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ABSTRACT OF THE EVIDENCE OF MEMBERS OF THE ROYAL COLLEGE OF SURGEONS IN LONDON, TAKEN BEFORE THE...

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666 each other, therefore they do not possess equal specific electricities, so that by making the disparity more apparent (which is done by giving each a higher charge, as when an electric spark is passed through them), they do attract each other and unite. Once united, their natural dispa- rity in electrical capacity suffices to hold them in union; so that we may consider that the difficulty of union of substances, and the quantity of additional electrical excitement required to make them com- bine, is a measure of the diffe2-eitee of their specific electricities. This theory will account also for a subistaiice evincing one kind of electrical excitement when about to combine with one substance, and the opposite state when about to combine with another. Thus, according to this view, sulphur possesses a greater specific elec- tricity than oxygen, and a less specific electrity than mercury, and is, consequent- 1.1f, positive with regard to oxygen, and negative in relation to mercury. I am, Sir. vour obedient servant. 26, Woburn Place, Aug. 11, 1835. EDWARD B. WALFORD. ABSTRACT OF THE EVIDENCE OF MEMBERS OF THE ROYAL COLLEGE OF SURGEONS IN LONDON, TAKEN BEFORE THE PARLIAMENTARY MEDICAL COMMITTEE IN 1834. WE refer to the following evidence as to that of a gentleman whose replies to the committee are likely to be looked for and perused with particular interest, for in the whole profession there is not a man whose feelings towards the practitioners of the medical- art are based upon better! principles, or have been adhered tothrough a long and most extensive intercourse, with greater firmness and integrity. The opinions of Mr. WARDROP on the govern- ment of the profession are liberal in the widest and purest sense of that word, aud such as become a man who has paid great attention to the claims of the science, the just demands of its followers, and the ne- cessities of the public. These circum- stances wilt be made quite evident to the reader, although Mr. WARDROF refrained, in the then-existing state of’ the inquiry, from offering to the Committee any details for the future government of the profession. The surgeons in general practice will see that in Mr. WARDROP, in whom they have so long had one of the ahlest coadju- tors in the consultation room, they have here one of the wannest public friends. EVIDENCE OF JAMES WARDROP. 509. You are a Member of the Royal Colleges of Surgeons, both of London and of Edinburgh; a Fellow of the Royal So. ciety of Edinburgh ; and were aurgeon to his late Majesty, and, lately, a lecturer on surgery ?"-" Yes." 509*. " Where did you receive your pro- fessional education?"-"At Edinburgh, at London, at Paris, and at Vienna." 510. When did you become a member of the College of Surgeons of Edinburgh?" —" At the age of twenty-two." 511. "Have you graduated?"—"Yes." 512. "When did you come to London?" " About six years after that period." 513. "Did you practise at Edinburgh ?" " I did for six years." 514. " Did you hold any office in the Edinburgh College of Surgeons ?"-" I was an examinator, and curator of the mu- seum." 515. "What was your age when you were an examinator of that College ?"- "Twenty-four." 516. "And your standing in the profes- sion ?"—" Two years." 517. "Were seniors associated with juniors, as examinators, in that College ?" ’ = ‘ The board consisted of six. Two juniors, two seniors, and two middlemen in point of age,—thus divided on a principle of convenience and propriety." 518. "What was the nature and scope of the examination?"-"The duty of the examinator was considered to be, to satisfy himself and those around him of the fitness of the individual, by the knowledge evinced in the answers given to appropriate qties- tions." 519. " Did the questions comprehend most of the subjects in the course now shown to you ?"-" I conceived myself en- titled to examine, and I was in the habit of examining, upon every one of those subiects." 520. ’- Might the practice of conjoining junior examiners with seniors be advan- tageously introduced into the London College of Surgeons ?"-" I think so." 521. " For attending examinations once a week, for five or six hours at a time, what would be, for a junior surgeon, a reasonable remuneration "--." It is dif-
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each other, therefore they do not possessequal specific electricities, so that bymaking the disparity more apparent (whichis done by giving each a higher charge,as when an electric spark is passed throughthem), they do attract each other andunite. Once united, their natural dispa-rity in electrical capacity suffices to holdthem in union; so that we may considerthat the difficulty of union of substances,and the quantity of additional electricalexcitement required to make them com-bine, is a measure of the diffe2-eitee of theirspecific electricities. This theory willaccount also for a subistaiice evincing onekind of electrical excitement when aboutto combine with one substance, and theopposite state when about to combine withanother. Thus, according to this view,sulphur possesses a greater specific elec-tricity than oxygen, and a less specificelectrity than mercury, and is, consequent-1.1f, positive with regard to oxygen, andnegative in relation to mercury. I am,Sir. vour obedient servant.

