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CONGRESSOF

MEDICAL MEN IN DUBLIN,TO SUPPORT A PROPOSAL TO CONVERT THE

ROYAL COLLEGE OF SURGEONSOF THAT CITY INTO A

NATIONAL FACULTY OF MEDICINE FORIRELAND.

(Abridgedf1’O1n the " Dublin Dledieul Press,"of JMM 5, 1839.)

A GREAT meeting of physicians and sur-geons of Ireland was held on Wednesday,the 29th of May, at the Royal College ofSurgeons in Dublin, and attended by largenumbers of medical gentlemen from all partsof the country. At one o’clock ProfessorMACARTNEY moved that Richard CAR-MICHAEL, Esq., do take the chair, which wasadopted by acclamation.Dr. MAUNSELL was appointed Secretary.The CHAIRMAN then rose and said,-Gen-

tlemen, we meet here to-day numbers of themost respectable members of the medicalprofession, delegated from all parts of Ire-land, because a great reform is necessary.We are daily sinking in public estimation,notwithstanding that medicine has, duringthe last quarter of a century, made the mostimportant advances, and we pay the mostassiduous attention to our duties. Some,even of our own profession, may pretend todoubt this statement; but we must acknow-ledge that there is a greater falling off inthe rate of remuneration during the last fewyears than can be attributable to any in-crease in the value of money. Happeningto obtain a tolerable share of practice in

early life, and in better times, I have be-come accustomed to the usual honorarium—a custom which it is not likely I shall nowforego, to the injury of my junior brethren. ITherefore, I cannot vouch for the deprecia-tion of our profession from my own experi- Ience, farther than this, that we are now sel-dom rewarded with the double honorariuinin consultation, even when held upon per-sonages of rank and fortune. But the mise-rable rate at which medical attendance isestimated b) the public in their paymentsto the juniors of the profession in Dublin,and to both seniors and juniors in all otherparts of Ireland, is unfortunately too wellknown. I will not offend your ears by re-peating what I have heard on this subject,but shall notice briefly, as another sign ofthe times, the wretched remuneration afford-ed to medical men for attendance upon dis-pensaries, the governors of which seem tovie with each other to reduce the salaries tothe lowest minimum, and render the dutiesof the situation as harassing as possible, byissuing constant orders for visits in distantquarters on the same day, amongst which

they seldom omit those upon their own im-mediate dependents. The dispensary systemin this country is most laborious and degrad-ing. and I believe of but little advantage tothe poor. Whenever a dispensary becomesvacant, candidates are seen flying about inall directions, beseeching the" sweet voices"of shopkeepers, squireens, agents, and mi-nisters ; thus contending for a paltry emolu-ment and degrading duties, that sink theprofession, in no slight degree, in the publicestimation. This cause of our degradationwill, in all probability, be removed as soonas the poor-laws come into full operation.It is true that our profession is overstocked.But this is only a partial cause of the greatcompetition. Constituted authorities, suchas coroners, lawyers, and even judges, haveof late assumed the habit of treating themembers of the medical profession, whominquests and crown prosecutions bring be-fore them, with disrespect, and even con-tumely. These insults usually occur in thecountry, or if they do sometimes also in

Dublin, they are in general only inflicted onpupils ; for the physicians and surgeons ofthe metropolitan hospitals will not sacrificetheir time at inquests and crown prosecu-tions. In the country, however, medicalmen of high reputation frequently are drag-ged from one end of the county to another,to attend a prosecution, and then are remu-nerated with an order to receive a pound foreach day, payable in six months. If theyremonstrate, they only meet with contumeli-ous language from underlings, and appealsto the bench are seldom more successful.But these great officers take their tone fromhead-quarters; for all Governments, whe-ther Whig or Tory, seem to regard medicalmen as beings of an inferior grade. For in-

stance, when the cholera ravaged this islandboth barristers and medical men were com-missioned by the Government to the differ-ent counties, the one to register freeholders,the other to combat that frightful epidemic.The first, though in general so young as per-haps never to have viewed a brief, wererewarded with five guineas per diem, besidestravelling expenses, while the medical men,working night and day, many of them fallingvictims to their duties, had doled out tothem ten shillings per diem, afterwardssomewhat increased, upon urgent remon-

strance ; but in no instance, no matter howdistant from Dublin the field of his exer-tions, was more than forty shillings a day,without travelling expenses, given to anymedical man, notwithstanding that in onetown alone (Sligo), four medical men in afew days fell victims to this direful disease.Recollect, also, that the few offices of rankor emolument which appertained to the me-dical profession have, one after another,been, within these few years, suppressed.The situations of surgeon and physician-general, of state-surgeon and state-physician,

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no longer exist. Even the paltry salaries physic itself has received its most importantwhich were allowed for half a century to the improvements from surgeons. I need onlysurgeons of the House of Industry, and its mention Cullen, Hunter,Abemethy, Bichat,hospitals, were discontinued, because it was and Laennec. The celebrated W. Cullendiscovered that they had some trifling emo- acted as surgeon’s mate in the Navy, inlument arising from pupils, although the which, amongst the turmoils of a cockpit,greater part of that emolument, which never he laid the foundation for that knowledgeexceeded 100L in the year to each, was de. of physic which is displayed in his celebrat.voted by them to the formation of a museum. ed 11 Materia Medica" and 11 First Lines,"But this contemptuous disregard on the part works which influence the practice of physicof the Government was encouraged by the even to the present times. Bichat’s exposi.meanness of some members of our own pro- tion of the animal tissues is of the utmostfession, who volunteered 110 do the duty importance in forming pathological views ofwithout salary. This instance alone is suf- disease. The great modern staff of phy.ficient to evince the necessity of union to sicians, the stethoscope; was conferred uponprotect our interests, repress malpractices, them by a surgeon. In the treatment of in-and encourage an honourable esprit du corps fiammation of all internal organs, whichamongst ourselves. There is not on earth a probably comprises three-fourths of the dis-class of men, who perform the divine pre- eases which fall to the physician’s lot-forcepts of Christianity with more disinterested instance, the brain, the lungs, the heart, thedevotion, and yet these very men are despis- viscera of the abdomen and pelvis, and theed by Government, and deprived of every investing membranes of those organs-allsituation which might serve as a stimulus to are now treated alike, and, after bloodlet.their ambition. How different is the con- ting, mercury in every instance is resortedduct of other governments to the medical to as the most efficient remedy. And fromprofession ! In France, Prussia, and the whom did physicians learn the great utilitydifferent German States, they are consulted of mercury in the treatment of inflamedon everything which concerns the public organs? From surgeons. The utility of ithealth, and, in consequence, fill the high situ- (in this country at least) was first practi.ations of privy councillors. If Government cally established by the late John Cunning-had condescended to cunsult our profession, ham Saunders, a surgeon, in the treatmentcould such abuses as exist in our cotton of inflammation of the iris. Its first exhibi.manufactories have destroyed annually thou- tion, most probably by a surgeon, was insands of miserable children? If the advice peritonitis, its second in pleuritis, and last,of medical men had been sought, would the though not least, in arachnitis. And yet,liberties of our city be constantly a focus of notwithstanding all these unanswerableinfection from the filth with which that dis- arguments for the reunion of the two

