appointments
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not only to pay the lecturers well, but to maintain clinical wards at thehospitals. Asked whether any distinguished men were excluded fromhospital appointments on account ot not possessing the Fellowshipdiploma, of the Royal College of Surgeons of England, hereplied, "Oh no,not at all. The fellowship is open to everyone. It is only a questionof the ability of those who are able to take this position. Every;hospital appointment is open ; but if candidates had not theknowledge to pass this examination they would not obtain one.There were no fewer than nineteen examining boards, differing verymuch in their examinations ; but the London examinations were byfar the most severe." The witness spoke in high terms of themethods of teaching adopted at the Vienna Medical School, whichwas under State direction, and said there was nothing in London to becompared with the instruction given there. The professors devotedtheir whole time to the work. Honorary work done by physicians and.turgeons gave great trouble, and was frequently a very great drawbackto private practice. In the course of eleven years his connexion withSt. George’s Hospital had cost him .622,003. The Chairman: Does yourexperience in a hospital lead you to believe that there is any reticenceon the part of men connected with the hospitals to come forward TheWitness : Those attached to the hospitals might scarcely be able to tellyour lordships anything more about them than is absolutely on thesurface, and it could scarcely he expected from those attached at thepresent moment to the hospitals that they should tell the wholetruth with regard to the working of them. He did not believe hospitalscould be reformed without detaching the schools from them.Lord Spencer : Do you consider that the workhouse infirmaries
would be important for the students at the central medical school?Witness : Well, I doubt very much if they would be. The cases inthose places are of no practical interest to the student. The witnessthought chronic cases could be seen in any ordinary hospital. He hadnot heard of any skilled practitioner using the out-patient departmentfor consultation.Lord Spencer : Would you make the Central Government appoint the
professors ? The Witness : That is a matter of detail. A compositeboard might be appointed for this purpose to examine candidates. The
witness, in reply to Lord Kimberley, stated that by adopting the planof Vienna a saving would be effected for the hospitals, and better men,with more time for study, would be appointed as lecturers.Lord Kimberley: As a result of this education at Vienna, which
you say is very superior to the education given here, are themedical men in Vienna and in the Austrian Dominions superior inknowledge and skill to those who are educated under our system ? TheWitness : We have in England no such men as Skoda or Rokitanski.His lordship repeated his question, and the witness replied that it was a’very invidious thing for him to say. Lord Kimberley : How can we judgeof such a system except by the results ? I want to ask you whether themen there are, for the most part, more highly and better qualified thanin London? The Witness: They are not perhaps better qualified thanthose who take the higher qualifications, but the majority of them arefar better qualified. On the question of special hospitals the witnessexpressed himself in favour of a controlling body which would beobliged to give licences or some permissive order, which he thoughtwould be a very great advantage indeed.On Thursday the first witness examined was Hemy S. Bennett,
M.B. Camb., L R.C.S., a general practitioner. After his general exami-nation, Lord Thring asked a number of questions referring to sub-scribers’ letters, which the witness said he looked upon as bribes tosubscribers. lIe admitted the system was legitimate, but not acharitable one, and said he regarded it as scandalous for an institutionlike St. Thomas’s, which had an endowed fund for purely charitablepurposes, to devote a portion, however small, to such cases as were.admitted to paying wards.
Dr. Sinclair Thumson, M.D., F.R.C.S.E., formerly consulting phy-sician to the General Hospital, Peterborough, and physician to theKensington Free Dispensary was called. He thought that a system ofcooperation between hospitals and dispensaries was much requiredHe considered the system of paying wards most useful. He suggestedthe establishment of a central board having inspectors to visit the dis-pensaries and hospitals not necessary under Government, but someauthority like the Charity Commissioners. -Lord Cadogan: Do youconsider that on the whole the condition of things which pievails callsfor any very drastic cure or amendment? The Witness : No.
