DEC. 21, 1895.] MEDICO-LEGAL AND MEDICO-ETHICAL. [1X; Ja 1591

H. B. PURVES, of the Bengal Establishment, which also has been already called the Director-General of the Indian Medical Department, a change announced in the BRITISH MEDIC&L JOURNAL, has likewise received the of title which has been in contemplation. for two or three years. sanction of the Queen. Surgeon-Lieutenant-Colonel W. M. COURTNEY, Bengal Establishment, has retired from the service, December 7th. Hle was appointed Assistant THE CASE OF SURGEON-MAJOR CLARENCE SMITH. Surgeon, October lst, 1F69, and Surgeon-Lieutenant-Colonel twenty years TH1E Commission that has been sitting to deal with the case of Surgeon- thereafter. He served with the Duffla expedition in 1873-74; with the Major Clarence Smith has concluded its inquiry, and the verdict will Burmese expedition in 1886-87, In medical charge of No. 1i Field Hospital now be awaited with much interest. Although the hearing was in camerd, with the 4th Brigade Upper Burmah Field Force (medal with clasp); and the thinks it possible that a report of the proceedings may with the Chin Lushal Expeditionary Force, under Brigadier-General eventually be published. Symons in 1889-90 as Senior Medical Officer in charge of the General Hospital. An examination for appointments in the Indian Medical Service will be held in on February 7th and following days. MEDICO-LEGAL AND MEDICO-ETHICAL. Brigade-Surgeon-Lieutenant Colonel RAJENDRA CHANDRA CEHANDRA, late of the Bengal Establishment, and formerly Professor at the Medical College, Calcutta, died in London on December 14th. He entered UNQUALIFIED PRACTITIONERS AT MANCHESTER. the service as Assistant-Surgeon January 27th, 1858, and becamre B-igade- AN advertising "hernial specialist," named Samuel John S-herman, of Surgeon February 28th, 1890. During the Indian Mutiny in 1858 he was 26, King street, Manchester, was summoned to appear at the Man- of County Court lately for the recovery of 21 guineas, which it present at the action with Ferozeshah on the banks the Junina. He was alleged was obtained by him by fraud. Damages were also claimed was also with the expedition against the Kookies in 1861, and in the for negligence in treating the plaint iff, Mr. John Howard, for rupture. Cossyah and Jyntiah Hills campaign in 1862-63. The evidence, according to the report in the Manchester Courier, showed that the plaintiff had seen tlhe advertisement4 issued by Sher- THE . man. in which a cure was guaranteed. He had visited the defendant, SURGEON RICHARD SAVILL HANBURY, M.D., formerly of the 2nd West and had paid him one guinea for examination, and was absolutely York Light Militia, died at Sidcup, Kent, on December 11th, assured of a cure. Upon this assurance he underwent the treatment, after a long and painful illness. which consisted in a bottle of a curative compound and an apparatus to be worn, and paid 20 guineas for the same. The appliance gave him great pain, which finally became so intolerable that he sought skilled THE VOLUNTEERS. surgical advice, consulting Mr. Whitehead, F.R.C S., who told him that SURGEON-LIEUTENANT T. E. STUART, 1st Essex Artillery (Eastern Division he had a small rupture on the right side, for which a proper truss was Royal Artillery, is promoted to be Surgeon-Captain, December 18th. needed, and that the apparatus he was wearing was of no use and was Surgeon-Lieutenant A. JONES, 9th Lancashire Artillery, has resigned the cause of the severe pain. The plaintiff went back to Sherman and his comomission, December 18th. told him what Mr. Whitehead had said, and was informed by him that Mr. BERKELEY GEORGE ANDREW MOYNIHAN, M.B., is appointed the rupture was on the left side, and that for 10 guineas more he could Surgeon-Lieutenant in the 3rd Volnnteer Battalion the Prince of Wales's be cured, The plaintiff continued the treatment, but 'after a short time Own West Yorkshire , December 18th. was obliged to abandon it owing to the pain. Surgeon-Lieutenant it. MITCHELL, M.D., 1st Volunteer Battalion the Mr. Whitehead supported the evidence of the plaintiff, and stated that , is promoted to be Surgeon-Captain, December 18th. there was no hernia on the lett side at all, and that the appliance was an Surgeon-Captain G. H. MACKAY, M.B., 3rd (Niorayshire) VoluDleer improper one, was cumbrous and heavy, and was wrongly applied. Battalion the , has resigned his commission, Sherman gave evidence in defence to the effect that he had not December 18th. promised a cure and that the truss applied was a good one. In cross- Surgeon-Captain G. T. RAWNSLEY, Army