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GENERAL MEDICAL COUNCIL.

PRESIDENT’S ADDRESS.

AT the opening of the one hundred and thirty-firstsession of the Council on May 27th, Sir DonaldMacAlister, the President, referred to the death,since their last meeting, of Principal John YuleMackay, for many years chairman of the EducationCommittee. "His eminence asa scientific anatomist,"he said, "and his experienced capacity as an

educational administrator, gave weight and distinctionto his often laborious contributions to our proceedings."Mr. Samuel Osborn had resigned his membershipafter five years’ tenure as the representative of theApothecaries’ Society of London, his place beingtaken by Lieut.-Colonel Charles Thomas Samman.

Indian Medical Degrees."The position," said [Sir Donald, "which I out-

lined in my address last November, with regard toIndian qualifications, was not modified by any actiontaken by the authorities prior to Feb. 24th of thisyear. The Executive Committee, to whom by thestanding orders is delegated the statutory responsi-bility of recognising overseas diplomas, and so ofguaranteeing that every holder thereof possesses therequisite knowledge and skill for the efficient practiceof medicine, surgery, and midwifery in this country,felt that the authoritative information placed atits disposal by the Indian authorities was inadequateand defective. The Committee was, in fact, no longerin a position to give this country the guarantee ofsufficiency required by law. Accordingly, the con-ditional recognition which since 1922 had beengranted until February, 1930, to certain Indian medicaldegrees, in the hope that a satisfactory method ofofficial standardisation and guarantee might in themeantime be brought into operation. lapsed on non-fulfilment of the conditions laid down. Until,therefore, a central body, such as the proposed All-India Medical Council, is established by Indianlegislation, and is empowered to control and pronounceupon provincial medical qualifications and standardsin India, the diplomas referred to, while they may beheld to meet the local needs of India itself, will not beregistrable here as conforming with the requirementsof practice at home.

" This decision was reluctantly but inevitablyarrived at, after much patient and sympatheticconsideration of present difficulties in India. It wasduly transmitted to the Secretary of State for Indiaand the Indian Government; but no further officialcommunication on the subject has been received. Itis, however, understood that steps towards centrallegislation will not be undertaken before, at earliest,the session of Assembly in the autumn.

" The Registrar," he added, " has drawn up, fromthe minutes of the Council since 1921, a memorandumsetting forth the successive steps in the long-drawn-out negotiations with the Indian authorities thathave led up to the present position."

Privileges of Foreign Practitioners.The Council had been asked by the Foreign Office*

through the Privy Council, for information regardingthe rules governing the privileges of foreign prac-tititoners, not registered in our register, in respect ofpractice among patients in hospitals established for’

‘

the treatment of foreigners in this country. Thequestion had arisen whether any such privilegesmight be extended to British practitioners practisingin hospitals established in France for the treatmentof British subjects. The law, said the President, iscontained in Section 6 of the amending Medical Act,1859, and is as follows :- .

Nothing in the said Act (Medical Act, 1858) contained shallprevent any person not a British subject who shall haveobtained from any foreign university a degree or diploma of !idoctor in medicine, and who shall have passed the regular i

examinations entitling him to practise medicine in his owncountry, from being and acting as the resident physician ormedical officer of any hospital established exclusively forthe relief of foreigners in sickness : provided always, thatsuch person is engaged in no medical practice except as suchresident physician or medical officer.

The French authorities, it is understood, are

considering the subject, with a view to an agreementto confer corresponding privileges on British prac-titioners in relation to hospitals for the treatment ofBritish subjects in France. The terms of such anagreement have been drafted with the assistance ofthe officers of the Council. ’

Pharmacopaeia.The Pharmacopoeia Committee would report on

the progress of the work of revision undertaken bythe Pharmacopoeia Commission. The preparationof a revised text was in an advanced state ; but inview of the considerable amount of new matter, inrelation, for example, to biological methods of testingunder the Therapeutic Substances Act, and other-wise, it appeared unlikely that the new Pharmacopoeiawould be ready for publication before the end of thisyear. The Commission and its Committees are,said the President, diligent in their devotion to thetasks assigned to them, and with their chairman,Dr. Beddard, deserve the grateful acknow-ledgments of the Council The Privy Council haveforwarded the text of the International Agreementrespecting the pharmacopoeial unification of potentremedies, drafted by the Brussels Conference of 1925,and approved by the Council subject to certainreserves. The text has been communicated to thePharmacopoeia Commission for its guidance.

