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EXAMINING BOARD IN ENGLAND, BY THEROYAL COLLEGE OF PHYSICIANS OFLONDON AND THE ROYAL COLLEGE OFSURGEONS OF ENGLAND,Under the Provisions of Clause XIX. of the Medical

Act (1858).

REGULATIONS RELATING TO PROFESSIONAL EDUCATIONAND EXAMINATIONS.

SECTION I.

Professional Education.-Any candidate who desires to obtain boththe licence of the Royal College of Physicians of London and thediploma of Member of the Royal College of Surgeons of England isrequired to comply with the following regulations, and to pass theexaminations hereinafter set forth. (See Section II.) Every suchcandidate who shall commence professional study on or after October1st, 1884, will be required, at the times prescribed in Section II. for therespective examinations, to produce satisfactory evidence :-

1. Of having been registered as a medical student by the GeneralMedical Council. (See regulations of the General Medical Council, tobe obtained of the Registrar, 299, Oxford-street, London, W. Note A.-Professional studies commenced before registration, except in thecases of chemistry and chemical physics, materia medica, botany, andpharmacy, will not be recognized.

2. Of having been engaged in professional studies at least forty-fivemonths, during which not less than three winter sessions and twosummer sessions shall have been passed at one or more of the medicalschools recognised by the two Colleges. One winter session and twosummer sessions may be passed in one or more of the following ways :-(a) Attending the practice of a hospital, infirmary, or other institution,recognised as affording satisfactory opportunities for professional study;(b) Receiving instruction as a pupil of a legally qualified practitionerholding such a public appointment, or having such opportunities ofimparting a practical knowledge of medicine, surgery, or midwifery, asshall be satisfactory to the two Colleges. (c) Attending lectures on oneor more of the required subjects of professional study at a recognisedplace of instruction.

3. Of having received instruction in the following subjects(a) Chemistry, including chemical physics, meaning thereby heat,light, and electricity. (b) Practical chemistry. (c) Materia medica;(d) Botany. (e) Pharmacy. Note B: The instruction in practicalpharmacy must be given by a registered medical practitioner, or by amember of the Pharmaceutical Society of Great Britain, or in a publichospital, infirmary, or dispensary. I

4. Of having performed dissections, at a recognised medical school, ]

during not less than twelve months. 15. Of having attended, at a recognised medical school :-(a) A course 1

of lectures on anatomy during not less than six months, or one wintersession. (b) A course of lectures on general anatomy and physiology Iduring not less than six months, or one winter session. (c) A separatepractical course of general anatomy and physiology during not less than Ithree months. i

6. Of having attended, at a recognised medical school :-(a) A course Jof lectures on medicine during not less than six months, or one winter ssession. (b) A course of lectures on surgery during not less than six Imonths, or one winter session. (c) A course of lectures on midwifery a

and diseases peculiar to women during not less than three months.Note C : A certificate must also be produced of attendance on not less I

than twenty labours, which certificate must be signed by one or more 1

legally qualified practitioners. (d) Systematic practical instruction inmedicine, surgery, and midwifery, including-(1) the application ofanatomical knowledge to the investigation of disease; (2) the methods r

of examining various organs and other parts of the body, in order to n

detect the evidence of disease or the effects of accidents ; (3) the em.ployment of instruments and apparatus used in diagnosis or treatment ; t

(4) the examination of diseased structures, whether recent or in amuseum ; (5) the chemical examination of morbid products; (6) the ,jEperformance of operations on the dead body ; (7) post-mortem exami-nations. (e) A course of lectures on pathological anatomy during not a

less than three months. (f) Demonstrations in the post-mortem roomduring the whole period of attendance on clinical lectures. (See a

Clause 8.) (g) A course of lectures on forensic medicine during not less pthan three months.

7. Of having attended, at a recognised hospital or hospitals, the o

practice of medicine and surgery during three winter and two summer tlsessions. Note D: No metropolitan hospital is recognised which con-tains less than 150, and no provincial or colonial hospital which con- 3.tains less than 100 patients. A three months’ course of clinical w

instruction in the wards of a recognised lunatic hospital or asylum may Cbe submitted for the same period of attendance in the medical wards ofa general hospital.

