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The earnings of the 1,003 families are stated as follows:

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The total amount, as shown in the preceding table, was 3291. 15s. 7d., to which was added from the parish funds 361. 3s. 4d., making a total of 365/. 18s. lld. From this the deduction for rent alone, supposing it to be paid, was 821. 3s. 4d., or 4s. 6d. in the pound. The following is an analysis of the weekly rates of payment :

s. d.

s. d.

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The effect of a suspension of business in forcing the work-people to pledge and sell their clothing and furniture, and reducing them rapidly to a state of destitution, is shown in a striking manner by some facts that were noticed, in this inquiry. One or two of the agents employed took an account of the number of pawn tickets which each family possessed, and of the value of their furniture, according to the estimate which they were induced to form of it. The number of families with regard to which these facts are recorded, amount to more than 200, but as they are not selected cases, they will serve as specimens of the whole body, although of course there may have been some families who were in a somewhat more favourable condition. .

The number of families possessing not more than five
pawn tickets, was

From 5 to 10

From 10 to 15

From 15 to 20

From 20 to 25

From 25 to 30

From 30 to 35

From 35 to 40

From 40 to 45

From 45 to 50

From 50 to 55

From 129

19

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This last individual was a tailor, having a wife and three children, and earning 5s. per week. His furniture was estimated at 3s.

The value of the furniture in the 246 cases observed averaged only 5s. 6d.

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Those who are acquainted with the feelings and habits of the working classes, and know the pride which they usually entertain in possessing solid and sometimes even showy pieces of furniture, will appreciate the extent of the distress which in these cases had forced them to denude their apartments, and, deprive themselves both of the comfort and appearance of respectability which they afforded. As for the most part the inquiry with regard to furniture and pawn tickets relates to the same families, there is evidence of their having once, and that recently, possessed superior means. 'It does not appear whether the pawn tickets apply to furniture or clothing; but if to the latter only, there can be little doubt that whatever' furniture these destitute families formerly possessed had already been disposed of, and that their clothing, seldom too ample in the best of times, had been their next and last resource.

Report of Private Medical Practice for 1840. By CHARLES COWAN, M.D. E. and P., Physician to the Royal Berkshire Hospital and Reading Dispensary, F.S.S, &c.

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THE following Report has been drawn up in accordance with the plan of registration detailed in the Ninth Volume of the. "Transactions of the Provincial Medical and Surgical Association." It includes all cases, gratuitous and others, which have presented themselves during the past. year, exclusive of those treated in the public institutions of the town. The details are limited to the facts which the register actually contains, our object being simply to illustrate the value and practical working of the forms we have ventured to recommend, without concealing the difficulties or imperfections attached to even a brief entry of any large number of cases. Were one hundred practitioners annually to publish the results of their experience on any uniform and comprehensive plan, much valuable information, as to the locality and treatment of disease, would be obtained, and many points in the natural history of particular com

VOL. V.-PART I.

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plaints, now uncertain or contested, might be satisfactorily demonstrated

and for ever set at rest.

The value of registration might, we think, be materially increased, and greater facility afforded, were a short outline of the leading and more prominent features of disease faithfully sketched, so that in the record of cases the negative or affirmative of particular facts might be invariably noticed. This would ensure a certain number of definite results, and render the labour of different observers convergent and comparable; while it would habituate the mind to rapid and correct observation, direct our attention to what was really important, and impart the satisfaction of feeling that we were not toiling in vain. A synopsis so constructed would soon be familiar to the memory, and by a few brief words more really essential points might be secured than are often included in pages of unmethodised description.

