48

lessness of the authorities, which only sometimes was supple-mented by strained constructions of the law, the evils in ques-tion were found very extensively, one or both of them, inoperation." To remedy this state of things, Mr. Simon holds that, in

the interests of our labouring population, the local authoritiesshould be able and willing to exercise the following powers :-

"1. To deal universally with overcrowding on the basis ofits being technically a ’nuisance,’ and to take as the sole testof overcrowding the proportion borne by the number of occu-pants to size and ventilation of given space.

"2. To apply to the so-called ’tenement houses’ of thepoor a system of registration and regulation akin to that whichis applied to common lodging-houses under the statutes of 1851and 1853.

" 3. To enforce everywhere against the use of cellar dwel-lings the restrictions which, under the 67th section of thePublic Health Act, 1848, are enforceable in places which areunder that Act and the Local Government Act.

" 4. To exercise against premises or parts of premises which,by want of access of light or air, or by dampness, or throughruinous condition, are -rendered unfit for human habitation,the same powers as against premises which by nuisances ’ arerendered unfit.

" 5. To acquire premises, by compulsory sale, either in orderto make needful openings and clearings where ground is tooclosely built upon, or for other sanitary improvements."

These propositions refer to existing and old-standing evils,and they would fairly meet the difficulties which are en-

countered in endeavouring to overcome them. But there is a

question which cannot be dissociated from the state of thingsto which these propositions have special reference, and whichit would be Well to consider in conjunction with this state.

It is tolerably certain that in towns and rural districts theprogress of building proceeds at a more rapid rate than theprogress of sanitary legislation or improvement. A recentexamination of the newer houses and cottages springing up,mushroom-like, in thriving centres - even centres where

Building Acts exist, renders it well-nigh certain that in alarge proportion of instances their construction and arrange-ment are such as of necessity to entail the most lamentableconsequences to the health of the inhabitants in the course ofa very brief period. This question, doubtless, does not comestrictly within the province of the medical department of thePrivy Council, but it seriously demands the attention of theLegislature. And it is obvious that any legislation must beso far defective which, while providing for the rectification ofcertain evils, does not provide against the continuous growthof those evils.An inquiry conducted by Dr. Buchanan into the effect of

sanitary works or regulations in improving health in diverslocalities was completecl at too late a period to have a place inMr. Simon’s present Report.In order to obtain more exact knowledge of the alleged

occasional conveyance of morbid contagion in the various stuffswhich form the staple of the rag trade, Dr. Bristowe wasinstructed to make a detailed inquiry. "It is a matter of

congratulation," Mr. Simon observes of this investigation,"that the results are almost negative, and such, I think, asfully to establish that the rag trade does not play any con-siderable part in the distribution of contagions of disease."

It is of great interest to learn that a series of scientificresearches in aid of the more immediately practical objects ofthe medical department have been begun under the superin-tendence of Mr. Simon. The inquiries already made withregard to the distribution and causes of all our most destruc-tive diseases, and of which the results have been published atlength in Mr. Simon’s series of invaluable reports, constitutea mass of information unrivalled for precision, extent, andnational value. The time has now come when more recondite

questions of the genesis of disease may occupy with advantageto the nation the attention of the department, and accordinglya series of investigations are now being carried out by Dr.

Thudichum with reference to the chemical processes of disease.Inquiries tending to a repetition of evidence on the subjectswhich had already been dealt with by the department wouldbe of but secondary interest ; whereas scientific researches

leading to a more intimate knowledge of the nature of morbid! processes which are yet to be prevented, and such as were notlikely to be undertaken here by private investigation, openout a field of utility of the highest promise.

The third portion of Mr. Simon’s Report is devoted to theforeign epidemics of the year, and the general question of con--tagion in its bearings on the public health. The outbreak of

epidemic cerebro-spinal meningitis in Northern Europe, thepresent extension of epidemic cholera on the continent, andthe importation of yellow fever into Swansea last year, give ean interest altogether exceptional to this part of Mr. Simon’sReport, and to the appended elaborate reports of Dr. J. BurdonSanderson, on the Epidemics of Cerebro-Spinal Meningitis onthe Lower Vistula in Europe; of Mr. John Netten Radcliffe,on the Sources and Diffusion of the present Epidemic of Cholera;of Professor Parkes on the Outbreak of Cholera at Southamp-ton in 1865; and of Dr. Buchanan, on the Outbreak of YellowFever at Swansea. We must postpone the consideration ofthis part of the Report.

ANNUAL DINNER OF THE FELLOWS OF THEROYAL COLLEGE OF SURGEONS.