Examinations.The cycle of inspections of final examinations was

now being carried out continuously by Dr. WardropGriffith, Mr. Farquhar MacRae, and Dr. Fairbairn.Reports on a number of licensing bodies had alreadybeen received by the Examination Committee, andwould in due course be submitted to the Council fortransmission to the Privy Council. Visitations ofparticular professional examinations by members ofthe Council had taken place, and the visitors’ reportswere under consideration by the Examination Com-mittee. It appeared that the complex subject compre-hending materia medica, pharmacy, pharmacology,and therapeutics, was very variously dealt with bydifferent licensing bodies. " The time seems to havecome for considering," said Sir Donald, " whether -greater uniformity in the systematic instruction inmethods of treatment, medicinal and other, has notbecome desirable and practicable." A report onthe subject was to be presented at the present,session.

Preventive medicine as a part of the medicalcurriculum had been occupying the attention of theCommittee, and much valuable information on theplace given to it by the medical schools and licensingbodies had been gathered from the visitors’ reports.Here, also, the great variety of emphasis assignedto the subject in different quarters seemed to call forserious consideration. The Council of the Societyof Medical Officers of Health had presented to theCouncil a careful and detailed report on the matterfrom an influential committee appointed by them,and this had been referred to the Education andExamination Committees, in the expectation thatthey would find it of assistance in framing conclusionsfor submission to the Council.The Education Committee had further considered

the question of the methods in use for the teachingof the applications of the pre-clinical subjects,chemistry, physics, biology, &c., during the later(clinical) years of the curriculum. Fuller and moredetailed information than was available last Novemberhad been gathered, and their conclusions would bereported pending the completion of the cycle ofinspections.

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Registration of Foreign Students.The Committee had also had before it the question

of the ascertainment and attestation of the certificatespresented by applicants for registration as medicalstudents from foreign countries. These presenteddifficulties that had, within the last few years, becomeembarrassing, in view of the very large influx ofintending medical students from overseas. In somecases the number of such applicants exceeded thosefrom this country, and it became the more importantto ensure that their general educational qualificationswere not inferior to those required of our own students,or indeed to those required in their own country,for admission to professional degrees and diplomas." The question," said Sir Donald, " will call forcareful and perhaps expert investigation, and forfriendly communication with the overseas authoritiesconcerned."At the conclusion of his address a vote of thanks

to the President was proposed by Sir NORMAN WALKER.and seconded by Sir HOLBURT WARING. TheCouncil then passed to the consideration of penalcases.

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DENTAL BOARD OF THE UNITED

KINGDOM.THE CHAIRMAN’S ADDRESS.

AT the opening of the eighteenth session of theBoard on Wednesday, May 14th, the Chairman, SirFrancis Dyke Acland, delivered an address in whichhe reviewed the present position of the dental pro-fession mainly from the economic standpoint in adiscursive but interesting manner. Dealing with thenumerical make-up of the profession he suggestedthat the rising annual entry to the dental schools wasa proof that under the Board the profession hadbecome more attractive, and speaking as layman hesuggested that statistics were against what he termedthe argument of the open door. He contemplated acessation to the dislike of recent legislation manifestedby the public, who, from a natural antipathy toprivileged callings, regretted the day when " anyone,however poor, could become a dentist; he had only totake up a forceps and start." The Chairman believedthat although the transition period was hardlyyet over the general public was becoming moreaccustomed to regard the dental profession as resemb-ling other professions-namely, privileged for thepublic good, while the bursary scheme furnished areply to the difficulty of enabling the poor man tobecome a dentist.On the question of whether the figure of 14,000

dentists, at which it was proposed to maintain theregister, was high enough, the chairman pointed outthat as health services developed there should be somuch the less dentistry required as general healthconditions improved. He pointed out, further, thatwhen a man works as a school dentist or in a clinicthe overhead charges which a dentist must carrywhenever he is not working are largely eliminated, andhe can afford to do more work for less money andwill do more work in less time than a dentist in privatework. If this can occur in a clinic because thepatients are arranged to suit the dentist’s time ratherthan the public convenience, it followed that theextent to which dentistry is carried on in clinicswill be related to the number of dentists needed.