Medical Staff, is appointed examination he stated that it was true he was not qualified, and that Adjutant of the Volunteer Medical Staff Corps, vice Surgeon-Captain D. previous to taking up the work of hernial specialist he was connected Al. O'Callaghan, who has resigned the appointment, December 18th. with horse trotting in the United States. The Volunteer Officers' Decoration has been bestowed upon Surgeon- The Judge gave Judgment for the plain'iff, observing that the case was Lieutenant-Colonel T. E. PEARSON. M.D)., 1st North Riding of Yorkshire one of considerable importance to the public. He held that the plaintiff Volunteer Artillery (Western Division Royal Artillery); Surgeon-Major had parted with his money upon fraudulent representation, and ordered S H. MuNRO, M.D . 5th Volunteer Battalion the Regiment; and £22 and costs to be paid him. Surgeon-Major G. W. BRAMWELL, 2nd Westmoreland Volunteer Battalion One of the features of this case was that " Dr. John Tanner of London," Ihe . who it was said "held a number of high qualifications," supported the evidence of Sherman in so far as the value of the appliance was con- PAY OF SURGEON-LIEUTENANTS ON SERVICE IN . cerned. It may be interesting to learn that a duly qualified medical A POINT on which a ruling seems called for, says the Pioneer, is the ques- practitioner was struck off the Medical Register last year for covering tion of how the pay of surgeon-lieutenants who are in temporary Sherman, at the instance of the Medical Defence Union; and that a chargeof regimentsshall be calculated,when theyareorderedtojoin afield hernial specialist of the same naiiie practising in London was about four hospital proceeding on service. For instance,a surgeon-lieutenant whohas years since prosecuted at Bow Street by the Medical Defence Union, and passed the lower standard Hindustani and is in officiating charge of a convicted for falsely using the title of "Dr." regiment draws Rs. 286. 10 plus Rs. 100 staff, a total of Rs. 386. 10. For The successful prosecution at the Manchester County Court is most practical purposes, this may be taken as the lowest pay drawn by any- satisfactory; if the public can only realise that when swindled by quacks one who has passed the L. S. Hindustani when in cantonments, since the law will aid them in at least getting their money back, a good deal of the iDstances where an officer remains unemployed are rare. As soon as mischief will be done to the fraternity of charlatans. they start in service, however, they are at once placed on unemployed pay on Rs. 317. 8, thus incurring a loss of Rs. 70 per mensem. The anomaly that an officer when he is hardest worked should receive unem- A CANCER CURER AT MANCHESTER. ployed pay seems to call for explanation. The present rules only act AN action for damages for negligence in treatment was brought by prejudicially as against the junior ranks, since those who are in perma- Harriet Bayliss, a cook of Bary, against Robert Whitehead, a " cancer nent charge of remain entitled to their full staff pay; but specialist," of 230, Brunswick Street, Chorlton-on-Medlock, Manchester, there is no reason why juniors should sufter wrongfully. last week. The plaintiff in her evidence, as reported in the Manchester Courier, stated that she had seen an advertisement of the dofendant's, and being THE ASHANTI EXPEDITION. ill went and consulted him, and was informed that she was suffering NEWS has been received from Cape Coast Castle to the effect that the from weakness. About two months later she noticed a growth on her preparations for the expedition are in an advanced state. A hospital for chest, which the defendant pronounced to be a "' tumour," adding that the troops is being erected at Connor's Hill. In it beds will be provided it would turn into a cancer. He gave her some plaster and medicine, for 5 officers and 75 men. A bearer company of 600 men has already been and painted the growth with something which gave her great pain. The organised to tarry the sick. A slight breakdown has occurred in the pain increased to such an extent that she spoke to her mistress, who transport service, owing to desertion of carriers at Mansu. In conse- sent her to Mr. Whitehead, F.R.C.S., Senior Surgeon to the Manchester quence work on the pontoon bridge, which is being constructed over the Royal Infirmary, who removed the growth by operation. Mr. Whitehead Prah, has been brought to a standstill. Three camps, capable of holding gave evidence, stating that the tumour was a benign one, but was much 30 men each, have been