Dr. Kay, of St. George’s-in-the-East, a practitioner of thirty years’standing, said he knew of mtny cases where the abuse by persons, whocould afford to ray, of the hospital was glaring. He instanced a numberof cases from his own knowledge. The competition had starved outseventeen good practices during the last twenty years. In the past,practitioners had made vast fortunes in that district. He thoughtsociety could not get on without the out-patient department of theLondon Hospital, as it removed and relieved a very great deal of misery,Me thought, however, that this department should be affiliated to theprovident dispensaries, and he would ra:her have patients in the firstinstance treated at the dispensaries. He would not mix pauperism upwith hospitals or the dispensaries. The present system tended topauperise the people and degrade the practitioner. Recipients ofhospital relief took it quite as a matter of course, and saw no charity init. He would like to see the whole of hospital charities under someboard of supervision, just as the board of guardians was supervised bythe Local Government Board. He thought the system of part payment,as a regular commercial system was very bad, as poisoning the publicmind, and taking away all respect for the charity.Mr. Lennox Browne was,recf1.11ed, and corrected some figures with
reference to the Throat and Ear Hospital given by the Charity Com-missioners. He stated that the cost per bed of that hospital for theyear 1887 amounted to .661 10s. 8d and the average for five yearswas R63 13s. 10d. He thought the Commissioners had no rightto puhlish figures referring to the cost per bed without giving thehospital authorities an opportunity for checking them.-LordThring: Have you any opinion as to the centralisation of medicalschools?-The Witness : I have no doubt it would be desirable, butvested interest is too strong to permit of its being easily brought about.The witness stated that he had a strnng opinion on the questionof the Scotch and Irish degrees. If a graduate of the United Kingdom-say, from Dublin or Edinburgh, Oxford or Cambridge-did not possesswhat was really an inferior degree (that of the Fellowship of the RoyalCctlege of Surgeons of England), he could not be admitted to an appoint-ment in these hospitals. The Chairman: And therefore you considerthat many good men are excluded from appointments because of this
protective system ? The Witness : I have no doubt of it. There is agentleman who has recently come to London, and who was formerly aprofessor in Andersen’s College, Glasgow, and an examiner for thequalification of the College of Surgeons in Glasgow, who is absolutelyunable to get a London hospital appointment because he does notpossess a London degree, and it is a hardship to ask a man of forty orforty-five years to take up an examination which he would have beenquite competent to pass as a student.-The Chairman : But that doesnot obtain in all the general hospitals ?-The Witness: I believe so,except in St. Mary’s.Mr. J. F. Garioch, secretary of the Tower Hamlets Dispensary, gave
evidence in support of the dispensary system, and contradicted thestatement of Sir Edmund Currie, which referred to dispensaries asmere doctors’ shops.The Committee adjourned.
Appointments.Successful applicants for Vacancies, Secretaries of Public Institutions, and
others possessing information suitable for this coltt7nn, are invited toforward at to THE LANCET Office, directed to the Sub-Editor, not laterthan 9 .0’clock on the Thursday morning of each week for publication inthe next number. ----------
ATTERIDGE, JOHN J., M.D., M.Ch.Irel., has been appointed MedicalOfficer of the St. Veronica’s Retreat, Chiswick.
BARCLAY, JOHN, M.D.Aberd., has been appointed Parochial MedicalOfficer for Banff, and Joint Parochial Medical Officer of Alvah,Banff. £ .
BURD, EDWARD, M.D., M.C. Cantab., &c., has been appointed Consult-ing Physician to the Salop Infirmary.
BURD, EDWARD LYCETT, B.A., M.D., B.C. Cantab., &c., has beenappointed Physician to the Salop Infirmary, vice Edwd. Burd, M.D.,M.C. Cantab., resigned.
COLTART, WILLIAM W., L.RC.P.Lond., M.RC.S., has been appointedMedical Officer for the Headley District of the Epsom Union.
CUTHBERT, WILLIAM, M.R.C.S., has been reappointed Medical Officerfor the Mendlesham District of the Hartisxnere Union.
DISNEY, HENRY, M.B., L.M.Dub., has been appointed Medical Officerfor Redbourn, St. Albans (Herts) Union, vice Wilson, resigned.
DUGUID, W. R., M.D.Aberd., has been appointed Parochial MedicalOfficer for Rathven, Banff.
EVANS, Hown.L T., M.R.C.S., has been appointed Medical Olficer forthe Rock District of the Bedwellty Union.
