511

local authorities who are guided by competent medical officersof health.

Wednesday, lllay 19th.-COMMONS.-Mr. Slaney moved forleave to bring in a Bill to enable grants of land to be madenear populous places, for the recreation of adults, and as play-grounds for children. An attempt was made to quash the mo-tion by counting the house, but forty members were fortunatelymustered.Mr. Briscoe seconded the motion, and after a few words of

approval from the Home Secretary, leave was given to bring inthe Bill.There is the clearest and most evident necessity for such a

provision of light and air for the poor, and if Mr. Slaney cansucceed in throwing down the brick walls and palings whichfence off many large and unused gardens and walks, even inLondon, he will deserve a statue in the best of them.

THE JENNER MONUMENT.

ON Monday last, the birth-day of the great JENNER, a nume-rous and highly-influential meeting was held at the Collegeof Physicians to inaugurate his statue, to do honour to hismemory, and to further the cause of vaccination. PRINCEALBERT presided, and, on taking the chair, made a short ad-dress on the objects of the meeting. He eulogised Jenner asone of the greatest benefactors of his species; and characterisedhis discovery of vaccination, not as one of the happy chancesof genius, but as the result of profound observation, of deepstudy, and of true inductive philosophy. He spoke of thebeneficial influence which vaccination had exerted on all

nations, and congratulated the meeting on the occasion of theirassembling to inaugurate a statue to the memory of its greatdiscoverer.Dr. CONOLLY read an eloquent eulogium upon Jenner. He

traced his career, and portrayed in a striking manner his simpleearly life, the difficulties with which he struggled in referenceto his first attempts to promulgate his great discovery, theindomitable perseverance with which he pursued his labours,and the crowning success which followed.A series of resolutions was passed, including votes of thanks

to the sculptor, Calder Marshall, R.A.; the Committee for theerection of the Jenner statue; the Honorary Secretary; andthe Chairman of the day. These various resolutions were car.ried amidst much enthusiasm, as was also a resolution respectingthe benefits and efficacy of vaccination.Dr. SEATON read an able and striking report on the present

state of vaccination throughout the world.Mr. PETTIGREW spoke in glowing terms of the faithful like-

ness which the sculptor had succeeded in making of the greatoriginal; a success the more commendable and remarkablefrom the circumstance of his having received no assistanceexcept from portraits.The meeting was also addressed by the venerable Marquis of

LANDSDOWNE, whose speech was received with great cheering.He had had the honour, nearly half a century ago, of proposingin the House of Commons a money grant to Jenner,-a grantwhich was cheerfully awarded.The proceedings altogether were of the most cheering and

satisfactory character. The Chairman was supported by theBishops of Oxford and Bath and Wells, Lords Ducie, Littleton,and Ashburton, the Lord Mayor, Dean Milman, and other per-sons of influence and station. The meeting was held in thelibrary of the College, and about three hundred members ofthe profession were present. Special reference was made, inthe course of the proceedings, to the assistance which had beenrendered to the fund by America, and by most of the nationsof Europe ; France having given her aid, although a statueof Jenner is about to be erected in her own capital.Mr. Marshall’s statue is placed at the south-west corner of

Trafalgar-square, immediately on the right of that recentlyerected to Sir Charles Napier. Jenner is represented seated ina chair, in an easy attitude. The fine, open, intelligent, andbenevolent face of the original is admirably portrayed. It isto be trusted that this monument, the first erected in the

metropolis to Jenner, may have the effect not only of render-ing his face and name more familiar to the great body of thepeople, but, as was expressed by more than one speaker at themeeting, serve to impress upon the public mind the inestimablevalue of vaccination.

MEDICAL REFORM.

ON Saturday last a numerous deputation of medical practi.tioners waited upon the Right Hon. Spencer Walpole, Secre-tary of State for the Home Department, for the purpose of en-listing his support and that of the Government to the MedicalBill introduced by the Hon. Wm. Cowper, M.P., late Presidentof the General Board of Health.The deputation consisted of Sir Charles Hastings, M.D.,

