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forts, it is to such things as these that I refer. In fact, as the Poor-law medical officer has it in his power to order medical comforts when necessary for the cure of his patient, I would have a somewhat similar discretionary power given to out-patient physicians and surgeons; and if the attendance were guarded in some such way as I have indicated I do not think there need be any fear of abuse, while, on the other hand, the benefit conferred would be immense.
In my former paper I pointed out how I desired to see the hospitals placed in an organized relation with the Poorlaw medical service, and with the Provident Dispensaries, so as to constitute them the central points of the medical machinery intended for the relief of the humbler classes of society; and that, not as at present, in a haphazard way, but by an established and recognized arrangement-the pauper being admitted to hospital treatment on the recommendation of the Poor-law medical officer; the member of a Provident Dispensary or Sick Club in virtue of his subscrip. tion, whenever additional advice was deemed necessary; while the class between these two, who, as I hold, are the proper clients for the hospitals, would be received in consideration of their necessities. Thus, all the cases which properly demand hospital treatment, would find their way to those institutions. The highest skill would be brought to bear on the needs of the sick poor, while, at the same time, the medical staff would have ample material for enlarging their experience and for clinical instruction, though the total number of their patients would be some what curtailed.
No doubt it is the special hospitals which are most abused. The general hospitals do not suffer in proportion to the same extent. Still it is desirable that all should work together, and move pari passu. Unless the general hospitals take the initiative, there is but small chance of anything effectual being done in this matter. They are to us what the cathedrals are to the clergy, or the Superior Law Courts to the legal
profession; and any change which they thought proper to inaugurate would be respectfully considered by the smaller and by the special hospitals; and the public would soon learn to ask, before giving their support, whether the plan which had been deemed expedient at the leading hospitals had been adopted by this or that minor one.
Supposing, now, that a hospital, or, better still, a group of hospitals, was willing to give these suggestions a trial, what would be needed? How would they have to approach the experiment?
In the first place it would be necessary to appoint an inquiry officer, to provide him with a suitable office, and to give him a short time to make himself acquainted with the district and with its medical charities. It would be his duty to obtain information about the general practitioners who are to be found rallying round all our larger hospitals. He would acquaint himself with the Provident Sick Societies. He would put himself in communication with the Poor-law medical officers, and besides all this he would make himself familiar with the lanes and courts of the neighbourhood, with the character of the population, with the scale of rents and the rate of wages. He would thus be furnished with the data necessary to enable him to form an opinion upon many cases that would come before him; and week by week, and month by month, his knowledge would be extending, so as to cover a larger area, and to enable him in a shorter time, and with less investigation, to form a correct estimate of the fitness of applicants who sought admission from a distance, and to refer those who were unsuitable to the agency best adapted for their case.
There need be nothing harsh or inquisitorial about such inquiries-only that measure of strictness which is inseparable from true kindness. I would desire to see these plans carried out with the utmost gentleness and consideration ; with a leaning always to the side of mercy, but yet with a firmness which bore ever in mind the importance in a national point of view of fostering habits of self-respect and selfreliance, and of protecting the rights of others; to wit—of the public who give their money to help those who are too poor to help themselves, and of the medical men practising among the lower middle grades of society, whose patients are now actually drawn away from them by the gratuitous advice which is offered at the hospitals.
Various suggestions have lately been made for remedying the abuses which are now almost universally admitted to exist. It has been proposed that all out-patients should pay some small sum for the relief which they receive. Again, it has been suggested that they should only obtain advice, and be furnished with prescriptions, being left to get the medicines elsewhere. In some quarters the plan has been adopted of admitting a limited number, and then closing the doors upon all other applicants. But with none of these suggestions can I agree, and that for one and the same reason. It is the glory of our hospitals to be purely charitable, to take nothing from those whom they relieve, and to relieve them promptly, efficiently, and with no grudging hand. But while this is granted, I think it may fairly be insisted upon that they should confine their bounty to those for whom it is properly intended. If they were to do this, no one would complain of their liberality. The “necessitous sick," the “really poor,” cannot be expected to pay anything. They need not merely prescriptions, but medicines as well, and this is the class whom the hospitals profess to relieve. But unless an organized system of inquiry is set on foot, others will assuredly creep in who have no business there. To shut the doors after a certain number have been admitted, must often cause the rejection of those who most need relief. The mere proposal of such a plan proves how excessive is the crowd which now throngs the doors, and overtaxes the time and energies of the medical staff.
I need hardly repeat that the plan of systematic inquiry would carry with it, as a matter of course, the abolition of Governors' Letters, so far at least as the out-patient department was concerned ; and poor sick people would no longer have to go about spending time and strength and heart in seeking for a letter of recommendation, but would betake themselves at once to the Inquiry-officer, knowing full well that their social position and the necessities of their case, and not the signature of a subscriber, would be their passport to the physician's or surgeon's consulting-room.
