within the meaning of Section 1 of the Elementary Education’ (Defective and Epileptic Children) Act, 1899.