President of the Council, and Chairman of the Medical ReformCommittee, of the British Medical Association, and of the fol.lowing members of the committee :-Mr. G. Bottomley, Croy-don ; Dr. W. Budd, Bristol; Mr. P. Cartwright, Oswestry; Dr.Lankester, President of the Metropolitan Counties Branch;Mr. G. Southam, Manchester; Mr. J. Stedman, Guildford;Dr. Vose, Liverpool; Dr. G. Webster, Dulwich; Mr. G. W.Hastings and Dr. A. Henry, secretaries to the Reform Com-mittee. Also of Mr. G. J. Squibb, President Elect of theMetropolitan Counties Branch; Mr. E. Bartleet, President,and Mr. E. H. Coleman, President Elect of the Birminghamand Midland Counties Branch; Mr. A. T. H. Waters; Dr.Chevallier, Ipswich; Dr. Pitt, Norwich; Mr. G. May, jun.;Professor J. Hughes Bennett, Edinburgh; Dr. C. H. Leet,Secretary to the Apothecaries’ Hall of Ireland; Dr. E. W.Murphy, Dr. Wynter, Mr. J. C. Clendon, Dr. C. F. Moore,Dr. Smiles, Mr. W. Bartlett, Dr. W. Camps, Dr. O’Connor,Dr. M’Loughlin, Mr. C. H. Rogers-Harrison, Mr. T. WatkinWilliams, Dr. Pursell, Mr. G. Boss, and Dr. Gibb. The de-putation was accompanied by the following members of Parlia-ment :-Mr. Slaney, Lord Elcho, Mr. Adderley, Mr. Tomline,Mr. Bright, Mr. Crawford, Mr. Tite, Mr. Hatchell, ViscountElmley, Sir T. Winnington, Mr. S. Estcourt, the Right Hon.W. F. Cowper, Mr. G. Langton, Mr. Massey, Mr. Schofield,Mr. O. Ricardo, Mr. Bovill, Mr. Alcock, Mr. C. E. Mangles,Mr. R. D. Mangles, Mr. Cheetham, Mr. T. Egerton, Mr.Brown, &c. The deputation having been introduced by Vis-count Elmley,

Sir CHARLES HASTINGS said: We appear before you as therepresentatives of the British Medical Association-a Societyformed twenty-five years ago for the advancement of medicalscience, and for the improvement of the organization and educa-tion of the medical profession. Our Association consists of up-wards of 2000 medical practitioners exercising the art of medi-cine in Great Britain, and especially in the large cities andtowns. From the very commencement of our labours we sawand regretted the evils that the public and the profession suf-fered from the imperfect state of medical education, and weagreed upon certain principles which we have adhered to as tothe basis on which any Bill for improving the condition of theprofession should be framed. These were: registration of allduly-qualified practitioners, uniformity of qualification, as faras practicable, equal right to practise, and the establishmentof the representative principle in governing bodies. For manyyears we have been engaged in pressing upon the Governmentand upon Parliament the urgent necessity for the adoption ofsome measures to protect the public from the effects whicharise from the art of medicine being exercised by ignorantpractitioners. The result of our endeavours has been so farsuccessful that both Government and Parliament are apparentlynow convinced that the time is arrived when a remedy shouldbe attempted for the present evils. Various Bills have duringthe last few years been brought forward, but our Associationhas always kept in view the principle before stated, and hasnever given its support to any Bill which did not more or lesscarry out those principles. During the last session of Parlia-ment two Bills were submitted to the House of Commons, theone by Lord Elcho and the other by Mr. Headlam. To thelatter our Association is deeply indebted for having taken muchpains to frame a Bill in accordance with the liberal principles

512

agreed to by the Association, and we last year exerted ourselveto the utmost to support that Bill, which was triumphant!carried by the large majority of 147 in the House of CommonsThis Bill, however, was objected to by the House on the groundthat it depressed them and gave too much support to the C01porations. In consequence of this opposition, the right honthe member for Hertford, acting on behalf of the late Government, undertook to frame a Bill with the view of reconcilingthese two parties, and at the same time of carrying out thossound principles of medical legislation for which the Britis]Medical Association has ever contended. That Bill has beerintroduced into the House of Commons, and stands for a secon(reading on the 2nd of June. At a committee of the Association which we represent, it has been our duty to examine theBill carefully, and we have come to a deliberate conviction tha;it is worthy of our best support. We do not assert that it is a

perfect measure, but we are convinced that the Bill is calculatecto remove many of the evils that have been so long felt by thepublic as well as by the profession. We have ventured to suggest various alterations to Mr. Cowper, to which he has kindleconsented to give his best attention. We come, therefore, tcyou to give the sanction of your high name and station to thisBill, and to prevail upon the Government of which you form apart to lend their aid in passing it into law, believing as we dcthat any Government will deserve well of the country which,by improving medical education, shall ensure, in time to come,that sanitary laws shall be more generally obeyed, for thenmuch of the misery which now oppresses a large portion of thecommunity may be mitigated, and health and happiness moregenerally prevail; and we may here, perhaps, without impro-priety remark, that, as an independent body, having no cor-porate interests or vested rights to defend, we may be fairlypresumed to take an impartial view of the Bill.A copy of the amendments proposed in Mr. Cowper’s Bill by

the Medical Reform Committee was given to Mr. Walpole bySir Charles Hastings.Mr. WALPOLE.-You say you have made some suggestions to

Mr. Cowper, and that he has accepted them. Will you tell mewhat those suggestions are ?