The present seems a fit time to discuss these questions, for the Hospital Sunday movement, which has been so successfully inaugurated, has called the attention of the public in a special manner to our medical charities. In all probability the amount of money which is annually contributed for their support will be considerably augmented-at any rate it will come in with greater certainty and regularity, and the public who supply these increased funds have a right to demand that they should be distributed with judgment and discrimination. The statistics I have brought forward show how much is already being done for the sick poor of the metropolis. Is it desirable to provide for any larger proportion of the population upon the eleemosynary principle ? or to tempt yet greater numbers to depend upon charity? If the augmentation of funds leads to such results as these, it will be a national misfortune; but if, on the other hand, the power of the purse is employed to enforce a greater amount of discrimination in the distribution of relief, and to encourage habits of forethought and thrift, the best wishes of the originators of the Hospital Sunday movement will have been fulfilled, and these noble institutions will be enabled to carry out their mission of mercy free from the serious drawbacks which now attend them.
W. FAIRLIE CLARKE,
JOHN STUART MILL.
My teacher ! su indeed thou art,
Though I was never at thy side : My fellow-Christian ! though thy heart,
Perhaps, the name would have denied :
I call thee happy: thou wert strong
In age with all the power of youth : With zeal for freedom, hate of wrong,
Reverence for man, and love of truth :
And thou couldst read, as in a scroll,
The laws of nature and of mind : But wherefore was it that thy soul
To higher things than these was blind ?
The world thy intellect descried
Was coloured with no heavenly glow : Thy thought, a dwelling fair and wide,
But lighted only from below.
And yet, if God is light indeed,
Then surely, whether clear or dim Our knowledge, all its rays proceed, —
Though they be broken rays,—from Him. And He, I know, will guide thee right.
The pure to Him shall see their way : The just shall tread a path of light,
Increasing to the perfect day :
And thou art such as these :—and He
Who healed the blind will touch thine eyes, To see the God thou didst not see,
The Christ thou didst not recognise :
And that which seemed a Stygian shore
Will prove a land of knowledge, grown From earthly germs yet more and more,
Till thou shalt know as thou art known.
JOSEPH JOHN MURPHY.
MY TIME, AND WHAT I'VE DONE WITH IT.
BY F. C. BURNAND,
much of it wiped away as will enable
him to see with occasional blinking, RINGHURST THEATRICALS—THEATRICALS IN GENERAL — MRS. CAVANDERA
which spasmodic movement of the eyes, HAPPY COUPLE—THE PERFORMANCE
however, might be taken for a sign of FINISHED-ANOTHER YOUNG LADY ON
suppressed emotion. The audience, at
first, recognize, in this extraordinary THE SCENE-A FAREWELL TO AUSTIN
character, neither the experienced ama-I RETURN TO OLD CARTER'S-PREPARATION FOR HOLYSHADE-MY PRO
teur, nor the venerable papa of the
misguided youth (a young gentleman GRESS.
addicted to card-sharping), but laugh The theatricals at Ringhurst (for which heartily under the impression that it is Mr. Verney was unable to stay, being the comic man disguised, for some reasummoned to town professionally) were son or other, as the baker, and salute merely a good specimen of what I have him accordingly. since known private theatricals to be, Dresses supposed to be “all right," everywhere, without exception. Bustle and therefore allowed to pass muster and hurry; everyone wanting assistance without being tried on, are suddenly from everyone else, and wondering at discovered to be all wrong. The imeverybody's selfishness. Laces that possibility of playing the Young Prehave been strong up to within a minute tender in the costume of Francis the of being wanted, suddenly snap. Gum, First has, somehow or other, to be got from which, at any other moment, there over. would have been no escape, now playing Ingenuity comes to the rescue. Pins the unfortunate cavalier false in the are in great request, and oaths plentiful, matter of moustaches. The handsome with apologies. Nobody's drink is secure young gentleman, who has to “make from anybody who is thirsty. All are himself up" for a lover, fails signally in thirsty. Everybody wishes everybody an attempt to give himself a beautiful else out of the way. Books have been complexion with carmine and bismuth, mislaid, and the Prompter, who has and comes down looking uncommonly craftily secreted his, is now waylaid, like a clown. The agitation of the and has it wrested from him by some unhand which is to make a delicate line fortunate amateur, who, in piteous tones, of black, causes a smudge on the cheek, cries: "Do let me have it, I'll give it as if you bad commenced a cartoon you back directly, but I have to go on there with charcoal. The experienced first." amateur, who has selected the part of a Everyone doubts his own appearance, hoary-headed veteran, whose grey hairs and is full of congratulations for everyare during the piece well-nigh brought one else, with a view to being congratudown with sorrow to the grave, and who lated in turn. All excitement. has a vast amount of stirring sentiment Then the voices won't pitch themselves and manly pathos to deliver hinıself of properly, everybody being more or less in consequence, suddenly, and at the inaudible, with the solitary exception of last moment, appears on the scene with the Prompter, whose every word can be his entire head apparently fresh from a beard, causing irrepressible titters among plunge into the flour tub, with just so those of the audience most remote from