"The only legitimate object for which punishment can be inflicted is the prevention of crime. Am I to be hanged for stealing a sheep?' said a criminal at the Old Bailey, addressing the bench. 'No,' replied the judge; 'you are not to be hanged for stealing a sheep, but that sheep may not be stolen.' Every punishment, argues Beccaria, which does not arise from absolute necessity is unjust. There should be a fixed proportion between crimes and punishments. Crimes are only to be estimated by the injury done to society; and the end of punishment is, to prevent the criminal from doing further injury, as well as to induce others from committing similar offences.

The act of suicide ought not to be considered as a crime in the legal definition of the term. It is not an offence that can be deemed cognizable by the civil magistrate. It is to be considered a sinful and vicious action. To punish suicide as a crime is to commit a solecism in legislation. The unfortunate individual, by the very act, of suicide, places himself beyond the vengeance of the law; he has anticipated its operation; he has rendered himself amenable to the highest tribunal-viz. that of his Creator; no penal enactments, however stringent, can affect him. What is the operation of the law under these circumstances? A verdict of felo de-se is returned, and the innocent relations of the suicide are disgraced and branded with infamy, and that too on evidence of an ex-parte nature. It is unjust, inhuman, unnatural, and unchristian, that the law should punish the innocent family of the man who, in a moment of frenzy, terminates his own miserable existence. It was clearly established, that before the alteration in the law respecting suicide, the fear of being buried in a cross-road, and having a stake driven through the body, had no beneficial effect in decreasing the number of suicides; and the verdict of felo-de-se, now occasionally returned, is productive of no advantage whatever, and only injures the surviving relatives.' 335.

It is a barbarous law no doubt, and is now nearly obsolete. But it is not the only barbarous law on our statute book. The man attainted with high treason forfeits his life, and his relatives are punished, after his death, by the forfeiture of his property, which ought to go to his heirs who have committed no crime. This is a still harder case than the other: for we much doubt whether the surviving relatives would not prefer a verdict of felo-de-se to that of insanity, than which is nothing more dreaded among families-the stain being a physical one, and considered, whether true or false, to be capable of extension by hereditary descent, which is not the case with a moral stain. The whole turns on the question-do these penalties and forfeitures act as checks on the commission of suicide and treason? In the latter case, it is probable that they do-in the former, we think they are almost entirely inefficacious. The following quotation will shew that solemn judges on the Bench have considered lunacy as nearly coeval with human nature, and the inevitable lot of every human being, at one or other time of life!

"If the mind be overpowered by 'grief, sickness, infirmity, or other accident,' as Sir Mathew Hale expresses it, the law presumes the existence of lunacy." 336.

Having shewn, then, that no penal law can prevent suicide, our author asks, is there no other means of staying the progress of the Act?

"In the prevention of suicide, too much stress cannot be laid on the importance of adopting a well-regulated, enlarged, and philosophic system of education, by which all the moral as well as the intellectual faculties will be

expanded and disciplined. The education of the intellect without any reference to the moral feelings is a species of instruction calculated to do an immense amount of injury. The tuition that addresses itself exclusively to the perceptive and reflective faculties is not the kind of education that will elevate the moral character of a people. Religion must be made the basis of all secular knowledge. We must be led to believe that the education which fits the possessor for another world is vastly superior to that which has relation only to the concerns of this life. We are no opponents to the diffusion of knowledge; but we are to that description of information which has only reference to the life that is, and not to that which is to be.' Such a system of instruction is of necessity defective, because it is partial in its operation. Teach a man his duty to God, as well as his obligations to his fellow-men; lead him to believe that his life is not his own; that disappointment and misery is the penalty of Adam's transgression, and one from which there is no hope of escaping; and, above all, inculcate a resignation to the decrees of Divine Providence. When life becomes a burden, when the mind is sinking under the weight of accumulated misfortunes, and no gleam of hope penetrates through the vista of futurity to gladden the heart, the intellect says, 'Commit suicide, and escape from a world of wretchedness and woe;' the moral principle says, 'Live,; it is your duty to bear with resignation the afflictions that overwhelm you; let the moral influence of your example be reflected in the characters of those by whom you are surrounded.'" 338.

From a short chapter on the appearances after death in suicide, we make the following extract in conclusion.

"From an examination of the particulars of 1333 cases of persons who have committed suicide, and who have been examined after death, the following analysis is made. The particulars of the cases referred to are recorded in the works of Pinel, Esquirol, Falret, Foderé, Arntzenius, Schlegel, Burrows, Haslam, &c.

