PROFESSIONAL ETIQUETTE.
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875 Cooper. It was his apparent attempt to affect the professional interests of his brethren, that elicited the remarks in THE LANCET. We are assured that Mr. Cooper is really what our correspondent has de- scribed him to be, and we therefore the more regret that he did not think his professional brethren worthy to receive the larger sum per case for vaccination. Observe the trouble which falls to the lot of the vacci- nator, for which Mr. Cooper thinks that eighteenpence is a sufficient remuneration:- He must, if he wish conscientiously to fulfil the intentions of the Vaccination Act, seek out the patient requiring vaccination ; in some cases only will he have the child brought to him. It has been well observed in the resolution contained in the above letter, that there are 14 a number of esta- blishments where vaccination may be ob- tained gratis,’ and yet Government has deemed it necessary not only to pass a new Act upon the subject, but has also most wisely rendered it compulsory on parishes and unions to see that the clauses of that Act be fully carried into effect. One reason for this rigorous enactment is, that mothers have a prejudice against the operation. Medical men have to conquer that prejudice by kind reasoning and attention; they must seek out the patient; they must frequently repeat the operation a second, a third, and a fourth time; they must again visit the pa- tient when the pock has become success- fully developed, for at this period another prejudice rises in the mother’s mind-against the removal of the lymph, for the purpose of communicating the benefits of the operation to others. He has, moreover, to make a return of his cases to the parish, and all this the members of a liberal profession must perform for eighteenpence. We think we see the sister professions smiling atour fall! And yet we are told that there are medical men, members of our profession, who coin- cide with the Poor-Law Commissioners in thinking this wretched sum enough. We cannot, indeed, envy them their humility. PROFESSIONAL ETIQUETTE. To the Editor qfTHE LANCf<:T. I SIR:-As a constant reader of THE LAN- CET, I beg the favour of your opinion in the following case : ’ A medical practitioner in the town in which I am an assistant, was requested to visit one of his patients, who was supposed to be in labour. Being unable to attend himself he sent me. On my arrival at the house I found that labour had not set in, the patient not having gone within a fortnight of her full time. I ordered her an anodyne draught to allay the pains, and, at the ex- piration of three weeks, we were again re- quested to see her, as she was then in labour. Being both of us out visiting at the time, our dispensing assistant requested another medical man in the town to attend the case for us, without delay. He obeyed the call, and on returning home, after the labour was concluded, he stopped at our door, to say that all had gone on well, and, at the same time, to book the case, according to custom. Strange to say, this very Gentleman subse- quently monopolised not only the midwifery case, but the medical attendance on the whole family. Upon hearing this, I wrote to him to knowwhether he intended to continue visiting the patient who was confined to its conclusion, or to give us up the case. His answer was, that upon the night of the day on which he attended the labour, the patient wrote for him to see her, she not feel- ing very well, and that he had visited her on that day, the third, and had ordered her some medicine, as usual in midwifery cases. Now, Sir, was this a breach of etiquette on the part of this medical practitioner, who, in the first instance, acted kindly towards us, and, in the second, in the manner I have described. I am, Sir, your obedient servant, Aug. 9, 1840. J. H. *** We erase names from this letter. The conduct described in it is not consistent with the custom which guides honourable men in their dealings with each other. Whatever steps are taken in such cases to adjust the question,-who shall continue to be the medical attendant of the patient or the family, the free-will of the latter being the first principle to be respected,-the re- fusal to observe either principle or rule of any kind on these occasions, converts the medi- cal practitioner into a professional brigand, whose company should be shunned. DISEASED MILK IN THE COW. IN the month of August last, writes Mr. Mayer, of Newcastle-under-Lyne, a farmer requested my advice about a cow, from whose milk a whitish sediment was de- posited at the bottom of the pans to the extent of nearly one ounce per quart. He stated, in answer to my inquiries, the following particulars. After he had had the cow about two months, she was put to the bull, and during that week she did not give her milk freely ; but they perceived,
Transcript of PROFESSIONAL ETIQUETTE.
