46 FEMALE MEDICAL COLLEGES.-MEDICAL COSTS.

quence of the state of the country, and but itn.te is receivedfrom tuition fees. Very few of the students are able to payfor tuition in addition to board and other expenses, so that thisneeds to be nearly as much a free institution as are the Statenormal schools."

Other clouds, too, have passed over the Female College duringthe past year. During its period of promise, when " all wentmerry as a marriage bell," the trustees established a Clinicalor Hospital Department for the practical education of the

lady students and the accommodation of patients. From the

difficulty which has arisen of obtaining funds, however, andin the hope that the students will be admitted to the female

wards of the new general hospital now being erected in the

city of Boston, the hospital department in question of theFemale College has been abandoned, and the services of the ladymanagers have been " also dispensed with." " As the first

estate, or Lords, of the institution are unable to pay for their tuition and subsistence, it was scarcely to be expected thatthe second, or Commonr, could very well do so. Consequently,we are not surprised to find the " Board" piteously exclaiming," Are there not gentlemen or ladies of wealth who will providethe College with a fund for the education of nurses ?"

"MACD. Stands Scotland where it did?"RossE. Alas, poor country !

Almost afraid to know itself."

Alas, poor College ! must we not say, when we learn that" The expenses of the institution for the coming year-for

rnt of a building, professors’ salaries, and miscellaneous pur-poses-will be about twenty-five thousand dollars ; and its in-come from its permanent fund about one thousand dollars."

What the income of the State may probably be from othersources, when neither Lords nor Commons have aught beyondthat which " hopeth all things," will not be difficult to predi-cate ! Further, the directors of the Female College have also toconfess that ’’ the objection urged in England against the edu-" cation of male and female medical students on the score of

"propriety, appears to us an entirely valid one," though theybelieve that it is likely to be avoided here as it is with them,by " the establishment of medical colleges for women." OurAmerican friends are, undoubtedly, a very sanguine if not a

very prudent body; for in spite of all the obstacles so clearlyexisting to their own progress and permanency, they cling tothe future. With the microscope of credulity they see thatthe nucleus of a female medical college has already beenformed in London," and consider that

" These favourable indications abroad are very encouragingto the promoters of the cause in our own country ; and themovement here will be accelerated by the reacting influence ofsuccessful European experiment, especially in our fatherland."

" Hope told a flattering tale ;" and this our Boston brethrenhave preferred to listen to, instead of the assurance profferedthem by their own most influential weekly journal. It told

them that the first lady who was bold enough to become theinnovator, who had been well educated, who had graduatedwith honour, who had not sought to pursue any irregularbranch of practice, but had been in the highest sense orthodox,had engaged in practice, and had been most unsuccessful. She

had had the sympathies of a large circle of wealthy and influ-ential friends; yet she failed of patronage, and hence of suc-cess. She was found unable to meet the exigencies of theevery-day duties of her profession, as everyone practicallyfamiliar with the exacting nature of those duties would have

foreseen. The storm, the cold, the night, the distance werebarriers which she could not overcome without assuming the

habits, dress, and manners of the opposite sex. Often, too,the disease which she encountered was of such a nature as to

compel her either to unsex herself in regard to her instinctivehabit of reticence and modesty, or preserve her feminine sensi-bilities by neglecting her professional duties.

Medical Annotations."Ne quid nimis."

MEDICAL COSTS.

A GRIEVANCE loses in interest by being common and oftrepeated. But its triteness, which brings familiarity, by nomeans takes from its urgency. The shoe which pinches often,does not pinch the less hardly ; and it may be doubted, not.withstanding the force of the proverb, whether eels are everreally reconciled by use to skinning. If habit could renderthis process agreeable, it is one to which the members of our

profession might be expected to submit with equanimity. But

although much philosophic resignation is habitually displayedunder such circumstances by medical men, we may be surethat the hardship is felt keenly by those on whom it speciallyfalls ; and it is well that we should not acquiesce in an act ofinjustice so often as to allow it to become an accepted custom.The present state of the law which enforces the attendance

of medical men at police courts, and which constantly inflictson them loss of time, anxiety, trouble, and responsibility, with.out remuneration, is a gross injustice. It is a matter of every-day occurrence. Cacus and his associates, who have been garot-ting the young Alcibiades on his way home from a supper withAspasia, amuse themselves by getting drunk with the proceeds,and the debauch ends in a drunken brawl. The nearest doctoris knocked up, and, after dressing the wounds of these repro-bates, as an act of charity which society demands at his hands,he is further called upon to attend the police court and give evi.dence as to the nature and extent of the injuries. The well-feed advocate puts everything in its best light for the scoun-drels at the bar; and, after one or two adjournments, the

