Графични страници
PDF файл
ePub
[ocr errors]
[ocr errors]

3. Diseases of the Urinary Organs, including Stricture of the Urethra,

Affections of the Prostate, and Stone in the Bladder. By JOHN W. S.

GOULEY, M.D., late Professor of Clinical Surgery and Genito-urinary

Diseases in the Medical Department of the University of the City of

New York; Surgeon to Bellevue Hospital; Fellow of the New York

Academy of Medicine; Member of the New York Pathological Society,

of the Medical Society of the County of New York, &c. With 103

wood engravings. New York and London, 1873

4. A Practical Treatise on the Surgical Diseases of the Genito-urinary

Organs, including Syphilis, designed as a Manual for Students and

Practitioners, with Engravings and Cases. By W. H. VAN Buren,

A.M., M.D., Professor of the Principles of Surgery, with Diseases of

the Genito-urinary System and Clinical Surgery, in Bellevue Hospital

Medical College; Consulting Surgeon to the New York Hospital, the

Bellevue Hospital, the Charity Hospital, &c.; and E. L. KEYES, A.M.,

M.D., Professor of Dermatology in Bellevue Hospital Medical College,

Surgeon to the Charity Hospital, Venereal Division; Consulting

Dermatologist to the Bureau of Out-door Relief, Bellevue Hospital,

&c. London, 1874

5. Address on Surgery delivered before the British Medical Association

at Norwich, August, 1874. By WILLIAM CADGE, F.R.C.S., Surgeon

to the Norfolk and Norwich Hospital

REV. VII.-1. Special Report from the Select Committee on Homicide Law

Amendment Bill; together with the Proceedings of the Committee,

Minutes of Evidence, and Appendix. 1874. (Ordered by the House

of Commons to be printed)

2. Responsibility in Mental Disease. By HENRY MAUDSLEY, M.D.

[merged small][merged small][merged small][merged small][merged small][ocr errors]
[ocr errors]

With Appen-

ib.

[ocr errors]

With Appen-

[ocr errors]

ib.

[merged small][ocr errors]
[ocr errors]
[ocr errors][ocr errors]
[merged small][ocr errors][merged small][merged small][ocr errors]
[ocr errors]
[ocr errors]
[ocr errors][ocr errors][ocr errors][merged small][merged small]
[ocr errors][ocr errors]
[ocr errors][ocr errors][merged small][merged small]
[ocr errors]

THE

BRITISH AND FOREIGN

MEDICO-CHIRURGICAL REVIEW.

JANUARY, 1875.

Analytical and Critical Reviews.

I.—The Limits of Unpaid Service.1

MUCH has been said of late years about the abuse of medical charity, and, as often happens, there has been a mixture of folly and wisdom in what has been said. Some persons who have spoken or written on the subject have betrayed their ignorance of the internal arrangements of our profession, and have advocated measures which were too sweeping to be practicable. Others, again, have professed to deny the existing evils altogether, and have been disposed to rest contented with the present state of things, and even to allow the abuses to go on growing with the growth of our population. But in the present review we shall aim at avoiding both these extremes. We hope to state the case fairly, without exaggeration, and we shall endeavour to propose only such remedies as are compatible with the present medical arrangements of the country. But we beg our readers to understand that, as becomes a medical review, we approach the subject from a professional stand-point. We shall not ignore general considerations, such as we might dwell upon if we were treating the matter from a national point of view; but we shall pass lightly over them,

11. Report of the London Hospital.

2. Report of the Royal Free Hospital (London).

3. Report of the Royal Ophthalmic Hospital, Moorfields.

4. Report of the Lock Hospital (London).

5. Report of the Hospital for Sick Children (London).

6. Report of the City Dispensary (London).

7. Report of the Chelsea Dispensary (London).

8. Report of the Royal Albert Hospital, Devonport.

9. Report of the Northampton Provident Dispensary.

10. Report of the Leamington Provident Dispensary.

11. Report of the Labourers' Self-aiding Medical Club of the Grantham Union. 109-LV.

1

and shall put most prominently forward, and discuss at most length, those questions which affect us as medical men, and which have the most direct bearing upon the standing and reputation of the medical profession.

We have put these numerous reports at the head of this article to show (1) the evils of which we have to complain, as they are exhibited on a large scale, and (2) the various forms of the remedy that we venture to urge.

The reports of the several medical charities-free hospitals and dispensaries-show how enormous is the number of persons who annually seek advice and medicine from these institutions. Several writers have computed what is the total number of individuals who annually apply to the medical charities of the metropolis, and they tell us that it is over a million. We have ourselves gone carefully through the figures for the year 1873, and we make the total 1,288,085. This is altogether exclusive of the Poor Law and of a great number of private and semiprivate institutions which publish no reports. Beyond the medical charity which can be estimated in figures there is a large amount which cannot be tabulated. We may, therefore, rest assured that the total at which we arrive by adding together the figures given in the various published reports is not an exaggerated one; but that, on the contrary, it repre sents only a proportion, a very large proportion, no doubt, but still only a proportion of the whole medical charity of the metropolis. And what is true of London is true also, though in a less degree, of the provincial towns and of the country at large. We may, therefore, safely conclude that a very large percentage of the community rely upon medical charity in time of sickness. In the metropolis this proportion amounts to something like a quarter.

This, then, is the first fact to which we call attention-the enormous number of persons who expect to receive their medical attendance and medicine at the expense of their neighbours, as a matter of charity. It needs no argument of ours to prove that this is a very undue number. In exceptional circumstances-for example, when famine devastates a countrya great part of the population may have to rely upon charity in one shape or another for the necessaries of life. But if such a state of things became chronic, we should think that it augured very ill for the prosperity of the people. Soup kitchens are excellent institutions on an emergency, but it would not be beneficial to have them always in operation for the supply of all comers. And the principle is the same with regard to medical charity. Sickness is not one of the necessities of life, and yet it may truly be said to be one of its neces

« ПредишнаНапред »