constructed for the passage of the river. Eight inflamed owing to the irritation from some caustic application. The rest camps have now been built along the route, and, with one exception, growth was not a cancer, and the treatment adopted was a barbarous and water is obtainable at all. Twenty officers and 380 non-commissioned painful one. The defendant gave evidence in his own favour, but the officers and men of the West Indian Regiment have left Freetown, Sierra judge gave judgment for the plaintiff for ;lO and costs, and stated: " In Leone. for Cape Coast Castle. The Special Service Corps and draft Medi- this case definite harm had been done: as long as people would pay for cal Staff Corps have left Las Palmas in the Coromandel, as also the trans- unqualified assistance. they must be allowed to do so." port Manila with the 2nd Battalion . from This case illustrates the value of the county court in exposing the Gibraltar for Ashanti; both these vessels sailed for Sierra Leone. methods of unqualified practitioners. Surgeon-Captain Eckersley has started to organise the hospital at Prahsu. A YOUTHFUL ASSISTANT. INQuIRER writes as follows: Would I be acting unlawfully by employing THE INDIAN MEDICAL SERVICES. as an assistant a gentleman who has passed all the examinations IT has been settled that the Bengal, Bombay, and Madras Indian Medical necessary for the degree M.B., C.M. (Univ. Glasg.), but who is unable to Services will be entirely amalgamated in January, under the control of graduate (and therefore register) in consequence of his age (20 years) ? the Surgeon-General with the Government of India. The Military He would reside only half a mile from my house, and would be under Assistant-Surgeon class of the three services was so amalgamated in my supervision. October last, but this was only preliminary to bringing the commissioned *** We think our correspondent may employ such an assistant, pro- rank into the service also. It is with a view to arranging the details of will under the immediate supervision of this scheme that Surgeon-Major-General Cleghorn is now on tour in the vided that the latter act only Bombay and Madras Presidencies. A not unimportant detail is the his employer, and will not be allowed to conduct a branch practice or change in the designation of that officer, who, it is understood, will be dispensary TM Bm. I 1592 1592IMM"T.51rnea1.IeuiurAlL]liommliLi THETE PROTECTIONPROTECTION OFOF SURGICALSURGICAL -APPLIANCES.PPLIANCES. [DEC.[Dime. 21921, 18951895. THE PROTECTION OF SURGICAL APPLIANCES. Worthing, I had to be satisfied with Inserting in a local newspaper my WE have received the following statement: A surgeon some years ago card,' simply notifying my address to visitors and any others it designed and made for himself a small apparatus for use in a certain might concern. I have to tbank you for giving prominence Bo the same class of operations. Several of his colleagues, recognising the utility of in the columns of the BRITIsH MEDICAL JOURNAL for December 7th, the apparatus, obtained permission to send the original apparatus to a p. 1464, for by this I hove that those of my formerly intimate and many firm of surgical instrument makers, who copied it and made altogether other highly esteemed professional brethren throughout England (of a considerable number of the apparatus. Recently these surgical whom, owing to long absence abroad, I have lost touch) will be made instrumeDt makers received a communication from another firm of aware of the present address of an old friend. surgical instrument makers, warning them that by continuing to make *** In giving insertion to the above note with the view to afford the and sell this apparatus they were infringing a patent of the second firm's. It appears on inquiry that this second firm patented the inven- practitioners of Worthing an opportunity of repudiating the question- tion some year or more after the surgeon had made and put into use able allegations with regard to the local "orthodox" mode of self- in hospital the original apparatus. This is proved by the printed announcement on commencing practice therein, we would simply re- receipts of a firm of instrument makers for supplying the surgeon mark that if it be based on tact a more glaringly unprofessional device with an essential part of the appliance which he could not make him- self. The matter has been brought to our notice by the surgeon in could not well be. question, who wishes to know: (1) Whether he or the firm of instrument makers who made the CHANGING THE " DR." apparatus from his pattern have any remedy. Supposing this firm to A. C.