’

trict is eternally choked ? If the Govern- branches of the profession, the College ofment had condescended to consult our pro- Physicians have actually declined to unitefession, would the Walcheren expedition with us. If pride prevents them it is foolish.have taken place at a season of certain de- If apprehension of loss of property, or ofstruction. But while we find our informa- four professorships, or the lucrative situa-tion thus neglected, and the few honourable tions of librarian and registrar, and two orappointments which belonged to us one after three hospital appointments, with but thirtyanother suppressed, we witness every day persons (of which the College is composed)new situations conferred upon the bar. eligible to them, they have no reason to fear;What is the reason of this palpable injus- for at the conference held with them we dis-tice ? Simply this, that the one profession tinctly stated that in order to facilitate theis disunited by absurd distinctions and per- union, the College of Surgeons was willingpetual dissensions, while the other acts in to make the most liberal sacrifices for tenunity, establishes a centre, and has a most years, or until the two bodies were by timeuseful surveillance over its members. This perfectly amalgamated; and we made thisunity it is which makes the bar respected, concession, although the entire College offeared, and even courted, by the Government. Physicians, including honorary fellows andGentlemen, let us take the hint before it is licentiates, scarcely amounts to one hun-too late. Proclaim loudly the absurd folly dred ; while the College of Surgeons, in.of the artificial division of the healing art cluding its members and licentiates, among t)

into surgery and physic. Seek to reunite whom are 250 physicians, amounts to up.parts of a system which could only have wards of 600, and the number in Irelandbeen separated by fraud. The education of belonging to other colleges who would hephysicians and surgeons should be precisely admissible into the proposed united college,alike. In large cities some will incline to probably amounts to two thousand threethe practice of physic, others to that of hundred more. Is it rational that thirtysurgery. But in smaller communities both gentlemen should be permitted to preventbranches must be practised by the same per- the accomplishment of this great nationalsons, and for this the proposed reform will object? If it be the apprehension of loss ofamply qualify them. The very practice of property which influences them, I can assure

469

them that the funds of the College of Sur- Company, Mr. Donovan, in a late letter togeons are far more than those of the College the Apothecaries of Ireland, proposes anof Physicians, bequeathed to them by Sir application to Parliament for a new CollegePatrick Dun. Our fixed capital, in build- of Pharmacy, for the due cultivation of theings, library, museum, &c., is at least equal pharmaceutic art, and the restriction ofto sixty thousand pounds. Our fluctuating apothecaries to their own peculiar province.income, besides, averages 30001. per annum. Mr. Donovan writes,-" Pharmacy, as a

Our property and income far stirpass theirs. profession, does not exist in Ireland ; it isBut since they have refused to unite with not cultivated in Ireland. It is little under-us let this College of one hundred members stood here, and, while the apothecaries ofremain unmolested, like Old Sarum, and let France and Germany teem with discoveries,us, the College of Surgeons, backed by the those of the British empire produce abso-remaining physicians and surgeons of Ire- lutely nothing, but adopt the efforts of theirland, petition the Legislature for a new brethren abroad." * * "The apothecariescharter of union. The College of Physi- of other countries are, for the most part,cians have advertised in all the newspapers, men eminent in intellectual endowments,in answer to our College, a resolution,- and scientific acquirements. They are the" That no beneficial results, either to medi- philosophers of the age. They have en-

cal science, or the profession at large, can riched science with its chief treasures.follow from the proposed union; but, on the They are respected throughout the world.contrary, consequences equally detrimental How do they differ from you? Are theyto science and the public." But should beg more intelligent or persevering? No ; butto inquire how it happens that this College, they follow their legitimate profession.seemingly in direct opposition to these Can we, ourselves, increase our knowledgewords, a shorttime before they made this de- of our own profession, while, morning,claration, appointed Dr. Harrison, a mem- noon, and night, we are occupied in prac-ber ofthe College of Surgeons, educated as a tising a different one ?" Dr. Kane, insurgeon, and not belonging to their College, a paper on Pharmacy in Germany, pub-Professor of Anatomy, to deliver clinical lished in 1836, says:—"The majority oflectures on the Practice of Medicine, in Sir the leading apothecaries whose acquaint-Patrick Dun’s Hospital, their only school ance I was so fortunate as to make were doc-of clinical medicine ; and yet they aver that tors in philosophy. In fact, the apothecarynot only no beneficial results can arise from is as usually a doctor in philosophy as thethe union of physic with surgery, but they physician is a doctor in medicine. He be-anticipate from it "consequences equally comes the fellow-labourer, but not the rival,detrimental to science and the interests of of the physician. His education is equal,the public!" I come now to the consideration though in a different path. His origin is asof the third estate in the realm-the apothe- high ; his income is as considerable ; andcaries. The evil example of England has he is received in general and learned so-so embarrassed this part of our subject, ciety on the same footing as any other manthat we cannot be surprised that Mr. War- possessing equal property and information.burton should relinquish, in despair, the If we look to any meeting of the GermanHerculean labour of regulating the profes- Association of Scientific Men we find ansion for the public benefit. His difficulties independent section for pharmacy ; and wewere owing to the conflicting testimony of likewise see that the great mass of the workthe members of the three adverse branches of the chemical and botanical sections isof the profession ; but while practitioners accomplished by persons who, if not apothe-in physic and surgery should be united into caries, were originally intended to be such,one body, the public interests require that had not their talents and love of science