26, Woburn Place, Aug. 11, 1835.EDWARD B. WALFORD.

ABSTRACT OF THE EVIDENCE OF

MEMBERS OF THE ROYAL COLLEGEOF SURGEONS IN LONDON,

TAKEN BEFORE THE

PARLIAMENTARY MEDICAL COMMITTEE IN 1834.

WE refer to the following evidence as tothat of a gentleman whose replies to thecommittee are likely to be looked for andperused with particular interest, for inthe whole profession there is not a manwhose feelings towards the practitionersof the medical- art are based upon better!principles, or have been adhered tothrougha long and most extensive intercourse,with greater firmness and integrity. The

opinions of Mr. WARDROP on the govern-ment of the profession are liberal in thewidest and purest sense of that word, audsuch as become a man who has paid greatattention to the claims of the science, the

just demands of its followers, and the ne-cessities of the public. These circum-stances wilt be made quite evident to thereader, although Mr. WARDROF refrained,in the then-existing state of’ the inquiry,

from offering to the Committee any detailsfor the future government of the profession.The surgeons in general practice will seethat in Mr. WARDROP, in whom they

have so long had one of the ahlest coadju-

tors in the consultation room, they havehere one of the wannest public friends.

EVIDENCE OF JAMES WARDROP.

509. You are a Member of the RoyalColleges of Surgeons, both of London andof Edinburgh; a Fellow of the Royal So.ciety of Edinburgh ; and were aurgeon tohis late Majesty, and, lately, a lecturer onsurgery ?"-" Yes."

509*. " Where did you receive your pro-fessional education?"-"At Edinburgh, atLondon, at Paris, and at Vienna."

510. When did you become a memberof the College of Surgeons of Edinburgh?"—" At the age of twenty-two."511. "Have you graduated?"—"Yes."512. "When did you come to London?"" About six years after that period."513. "Did you practise at Edinburgh ?"

" I did for six years."514. " Did you hold any office in the

Edinburgh College of Surgeons ?"-" I wasan examinator, and curator of the mu-seum."

515. "What was your age when youwere an examinator of that College ?"-"Twenty-four."

516. "And your standing in the profes-sion ?"—" Two years."

517. "Were seniors associated withjuniors, as examinators, in that College ?"’ = ‘ The board consisted of six. Twojuniors, two seniors, and two middlemen inpoint of age,—thus divided on a principleof convenience and propriety."

518. "What was the nature and scopeof the examination?"-"The duty of theexaminator was considered to be, to satisfyhimself and those around him of the fitnessof the individual, by the knowledge evincedin the answers given to appropriate qties-tions."

519. " Did the questions comprehendmost of the subjects in the course nowshown to you ?"-" I conceived myself en-titled to examine, and I was in the habitof examining, upon every one of thosesubiects."

520. ’- Might the practice of conjoiningjunior examiners with seniors be advan-tageously introduced into the LondonCollege of Surgeons ?"-" I think so."

521. " For attending examinations oncea week, for five or six hours at a time,what would be, for a junior surgeon, areasonable remuneration "--." It is dif-

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6eult to say; but they ought to be wellpaid, at the same time not making theremuneration the sple motive for accept-ing the appointment, but partly the ho-nour and credit attached to it."522. How long have you been in prac-

tice in London ?’ =" Twenty-two years."523. To what branch has your atten-

tion been more particularly devoted ?"-" It has not been devoted to any particu-lar part. My mind has been occupied instudying the whole of what has been call-ed medical science."

524. " As surgeon to his late Majesty,did you receive any remuneration?"!‘ Idid, I received 1000l."

525. " How long were you surgeon?"-" I was one of the surgeons extraordi-nary for about eight or ten years, andsurgeon to the Person’ during the lastthree or four years of his Majesty’s life."

526. " Can you define the boundarywhich separates the practice of the physi-cian from that of the surgeon; and of thephysician and surgeon from that of thegeneral practitioner?"-" The generalpractitioner is a man who is supposed topossess the knowledge both of the physi-cian and the surgeon; and he ought topossess it, from the nature of his avoca-tions."

527. " Is not a very large share of thesurgeon’s practice of a medical nature?"- Almost the whole of it. I believe thenumber of operations that are performed,or at least are performed with success(and the success measures the proprietyof performing them), are very few. Thegreat business of the surgeon is, to pre-vent diseases going to that length whichrequires an operation."

