1012 THE WORKMEN’S COMPENSATION BILL.

THE WORKMEN’S COMPENSATION BILL.

(AS AMENDED BY THE STANDING COMMITTEE ON LAW, &C.)BY ALBERT BENTHALL, F.R.C.P. EDIN.

AFTER various interviews with leading railway, insurance,and other officials representing large employers of labour,I have drafted the following questions which are being putbefore the Highways Committee of the London CountyCouncil, the Railway Committee, and the Committee of theAccident Insurance Offices Association. I shall be obligedif you will allow me to place them before the professionthrough your columns with the notes explanatory of the

position, which I have appended :-MEDICAL QUESTIONS FOR CONSIDERATION

Be Notice of Accident, Clause 2, (2), page 3, lines 2-3.Question 1.-Should not the workman state the cause of the accident

and nature and extent of the injury ?" "

Question S.—If so, whether " in ordinary language" or on a form ?Be Examinations of Medical Referees, (15), page 20, lines 8, 9, 10.Question S.-Should the employer have notice of the time and place

fixed for the examination ? PQuestion 4.-Should the medical referee, when declining to give a

certificate, state his reasons for so declining ? (The certificate of themedical referee is to be conclusive.)Re Examinations by Medical Practitioners provided and paid by Em-

ploye,rs. 1st Schedule, page lD, (15). (In future these examinationswill only be made under the regulations of the Secretary of Stateand at the intervals prescribed therein.)

Question 5.--Should notice of the intended examination be sent tothe workman, so that his doctor may be present if the workmandesires it ?

Question 6.-Or are in some cases surprise visits necessary ? PQitestio)t 7.- Should a workman be required to submit himself for

examination awav from his home ?Question 8.-What should be the regulations as to the intervals

, between examinations ?

-, Question 9.-Do the present medical referees in all cases commandt the confidence of the public ?f Question 10.-If not, what should be the requirements of the Secre-

tary of State when appointing medical referees with the largelyincreased powers of the new Act ?

NOTES.

Question 1.-1 originally suggested, before the Depart-mental Committee of the Home Office was appointed, thata workman in his notice of accident should append a shortmedical certificate, and I still am of opinion that this wouldbe in the interest of every bona fide injured workman andthat it would save employers from many bogus claims. Iwas informed, however, that it was impossible, as the laboursocieties were strongly opposed to it on the ground thatmany injured workmen could not afford the expense, thatthe Government certainly would not pay the fees, and thatthe employers could not be asked to pay for certificateswhich it was the interest of the workman to place beforethem. In view of all this, I have put the question in theabove form and there is a general consensus of opinion thatthe "cause of the accident and nature and extent of the

injury" should be stated.Question 2,-1 think it is evident that if the above is

required it should not be in the ordinary language of theworkman but on a short form requiring only short answers,which could be obtained free at any post-office.

Question 3.-The medical referee is to act as a judgewhose decision is final and not subject to appeal. It isevident that the workman must be informed of the time andplace of examination and that he can have his medicalattendant present at the examination. It is considered byemployers that it would be unfair if they had not the rightof being represented at the examination by a medical man incases in which they thought it necessary.

Question 4.-It is considered that it would be no hardshipon the medical referee, since he will have received his fee forthe examination and certificate, if when he declines to givea certificate, that he should be obliged to give a detailedstatement of his reasons for so declining, and that thiswould be in the interest of both employer and workman.

Qltestions 5 and 6.-This raises a very important questionit is evident that no medical practitioner provided and paidby the employer can interfere with another medical man’spatient or remove dressings and at first sight it would seemthat the workman should be in every case notified of thetime and place of the intended examination, so that he couldhave his medical attendant present, but we have to consider Ithe experience of the last seven years and certain hard I

facts which it must be admitted occur, and which mustbe provided against. It has been found that when the

,

workman knows the time of the examination he veryseldom has his medical attendant present, as he doesnot wish to pay any fee; it is only when the employerdisputes the fact alleged as to the injury and the case is inthe hands of a solicitor that a medical man attends on the

part of the workman and then in nine cases out of ten notthe medical attendant but a stranger, imported by thesolicitor into the case, of which he knows nothing. Again,it is stated that in certain cases of malingering, if notice ofan intended visit is given, the patient will be found groaningin bed instead of about the house and dressed or away fromhis house altogether. There is therefore a strong consensusof opinion on this point that surprise visits should be allowedand I do not think that this will be against the interest ofthe profession, as employers will not send a "medical prac.titioner " to make a surprise visit, except in suspicious cases,as he could not report if the man was out or if his injurywas in antiseptic or other dressings which could not beremoved without the medical attendant.