pharmacy ought to be distinct from both. carried them to a higher sphere of action."Here the absolute necessity of the division Contrast him with his aspiring but degradedof labour influences this important question. confrére in Great Britain, "the counterfeitThe apothecary or pharmacien should be a presentment of two brothers." If the En-

good chemist and a good botanist. He glish apothecary is abroad all day, enactingought to make in his own laboratory all the the parts of physician and surgeon, whilepreparations employed in medicine ; but the the senior apprentices are preparing to catchgenerality of apothecaries, on the contrary, hasty glimpses at dissecting-rooms and hos-resort to the wholesale druggist, who is pitals, who is to compound the prescrip-himself supplied from wholesale chemists ; tions? The answer must be, the juniorand thus the same laboratories which fur- apprentices-mere boys-ignorant of every-nish the various manufactories with coarse thing pharmaceutical, even of the characterschemicals also supply the apothecaries with and appearances of the medicines whichthose medicaments which they themselves they have to compound. Hence the nu-ought to prepare with the utmost accuracy. merous mistakes which are every day oc-The adulteration of various medicines thus curring. A letter lately received from Mr.is a cause of frequent failure in the practice Yalentine Flood fnbrds a case in point.of physic. A member of the Apothecaries’ Mr. Flood says, in it,-" I feel it a public

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duty to relate the following case. I am amedical practitioner, residing in London,and having had dyspeptic symptoms, sentat night to an apothecary for thirty grainsof Plummer’s pill, to be divided into sixpills. On the following morning I swal-lowed one, and, shortly after, symptoms ofpoisoning set in. I immediately suspectedthe pills, and, having broken one, I hadlittle doubt that the pills consisted of ex-tract of belladonna, and, on sending to theapothecary, was informed that my suspicionswere perfectly correct; his apprentice (a ifboy) had taken a jar having belladonna onone side, and ’an old mark of Plummer’spill on the other. At the end of aboutthree days the nervous symptoms had goneoff, but were followed by very aggravateddyspepsia, which obliged me to leave mybusiness and remove to the country. Ishall withhold the apothecary’s name, butI pledge myself to satisfy Mr. Warburton,or any committee of inquiry, as to the accu-racy of this statement. Many suddendeaths, not accounted for, have occurred inthis way."-Had not Dr. Flood been amedical man, he would, probably, have goneon with the pills. I attended, some yearssince, a lady, on account of a cancerousdisease of the uterus. I prescribed for herten grains of the tartarised iron, three timesa day. After a week I saw her again, butso sadlv reduced in strength that her disso-lution, which was inevitable from her dis-ease, was hastened by several months, inconsequence of the severe vomiting occa-sioned by the medicine, which, on examina-tion, I found to be the sulphate of zinc(white vitriol), instead of the preparationof iron directed. But the mischief doesnot stop here, for even mere druggists nowhave become doctors and surgeons, and

prescribe with impunity. But we are toldthat this is a necessary inconvenience at-tendant upon the advantage of living undera free constitution. In matters respectingpolitical medicine it would be fortunatewere our rulers to consider the freedom of thepeople less, and their health more. But Isuspect that this is a mere pretext for raising ia revenue by stamp duties. Gentlemen,from the views I have taken I trust you areconvinced of the necessity of the reunion ofphysic and surgery, and of the separation ofpharmacy from both. But many people willturn on you, and observe, families will havea cheap medical man, whom they can callupon at all hours, a kind of male gossip,often taken out of his bed at night on themost trivial occasions; besides, he must beadvanced in years, and married. Theseobservations were made to me by a phy-sician in high practice. A paper signedVerax," in the eighth number of the"Dublin Medical Press," adduces incon-testable facts, which show that the employ-ment of the cheap apothecary is actually

the most extravagant; and as to the objec.tion that elderly physicians and surgeonscannot be had on moderate terms, I am sorryto observe so many temples whitening with-out filling the pockets, though these meri.torious confreres, perhaps, would be wellsatisfied at receiving a guinea for everysecond or third visit, or to be paid annuallya regular stipend for attendance uponfarnilies, who would thus be secured fromover-dosing. And as to the necessity ofbeing married, let me assure the public thatfar greater security is afforded them in themoral, religious, and honourable principlesof well-educated gentlemen. The general Bpractitionership which has been long es- ’itablished in England, is only on the thresh-

Ihold of this country, and will, I trust, be Istopped in its progress by this meeting, ’,before it obtains a firm footing. Its truenature was accidentally well explained tome the other day by a pupil of the RichmondHospital, a native of South Wales, whocame to me to have his hospital certificatesigned before he returned home to followthe craft of a general practitioner. I in-quired of him how gentlemen in this depart-ment were paid in Wales. His reply was,a shilling a visit in the town, but for visits

Bin the country half-a-crown the first mile,and a shilling for every mile afterwards.He added, however, with much naivete," My master, to whom I was apprenticed,

Ithought but little of this source of emolu-ment ; it was by the medicine he chieflylived." "Draughts, of course?" I inquired. I"Yes," he replied, with great emphasis," and plenty of them!" Gentlemen, this-miserable system we must not adopt in thiscountry. All our institutions must notassimilate with those of our elder sister.Let us reject what is bad in everythingwhich relates to the arrangements of theEnglish for the treatment of disease. Eventheir hospitals are the worst conducted inEurope. For, notwithstanding the immenseincome and ample accommodation of someof them, there is no arrangement of theirpatients; surgical and medical cases are

jumbled together in the same wards, so thatit is not unusual to see a bad case of typhusin the adjoining bed to that of a fracturedleg. Their mode of attending those hos.

pitals is certainly not such as it would bedesirable to imitate. The hour of visitationis usually at noon, the period of the daywhen professional men are in most demandfor private practice; and the attendantshurry over their hospital duties with a pre-cipitation most indecorous, and injurious topatients and pupils. The latter call theirattendance " walking the hospitals;" gal-loping would better express it. We are notbound by the Union to follow our wealthysister in everything bad as well as good.Far better would it be to follow the UnitedStates of America, which is every day