528. " If no defined line of separationcan be drawn between the two depart-ments of practice, upon what well-foundeddistinctions have separate colleges beenestablished for medicine and surgery ?’’-11 I believe -there is no real distinction ;and the division leads to a great deal ofbad feeling amongst the members of thedifferent colleges. Cases are constantlyoccurring, in which disputes arise uponpoints of professional etiquette ; and thereis no printed authority to refer to, to knowwho is right."

"

529. " Is it not desirable that both phy-sicians and surgeons should confine orextend their practice as they please ?"-" No dotibt of it, for the public interests ;although it may not be so for the interestsof some individuals. There are associa.tions or cliques of medical men, the sameas in other trades, who, by associatingwith each other, contrive to make em-ployment for one another; wherefore apatient, instead of being attended by one

competent medical man, is attended by a.surgeon, a physician, and an apothecary;so that three advisers are paid, instead ofone."

530. " On the whole, should you saythat the most highly instructed surgeonsin general practice in this country, as aclass, from the precision of the knowledgethey are compelled to acquire of the

healthy and morbid structure and func-tions of the human body, are better calcu-lated to throw light upon medicine thanthe most highly educated physicians ?"-" They are, because it is quite necessaryfor a surgeon to know physic, but it isnot necessary for a physician to knowsurgery."

531. " Then you are not of opinion thatthe physician can be a safe practitionerwho has not an intimate knowledge ofsurgery?"-" By no means."

532. " In the course of your practice,are you in the habit of meeting physiciansin consultation upon strictly medicalcases?"—" At one time or another I havemet in consultation almost all the phy.sicians and surgeons of eminence inLondon ; and I have often met physicianson surgical cases, and surgeons on medi.cal cases."533. "You would not expect, now-a-days, a physician to object to consult withyou on a purely medical case, because youare a surgeon ?"—" Certainly not; unlessperhaps the case was of such notorietythat he would be afraid of being exposedto his own body of collegiate fellows ; butthat never happened to myself."

534. " In your time at Edinburgh, hadmost of the candidates for the diplomaof the Edinburgh College of Surgeons,received a preliminary education?"—!’’ Every one, almost, preliminary educa-tion, in Scotland, is much more easily ac-quired than in most other parts of Europe ;and, therefore, people of a very humblegrade iu life receive all the advantages ofan education which cannot be acquired inEngland except by persons of much higherstation in societv." ,

535. "Have the generality of the youngmen who apply for the London diploma,received a reasonably good preliminaryeducation?"—" A great number of them,I fear, are very deficietit. 1 have an im-

piession that that arises, in many in-stances, from young men being compelledto serve an apprenticeship in druggists’shops, where they have no opportunity ofattending to their education. In Edin-burgh, where there are many young menbound apprentices, they at the same timeattend the different classes of the Uulver-sity."

536. " Do you approve of the curriculum

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of study required by the London Collegeof Surgeons ? "-" Its chief defect, as it J’has always appeared to me, is, that as the Idiploma of the College of Surgeons is notgiven to a man who practises surgery only,but who is to practise physic as well assurgery, the medical part of the curricu-lum is not sufficiently comprehensive.

537. "Do you think that the Council ofthe London College of Surgeons is so con-stituted as to be liable to the imputationof making rules, or deciding cases, out ofregard to the personal interests of some ofits own members ?"-" It appears to methat the whole of the regulations havebeen framed, on purpose to serve the pri-vate interests of a large portion of the in-dividuals who framed them."

538. "What is the scale of hospitalwhich you would fix upon as the mini-mum which the College ought to reoog-nise ?"—"Those who are best able to

jndge, and who have no personal interestinforming an opinion on the matter, havethought, that the fewer subjects the stu-dent had before him to contemplate, themore likely he would be to become masterof the cases ; and, therefore, that the largeinstitutions were less likely than smallones to answer the purposes of education.Richter of Goettingen, who was consideredthe first surgeon that Germany ever pro-dueed,had only fifteen beds in his hospital.*,I am aware of the common opinion, thatexperience, as it is called, over an exten-sive field of observation, is to be preferredto a smaller field. But it is not so, in myhumble opinion, with regard to the studentsof medicine. In after-life, a man who haslearned the rudiments of his profession,

* The following is an extract fromRichter’s Medical and Surgical Observa-tions : " There are only fifteen beds in thepublic hospital of this place (Goettingen),and 1 do not wish for more. I have per-mission and the opportunity to choose mypatients, and of course I make choice ofsuch cases as promise to be more par-ticularly important and instructive. In-deed I do not think that the experiencedpractitioner is formed by the number ofpatients. Experience is the result, not ofseeing merely, but of reflecting. It is not

eating alone, but digestion, that givesstrength. A physician who tells us thathe visits 150 and even a greater numberof sick people daily, has, in my opinion, solittle pretensions to the title of an experienced practitioner, that I would even

deny he had any experience at all. Truly,nature is not so complaisant, that she willunveil herself at once to whoever willmerely cast his eyes upon her."

may select from a large field the par-ricular case that he may wish to contem-

plate at one time, with great effect. At

Edinburgh they act upon that principle.They select out of the whole mass of sickin their infirmary only a few individualcases which are put into the clinicalwards."