Question 7.-This would be necessary in many cases andwould not be a hardship if the distance were not unreasonableand the employer paid the fare, but the workman should notbe under the obligation if he wished his medical attendantto be present, as the expense of bringing the medical manaway from his visiting district would be prohibitory.

Question 8.-This is almost an insolvable problem ; theclause has evidently been introduced to prevent a certainpractice which is highly objectionable-that of continuallyrequiring the workman to submit himself for examinationwith a view of worrying him into a settlement of his claim.I think, however, that this practice will automatically ceasewhen settlements have to be registered in the county courtand will be upset if unfair. If, however, the Secretary ofState must make regulations it is clear that one interval willnot suit all the differing cases and hardship might arise. Ithink a limit might be fixed, to be altered, however, in anycase with the consent of the medical attendant of the work-man.

Q1bestion 9.-1 am sorry to say that in some instancesmedical referees do not command the confidence of theprofession in their districts or of many employers that I havemet.

Question 10.-It has been impressed on me by bothemployers and workmen that a new list of medical refereesshould be appointed, each newly appointed man being asurgeon of experience, used to the examination of accidentalinjuries and all forms of malingering ; he should not be

employed by any firm of employers, or society of workmen,or by an insurance office doing workmen’s compensationbusiness, and, if possible, he should be a surgeon to thelocal hospital. It is certain that if the medical referee whosedecisions are to be final and conclusive does not commandthe entire confidence of the profession in his district anintolerable state of things would arise and the Act becomeunworkable.

THE QUATERCENTENARY OF THEUNIVERSITY OF ABERDEEN.

A BRILLIANT series of functions took place from Sept. 25tbto 28th inclusive, both town and gown uniting in

making celebration week one never to be forgotten in thehistory of the University. Among the most notable featureswere the absolutely perfect weather, the catholicity of theresponse to the University’s invitation-from Canada and theCape, from Australia and India, from North and South

America, from Syria and Japan, and from every country inEurope-and the excellence of the organieation, the detailsof all the ceremonies being attended to with Japanese fore-thought and thoroughness. The only suggested improvementwas that of Professor Ostwald that the text of a speaker’saddress should be projected by means of an optical lanternon a large screen above the speaker, line by line appearingas he proceeded, so that every one of the many thousandspresent could have followed the words.The celebrations opened on the morning of the 25th with a

commemoration service in King’s College Chapel. Theattendance had to be limited but was strictly representativeand cosmopolitan. The rich colours of the gowns and

1013THE QUATERCENTENARY OF THE UNIVERSITY OF ABERDEEN.

uniforms worn blended in picturesque harmony with thebeautiful chapel, the whole forming a picture of the greatestbrilliance and splendour. In the afternoon a procession ofthe members of the University, guests and delegates, andthe town officials took place from Marischal College tothe Strathcona Hall, between 3000 and 4000 personstaking part. It was a magnificent and brilliant

spectacle, nothing like it having ever been seen inAberdeen, and in point of gorgeousness of colour and of

picturesqueness it was superb, while the number of dis-

tinguished men from many lands was remarkable. In thehall a most imposing ceremony took place in the receptionof the delegates. The delegates of each country rose whencalled on and approached the dais, while the band playedthe national air of their country. One delegate spoke foreach country and many congratulatory addresses from thevarious universities and institutions were presented to theChancellor. There was a constant succession of delegatesfor about two hours. St. Bartholomew’s Hospital, London,was represented by Sir Dyce Duckworth and the text of hisaddress was as follows :-

UNIVERSITATI ABERDONENSISCHOLA. MEDICINAE SANCTI BARTHOLOMAEI APOSTOLI APUD

LONDINENSESS. P. D.