Sir Francis concluded his address with some

general remarks on the present and probable futureposition of dentistry as a benefit under health insur-ance, laying stress on the need for dental treatment,especially between the ages of 16 and 19. He com-pared the present dental benefit scheme to rain,saying,

" One has rainy periods and less rainy periods,fine days and wet days ; rain may be a deluge or asprinkle, it may do great good or none, and it neverreally comes when one wants it most. Each point of i

comparison can be made good-rainy periods and lessrainy periods-because though there are so manymillions entitled to dental benefit at one date, there is,I think, no certainty that there will be the samenumber entitled to it at another. Fine days and wetdays because the scheme of dental benefit is full ofgaps, for some societies give no benefit at all andnever have done. The rain varies in intensity, andhere, though the analogy is perhaps weak, it still holdsgood, for some societies adopt one scale, some another,a matter which has caused great feeling and friction.Rain may do great good or none-so may the dentalbenefit scheme, for unless the insured person can payhis share of the estimate the whole scheme is nuga-tory. And rain never comes when I want it most, notdoes dental treatment which I want most between16 and 19. There are five things, three of whichit seems possible to put right fairly quickly and theother two can be got right some day if we clearly seethe present facts as evils and help to get themremedied... If those now negotiating aboutinsurance practice can help to secure that societiesshall always provide benefit, that all societies shallprovide benefit, and that the benefit shall be on auniform scale, they will have done three good thingsand they will deserve well of the public and of theprofession, and in this connexion there can surely beno distinction between the two. Then two thingsremain, and the first is, how to help those who atpresent cannot afford their share, and I believe thatin some places people would save if a saving systemwere organised, and slightly helped. The secondpoint is that from the point of view of public healthwe want to shorten the gaps in people’s lives duringwhich dental treatment depends not on design butchance, which means that there generally isn’t any.These gaps are obvious, the period under school age,the period after school age and before insurancebegins, and the waiting period after insurance beginsbefore there is any dental benefit. Looking at thematter as a whole, things are improving for, with theextension of the school age, the second gap will beshortened. But I am dealing now with the lastperiod. I believe it has recently been shortened fromfive years to three, which is splendid. But if I payan insurance premium for fire, and my house burnsdown next day, I get paid, provided I did not set italight. And though I know, of course, that thescheme of health insurance is utterly different fromthat of fire or life insurance, it should not bebeyond the wit of man to prevent the principlesupon which it is built from operating permanently asdefects."

UNIVERSITY OF MANCHESTER.-From May 22nd to24th this university celebrated the eightieth anniversaryof its foundation as Owens College and the jubilee of itsfoundation as the Victoria University of Manchester. OnMay 23rd honorary degrees were conferred, amongst others,on Dr. J. Lorrain Smith, F.R.S., professor of pathology inthe University of Edinburgh, who has for several yearsbeen professor of that subject at Manchester.

MIDDLESEX HOSPITAL CLUB.-This club, whichheld its annual meeting last week, was founded many yearsago with the idea of arranging reunions. An annual sub-scription is paid by the members with a view to buildingup a fund which can be used to relieve old Middlesex menin distressed circumstances or to assist in any scheme forthe benefit of the hospital or medical school. At the lastmeeting a further sum of 2250 was voted for a squashracquets court for the residents.

KING EDWARD’S HOSPITAL FUND FOR LONDON.-The annual meeting of this Fund for the purpose of receiv-ing the accounts and reports was held at St. James’s Palaceon May 27th, when the Prince of Wales, who presided, reada message from the King, expressing his pleasure at theresults of the Thankoffering Fund and the gifts receivedfrom Sir Otto Beit and Mr. Roger Parr, which had enabledthe Fund to lend a large supply of radium to hospitals.The activities of the Fund during 1929 were fully describedat the meeting on December 14th, which was reported inour columns at the time (THE LANCET, 1929, ii., 1355).