1870 The Lancet  
638 health, when there is time to ascertain their position and circumstances; and should any person, after admission, be found capable of paying ordinary medical charges, they are, by a rule of such institutions, subject to immediate dismissal. Whilst an effectual check is thus afforded to imposition on medical charity, efficient medical attendance is placed by these institutions within the reach of all the poorer classes above the position of the pauper. It is found, too, that the small
more » ... at the small periodical payments of the patients are sufficient to defray the cost of their supply of medicine, and, by the surplus over this cost, to leave a fair sum to be divided amongst the medical men who attend them. At Coventry, the medical officers generally receive about £ 150 a year each. At Northampton, I believe, the amount anjlually paid to the several medical attendants is from £300 to £600. At Derby, Burton-on-Trent, Leicester, and for the out-patient department of the Albert Hospital, at Devonport, this plan is also successful. It must be obvious to anyone who inquires into, and jenects on, this system of supplying medical aid to the poor that it has many advantages over the existing modes of dispensing public and private medical charity. It is a mistake to suppose that, whilst contending against the extension of charities to the more affluent, it excludes by " a hard and fast line" the very indigent from its aid; for there is in these institutions always a rule to enable any poor person, labouring under disease, to obtain medical relief-only, in doing so, endeavouring to prevent his becoming a confirmed recipient of charity. I feel assured, too, that by our liberal profession a system which tends to raise the character of the poor will not be lightly esteemed, and that they will fully appreciate the importance and great good of raising amongst the industrial classes a spirit of self-reliance and mutual help, especially in teaching them to co-operate amongst themselves, with forethought and providence against times of sickness and ill-health, which are always to them times of such severe adversity.-I am, Sir, yours faithfully, Torquay, April 9, 1870. C. B. NANKIVELL, M.D. P.S.-I would beg to add a caution against any attempt to combine in one institution the provident and gratuitous .systems of dispensaries. Such attempts have always failed. CÆSAREAN SECTION.
doi:10.1016/s0140-6736(02)66300-7 fatcat:yyhuq56v4fd5hpxkeyymrcygny