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adding to its unincumbered institutions the he was happy that it was responded touseful practices of the oldercountries,while throughout the country. (Hear, hear.) Theit rejects those that are injurious. Gentle- claims of medical practitioners in Irelandmen, I shall not longer occupy your time. justified them to the fullest extent in de-On your adoption of the resolutions which manding legitimate protection. Mr. Portershall be submitted to you depends your concluded by moving,-future respectability. I have no doubt that " That the physicians and surgeons ofour example will stimulate our brethren in Ireland feel that it is not unreasonable forEngland to exert themselves to recover their them to expect from the Legislature protec-respectability. They have been trodden tion which shall be equal to that which isunder foot, and rolled in the very mire. afforded to the members of other liberalThink of the degradation inflicted on them professions."by the Poor-Law Commissioners, who, Sir JAMES MURRAY, in rising to secondtaking advantage of the necessities of needy the resolution, expressed his admiration ofmedical men, form contracts for medicine the liberality with which the College ofand attendance upon the poor, under the Surgeons threw open its portals to the pro-disgraceful system of tender, or auction, fession. He regretted that any oppositionknocking down the contract to the lowest should operate against the objects of thebidder, totally regardless of the profes- present meeting. But he trusted that itsional qualifications or moral character of would subside on reflecting that the objectthe person with whom they conclude their of the College of Surgeons was to givedisgraceful bargains, so that attendance in to every man the privilege to render himselfthis way has been obtained at the low rate eligible to be elected to infirmaries andof even threepence per head by the year, in other public institutions. (Hear hear.) Thea district of eight or nine square miles. gentlemen present at that meeting had notWhen the poor-laws come into operation taken part in it as a political matter. Asin this country, I trust we shall be prepared to himself he was not guided by any selfishto refuse, with contempt, such degrading motive, for he belonged both to the Dublinoffers, by a well-organised union. A sys- and Edinburgh Colleges. Nor did he wishtem of organisation will be submitted to to shoulder out the poor apothecaries. Heyou, for district associations, all holding felt equally interested for each of the threeregular communication with this College, branches; but the measure then contem-the centre of union. We have a weekly plated would prevent the recurrence of dis-periodical, ably conducted, ready to advo- putes, and stop the settlement of paltrycate our rights, and when any of our body differences of opinion by a case of pistols oris unjustly assailed, we shall be well able pulling noses. (Laughter.) He would tellto repel the aggressor. In all those ar- the profession that it was in their own powerrangements, vested rights, or sources of to get what they now sought forf Where wasemolument possessed by individuals at pre- there a situation of emolument in thesent, are to be esteemed inviolate. We pro- country to which any medical man waspose alterations affecting those only who in appointed if a lawyer could be got to stufffuture will enter the profession, whilst we into it? Every situation under the newhold out advantages of no minor considera- Poor-Law was given to lawyers, althoughtion to those who are actually in practice. from the avocations of a medical man, andEven though we fail in the next session of his knowledge of the condition and neces-Parliament, or the session afterwards, in sities of the poor, he was fifty times betterobtaining this new charter, uniting the two qualified to discharge the duties than anybranches of the profession, we shall, sooner Blackstonite. There was the office ofor later, be fortunate ; and I feel no small Coroner, which was to be given only to per-degree of pride that this College should sons possessing 2001. a year, an office whichcome forward in this liberal manner to set ought to be filled by medical men, yet intoan example to the other chartered bodies of which persons were thrust without sense orthe empire. When combined we can exert intelligence, or sufficient knowledge toa powerful influence in the return of mem- ascertain whether the patients upon whombers to Parliament. Let us support only inquests were held were dead or alive. Thethose candidates who pledge themselves to learned gentleman, after urging the neces-advocate our cause. Gentlemen, be assured sity of having one central tribunal, said thatthat it is only by union that we can support they might expect protection till the day ofour just position in society, preserve our judgment, as the countryman waited till thepurity, resist oppression, and maintain our Liffey flowed by, unless they acted on theirrights.-( Very great applause.) own behalf.

Professor PORTER rose to propose the The resolution was unanimously agreedfirst resolution. It formed the foundation- to.stone of the objects for which that meeting Dr. KIDD, of Armagh, said he could de-was convened. The principle of unanimity tail several instances of hardships to whichwas first adopted by the College of Sur- the profession was exposed. On one occa-

geons, without one dissentient voice, and sion a most respectable member of that Col

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lege was called upon’by the Coroner to makea post-mortem examination ; he gotan orderfor two guineas, which was subsequentlycut down to half that sum at the specialsessions. In another instance the same

practitioner was olfered 2s. 6d. by the WarOffice, for examining a soldier, to ascertainif he was fit for service The learned gen-tleman proposed,-"That the services of medical men were

constantly enforced in the administration ofpublic justice, without any, or with insuf-ficient, provision being made for their re-muneration."

Professor HART seconded the resolution,which was passed unanimously.

Dr. MARTIN, of Waterford, observed that Ithe grand jury in his county never paid anymedical man for his attendance on inquests, Iunless there were suspicions of murder. Inone instance, in which he refused to giveevidence unless he was paid, the Coronersaid he would do without his evidence, al-though it was absolutely necessary.

Dr. MACARTNEY said that they had allheard of the bundle of sticks which, whentied together, it was impossible to break.The union recommended he cordially ap-proved. Had the lawyers been divided theywould not monopolise as they did all thepatronage of the country. It was said thathe (Dr. Macartney) was opposed by theCollege of Surgeons at one time, and thathe had suffered by the opposition. True;but he had not that day come to rake up by-gone differences. He was reproached withhaving gone over to the College, but suchwas not the tet, for they, on the contrary,had come over to him. (Cheers.) He hadat all times recommended an union of thetwo branches of medical science, and a

complete medical education; and he did

hope that the College of Surgeons wouldnow act fairly and honestly. He had re-commended to the College of Physicians todiscuss the possibility of union, but he wasleft in a minority of three to twenty-two.He would propose,-

" That it is the opinion of this meetingthat the cause of all these evils is to’ betraced to the existence of divisions andseparate interests among the members of themediad profession ; and that their effectualremedy is to be sought for in a permanentunion."

