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to, there is still much, nay more, for them to do. They donot lack either the power or the means to perform the respon-sible duties entrusted to them, and their subsequent action inthe case of the localities which the recent inquess have madeso notorious will we would fain hope prove that they possessthe will also.

THE FITNESS OF APPLICANTS FORHOSPITAL RELIEF.

THE medical officers of the Children’s Hospital, Birminghamrequest us to give publicity to the following memorandum. Athe questions involved are of deep interest to the public and tthe medical profession, it has been thought advisable to evokdiscussion upon them, previous to the sitting of the managin!committee, on the 13th of October. The chairman of that com

mittee, the Rev. Dr. Miller, concurs with the desire of thimedical officers that a free discussion of the document is de

sirable ; and no doubt our readers will find in it much food fothought.

" MEMORANDUM.

" The Medical Committee have become aware of the frequeniabuse of this charity on the part of parents bringing theirchildren for advice and medicine, who were well able to paythe ordinary costs of these.

" They feel themselves bound by every social considerationto remedy this evil as far as possible, and, therefore, suggestto the Committee of Management the adoption of the following regulations :- " They think it useful at the outset to define the principles

which have guided them in their deliberations. They considerthat the proper objects of the institution are :-

" 1st. The relief of those children labouring under ordinarymaladies, whose parents cannot afford to pay for advice andmedicine, and who yet are not in receipt of parochial pay.

" 2nd. The relief of those children labouring under verysevere or very protracted maladies, whose parents have alreadytaken every means in their power on behalf of their children,and who are able and willing to pay their regular attendants,but who become desirous to have the advantage of the opinionof an additional practitioner, and are unable to remunerate hisservices.

" Regulat-iol1s.1. That the dispenser shall give out the notes daily, be-

tween the hours of three and five in the afternoon." 2. That in the absence of the dispenser, the house-surgeon

shall perform this duty."3. That previous to giving a note, the dispenser shall

institute a series of inquiries as to the pecuniary means ofthe parents or friends of the child, to embrace the followingpoints :-

" A. The total earnings of family." B. The number in family." C. The nature, so far as he can learn, and the duration of

the illness."D. The reception or non-reception of parochial relief, at

the time of application." E. The number of children for whom relief is desired." 4. That in the event of the earnings of the family amount-

ing to 21s. per week, the number of children not being morethan three, the dispenser shall refuse a ticket, supposing thecase is one of ordinary illness of recent origin.

" 5. That he shall refuse a ticket to the parents of a childthe united earnings of whose family amount to :6s. per week,the children being more than three, supposing the case is of thenature specified in No. 4.

"’ 6. That he shall refuse a ticket to persons in the receipt ofparish pay, supposing the case is of the nature specified inRegulation No. 4.

"7. That he shall refuse tickets to more than two of onefamily at the same time, unless the cases are of great urgency,or of contagious nature.

" 8. That he shall refuse tickets, under all circumstances, toshopkeepers, beerhouse keepers, employers of labour, whetherdomestic servants or otherwise.

"9. That in the event of parents bringing a child for relief,suffering from a disease of unusual severity, or of protractedduration, or labouring under a condition requiring for its cure

a delicate surgical operation, a note shall be given to suchparents, providing they do not fall under Regulation No. 8,even if their weekly earnings should amount to a sum abovethe maximum mentioned in llegulations No. 4 and No. 5, or ifthey should be in receipt of parish pay. In such cases, theabove facts to be endorsed upon the back of the notes, for thefurther consideration of the physician or surgeon under whosecare the (taste should come.

" 10. 111 the event of a case having been under the care of aqualified medical attendant, and of that attendant furnishing acerticteate of fitness, a note to be given without further in.quiry. A certificate from a clergyman or minister of religionto be similarly accepted. The Medical Committee reserve tothemselves the right already accorded to them by the laws,and by the express resolutions of the Managing Committee, ofadmitting without delay, either as out patients or as in-

patients, children labouring under disorders of great urgency,as croup, haemorrhage, scarlatina, or malignant sloughing, &c.They propose, however, in the event of the parents of suchcases being in no proper sene of the word necessitous,’that the administration should be entitled to charge them sucha sum per diem as will just cover the expenses of the class ofpatients to which they belong. In the event of refusal tocomply with this regulation, the medical officers propose toexercise their power to dismiss the patients.

,. The Medical Committee are well aware that these regula-tions may have to be moditled, as their experience in the

adaptation of restrictions to improper applicants enlarges.But they believe that the principles embodied in the aboveregulations will be found of general and easy application. Itis important it be thoroughly understood that the aim of theinstitution is the relief of deserving objects only. The Com-mittee, therefore, earnestly invoke the aid of the medical menof the town in discovering attempts on the part of improperpersons to obtain the benefits of this charity, and they pledgethemselves to investigate fully such cases of imposition as maybe brought under their notice.

" They request, in conclusion, that every publicity be givento these regulations, that applicants may be put to as littleinconvenience as possible."

Correspondence.

THE ARMY MEDICAL SERVICE.

"Audi alteram partem."

To the Editor of THE LANCET.

SIR,—THE LANCET of the 26th ult. contains a letter from" A Deputy Inspector- General," which has appeared to a greatmany medical officers to be very specious in its reasoning, andto have misrepresented the grievances,. real or supposed, atpresent agitating the department.

It is very easy for a member of the Inspectorial rank-occu-pying a secure berth or hoping to obtain a better one-to lookback with complacency upon his progress in the service ; butwould the " Deputy Inspector" give his sons (supposing him tohave any) the expensive education now required of men enter-ing the medical profession, and rest satisfied with the emolu-ments, position, and mode of life offered by the army medicaldepartment ? If so, he is a great exception to his brethren.In the absence of abler criticism I would desire to place beforethe public the following out of the many facts which could beurged in reply.The "Deputy Inspector" commences by stating that ‘‘ many

imaginary grievances are set forth to frighten the aspiringmedical youth from entering the department." Will he bekind enough to state any one of these so purely imaginary asto have had no foundation in fact ?

1st. It is undeniable that by the warrant of 1858 certainrights were guaranteed which were afterwards cancelled, andit is equally clear that it was the pressure from without whichforced their partial restoration in the warrant issued somemonths ago. Now, with every individual who entered themedical service under the terms of the warrant of 1858, faithwas broken when a single one of those terms was abrogated.The discontent thereby produced, which never needed to