' MONTHLY REVIEW OF LITERATURE. 285 



be traced much of the national importance. In no other country is there such 

 a large mass of what is styled the middle class ; and no where is that import- 

 ant part of society so peculiarly characterised hy regularity and honesty. 

 Removed above the coarseness of the labouring class, and uncorrupted by the 

 luxuries of the wealthy, its members pass their lives, in most instances, in an 

 unvaried routine, and in unremitting attention to their duties. Their pecu- 

 niary resources extend from a bare competency to an income which, carefully 

 managed, may afford all the necessaries and some of the refinements of life. 

 Care for their families, one of their most prominent and best characteristics, 

 begets a rigid prudence ; and year follows year with the same expenditure. 

 Provision is carefully made for the landlord, the butcher, and the baker the 

 tailor and the linen-draper have their appropriated portion of the income ; and 

 instruction and even pleasure are duly provided for. But one, and that the 

 most important item, is not deliberated upon ; it may not come ; it is painful 

 to speculate upon ; and no provision is made for sickness and its long train 

 of expenses. ' The Doctor ' is not provided against : he will be sure to at- 

 tend when called upon : he is very liberal when engaged : and, in fact, it is a 

 distant evil. But the child sickens, or the stirring housewife and mother is 

 become feeble and nerveless or the active father, on whom all depends, is 

 prostrated by the burning fever. Then come the hourly draughts ; the costly 

 prescriptions ; the frequent fee ; the daily visit ; the nightly visit ; and, lastly, 

 the long, but just bill! the fear of which has added to the very evil the anxious 

 patient dreaded. It is true, medical men are in general easy creditors ; they 

 will take their demand as is most convenient ; often inconvenience themselves 

 rather than their patient : but the day of payment must and does arrive ; and 

 sad inroad and havoc is then made on the year's slender income ; an eighth or a 

 sixth of it is gone : and that at a time when the expediture has been increased, 

 and the means of procuring the income lessened. Involvement is thus often 

 commenced : the exactness of expenditure is destroyed ; and an anxious and 

 ruinous state of circumstances is too frequently the result. Those who may 

 think this statement overcharged, have only to observe from what almost im- 

 perceptible irregularities and pecuniary embarrassment begins, to acknowledge 

 its correctness." 



The author of this little pamphlet purposes to remedy or alleviate the evils 

 in question by forming an association, the objects of which shall be to 



" 1 . Prevent sickness by timely treatment. 



" 2. Procure the best medical advice at the most reasonable and easy rate ; 

 and 



" 3. To make such arrangements as shall give the Profession an interest in 

 promoting health rather than sickness. 



" To secure these desirable results, the following means are suggested : 



*' 1. To form a Medical Establishment or Board, on the principles of the 

 common Dispensaries ; but as it will not be established for charitable pur- 

 poses, but with the full intention of liberally rewarding professional talent, a 

 greater control than is usual at such institutions to be vested in the subscribers, 

 who will be in the same situation as private patients, paying, though in a dif- 

 ferent way, for attendance and medicine. 



" 2. This Board to consist of such functionaries as shall be found necessary; 

 including one or more eminent physicians ; one or more eminent surgeons ; 

 and practising and visiting medical men of approved ability ; together with 

 an establishment for the purchasing and compounding, at the cost prices, the 

 most genuine medicines. 



" 3. The expenses thus occasioned to be defrayed by annual subscriptions, 

 the amount of which is to be based on the outlay ; which shall be such as to 

 afford a liberal remuneration to medical ability, but no profit on the medicines, 

 they being compounded and dispensed from prescriptions by a servant of the 

 institution, who is to be paid by salary. 



" 4. Such regulations to be made as, on a full examination of the circum- 



M.M. No. 3. Y 