Professor HARGRAVE seconded the resolu-tion. He was sure that union would bemost advantageous to them. The Collegeof Surgeons had, so far back as fifteen yearsago, sent a petition to Parliament for pro-tecting the interests of the profession at

large, and whatever steps they subsequentlytook were under the directions of high au-thority, and as sworn corporators, thoughthey were punished as individuals for doingtheir duties as members of the body. Manyof the gentlemen who composed that meet-

ing did not require the advantages whichwould result from their exertions; but itwas for the advantage of the children ofthose men, who, when they came to practise,ought to find it honourable and remunera-tive. (Applause.)

! Dr. O’BEIRNE said that one would sup.pose that it was not necessary in the nine.teenth century to advance any proofs of thetruth of the proposition contained in theresolution ; but it had been distinctly de-nied by the King and Queen’s College ofPhysicians. They not only contended thatphysic and surgery should be kept divided,but even asserted that their union would bedetrimental to science and the public. Butthe public had become the arbitrators be-tween them, incompetent as they were todecide their differences. The unity of physicand surgery was drawn from the history oftheir profession. The professions, at theircommencement, were closely allied, and theywere now separated. Physic and surgerywere united for more than sixteen centu-ries, and were separated for ecclesiastical.reasons only. They were reunited in Francein 1795, and subsequently in Germany, inconsequence of their intimate dependanceon each other, and so they continued inthose countries. Hippocrates did not treatthe professions separately. In the wholeof the Greek, Roman, and Arabian schools, ·

both professions were united, and con-

tinued united up to the thirteenth century ofthe Christian era, when the separation wasproduced by the Council of Lateran, in

1216, from ecclesiastical reasons, and notreasons connected with the theory or prac-tice of medicine. (Hear, hear.) An intimateknowledge of physic was absolutely neces-sary to the surgeon. Suppose a violentbleeding of the nose. The surgeon exa-mines the pulse, countenance, and generalhealth. The bleeding was an effort of na-ture ; if stopped his patient would dieeither apoplectic or paralytic. He allowsit to go on, life is preserved ; a differentcourse might have killed him. Suppose an-other case; inflammation of the eyes ; someof the causes of that inflammation are con-nected with syphilis, rheumatism, or scro-

fula. The surgeon prescribes accordingly;but if not acquainted with those diseases,he will not relieve the patient. A surgeonin croup must examine the lungs. In thefalse croup distinct and remarkable inter-missions are observable. The person at one

period is nearly strangled, and in a fewminutes afterwards is free from all difficultyof breathing. The surgeon knows that nosuch symptoms characterise croup. He there-fore treats the disease in quite an oppositeway, and with success. A strangulatedhernia is attended with inflammation of thebowels. Upon his accurate knowledge ofthis would depend the time which he wouldgive to reduce the hernia. Frequently he

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6nds that fractures will not unite ; he look 11 That the true basis of union should be afor the cause; it is traced to syphilis, similarity of studies, pursuits, and interests ;scurvy, or some other source. Malignant and that the physicians and surgeons oftamours frequently present themselves, ne- Ireland now assembled, do declare that

cessarily connected with a constitutional medicine and surgery are one science andinfirmity or disease. And the intimate one profession, and that their separate prac-knowledge of surgery is equally essen- tice was merely an expedient division oftial to the physician. Mistakes are made labour, having no reference to education orby them in consequence of deficiency of to professional interests."information in this practice. In intermit- Dr. JAGO, of Kinsale, seconded the motion.tent fevers treatment may be ineffectual He anticipated many beneficial results fromtill they detect a stricture of the urethra, co-operation. A society was established tenIn inflammation of the bowels, caused years ago in the county of Cork, and sinceby hernia, frequently the cause of the dis- its establishment the profession in that dis-ease has been overlooked; notunfrequently trict had greatly increased in respectabilitya person presenting himself for operation and importance. (Hear.)for fistula is attacked with disease of his Dr. BULLEN, of Cork, said that the prac-lungs, and therefore the operation is not tical measures for carrying the great princi-performed, because it would only hasten ple of union into effect urgently requireddissolution. The most important and last- to be immediately commenced. The first

ing improvements had been made in medi- question which was naturally asked by everycine by surgeons, or by physicians who had provincial practitioner was, what immediatebeen surgeons. Hunter was a surgeon. Not gains were to be obtained. In endeavouring50 years ago physicians were totally igno- to carry out the contemplated union eachrant of the laws which the different mem- must make some pecuniary sacrifice. Tobranes obeyed under disease, but were now survey their present position they shoulddaily acting upon the important principles look back and study their relations withestablished by Bichat, a surgeon. Laennec the College of Surgeons. Till within thewas a surgeon. Was any physician igno- last few years certain regulations were re-

rant of the splendid expositions made by quired by the College with regard to appren-Sir Charles Bell? Why should they not tices, in order to qualify persons to becomealso allude to the labours of their present members of that body. The College haddistinguished chairman, on a very multi- altered those regulations, but the professionform and intractable constitutional disease? in Ireland was suffering still from the ap-He alluded to his original and interesting prenticeship system as originally introduced.views of the hydatid origin of tubercles, Those regulations required that to become awhich might well be called the seeds of con- member of the College they should serve asumption. But physic and surgery were regular apprenticeship to a College surgeon.also confessedly united in that department This drove the great mass of persons to ob-which connected medicine with the admi- tain their education in the Scotch and Eng-nistration of the laws. He meant medical lish schools, and denationalised the Irish

jurisprudence. Moreover, all attempts had College. The consequence had been, thatfailed in defining the limits between the pro- out of 3000 medical practitioners in Ireland,fession of physician and surgeon, because only 600 were members of the NationalGod and nature had made both professions School of Surgery. (Hear, hear.) Whatwasone. (Hean, hear.) He (Dr. O’B.) declared the intention of the meeting that day? Itit to be his conviction that both the advance- was that the Irish College of Surgeons, feel-ment of medical science, and the best inte- ing the time, and the disposition of the Irishrests of the public, loudly called for an to join a national institution, founded uponincorporation under one College of Medi- equitable principles, had consented to foundcine. These opinions were not new. He an Irish National Faculty ; and the suresthad strongly advocated them before the Par- way for that institution to preserve even itsliamentary Committee, of which Mr. War- existence, was to call within its fold allburton was chairman, in 1834. He would classes, and no longer sacrifice the interestnotice one more great source of their griev- of the many for that of the few. (Hear, hear.)ances. Although the members of the Col- There was another advantage of union. Theleges in Ireland were upon the very best resolutions called upon the Legislature toterms, the strongest feeling of distrust had enable them to obtain an Act to effect medi-existed between them for years, because cal educational reform. But that questionone body believed that the other could not involved other interests. They had to con-press any legislative purpose without draw- sider the medical institutions of Englanding a counter-petition from the other. This and Scotland, and they never could attemptmisunderstanding should be removed, for to carry any measure which would excludesuch dissensions tied up the hands of the the regularly educated graduates of otherGovernment, and prevented them from doing British schools. (Hear, hear.) It would illthe profession justice. He would propose become them, within those walls, to carrythe following resolution :- out that principle of exclusion which they