magistrate, finding frum the doctor that the injuries have not, proved serious, resolves to " deal with the case summarily.’TThis decision is very satisfactory to everyone concerned exceptthe unfortunate medical attendant. Where a case is sent upto the assizes, a medical practitioner gets a pitiful allowancefor his time and trouble ; but where it is decided in the magis-trate’s court, the magistrate has no fund at his disposal, andcannot allow any expenses. The grievance is monstrous, butthe case is not unfrequent. An instance occurred this week:--A bricklayer’s labourer brutally assailed a woman in the

street, and inflicted on her a serious wound in the scalp. She

was brought to the surgery of Dr. James Greenwood, of York-place, Upper-street, Islington, and he attended to her. Sub-

sequently, Dr. Greenwood, at the close of the case before themagistrate, applied for his costs of attendance on two occasionsat the court. He had attended the complainant ever since theassauit, and had not been paid. Mr. D’Eyncourt said "hecould not allow expenses, as he had no fund at his disposal forthat purpose."

This is so obviously wrong that we cannot doubt the magis-trates would lend their aid to the introduction of a legislativemeasure providing for the due remuneration of medical prac-titioners summoned to give their evidence in such cases. Herethe magistrate is paid, the lawyer is paid, and so are the

clerks, the ushers, and the policemen : everybody is paid for’ his trouble except the medical man. It used to be so in’

the Coroner’s Court until the late Mr. Wakley placed the. injustice of such an oppressive impost on medical men in

47

so strong a light that the Legislature gave way, and every ments which are stated to have furnished the greater numberprivate medical practitioner who is now summoned to give of cases:-Basses- Pyrénées, Dordogne, Calvados, Gers, Puy deevidence in the Coroner’s Court receives a fee of one or Dome, Ariege, Aveyron, Gironde, Landes, Lot, Ardche, Can-two guineas. The extent of services previomly exacted gra- tal, Doubs, Seine, and Tarn et Garonne. As the mountainous

tuitously may be guessed from the fact that some £70,000 an- countries stand first in the series, some astonishment might benually are now received by members of the medical profession expected at finding the Seine mentioned. Looking at thefor services rendered in the Coroner’s Court. Common justice average duration of life, those Departments do not, however,demands that the services given in the Magistrate’s Court maintain the same rank; which circumstance supplies data forshould be equally well remunerated. At present, the only doubting whether a few instances of extreme longevity affordway of obtaining any payment for services so rendered is by any basis for a judgment favourable to the high standard ofapplication to the Home Secretary upon the certificate of the vitality in the locality in which they occur. The Depart-magistrate that there are special circumstances in the case. ments in question stand in the following order : - Basses-This mode of procedure should always be kept in view. Pyrenees, 7; Dordogne, 42; Calvados, 2; Gers, 20; Puy de

____ Dome, 30; Ariège, 48; Aveyron, 34; Gironde, 18; Landes,52; Lot, 53; Ardè0he, 43; Cantal, 23; Doub.,3, 25; Seine, 54;

THE EXAMINATION OF THE DEAD. Tarn et Garonne, 13.AMONGST the records of the inquests recently held by Dr. The subject is one of interest to statisticians, and of some

Lankester there is one which deserves notice as emphasizing practical importance. Certainly a popular belief is likely toan important caution not always sufficiently remembered. A arise as to the general salubrity of any village or locality notedperson had fallen dead after retching violently, and the coroner, for one or two instances of remarkable longevity. Old Parr

being informed, appointed an inquest, and desired a medical made the fortune of his natal place; and many a village hasgentleman to perform a post-mortem examination. The ac- flourished in filth and insalubrity on the strength of some phe-counts given of the manner of death suggested apoplexy of the nomenal ancient, proof against all the influences which lower

brain as the probable cause; and this supposition was favoured the life-rate of ordinary and average mortals.by all the friends, and generally given out. The post-mortem ____

examination revealed that apoplexy had really been the imme-diate cause : a large clot of blood was effused over the brain ; ARSENICAL POISONING.