Thickness of cranium....
No apparent structural change.
Bony execrescences.

Tumours in brain. .

Accretions of the membranes of the brain are often found in suicides. The dura mater is often ossified, and the pia mater inflamed, and the arachnoid thickened. Osiander considers congestion of the vessels of the brain a frequent cause of suicide." 281.

Here we must close our very imperfect notice of a volume which does infinite credit to the head and the heart of the author.

PAROCHIAL MEDICAL RELIEF, considered in a Letter to thE "POOR-LAW COMMISSIONERS," DEVELOPING AN ENTIRELY NEW SYSTEM OF MEDICAL REMUNERATION, ALIKE CONDUCIVE TO THE INTERESTS OF THE RATE-PAYERS, THE WELLBEING OF THE POOR, AND THE RESPECTABILITY OF THE PROFESSION. By E. T. Meredith, Member of the Royal College of Surgeons, London. Pp. 36. Highley, 1840.

THE question of Parochial Medical Relief has certainly lost nothing of its im portance, and would appear to have lost little of its complexity. After all the evidence that has been taken, and the experience that has been obtained, we have before us what we believe to be a novel proposition, candidly urged and ingeniously supported by a gentleman who appears to be practically well acquainted with the subject.

When the Poor-Law Commissioners began their unjust and tyrannical crusade against the medical profession, we told them that it was no less impolitic than wrong, and would probably be as unsuccessful as impolitic. As if it were not enough to inflame the prejudices and outrage the feelings of the lower classes, they must array against the law which they misapplied, the influence of an insulted and a powerful profession. The Commissioners were warned of this, but they persisted in their contumelious course, and much of the difficulty which the Poor Law has encountered may be traced to their perverse, we might almost say their insolent, obstinacy.

No honourable man in the profession contends that medical relief to the poor should be looked on essentially as a medical question. It is in all its length and breadth the poor man's question. It affects him in the most vital way, for on its right solution hang his health and strength and life. If those on whose skill his fate depends are so insufficiently remunerated, that their interests lead them to neglect him, he knows enough to be well aware that neglected he must be. The motives that influence bodies of men are no secret, human nature is not altered by the lawyer's coif or the doctor's degree, and though individual instances of extraordinary, or, perhaps, quixotic benevolence, may stand out here and there beyond the common level of the feelings of the community, these must not be allowed to form the elements of selfish calculations.

The abominations of the "Tender System" have, we trust, passed awaythe Commissioners, we hope, have ceased to protest that the minimum of medical remuneration is the maximum of perfection of the poor-law-well paid themselves for their philanthropy, they have been forced to the acknowledgment that the medical profession is to be no loser by its labours-and the problem which now waits solution is, how the public interest may fairly be consulted with a due regard to that of the poor and the profession. Like all

questions of detail this does not admit of a speedy, scarcely of a satisfactory

settlement.

Without going into the various plans that have been latterly proposed, to most of which, indeed, we recently devoted some attention, we think it only right to bring Mr. Meredith's under the notice of our readers. As we cannot pretend to a nice and practical acquaintance with this important matter, we shall content ourselves with bringing forward the main features of Mr. Meredith's proposals, and enabling our readers to form their own judgment upon them.

He entertains some strong objections to the system of paying by the case, and by family tickets. This plan, if persevered in, will, he is convinced, lay open a wide field for the exercise of intrigue, and prove a fertile source, nay, offer a premium upon the accomplishment, of fraud; for the object of the illpaid medical officer will assuredly be to increase the number of applicants, and so impose on the rates; and the object of the relieving officer will be to protect the rates, and so deprive the sick poor of that relief to which the law entitles them. This conclusion may be questioned-it may be said that the character of the profession is above such a suspicion that the relieving officer can have no motive for so abusing his trust;-nevertheless it must be admitted that the system is open to this most serious objection. How desirable then any plan must be that tends to relieve the profession from the imputation of selfish, mercenary, and faithless conduct and the relieving officer from such an embarrassing position-and also removes the source of that interminable contention inseparable from such contingencies, and which cannot be otherwise than prejudicial to all parties interested in the contract.

Prior to developing his scheme of medical remuneration, Mr. Meredith is at the pains to define the duties of medical officers.

