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the present inequitable and unjust state of things, though Ifear that no fair appreciation or just treatment will be con-ceded us by these potentates until a medical man or a medicalcommittee form a portion of the presiding powers over thepoor-law department at Somerset House.May 19th, 1848.

COPY OF THE REPORT OF THE COMMITTEE APPOINTED BY THEBOARD OF GUARDIANS TO INQUIRE INTO THE REMUNERATIONOF THE MEDICAL OFFICERS OF THE DROITWICH UNION." Your committee report to the board, that in carrying out

the objects for which they were appointed, they proceeded inthe first instance to ascertain, as far as possible, whether thesalaries of the medical officers, as at present appointed, bear afair proportion to each other. After a lengthened inquiryinto this part of the question, your committee recommend anincrease of the salaries of Messrs. Lamb and Barnett, theofficers of the Hartlebury and Ombersley districts,-viz., thatMr. Lamb’s salary be raised from X32 to £40, and that of Mr.Barnett’s, from X35 to £50, the salaries of the other medicalofficers remaining unchanged.

" Your committee in the next place entered upon the generalquestion of remuneration to the medical officers, and areof opinion that the present salaries are not adequate to theamount of labour required of, and performed by, such officers.Your committee are assured by the medical officers that theirsalaries barely cover the cost of drugs used by them in theirattendance upon the sick poor, and that when the cost andkeep of a horse are taken into consideration, they are at apositive loss by their office. Without entering into furtherdetails as to the number of cases, of visits paid, and miles tra-velled by the respective officers, (all of which, however, havebeen under the consideration of your committee,) your com-mittee recommend an increase of X25 per cent. on the salariesof the medical officers, as above amended. This recommen-dation, if adopted, would involve an additional annual ex-

pense of S73 5s., to which must be added the increase ofMessrs. Lamb and Barnett of £23, making a total increase ofX96 5s."Your committee abstain from offering any remarks upon

the general working of the medical department of the poor-law ; at the same time they cannot conclude their report with-out expressing an opinion, that it might be advantageous tothe poor that medicines should be supplied by the unionrather than by the medical officers, who in that case shouldbe paid for journeys and attendance only.May 17th, 1848. W. C. TALBOT, Chairman.W. C. TALBOT, Chairman.

POOR-LAW ARRANGEMENTS IN ORSETT UNION.

DAVID CORBET, M.D.

To the Editor of THE LANCET.SIR A correspondent in the last number of THE LANCET

calls upon the medical officers of the Orsett Union to statethe reasons why they are satisfied with their status, and heseems incredulous that a board of guardians can be a bodyof gentlemen acting honourably to their medical officers. Imistake if a very short statement will not suffice to convincehim of his error.At the formation of the Orsett Union, when the medical

arrangements were about to be entered into, it was requestedthat the medical gentlemen who then held the office of sur-geon to any parish constituting the union, should meet togetherand agree among themselves in what groups of parishes themedical districts should be formed, and it was also intimatedthat the board wished to see no new faces. A meeting ac-cordingly took place, and the arrangements of the districtssuggested by the resident medical men were literally adoptedby the board.At the end of a year, the commissioners, wishing to put on

the screw, wrote the board, advising it to advertise for11 tenders" from medical men for the several districts. The

reply of the Orsett guardians was, that they could not so farforget themselves as to insult professional gentlemen byasking them " to tender." The commissioners, seeing thatthey had to deal with men of gentlemanly feelings, forboreurging the disgusting proposal. Again, the moment the rulesof the poor-law commission permitted, a distinct minute wasmade by the Orsett board, making their medical appoint-ments pro vita ccrt ne eulpa.There have been various modes of remuneration adopted in

this union; not to ascertain the lowest, but to see how thedifferent systems would work in unison with the poor-lawitself. The medical officers were at one time paid entirelyby the case; llg. the case for out-parishes, and 98. 6d. for those

y

in the home-parish. Again, a schedule was added to this, 58.per head, well or ill, but I think I may say that no change wasadopted by the board without a previous consultation withtheir medical officers. We are now paid by a fixed salary,and the extras, as in the minute of the poor-law commis-sioners. I believe the following is pretty nearly correct.

The union house, inmates from 100 to 190, Dr. Corbet, £40.

In conclusion, I may add, that I believe the best under-standing exists between the guardians and medical officers;that any wishes of the former are readily complied with bythe latter, and that any suggestions by the latter are alwaysrespectfully listened to by the board. When in contact withmy brethren in neighbouring unions, and talking over poor-law matters, I often say-° Ah! Orsett is a model union;" andI leave it to your correspondent to say whether or net there isany truth in the remark. I do not so much allude to theamount of remuneration,—that might well be better,-but tothe position of the medical men in the union with reference tothe board.--I remain, yours truly,

Orsett, Essex, June, 1848. DAVID CORBET, M.D.

THE CHARTERS OF THE COLLEGES OF PHYSI-CIANS AND SURGEONS.

