900 EXPOSURE OF MESMERIC DELUSIONS.

humble opinion, were excited by her own

will, and not by Dr. ELLIOTSON; but this ex-

planation will not suit the marvellous wit-nesses of the wonderful counsellor.

The whole delusion might be immediatelydetected and exposed at these exhibitions byanybody who will take the trouble to per-form the experiments in a proper manner.If the hand be raised by mesmeric action,no philosophic mind will require further

evidence of the existence of the force. At

the next meeting let the « young woman’s"eyes be carefully bandaged, and the usualmanipulations be performed, which are said todraw the arm, in three different directions.

Dr. ELLIOTSON should be out of the room,and the experiment should be performed byan intelligent person, accustomed to scientific

investigation. We pledge the existence ofTHE LANCET that the experiment would fail,and succeed in bringing the imposture to

light.If Dr. ELLIOTSON had a philosophical mind,

and a sincere conviction that this force ex-

isted, he might easily devise experiments fordemonstrating its existence. If the attraction

be real, the girls might be seated in a smallfour-wheeled carriage, and drawn round the

drawing-room by the attractive mesmeric

force of the magnetic doctor. Or, by accu-mulating the force, putting, for instance, a i

considerable number of epileptic" youngwomen" in a railway carriage, the doctor

and his disciples might succeed in drawingthem along the line. Mr. BRUNEL would no

doubt place a carriage at Dr. ELLIOTSON’S

disposal on the Great Western Railway; or,if those carriages should be too large for hisfirst essay, he might try his hand on the

Southampton.Everybody must remember the highly

interesting researches of which the gym-

notus at the Adelaide Gallery was the sub-

ject, and the results which were communi-

cated to the Royal Society by Professor FARA-DAY. But the curiosity excited by the investi-

gation of the phenomena exhibited by theelectric eel, could not for a moment be com-

pared with the interest which similar re-

searches would excite in the public mind,when pursued on the person of a Fellow ofthe Royal College of Physicians, who is

understood to have no special nerves or

’, organs, like the gymnotus or torpedo, for the

production of the wonderful force in question.Professor FARADAY might be asked to con-duct these, also. But whatever the result,if the magnetic doctor continue his freaks, hewill inevitably find his way either into the

Adelaide Gallery or into Bedlam.

MEDICAL ARRANGEMENTSUNDER THE

POOR-LAW AMENDMENT ACT.

To the Editor of THE LANCET.

SiR :-l3aving had some experience inthe working of the new poor-law in ruraldistricts, I beg to offer a few desultory re-flections thereon, especially in relation tothose parts of it which relate to the medicalattendance on the poor.We are said to belong to a liberal profes-

sion, and are certainly pre-eminently entitledto the designation, if the readiness withwhich we offer our services gratuitously, orfor an inadequate remuneration, be takeninto consideration. It is not to be wonderedat that the public should hold us in lightesteem, when we ourselves set so little valueon our services ; for the old adage is in verygeneral acceptation-

The valne of a thing,Is just as much as it will bring.

The poor-law commissioners have done ussome mischief, but we have to thank our-selves for the greater part of the injury wehave incurred from the legislative enactionin question-the discord and jealousy whichpervade our ranks have done the work. Weare a terribly quarrelsome set, and the barerthe bone of contention, the more do wesnarl over it. The poor-law bashaws werecertainly ready enough to grind us down,but we have even underbid them, and sofavoured their tactics. Had we but beentrue to ourselves, and remained firm andunited, we might have successfully resistedtheir unfair dictation, but the supinenessand mutual distrust which reigned amongus invited attack.The pecuniary advantage to be derived

by the rate-payers under the new system,evidently constituted the means by whichthe commissioners trusted to make it ac-ceptable, and not by its intrinsic value.They have endeavoured to bring into fulloperation a measure most harsh and strin-gent on the lower classes, and which hasundoubtedly entailed upon them a vast

