Licence: Public Domain Mark
Credit: The second annual report of the Southam Dispensary. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![The following NOTES, and commentary on the piitcdiiig resolutions, are respectfully oflered bv Hfr Smith to ll,„ President and Coininiltee, and tile Geiilleiiien of tlie conntiesof Warwick and Northampton, who are concerned in'that'nart of car laws which respects the civil economy and comforts of tli,|,„„r,-as well as the Clergy, and Members of the MedicM Pro lessioii, who will feel the viilue of establishing a method wli,ro there has liitherto been, from the want of it, air onoortniiitv for neglect and oppression to pass almost iniiiolleed and linredressel i or for attention and skill, however faithfully aiiolied and with the greatest mental and bodily sacriHces, to coiiliiiiie for a serio of years unregarded and comparalively unpaid. He hones the scheme and notes will be received will, indulgeiice,-as the .buses they unfold have been of long standing, and liave increased Will! our poor laws, and present a wide, Uioiigh uncultivated fold, of pliilaulhropic inquiry. ]. District or Coiitripelal Dispensary a[)pears a good name, to distinguish Institutions of liiis sort from Hospitals, Infirmaries, or other Dispensaries, supported by the annual subscriptions of tlie rich. 2. o 336 members, ofwhom215are adults, and 121 children. *270 patients, their diseases generally slight, as they have been enabled lo apply for relief at once, and with- out fear of expense or difficulty of access. U liave died, 6 of which were cases of pthisis:—these cases are usually excluded from other Institutions, and when they come under the care of a parish surgeon as confessedly incurable, are frequently left to sink into the grave without those pal- liatives that medicine, occasionally given, can afford in this untractable, as well as in many other incurable disordei-s. 48 of these 270 would have applied to their ]>arishes for a surgeon, had it not been that they were members, allhough they had never done so before, but having small families it would have been imprudent to incur bills; and about 64 who had in their previous illnesses been attended by parish sur- geons, have, and will for ever, if possible, in this respect, renounce parish aid. 30 are servants, taking small wages. 3. ^That labouring tamilies apply to their parishes for assistance on account of medical e^vpmses,—and ihat alone in many instances may be learnt from this faci—that at Sonlhani, previous to the establishment of the Dispensary, whilst only 145 individuals were considered as [iroper ob- jects to be assisted with parish pay, upwards of 400 were occasionally supplied with orders lo ilie |>ai i>.li surgeon; of course 250 of these may be considered as floating between independence and pauperism,—belonging to the former in their youth and health aud when wages and work are plen- tiful, and to the latter when they are deprived of any of these advantages; all of whom could at some time in the year, especially in the summer, or by quarterly pay- ments, spare the money that would be required lo be- come members of the Dispensary, particularly if they were stimulated to do so by their luas'ers, and had any increased respect shewn them for this effort to keep from applying to their parishes Besides these 250, who may be called occasional pau- pers, there are probably about the same number who incur bills which lliey either cannot or which distress them exces- sively to pay,—many die rather than get in debt, or apply lo tiieir parishes. The numbers thus situated are very con- siderable. Soutliam contains 1161 inliabitants,—335 of whom are sufficiently rich to be under the usual circum- stances of life, independent of any assistance but what may be derived from their own resources without manual labour, —as before observed, 145 as applying to their [larishes for maintenance, rent, or clothing, may properly be called paupers. If these two classes, the rich and the poor, are sub- tracted from the whole population, 681 are consequently the number of persons, who may be conshtered as ealing their bread in the sweat of the brow',—and whom it be- hoves the public to save from the evils above pointed out, to one or oilier of which they are liable, if sickness should deprive them of the means of continuing in that station of life in which they are placed; and who, whilst struggling to live in respect and comfort, should have every possible aid, countenance, and protection,—far more than those who without an effort to prevent it, throw themselves upon liie parish on all occasions. Of these 681—170 are members of the Dispensary, above one half of them must otherwise go to the parish in sickness ; but who would not now do so, as they would be unwilling to forego the step towards independence they may be