249Mr. Phillips states that nothing is gained by this process; for

the usual mode (he says) of preparing iodide of barium is by theaction of hydriodic acid on the carbonate of barytes. I have

repeatedly prepared the bromide and iodide of barium for medi-cinal and physiological purposes, and always, in the case of theformer salt, by boiling the carbonate of barytes with solution ofbromide of iron; in the case of the latter salt, by the action ofcaustic barytes on the solution of the iodide of iron. I neveronce thought of having recourse to the process which Mr. Phillipsterms the common one.

Berzelius incorrectly states that I separate the hydracids bydistillation. All that is necessary when the decomposition iscomplete is to filter. The said solutions may be concentrated if

required. Precautions must be taken to prevent any sulphuricacid remaining in the solution, and to avoid decomposition inconcentrating. Your obedient servant,

ROBERT MORTIMER GLOVER, M.D.Northumberland-street, Newcastle, Feb. 11, 1845.

ROBERT MORTIMER GLOVER, M.D.

ARMY AND NAVY SURGEONS.To the Editor of THE LANCET.

SIR,—It is rather an extraordinary circumstance that, duringthe many discussions concerning the Bill lately brought into Par-liament by Sir James Graham, for the better government of themedical profession, no allusion whatever has been made to themedical officers of the army and navy, who are, one and all of ’,them, strictly speaking, general practitioners.

If the general practitioner be of an inferior grade, why is heappointed to take charge of the lives of our soldiers and sailors,both at home and abroad, and frequently under circumstances re-quiring the very first medical and surgical ability? Why notsend one of the Pures, if they be so very superior in professionalacquirements, to each regiment and ship of war? Surely ourbrave defenders by sea and land are well entitled to the bestmedical and surgical assistance the nation can procure for them.

I am, &c. A. B.Corner in the North, Feb. IS, 1845.

THE HEADS OF CHARTER.To the Editor of THE LANCET.

SIR.—Your correspondent (" M.R.C.S. and L.A.C.") is ac-tuated by a laudable desire to prevent the too easy attainment ofmembership in the proposed College of General Practitioners.But it must be remembered that to gain a great future advantagea small temporary evil may surely be overlooked. I think the

provisional committee have, en the whole, acted prudently withregard to members to he admitted " in the first instance ;" fornumbers of respectable men are now practising generally with-out the apothecaries’ licence, enjoying the confidence both oftheir patients and their professional brethren. Upon such menit would be hard suddenly to cast the stigma of exclusion. Buta, much more important and cogent reason for leniency on thispoint is, that by admitting the members of all colleges of phy-sicians and surgeons and societies of apothecaries, and of everyM.B. and M.D. of universities throughout the empire, a largeand powerful body of men are conciliated, perhaps converted,into zealous advocates of the new college. On the other hand,divisions and jealousies, and over-strictness with respect to

present qualifications, may prove fatal to the general practitioners.When you have-once got your charter, make your regulations forthefuture admission of members and fellows as stringent as youwill,-the more so the better. But do not split upon a strawwhile you have everything to gain. Divisions will delight SirJames Graham, but must be fatal to the profession.

I am. Sir, yours respectfully,M.D., M.R.C.S.L., & L.A.C.

Feb. 25, 1845.

HOUSE OF COMMONS.Tuesday, February 25th, 1845.

NEW MEDICAL BILLS.

Colonel WOOD presented two petitions from the medicalpractitioners of Kensington and Chelsea, praying, amongst otherthings, that the house would pass no general measure respectingthe medical profession which did not recognise the rights of thegeneral practitioners.

