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lect committee of the House of Commons. Already this committee has had before it a number of witnesses, among whom were doctors, coroners, registrars, health officers, and, with the usual impartiality of such committees, a representative of unqualified practitioners, and especially of herbalists. The last-named seem fairly satisfied with the present system, though they would prefer it to Nortriptyline 25mg be rather more lax. They evidently fear that any alteration will be in the opposite direction. Ordinarily, medical men are required to certify the deaths of their patients on a form provided by the Registrar-General, giving the date when last seen and the day and cause of death. This cer- tificate passes to the Registrar of the district, who gives his certificate of registration to the person authorized to conduct the funeral. It is from these certificates, which are not paid for, that the Registrar-General's valuable statistics are framed. The profession, knowing the im- portance of such statistics, has always been willing to give its assistance, and may surely expect in return that certificates should be accepted from qualified practitioners only. It seems, however, that great irregularities in this respect have prevailed, and when no qualified practitioner has seen the case or been willing to certify, that registra- tion has nevertheless been effected. Such cases ought to be inquired into by the coroners, but inquests are very unpopular and some of these functionaries, whose salaries do not depend on the number of their inquiries, have not been too anxious to increase them. In other ways, too, abuses have crept in — it is not usual Generic Nortriptyline to register still- births, a midwife's certificate is merely given to the undertaker. Moreover, great laxity has prevailed, with here and there a medical man who has signed blank forms and allowed his a.ssistant to use them. Some, too, have done this for unqualified men and so "covered" them; but the Medical Council has decided that "cover- ing " is ''infamous in a professional respect," to use the words of the Act of Parliament, and will entail ex- clusion from the Register, so that this offence will prob- ably cease. It seems to be generally admitted that regis- tration of deaths should be made compulsory, that quali- fied men should be paid for certifying, and that all cases not certified by them should be subject to a coroner's in- quest. The session of the Medical Council opened on Tuesday, with the usual address of the President, giving a summaiy of the business to be transacted. A very full agenda was before the members, including important reports of the Education Committee, and the Examination Committee. The former is under discussion as I write ; the former con- tained reports of the visitors of e.xaminations, and was dis- cussed on Thursday in reference to some defects pointed out in one of the examinations of the Dublin University, which the representative of that body a.ssured the Coun- cil Nortriptyline 25 Mg would at once be removed. Sir Philip Smyly took his seat as the successor of the late Dr. Macnamara, whose death I have previously mentioned, and to whom MEDICAL RECORD. [July I, il the President paid a feeling tribute. He mentioned the action in which the College of Physicians had succeeded against the Council, and that the costs thereby incurred will be little short of one thousand pounds. Does it not seem deplorable that a thousand pounds sterling should be squandered in a legal contest which could not benefit the practitioners who have contributed the funds ? And all the while the country swarms with (juacks which the Council does not suppress. No one cared a farthing about the lawsuit undertaken except the College, which naturally fought for its privileges. No one doubted that its licentiates were fully qualified, and yet the Council re- fused to recognize the license as a double qualification, while it takes no thought or does next to nothing as to men with no qualification at all. On Wednesday and part of Thursday cases of discipline were undertaken. Three names were ordered to be removed from the Regis- ter. One name was restored. This leads me to remark that in all directions there seems to be a growing feeling that restoration is too easily obtained. Of course there are differences in the offences, and the greatest care ought to be exercised to prevent expulsion becoming too light a punishment. An interval might, perhaps, in each case be fixed before the Cheap Nortriptyline expiration of which no application for restoration could be entertained. Papers were laid before the Council on the subject of reciprocity in practice in various countries. France and .Switzerland are the most exclusive, especially the latter, (ireat complaints have been made that English physi- cians cannot attend their patients in various health-re- sorts. The remedy is to send our patients to other equally beneficial localities where more liberal views pre- vail. When Switzerland has diverted the stream from which much of her prosperity comes she will have time enough to repent of her folly. Small- pox continues to spread. There were 537 cases in the Metropolitan Asylums Board's hospitals on the 20th instant, and fresh outbreaks are reported from va- rious towns Scarlet fever also continues to prevail both in London and the country. Surgery has lost a distinguished exponent, and Uni- versity College a model and beloved teacher, in Mr. Mar- cus Beck, who died on Sunday last and was buried on Thursday in a burying-ground of the Society of Friends. He was the subject of diabetes, but never suffered that to interfere with his devotion to his work. An attack of influenza hastened the end, and he died of diabetic coma at the early age of forty-nine. His name must be Nortriptyline 10 Mg well known to your readers as the editor of recent edi- tions of Erichsen's " Surgery." A man of somewhat similar sturdy character, but whose lot was cast in a country town, was Thomas Simpson, of Coggeshall, where he spent some forty yea^rs of unpre- tending, earnest labor. I knew him well, and like his other friends, held him in high esteem. He loved litera- ture, science, and his profession ; was intellectual, be- nevolent, pious, and well cultivated. His death will leave a great blank in