payment of hospital physicians and surgeons

1
320 You are of course aware, Sir, how the wonderful cures attri- buted to these amulets should be regarded. I need not tell you that the generality of people are for ever tormented with the propensity of worshipping some newly-devised super- natural powers; and that they will needs seek the assistance of mysterious agencies, when they could be relieved more simply by rational means, based upon practical experience. Who does not remember, that towards the end of the last century, the so-called age of philosophy, crowds of all ranks flocked to the cemetery of St. Medard, at Paris, to witness miraculous cures of paralysis upon the tomb of a saint ? People were, however, soon undeceived, and the cemetery was closed by order of the magistrates. We all know how glaringly the juggleries of mesmerism were exposed in France by a scientific committee, presided over by the celebrated Berthollet, after four years’ careful in- vestigation. It is well known that homoeopathy, which has had so many foolish supporters throughout Europe, is dying away, destroyed by its own absurdities. The votaries of animal magnetism and clairvoyance still find dupes here and there, though, especially in France, they are daily brought before courts of law, and punished for swindling. In fine, no one is unacquainted with the fact, that the tenets of phrenology have been exaggerated and disfigured; that they have come down to sleight-of-hand deception; and that their vagaries have been confuted by sound logical reasoning, and the ridicule which they richly deserve. As, however, there are in the world a reat many people anxious to investigate for themselves, I shall present them with the means of constructing, for a few pence, a little voltaic apparatus, which far surpasses all those I have named above, both by the constancy of its action and the simplicity of its construction. To this I have given the name of VOLTAIC LEMON. This galvanic toy, the external and internal portions of which already constitute three elements of the pile, decom- poses water like the chain, acts powerfully, but in a mediate manner, on the magnetic needle, precipitates metals, acts on the muscles and nerves of the eye, &c.; but its direct action upon the body is extremely weak. The Voltaic Lemon is constructed in accordance with theoretical laws: it contains in itself the elements of the pile, the exriting acid solution, and the porous membrane formed by the internal skin of the fruit. The duration of its action depends on the quantity of citric acid fluid contained in the lemon, which fluid, owing to its great abundance, will keep up the activity of the instrument for a long period. I may state, without exaggerating, that this apparatus offers 1000 times more advantage than the hydro-electric chain. , I remain, Sir, yours respectfully, Bentinck-street, Cavendish-square, CHEVALIER LE MOLT. March, 1852. PAYMENT OF HOSPITAL PHYSICIANS AND SURGEONS. To the Editor of THE LANCET. SIR,—There must have been an error, either in my manuscript or in the printing of my letter in your number of March 6th. The sums put down as paid to the assistant physicians and surgeons at St. Luke’s, London Fever Hospital, and Small-Pox Hospital, should have been put down as paid to the senior physicians and surgeons ; also in the list of dispensaries, we should read physician and surgeon for assistant-physician and assistant- surgeon. The error, however, is immaterial, as the real question at issue is, not how much certain hospitals pay, but what hospitals do not pay at all. In continuation of the list, I have to add- The Lock Hospital and the Charing-cross Hospital have the unenviable notoriety of being added to the non-paying list. You are quite correct in your statement " that in some of the institutions named in the second list, the medical officers divide amongst them the fees of students." This is the case also at St. Bartholomew’s, Guy’s, St. Thomas’s; indeed, this practice may be taken as the rule at all the metropolitan hospitals. But it is most important-and I beg to urge this point strongly upon you-to remember that in no one case do the assistant-physicians and assistant-surgeons share in this division: only the seniors. Nor have the assistants any claim to a share. We see, therefore, that in the hospitals in the second list, the assistant physicians and surgeons receive no remuneration in any shape or form. In the consideration of the subject, therefore, as respects the assistant physicians and surgeons, the pupils’ fees for hospital attendance are not to be considered. Even with the full physicians and surgeons, these fees ought not to be calculated upon, as their amount varies annually ; indeed, it would add to the dignity of the staff if no such fees passed directly into their hands, but were considered hospital property, and an equivalent salary given to both seniors and assistants. There would be more independence of feeling in both parties. When the time comes-and, sooner or later, come it will-that all the hospitals and other charitable institutions shall pay their medical staff, arrangements must ensue between the seniors and juniors; for of course the assistants cannot be paid directly from the funds, or any other fund, of the hospital, without the concur- rence of the seniors; but which of course would be at once granted by the latter, and, therefore, any necessary arrangement on this point may be safely left to the parties principally concerned. I see that there is already organized, in St. Mary’s Hospital, an institution which has not yet been one entire year in working order, a " Clerical Endowment Fund." I have no invidious feeling on this matter, and I disclaim all desire to contrast spiritual with medical advice given in hospitals; but I cannot forget that those institutions were, and are, not established for the former, but essentially for the latter purpose; therefore, à fortiori, the medical staff deserve remuneration ; and we can only i attribute the previous neglect of the public to an imperfect know- ledge of the facts. I am, Sir, your obedient servant, r SPES. THE TORY ADMIRALTY AND NAVAL-ASSISTANT SURGEONS. To the Editor of THE LANCET. SIR,—I have, with great regret, perused in THE LANCET of March 13, a letter on the subject of the Assistant-Surgeons of the Royal Navy, by a correspondent who styles himself " Amicus Justitise." Were the writer really what his signa- ture implies, he would be aware that he has no right to pre. judge a cause, especially when the party accused has had neither time nor opportunity for reply. It is, to say the very least, an extremely ill-timed production, and one calculated greatly to injure the question he appears to have at heart. None of the present Admiralty have ever given an official opinion on the subject; and until that has been heard, we must not condemn them. Much, in my humble opinion, may be expected from the new Board, which is generally acknowledged by all, except " Amicus Justitise," to be one of the most efficient of modern times. The Duke of Northumberland, the First Lord, is well known as a most liberal-minded nobleman, of high acquire- ments, and a patron of literature and science. Admiral Parker is universally allowed to be one of the most active- minded and indefatigable officers in the service, and certainly little deserving of the ungenerous, little-minded allusions to his bodily infirmities, contained in the letter; and none of the other new members of the Board have ever, as far as I am aware, done anything to prejudice naval medical officers against them. I am certain that I am uttering the deliberate opinion of a large majority of those most immediately con- cerned, when I say that our prospects are a hundredfold better under the present, than they were under the late admiralty. In conclusion, I wish, for a moment, to advert to the ex- tremely injudicious behaviour of many, who in their headlong and intemperate zeal for attaining their end, never for a moment reflect whether the means they are employing be creditable or advisable. I am constrained to speak thus strongly,from the great mischief I have myself seen effected by such conduct. I have met some fiery enthusiasts who breathe nothing but fire and sword, not only against those who differ from them in opinion,-which they never allow to be done conscientiously,-but even against more temperate persons, who will not proceed to the same lengths as themselves. Others make use of unguarded language; introduce the subject on all occasions, and into all societies, and make not only themselves to be regarded as nuisances, but likewise bring great discredit on the whole of the body to which they belong. The cause which we all believe in, and adhere to, will never be advanced by such persons; on the contrary, it is