539. "Do you concur in the followingopinion, expressed by Mr. Lawrence in1826 ? After mentioning the name ofScarpa, Mr. Lawrence says: ’The hos.pital which lias enabled him to renderthese important services to our science,contains, I believe, about twenty beds.Richter, the contemporary of Haller inthe University of Goettingen, celebratedthroughout Europe for his judgment andpractical skill, as well as for the clearnessand good sense of his writings, had anhospital of fifteen beds. The same insti-tution, now under the care of ProfessorLangenbeck, an accomplished anatomii-tj ’ and very dexterous operator, does not

’ ‘ contain more than twenty-five beds.The medical clinic in the general hos-‘ pital at Vienna consisted of two wards,each containing twelve beds; and that ofthe illustrious J. P. Frank, at Pavia, didnot contain more than twenty. Thesurgical clinic at Vienna consists of four-’teen beds, eight for males, and six for’females; and that for diseases of the eye, oftwenty-four. Thus, gentlemen, the great’men whom I have cited (and the annals) of onr profession contain no names more’deservedly venerated than those of Rich-ter, Scarpa, Von Hildenbrand, Frank,and Beer), instead of estimating the ad-vantage of the student in a direct ratioto the number of patients submitted tohis observation, have considered it most‘ conducive to his instruction to limit his! attention to a few cases ; making each ofthese a study, carefully investigating thehistory, symptoms, and causes, showingthe nature and seat of the affection, andthe changes produced in the sufferingorgans, pointing out the distinctions, andthe probable course and termination ofthe disorder; and then explaining theprinciple of treatment, whether by diet,medicine, or general management."’-" I perfectly accord with those opinions,which, in fact, I had often canvassed withMr. Lawrence, previously to his deliveringthem publicly."

540. "And therefore, in your opinion,any limitation of the scale of hospitals en-titled to recognition by a medical board,requiring them to have at lest 100 beds, isnot a judicious limitation?"—"No morethan I should conceive it would be judi-cious to have a law, that no man should beaccounted learned, who should study in a

669

library that contained less than a certainnumber of books."

541. " You think, then, that if a surgeonwere to set on foot an hospital containingtwenty patients, and were to direct thestudent’s particular attention to all thecircumstances of each case, as Richter didat Goettingen, such an hospital ought,above all others, to meet with recognitionfrom the Council ?"" should think itthe best possible institution for the educa-tion of students in medicine."

542. 11 sought lecturers, or hospital sur-geons who have a class of pupils at an

hospital, to be eligible as members of theCourt of Examiners ; considering that theywould have to examine their own pupils, Ior those of rival teachers; or at least tovote on their being allowed to pass ?"-" As a general rule, I should think, that noteacher ought to be an examiner; butthere might possibly be some exceptions."

543. " Considering that by far thegreater number of the members of theCollege of Surgeons are general practi-tioners, is it reasonable to exclude themfrom the government of their own Col-lege ?"—" I do not consider it reasonable."

544. "What is your standing as a mem-her of the London College?’=" Abouttwenty years. ,

545. " Do you believe that members ofthe College have been passed over by theCouncil, and thereby for ever excludedfrom the Council, simply for expressingopinions in disapprobation of the existingconstitution of the Council?"-" I havereason to believe so."

546. " Have you reason to believe that

you have been passed over by the Coun-cil?"-‘‘ I have, and also thit Mr. Law-rence was elected into the Council by amajority of only one, and was thereforewithin an ace of being passed over."

547. " Did not vou and Mr. Lawrencein 1826 express strong opinions againstthe regulations of the Council, and againstits existing constitution ; and did not bothof you, in the same year, take an activepart in the discussions of these matters atthe meetings which were held of the mem-bers of the College?"—" We did."

548. *’ Were you ever surgeon to anyhospital in London ?"-" I was surgeon tothe Hospital of Surgery in Panton Square,which was founded on the model of thosehospitals in foreign countries that havebeen just alluded to."