AFTER the election of members of the Council, on Thursday,the 5th inst., this dinner took place, as usual, at the AlbionTavern, Aldersgate-street. Upwards of 100 gentlemen werepresent; Mr. Wormald, President of the College, in the chair.The customary loyal and patriotic toasts having been drunkwith enthusiasm, the Chairman appropriately alluded to themarriage of the Princess Helena on that day.

" The Medical Department of the Army" was then proposed,and replied to by Mr. PIPER and Mr. JUDD.

Mr. BrsK, on behalf of the Government Committee, nothaving had notice that he would be called on to speak, wouldonly refer the profession to the Report which had been recentlyissued. He believed that if the recommendations of the Com-mittee were carried out every real grievance of the medical

department would be removed." The General Medical Council" " was duly honoured in

silence ; some regret being felt and generally expressed thatthe Council was conspicuous for the absence of any representa-tive on the occasion.‘ " The Medical Corporations " was responded to by Dr.CAMP, who, in the absence of Sir Thomas ’Vatson, on thepart of the College of Physicians, made a few remarks.

"The Provincial Schools," by Mr. HiLTON, followed, whowas greeted with continued cheering. He thanked them forhis re-election, and by so triumphant a majority. There was

a feeling of competition between the metropolitan and provin-cial schools, but it was an honest rivalry which gave strengthand force to both. Looking at the heavy labour and expense, necessary to keep a large school in working order, he felt that; many very able provincial men deserved great credit for main-taining schools, which, in a pecuniary sense, could not beremunerative. The expense of working a large metropolitan school was very considerable; and although he would admit; that students were generally well prepared for their examina-tions at provincial schools, yet he believed that the time wascoming when those schools must inevitably dwindle, owing tothe great expense necessary to make any school efficient.i Mr. TURNER, in reply to the toast, said that in spite of’ distance from London, professional losses and other incon-

veniences, he trusted that he had done his duty on the Council,since his election last year, and on this point he would appealto the President and his colleagues. (Cheers.) He had learnt

much in the Council chamber which would be of great serviceto them in the provinces ; and, in fact, he had been a goodlistener, and had profited much. As regards the utility ofprovincial schools, if the apprenticeship system is to be con

49tinued future students ought not to remain merely with privatepractitioners. Hence one use of provincial schools ; but in-termediately only; they should not supersede attendance onLondon schools. Then again the former have also done muchto secure the efficiency of the profession in the provinces.(Applause.)

" The London Schools," with Mr. Partridge, was appro-priately acknowledged by delicately eulogising the surgicalmerits and distinction of the London fellows.Mr. HANCOCK, proposed the health of the Chairman, as

"our worthy and beloved President," a sentiment which wasduly honoured.Mr. WORMALD, in thanking them for the manner in which

.his health had been drunk, said that he had never throughlife been in the habit of grasping and going ahead, but had letthings come to him, and now that he was nearly at the end- of his tether he had found that the best policy ever was to bea straightforward honest man. (Loud cheers.) Extending hishand with a large bumper of wine, "I drink this," he said,"heartily wishing that in this world you may all be blessed inyour basket and in your store; and when you die may youhave your deserts in the next."

Sir WILLIAM FERGUSSON, on rising, was enthusiasticallycheered. He proposed the "Medical Benevolent Institutions," gracefully alluding to "the tinge of melancholy" associatedtherewith, and especially commending the Medical BenevolentFund and the Royal Medical Benevolent College.Mr. CHARLES HAWKINS briefly responded to the toast,

thanking the Fellows, also, for the honour they had that dayconferred on him in electing him a member of the Council. Hetrusted he should prove himself worthy of the confidencethey had reposed in him.

"The Stewards," by Mr. HOLDEN, was coupled with Mr.W. ADAMS, who referred the whole credit of the labour, whichhad been great, in connexion with the dinner, to the servicesof Mr. Hulme, hon. secretary.A tew words of acknowledgment concluded a very agreeable

réunion. The utmost unanimity apparently prevailed ; and,indeed, if only half the good wishes reciprocated come tomaturity, the millenium will undoubtedly begin in the College.of Surgeons.

Correspondence.

CLASS-EXAMINATIONS IN GLASGOWUNIVERSITY.

"Audi alteram partem:’

To the Editor of THE LANCET.

