552 FRIENDLY SOCIETIES’ PROVIDENT MEDICAL INSTITUTIONS.

milligrammes; 100 grammes of cardiac tissue, 311 milli-

grammes ; 100 grammes of spleen, 662 milligrammes. Theobservers always noticed that the urea injected under theskin was never completely absorbed, even at the time ofdeath, though death might have been delayed for ten hours.By exposing the sciatic nerve and displaying the calf muscles,to the cut tendo Achillis of which a dynamometer wasconnected, the authors decided that uræmia does not increaseor diminish muscular contractility. The blood of the deadanimals, when submitted to distillation at a temperature of40° C. in vacuo, furnished a liquid absolutely free from

ammonia ; the conclusion drawn from this experiment is thaturea does not act as ammonic carbonate.

FRIENDLY SOCIETIES’ PROVIDENT MEDICALINSTITUTIONS.

OUR readers are well aware that in some towns the old and friendly institution of the" club doctor" has been a

threatened with overthrow by the wholesale amalgamation dof Friendly Societies into one huge Provident Medical t

Institution, to be served medically by one doctor, with

perhaps an assistant. Everything in this institution wasto be on a huge scale, except the remuneration and the liberty of the medical man. His work was to be that ofseveral medical men; he was not to be allowed to do it in o

his own way, but on a system of iron rules, and his salary twas to be as small as his liberty. Such arrangements have iinever had our approval. They did not appear to us likely tto secure the best results to the members of sick societies Iand their friends; they treat thousands of human beings as Iif they were without choice and preference in regard to a

medical practitioners; they presume on the eagerness of c

young medical men " wanting a start" and tempted to over- 1look what is due to the profession and to seniors who have c

worked other provident arrangements patiently and con- I

scientiously, and by so doing have formed extensive medical B

relations with the working classes which are most beneficial rand creditable. Moreover, such institutions seem to be a

manipulated by small committees or caucuses, without reference to the wishes of the members, and with such scanty sappreciation of the respect due to professional men, that even the youngest and most eager of these must soon find that in serving them he is serving a hard master. We have ’on various occasions expressed these views, but never with i

any but the most respectful feelings to the members of i

friendly societies, who deserve all praise for their providentintentions and for their efforts to put the medical attendanceof the working classes on an independent footing. Our

objections meet with striking illustration and confirmationin a pamphlet sent us by Dr. Maunsell, containing letterspublished first in the Batlb Argus, and setting forth thearbitrary way in which the Committee of the Bath Amal-gamated Friendly Societies’Provident Medical Institute havecalled for his resignation, without deigning to give anyreasons. The only reason seems to be that he appears tohave been overcome with doubts as to the perfectly satis-factory working of such institutes, and to have been boldenough to suggest changes for " placing them on a basis thatwill enable medical men to accept and retain the appoint.ments. " He has published letters from gentlemen holding theexisting appointments, some of which are no doubt aggravat-ing to committees of such institutes as the B.A.F. S. P.M.I.One honorary surgeon of the Bath Institute, Mr. Hoblyn,says : "I know very little of their rules, or how they intendto work, but from all that I can make out I do not see howany man is to do all the work, and I do not suppose that any-one can retain the appointment longer than six months.For my own part, I do not, at my age, intend to be tieddown to them in any fashion. I would not allow myself to

be called consulting surgeon, with any definite duties toperform, for a guinea a visit." A medical officer of such aninstitution writes : " I am working beyond powers of endur.ance." " Another says : " I ’ put up’ with the work for threeyears, during which time I suffered enough insult and annoy-ance to last a moderate lifetime, had it not been condensedinto three years. I resigned in disgust because the com-mittee was powerless to enforce their own rules, the membersof which body were quite at the mercy of their various clubs,and although quite ready to make rules, only required meto keep them, and always interpreted them as the membersof the Association wished. Professionally, the rank and fileof the medical profession here put me ’in Coventry;’ theconsulting men did not actually refuse to meet me, but prac-tically I was outside the profession." The Bath Instituteshould initiate a testimonial to Dr. Maunsell instead of dis.

missing him. Let the working classes take the whole pro.fession a little more into their respect and consideration,and they will find that they have no better friends in thedark days of trouble and sickness than the tried practi.tioners by whom they are surrounded.

COMMITTAL AND DISCHARGE OF DR. WOLFF.

OUR readers will remember that during the conflict ofopinions that has raged at the Diamond Fields respectingthe nature of the disease which has proved so disastrous inits results, Dr. Wolff has been a persistent opponent of thetheory which supposes the epidemic to be one of small-pox.It was with deep regret that we heard of the committal ofDr. Wolff on the charge of " culpable homicide " for having,as alleged, allowed a woman to be exposed to the contagionof small-pox, not only without warning her of the danger,but with the positive assertion that neither infection nor

contagion was to be feared. According to the sworn testi-mony of the witnesses, Dr. Wolff attended a patient whowas suffering from an eruptive fever which proved fatal.The woman who laid out the deceased sickened twelve daysafterwards and died, from the effects of what Dr. Grimmer,who was called in to see her, declared was no other thansmall-pox. It was of having indirectly caused her deaththat Dr. Wolff was accused. For obvious reasons we didnot discuss the merits of the case at an earlier date, althoughwe were then, as now, convinced that before a grand jury

found a true bill they would have to satisfy themselves-! (1) that Dr. Wolff was primâfacie answerable for having con-tributed to the death through wilful and culpable negligence;: (2) that he had contravened the 35th section of the Public’ Health Act, which orders that a medical practitioner shallL inform a householder as early as possible of a case of small- pox, or a disease declared by the governor to be infectious,i having occurred in his house; (3) that even supposing the- deceased to have succumbed to small-pox, the infection was,! without reasonable doubt, derived from the source set forthr in the indictment. Drs. Sauer, Grimmer, and Smith, who) examined the body after its exhumation, were agreed that- the death was due to confluent small-pox, and the two1 former deposed to that effect. Dr. L. S. Jameson, who wast called for the defence, is reported to have said that the. epidemic is not one of small-pox, and that it is not con-e tagious, and is probably propagated by the soil. Not.. withstanding we are entirely opposed to this view of Drs.. Jameson and Wolff, we give them the credit of being, honestly persuaded of its truth, and it would be unfair tod hold Dr. Wolff responsible for the consequences of an errorv of judgment. As he stated in his defence, if he believed the’- disease was not small-pox he could not be expected to certify!. that it was. The present epidemic has not been declared byd the governor to be small-pox, and the only disease other thano ’ small-pox specified as infectious in the section oftheActabove