549. " Was that hospital recognised bythe College ?"-" No, the hospital was

founded upon principles, in most respects,quite opposite to that of the other hospi-tals, members of the medical profes-sion having access to it without the payment of any fee. I did not take any pu-

pils, and therefore had no wish that itshould be recognised. It was supportedby subscription, and instituted for the ad·vancement of medical knowledge. I wasalso anxious to have the opportunity ofproving the great advantages which thesick poor might derive from small institu-tions, as well as the much greater extentof benefit which, by comparison, the do-nations of the charitable were by themenabled to perform. Great benefit alsowas derived by this hospital being thrownopen to the profession; all our public in-stitutions being closed, unless on the pay-ment of exorbitant fees. It was openedin 1824, and closed in 1831."

550. " What, on the average, was themonthly expense of each patient ?"-" Theexpense of an in-patient did not exceedone shilling a day. The out-patients pro-vided themselves with medicines, and carewas taken to prescribe for them in aseconomical a form as possible. It wasoften remarked by patients who had for-merly attended dispensaries, that theywere frequently kept waiting for themedicines so long, that they preferredpaying for them, their time being ofgreater value. 5001. a year was quite am-ple to sustain the institution on the scaleand for the purposes for which it was ori-ginally intended. There was a house-keeper and one servant maid. Attentionwas paid to the arrangement of the pay-tients in each room, so that if one was ina helpless condition, the other was capa-ble of affording him assistance when inneed; and those who had to undergo anysevere operation, had usually some rela-tive who attended and nursed them, fromwhich arrangement the sufferers foundthe greatest comfort, and the charity wasenabled, with its limited means, greatly toextend its objects. A house surgeon, wholived adjoining to the hospital, was theonly officer in constant attendance."

551. " What means did you take to pro-vide the hospital with cases?"—" I had

long been in the habit of giving advice tothe sick poor at my own dwelling. TheseI afterwards received at the hospital,where they were admitted without anyrecommendation but their bodily afllic-tions. Moreover, the circumstance of theinstitution being open to the medical pro-fession, and weekly meetings being heldin the operation room, the numerous visi-tors took every opportunity of bringingcases of peculiar interest, and hence, moreexamples of remarkable diseases presentedthemselves at this small institution thanperhaps at some of the large hospitals."

552. " Does nepotism prevail in thedifferent London hospitals ?"-—" To a very

670

considerable extent I believe. I should think you would find, if you go over thelist of the surgeons of the hospitals ofLondon, that a considerable portion of Ithem are, either immediately or more distantly, related to some one or other of themedical officers who have preceded them."

553. " What changes should be madein the Boards which examine candidatesfor practice in the profession ?"-" Thereis evidently great room for improvement."

554. " Should there be one generalboard to examine all candidates for prac-.tice, and grant medical degrees?"—" Itwould be infinitely better than the pre-sent system."555. " How many years of study will

render a man competent to practise sur-gery?"-" A man ought to begin to prac-tise his profession at the age of twenty-one. His medical studies ought to becommenced very early,— combined with hisgeneral studies,-not requiring a man tohave completed a certain course of literaryand philosophical study before he begins hismedical pursuits. A great deal of the drud-gery of medicine can be learnt best in

youth, such as that of dissection, and ofpractical chemistry and pharmacy. At an

early period of life these things can be ac-quired with much more facility than a

knowledge of moral and natural phiio-ennhv "

556. " Should there be one or two Igrades in the profession ?"" I do not like a difference of grades; it often cre. !

ates injustice, and always a great deal ofdissention amongst Mankind, and it leadsto no public good that I am aware of. Itshould rest with the public to conferwhatever distinction it pleases, and the

public will always judge of men by thequantity of their brains and their moralconduct."

557. "Are there many London sur-

geons who have distinguished themselvesby their writings on, and their mode oftreating, diseases of the eye ?"-" Thereare several."

558. " Are the public disposed to placemore confidence in regular surgeons whohave made eye-surgery their study thanin persons who are mere oculists ?"-" Ibelieve they are."

559. " Is a surgeon who acquires repu-tation in the practice of eye surgery liableto suffer in estimation from an apprehen-sion that because he is skilled in that de-

partment he must be less skilful as a gene-ral surgeon ?"-" I have no reason tothink so."

560. " Then why should that objectionlie to a combination of the surgery of theuterus, or midwifery, with general sur-

gery ?"-" I am not aware that such an

objection exists."561. "Is the education less good inScotland in consequence of being less

expensive ?’ =" 1 think it is better : thebest masters I have ever had, have beenthe cheapest."

