FiR. 9, 1856. A88OCIATION MEDICL JOURNAL 118 lave been in opeation to produce such a remarkable and gradual decrease. To this I beg to direct attention. " The salary remaining the same each year, this diminution is, of course, attributable to something afedting the extras; and her, not being unmindful of the fact that such extas are liable to considerable fluctuation, because they are made up partly of accidents, I would beg to mention that many poor women, who are altogether and entirely

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... s on the paribs, and who are receiving medical relief for themselves, their childrm, and their husbands, throughout the whole year, are yet refused an order for attendance in confinement. This refusal operates prejudicially in many ways; for it deprives the medical officer of his fee; and such fees being amongst the extras, are important to him, as they contribute, in some degree, to ameliorate his condition, and it acts prejudicially to the paupers themselves, in preventing their having seasonable and proper attendance; for those who cannot obtain orders are often attended by a midwife, and whben the confinement is fairly over, but not before, an order is granted, by which the whole responsibility of the case is thus shifted upon the medical officer, without any kind of remuneration whatever. A