8. Of having attended, at a recognised hospital or hospitals, during n,

nine months clinical lectures on medicine, and during nine monthsclinical lectures on surgery, and of having been engaged during a period irof three months in the clinical study of diseases peculiar to women. d,Note E : These clinical lectures must be attended after the candidate tlhas passed the second examination. w

9. Of having discharged, after he has passed the second examination, ui

the duties of a medical clinical clerk during six months, and of asurgical eresser during other six months. Note F.-These duties maybe discharged at a general hospital, infirmary, or dispensary, or

parochial or union infirmary, recognised for this purpose, or in suchother similar manner as shall, in the opinion of the two Colleges, affordsufficient opportunity for the acquirement of practical knowledge.

10. Of having received instruction in the practice of vaccination.Note G : The certificate must be such as will qualify its holder to con.tract as a public vaccinator under the regulations, at the time in force,of the Local Government Board. Students are required to attendexaminations which are held in the several classes. N.B.-Exemptionfrom any of the foregoing regulations can only be granted by the com.mittee of management.

SECTION II.

Professional Examinations.-There are three professional examina.tions, called herein the first examination, the second examination, andthe third or final examination, each being partly written, partly oral,and partly practical. These examinations will be held in the months ofJanuary, April, July, and October, unless otherwise appointed.N.B.-Every candidate intending to present himself for examination isrequired to give notice in writing to the registrar of the Royal Collegeof Physicians, or to the secretary of the Royal College of Surgeons,fourteen clear days before the day on which the examination commences,transmitting at the same time the required certificates. All fees mustbe paid three days prior to the day on which the examinationcommences.

The First Examination.-The subjects of the first examination are :Chemistry and chemical physics, meaning thereby heat, light, andelectricity. Materia medica, medical botany, and pharmacy. Elementaryanatomy, and elementary physiology. (Synopses indicating the rangeof subjects in the examinations in chemistry and chemical physics,materia medica, medical botany, pharmacy, elementary anatomy, andelementary physiology may be obtained, together with the regulations.)A candidate may take this examination in two parts at different times,or he may present himself for the whole at one time. A candidate willbe admitted to the examination on chemistry and chemical physics,materia medica, medical botany, and pharmacy on producing evidenceof having been registered as a medical student by the General MedicalCouncil, and of having complied with the regulations prescribed inSection I., Clause 3; but he will not be admitted to the examination onelementary anatomy and elementary physiology earlier than the end ofhis first winter session at a medical school. A candidate rejected ineither part or in both parts of the first examination will not be admittedto re-examination until after the lapse of a period of not less than threemonths from the date of rejection, and he will be re-examined in thesubject or subjects in which he has been rejected. The fees for ad.mission to the first examination are as follows :-For the whole exami.nation, £10 10s. for re-examination after rejection in either of the two

parts, £3 3s. Any candidate who shall produce satisfactory evidence ofhaving passed an examination on any of the subjects of the first part ofthis examination conducted at a University in the United Kingdom, inIndia, or in a British Colony, will be exempt from examination on thosesubjects in which he has passed.The Second Examination.—The subjects of the second examination

are :-Anatomy, physiology. (A synopsis indicating the range of subjectsin the examination in physiology may be obtained with the regulations,)A candidate may present himself for examination in either of thesesubjects or parts separately, or in both at one time. A candidate willbe admitted to the second examination after the lapse of not less thansix months from the date of his passing the first examination, on pro.ducing evidence of having completed, subsequently to registration as amedical student, eighteen months of professional study at a recognisedmedical school or schools, and of having complied with the regulationsprescribed in Section I., Clauses 4 and 5. A candidate rejected in eitherpart or in both parts of the second examination will not be admitted tore-examination until after the lapse of a period of not less than threemonths from the date of rejection, and will be re-examined in the sub-ject or subjects in which he has been rejected. The fees for admissionto the second examination are as follow :-For the whole examination,£10 10s. for re-examination after rejection in either of the two parts,.S3 3s.The 7hird or Final Examination.—The subjects of the final examination

are :-Medicine, including therapeutics, medical anatomy, and patho-logy ; surgery, including surgical anatomy and pathology; midwifery,and diseases peculiar to women. (Questions on forensic medicine andpublic health will be included in the third or final examination.) Acandidate may present himself for examination in these three subjectsor parts separately or at one time. A candidate will be admitted tothe third or final examination on producing evidence :-1. Of beingtwenty-one years of age. 2. Of having passed the second examination.3. Of having studied medicine, surgery, and midwifery, in accordancewith the regulations prescribed in Section I., Clauses 2 and 6 to 10. The