562. " Whatever changes may be madein the laws or usages of the medical pro.fession, if those changes are to be pro-ductive of any good, will it not be essen-tial to take care that the expense of goodmedical instruction is kept low?"-" De-cidedly. If a man have any reputationas a teacher in any of the great towns,London, Dublin, or Edinburgh; he can geta very handsome income, though the stu-dents pay him only a very moderate fee.The fees, I think, are much too high inthis metropolis. They are higher in pro-portion to the value of money, or of othercommodities, than in the north."

563. " Ought the state to punish irregu-lar practitioners, for practising, or only forassuming a professional title ?"-" Fromourknowledge of mankind upon the sub-ject of quackery, I do not think that anylegislative enactment can be of the least

service. The best educated men, the bestmen in society, are the greatest patrons of

quackery. My own impression is, that all

attempts to prevent quackery, rather tendto make it of more importance. As forpunishing the unqualified man for prac-tising under the assumed title of a quali-fied man, the name is of no importance.I think the legislature would do muchmore good by rendering medical edii-cation more accessible to students whohave little money to bestow on it, andthus provide that numerous portion of thepublic who cannot afford to pay dearlyfor medical advice, with a better class of

medical practitioners. That is the best

and most effectual means of meeting theirregular practitioner."

EVIDENCE OF

MR. JOHN SCOTT.

564. " You are surgeon to the LondonHospital, and to the Ophthalmic Infirmary,lecturer on surgery, a member of theCollege of Surgeons, and a licentiate ofthe Company of Apothecaries."-" I am."

565. " What examination did you iin-

dergo at the College of Surgeons ?"-" Itwas on surgery and anatomy only. Itlasted about half an hour. This was six-

I teen years ago. As a test of professionalknowledge, I do not think it was sufli-

ciently extensive. But there is a marked

671

improvement in the medical students oflate days."

566. " Do you approve of allowing fouryears and a half, passed in a druggist’s orapothecary’s shop, to count as part of thesix years spent in the acquirement of pro-fessional knowledge ?" - " Certainly not.

One year only should be allowed for thedispensing of medicines, and three foreducation where medicine is efficientlytaught."

567. " Do you contemplate two gradesin the profession ?"-" Experience proves,that two classes in the profession will ne-cessarily and invariably exist; and, there-,fore, it might he well to make, betweenthose two classes, a distinction in pointof acquirement."—It will be well to makea distinction where a distinction will ne-cessarily and invariably exist. He firstdeclares that a distinction is natural, andthen contends that it will be " well " tocreate it by artificial arrangements. Thisis a trap to catch FEES.568. " In regulating the curriculum ofstudy for each grade, would you institutean annual examination of students uponwhat they have already learnt?"-" Yes,and the examination should vary with thestudies in each successive year."-So thatat the last examination, as no inquiry ismade into the subjects of the first andother years’ examinations, all the formerportion of his studies may have been for-gotten, and the candidate go forth as a

practitioner without any guarantee that heis then possessed of more than the lastdivision of the knowledge he has acquired.No. The examination for the diplomamust be one, perfect, and final.

569. "Is it not essential that a personintended for the practice of surgery,should study medicine in all its branches?"—" Indispensable."

570. " Does it ever fall to you to meet

physicians, in consultation upon medicalcases ?"-" Occasionally it has. The an-cient boundaries of practice are entirelybroken down. Both parties now encroachupon each other as much as they can, andif they possess the requisite knowledge,it is as well that they should do so. If

surgeons and physicians were to be unitedin one common profession, the public,unaided by any distinction of professionaltitle, would be able to discover who theparties were that were best able to operate,if necessary, and who to advise as to thenature and treatment of any internalcomplaint."

571. "Do you approve of the presentconstitution of the Council of the Collegeof Surgeons ?"-" No."

572. " State your views upon that sub-j ect ?"-" I think there should be an amal-

gamation of the three present divisions ot

the profession under one superintendence.The science of medicine is one and indi-visible, and therefore it is proper to unitethe boards who examine upon it, includingmidwifery in their examinations

"

573. " Do you approve of excludingfrom the Council of the College of Sur-geons practitioners in midwifery, or phar-macy?’ -" I think that the habits and du-ties of the general practitioner, are suchas do not well qualify him to be a member ofthe Council." .

574. 11 Would any inconvenience arisefrom making all members of the College ofSurgeons eligible as councillors and elec-tors ?"-" I do not think there would."—Weare rather puzzled to reconcile the opi-nions expressed in this and the previousanswer, and the answer to the questionthat follows. Mr. Scott, liberal as are

many of his views, has come to hisexamination like his colleagues, withouthaving laid down for his guidance anyprinciples that will bear the test of scru-

tiny.575. "If there is to be no amalgamationof boards, who should be made eligible asmembers of the Council of the College ofSurgeons, and who should be the electorsof the Council?"-"I do not know."