The plan we have pursued in drawing up the present Report is that of first revising the whole, and deducing the general results; and then analysing particular groups of disease; detailing individual cases of more than common interest, and appending any brief explanatory remarks which the facts might suggest.*

To accomplish this it was necessary to construct, in the first place, general, and then secondary tables, and to frame these in relation to the nature and number of the details as noted in the register. This was a work requiring time and labour, but those who may undertake a similar task will not fail to discover its utility and advantage. There is a value in numerical researches which cannot be too highly estimated. The mere aggregation of numerous analogous facts elicits unexpected results, and often falsifies the conclusions of unrecorded experience. We are enabled to recognise peculiarities in the history, diagnosis, or treatment of disease, which would otherwise have been overlooked; and the nature and extent of our practice is very differently impressed upon the mind than when pourtrayed in the dim chambers of unaided memory. We shall now proceed to report generally upon the cases before us, appending occasional explanatory remarks.

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Seasons.—Winter, 254. Spring, 375. Summer, 372. Autumn, 348.

As this latter portion of the report belongs to medical rather than to statistical science, it has been here omitted.

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The remainder present only single instances and need not be detailed. A large number had no occupation.

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Remarks.

Transferred to hospital or dispensary

Remaining under treatment

Total

Average duration of Treatment.

Of 523 Cases it was 21 days and one-seventh.

There are several accidental reasons which increase the number of female applicants. Men are less inclined to resort to physic for every passing ailment; they have less time and opportunity for doing

so; from greater vigour of constitution and a more nourishing diet they are less seriously affected; their nervous system is less excitable and their moral sensibility less acute; and, besides many sexual exemptions, the proportion of such cases is, from evident causes, less in a physician's than a surgeon's practice.

The absence of extensive manufactories, and the size of Reading, would render an analysis of the difference in the diseases of the town and country useless. The number of entries in the different seasons is dependent partly on the fineness of the weather, as well as on the prevalence of disease, many coming from a distance.

The list of occupations presents nothing worthy of special remark.

The table of ages shows the great preponderance of applicants in the middle, and what we might justly call the more healthy periods of life. But though the natural functions are then most vigorous, yet the greater exposure to external influences, the struggling for bare support, the turmoil of the passions, the blighted hopes, the ambitious cravings, the sensual as well as mental excesses,—all combine to excite disease, and to render this portion of our existence the most stormy, and the functional disturbances the most frequent and complicated. It would seem, in fact, to present the maximum of disease, though not of mortality.

The table of the "Anterior Duration of Disease" cannot be regarded as more than an approximation to the truth. Strict accuracy, in the majority of instances, is impossible; but notwithstanding necessary error, a distinct line can, in large numbers, be drawn between chronic and acute diseases. It will be seen that two-thirds of the whole exceeded a month's duration, and that one-fourth exceeded twelve months, proving the very large proportion of chronic cases. This depends on the nature of a physician's practice. The great majority of applicants have already consulted a surgeon; many, after having for years been seeking relief from a succession of medical men, are attracted by a fresh name, and from renewed hopes are often for a time benefited, until the novelty wears off. Another reason is, that as many come from a distance, those suffering from acute and more dangerous disorders are prevented from applying. This fact would also partly account for the proportion of adults in the middle period of life.

Results. The large number marked "irregular" depends upon several causes. It includes, in the first place, all of whom the result was not known. Some, finding the medicine too expensive, never return; others are too distant to repeat the visit; others get well from the first prescription, or are satisfied with the amount of relief obtained. Some, experiencing no benefit, seek other advice; others become too ill to continue attendance, or they die; some merely come for an opinion; and lastly, many are probably forgotten to be inserted when discharged, owing to the want of diligence and zeal in the reporter.

The column "Relieved" includes the incurable cases where the symptoms were palliated, as well as those which were convalescent. The 23 deaths cannot be regarded as any real test of the actual mortality, the majority of the incurable cases dying under other treatment.

The causes of death in those noted were as follows:-phthisis 6, peritonitis 3, morbus cordis and bronchitis each 2, pneumonia, dentition, perforated bowel, caries, menorrhagia, fever, apoplexy, epilepsy, enteritis and Bright's disease each 1.

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