. Sir JAMES GRAHAM rose and said,-Sir, I should not haveconsidered it consistent with that duty which I am called upon toperform, to have troubled the house’at any length upon the sub-

ject of the motion which I am about to make, had I not thoughtthat a very great impression has been created on the publicmind, and extreme anxiety, as well as no little excitementamongst the medical practitioners, with respect to the alter-ations which it is the intention of the Bills that I am aboutto ask leave to bring in to introduce into that profession. I shouldnot but for this have trespassed at so late an hour upon the atten-tion of the house. But it will no doubt remember, when ’Iintroduced, at the latter end of last session, a Bill for the regu-lation of the medical profession, that I then stated, that consideringthe various important interests which that measure would affect,as well with respect to the public at large as to the medical prac-titioners themselves, hasty legislation upon such a subject wouldnot only be inexpedient, but unjust to the profession, andthat I thought I should best consult the public interest,and accord that justice which was due to all parties, if Ilaid the then projected measure on the table of the house, inorder that its merits, and the various enactments which wereproposed in its clauses, might be canvassed and thoroughlysifted during the ensuing recess. It was not denied that this pro-ceeding on my part was characterized by fairness, and by a wil-lingness to afford an opportunity for thoroughly examining theproposed Bill, and I am now prepared to admit also its useful-ness, for the discussions which have since taken place with re-spect to that measure have enabled me to state what I am nowprepared to do. And first, it will be necessarv for me to recapi-tulate the leading object of the Bill to which I refer, and then Ishall state the changes which I have introduced in the measure Iam now about to propose. The first provision of that Bill towhich I propose to adhere, is the establishment of a Council ofHealth, which shall have the superintendence and control overmedical and surgical education, and which shall constitutea board, the seat of which shall be in the metropolis, so as tobe easy of access to the executive government, in order to assistthe authorities with its advice upon all questions affecting thehealth of the people at large, such as on occasions when thecholera rages, or when fevers or epidemics are about. This sani-tary board will advise the measures to be taken by the govern-ment with reference to the general health of the people in largeand populous cities, and it will constitute a council easily acces-sible to the executive government, as its seat will be in the metro-polis. This is the first object of the Bill. The second objectwhich the measure is intended to effect is, to abolish all mono-

polies of the medical profession, and to secure to all medicalpractitioners equal facilities of practice. (hear, hear,) as well asto afford the security to the public of an equality of attainmentson the part of the medical practitioners, so that whilst on the onehand equality of practice is given to the profession, equalityof attainments is secured to the public on the other ; theseattainments being certified and made notorious to the publicby the registration of all the medical practitioners afterthey shall have undergone an examination before the consti-tuted authorities, and thereby afforded a proof that they havecome up to that standard which shall be deemed requisiteto qualify them to practise in medicine and surgery; and -by thelaw, as it will in future stand, no title to practise in the threekingdoms will be given in any ona of the three branches -ofmedicine and surgery to those who shall not have undergone suchan examination and be found competent. These were the leadingobjects of the Bill which I introduced last year; to those objectsI still adhere in the Bill which I contemplate; and if the housegives me permission to bring it in, it shall be my care that theprovisions which I have pointed out shall be fully secured to thepublic. Having thus shortly stated the leading objects of theproposed measure, I will now proceed to lay before the house thealterations in the Bill of last session which it is my intention tomake. In that Bill I proposed to repeal the statute of Henry VIIL,(14 and 15, c. 5,) which gives to the members of the College ofPhysicians the exclusive right of practising as physicians in themetropolis, and within seven miles of it. I do not now propose torepeal that Act entirely, but I do so only so far as to exempt fromits penalties all physicians who shall be registered according tothe provisions of the proposed measure, and I have also framed aclause whereby the Universities of Oxford and Cambridge will beexempted from its operation, and their graduates will consequentlybe secured in all their present privileges. (Hear.) There exists,I am sorry to say, both at Cambridge and Oxford, a great jealousyrespecting their privileges, and they have not as yet consented toforego their rights and to come within the operation of the pro-posed measure; I have therefore thought it expedient to intro-duce a clause into this Bill exempting their graduates from itsoperation, and consequently conferring on them the right to prac-tise according to their respective degrees throughout all Englandand Wales, save and except in the metropolis, and within seven.miles of it. This provision respecting the right of the two

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universities will be inserted in the proposed Bill, unless theyshall, subsequently to its introduction, agree to come under its,operation., The particular arrangement that has been entered.into between the College of Physicians and the Universities, is,.that an assessor from the College of Physicians shall go down to- Cambridge or Oxford, and have the power of granting medical.degrees in conjunction with them, which degrees shall confer onthe graduate the same right of practising in the metropolis, and

