584

THE LANCET.

London, Saturday, July 23, 1842.

BRENTFORD UNION.-THE PRACTICE OF MEDICINE AS

WE are sorry to see that the medical prac-titioners of the Brentford Union have not

continued to act together with the una-

nimity which circumstances seemed to

require. The guardians act in concert.

They have proposed terms for attendance

upon the sick poorof Brentford : those terms

are, we believe, inadequate. The salaries

will not purchase sufficient medicines forthe pauper patients, if the average proportionof the population is attended in the union ;at any rate, they will not yield the medicalmen more than a few halfpence a visit fortheir professional advice. The medical offi-

cers would, therefore, have to do the work ifor little or nothing (though the clergy tellus that the labourer is worthy of his hire),and to defraud the sick of proper medicines

and advice, or to supply them at a pecuniarysacrifice. In the uncertainty that prevailedas to the number of patients, it was impossi-ble to fix the salaries on a fair footing. iWhat, then, was the reasonable course totake? Was it fair or reasonable that the

guardians should be left, without any accu-rate information, to fix the salaries, and todictate at random to the medical professionthe terms on which their professional ser-vices should be rendered? The interests of

three classes are at stake-the sick poor,the medical profession, and the ratepayers.It is admitted on all hands that the sick poorshould be supplied with good medicinesand advice ; the cost price of medicines is

known, and the general rate of remunerationhas been agreed upon: all that remains to

do, therefore, is to adjust the salaries in eachdistrict on this basis, taking into account the,number of patients to be attended, and thesize of the district over which they are dis-tributed. The way is plain ; the ratepayershave their representatives in the guardians,and the medical men should nominate a

committee to acquire the requisite informa-

tion, and to confer with the guardians on the

subject of the salaries. There can be no

difficulty and no dispute, if both parties willtake the trouble to consult the medical evi-

dence submitted to the Parliamentary Com-

mittee, and the minute of the Poor-law

Commissioners. Let the guardians draw uptheir list of permanent paupers to be at-

tended, and agree to pay the sum suggestedby the Poor-law Commissioners for casual

cases. The affair would thus be amicablysettled; or the salaries may be computedfrom the average number of cases, and the

average numbers constantly on the sick-listin each district during the last two years.Here we cannot help regretting that the

guardians and the medical officers derive solittle assistance in practical matters from theAssistant Poor-law Commissioners. The

Assistant-Commissioners were often heard

of when the sick poor were to be depriveof medical attendance, and the remuneratioof the medical officers was to be reduced byDutch auction.

..

THE present state of the law with referenceto unqualified practitioners in medicine, andmore particularly to chemists and druggists,appears to be unknown to some of our re-

formers, otherwise they would not so lightlypropose with the colleges to abandon the

public to the mercy of quacks, and the igno-rance of unlicensed medical pretenders. As

the law now stands, the chemist and druggistcannot practise as an apothecary with impu-nity ; the Apothecaries’ Company have,greatly to their credit, succeeded in establish-

ing this point, beyond a doubt, by repeateddecisions obtained under the direction of the

learned judges. That6the law is violated,we are well aware; still it exists; and it

does unquestionably exercise a most salutaryrestraint on great numbers of ignorant per-sons, who would otherwise engage in the

illicit and destructive administration of drugs.What would be the consequence of emanci-

pating these persons from the terrors of th

585A LEGAL PROCEEDING.-THE TEMPORARY UNIVERSITY.

law and the Apothecaries’ Company? Shouldwe not see hundreds of druggists immediatelystep from behind their counters, and, likeMr. ROBERTS, of Cheltenham, take their sta-tion by the bedside, or meet the fellows of

the College of Physicians in consultation ?

Would not the poor and ignorant be morethan ever their prey ? You say that you

would not appoint them to any office, butwhat would they care for that?

It is asserted that quackery cannot be sup-pressed by law, and that it can only be

banished by the progress of education. The

same remark will apply to the laws againstrobbery and murder; for quackery and crimecannot be altogether suppressed, but theymay be materially diminished, by the laws,if we are to pay any attention to the opinionsand experience of mankind. Theft, it maybe hoped, will decrease as education ad-

vances ; in the mean time, the dread of thetreadmill and other little prison appliances,do keep many young gentlemen’s fingers outof our pockets, and deter other enterprisingindividuals from breaking open dwelling-houses." Why would you maintain a monopoly, or

" prevent people from consulting whomsoever

"theyplease?" asks another class of objectors." Is a druggist not to prescribe a rhubarbpill, tincture of bark, or an emetic ?" iWe are no friends to monopoly. We are liwell aware of the advantages of competi-tion, and have no desire to infringe unne-cessarily upon the natural rights of every manto exercise any profession to which he maychoose to devote himself. We do not pre-tend for a moment that a man who wishes to

practise medicine should be deterred from

doing so because he has not in youth gonethrough a prescribed curricula, or obtaineda specific number of certificates. The systemof caste and hereditary professions has donemischief enough in India and Egypt; wewant nothing of it in England. We do notask for anything so contemptible as " protec-tion," for, thank GoD, we are able to protectourselves ; and if we were not, we are wellaware that we should have very little chance

of obtaining protection from the Legislature,which has none to spare for anybody, exceptthose helpless innocents, the farmers and

their 11 friends," the landlords.To attempt to prevent people from taking

salts, or senna, or bark, or any such simples,would be absurd ; and it would be still moreabsurd to attempt to prevent them from con-

sulting or taking the opinion of any neighbour,old woman, or druggist, upon the conditionand cachexies of their economy. But this is

not the question. Various powerful remediesare required, and are administered in dis-

ease ; and it is clearly evident that in suchcircumstances life will be sacrificed in many

instances, if the charge of the cases be suf-fered to fall into the hands of ignorant per-sons. What, then, can be more advantageousto the public, than to say that all who willestablish their competency shall be at liberty

to practise medicine; but that unqualifiedpersons shall not attend as medical advisers,nor be permitted to tamper with the lives of

Englishmen ? This restraint on the" freedomof trade" would be of precisely the samecharacter as legal restraints on murder andsuicide: would it be less wise and reason-

able ?

UNIVERSITY OF LONDON.

THE following conversation occurred in theHouse of Commons, when it was proposedto vote 451Cl. for the purpose of defrayingthe expenses of the University of London :-Mr. G. W. WooD inquired whether the

vote was the same as last year, and if notwhy it had been diminished ?The CHANCELLOR of the EXCHEQUER said

there was a diminution in the vote of 5871.Communications had been had with the uni-versity, and the reduction in the salaries tothat amount had been agreed to.Mr. G. W. WooD believed the senate did

not concur in the proposed reduction. Theyacquiesced, but were opposed to it.

Sir J. GRAHAM: The reductions madewere principally in the salaries of the exa-miners, and as several of them were interestedin the vote no doubt many of them were op-posed to the reduction. They had also seatsin the council, and voted in the apportionmentof their own salaries. He was glad to say,however, that many of them approved ofwhat Government proposed. One of the