875
Cooper. It was his apparent attempt toaffect the professional interests of his
brethren, that elicited the remarks in THELANCET. We are assured that Mr. Cooperis really what our correspondent has de-
scribed him to be, and we therefore the moreregret that he did not think his professionalbrethren worthy to receive the larger sumper case for vaccination. Observe the
trouble which falls to the lot of the vacci-
nator, for which Mr. Cooper thinks thateighteenpence is a sufficient remuneration:-He must, if he wish conscientiously to fulfilthe intentions of the Vaccination Act, seekout the patient requiring vaccination ; insome cases only will he have the child
brought to him. It has been well observedin the resolution contained in the above
letter, that there are 14 a number of esta-blishments where vaccination may be ob-tained gratis,’ and yet Government hasdeemed it necessary not only to pass a newAct upon the subject, but has also most
wisely rendered it compulsory on parishesand unions to see that the clauses of thatAct be fully carried into effect. One reasonfor this rigorous enactment is, that mothershave a prejudice against the operation.Medical men have to conquer that prejudiceby kind reasoning and attention; they mustseek out the patient; they must frequentlyrepeat the operation a second, a third, and afourth time; they must again visit the pa-tient when the pock has become success-fully developed, for at this period anotherprejudice rises in the mother’s mind-againstthe removal of the lymph, for the purpose ofcommunicating the benefits of the operationto others. He has, moreover, to make areturn of his cases to the parish, and all thisthe members of a liberal profession mustperform for eighteenpence. We think wesee the sister professions smiling atour fall!And yet we are told that there are medicalmen, members of our profession, who coin-cide with the Poor-Law Commissioners in
thinking this wretched sum enough. We
cannot, indeed, envy them their humility.
PROFESSIONAL ETIQUETTE.
To the Editor qfTHE LANCf<:T. ISIR:-As a constant reader of THE LAN-
CET, I beg the favour of your opinion in thefollowing case :
’
A medical practitioner in the town in
which I am an assistant, was requested tovisit one of his patients, who was supposedto be in labour. Being unable to attendhimself he sent me. On my arrival at thehouse I found that labour had not set in,the patient not having gone within a fortnightof her full time. I ordered her an anodynedraught to allay the pains, and, at the ex-piration of three weeks, we were again re-quested to see her, as she was then in labour.Being both of us out visiting at the time,our dispensing assistant requested anothermedical man in the town to attend the casefor us, without delay. He obeyed the call,and on returning home, after the labour wasconcluded, he stopped at our door, to saythat all had gone on well, and, at the sametime, to book the case, according to custom.Strange to say, this very Gentleman subse-quently monopolised not only the midwiferycase, but the medical attendance on thewhole family. Upon hearing this, I wrote tohim to knowwhether he intended to continuevisiting the patient who was confined toits conclusion, or to give us up the case.His answer was, that upon the night of theday on which he attended the labour, thepatient wrote for him to see her, she not feel-ing very well, and that he had visited her onthat day, the third, and had ordered hersome medicine, as usual in midwifery cases.Now, Sir, was this a breach of etiquette onthe part of this medical practitioner, who,in the first instance, acted kindly towardsus, and, in the second, in the manner I havedescribed. I am, Sir, your obedient servant,
Aug. 9, 1840. J. H.
*** We erase names from this letter. Theconduct described in it is not consistentwith the custom which guides honourablemen in their dealings with each other.Whatever steps are taken in such cases toadjust the question,-who shall continue tobe the medical attendant of the patient or
-
the family, the free-will of the latter beingthe first principle to be respected,-the re-fusal to observe either principle or rule of anykind on these occasions, converts the medi-cal practitioner into a professional brigand,whose company should be shunned.
DISEASED MILK IN THE COW.
IN the month of August last, writes Mr.Mayer, of Newcastle-under-Lyne, a farmerrequested my advice about a cow, fromwhose milk a whitish sediment was de-posited at the bottom of the pans to theextent of nearly one ounce per quart.He stated, in answer to my inquiries, the
following particulars. After he had hadthe cow about two months, she was put tothe bull, and during that week she did notgive her milk freely ; but they perceived,