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themselves so unanimously condemned.Therefore, the movement that day was notexclusively Irish, but one that should be re-sponded to by all the schools of England andScotland. It might be apprehended thatthey were only endeavouring to cloak an-other monopoly by the proceeding whichthey had undertaken; the best way, there-fore, to avoid such a suspicion was to putforward that the only test of competencywith them was, that the degree giving alicense to practise should be a bona fideproof of intellectual capacity and acquire-ments. If they adopted this principle nogovernment could refrain uniting with themin medical educational reform. (Applause.)

’

Dr. Bullen then proposed :-" That it is our opinion that a legislative

measure should be sought, to unite themedical profession of Ireland into a corpo-ration upon such principles as shall consti-tute them one National Faculty, therebyidentifying the great mass of provincialpractitioners with their metropolitan bre-thren."

Professor .WILLIAMS seconded the motion.Dr. ORPEN had advocated these views for

many years. In consequence of them hehad long abstained from attending the Col.lege, for there were persons in it whom hedid not like to oppose. But now the Col-lege did not seek to maintain merely itsown interests in Dublin, but the interestsof the entire profession. He was exceed-ingly happy that the president had animad.verted upon the lawyers,-a set of men whomade laws to benefit themselves, and spenttheir time in helping people to evade thelaw, or in getting people out of difficultiesincurred by contravening the law, degradingevery other profession. There was lately ameeting of barristers held to resolve onpractising at the quarter sessions, and tak-ing half-guinea fees, for they found thattheir profession was over done. There wasbeginning between them and the attorneysthe same quarrel as between the physiciansand surgeons, and the practising apothe-caries. He heartily wished them success intheir quarrel. Dr. Orpen concluded bymoving :-" That steps be at once taken to form dis-

trict medical associations throughout Ire-land, composed of all practitioners in medi-cine holding degrees or diplomas from anyof the legal!y constituted colleges, corpo-rations, or universities, who are of irre.proachable moral and professional charac.ter, and who are not engaged in retailingdrugs, or compounding the prescriptions ofothers."Dr. JONES, of Waterford, seconded the

resolution. He was rejoiced to witness theCollege come forward this day on behalf oithe profession. He was instructed by thewhole of his brethren in Waterford to givetheir concurrence to the proposed union,

The course they were now pursuing wouldeventually spread to England and Scotland.The principles they were advocating pre-vailed, in a great degree, throughout theContinent of Europe.Dr. PHELAN (a Poor-Law Commissioner)

had before taken an active share in theaffairs of the medical profession; but he

happened now to be in a position in whichit would be unbecoming to take the sameshare which his anxiety for the professionwould incline him. He must acquire moreinformation, and in that meeting he couldnot fail to obtain some. Reference had beenmade to tenders being sometimes the modeof appointing medical men to workhouses.He would say that there would be no ten-ders in Ireland, but certain reasonable fixedsalaries, without tenders. He would gofurther, and state that he believed it wouldbe given up in England. (Hear.) Moreover,he was glad to be able to tell them that ineach workhouse there would be a good in.firmary, with fever wards. (Hear.) TheChairman had observed that the Poor-LawCommissioners used the tender system inEngland. Now, long before the new Poor-law Bill passed, the tender system was verymuch practised; therefore it became partof the working of the law, and was not theact of the Commissioners; but it was lessand less practised.The CHATRMAN was happy to hear that

the disgraceful system was not to be extend-ed to Ireland.

Dr. CRANFIELD, of Enniscorthy, dwelt onthe improper manner in which elections todispensaries and infirmaries were carriedon. He was himself a candidate on one oc-casion, and though he had a large majorityof the subscribers in his favour, thetreasurer and secretaries managed to closethe doors against him, and admit their ownfriend. He took legal proceedings againstthese parties, but after going to upwards of90t. costs, the proceedings all fell to theground. He proposed:-" That the members of the district asso-

ciations shall elect officers from amongthemselves, and nominate delegates to repre-sent their interests at the general meetingsof the profession, and obtain local informa-tion regarding all matters of medical police;settle disputes among their own members ;and communicate with a central metropoli-tan Council."Dr. CANE, of Kilkenny, seconded the reo

solution. He complained of the great hard.ships they were exposed to from the slightremuneration afforded them by coroners, orits total absence in Ireland. He should re-turn to Kilkenny, and tell his brethren thegratifying news, that they were unanimous

that day in erecting a great temple ofsurgery and medicine.

: Dr. JACOB presented a sketch of the pro-posed constitution of the College which was

475

contemplated. It avoided details, which Dr. HESRY (Fellow of the College ofwould come more properly when they had Physicians), said that the sentiments whiahsettled on principles. Let them solicit sug- he was about to utter were his own, not

gestions from every quarter to improve tke those of the body to which he had the honourplan. He could easily contemplate opposi- to belong. He agreed in the views whichtion from gentlemen possessing existing pervaded the meeting. He had himself, inrights, who were not pleased to divide them 1829, drawn out a plan of a medical uni-with others. He would be told that the versity, and waited upon almost all the me-scheme was fanciful, but all they wanted dical men in Dublin to ascertain their senti.was the cordial consent of the Royal College ments on the subject; and, although someof Surgeons, and the active adherence of the dissented, yet most of them were in favourmembers all over the country. He was told of such a measure. They all, however,that the University and other Colleges would declared its impracticability. This greatoppose them ; so they might. If there were meeting refuted that. The respected Chair-a certain number of names to a petition, he man was one upon whom he called at thatdefied them. The Oxford, Cambridge, and period. He then thought the measure im-Dublin Universities exerted themselves practicable ; he does not think so now, butagainst a charter for the London University, was a principal means of rendering it prac-and yet it was accomplished. United Irish- ticable, necessary, unavoidable. Dr. Henrymen might accomplish anything. Twelve had also called, in 1829, on the late Dr.years:ago, when an alteration in the College Cheyne, that enlightened physician, whowas proposed, gentlemen shrugged up their entered into the subject with deep interest,shoulders and said, 11 what a set of fellows! and handed him some suggestions on theyou attempt an impossible thing." But subject, though he said that the executionwhat did they see within the last twelve of the plan was beset with so many difficul-years ? They were accused of being inno- ties, and opposed by so many interests, thatvators, levellers, disturbers of men’s rights, he despaired of living to see its accomplish-but their object was that no man hereafter ment.