Quarto jam saeculo diem referente natalem Universitatis vestra9,gratulatur vobis animo libentissimo schola Hospitii Sancti Bartholomaei,et bona omnia et fausta precatur.Misimus feriarum vestrarum non modo testem sed etiam participem

collegam nostrum Dyce Duckworth, Equitem Auratum, emeritumhospitii nostri medicum.Non enim sumus immemores inter alumnos Aberdonenses qui

doetrina ae virtute UniB er i’atis suae annales exornaverunt. compluresin re medica illustre.3 scholae nostr.1e ampliorem ’amam contulisse.Nihil ergo, viri doctissimi. hodie auspicatius arbitramur quam

doctrinae sedi tam insigni in posterum per saecula plurima fortunam indies feliciorem exoptare. Valete !

The following is the text of an address presented by Mr.Henry R. Swanzy, President of the Royal College of Sargeonsin Ireland, in the name of the College :-

PBAECLARAE UNIVERSITATI ABERDONENSIREGIUM COLLEGIUM CHIRURGORUM APUD HIBERNOS

S. P. D.Vehementer vobis, viri illustres, gratulamur quod quattuor saeculis

prospere decursis quintum iam auspiciis faustissimis inch"atis.Universitas Aberdonensis cum primum orta est anno post Christum

natum MCCCCXCV. in ipsis incunabulis Facultatem Medicinae longein his finibus antiquissimam instituit-cuius rei gratia sit conditorivestro sagacissimo Gulielmo Elphinstone.Unde est orsa in eo perstitit atque nunc perseverat. Per annos iam

quadringentos haec regna, imperium Britannicum, cuncti deniquehomines Universitati vestrae Scientiam Disciplinamque Medicamauctas fotas ornatas gratis animis assignarunt et assignant.Anatomiam Activam, quae dicitur,-studium arti quam praecipue

noscolimus coniunctissimum-usque ab anno MDOXXXII. successuoptimo exercuistis.Iuvat referre nomina Professorum et Alumnorum Aberdonensium qui

in summam claritudinem rei Medim et peritia et exercitatione perven-erunt. Ne taceamus Andraeum Moir. Gulielmum Pirie, MatthaeumDuncan, Andraeum Clark, quattuor denique Gregorios qui de ScholaMedica intra muros Academicos condenda tam bene meriti sunt.Plures immo plurimos alios viros insignes memorare liberet, sed finibiseertis continemur ultra quos veremur ne iam iam egressi simus.Restat ut Universitati Aberdonensi totis animis de hae tam felici

oecasioneetiamatqueetiam gratulemur et votadignissimanuncupemus {pro perpetua eius incolumitate faustoque novi saeculi initio.

Nomina Subnotabamus.HEKNicus R. SwANzy, Praeses.

’

JOHANNES LENTAIGNF, Praesidis Vicarius. 1

Id. Sext. MCMVI. CAROLUS CAMERON, Secretarius. :In the evening a banquet was given in the music hall by ]

the town council, the students meantime having a torchlight iprocession.The opening ceremonial on Sept. 26th was the conferment

of honorary degrees in the Mitchell Hall. Seldom, if ever,has any university had the privilege of bestowing the highesthonour in its gift upon such a large and representativecompany of eminent men, among whom were the followingdistinguished medical men : Sir James Crichton-Browne,Lord Chancellor’s visitor in lunacy ; W. Einthoven, pro- :fessor of physiology, Leyden ; Herbert Mackay Ellis,Director-General of the Royal Navy Medical Service ;Carl Flügge, professor of hygiene, Breslau ; H. J. Ham-

burger, professor of physiology, Groningen ; Ferdinand l

Hueppe, professor of hygiene, Prague; Howard A. Kelly,professor of gynaecology, Johns Hophins University,Baltimore; Sir Alfred Keogh, Director-General of the t