the. place that had known his worth so long. Another friend of mine, although an Italian, was well known to many in London, Professor Pacchiotti, of Turin. The last time I saw him was at my own clinic, where he came with all his usual professional ardor. Italy has lost in him a noble representative. She has in- deed been severely visited of late, for within a few days she has lost him and Cantani, and also her world-re- nowned adopted son. James Moleschott. London, June 3, 1893. Medical aid associations, as they are called, have been formed in various towns, to apply the co-operative prin- ciple to Buy Nortriptyline medical attendance. This is an advance on the friendly societies or clubs which have long been recog- nized as useful institutions. Much opposition has been roused by these newly-formed associations. It has been urged that they are in reality gigantic co-operative soci- eties dealing in unqualified medical practice protected by the "covering" of a qualified man. Various other charges have been made, such as that of " sweating " the doctors, making them utterly dependent, and touting for practice in a disgraceful manner. No one can doubt that a great abuse has sprung up. but who is to blame? So rapidly has the abuse spread that the General Medical Council has been compelled by the outcry raised to look into the matter. The Council accordingly appointed a committee to investigate and report, and the present ses- sion has been eagerly looked forward to in the expecta- tion of an important resolution being adopted. But the eager spirits who had not gauged the vis inertiic of the Council have been doomed to disappointment. The report of the committee was indeed brought up on May 26th, and so feeble a document it proved to be that it might almost have been mistaken for the offspring of the Council itself. But not quite, and so the Council pro- ceeded to its usual work — talk and empty resolutions of platitudes. A day was consumed over this, which, at the rate of about a guinea per minute (the amount the Coun- cil meetings have been calculated to cost the profession), will be enough perhaps to deter any further appeal to its authority by the enthusiasts who expect the dignity of the profession to be maintained by its action. That dig- nity is upheld by the gentlemen who collect their fees for attending these meetings. The committee had proposed to stigmatize certain actions as " reprehensible," but ob- jection was taken to this on the ground that the Act ot Patliament used the term " infamous in a professional re- spect," and that therefore the Council was not empow- ered to use any other term. This objection was not taken with a view to the use of the term infamous, but to get rid of the condemnatory resolution, as it was well under- stood the Council would not display the courage of its convictions. No doubt it is a severe punishment to re- move a name Nortriptyline Mg from the Register, but when lawyers are "struck off the roll " we hear no feeble sentimentalism of that kind, and so the sister profession manages to keep up its reputation at a high social level. The Council did agree to declare that the offence of " covering " was committed by medical officers of these associations kee])- ing unqualified assistants, and further, that the " report of the committee with reference to certain evils which it describes could not fail to be instructive to the e.xecutive committees and medical officers concerned," and copies are to be forwarded to these persons. Those who know the history of the Council will take this as the usual lais- sezfaire policy. Possibly one or two of the bodies may take it as a warning to mend their ways. If not, the Council may look for further disturbance of its slumbers. The report of the visitors of examinations was the next most important subject before the Council, and the attention of several qualifying bodies was called to cer- Buy Nortriptyline Online tain defects in their methods of examination, which will no doubt be speedily removed. The curriculum of five years was considered to be evaded by those Nortriptyline 25 bodies which admit study in science previous to registration to count. This point may cause the Council a difficulty before which it will relapse into its well-loved inaction ; for the regu- lations of the Scottish I'niversities have been settled by commissioners under Act of Parliament. The Pharmacopoeia Committee was authorized to take steps to make the next edition of the work, which may appear two or three years hence, more acceptable to India and the colonies by including their more important natu- ral remedies. Will this prove a step toward an interna- tional codex? The Council determined to suspend for a time the reg- istration of American diplomas in dentistry, as it ap- peared they were granted after a less curriculum than British dental diplomas. The names of those already on the foreign dentists' list will of Order Nortriptyline Online course be retained. The annual meeting closing the session ol the Clinical Society was held on the 26th ult , under sad circumstances. The chair on the right hand of the President, filled at the last meeting as usual by the senior secretary. Dr. W. B. Hadden, was vacant. Within the few days that had in- July I, 1893] MEDICAL RECORD. 3^ tervened since that last meeting, Dr. Hadden, then in full health and enjoying his work, was struck down by pneumonia of septic origin. To some present the first intimation of his untimely decease came at the meeting, for he had only died that day, and he was to have read a paper at this very meeting. The President referred in touching terms to this sudd-en event, and bore testimony to the excellence of Dr. Hadden's work as a scientific in- vestigator, to the energy he evinced in all he undertook, and to the courtesy and zeal with which for the past two years he had devoted himself to the duties of secretary of the Society. The condolences of the Society were voted to Nortriptyline 10mg the parents of Dr. Hadden, on their great loss. He was senior assistant physician to St. Thomas's Hospital, and also on the staff of the Children's Hospital, and only thirty-seven years of age. He would have been re elected secretary at this meeting with the other officers whose names were on the list, which was duly passed.

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