t)

should pay 150 guineas to get into this Col- Dr. TUOHILL said that he was one of thelege. They then passed a law that no man first individuals who entered the Collegeshould be compelled to serve an apprentice- of Surgeons under the provisions of the newship, but should merely answer certain exa- charter, being at that period a graduate inminations. The result was that the College medicine of two years standing; as soon aswas completely opened. In accordance he gained a voice in its councils he advo-with the changes of public feeling, sacri- cated a measure which was similar in prin-fices must be made. Dr. Jacob proposed ciple and application to that now suggested.the following resolution : Dr. Tuohill now proposed the following re-

" That the following principles should be solution:-held in view in constructing the constitution 11 That at the first formation of the newof the new College :- College Faculty, all persons holding de-"1. Fundamental regulations with regard grees or diplomas in medicine or surgery

to education, to be permanently established. from any of the Colleges or Universities at« 2. Compliance with them to be rewarded present legally authorised to grant the same,

with the license of the College, conferring who have been five years in the practice ofequal rights on all holders. their profession, not following the business

"3. All persons so licensed, to be members or profession of a retail druggist or apothe-of the corporation, after a certain period of cary, and who can produce evidence ofprobation, on evidence of irreproachable irreproachable moral and professional cha-moral and professional character. racter, shall be enrolled as members of the

° 4. Every individual so enrolled to be Corporation, upon payment of a sum not ex-free to act in the College, in every corporate ceeding 20 guineas."capacity. Dr. REARDON seconded the motion.

" 5. A general meeting of the whole Col- Dr. BEWLEY, of Moate, rose to propose anlege to be held in May, each year, to which amendment to the resolution. To the expe-district associations may send representa- diency of admitting other practitioners intotives, the business being to elect an execu- the College without a previous examinationtive council, &c. to govern the College dur- he must demur. The College enjoyed a re-ing the year, at all times sitting and voting putation superior to that of all other similarwith open doors. bodies, owing to the known severity and

« 6. A general meeting to be called at any publicity of its examination. Many mem-time by the Council, or upon a requisition bers of other medical bodies were equallysigned by at least twenty members." . well educated, but the public had not the

" The title of this College shall be the same security for their being so. The ex-Royal College of Medicine and Surgery in amination at many medical colleges wasIreland, uniting medicine and surgery into notoriously a mere farce. Provided a can.one faculty." didate produced a certain number of certifi-Dr. DUNN, of Drumsna, seconded the re- cates (only so many receipts for money paidsolution.

476

to certain persons countenanced, or, as the sixteen or seventeen rival corporations com-phrase is, recognised, by the College), and peted with each other in a Dutch auction,deposited the price of his diploma, he had as to which should sell its license to prac-little to apprehend from an examination, tise. The only remedy was to unite medi-What, then, was the Irish College called cine and surgery into one body. In theupon to do? Neither more nor less than to new College no one desired to give indiscri-put it on a level with those Colleges which minate admission to all who might apply. Aconferred their diplomas on insufficient ex- test must be devised, and the opinions ofaminations. It is proposed that we shall their own and other colleges should bebestow ours without any examination at all! sought, from which a safe measure mightWe are called on to acknowledge this day spring. The test of examination could notthat our position hitherto in society has been be made to apply. It was not to be sup-a false one-one continued lie. And for posed that gentlemen of twenty, or thirty,, orwhat equivalent are we to make these sacri- ten years’ experience, would undergo anyiices ? We are at present a very powerful examination. They ought not to do so, andbody ; students from all parts of the British he (Dr. M.) upon principle would himselfempire fiock to our lecture-rooms. We refuse to submit to any such test. (Hear.)possess this magnificent building and a noble The original resolution was unanimouslymuseum. We enjoy (unjustly, perhaps), a agreed to.monopoly of the county infirmaries. " All Professor BENSON then moved,-this," said Haman, " availeth us nothing so « That persons who have not been fivelong as I see Alordecaithe Jew sitting at the years in practice, shall, on paying not ex-king’s gate." I am not averse to the union ceeding 20 guineas, be enrolled as licen-of the two branches of the profession. No tiates of the College, to be enrolled as mem-man can more ardently desire to see this bers in five years from the date of their ori-most foolish distinction abolished. The end ginal degree or diploma, without furtheris undoubtedly good, but against the means expense."I respectfully protest, and support the fol- Dr. M’CoRMAC, of Belfast, seconded thelowing amendment:- resolution; he for one, if Dr. Bewley wasThat it is expedient that the College of satisfied to undergo an examination upon

Surgeons in Ireland should possess the admission, would submit to the same test.

power of conferring the title of Doctor of (Cheers.)Medicine and Surgery only on those who Dr. BLACKWELL, of Dunleer, proposed,-submit to a searching examination." " That members and licentiates of the

Dr. JOHN JACOB, of Maryborough, observ- Colleges of Surgeons and College of Physi-ed with some warmth, that the observations cians (provided the latter body join theof Dr. Bewley were treated with uncalled- union) shall be exempted from any suchfor disregard. They were worthy of marked payment."attention. He would not, however, say that Dr. BRADLEY, of Castlecomer, secondedgentlemen should be required to pass an ex- the resolution, which was agreed to.amination previous to being admitted into Dr. MACDONNELL moved,-the proposed College, because he felt how "That persons now enrolling their names,utterly impossible it would be for himself, shall, with the College, constitute an asso-at this period of his life, to submit to such ciation, to continue until the new charteran ordeal; but he would say that some other slaall be obtained."efficient test should be instituted as to pro- Seconded by Dr. LANGLEY, of Nenagh.fessional fitness. Agreed to.