Sir CHARLES HASTINGS said they were in reference to thestandard of education which should be required by medicalpractitioners. It was most desirable-whether they had one ormore councils of examination-that they should have a lawwhich should come up to a certain standard of education. Inthe present instance there was no less than twenty-one bodieswhich had the power to pass medical men, so as to enable themto practise, and each of them adopted a different basis or

Atatidard of education, the result of which was that only half-educated medical men, in accordance with some standards, gotinto practice ; and they felt that there should be one counciland one standard of education, and that the very highest thatcould be obtained before the candidate should be permitted topass. Another suggestion was that they thought it most un-desirable to keep up the distinction of apothecary.

Mr. SOUTHAM said the committee were of opinion that thethree distinctive appellations should be abolished, and thatthere should for the future only be two-namely, that of phy-sician and surgeon.

Dr. BUDD, of Bristol, said it seemed to them, in the firstplace, that it would be desirable there should be a centralcouncil, which should not only fix the standard of educationfor medical practitioners, but that they should also have thepower to enforce it; without that the powers of such a councilwould be useless. It would be no use whatever to give powerto a council to draw up a scheme to regulate the standard ofeducation required for medical men unless they had also thepower given them to ratify or refuse to ratify their credentials,which credentials should be the only guarantee to the publichealth that the person holding them was a duly qualified medi-cal practitioner. He (Dr. Budd) believed he was speaking thesentiments of the entire deputation when he said that theylooked upon the point as the very essence of a measure calcu-lated to benefit the profession and the public, and that theywould rather not have the Bill at all if this power were with-drawn. (Hear, hear, from the deputation.)

Dr. LANKESTLR said the great point they had in view, andwhich was exceedingly prejudicial, was to get rid of a thirdperson in the medical profession, known as a General Practi-tioner. In all the large cities and towns of the kingdom ageneral practitioner was a surgeon, and what they wanted todo was to abolish that term, and let there be but two in theprofession-physicians and surgeons. It was in their opinionunwise in legislation to keep up these professional distinctions.The College of Surgeons, for the last twenty-five years, had

compelled an examination, only applying to particular branchesof the medical science; but what they contended for was, thatevery one taking the position of surgeon ought to have thesame education as a physician; not merely to be enabled tounderstand the science of anatomy, but that he should have athorough knowledge of all the branches of the healing art.(Hear. )

Dr. WEBSTER, of Dulwich, thought the term apothecaryshould be abolished in connexion with surgeon, and that thereshould only be two classes, physician and surgeon; and, aboveall, the necessity for a licence from the Apothecaries’ Companyought to be at once abolished. That licence from the Apothe-caries’ Company was a licence from a mere trading society, andhad tended to throw upon the professois of the healing art agreat deal of obloquy. There was also a great reform requiredin the abolition of the term general practitioner. The Collegeof Surgeons gave a diploma for examinations in anatomy, sur-gery, and philosophy; latterly they had added midwifery. Theexamination in midwifery was not necessary to be a member ofthe College; it was only an additional means of obtainiug funds;but those examinations alone were an exceedingly low standardof education for a properly qualified medical man. It was verydifferent in Edinburgh and Dublin. There, proficiency in thewhole range of medical science was insisted upon, and theresult was that medical men, who had been educated andpassed in these schools, possessed a higher standard of medicaleducation than was obtained in England, on account of thefoolish prejudice of the College of Surgeons. He would contendthat the necessity for a licence from the Apothecaries’ Companyshould be abolished altogether, although it must be admittedthat as far as the Company’s examiners went they dischargedtheir duty well. They did not look upon this Bill of Mr.Cowper’s as a perfect Bill. It was a compromise; but althoughit was not so good a Bill as they could any one of them drawup themselves, still this was the thin edge of the wedge, andmight lead to something better.The Hon. Mr. COWOPER said, what he understood the depu-