901

amount of additional misery and disease, about their crusade against poverty, deter-more especially in the manufacturing dis- mined to make it poorer still, and by dint oftricts, for the present prosperous state of the reducing diet to an homoeopathic scale, dis-agricultural interest has prevented the pres- regarding all the trifling links of society,-assure being as much felt as it otherwise wedlock, paternity, filial affection, renderingwould have been; but the measure is in the misery of life yet more wretched, andmany respects a failure, for on every side death 11 a consummation devoutly to behave they unwillingly been compelled to wished,"-they reduced the monies ex-

submit to the relaxation of the rules they pended for the relief of the poor from 30 tohad laid down for the guidance of boards 50 per cent. Supposing that half the savingof guardians, under the plea of expediency. was laudable economy, and we will ac-

The outcry is strong against them, and they knowledge that there was room for it, theare now even inclined to do away with the remainder was wrung from the sweat ofsystem of putting up the poor to a Dutch wretchedness, the heart-blood of misery ;auction in respect to medical attendance, surely if ever money was unholy, accursed,and substituting fixed salaries, affording in that was.many instances a somewhat better rate of From the expense of medical attendanceremuneration. on the paupers some proportion of the

I am far from regarding the Poor-law saving was derived, as may be judged fromAmendment Act as objectionable in all its the fact that many of the salaries of thedetails, though highly so in the spirit which medical officers were reduced more than 50actuates its working. Much of the old per cent., and the poor were farmed out tosystem has been very judiciously done away the lowest bidder, from the nature of whosewith, but the greater part of the additional qualifications and the extent of whose expe-structure is no less unwise than cruel, espe- rience the frequent requisition of the ser-

cially that which makes the workhouse the vices of an undertaker appeared an extremetest of destitution. At the period when the probability. Of the degradation of the pro-new poor-law was concocted, there can be fession by the system of tender much hasno question that the progress of pauperism been said ; and so loud has been the voicewas fearful-the evil was becoming more of complaint, that, as I have already men-and more deeply rooted, so that parochial tioned, the poor-law commissioners begin topensions were becoming a right of custom show themselves willing to permit the medi-to the lower classes, and a premium was cal officers at a fixed salary. Likewiseextended for the increase of pauper popula- some of the unions have been divided intotion, thereby inculcating anything but habits smaller districts than was originally theof thrift and forethought. To obviate the case, or the districts allowed to be parti-mischief, it was evidently necessary to abo- tioned ; so that in the part of the countrylish the existing vicious system of palliating with which I am acquainted, the extent ofthe necessities of the working-classes-to the allotments is not greater than the rangemake them rely on their own resources, and of practice will admit of. Still I cannot butnot to suffer them to continue so burden- consider the allotment of sick paupers of asome on agricultural and mercantile capital. rural district, or a part thereof, to the careIt should in fairness have been endeavoured of one particular medical man as pregnantto ensure the adequacy of their resources with mischief and inconvenience, and that,for subsistence, ere compelling the poor to for reasons I will now proceed to mention,rely on them solely : but the distressed state I am inclined to deem the payment per caseof the majority of the productive classes, as preferable in many respects.from insufficient remuneration and deficient In the first place, we find that the irregu-employ, was wholly lost sight of. No lar shape of many districts, and even ofremedy was simultaneously directed against single parishes, will often place one portionthese roots of evil; it was assumed that the thereof more especially in the beat of oneinability of the poor to provide against the medical man, while the remainder may bestorms of sickness and the bleak winter of more convenient to others. This is moreage, was altogether ascribable to indolence, particularly the case in proportion as theimprovidence, and intemperance; that, in population is scanty, and often occasionsfact, it was the result, and almost identical the utmost inconvenience to all parties, andwith crime, and as such should be treated : is pregnant with injury to the patient.perhaps it was thought that by making this When practicable, it is decidedly desira-world a place of extra punishment, a kind bIe that the patient, even though he be aof Roman Catholic purgatory, the sin of pauper, should have an option in respect topoverty might be expiated and forgiven. his medical attendant, for we know howTo proceed, however,-the Whigs were well much the body is under mental influence.acquainted with human nature, they knew If the patient have confidence in the medicalthat man was essentially a selfish animal, man, faith will gild the pill and sweeten theand that the most effectual mode of appeal- nauseous draught with the hope of recovery,ing to his understanding was through the and I do not hesitate to say render medicinemedium of his pocket; they therefore set doubly efficacious; for one reason, because