Dr. JACOB, of Dublin, in reply to the ob- Dr. NUGENT, of Cork, then proposed (se-servations of his brother, strongly recom- conded by Dr. HEALY, of Ennis), the imme-mended gentlemen who prided themselves diate election of a Provisional Council, &c.on their acquirements and qualifications, not Dr. O’GRADY, of Swords, proposed,-to suppose that others who enjoyed qualifi- " That Richard Carmichael, Esq. be Pre-cations from a different source were inferior sident of the Provisional Council, and Dr.in knowledge. He had been for ten years Maunsell Secretary, and that the Councilthe instructor of the very class of practi- consist of the Committee of Correspondencetioners to whom allusion had been indirectly of the College of Surgeons, with the depu-made, while demonstrator to Dr.Macartney, ties of the local associations now existing,and he declared that those gentlemen were or hereafter to be appointed, with power todistinguished for knowledge and ambition add to their number."for honours which the exclusive regulations Seconded by Dr. COLOHAN, of Galway, andof some of the institutions did not permit agreed to.them to obtain. Surgeon WHITE then proposed the fifteenthDr. MAUNSELL said it was proposed that resolution, on which much misrepresentation

the road of entrance to the medical profes- had gone forth, producing feelings of ansion should be that of education alone, at unpleasant nature. It would set them rightthe highest possible standard, an object with the apothecaries. The first proposi-which could never be effected so long as tion of this resolution was, " that encou-

477

ragement should be given to a class ofscientific apothecaries." Inasmuch as theirpresent emoluments were derived princi-pally from their own prescriptions of theirown medicine, if a future race were to beprevented from prescribing, the chief sourceof their subsistence would be withdrawn.But then how was encouragement to be given?Why, by incorporating a College of Pharomacy. One of its by-laws would no doubtbe that the education and qualification ofthe candidates for its diploma should be ofthe very highest order. The public wouldhave the services of a far higher order of pure apothecaries, and the profession wouldbe more limited as to numbers. The apo-thecaries are too numerous by three-fourths- the quantity of pharmaceutical businessis inadeqljate to support them in comfortand respectability. The College of Phar-macy would no doubt secure to the apothe-caries of Ireland the exclusive sale of me-dicines, a source of profit at present more inthe hands of the grocer than the apothecary.The resolution contemplated the preven-tion of medical practitioners from compound-ing the prescriptions of others, but providedfor general practitioners compounding theirown. The Irish apothecary had been a per-son who may or may not possess a know-

ledge of the healing art. He concluded bymoving,-"That encouragement should be given to

scientitic apothecaries (whose time wouldbe exclusively devoted to the preparationand compounding of medicines), by the es-tablishmeut of a College of Pharmacy ; bypreventing medical practitioners from keep-ing shops for the sale of drugs, or compound-ing the prescriptions of others, and byaffordinG to regularly-educated apothecariesan exclusive right of dealing in medicinalarticles."

Seconded by Dr. KINGSLEY, of Roscrea,and agreed to.

Dr. WALSH, of Tullamore, moved,«Thatwe disclaim all intention of interfering withvested rights now enjoyed by any indi-viduals."

Dr. MORRISON seconded the resolution,which was adopted.

Dr.TABUTEAU moved, "That the establish-ment of a relief and widows’ fund be re-commended to the Provisional Council."

-

Seconded by Sir A. CLARKE, and agreedto.The best thanks of the meeting were then

given to Mr. Carmichael, the Chairman.

In the evening the principal delegates andfriends dined together at Radley’s Hotel,Commercial - buildings, Mr. Carmichaelbeing President.The cloth being removed, the following

toasts were drunk:—" The Queen," " TheLord Lieutenant," " The Medical Union ofIreland," " Richard Carmichael," " The

Irish College of Sargeons, and Dr. Jacob,""The Infirmary, Dispensary, and ArmySurgeons, of Ireland," 11 The Physicians ofIreland," "The Medical Press," "TheWestern Medical Society, the oldest in Ire-land," " The Provincial Medical Associa-tions," and " The Stewards."At twelve o’clock the party broke up,

after an evening of undisturbed harmony.On the following Friday, the President

and Council of the Association waited onthe Lord Lieutenant, to lay before him theresolutions adopted at the Congress, andto pray his consideration of them. His

Excellency entered into the subject withinterest. He was informed that it was notthe object of the deputation to press for areply to any request, but partly to anticipateany statements which might be made re-

specting the objects of the meeting by per-sons who did not coincide in its views.After a long conversation, the deputationretired, much gratified at their reception.

A CASE OF

I N T U S - S U S C E P T I O,WITH SEPARATION OF FIVE INCHES OF INTES-

TINE, FOLLOWED BY COMPLETE RECOVERY.

By JOHN Fox, Esq., Surgeon, Cerne Abbas.HEKRY DIMENT, a:t. 16, residing in the

parish of Nether Cerne, was taken ill on themorning of Monday, September the 10th.I first saw him at four in the afternoon.On inquiry, I found he had felt a little un-easiness in his bowels on the preceding day,with a slight sense of chilliness, and hadtaken a little milk and water, with a smallquantity of bread in it, instead of his usualmore substantial breakfast ; that he hadeaten some nuts on the 8th, but had, priorto the 9th, enjoyed an excellent state ofhealth. He had passed a restless night, andhad suffered from dull pain about the navelfor a minute or two several times in an hour;had taken several ounces of castor oil with.out effect; bowels had not been opened for24 hours. The tongue was slightly coated,but moist; he had no thirst; pulae 82, soft,and a little irregular; skin natural; urineof pale straw colour, and passed withoutinconvenience. The abdomen appearedsomewhat tumid, but the pain, which hedescribed as a " dull, griping pain," wasdiminished by steady pressure. I prescrib-ed five grains of calomel and one grain ofopium, to be taken immediately, and half anounce of castor oil every four hours, untilthe bowels had been freely opened.

Sept. llth, seven A.M.—He has passed asleepless, restless night; the same kind ofpain continues about the umbilicus, not in-creased on pressure; thirst more urgent;

has rejected every dose of the oil ; pulse96, small and intermitting, but soft and