Army Medical Service ; Radolf E. Robert, professor of i

pharmacology, Rostock ; Casimir Kostanecki, professor of l

anatomy, Cracow; Hugo Kronecker, professor of physiology, t

Bern ; Sir Francis H. Laking, physician-in-ordinary to HisMajesty the King ; Oscar Liebreich, professor of pharmaco- (

logy, Berlin ; Friedrich Loeffler, professor of hygiene,

Greifswald; Uesare Lombroso, professor of psychiatry,Turin; Donald MacAlister, President of the General MedicalCouncil ; A. B. Macallum, professor of physiology, Toronto;Sir John Macfadyean, principal of the Royal Veterinary0 ’liege; Jinzo Matsumura, professor of botany, Tokyo ;Edmund Owen, Vice-President of the Royal College ofSurgeons of England; Rev. George E. Post, professorof surgery in Johanite Hospital, Beirut ; Sir Richard DouglasPowell, President of the Royal College of Physicians ofLondon ; Guglielmo Romiti, professor of anatomy, Pisa ;Ronald Ross, professor of tropical medicine, University ofLiverpool ; Frederick Trendelenburg, professor of surgery,University of Leipsic; Sir William Turner, Principalof the University of Edinburgh ; J. William White, pro-fessor of surgery, University of Pennsylvania; J. W. vanWijhe, professor of anatomy, University of Groningen ; andSir John Williams, late professor of midwifery, UniversityCollege, London.

In the afternoon an interesting feature was the athleticsports at King’s College, while in the evening a reception inthe Art Gallery and a students’ ball attracted the attentionof the visitors. The Medico-Chirurgical Society held dinnerson the 26th and the 28th, at which Professor A. Ogston andDr. Angus Fraser respectively presided over very pleasantcompanies of eminent medical men.

Thursday, the 27th, proved the most memorable day, whenHis Majesty the King, accompanied by the Queen, came todeclare the new buildings open. The quadrangle was con-verted into a spacious assembly hall for the occasion, andthe seating of over 4000 spectators was carried outwithout a hitch. The scene during the arrival of the greatassemblage was exceedingly picturesque. Their Majestieshad a most cordial reception. Miss Ramsaypresented theQueen with a bouquet and Principal Lang read the addressfrom the University. The King, in reply, said: ° Onbahalf of myself and the Queen, I thank you heartily foryour cordial welcome and your dutiful address. It givesus great pleasure to be present at this commemoration of thefounding of the two institutions incorporated with theUniversity of Aberdeen, which, during four centuries, hasplayed so distinguished a part in the advancement oflearning. Your allusions to the close association of many ofmy predecessors on the Throne, especially of my august andbeloved mother, with the University are of deep interest, andI shall always feel a lively concern for its welfare. I am

glad to know that with this commemoration is combined anotable addition to the equipment of the University. It

gives me much pleasure to open these new buildings for thepromotion of scientific and higher education, for I am wellassured that the further pursuit of those studies will advancethe prosperity of this part of my realm and add to the greatname and traditions of the University."The Royal visitors graciously inspected part of the new

buildings. The Royal Army Medical Corps (Volunteers),under the command of Major J. Scott Riddell, M.V.O., wereproud of the distinction accorded them of forming a guardof honour at the entrance to the quadrangle.

Their Majesties, after leaving the University, were enter-tained by the corporation at the Town House, while duringthe evening the great Strathcona banquet was held, at which2400 guests were present. 0 ver 70 tables were set and apleasing feature was the seating together of old class-fellows,so that the gathering really resolved itself into a series ofclass reunions. The hall presented a magnificent spectacleand the whole occasion was a conspicuous success. In givingthe toast of " The University of Aberdeen," Lord Balfour ofBurleigh paid a high tribute to the virtues of the universitiesof Scotland ; they were, he said, national institutions whichhad caught the genius of the nation and rendered signalservice to the nation at large. They had been animated bya high tone of learning for learning’s sake and that was whythey had been successful. The banquet was a remarkableevent in the University’s history and the graduates andstudents will not readily forget the generous hospitality ofLord Strathcona.

In the forenoon of the 28th excursions were made to placesof interest, while in the afternoon a reception was held atthe infirmary. The closing functions were an "at home"

"

in Marischal College and a students’ symposium in theMusic Hall. All the buildings were thrown open for inspec-tion during the former function.On reviewing, in Professor J. Arthur Thomson’s words, the

days of celebration one sees again a succession of impressivepictures-the chapel service, the light streaming through a.