902

it causes the medical attendant’s directions would show, especially before the new lawto be far more implicitly followed than they came into action : there may be three timesotherwise would be. as much pauperism in one parish as

It is right to ensure, as completely as there is in another ; by which circumstancepossible, the proper performance of the the amount of services required from themedical duties to the fair satisfaction of the medical man must, of course, be much influ-pauper sick, as well as that of the parish enced: indeed, the calculation of the numberauthorities. Now giving the poor some of paupers in one parish would constitutealternative of choice, would constitute some one of the best guides to determining theguarantee against neglect and mal-treatment amount of a fixed salary for the medicalon the part of the medical man. Under the attendant. Again, one parish may be as

present system, however, just cause of dis- unhealthy again as another, from the naturesatisfaction may exist, the poor will not of the soil, deficient drainage, &c. &c.readily complain, for they feel that they Again, the want of residents with independ-have but little chance of making out a case, ent means is often severely felt by the poor;or obtaining redress from a partial board of the extra pecuniary circulation derived fromguardians, who are prejudiced in favour of such a source, often adding materially totheir appointed officer, whose conduct must the means of the lower classes, contributinggenerally be most glaringly blameable before to their comfort, and thereby promoting athey will take any cognisance of it. higher state of health. In the respective

It is most desirable to do away with the returns from two large parishes with whichill feeling which is often occasioned by the I am well acquainted, the influence of thecontests for the medical appointments, these circumstances to which I have just alludedcontests not only give rise to dissensions are well exemplified; they are about equalamong medical men, instead of that amity in size and population ; but while the ratioand brotherly feeling which the general in- of the number of the sick on the medicalterests of suffering humanity render so de- return-books for the parish, under favour-sirable, but they are almost invariably able auspices as to soil and the circum-made the medium of party spirit and personal stances of the inhabitants, may be taken aspique, and it is seldom the case that the in- ten; that of the other, where the relationsterests of the poor are at all taken into con- are unfavourable, has rarely been undersideration. I have more than once seen it twenty-five, yet the salary in both instancesoccur in the election of a medical officer is the same.for a portion of an union, that though far the Having thus briefly alluded to some of thegreater number of guardians connected with disadvantages of the present system, I willthe district in question were unanimous in now add a few words as to that which Ithe choice of one surgeon, yet a majority in deem preferable, by which much would befavour of another was constituted by guar- effected which is desirable, and much avoideddians of other districts, who attended ex- which is objectionable. I believe, as I havepressly to vote on that particular question, already said, that it would be far preferablequite regardless of the respective eligibility that the present system of consigning pau-of the candidates. pers wholesale to a medical man’s care

It is fair to secure to the medical attend- should be done away with entirely, and thatant payment proportionate to the services he should be paid at so much per case ; therendered by him, though, of course, at a rate average distance of the paupers of a parishless remunerative than private practice from the residences of the neighbouringwould afford. Not only is the present rate medical men, who are eligible and willingof remuneration too low, but also its allot- to undertake the attendance, being takenment is decidedly unfair. The amount of into consideration, so as to afford a certaintrouble connected with attendance in wide extra proportionate allowance, a kind ofand thinly-populated districts, is far greater mileage, beyond the remuneration for actualin proportion than when the population is attendance and medicines. This rate ofconcentrated. In one instance which comes payment per case should be settled by awithin my knowledge, I am confident that medical commissioner, the nature of thethe trouble and expense of attendance in an country, its populousness, and other circum-851. district is not near double those of the stances being taken into consideration. Theattendance on another portion of the union attendance should be offered to all the medicalfor which only 281. is received. The area men in the vicinity conjointly; any of whom,of a district and its amount of population within a certain distance, might undertakeare by no means the only elements of calcu- the care of a case, according to the choice oflation to be considered : there are many the patient, on the receipt of an order fromother circumstances which help to determine the relieving officer, renewable every threethe trouble and expense of the medical man, months : midwifery and capital surgery torendering the present mode of regulating be paid extra. The accounts of the differentthe remuneration decidedly unfair. For medical men could then be settled quarterly.example, the rate of pauperism varies in I cannot perceive any serious objection to

every parish, as the amount of poor-rates which the plan I have now briefly outlined

903

would be liable; but, on the contrary, I be-lieve that the ends of humanity would bemore effectually seived, and that the inte-rests of the medical profession would bemore fairly consulted than under the existingsystem. I do not put the plan forward as anovel suggestion, but from some actual ex-perience in the present method I deem itdesirable to urge the matter further on theconsideration of the profession.Hoping that the above views may find an

abler advocate among your numerous pro-vincial readers, I remain your obedienthumble servant,

RUSTICUS.