576. " Do you commend the presentmode of self-election?"—"I think it isvery bad."

577. "Are you prepared to recommendany other ?"-" .2Vb."

578. "Were there two grades in theprofession, would vou make the highergrade the elective body, and out of themto choose the Council ?"-" I do not likesuch an invidious distinction."

579. "May not a man be passed over bythe Council, under the self-elective prin-ciple, who is most eminently qualified tobe a councillor; and to exclude whom,would reflect dishonour on the Council ?"- "It is possible. I was not aware of thegentleman who was last examined havingbeen passed over till after I came intothis room, and I should now say, that it

may have that effect."580. "Ought not every by-law to be

reduced to writing by the Council ?"-" Certainly. Particularly, since it mayprove, when reduced to writing, and suh-mitted to the chancellor and the judges,that, as a by-law, it would be illegal."

581. "Should the governors of an hos-

pital elect the teachers in the school ?"-"I do not think that any party can bepointed out more unfit than the gover-nors, to judge of a man’s qualifications forteaching a profession. All the medicalofficers of hospitals should be appointed,not by election, but by concoyrs, which is

672

infinitely preferable to our plan. Many’, of the hospitals depend for their subsist-ence upon annual subscriptions, but mostof them are very largely endowed, and

come, I presume, in some degree, underthe protection of the legislature."

582. " How would you reconcile thegovernors, accustomed as they are toexercise the patronage of voting, to elec-tions on the principle of concours ?"" I Ido not think that anything more can bedone, than for the present Committee torecommend it :’

583. "How would you have the con-cours conducted?" -" By a medical tribu-nal,.selected by the governors themselves,and the trial should be the most rigorousexamination that could be instituted."

584. " Should there be any fixed age atwhich parties should retire from being themedical officers of hospitals ?" -" Cer-tainly. I think that any man who staysbeyond 65, stays too long."

585. "Would you peremptorily requirea student to study a part of the time inLondon, Edinburgh, or Dublin ?"—" Thatwould be desirable; but the difficultymight, perhaps, be met, by requiring a

longer period at those provincial schoolswhich afforded less facilities of acquiringknowledge; so that what was wanting inpower, might be made up for in time :though I do not see why a surgeon atManchester should not be as competentas one within the sound of Bow-bells.

They are not so far behind in the countryas some people suppose; yet a studentwould become a more accomplished sur-geon by studying the last year in London."

586. " Were you to nx a limit for thesize of an hospital of instruction, whereshould you fix it ?’ =" I should let it con-tain 100 beds."

-

587. "Do you approve of limiting theelection of the medical officers of hospitalsto medical men who once were pupils orapprentices in those hospitals?" -" Yes, Ido. Those men who have been educatedat the hospital are preferred. I shouldalways prefer a man whom I knew, to aman whom I did not. Every man oughtto stand the best chance of success in hisown school."—These are the thoughtlesswords of an advocate of the concours. See

paragraph 681. To what absurditieswould not the observance of his proposallead! A vacancy occurs, say at Guy’sHospital. Two men retire from hospitalstudies, one from Guy’s, and the other sayfrom the Nortlt London or St. Bartholo-meui Hospitals. They go to some largeprovincial city or town, and obtain ex-tensive knowledge and experience. The

vacancy is announced, and one of thesetwo able men is shut out from all opportu-

nity of competing for the office,—becauseAg was educated at the North London or atSt. Bartholomew’s Hospitals! But sup-pose that the North London man is far

superior in talents and acquirements tothe G2ey’s man. Observe the effects of thesame consequent in that case. Why domen run into such errors as these in theirtheories? Because they legislate for theinterests of themselves, instead of those ofthe patients. It is the very essence of theconcours that the first talent in the coun-try shall win.

588. " Would it not be better to allowyour reasons to operate freely upon each

elector, than to draw a line of exclusionagainst many distinguished medical menwho have not had the good fortune to beeducated at a particular hospital ?"-" Iam not aware that tleere is any line drauwnwhatever in a single hospital.* I believethat all that is required is, to be a memberof the College of Surgeons; and that it ismerely afeeling which prevails, to the ex-tent I have just alluded to, and which I

confess operates with myself. I should be

sorry to see it changed. Every man mustbe educated at some hospital, of course,and his greatest claims are there."-Ah,

but the " claims " of the patients are

greater even than his qreatest.I 589. " Is it important that country hos-pitals should be recognised ?"-" I do notlike any exclusions of any kind! !! ! If theLondon hospitals, with all their advan-tages, cannot compete with the countryschools, without imposing restrictionsupon them, I think that the London hos-pitals deserve to lose their pupils."