"The duties of medical officers to Unions, (trusses and unusual bandages being paid for at cost price,) should be to attend upon, and furnish all necessary medicines and surgical assistance, (including operations* and vaccination), to the sick paupers, disabled by accident or otherwise, residing in the Union, upon their own application; each officer certifying every case as it occurs, in his own district, to the relieving officer, who should as early as possible, visit the same, in order to detect any imposition that may be practised on the part of the applicant, and check any unnecessary attendance on the part of the medical officer; -an exception must be made of difficult midwifery cases, for which an extra fee of 10s. 6d. should be allowed ;-other cases of sickness, or accident, happening to those not strictly paupers, and not being in the receipt of more than 14s. per week, but who have an order for medical relief from the relieving officer, or any authorised person, guardian, or overseer, should be equally attended to; these cases not being charged without producing the authorized orders. Others again whose income does not exceed 1. 1s, a week, should be entitled to the same attendance, &c. by obtaining a loan ticket, for which they should pay 7s. 6d. ; (if midwifery 10s. 6d. by giving one month's notice, and paying 5s. in advance; or 1. 1s. on the emergency); to the relieving officer, to be paid by him to the medical officer, who will return the ticket as a receipt; these loan cases, of course, will not become chargeable to the Union, further than being considered as forming part of the annual average number of cases. In order to prevent any equivocation, as to the cure of a case, and repeated attacks of the same, or the accession of another disease, in the same person; I

* "I have seen no good reason alleged, why an extra fee should be allowed for operations-such however has been suggested by many, for whose opinions I entertain a high respect; notwithstanding which I cannot assent to their views on this occasion."

propose that a case should be considered as lasting three months, after the expiration of which, the application must be renewed, if the case continues, or a fresh illness arises, but the same individual should not be charged more than twice in the year. The medical officer should as now make a weekly return of the sick under his treatment, accompanied with such observations as the cases call for; which return should be examined by the Board, and certified by the Chairman as approved, or otherwise, as the case may be; but all other reports, involving opinions not immediately connected with cases under his care, he should not be expected to make, without receiving a proportionate fee for his trouble. Some provision should be made to ensure promptitude, in the execution of the necessary orders for extra diet, &c., issued by the medical officer;-this at present is badly arranged-would it not be well to allow the medical officer to send his orders direct to the parties contracting for the several articles, at least in those cases, where the applicants are receiving pauper relief? The medical districts should be limited to a surface of forty square miles; and no district should furnish on an average more than 600 cases, nor less than 50, annually; neither should a district of forty square miles exceed 300 cases annually-thirty miles 400, and other districts in the same proportion.* I have made no separate provision for attendance, &c., at the workhouse, believing the duties thereof may safely be included in the general arrangement."

The Remuneration of those officers is set forth in the following Propositions, which we find it utterly impossible to abridge.

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First, That the Medical Officer should be remunerated by a 'fixed annual salary,' and a 'sum,'-proportioned to the number of cases attended during the year; but, as the amount of this 'sum' cannot be ascertained before the end of the year, and as the payments are made quarterly, I would advise a portion, from three to five pounds less than the average, to be paid with the quarterly 'fixed salary,' leaving the balance to be adjusted at the last quarter when the total number of cases will be known.

Second, That the fixed salary' should consist of two sums;-the first, depending upon the extent of the district, and the progressive value of the whole of the cases occurring therein, and which may be considered as ‘milage ;' the second depending upon the annual number of cases, (the value and number being taken on an average of the three preceding years)† and which may be regarded as a 'per centage' on stock in trade.

The 'fixed salary' thus established will guarantee the medical officer from loss; (it is much to be feared that Boards of Guardians attach little import to this), the necessity of which will perhaps more readily be conceded, when I affirm that the expenses incurred in conducting a country private practice of 300 cases

"It has been proposed to found the calculation of the value of medical salaries, upon the extent of the district, and the amount of population; this principle, however, can never safely be applied, because the sickly, or healthful character of a district may be quite uninfluenced by the amount of its population; again, the population may be comparatively rich or poor.-An area of forty square miles I know is by many considered too extensive, but with the reservations here laid down I think the objection vanishes."

"In adopting this system where the remuneration has been by a sole annual salary, the first year will necessarily be experimental in regard to the average, as the present returns will scarcely afford a just criterion of the number of bonafide cases; taking this into consideration, I therefore think that one fourth of the reported cases may be safely and fairly deducted from the three preceding annual returns and the average taken on the remaining three fourths."

These expenses do not include the capital sunk in education, &c. the interest on which cannot be estimated at less than 50l. per annum.