’-within seven miles oaf, it, which they will possess with respect toall the other parts of England and Wales, under the operation of

;,,the clause I have already referred to. But if the Universitiesshall, previous to the passing of this Bill into a law, consent toJ’w.aiv,e their exclusive privileges, and to place their graduatesunder its operation, then the clause can be withdrawn in com-mittee, and the same arrangement can be made with respect toihem, which I am happy to say the universities in Ireland andScotland have already acceded to. I now come to the question- more particularly referred to in the petition just presented--namely, the question of the repeal of the Apothecaries’ Act.-After having reflected upon this subject with great anxiety, I.have come to the conclusion that it is not expedient to propose,the total repeal of the Apothecaries’ Act. It is my intention topropose the repeal of that Act only so far as parties who shall be.registered under the Bill I am about to introduce shall be con-cerned. A great complaint made against the measure proposed.by me last session was, that I gave no additional security againstempiricism, and that I abolished the penalties already in force.In the present Bill, whilst I propose the partial repeal ofthe Apothecaries’ Act, I shall leave the full exercise of thepowers to enforce penalties untouched. (Hear, hear.) TheApothecaries’ Company will still be allowed to prosecute allthose practitioners who shall not be registered under this Bill,,and who shall practise without being so registered. I confess,Sir, that I do not attach much value to the enforcement of thesepenalties, but I am content to leave the power. Now, I do notstop here; I do hope that I shall be able to give an additionalsecurity to that offered in the Bill of last year, and as I think itis a security which I can offer consistently with the principle I.maintain, against the simulation of the right to practise by any.individual who shall not be duly enrolled. I cannot regard itas an offence for any person not professing to possess the re-quired standard of an examination to practise surgery or medi-cine, subject to the risk which he runs of a criminal prosecu-tion, and, I believe, also of a civil action, if any injury shallresult from his practice. He will still be subject to the generaloperation of the law, and if he does not pretend to be what he isnot, I cannot see why we should make any new crime. I pro-pose, however, to go the length of saying that there should be anadditional restraint, by making it penal for any unqualified per-son to assume the title of physician, of surgeon, or of apothe-cary or doctor, or any other title recognised by this Bill. Mybest course, however, will be, as this is a most important clause,that I should read the whole clause, which runs in these words:- -" And be it enacted, that every unregistered person whoshall wilfully and falsely pretend to be, or take or use the nameor title of physician, doctor, bachelor, or inceptor in the facultyof medicine, or surgeon, or licentiate in medicine and surgery,or apothecary"-(I retain that, because I do not now propose torepeal the Apothecaries’ Act)-" or any name, title, or addition,implying that he is registered under this Act, or recognised bylaw as a medical or surgical practitioner, shall be deemed guiltyof a misdemeanor in England and Ireland, and in Scotland of acrime and offence, and being convicted thereof shall be punishedby fine or imprisonment, or both, as the court before which heshall be convicted shall award." I shall meet many objectionsby this provision, and I feel it consistent with my duty to go thefull length against empiricism, and against the pretenders tomedical practice who have not the qualifications they claim. I

propose also to repeal so much of the Apothecaries’ Act as re-quires the examiners, who will hereafter be conjoined with phy-sicians in the examination of licentiates in medicine, of necessityto be members of the civic guild of apothecaries of the city ofLondon. The examiners are now part and parcel of a civicguild, the admission to which may be by purchase or by in-heritance, without any medical knowledge or examination.In lieu of the present provision, I propose that the qua-lification for an examiner shall in future be an apothecaryof ten years’ standing, who shall be in practice as an apo-thecary, or a licentiate in medicine of ten years’ standing ;anticipating that after the lapse of ten years the examinerswill, in fact, be licentiates in medicine under this Act, andthat under the general name of " licentiates" the examinersWill be general practitioners. (Hear, hear.) I come now toanother alteration to which I attach great importance. Iconfess that I earnestly desire to see one admission to practise by

