poor-law medical officers' association
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result? Or should mercury be expected simply to controlthe successive attacks of which the total evolution of thedisease is composed? In the first case, what should be theduration of the supposed radical cure ? In the second, dothe symptoms of whatever kind, either isolated or in groups,forcibly point, as soon as they appear, to the resumption ofthe mercurial treatment? What amount of confidenceshould be given to the agents of the local treatment usedfor certain forms or certain relapses of the disease ? Shouldthe treatment by cutaneous or subcutaneous absorption(Lewin’s method), either generally or in some cases to bespecified, be preferred to the usual treatment by means ofthe absorbing faculty of the digestive organs ? What isthe value, and what are the comparative indications of thepreparations of mercury and iodine ? Point out, by meansof well-ascertained facts, what reliance the medical mancan place on the use of mineral waters, and especially sul-phureous waters, in the treatment of given forms ofsyphilis.Seventh question: " On the Reorganisation of thTeaching of Medicine and Pharmacy in France."Eighth question: ,On the Practical Means of Improving
the Condition of Medical Men, and of bringing this condi.tion into harmony with the importance of the position theyare expected to take in society." The committee wouldcall attention to the following points :-1. Prevention ofthe illegal practice of medicine and pharmacy. 2. The in-stitution of corporative commissions. 3. More equitablearrangements between medical men and benefit societies.These questions will be treated in the order in which they
stand upon the programme. Thus, the first question willbe taken up on Wednesday, the 18th; the second on the19th ; the third on the 20th; the fourth on the 21st; therewill be no meeting on Sunday except the importance of theagenda require it; the fifth on Monday the 23rd ; thesixth on the 24th ; the seventh on the 25th; and theeighth on the 26th. This document is signed by the pre-sident of the committee, P. Diday, and the secretary, A.Dron.
It will be seen, by a perusal of the questions and thecomments accompanying them, that a large share hasbeen granted to professional interests, surgery, and Statemedicine, whilst medicine proper is left rather in thebackground. Altogether, however, there is a vast field forexertion, both for the medical men of France and suchprofessional brethren in this or other countries as mayfeel disposed to write essays or join in the discussions. Onething is certain, and that is the cordial leception which medical men from these islands will receive at the hands ofour neighbours.
POOR-LAW MEDICAL OFFICERS’ ASSOCIATION.
AT a meeting of the Council of this Association held onthe 2nd inst., the following resolutions were unanimouslyadopted :-
1. That the system of Poor-law medical relief in Englandand Wales is in the highest degree unsatisfactory and ur-gently requires amendment.
2. That as the provision of drugs by the medical officer I
frequently places him in a delicate and false position byprovoking a conflict between his interest and his duty, theextension of the dispensary system to all country towns andpracticable rural areas would be most desirable; and that,as the excess of area in many rural and of population inmany urban districts is very disadvantageous to the sickpoor by precluding even the possibility of efficient medicalattendance, such excessive districts should be reduced, andin no case allowed to extend beyond the limits already de-termined by the Poor-law Board — viz., an acreage of15,000 in rural districts and a population of 15,000 in urbandistricts.
3. That it is desirable that the salaries of Poor-law me-dical officers should be placed on a uniform basis and re-vised triennially, so that the salaries may be estimatedaccording to the average number of cases annually attended(due regard being paid to area); and that, as the duties ofmedical officers are essentially imperial, it is expedient thatthe whole of such salaries should be paid out of the Con-solidated Fund instead of part only, as at present, or that
one-half should be paid from the Consolidated Fundand the other half from a rate distributed over a wholecounty.
4. That as the position of the Poor-law medical officer isnot sufficiently independent of local influences to justifyhis appointment as sole health officer of his district, it isexpedient that a superior health officer, debarred from
private practice, and devoting his whole time to the dutiesof his office, should be appointed to act over a considerablearea, the district medical officer standing in the position ofdeputy health officer only.
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5. That pending the introduction of the dispensarysystem, which, if generally adopted, would amount to avirtual reorganisation of the service, all additional reportsand duties to be required of district medical officers shouldbe paid for on a basis to be determined by the LocalGovernment Board.
6. That copies of these resolutions be sent to the medicalpress, to members of Parliament, and to the President ofthe Local Government Board.
Correspondence.
THE CLINICAL SOCIETY.
"Audi alteram partem."
To the Editor of THE LANCET.SIR,-In your annotation, headed " Clinical Society," in
to-day’s LANCET, I am reported to have slit up the urethra-of one patient to " within a few lines of the meatus." Now,in the case referred to, I stated I had slit up the urethra to"within a few inches of the meatus," and not, as described
by you, to within a few lines of the meatus.The patient will be presented for examination at the next
meeting of the Clinical Society, when you, Sir, will be ableto judge for yourself.
It is only fair to Mr. Jonathan Hutchinson to observethat I did not quote his opinion in support of the operation,but merely to the effect that he considered a patient whopassed his urine through a fistula in the perineum betteroff than one who micturated through a fistula in the rectum,and that I had gathered such opinion from a conversation Ihad with that gentleman in consultation on a case. Mr.Hutchinson had no knowledge of the cases I brought beforethe Society, and could not, therefore, have expressed anyopinion.
I remain, Sir, your obedient servant,Portman-square, March 30th, 1872. W. F. TEEVAN.
*** We regret that our " lines," though few, have notfallen in pleasant places"; but, as Mr. Teevan is positivethat he spoke of inches, we willingly yield him as many ashe chooses to claim. The name of Mr. Jonathan Hutchinsonwas mentioned in connexion with one of several classes of
ases, quoted incidentally by Mr. Teevan in the course of;he discussion, with the very proper and natural object ofstrengthening his position as to the "line of action"adopted
THE "MEDICAL DECLARATION" CONCERNINGALCOHOL.
I To the Editor of THE LANCET.
SIR,- With all respect to the leading members of theprofession who have signed the ,Medical Declaration"concerning the use of alcohol, it has occurred to me that,as regards young practitioners, this " Declaration " is calcu-lated to deter them from using alcohol in proper doses incases in which, in my opinion, it is urgently required. Underthese circumstances, I send you the result of the use ofalcohol in a very bad case of typhoid fever now under mycare. A few days back I was called to see a tall, thin,delicate lad of fifteen years of age, suffering from typhoidfever, well marked: from inquiry, as well as I could makeout, the disease had reached the tenth day. The treatmentduring that time had been occasional doses of aperient