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Page 1: PAYMENT OF HOSPITAL PHYSICIANS AND SURGEONS

320

You are of course aware, Sir, how the wonderful cures attri-buted to these amulets should be regarded. I need not tellyou that the generality of people are for ever tormented withthe propensity of worshipping some newly-devised super-natural powers; and that they will needs seek the assistanceof mysterious agencies, when they could be relieved moresimply by rational means, based upon practical experience.Who does not remember, that towards the end of the last

century, the so-called age of philosophy, crowds of all ranksflocked to the cemetery of St. Medard, at Paris, to witnessmiraculous cures of paralysis upon the tomb of a saint ?People were, however, soon undeceived, and the cemeterywas closed by order of the magistrates.We all know how glaringly the juggleries of mesmerism

were exposed in France by a scientific committee, presidedover by the celebrated Berthollet, after four years’ careful in-vestigation.

It is well known that homoeopathy, which has had so manyfoolish supporters throughout Europe, is dying away, destroyedby its own absurdities.The votaries of animal magnetism and clairvoyance still

find dupes here and there, though, especially in France, theyare daily brought before courts of law, and punished forswindling.In fine, no one is unacquainted with the fact, that the tenets

of phrenology have been exaggerated and disfigured; that theyhave come down to sleight-of-hand deception; and that theirvagaries have been confuted by sound logical reasoning, andthe ridicule which they richly deserve.

As, however, there are in the world a reat many peopleanxious to investigate for themselves, I shall present themwith the means of constructing, for a few pence, a littlevoltaic apparatus, which far surpasses all those I have namedabove, both by the constancy of its action and the simplicityof its construction. To this I have given the name of VOLTAICLEMON.This galvanic toy, the external and internal portions of

which already constitute three elements of the pile, decom-poses water like the chain, acts powerfully, but in a mediatemanner, on the magnetic needle, precipitates metals, acts onthe muscles and nerves of the eye, &c.; but its direct actionupon the body is extremely weak. The Voltaic Lemon isconstructed in accordance with theoretical laws: it containsin itself the elements of the pile, the exriting acid solution, andthe porous membrane formed by the internal skin of the fruit.The duration of its action depends on the quantity of citricacid fluid contained in the lemon, which fluid, owing to itsgreat abundance, will keep up the activity of the instrumentfor a long period. I may state, without exaggerating, thatthis apparatus offers 1000 times more advantage than thehydro-electric chain. ,

I remain, Sir, yours respectfully,Bentinck-street, Cavendish-square, CHEVALIER LE MOLT.

March, 1852.

PAYMENT OF HOSPITAL PHYSICIANS ANDSURGEONS.