an examination common to all, and that after all shall havepassed one common portal each should choose what branch ofmedicine he may wish to practise. I would earnestly desire tosee that common examination, but I have found objections raisedto that plan which appear to me to be reasonable and to be in-superable. The College of Physicians has always attached, andas it appears, rightly attached, great importance to an universityeducation, and to enforce upon persons who have received thateducation another examination, such as would be enforced uponothers at an earlier period, would greatly increase the protractedstudy of the physician, who could not, as I propose, enter intopractice till he is twenty-six, which is certainly not too late aperiod of life for a physician to commence practice.. This objec.tion is made, that academical education is not so various, and notso full upon particular points of the curriculum of education.This objection, therefore, does not apply to surgeons, and I havegreat satisfaction in knowing, as far as my inquiries have gone,that there is not on the part of the College of Surgeons, or of thesurgeons generally, any objection to a provision in this Bill, towhich I attach great importance,-that no one shall be qualifiedas a surgeon till he is twenty-five years of age, or unless he shallhave been previously examined as a licentiate in surgery andmedicine, and shall have passed the examination as licentiate inmedicine as well as surgery. There was also an objection madeto the Bill of last year, which was not so much a real as anapparent objection-that there was no direct provision for anexamination in midwifery. I propose that henceforth it shall benecessary to make provision in all parts of the United Kingdomfor an examination in midwifery, and that there shall be in theregistration a distinct mark that the party has undergone anexamination in midwifery, and has so passed. Now, there havebeen several petitions presented, requiring that the general prac-titioners should be incorporated. I have, Sir, given my mostanxious consideration to that subject, and at all events I am mostanxious not to preclude myself from the power of taking that steptill the profession at large shall have had an opportunity of con-sidering the very important alterations made in the Bill which Iam now opening to the house. I had proposed to repeal theApothecaries’ Act, and thereby, for the purposes of medicine, toleave the Apothecaries’ Company to act only as a guild of drug-gists. I have now departed from that intention, and I do not nowpropose to repeal the Apothecaries’ Act. I should most deeplyregret the separation of the general practitioners from the Collegeof Surgeons. That might, in some degree, have been the conse-quence of the measure as it was proposed last year, but I thinkthat evil has been much met by the proposition that no one shallbe able to qualify as a surgeon without having previously becomea licentiate in medicine. I will not now anticipate a discussionon the new charter granted to the College of Surgeons-that thereare defects in it I am fully aware-but when I introduced for thefirst time a particular order into that body, which existed in everyother college in England, Scotland, and Ireland-namely, theorder of fellows of the College, it was necessary that I shouldcreate a constituency for the election of the council. I only statethe difficulty in the recent change, but I now hope that the generalpractitioners and the College of’ Surgeons will be in a more closeand honourable connexion than at any antecedent period. Now,reserving to myself the right of advising the Crown to grant acharter of incorporation to the general practitioners, and statingthat I shall be ready to give that advice if I shall deem it desirable,I may say that I am most anxious to sustain the station, thehonour, and the attainments of the general practitioners. (Cheers.)I believe them to be one of the most useful bodies of menin this country. (Cheers.) In large cities, where the numbersare great, a division of labour is not only possible, but itis also desirable, for it leads to increased qualifications andgreater remuneration; in great cities the division into physician,surgeon, and general practitioner, arises by the force of cir-cumstances, but we have to consider the interest of the com-munity at large, and we know that the great body of therural population must look to the general practitioner, (cheers;)and so far it is desirable for the interests of the public that weshould use all our power to uphold the character, the station, andthe attainments of the general practitioner. These, Sir, are mystrong opinions, and entertaining these opinions, I doubt whe-ther we should be doing good, and should advance the honourand the station of the general practitioners, by dissolving theconnexion between them and the College of Surgeons, and bygiving them an institution which might be as good as the Collegeof Surgeons, but which would be wholly new-a College ofGeneral Practitioners. I am anxious that the alterations I pro-pose should tend to promote the spirit of conciliation, and Iwould consult as far as I can the feelings and wishes of the wholebody of general practitioners. They will have an opportunityof considering the changes I have made, and to review the requi-