Colleges do not admit to either part of the Third or final examinationany candidate (not exempted from registration) whose name has notbeen entered in the Medical Students’ Register at least forty-five months,nor till the expiration of two years after bis having passed the second ex-amination.-NOTE : Students are recommended to pass these two yearain acquiring practical knowledge in the wards, or in the out-patients’department, of a recognised hospital. A candidate rejected in thethird or final examination, or in one or more of the three parts intowhich be may have divided it, will not be admitted to re-examinationuntil after the lapse of a period of not less than six months from the

973

date of rejection, and he will be re-examined in the subject or subjectsin which he previously failed to pass. Any candidate who shall haveobtained a colonial, Indian, or foreign qualification which entitles himto practise medicine or surgery in the country where such qualificationhas been conferred, after a course of study and an examination equiva-lent to those required by the regulations of the two Colleges, shall, onproduction of satisfactory evidence as to age, and proficiency in vacci-nation, be admissible to the second and third examinations. The feesfor admission to the third or final examination are as follows :-For thewhole examination, Z15 15s. ; for re-examination after rejection inmedicine, £5 5s.; for re-examination after rejection in surgery, e5 5s. ;for re-examination after rejection in midwifery, .83 3s. Every candidatewho shall have passed the third or final examination is, subject to thebye-laws of the two Colleges, entitled to receive the licence of the RoyalCollege of Physicians of London and the diploma of Member of theRoyal College of Surgeons of England, (Forms of the required certifi-cates may be obtained of the registrar of the Royal College of Phy-sicians, or of the secretary of the Royal College of Surgeons.)

FREDERICK A. MAHOMED, M.B. CANTAB.,F.R.C.P. LOND.

ANOTHER instance of a fellow-labourer of great promise"Dead, dead ere his prime."

’

The profession in London for the last fortnight had beenaware that this brave worker in the fever-field was himselfsmitten with typhoid and had trembled for the result, which,alas ! is very bad. We shall not now attempt to do justiceto the labours and to the hopes of Mahomed, for he was abold and ambitious explorer "in the regions beyond" theaccepted limits of pathology. It is not the least sig-nificant proof of his character that we are supplied or pro-mised on all hands, from worthy contemporaries, not to sayrivals, accounts of his work and of himself. One, andno mean tribute, from a capable and generous hand wehere produce :-" I have known Frederick Mahomed during the whole

period of his too short career in scientific medicine, andhe has always seemed to have possessed an individualityfar more strongly marked than most of us who are hiscontemporaries. It must be twelve years ago that thereappeared in the Medical Times that series of papers uponthe sphygmograph which at once stamped him as an

ardent and industrious student; indeed, he was charac-terised by an ardour and energy which often made himformulate propositions far in advance of the ideas of hismore cautious comrades, and led him sometimes into mis-taken inferences, but none the less honestly believedand advocated. It was a common saying that no one butMahomed could interpret all the teachings of the sphygmo-graph, and it may be that this study of its records led himto place too strong a reliance upon the faithfulness of amechanical contrivance, without due allowance for its neces-sary imperfections. In spite of that it cannot be deniedthat his fervent advocacy did much to re-establish thesphygmograph in clinical estimation. These early studiesof the pulse gave a bias to all his future work, whichwas mainly centred upon the subject of Bright’s disease.One of the first fruits of this pursuit is to be found in thepaper read in 1874 before the Royal Medical and Chirur-gical Society on the Pre-albuminuric Stage of ScarlatinalNephritis. He showed here from a wide experience, dueto his connexion with the London Fever Hospital, thatthe occurrence of albuminuria in scarlatinal subjects waspreceded by increase in arterial tension, and often by thetransudation into the urine of hæmoglobin; and he showed,further, that this was so constantly preceded by constipa-tion as to suggest a causative relation, and the prescriptionof purgation with the view of anticipating, and even pre-venting, the supervention of nephritis. The importance ofsuch an increase in arterial tension as a prodromal pheno-menon in renal disease became clearer to him as timewent on ; and he devoted himself to solve the riddle ofBright’s disease, and determine the significance of albu-minuria. His last production on this subject is to be foundin the recently issued volume of Guy’s Hospital Reports,but he had previously made it the subject of his graduationthesis at Cambridge University, and communicated a paperupon it to the International Medical Congress of 1881, aswell as to a previous volume of the Reports. It is beyondmy power to condense into a few words the outcome