MIDDLESEX HOSPITAL.

AMAUROSIS CURED BY IODIDE OF POTASSIUM.

H. CHARLWOOD, aged 13 years, was ad-mitted January 19, under the care of Mr.Arnott. He cannot distinguish, with hisleft eye, any object, and so complete is theloss of perception in this organ, that it isonly where there is a bright light that hecan distinguish the shade occasioned by thepassage of the hand between it and the light.This pupil is more dilated than that of theright eye ; and the iris, without being quitefixed, has but a very limited extent of mo- 1tion, and that is sluggish. The vision ofthe right eye is good. The boy has a patlidappearance. He says that he has often beenaffected with pain in the head and the leftside of the face. About two years ago hefirst noticed that when he looked at objectsthere appeared a little black spot, as it were,before the left eye, which partially obscuredthe object. This spot gradually increasedin size until about three months since, whenvision of the left eye was completely lost.On examining his mouth the teeth are foundto be very irregular and crowded, owing tohis not having shed any of his temporarymolars or canines, some of which are

decaying. He has occasionally had tooth-ach. Some time ago a portion of bone cameaway from his upper jaw, and he pointed tothe palate as the spot whence it separated,and where there is the appearance of acicatrix.

’

Mr. Arnott remarked, that in inquiry intothe causes of amaurosis in this case, with aview to determine the plan of treatment tobe adopted, it was first of all clear thatthere was no evidence of local excitement,and that it was not a case requiring, andnot likely to be benefitted by, mercury ordepletion. It was probable, in the next

place, that the amaurosis might be connectedwith the diseased condition of the upper jawwhich had previously existed, and possiblydid still exist, and the irritation from the

presence, at his age, of temporary and per-manent teeth at the same time. But, as the

tongue was coated, it was advisable to gethis stomach and bowels first into a freerstate. Accordingly, until the 30th of themonth, he underwent a course of alterativesand aperients, but without benefit to the

sight.Feb. 1. Eight temporary teeth and stumpswere extracted, namely, one canine andthree molars from the upper jaw on the leftside, one molar on the right, and threemolars from the lower jaw.Feb. 6 and 8. No improvement ; sees no

better.

It was now determined, with a view tothe possibly still existing diseased state ofthe bone or periosteum of the jaw, to puthim upon a course of iodide of potassiumand sarsaparilla. He was, therefore, orderedon the 8th to have a grain and a half ofiodide of potassium, with two ounces ofdecoction of sarsaparilla, three times a-day.

15. There has been some improvement inthe left eye during the last day or two ; ontrial this forenoon he distinguished whenthe hand was held up before him whether itwas open or closed, and he discovered thatthree fingers only were extended. Continuethe medicine.

22. A still further improvement ; he saysthere is less thickness of vision.

27. Is slightly better; grinds his teeth atnight. To have a scruple of compound jalappowder directly. Continue the medicine.

March 8. Distinctly better. Distinguisheda black button on the grey ground of a waist-coat of one of the pupils.

11. Distinguished the colour of a sove.reign from that of a shilling.

15. Recognised the colour of a blue flowerin the button-hole of a gentleman’s coat.Told the time by Mr. Arnott’s watch afterexamining it for a little time, and holdingit in various positions to the light. Has hadsoup diet ; to now have meat. Continueshis medicine.

April 1. Sight improving; can read thediet-card, but he complains of pain in hishead to-day. Let his meat be changed forsoup. Stop his medicine for a day or two,and let him have a compound senna draughtdirectly.

8. Read, though with difficulty, in one ofthe religious tracts given by the clergymanto the patients. To go on with the iodideand the sarsaparilla. The pupil of the lefteye is now of nearly the same size as that ofthe other, and the motions of the iris arealmost as rapid.May 4. The boy has for some time been

able to read his Bible with facility. Dis-charged cured.