251

sition they have made for a new charter of incorporation. Ishall be delighted if the result shall be that they will withdrawthat requisition, and, as a consequence, form a close alliance withthe College of Surgeons—a great and noble institution, which,’With all its defects, has produced some of the most eminent andhest surgeons in Europe—which possesses, at this moment, thefinest museum in Europe . and, as a visitor, I may. assert, one ofthe mot renowned colltctions in physiology. It is impossiblethat such a connexion can carry with it any other e’Sict thanhonour and distinction to the general practitioner; and I cannotanticipate any new arrangement which will be more conduciveto the honour, the character, and the station of the generalpractitioner. (Hear.) I pass on now to another alteration I pro-posed in the Bill of last session. It was an obvious error to pro-vide that a gentleman seeking to be qualified as a physicianshould for the two years immediately preceding his examination,at the College of Physicians have resided in the university. Inmany cases this would be found a great hindrance to attendanceon foreign universities and for foreign education. I propose tochange the necessity to two years’ residence at the universityafter matriculation, instead of two years before examination.So, also, with respect to attendance on foreign universities; Ithink upon the whole it expedient to propose that only one year’sresidence at. a foreign university should be required, and thatthe required studies should be three years, in the whole ofwhich at least one should be passed in some one foreign univer-sity. I now come to the general constitution of the council, and itis a point of great importance. If, Sir, I filled any other situationthan that which I lmve the honour to hold, I should, perhaps,have ventured to propose some alteration in the Bill in this re-spect. It is my opinion that it would lead to far greater safetyif there were left to the executive government, acting, on its re-

sponsibility in Parliament, the power of nominating permanentlythe council. I think there are evils arising from the election ofmembers by the general medical body which would thus beavoided, but having proposed a mixed scheme of nomination andof election, on the whole I adhere to the proposition as it was in-troduced in the Bill of last session. That point may still be openfor discussion, but I beg to state distinctly, that in reserving tothe Crown the nomination of’ six members of the council, I donot introduce that provision, without stating, that any advice Imay give to the Crown will be with a knowledge that a portion,at least, must be general practitioners, and a portion of themcountry practitioners. Upon that point I am clear, that the gene-ral practitioners and the country practitioners have a right to berepresented in the council. (Cheers ) There was also in the Billof last year an omission which I propose to supply. There wasno power given to the council to remove a person from the reges-ter in case of any flagrant misconduct. I propose now to investthe council with power to remove from the register all partieswho may be convicted in a court of law of any criminal offence,or if he should have used any false or simulated testimonials toobtain admission. (Hear, hear.) One other alteration I proposein a provision of the Bill, which arose from a misconception onmy part last year. I proposed to give the faculty of physiciansand surgeons of Glasgow equal power of licensing with the facultyof physicians and surgeons of Edinburgh. I made that proposi-tion in the belief that the faculty of physicians and surgeons inGlasgow had, in the four counties adjacent to that city, power tolicense practitioners both in surgery and medicine; but by sub-sequent information, I have discovered that they have no powerto grant licences for practising medicine. The question has beendirectly raised, and it has been determined that they have notsuch power. I made the proposition on a false conception oftheir power, and on the whole I think it better to withdraw thatprovision, and to give the sole power of licensing to the College ofPhysicians and Surgeons in Edinburgh. I am not aware that thereis any other change proposed in the Bill which I have omittedto state to the house. I have recapitulated the various provisions ofthe original Bill, and I have pointed out those alterations I intend tomake, which, so far from being at variance with any of the objects ofthe original measure, are quite consistent with them, and conduciveto their accomplishment. I have endeavoured to meet fairly theobjections of the great body of medical men who have canvassedmy measure. I do not complain in the least of the severity ofcriticism to which it was subjected. I was only anxious to availmyself of the knowledge of the subject which that criticism dis-closed. I do now commit the Bill to the candid consideration ofthe profession and the public. I certainly have taken a calmand dispassionate view of the whole subject, and with only onedesire-to promote the interests of the profession and of the com-munity. No labour I have bestowed on it will be thrown awav,in the least degree, if that object shall be gained ; and I certainlycommit it to the further consideration of the house and thecountry in the confident hope and expectation that this session

will not close without some measure receiving the sanction ofParliament which shall better regulate medical practice thfongh-out the United Kingdom. (Hear, hear.) The right hon. baronetconcluded by moving for leave to introduce the Bill.The question having been put,

