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SUPPLEMENT TO THU 1350 BBITI8H MZDICAL JOURNALJ INSURANCE BILL. [SEPT. i6, I9II.INSURANCEBILL.BRIGHTON DIVISION OF THE BRITISH MEDICAL AssoCIATIONMEDICAL PRACTITIONERS' DEFENCE FUND.NESTOR writes: I see in the SUPPLEMENT of September 9ththat the Brighton practitioners have instituted a defencefund. I note that in Clause 4 a practitioner holding clubappointments is to guarantee a sum equal to at least 25per cent. of his gross annual club income; those not holdingsuch appointments to guarantee at least £10. I do notknow how many doctors hold club appointments in such afashionable resort as Brighton, nor do I understand thisunequal guarantee. Whatever the effect may be upon theprofession as a whole when this bill is passed, it is quitecertain that the men who hold the club appointments willbe the lminediate sufferers should it be found necessaryfor them to resign their club appointments. In fact theselatter, in most country practices, form a very valuableasset, both from a capital as well as an income value.Surely, then, it is the duty of men who do not hold clubappointments to see that the sacrifice of their brethrenshould not be left uncompensated. It would seem to me,if there be any difference in the amount of the guarantee,it is those who do not hold these appointments who shouldsubscribe the larger sum. Better still, all should guaranteea minimum sum of the same value. Such as are able toafford it should give more. It is the club doctors who canmake or mar this bill, but I hardly think any other Divisionwould introduce such a flagrant inequality as is containedin the clause already referred to.MR. HARMSWORTH'S AMENDMENT,H. D. writes: As the acceptance of Mr. Cecil Harmsworth'samendment is a contradiction to Dr. Addison'samendment, as will be found in the working, would it notbe as well to try and prevail on the author of the billto accept some way out of his difficulties-he is clearlytrying to concifiate two classes, the medical professionand the friendly societies, so far with poor success? Itseems to mie the only way to do it is to throw the wholebody of doctors open to clubs by paying medical men forwork done per scale. If the expense is a formidableobjection a modification of the same idea would be tocompel clubs to pay medical men for work done per scaleand to compel clubs to form a fund for such a purpose by,in the first instance, a levy of 4s. a member per year.Should the fund so started be insufficient for the purpose, afresh levy on the members could be made to meet the deficit.The prospect of a fresh levy, which would be a varyingsum, would prove a great check on the clubs and membersgoing to the doctor too freely.I, with a great many others, will rejoice to see ourprofession stripped of the contract system. The first tobenefit by any change of this kind would be the clubmembers themselves, as it provides them with a realchoice of doctor, for they can consult which doctor theyfancy provided he accepts the scale fees. Under thissystem medical men will at once begin to take an intelligentinterest in club work, and the best men will get themost work. This is as it should be, in everybody'sinterests.THE INSURANCE BILL AND THE PUBLIC.Dr. WM. EARDLEY (Goole) writes: I read with interestbut also with surprise the article in the NineteenthCentury of July, which was reviewed in the BRITISHMEDICAL JOURNAL of September 2nd. The article, as itseemed to me, was a, misstatement of our positionso misleading to the public as to call for an answerfrom some medical man knowing the facts and able tostate them. Hence we may be glad to see the NineteenthCentury of this month (September) contains an article byProfessor Lindsay of Belfast entitled The Ethics ofMedical Practice, in which the writer ably, briefly, andimpartially states the truth in regard to the medicalprofession, disproving the charges brought against it.Written in language which the laity can understand,Professor Lindsay's article is in the main a reply tothat in the July magazine, and may well convince anybut the most ignorant and bigoted of the following facts:that, so far from being " actuated only by the most sordidmotives," the medical profession is at bottom essentiallyaltruistic; no other profession does so much unpaid work;doctors generally are not mere self-seekers, but