590. "What determines the distinctionin the two classes of pupils, one who dressthe patients, and the other who do not ?"-"The amount of the fee that they pay tothe surgeon."

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591. " Then is an extra fee paid fordressing?"—"Yes, I am sorry to saythere is." ’

592. "Explain the reason for that ex-pression of regret?"—" I consider thatwhat I have said with regard to the ap-pointment of the surgeon should extendto the dressing pupils. I am not a friendto the paying for any appointment whichhas a duty attached to it."

593. "Then the principle of concours,which in the French hospitals determinesthe appointment of agrlyes to perform allsuch minor duties, honourable duties asthey consider, might be advantageouslyintroduced into the London hospitals ?"—} With the greatest possible advantage."

* Mr. Scott ought to blush at readingthis line in print, if he did not blush atexpressing it.

673

59-1. "Is it necessary that examinersshould all be men of mature age and ex-perience ?"-" It is only to the principlesof medical science that the examinationof candidates ought to extend; and there-fore no objection lies, on the score ofwant of experience, to introducing a pro-portion of young examiners."

595. "You have stated that you wouldat once provide a general board cf ex-aminers, by uniting into one board theexaminers of the three medical corpora-tions. How would you propose to till upvacancies in that board ?"-"By concours,the competitors being required to be mem-bers of tl’4e higher grade. * I would make the Council of the College the tribunal tojudge of the merits of the competitors ;and I would allow all the members of theCollege to be present at the concours. Noteacher, however, or hospital surgeon, orhospital physician, ought to be appointedan examiner; and if any examiner wereto be elected physician or surgeon to anyLondon hospital, he ought to vacate hisseat at the general board of examiners.The principal advantage that would resultfrom this plan, is the impetus that itwould give to medical science, by applying ’,a stimulus to young men. Success at thisconcours would alone stamp a man’s cha-racter with the public, and would occasionhis being advanced to the most honour-able posts in the profession. The majorityof governors at every hospital would be soimpressed with the irresistible claims thatsuch a distinction would give, that anyother candidate, not possessing the samedistinction, would have little chance in

competition with him ; and thus it wouldbe, virtually, by concours that men wouldbe promoted to the medical offices at hos-pitals."-All these expressions are exceed-ingly favourable to the principle of the

concours yet analyse the proposal, and itwill be found to amount to this, that nonebut men who would falsely rank as higher-grade surgeons, that is, as " pures," wouldbe enabled to take advantage of the con-cours for important medical appointmentsin this country. We have already beentold that the class of "higher-grade" sur-geons would most probably not amount totwo hundred in number, for all England;consequently Mr. Scott’s attempts to bevery liberal are as bad as the declaredilliberalities of Messrs. Guthrie, Travers,and Co. Here Mr. Scott’s evidence ter-minates. We wish for his own credit thatit had been more equal in its parts.

11 This is another thoughtless sentenceof one who has said (paragraph 689), "I do not like any exclusions of any kind."

Report of the Ophthalmological Clinique atthe School of Wiener, during the session1832-3.—By Dr. ROSAS.

Report of the Ophthalmological Clinique atj the S’chool of 6f’iener, during the session

I 1832-3.-By Dr. ROSAS. -

WE are induced to translate this reportnearly in full, because it not only furnishessome very interesting statistical results inthe department of ophthalmalogical surgerybut because it lays before the English rea- der a very complete view of this branch ofthe art as it exists in one of the best schoolsin Germany, where the diseases of the eyehave been studied with more care and mi-

nuteness than, perhaps, in any other partof Europe.

! The number of patients treated in thecourse of the year, comprised in the re-

port, amounted to 1067, of whom 153 were

permanent patients, and the rest, 914,were dispensary patients. Of the perma-nent patients, 92 were males, and 61 werefernales. The periods of life comprehend-ing the greatest number of patients, werethe ages ranging from 10 to 20 years, andfrom 20 to 30. The forms of disease maybe distinguished under the following heads:

! Of the patients affected with e1’ysipelaspalpebrarum, the last is the only one weshall notice; this patient fell with his faceon a heap of stones, and was carried homein a state of unconsciousness : in three dayshe was able to leave the house, but he hadhardly remained a few hours in the freeair, when he was seized with feverish

symptoms, and a burning pain in the region


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