considered to have gained. If the same calculations are applied to the villages that surround Soutliaij^ and m IucIi are not particularly numerous or populous, it will be found that there are 10,000 persons within five miles, it is probable that there are upwards of 6,000 proper to become subscribers—and which ivould give an income of £.750 per annum ; to which may be atlded £.300, the sum the parishes should pay, at the rate of £.3 for every hundred of their population, (which is not more than they now pay). Qbserve, this sum should vary ac- cording to the distance of each village from the Dispensary, as parishes would have tio journies or other extras to pay and it would give the sum of £.1050 for the use of the Dis- )»ensary,—£.250 of which would be sufficient for the snp- ply of drugs, rent, wine, cS:c. &c. and the remaining £.800 divided amongst the medical men for their services. It is not to be expected that above one half or one third can be made sufficiently provident thus to insure themselves the advantages of the Dispensary,—but it is probable that no- thing like one third of the above sum is at present paid to the regular medical men for attendance on tliis (in this par- ticular.) oppressed class of society as unless they come in forma pavpens with a ticket from an overseer, regular med- ical attendance is beyond tluir means,—and the objections to this mode will be seen by reference to the Petition. These calculations are submitted to the consideration of magistrates and land owners, in the hope that they may elucidate the benevolence and policy of stimulating their labourers and servants to provide ihcir own funds for this purpose, as an aggregate fund alone can defend the earn- ings of their yonlh, from becoming a sacrifice to an accident, or fit of sicknevs, against which no prudence can guard, and whicii scheme, in conjunction with a Savings Bank, or Friendly Society on 'improved principles, may leach every family, where the bread winners can earn 12s. a week, lo part with their ancient inheritance,—^jaWsA pay and the U'oi'khovsp. It may be acceptable to the piofession, and to those gentlemen tvlio are friendly to the principles of the Dispen- sary, but have felt delicate in interfering with the pre- sent mode of remunerating attendance, (though an acknow- ledged barl one,) as it may convince them the sum to be divided will be more considerable than what is now obtained from these classes of ptople. I’he importance of these calculations, as one of many excellent means of elevating the character of our working population, may be estimated by recollecting that in this county alone it is probably 200,000, and that in those cities and towns which are densely inhabited, the funds would amount to a sum fully equal to pay medical inenYor attendance, in as great degree as they now receive from the more affluent. The outfit for forty Dispensaries would not exceed the annual tax on the benevolent for one County Hospital. About 30 of the members are casual poor, or those who belong to a different parish from that in which they reside; tliey have therefore no legal claim to local medical relief,— “ and to procure an order for it from their own paiish requires a negociatioii of no small difficulty between the pauper and overseer; Hie latter of whom generally cuts it short by re- quiring him to be brought home for assistance. But as this would either endanger bis life, or deprive himself and family of that employ which kept him, and them, from the poor house,—he is constrained to give up all thoughts of paro- chial aid, and to rely on the mercy of Heaven to send liini the good Samaritan,” and “ llie Ladies Bountiful^ The Dispensary Lo the casual pooj- will be a great blessing. 4. It is desirable to conlimie the annual subscriptions to the Nortliainpton General Infirmary, and to the Charita- ble Baths at Leamington ; and wiien the funds are sullici- cient, to become subscribers to the Hospitals at Oxford and Bii-niingham. and the Sea Bathing Infirmary at Mar- gate. Iliiis, in the worst cases that can arise, ensuring the best care and advice in the kingdom for each individual belonging to it, without the sacrifice of independence in- cluded in begging an Hospital ticket. The governors of these e.xcellent charities, but especi- ally the medical officers, will value these occasional tributes paid to their superior advantages by the Dispensary sur- geons; and their wards (if this sort of Dispensary should become general,) would be occupied with more suitable cases, than those fiecpieiUlyipeiit by philanthiopic individu- als, not of the prolession. Liver diseases, aneurisms, stone, scrofula. Arc. Arc. would promptly come under the care of those surgeous, at these respective establishments.](https://iiif.wellcomecollection.org/image/b22344378_0002.jp2/full/800%2C/0/default.jpg)