-The excerpt transmitted by B. formed only part of the ruIe re- go on selling the apparatus, to what penalties are they liable and how ferred to, and especially related to the case therewith submitted. We are these reeovered? now append the entire rule, which, if fulfilled by our correspondent And generally he asks (2) for advice as to what would be the proper would justify the course he pursued. " When a practitioner is called course for members of the medical profession to follow in like case, in to or consulted by a patient -who has recently been, or still may be, with the view of preventing outsiders from seizing upon devices which under the care of another for the same lilness, he should on no account the inventor desires should be placed at the disposal of the medical interfere in the case, except in an emergency, having provided for profession in the public interest, bearing in mind that the medical which he should request a consultation with the gentleman in previous profession generally consider it undesirable that surgical appliances attendance, and -decline further direction of the case except in con- should be patented. sultation with him. If. however, the latter refuse this, or If the ** patient insist on dispensing with his services, and a communication to We have submitted this statement to a legal correspondent, who that effect be made to him, the practitioner last consulted will be justi- writes: fled In takiDg charge of the case, ere assuming which, however, he (1) I am of opinion that the alleged patent is bad, and that the should satisfy himself that such intimation has been given by the firm of instrument makers who have issued the warning referred patientor family. Under such circumstances no unjust or' illiberal insinuations should be thrown out in reference to the conduct or prac- to have probably no right in the matter at all, assuming, as I do tice previously pursued, which, as far as candour and regard for truth from the facts stated, that the appliance they purported to patent and probity will permit, should not only be justifled, but, if right, is the same thing as that originally invented in the hospital, honourably pereisted in; for it often bappens that when patients and " published" to all surgeons who chose to use it, a year (capricious ones especially) do not experience immediate relief from the treatment they become dissatisfied, and under the impression that or more before the patent was taken out. I am also of opinion their case is not understood by the 'doctor,' unjustly impute the that the surgeon who originallyinvented the appliance, or the firm of blame to him. Many diseases, moreover, are per se of so protracted a instrument makers who are authorised by him to manufacture it, may nature that the want of suece£s in the early stage of treatment affords petition for the revocation of the patent, on the ground that the sur- no evidtnce of a lack of skilled professional knowledge."' geon was the true inventor of the invention, and that it had been publicly used within the realm before the date of the patent. These SPECIALIST DOOELPLATE3. A. B. writes: Is it desirable, or if not desirable, can the medical men of proceedings would now be taken under the Patent Act (1883), and if the a district, with justice, take exception to the prefix "Ophthalmic" on a facts are correctly stated in the memorandum, I think they ought to be doorplate (8ic), "Dr. Smith, Ophthalmic Surgeon," the plate being successful. In this view it is also clear that the original firm who affixed to the door of a house in a town where thereis no eye hospita, manufacture under the authority of the real inventor are liable to no nor other possibility of acquainting the Dublic with Dr. S.'s special acquirements, about which tnere is no doubt. It inadvisable, kindly penalties whatever, and that if any actiontor damages forinfringement state how the public should be made acquainted with the fact that should be commenced against them they can successfully resist it. their eyes can be attended to by a competent specialist at thieir doors (2) As to the general question, it appears to me that there is much to instead of having to go twenty miles for special treatment. be said in favour of the legal protection of new appliances by their *** With reference to the proposed innovation, although no legitimate originalinventors, as being the best means of carrying out the desire objection could well be taken thereto by the district practitioners, we of the medical