10 the Editor, of THE LANCET.;

SIR,—Will you give insertion to a few remarks I wish to, make in answer to a letter by Mr. John Foote in a late num-

ber of the LANCET ?Believing him deserving of praise for his attempt to bring

.

forward the claims of the ill-used members of the College ofSurgeons, (of whom I am one,) I still must demur at his illogicalattempt to institute a comparison between the injuries which

, have been inflicted upon the members of the College of

, Surgeons and those which would have been inflicted upon theextra-licentiates of the College of Physicians.

First, it is not true that all the extras have undergone buta single examination! I myself was examined amongst therest by the highest authority in the college, the President,and underwent an examination of three days’ duration, afterproducing precisely the same testimonials as those requiredfor the licence-namely, a diploma, three years’ hospital prac-tice, and five years’ attendance upon lectures. I had tworeasons for not procuring the licence, which would continuein as full force after the passing of any new law as they are atpresent.

First,-I do not intend to practise in London; it does notagree with my health, and I do not like the place. Secondly,I am what I wished to be, a legal full physician out of London;an intra-licentiate is not as the strict law now stands!Now, Sir, being completely satisfied with what I already

legally possess, and not desiring incorporation with the so-called licentiates, why, in the name of common sense, am I tobe forced to pay an additional fee, if not to pass a fresh ex-amination, not only for what I would rather be without, butalso for what cannot by any possibility be of service to me?I wish not factiously to offer any opposition to medical re-form, but I certainly shall object and refuse to be forced topurchase what I want not. I beg to suggest that those extraswho, like myself, do not appreciate the change, should beallowed to place their names, free of expense, in a sort of sup-plemental list, as one of those provincial British physicianswho did not choose to comply with the new regulations-timewould soon wear it out, and no injustice will have been com-mitted ; thus, too, I shall not be robbed of any pre-existingtitle or right, and the college may, if they think proper, allowthose who do comply to pay their entrance fee, and pass anexamination afresh.When I became a member of the College of Surgeons, I

acquired the privilege of practising as a surgeon, and callingmyself one-and the much and deservedly abused Charter hasnot in any way restricted my practice; the only injustice is aa nominal one; it has created a higher body; but I still remain what I was, " a surgeon," without further examinationor fee.Your correspondent strangely mixes together a nominal

, with an actual grievance. By the new charter to which he

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makes allusion, it was not intended to create a new and higherorder in the College of Physicians-a creation embracing apassive injustice to myself, as in the creation of the fellow-ship of the College of Surgeons. That I should not object to;but it was contemplated to rob me of the title of physician!!or rather, to take away my licence to practise, unless I under-went a fresh examination, and paid a fresh fine. My hold uponmy patients is such that all the titles in the world, whetherheaped upon myself, or lavished upon others to my exclusion,would not affect me one straw; and I could cite many in-stances of surgeons created fellows who have not therebygained a single additional patient; and the converse holdsgood in regard to those who have not been made. I quarrelwith the substance, not with the shadow. My college maycreate what new titles they please, and I am content to leaveit to others to investigate their right to exclude me, or anyone else. But I shall not yield up one tittle of the rights Ialready possess. Like the Taunton pastry-cook, who refusedto give up his diploma of surgeon-who refused suicidally todestroy the only tangible proof of the college having declaredhe was fit and proper to exercise the art and science of sur-gery-like him I should retain, and refuse to deliver up,my diploma of physician. And strange, indeed, must be thatcharter, or that Act of Parliament, which should enable aprosecution to be sustained against me for practising as aphysician, when I already possess the signature of the Presi-dent &c. of the College of Physicians to a legal document,stamped and paid for, certifying that I am from this timeforth for evermore, entitled to practise as a physician in theBritish provinces.Let me, in conclusion, say one word more about another

grievance. An M.D. of London University may at thepresent time dispense his own medicines if he has passed theHall; by the new law he would be disfranchised for disgrac-ing the cloth of a physician. Is it wise to make this law retro-spective ? May I not suggest that those physicians alreadyexisting-who became such under the impression that theymight be allowed to practise generally until their pocketsenabled them to practise as PURES—may they not, I sug-gest, be placed in a supplemental list similar to the onedescribed above? The future law may be another thing.

I remain, Sir, your obedient servant,May 29, 1848. AN OLD ADMIRER.

N.B -When I became a licentiate of the College of Phy-sicians, I became eligible for a fellowship. What a boon,Mr. Foote! How valuable to me!!—too OLD ever by possibi-lity to succeed in rotation, and much too old and too common-place in intellect ever to succeed through merit.

NAVAL ASSISTANT-SURGEONS.To the Editor of TiaE LANCET.

SIR,—Through the medium of the daily press, the public arewell acquainted with the allusions of Mr. Hume in the

’’

House on the 26th inst. The speech of the hon. memberfor Montrose is deserving the thanks of naval medical men.For the information of those medical gentlemen who are moredevoted to medical than general politics, I will quote thespeech of the hon. gentleman, together with the replies ofCaptain Berkeley and Mr. Elliott, as they appeared in TheTimes of May 27, 1848. But as the replies of the latter twohonourable members are evasive, unsatisfactory, and un-

meaning, and deficient in matter, it will be necessary to sub-ject their remarks to a patient and impartial analysis, andthen, Sir, your readers will inquire where is the justice oftreating medical men as boys ? They should bear in mindthat there are two learned professions on shipboard-divinityand physic-yet the profession of medicine is singled out forsuch exclusive and cruel treatment by the naval authorities.