tation wanted to bring under the notice of the Secretary-of.State was, that there should be only two distinctive marks inthe profession-namely, that of physician and surgeon. Atpresent, a member of the College of Physicians was prohibitedfrom practising surgery; and to so great an extent was theetiquette of the profession pursued, that there was a fact onrecord that Sir Henry Halford, whilst travelling in a railwaycarriage with a personal friend (the late Mr. Lockey), whowas seized with apoplexy, and died for want of immediatebleeding, refused to bleed him, because it was contrary to theetiquette of a member of the College of Physicians to do so.(Hear, hear.) Now, it was a principle of this Bill that for thefuture a physician should be versed in surgery as well as medi-cine, and vice versd. It was true a surgeon might write a pre-scription now, as well as a physician, but then the surgeonmust write his name in full, whereas the physician had theprivilege of writing a prescription and simply putting hisinitials thereto. (Laughter.) That was the distinction. Withregard to his (Mr. Cowper’s) Bill, it did not repeal the Act ofHenry the Eighth, or in any way interfere with the charter tothe College of Physiciams. Therefore there was nothing cal-culated to interfere with the dignity of the College of Physi-cians. The object of the Bill was to insist on the higheststandard of education as a qualification to persons to practisemedicine and surgery throughout the kingdom, and that thatstandard should be fixed by a council or body appointed forthat purpose, and that there should be one standard of quali-fication instead of several. At the present time there was

great difficulty in defining what was a physician, in conse-quence of the conflicting claims of the universities of Oxford,Cambridge, and London, each of which maintained the rightto confer degrees as physicians, each adopting its own standardof qualification. Therefore, in proposing his (Mr. CowPeJ;’s)Bill, he did not see that the College of Physicians could in anypoint complain, as he left them just where they were. It didnot interfere with them as Mr. Headlam’s Bill did, but leftthem just where they were, so far as their rights and privilegesas physicians were concerned.Mr. WALPOLE said he had paid much attention to this sub-

ject, and he thought, in the first place, that it was exceedinglydesirable that there should be no exclusive practice within anyparticular limits; secondly, he agreed that it would be exceed-ingly desirable that the medical profession should get a properregistration, so that the country might know who were duly-qualified medical practitioners. In the third place, he thoughtit necessary that the public should have a guarantee from somecouncil as to the qualification of every practitioner. In all

513

this he.went with the deputation. Then came the question asto the licensing power to be kept up by the several medicalbodies now existing. If they were to commence to legislatede novo upon this subject, then it would possibly be advisablethat the power of licensing should be in one central body; buthe thought that wherever it was otherwise, it was advisable tolegislate so as to make charges as small as possible compatiblewith the public interest. His fear was, whether Mr. Cowper’sBill kept up proper distinctions between the various classes ofthe medical profession. The objections raised were that ifthey gave all the power to a central council sitting in London,it would have the effect of preventing the participation of dulyamd highly qualified medical practitioners throughout thecountry attending it, and the result would be that there wouldnot be so many eminently-qualified medical men in the countryas there were at present. Again, it was urged that the effectof having but one council sitting in London, which was to bethe only medium through which a legal medical qualificationcould be obtained, would have the effect of destroying thecompetition which now existed in the various schools of medi-cine, and you would thereby not get the best medical prac-titioners to come up to town, but they would depute others.He (Mr. Walpole) was of opinion that if they could keep upthe existing bodies under a corporation, in conjunction withsuch council, then he thought the effect would be to send outthroughout the country the best practitioners. There werethree Bills now before Parliament, without reference to theBill introduced by Mr. Headlam last year, upon this veryimportant subject; and what he proposed to do was this-toget the whole of those Bills and see what was the best mea-sure he could frame from them. He admitted that the prin-ciples enunciated by the deputation ought to be embodied-namely, the right of the public to a guarantee as to the quali-fication of medical practitioners, by means of registration, atthe same time to maintain the rights and privileges of differentexisting medical institutions. These were his opinions at thepresent time; but he did not wish it to be understood or to goforth that he was to be bound by them after further investi-gation of the subject. These were the objects he had in view,and he thought if they were carried out they would meet aUthe requirements of the medical profession and the public.The deputation, having thanked the Home Secretary for hia

courtesy, then retired.

METROPOLITAN DRAINAGE.MEETING OF DELEGATES.

A PUBLIC meeting was held in reference to this subject atthe Freemasons’ Tavern, Great Queen-street, but the attend-ance was very scanty, despite preliminary placarding. Mr.

Crawford, M.P. for London, Mr. Cox, M.P., and Mr. Ayrton,M.P., were present.The object of the meeting was "to consider the present

position of the question of the main drainage of the metropolis,and to take the necessary steps for protecting the interests ofthe metropolitan ratepayers in Parliament." Resolutions wereproposed and carried to the effect-" That the plans hitherto proposed for the main drainage of

the metropolis are incomplete, conflicting, and unsatisfactory,certain to entail a heavy burden on the ratepayers, and of pro-blematical utility to the public health. That while it has notbeen proved that the Thames exerts a prejudicial influence onthe health of the metropolis, it is still desirable to improve thedraining and self-cleansing powers of the river, and to preventthe deposit of mud in its channel and on its banks."