profession that such improvements should be available hold it to be professionally undesirable, and it would m:reover be for the use of all authorised persons. If a surgeon obtains legal pro- attended by the serious disadvantage of being unintelligible, to the tection for some novel appliance, he would, as I understand, be bound majority of the public. The most unexceptionable mode of intimating by the prescriptive rule of conduct to charge no royalties our correspondent's speciality might be to effect a cure of some oph- to anybody for the use of it,and not to restrict its use for professional thalmic case, and let the fact speak for itself through the medium of or scientific purposes in every legitimate way. He would, however, be the patient, who probably would not be slow to make it known. able, if it was thought right, to prevent unauthorised makers or sellers ofinstruments from producing some counterfeit which would be in- FREE ATTENDANCE ON HOM(EOPATHIC PRACTITIONERS. correct, and which might, of course, undersell in the market the DOUBTER asks: Has a fully-qualified medical man, who has spent his proper and authorised appliances. Beyond this, however, there is a whole Ilfe as a professea homceopathic physician, any claim on further danger of still greater importance. Although, as I have said members of the medical profession for gratuitous advice? above, any patent which may be taken out by somebody who is not the *** In response to our correspondent's query, we deemJt best to refer him to the following authoritative view expressed in the Code of Medical true inventor, for an appliance which has already been invented and chap. ii., sec. rule 1, and leave made known, Isinitself invalid, and can, it necessary, be struck out; Ethics, 2, him to form his own conclusion nevertheless, it must be remembered that it is not at all impos- as to the legitimacy (so to phrase it), or otherwise, of the homceopathic sible for an unscrupulous trader to obtain a patent for some- practitioner in question: " 1. All legitimate practitioners of medicine, thing which he may allege to be an improvement upon the original their wives, and children while under the paternal care, are entitled appliance. Such an" improvement" might be initself, from the scien- (not as a matter of right, but) by professional courtesy, to the reason- tific point of view, a matter of small moment, and yet it might be able and gratuitous services-railway and like expenses excepted-of suffi- the faculty residentin theirimmediate or near cient to make the subsequent patent to a certain extent valid, so as to neighbourhood, whose cause considerable trouble. assistance may be desired," etc. My view, therefore, upon the whole question is that it will be found NOTE PAPER. in the end to be the safest course for the medical profession, if M.O.-In answer to our correspondent's question, we are distinctly of surgeons who invent appliances will have them protected eitherin opinion that exception might justly be taken to the third line of the their own name orin that of an authorised instrument maker, with a proposed heading, which we regard not only as ethically injudicious, distinct covenant to the effect that no royalties shall be charged, and but, as printed, calculated to convey an erroneousimpression as to the real source of the title. We would suggest, therefore, the substitutionb that all members of the profession shall be entitled to use them for of" Medical Officer of Health," which would be ethically unobjection- professional:purposes without hindrance. able, and, moreover, fulfil the expressed object in view.

"A CARD." CERTIFICATES TO TRADESMEN. DR. ALFRED WRIGHT (Worthing) writes: On returning from abroad after INQuIRER.-The proposed report,if it be directly orindirectly recom- an absence of ten years, I came in August last to settle here. Being a mendatory of an article of daily consumption, and printed on the back stranger in the place, and finding that, owing to the local Guide having of the vendor's business card as suggested, with the practitioner's name- but recently been published, I had arrived too late to take advantage appended, would not only contravene a well understood ethical rule, of the orthodox method of medical advertising followed In this town, butconstitute a covert mode of unprofessional advertising, and therefore which is done, it appears, by having the doctors' portraits, with subject him to severe criticism. their names and qualifications, printed in the l'ustrated Guide to 1 Code of Medical Ethic, Ch 'p.ii, Sect. 5, Rule9