FERGUSSON, WILLIAM, M.D.Aberd., has been appointed ParochialMedical Officer for Boyndie, and Joint Parochial Medical Ofiicer forAlvah, Banff.
FORBES, GEORGE. M.D.Aberd., has been appointed Parochial MedicalOfficer for Bellie, Banff. £ .
HALL, F. W., M.R.C.S., L.R.C.P., has been appointed Assistant HousePhysician to Guy’s Hospital.
HARRIES, JOHN D., M.R.C.S., has been appointed a Surgeon extra-ordinary to the Salop Infirmary.
HEHNER, OTTO, has been appointed Public Analyst for the adininistra-tive county of the Isle of Wight.
HICKMAN, H. V., M.R.C.S., L.R.C.P., has been appointed House Phy-sician to Guy’s Hospital.
HUTCHINSON. R. JAS., M.D.Edin., has been reappointed Medical Officerand Public Vaccinator for the No. 2 District of the CockermouthUnion.
JACKSON, ARTHUR, F.R.C.S., has been appointed Surgeon to the SalopInfirmary, vice Harries, resigned.
LATHAM, GEO., L.R.C.S., L.R.C.P. Edin., has been appointed MedicalOfficer to the Walsall and West Bromwich District Schools, vice A.P. Evans, resigned.
MORCOM, AUGUSTUS, L.R.C.S. Edin., has been reappointed MedicalOfficer for the Houghton Regis District of the Luton Union.
MORRISON, R. S., M B., C.M. Edin., has been reappointed MedicalOfficer for Cleckheaton.
NiSBET, F. J., M.R.C.S., L.R.C.P., has been appointed House Surgeonto Guy’s Hospital.
PAGET, P.. M.R.C.S., L.R.C.P., has been appointed House Surgeon toGuy’s Hospital.
PRITCHARD, TREVORJ., M.B.Edin., L.R.C.P.Loiid., hasbeen appointedMedical Officer for the East Retford District of the Retford Union.PURSLOW, C. E., M.D.Lond., M.R.C.S., Honorary Obstetric Officer to
Queen’s Hospital, Birmingham, has been appointed Ingleby Ex-aminer, Queen’s College, Birmingham, in conjunction with ProfessorLawson Tait.
ROBERTS, JOHN L., M.B., C.M.Edin., has been appointed MedicalOfficer for the Abergele and Pensarn Union District.
SCOTT, C. G. ROBSON, M.B. Edin., M.R.C.S., L.R.C.P. Lond., has beenappointed House Physician to the City of London Hospital forDiseases of the Chest, Victoria-park.
STEWART, WM. L., M.D. Aberd., has been appointed Parochial MedicalOfficer for Fordyce, Banff.
SYREE, ANTON HUGH, M.R.C.S., E.S.A. Lond., Assistant MedicalOfficer to the Wilts Asylum, has been appointed Assistant MedicalOfficer to the City of London Asylum, vice Thos. Duncan Greenlees,M.B., C.M.Edin., prnmoted to the Medical Superintendency ofGrahamstown Asylum, Cape Colony.
THOMSON, H. ARNOLD, F.R.C.S.Irel., has been appointed MedicalOfficer and Public Vaccinator for the Bray and Hurley Districts ofthe Cookham Union, vice Dr. Curwen, resigned. Also to the staffof the Maidenhead Hospital.
TWEEDIE, F. KING. M.B.Irel., has been appointed Assistant MedicalOfficer for the Fourth District of the Mansfield Union.
WALLIS, A. WM , M.R.C.S., has been appointed Medical Officer for theCottage Homes of the Parish of Shoreditch.
WILLIAMSON, R. T., M.D., M.R.C.P.Lond., B.S., M.R.C.S., L.S.A., hasbeen appointed Honorary Medical Officer to the Pendleton BranchDispensary of the Salford Royal Hospital, vice A. Jasper Anderson,M.A., M.B. Oxon., resigned.
ERRATUM.—In the last issue of THE LANCET, the qualificationsfollowing the name of Thomas Nesbett Wright should have beenM.R.C.S., L.R.C.P. Lond., instead of L.R.C.S., L.M. IreL