" Mr. HuME said-There was one class of persons connectedwith the navy whose case he was anxious to call attention to;he meant the class of assistant-surgeons. It might not, per-haps, be generally known that those persons were requiredto possess far higher qualifications than was necessary forthose who derived their powers to practise from the Collegeof Surgeons. It was necessary that they should attain anefficiency in three or four branches of knowledge, beyondwhat was required by the Colleges in Edinburgh and London;and yet these assistant-surgeons when put on board ship werecompelled to associate with mere boys, (hear, hear;) they wereplaced among young midshipmen, and were in no respecttreated as gentlemen of acquirements ought to be. The housewould be surprised when h told them of the fact, that aweek ago there was not a single assistant-surgeon a can-

didate for the navy-not one. If Sir William Burnett, a manwhose whole life had been devoted to impart the highest qua-lifications to the profession,-if he had been asked to providean assistant-surgeon for any ship, he would have been com-pelled to admit that there was no candidate for the appoint-ment. Such was the reluctance, nay, the aversion of profes-sional men to enter the naval service in the capacity ofassistant-surgeons. This arose entirely from the neglect shownby the Admiralty to the application made on the part of theassistant-surgeons five years ago. Since that application wasmade the Admiralty had put an assistant-engineer in thesame position as the lieutenants, the very situation in whichthey said they had no accommodation for a medical man.There was no other branch of the service, above the rank ofa private, in which there were not candidates innumerable forvacant situations, and he submitted that this subject wasworthy of being taken into consideration by the Admiralty.Captain BERKELEY said-That the Board of Admiralty

were willing to do everything they possibly could to providegood surgical assistance for the navy, and this was the firsttime he had ever heard of there being any difficulty in gettingassistant-surgeons. With regard to what the hon. memberfor Montrose had stated about accommodation having beenprovided for an assistant-engineer, the lton, member shouldbear in mind that an assistant-engineer is ;not wanted in asailing-ship, and that if he had a cabin in a steamer, it did notinterfere with the gun-room arrangements. But it would betotally impossible, if an assistant-surgeon were obliged to gointo a small brig, to provide him with a cabin, and the conse-quence of yielding to the suggestions made bv the lion. mem.ber would be, to make these young men shirk an unpleasantduty, as well as require more pay, if they went into the ward-room. He must say, for himself, and for those with whom henow acted, that he thought it would be of the greatest pos-sible injury to the service, if the Admiralty were to put theseyoung men over the heads of mates, who were in all respectstheir superior officers.Mr. HUME would be glad to Know m what respect the

mates were superior to the assistant-surgeons-men who hadbeen educated at college.Mr. ELLIOTT remarked that the hon. member for Montrose

seemed to think that mates and midshipmen belonged to thelower order of seamen, whereas in fact they were frequentlysons of noblemen, and in every other respect eligible asso-ciates for the assistant-surgeons.Mr. HUME contended that no sufficient reason had been

pointed out why the assistant-surgeon of the ship should notbe placed on the same footing as the chaplain. He receivedas good an education, and ought to be treated in the sameway."

It is acknowledged by all men of reading, observation, andexperience, that to maintain acquired information, it is neces-sary to be a student through life. Doubly do these remarksapply to medical men, as the longer they practise the healingart, they cannot but acknowledge their imperfect masteryover the two opposites-health and disease. If their lordscommissioners of the Admiralty had really studied to makemedical men inefficient, a more ingenious method could nothave been devised than the present. It is a startling piece ofinformation in these troubled times, that the naval servicecannot command qualified medical men. It is as embarras-sing to the naval authorities as the question in the house,some weeks since, from Lord Arthur Lennox-how thegovernment were to procure medical men for the emigrantships ? If we refer to sanitary measures, to the poor-law andthe public services, the claims of medical men are thrust intothe shade. I believe in 1836 naval instructors were admittedward-room officers, and in 1847 engineers came to the lieu-tenants’ mess, but as these officers are not in brigs, thesevessels have been, with an unaccountable partiality, mentionedas the class where assistant-surgeons cannot be accommodatedwith cabins. Could we not be accommodated with cabins inline-of-battle ships and frigates (of the steam and sailingorder ?) and would one additional cabin in a brig cause thecrew to mutiny, or excite the envy of one private marine orseaman ? We are told that an engineer having a cabin doesnot interfere with the "gun-room arrangements:" this is a

piece of ambiguous verbiage we cannot comprehend. We are; told it is impossible to get cabins in brigs; and this inconsistent

remark betrays itself in the same sentence, when the perilsi to the service that would accrue are spoken of, if the Admi-

ralty were to yield to the suggestion of the hon. member forMontrose : which remark is tantamount to an acknowledgmentthat it can be done.

- Naval medical men, whether amidst the haunts of con-