of all this labour, for his writings upon the subject teemwith pathological and clinical observations. Suffice it tosay that the attempt to lay greater stress upon cardio-vascular change than upon the structural lesions of thekidney was supported by many facts, and harmonised withthe doctrine of arterio- capillary fibrosis expounded by SirW. Gull and Dr. Sutton. But Mahomed did not confinehimself to this one subject, vast as that subject was. Hisactivities and sympathies were far wider. He was a mostconstant attendant at the meetings of the metropolitanmedical societies, and a frequent speaker in the discussions,showing a familiarity with many subjects and the good useto which he had put his faculty of observation and hisretentive memory. Of late his activity seemed to haveredoubled, and as an instance may be cited the fact thatlast spring he attended a meeting of the Glasgow Pathologi-cal and Clinical Society to take part in a debate on albumi-nuria, while at the same time he contributed the results ofhis experience of the use of cold baths in the treatment oftyphoid fever to the Medical Society of London. It mayhere be remarked that his experience of this treatment atthe London Fever Hospital convinced him of its utility tosuch an extent that he urged its adoption in his owncase, but owing to the mild course of the fever in itsearly weeks it was not deemed necessary to resort to it.The work with which Mahomed himself would perhaps mostwish to be remembered is, I imagine, not his personalscientific labour so much as the share he took in establishinga scheme to encourage accurate observation and record bymedical practitioners generally. Whatever may be the out-come of collective investigation, and to what extent it willbe found practically useful, it is almost entirely owing tohim that the idea took form in this country, in the BritishMedical Association. The movement has since been takenup by other countries, and finally by the InternationalMedical Congress. All who have been associated with himin the furtherance of this scheme must have felt how largelythe whole plan and method of procedure were the creation ofhimself ; and such progress as collective investigation hasmade in this country is mainly due to the unremitting labourand enthusiastic advocacy which he bestowed on it. Tothose who have heid aloof from the movement, or who see init no practical gain, we would wish for a little of thisenthusiastic spirit. It must not be forgotten that as yetand for some time to come the prosecution of the workmust be regarded as experimental. No one-not even thesanguine mind of Mahomed himself-could have imaginedthat so novel and striking an effort should be commenced inas perfect a form as it was possible it might attain ; butthe central principle of the movement remains unshaken, nomatter how faulty tile methods whereby it is carried on. Itis an extension of the same idea and the endeavour tocollate facts bearing on the transmission and aflioities ofdiseases that has been attempted by Mr. Francis Galton, inconjunction with Dr. Mahomed, in the encouragement offamily registers ; and the anthropometrical laboratory, sopopular at the Health Exhibition, was a type of an institu-tion which the same inquirers hoped might one day be mul-tiplied over the country. It was upon these collateral subjects,which some may regard as impracticable, that Mahomedexpended much time and energy, pursuing them with whatto many seemed an almost Quixotic ardour. Yet on thesesubjects, as on others, he did not rest until he had followedthem up to the full ; and everything he undertook,down to his last public act at the College of Phy-sicians, where he vainly urged the College to take mea-sures to enforce the regulation of the sale of drugs,was done with an intensity and a fervour rarely to bemet with. It was by virtue of these qualities that, youngas he was, Frederick Mahomed was perhaps better and morewidely known than any of his contemporaries; and in theknowledge of these elements in his character his friends feltthat there was opening to him a prosperous career-now,alas ! abruptly brought to a close."The first symptoms of Dr. Mahomed’s fatal illness ap-

peared on October 30th, the day on which he brought forwardat the Royal College of Physicians a motion to appoint acommittee for the purpose of urging the Government toexercise control over the quality and composition of patentmedicines and drugs. Then followed some days of malaise,and in about a week the true nature of the malady becameclear. For the first fortnight the fever ran a mild course,being marked by conetipation. Then the temperature roseto 104°, and on the nineteenth day a severe attack of intes-