1014 HOSPITAL AND MEDICAL SCHOOL DINNERS.

window and almost transfiguring a well-known venerablethinker who looked like a picture of philosophy ; theacademic pageant with its dazzling variety of costumewinding through the crowded streets ; the reception of

delegates, when university after university, country aftercountry, marched past the Chancellor leaving addresses ofgreeting ; the capping of the honorary graduates, a phalanxof immortals ; the sea of faces filling the quadrangle whenthe King opened the new buildings ; and the feeding the2400 in the Strathcona Hall. In all these pictures therewas immediate stimulus to memory and outlook, to pride andgratitude ; but when all the bustle has passed away we feelthat they had a significance which grows more impressive aswe think over it, which will never lose its hold on thosewho have felt it all. Vivat, cresccct, floreat UniversitasAberdonensis.

HOSPITAL AND MEDICAL SCHOOLDINNERS.

St. Bartholomen’s Hospital.-The annual dinner of theold students of St. Bartholomew’s Hospital took place inthe great ball of the hospital on Oct. lst. Dr. J. A.Ormerod was in the chair and 148 gentlemen werepresent. The chairman, in proposing "Prosperity to theHospital and Medical School," took occasion to insist on theunity and mutual inter-dependence of hospital and school.He reviewed the history of the last few years, which hadnecessarily been a time of anxiety, and the present satis-factory condition of the institution, and said that thematerial improvements now in progress, the zeal of thosewho worked there, and the loyalty of old St. Bartholomew’smen were certain guarantees of success. Mr. Acton Davis,in responding, affirmed the strong interest taken by thegovernors in the welfare of the school. He mentioned the

approaching completion of the great new block of the out-patient and special departments, and the inception in theimmediate future of the pathological block, and followingthis of the nurses’ home. He appealed to old students tointerest others in the work. The toast of "The Guests"was proposed by Mr. H. T. Butlin, who, coupling Pro-fessor W. Osler’s name with it, remarked that his I Practiceof Medicine " was in constant use even in the surgical wards.Professor Osler, in responding, observed that he always foundsurgical wards full of interesting medical cases. He recalledhis old days as a student at St. Bartholomew’s and referringto the new buildings in progress remarked that though newequipment was important, more important still was the old

spirit. He expressed his pleasure at hearing of the inceptionof the pathological block and said how necessary pathologywas to the proper performance of hospital work. Above allhe desired to emphasise the immense importance of thepresence of medical students in a hospital. He declaredthat it made all the difference in the way in which the workwas carried out. Dr. Norman Moore proposed "The Healthof the Chairman," and after dinner an adjournment wasmade to the library for tea, coffee, and conversation.

Charing Cross Hospital.-The past and present studentsof the Charing Cross Hospital and Medical School dinedtogether at the Hotel Cecil, Strand, London, on Oct. lst.The chair was taken by Dr. William Carter of Liver-

pool, who sat between Professor Ivan Petrovitsch Pawlowof St. Petersburg and Lord Kilmorey, the chairmanof the hospital. The toast of "The Charing Cross HospitalMedical School " was intrusted to Lord Kilmorey whodelivered himself of an indignant protest against thenoise caused by the motor omnibuses in King William-street. He said the noise was so great that the patientsin the wards of the hospitals were disturbed in their sleepand he emphasised the importance of diminishing thenuisance. He also explained why it was inadvisable forthe hospital to be moved from its present position. Dr.Christopher Addison, in replying to this toast, dwelt on thefact that the number of medical students in London was

diminishing. The number of medical students at the pro-vincial centres was increasing but he did not think on thataccount that the Charing Cross Hospital Medical Schoolneed have any apprehension because its defects had beenremedied and necessary economies introduced so success-

fully that the financial year of the school had ended witha small balance on the right side. Dr. T. W. Eden,in a few well-chosen words, proposed the toast of "TheGuests," which was replied to by Professor Pawlow and Mr.