To the Editor of THE LANCET.SIR,—There must have been an error, either in my manuscript

or in the printing of my letter in your number of March 6th.The sums put down as paid to the assistant physicians andsurgeons at St. Luke’s, London Fever Hospital, and Small-PoxHospital, should have been put down as paid to the seniorphysicians and surgeons ; also in the list of dispensaries, we shouldread physician and surgeon for assistant-physician and assistant-surgeon.The error, however, is immaterial, as the real question at issue

is, not how much certain hospitals pay, but what hospitals do notpay at all. In continuation of the list, I have to add-

The Lock Hospital and the Charing-cross Hospital have theunenviable notoriety of being added to the non-paying list.You are quite correct in your statement " that in some of the

institutions named in the second list, the medical officers divideamongst them the fees of students." This is the case also atSt. Bartholomew’s, Guy’s, St. Thomas’s; indeed, this practicemay be taken as the rule at all the metropolitan hospitals. Butit is most important-and I beg to urge this point strongly upon

you-to remember that in no one case do the assistant-physiciansand assistant-surgeons share in this division: only the seniors.Nor have the assistants any claim to a share. We see, therefore,that in the hospitals in the second list, the assistant physiciansand surgeons receive no remuneration in any shape or form. Inthe consideration of the subject, therefore, as respects theassistant physicians and surgeons, the pupils’ fees for hospitalattendance are not to be considered. Even with the full physiciansand surgeons, these fees ought not to be calculated upon, as theiramount varies annually ; indeed, it would add to the dignity ofthe staff if no such fees passed directly into their hands, but wereconsidered hospital property, and an equivalent salary given toboth seniors and assistants. There would be more independenceof feeling in both parties.When the time comes-and, sooner or later, come it will-that

all the hospitals and other charitable institutions shall pay theirmedical staff, arrangements must ensue between the seniors andjuniors; for of course the assistants cannot be paid directly fromthe funds, or any other fund, of the hospital, without the concur-rence of the seniors; but which of course would be at once grantedby the latter, and, therefore, any necessary arrangement on thispoint may be safely left to the parties principally concerned.

I see that there is already organized, in St. Mary’s Hospital, aninstitution which has not yet been one entire year in workingorder, a " Clerical Endowment Fund." I have no invidious

feeling on this matter, and I disclaim all desire to contrast’ spiritual with medical advice given in hospitals; but I cannot. forget that those institutions were, and are, not established for the

former, but essentially for the latter purpose; therefore, à fortiori,the medical staff deserve remuneration ; and we can only

i attribute the previous neglect of the public to an imperfect know-ledge of the facts.

I am, Sir, your obedient servant,r SPES.

THE TORY ADMIRALTY AND NAVAL-ASSISTANTSURGEONS.

To the Editor of THE LANCET.SIR,—I have, with great regret, perused in THE LANCET of

March 13, a letter on the subject of the Assistant-Surgeons ofthe Royal Navy, by a correspondent who styles himself" Amicus Justitise." Were the writer really what his signa-ture implies, he would be aware that he has no right to pre.judge a cause, especially when the party accused has hadneither time nor opportunity for reply. It is, to say the veryleast, an extremely ill-timed production, and one calculatedgreatly to injure the question he appears to have at heart.None of the present Admiralty have ever given an officialopinion on the subject; and until that has been heard, wemust not condemn them.Much, in my humble opinion, may be expected from the

new Board, which is generally acknowledged by all, except" Amicus Justitise," to be one of the most efficient of moderntimes. The Duke of Northumberland, the First Lord, is wellknown as a most liberal-minded nobleman, of high acquire-ments, and a patron of literature and science. AdmiralParker is universally allowed to be one of the most active-minded and indefatigable officers in the service, and certainlylittle deserving of the ungenerous, little-minded allusions tohis bodily infirmities, contained in the letter; and none of theother new members of the Board have ever, as far as I amaware, done anything to prejudice naval medical officersagainst them. I am certain that I am uttering the deliberateopinion of a large majority of those most immediately con-cerned, when I say that our prospects are a hundredfoldbetter under the present, than they were under the lateadmiralty.

In conclusion, I wish, for a moment, to advert to the ex-tremely injudicious behaviour of many, who in their headlongand intemperate zeal for attaining their end, never for amoment reflect whether the means they are employing becreditable or advisable. I am constrained to speak thusstrongly,from the great mischief I have myself seen effectedby such conduct. I have met some fiery enthusiasts whobreathe nothing but fire and sword, not only against thosewho differ from them in opinion,-which they never allow tobe done conscientiously,-but even against more temperatepersons, who will not proceed to the same lengths as themselves.

’ Others make use of unguarded language; introduce the subjecton all occasions, and into all societies, and make not onlythemselves to be regarded as nuisances, but likewise bringgreat discredit on the whole of the body to which theybelong. The cause which we all believe in, and adhere to,

will never be advanced by such persons; on the contrary, it is