SIR,—From having been on the Continent at the time theMedical Council terminated its sittings, I did not become ac-quainted until very recently with the criticisms introduced byDr. Andrew Wood into one of the discussions, and obviouslyintended to bear unfavourably on the University of Glasgow.I have also learned, since reading these criticisms of Dr. Wood,that Dr. Allen Thomson was somewhat restrained by a feeling ofjust consideration for the valuable time of the Council from enter-ing at large on the subject at the time of the remarks. Underthesecircumstances the remarks which follow may not be altogetherout of place even now, not, certainly, as an apology or defenceof the University (for I have no idea that such an apology isrequired), but as the statement of a principle which most ofits professors believe to be an important one. Having beenone of those who from the first have most cordially recognisedthat principle, while in practice pursuing a middle course, ascompared with some of my colleagues, I shall not be unfavour-ably placed for stating their views in general terms, as well asmy own.We believe then, Sir, and in different degrees we act upon

the belief, as regards the value of regulated class-examinations,expressed by Mr. Syme in his pamphlet on Medical Educationand Examination in 1864. That pamphlet was very thoroughlydiscussed in the medical journals at the time of its publication,and my own opinion upon it was expressed in your columns(April 9th, 1864, p. 422) to the following effect :—" Like Mr.Syme, I have long been entirely convinced that what is wanted

is a system of examinations operating along the zchole coa!r.:e ofa student’ s period of tuition, and not confined to a squeeze and acram at the end of it...... But by presenting his scheme ofclass-examinations as intended to supersede the final examina-tions for degrees and diplomas, Mr. Syme at once raised ob-jections and created difficulties [which were ably expressed inTHE LANCET of March 26th, 1864, p. 364, by a leading teacherof the highest eminence in the metropolis]. I believe thewhole of these complications will at once disappear if it beadmitted that the class-examinations will not formally set

aside, or even practically supersede, the functions of thefinal examiners, but only be admitted to consideration as

part of the evidence they have to deal with. .... By simplyannouncing the principle alluded to above, and leaving thedetails to be worked out gradually, without any express legis-lation, there would be no violent disruption of the presentsystem of examination, ...... and no need for confining thesystem in its application to the Scotch or any other univer-sities." The University of Glasgow has been practically acting upon

these principles ever since 1864; but confessedly as an expe-riment, and, as above stated, " without any express legis-lation." By avoiding express legislation, we have (as we be-lieve) successfully avoided the grave perplexities which after-wards arose in Edinburgh, and which led to an abandonmentthere of what we earnestly and seriously regard as a veryimportant improvement in the entire system ot our education.And I, for one, am not disposed, at least without clear causeshown, to yield to my friend Dr. Andrew Wood’s polite in- ’-vitation to steer, with eyes open, into the very midst of theseperplexities by calling upon the University Court at present toalter our statutes. These changes in the method of our ex-aminations have not been rashly or unadvisedly gone about;they are sanctioned by the Senatus Academicus, and, althoughnot yet embodied in formal statutes, are, as we believe, entirelyin accordance with the whole spirit of the ordinances underwhich we act. I am sure that I indicate the wishes of thewhole medical faculty when I respectfully invite the visitorsfrom the Medical Council to advise with us, and to give inevery way the fullest inquiry and consideration to our systemof class-examinations ; but I also think that it will be timeenough to apply for a new ordinance when we are able to pleadsome years’ further experience in favour of what we really be-lieve to be a system destined to exercise a most beneficial in-fluence on the course of medical education.

Let me endeavour to show your readers briefly what is im-plied in this last sentence.Every student, say of anatomy or of medicine or surgery, in

this University, now knows, and knows well, that from thefirst moment he sets foot in the class-rooms his fate is prac-tically being influenced by every appearance he makes at everyclass-examination. He is earning his character, as it were,step by step as he goes along. The results and proofs of hisprogress are examined by the professor and by a non-profes-sorial examiner, and a record of them is kept according to acertain notation which is understood by the whole body ofexaminers. It is open to a student, if he pleases, to declinethese intermediate trials altogether, and ta rest everythingupon the final examination. It is also open to him to come upto his final examination, whether he has been well or ill placedin the intermediate ones, and in no case is an unfavourableverdict formally given upon the latter alone. But still the in-termediate or class examinations are systematically and dili-gently followed by a very large proportion of our students ;and, what is more, I beg to assure you that they are

thoroughly appreciated and earnestly desired by them, in-somuch that at the last graduation the character of by farthe greater number of the candidates had been thoroughlyestablished in a multitude of class-examinations before theycame up for the final examinations; and accordingly, amongtwenty-eight candidates (eighteen of whom were under thenew system), there was not a single rejection, which has neverhappened before within my experience as an examiner. In-deed there is not a doubt in my mind, nor I believe in that ofany of my colleagues who has taken part in our more recentfinal examinations, that the average of merit among the candi-dates has been very greatly raised by this system of regulatedclass-examinations-the good men becoming better, the indiffe-rent comparatively good, and the inferior men being madeaware of their own deficiencies, long before the final judgmentcomes to be given. And it is both important and gratifying tobe able to inform your readers that this system is consideredby the students an additional guarantee for fair dealing in thefinal examinations, and an additional inducement for them to