" That the utmost uncertainty appears to prevail in theminds of the framers of the reports and estimates hitherto pre-pared, as to the extent and cost of the works required, rangingfrom upwards of 2,000,000 to nearly 11,000,000, demon-strating that this important question is not yet ripe for solu-tion, and that a hasty decision will impose a frightfully enor-mous taxation upon the already heavily-burdened ratepayers,and that therefore, before any final course be adopted, thereshould be, a complete and comprehensive report upon the wholequestion, and ample opportunity should be given to the rate-payers to examine and consider the same."" That the metropolitan delegates be requested to impress

upon the Metropolitan Board of Works the views expressed inthe foregoing resolutions, and to take such steps as they maysee fit for the proper representation of the same in Parliament." "This may probably be considered as a fair review of the pre-

sent state of the question. The first resolution propounds avery questionable assertion as to the sanitary influence of thestate of the Thames, and virtually contradicts itself by suggest-ing means of improvement for that which it has just before de-clared to need none. This vacillation may be attributed to theinfluence of the arguments of a somewhat eccentric school ofsanitarians who have taken the matter in hand, and probablyis not altogether unaffected by the argumentum pecuniosum.However, no one can be unwilling to see the fullest and mostcareful deliberation of a plan which involves the expenditureof many millions of money, however much he may desire tosee the day arrive when he may be permitted to consider thedebate as concluded, and authorized to drop all the blue books,statements, and reports which relate to it through the opengratings of Memory into the common sewer of Oblivion.

WANT OF VACCINATION IN IRELAND.

THE question of compulsory vaccination is one of the highestimportance for the welfare of the people. There is a deep-seated prejudice against the practice in the minds of the vulgar.In Ireland the number unvaccinated is enormous. The subjectwas mooted in the House of Commons recently, and Lord Naaspromised that measures should be taken by the Governmentduring the present session. How urgent the necessity is forsuch a provision appears from the statements of the Poor-lawCommissioners of Ireland in their sixth annual Report justpublished. They declare that during the last year nearly100,000 children have missed vaccination amongst the poorerclasses only. They justly assert that the number of personsin the country altogether unprotected from the consequences ofvariolous exposure is so great as to justify the expectation of £the most serious loss of life and other evils, in the event of theoccurrence of a severe epidemic small-pox. Judging from pastexperience of what has taken place since the discovery of vac-cination, we may expect an epidemic visitation of small-poxwithin recurring periods of limited extent; and it is not pos-sible to predict when that concurrence of circumstances willarise which would render any of these visitations virulent.Even in the absence of epidemic, the evils consequent uponthere being a large population liable to contract small-pox on exposure to infection are not inconsiderable. Theauthors of the report point out that the inoculators, by thepractice of their mischievous trade, keep the contagion ofsmall-pox permanently active in numerous localities. A largeproportion of the unprotected who come within the sphere ofinfection of the disease thus artificially produced will contractthe natural disease, and of these some will die. Of those whodo not fall victims, a considerable portion will lose their sight,or recover with constitutions permanently enfeebled; and asthese cases occur nearly altogether among the poor, the sub-jects of them will become burdens on the public for supportduring the remainder of their lives. These evils, existing inthe absence of epidemic, are of course greatly aggravated whenthe disease becomes epidemic. Nearly all this disease and lossof life are preventible by the enforcement of a complete systemof efficient vaccination. The case thus made out by the authorsof the report is of irresistible force, and the matter is one of sogreat public importance that legislation on the subject cannot,we think, be long delayed.

THE INDIAN MUTINY.

LIST OF MEDICAL OFFICERS OF THE BENGAL ESTABLISHMENT WHO

HAVE FALLEN DURING THE RECENT MUTINY.

SURGEONS.SENIOR SURGEON JAMES GRAHAM, M.D., superintending

surgeon Trans-Ravee Circle.—Murdered during the mutiny atSealkote. Dr. Graham, accompanied by his daughter, wasattempting to escape to the fort in his buggy, when he wasshot by troopers of the 9th Cavalry. Miss Graham was spared,and drove on, carrying with her the lifeless body of her father.Dr. Graham entered the service in 1819, and having accumu-lated a comfortable independence, intended to retire during thepresent cold season. The following is a summary of his warservices :-Served as staff and senior surgeon with the left wingof the army of Gwalior. and was present at the battle of Pun-