R. M. Pattison. Professor Pawlow only spoke a few wordsin German, thanking the students of Charing Cross Hospitalfor their kind reception of him, and ended with the word" Lebewohl." Mr. James Cantlie, in submitting the toast ofThe Chairman," stated that in his opinion the provincialuniversities, especially the University of Birmingham, hadbeen emptying the London medical schools. After a short

reply from Dr. Carter the formal proceedings ended. In thecourse of the evening Dr. F. W. Mott was called upon to singand was obliged to give an encore, his rendering of " Here’sa Health unto His Majesty " eliciting loud applause.London School of Tropical Medicine and London School of

Clinical Medicine.--The dinner of these two schools washeld on Oct. 8th at the Hotel Cecil, and in consequence of theunavoidable absence of the Duke of Marlborough the chair wastaken by Sir William H. Treacher. Among those present werethe following: Professor Blanchard of Paris, the Director-General of the Royal Navy Medical Service, the President ofthe Medical Board of the India Office, Sir Dyce Duckworth,Sir Patrick Manson, Colonel Kenneth Macleod, Mr. H. J.Read of the Colonial Office, Dr. Paul Joly of theMinistry of Marine of Paris, Sir William H. Bennett, Mr.Malcolm Morris, Sir Francis H. Lovell, Dr. Guthrie Rankin,Professor W. J. R. Simpson, Mr. L. Vernon Cargill, and Mr.Perceval A. Nairne (chairman of the committee of manage-ment). Professor Blanchard gave an eloquent address inFrench and laid special emphasis on the world-wide reputa-tion of the Tropical School in having attracted to it, amongthe 40 students now in the laboratories, representatives fromthe following countries among others : Greece, Finland,Holland, Italy, the United States of America, Guatemala,and Honduras.

St. George’s Hospital.-The annual dinner of past andpresent students of St. George’s Hospital was held at theWhitehall Rooms, Hotel Metropole, on the evening ofOct. lst, when a company of about 120 supported thechairman, Mr. Clinton T. Dent, senior surgeon to thehospital. The numerous speeches were remarkable fortheir excellence and their brevity-terms often almostsynonymous when they refer to after-dinner oratory. Thechairman, who has a happy knack of postprandial epigram,was in excellent vein ; and the Bishop of Bristol, who hadin the afternoon delivered a most eloquent address atSt. George’s Hospital, an abstract of which will be foundat p. 982, was no less admirable and to the point in hiswitty and well-delivered speech after dinner. Dealing withmedical school statistics Mr. F. Jaffrey was able to state animprovement in the entry figures for the ensuing session.It is satisfactory, therefore, that as a purely clinical schoolthe first steps of this ancient institution seem to tread anauspicious path.

hing’s College Hospital.—The annual dinner of the oldstudents of King’s College Hospital was held at the HotelCecil on Oct. 2nd, Professor Nestor Tirard being in thechair. In spite of the wet weather a goodly representa-tion of old friends was gathered together, numbering about100, and as vi-itors were General Lord Methuen, chairman ofthe hospital ; Sir Charles Ollivant, K C.I.E. ; the Rev. Dr.Headlam, principal of King’s College and vice-chairman ofthe hospital ; Mr. Charles Awdry, treasurer ; and Mr. W. A.Pite, architect to the new hospital. Amongst the membersof the staff were Professor U. Pritchard, Dr. J. Phillips, Dr.N. Dalton, Dr. J. F. W. Silk, Dr. StClair Thomson, Dr.R. H. P. Crawfurd, Dr. G. F. Still, Sir Hugh R. Beevor,Professor Watson Cneyne, Professor M. McHardy, Mr.F. F. Burghard, Mr. P. T. B. Beale, Mr. L. V. Cargill, andMr. A. Carless. The army was represented by Colonel A. T.Sloggett, C.M.G., Colonel Bond, and Major Vipan, and theIndian Medical Service by Major R. H. Castor. Notes ofregret for non-attendance were received from a number of oldfriends, and expressions of goodwill and wishesfor a successfulwinter session were exchanged with University Collegeand St. Thomas’s Hospitals, the dinners of which weretaking place in the same building. In proposing the toastof the evening, I Success to King’s College Hospital and itsMedical School," Professor Tirard alluded to the two factorswhich were guiding the evolution of medical teaching at thepresent day-namely, the centralisation of the earlier studiesand the decentralisation of hospitals. Both of these had in-fluenced King’s College Hospital to a considerable extent. Onthe one hand, the clinical school of the hospital had beencompletely dissociated from the scientific faculty at King’sCollege, into which the departments of anatomy and physio-logy were now incorporated. Other hospitals showed theirappreciation of this arrangement by sending their students to