’

Mr. WAKLEY said,-I have heard with very great satisfac-tion the statement of the right hon. baronet, and I earnestlyhope, and really believe, that the difficulties which beset thissubject, will be amicably arranged and finally settled. Theright hon. gentleman has shewn, by the alterations he has pro-posed, that he is most anxious to consider every matter mootedby the general practitioners and the profession. I believe theright hon. gentleman, and the government to which he belongs,could scarcely have been aware of the difficulties by which thissubject is encompassed. There are so many various interests, somany laws affecting the profession, so many rights conferred bythose different laws, in some instances opposed apparently toevery principle of sense and reason, that more difficulties were,in fact, connected with this subject, than almost any other re-quiring the legislative interference of the house. I felt verystrongly opposed to the other bill. I considered some portionsof it most objectionable; but I do not now wish to refer to thosëunpleasant topics. I am so satisfied that the right hon. ,gen-

tleman, from the alterations he has proposed, is anxious to con·

ciliate all parties in the profession, and to listen attentively anddeliberately to the various suggestions that may be made, that Ihave only now to request that he will not propose the secondreading of the bill at an early period, but give time for the mostmature consideration of its provisions by the profession. If the

right hon. gentleman will only continue to pursue the course hehas now taken, he will receive, I can assure him, the gratitudeof one of the most important bodies of men to be found in this

country. (Cheers.)Sir J. GRAHAM said be had heard with great delight the

observations of the hon. member for Finsbury. His proposalshad been received by that hon. member in such a cordial spirit,it gave him hopes that satisfaction would ultimately be producedby his measure. He would at once accede to the request of thehon. member, and would state that he should not bring on theBill for the second reading until after Easter. (Cheers.)

THE MEDICAL CHARTERS BILL.

I Sir JAMES GRAHAM afterwards said, that, in as fewwords as possible, he would state the heads of the Bill whichstood next on the paper. This Bill was to enable her Majestyto grant new charters to certain colleges of physicians andsurgeons. He woud state that it was his intention, in orderto enable the house to comprehend the entire bearing of the *measure, to lay upon the table of the house the grants of fourcharters relating to the Colleges of Physicians and Surgeons inLondon, the Colleges of Physicians in Dublin, the College ofPhysicians in Edinburgh, and the College of Surgeons in Edin-burgh. When these were produced, it would then be seen how

far they were connected with the whole question of medical re-

form, and with his proposed measure on the subject. He shouldconclude by moving for leave to bring in a Bill to enable her

Majesty to grant new charters to certain colleges of physiciansand surgeons.The Bill was then brought in.Both the above measures having been introduced, and formally

read a first time, Sir James Graham appointed, in relation to each,MONDAY, APRIL 7TH, FOR THE SECOND READING.

NEWS OF THE WEEK.

VOTING FOR REPRESENTATIVES IN MEDICAL IN-STITUTIONS.—To the Editor.—Sir: Allow me to suggest theappointment of a central spot upon which the voters by ballotand the voters by proxy may meet. Let those residing withincertain limits be compelld to attend, personally, to vote, and letthose living without those limits have the privilege of voting byproxy. This arrangement would preserve to country voters theirprivilege, and ensure a large assemblage of members at the an-nual meetings. Yours obediently, PHŒNIX. Feb. 23.

PETITION FROM BATH IN FAVOUR OF MIDWIFERY.- own Thursday, the 20th Feb., a petition from Bath was pre-sented to the House of Commons, praying the honourable houseto enact a law which shall secure to her Majesty’s subjects pro-tection from dangerous and incompetent practitioners in mid-wifery, protect the privileges of the properly educated and dulylicensed, and thereby uphold the dignity of an honourable auseful profession.