it was recent, and was more than enough to account for death. THE recent inquest on a case of suspected arsenical poisoningThe gentleman concerned in conducting the autopsy proceeded, has not presented any novel features of toxicological interest.however, to carry out his duty thoroughly; and on passing to But it should be observed that here, as in other attempts atthe section of the thorax and abdomen, he found the stomach secret poisoning by arsenic, the death was registered as fromand oesophagus to present abnormal appearances indicative of diarhæa. The evidence of the registrar is somewhat am.the action of an irritant poison. This led to further investiga- biguously worded. It is reported thus in The Times:-tions, and it was ultimately proved conclusively that the de- "I accidentally heard of her death on the 6th of February.ceased person had taken oxalic acid as a means of suicide, and I entered the cause of death as six days’ diarrhœa., on the in-that the vomiting induced had caused apoplexy by rupture of formation of John Garner. (The original entry was here pro-vessels of the brain. duced.) There having been medical attendance, I did not

This case -

’

t -ti. 1 - i - t. .i hesitate to register the cause of death."This case is pregnant with an obviously important lesson; hesitate to register the cause of death."and it may not be out of place here to express a regret that It is not easy to determine here whether a medical certificate

the autopsies performed by medical practitioners for the Coro- was given ; but we infer that it was not ; and if so, the factner’s Court and for other purposes are not conducted with greater of registering a death without the certificate of the medicalcare and minuteness of detail than that which in many cases is

attendant seems to us to imply culpable negligence. We trust

found to be given to them. For the purposes of justice, all the that the Registrar General will institute inquiries into the cir.

parts of the body should usually be examined; and a more pre- cumstances under which this death was registered. Negligencecise phraseology, as well as a more accurate estimation of the on the *part of the registrars is the safeguard of secret poi-immediate causes of death, is often much to be desired. Those soners ; and if the certificate of a medical practitioner were in

who have introduced into pathological language the phrase every instance demanded, poisoning would be much more rare.

"fatty heart" have much to answer f r. Since that very loose A noteworthy feature in the evidence of Dr. Taylor in thm

term was adopted, it is astonishing how many people have case was the statement that in a portion of earth from the

died of "fatty heart. " Very various notions are entertained of grave a small quantity of arsenic was found, but that the

what constitutes a fatty heart. Some few evidently consider arsenic in this was in a form perfectly insoluble in water, andthat the presence of fat about the heart warrants that descrip- it could not in any way account for the arsenic found in thetion; and those more skilled pathologists who describe the body of the deceased. This difficulty has sometimes provedcondition of " fatty degeneration of the heart" as the cause of serious, and it is a question which the toxicologist must alwaysdeath, rarely think it necessary to authenticate their opinion be prepared to meet.by more than a hasty glance at the organ implicated. If the

-

heart be found to be "fatty," that is very often considered as COMPARATIVE MORTALITY IN MEDICAL AND SURGICAL

a satisfactory explanation of almost any form of sudden death, CASES.-In 1861, the rate of mortality in the medial wards of

and other organs are disreoarded. Frequently, indeed, examina- ’ the London hospitals ranged between 79 and 107 in 1000;

and other organs are disregarded. Frequently, indeed, examma- while that of the surgical wards had the much narrower rangetions are made with as much care for the Coroner’s Court as for of 4S to 85 in 1000. The highest mortality among medicala well-conducted hospital inspection; less should never be cases was attained in St. Bartholomew’s Hospital; and theexercised, and often more is desirable. highest in surgical cases in St. Mary’s. The mortality among,

male patients was in excess of that prevailing among femalepatients. For men it ranged from 50 to 13S in 1000, for

RELATION OF LONGEVITY TO AVERAGE HEALTH. women between 61 and 92 in 1000. The highest mortalityKtLAOUM Ui- LUMhVOY TO AVt-KAL HLAHH. (without"dis:,2nc!ion of medical and surgical cases) was attained

A CURIOUS calculation has been made for the year 1860 and in King’s College Hospital. The highest rate of mortality inthree preceding years, on the comparative longevity in each of

medical cases, among men, occurred in the same hospital ; but.. -r.’’ ,.. Ti ,- , i , the highest rate among women, in the same class of cases, wasthe French Departments. From this we learn that the annual at Guy’s Hospital. In surgecial cases, however, the greatestaverage number of deaths of persons a hundred years old and mortality among men occurred at St. Mary’s; but the greatestUpwards in France is 148. The following are the fifteen Depart- among women iu the London Hospital.