highminded,public-spirited men, concerned at least as muchwith promoting the welfare and health of the public aswith filling their own pockets; we do not blow our owntrumpets, " the medical profession is intolerant of selfadvertisement,"but we yield to none in our desire to helpthe poor, a desire put into practice by almost every doctorevery day; and finally, thanks to the energies of medicalmen, to the spirit and performance of present-day medicalscience, this is pre-eminently the age, not of mere quackeryand humbug, but of preventive medicine.The extraordinary suggestion that the medical Drofessionis " parasitic upon diseased persons " is too silly to domuch harm. As well say the legal profession is "parasitic" upon the rogueries, or the Church " parasitic " uponthe sins, of mankind. Such language exceeds the boundsof common sense." The art of medicine needs no apology," as ProfessorLindsay observes. " Its triumphs are written on the pageof history, and shine nowhere more brilliantly than in therecords of the last few decades."He concludes with a passage from R. L. Stevenson,which may encourage us when we feel disheartened evenby unjust criticism:There are men and classes of men that stand above thecommon herd-the soldier, the sailor, and the shepherd notunfrequently, the artist rarely, the physician almost as a rule.He is the flower (such as it is) of our civilization. . . . Generosityhe has, such as is possible to those who practise an art,never to those who drive a trade; discretion, tried by a hundredsecrets; tact, tried by a thousand embarrassments; and whatare more important, Herculean cheerfulness and courage. Soit is that he brings air and cheer into the sick-room, and oftenenough, though not so often as he wishes, brings healing.The verdict of Stevenson may well be allowed to outweighthat of a writer who attacks, disparages, and misrepresentshis own profession.LIBRARY OF THE BRITISH MEDICALASSOCIATION.LENDING DEPARTMENT.A LIST of periodical publications, official reports, and BlueBooks in the Library of the British Medical Associationavailable for issue to members on loan has been printed, andcopies can be obtained free on application to the Librarian,at the house of the Association, 429, Strand, W.C. Theregulations governing the loan of these publications arestated in the introduction to the list.The Library is open for consultation from 10 a.m. till5 p.m. (on Saturdays till 2 p.m.).ja l aub ftiIitarg Appoinntnts.ROYAL NAVY MEDICAL SERVICE.FLEET SURGEON J. L. THOMAS has been placed on the retired list,with the rank of Deputy Surgeon-General, September 3rd. He wasthe senior Fleet Surgeon in the Royal Navy, having been appointedSurgeon, February 11th, 1884; Staff Surgeon, February 11th, 1896; andFleet Surgeon, November 9th, 1896. He was Surgeon of Temeraire(Flag) Mediterranean, and attached to torpedo boat flotilla during theblockade of Greek ports by the International Fleet (1886). Surgeon incharge of Britannia (Cadets' School), and mentioned to their Lordshipsfor introducing and conducting classes on " First Aid."Especial mention by their Lordships for medical services renderedduring an epidemic of yellow fever (November, 1891, to February,1892), whilst Surgeon of the Naval Hospital, Jamaica. Surgeon ofPorpoise during the China-Japan war, 1894-95, and witnessed thesurgical treatment of the Japanese wounded immediately after the.Yalu naval action; present at the storming and fall of Port Arthur(November, 1894), and at the bombardment and capitulation ofWei-hai-Wei (February, 1895): landed at Chefoo in charge of a nativehospital there, and received their Lordships' thanks for services performedto the wounded Chinese soldiers and sailors; favourably notedby the Admiralty for this service; bestowed by the Imperial ChineseGovernment (through the British Minister, Peking) with the GrandOrder of the Double Dragon of China of the First Division, 3rd Class;P.M.O. of the Naval Brigade in the advance with the Allied Forcestowards Peking; present in the actions on the route Tientsin toPeking and Relief of the Legations (1900), (mentioned in dispatches,promoted to Fleet-Surgeon, medal with clasp).The following appointments have been made at the Admiiiralty:Fleet Surgeon J. C. FERGUSON, M.B., and Surgeon A. C. W. NEWPORTto the Japiter, on its becoming the parent ship, September 1st; Fleet