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France (See LANCET for Jan. 13, 1844).Now that, thanks to steam navigation, Syriahas become so accessible to travellers, this isa point well worth a careful examination, andwe urgently direct Dr. KERNS’ attention toits elucidation. Under the head of eruptionswe find 190 cases mentioned ; but as no otherdetails are given, we cannot form any ideaof the different classes of cutaneous dis-

eases seen and treated. We hope, in futurereports, to meet with lengthened details onthis subject ; it would be very interesting toknow what is the state of cutaneous patho-logy in that country from which our ances-

tors, at the time of the crusades, appear tohave brought so many intense forms of cu-

taneous disease. Dr. HOLT YATES, the

energetic and persevering friend of the

Syrian Society, has very scientifically at-

tempted to explain the frequency of inter-mittent fever in a country where there are

no stagnant pools and no marshes, but wemust look to Dr. KERNS for the descriptionof the form of ague which he daily sees;he may, and, indeed, will, no doubt, find im.

portant diff’erences between it and the agueof marshy countries. In the report we findnoted 282 cases of ulcers; here again wewant information as to the causes which

render ulcers so prevalent, as to the treatmentpursued, and as to its comparative success ornon-success.

We shall conclude these brief remarks bywishing Dr. KERNS success in the pi-osecu -tion of his arduous task, and by assuringhim and his friends that we shall ever be

happy to give the publicity that our co-

lumns affords to the scientific results atwhich he may arrive. How is it, by the by,that the medical world as yet has heardnothing of Dr. MGowAN, the physician tothe Bishop of Jerusalem, who, we believe,is at the head of a dispensary, similar to thatof Dr. KERNS, at Jerusalem ?

CURE FOR TooTHACH.—According to Dr.Stanelli the chloride of zinc, liquified by ex- Iposure to the air, possesses the property ofcalming dental pains. By means of a smallhair-pencil a small quantity of it is appliedto the cavity of the painful tooth, and in thespace of a few minutes it appeases the mostacute sufferings.-The Chemist.

MEDICAL REFORM.

ADDRESS OF THE COMMITTEEOF THE

MEDICAL PROFESSION.TO THE PRACTITIONERS OF THE BRITISH

EMPIRE.

IT has been deemed advisable by the com-mittee appointed by the meeting of themedical profession, convened by public ad-vertisement, to submit at this importantcrisis the following address, detailing thegrievances of which we complain, invitingcounsel and assistance, and suggestingsimple, reasonable, unobjectionable, and, wehope, efficient means of redress. We aredesirous to impress upon our medicalbrethren that we have no personal ends toattain, no ambition, no selfish objects to

gratify-we struggle to vindicate your in-terests, your honour, your rights-we haveembarked in a contest little in consonancewith our inclinations and usual habits-weare stimulated in our endeavours by thedesire of protecting our rights from aggres-sion, of maintaining our rank in the profes-sion and society. It would now be dishonourto bow to injustice; meanness or servility tobe calm ; indifference would be insensibility,treason to the solemn vow we made on ourinitiation to uphold the dignity and respect-ability of our profession. There is a pointin human nature beyond which any outragecannot be suffered, nor indignity borne-itis the natural effect of oppression to begetresistance. We have arrived at that limit.We entered the profession, devoted years

to toil and study, and paid for our diplomason the faith of enjoying an honourableequality. This implied, but no less sacred,covenant has been wantonly violated. The

charters recently granted to the Royal Col-leges of Surgeons narrow and confine theelection of the governing bodies to an

irresponsible few, introduce invidious dis-tinctions between the members who werebefore equal,-who had undergone the samecurriculum of education, who had passedthe same examination,—and capriciouslyelevate over them a body of FELLOWS with-out any additional test of merit, without anyfixed standard of qualification, or withoutreference to age, station, attainment, or

utility.This temporising expedient, unjust, ineffi-

cient, complicated, and contradictory, wasframed in a forced and reluctant spirit ofsubmission to demands which could be no

longer resisted, and was designed to em-barrass them with restrictions so as to renderthem nugatory and inoperative. It was

granted without consulting the wishes ofthe great body, and at the instigation of menwhose acts had estranged the respect andconfidence of the members-who had, for a

768

series of years, only consulted the instinctsof their own interests-upon whose lawsinjustice was strongly impressed—whosecnbrts were not directed to enhance therespectability of the general body, but toincrease the amount of fees to themselves,their relations, and friends—who issuedlaws so shamefully and obviously illiberalthat they were obliged to withdraw themwhen published-who, for years, refused toadmit the certificates of country surgeonswhose field of observation and practice wasgreater than their own-who now refuse to

recognise knowledge gained at the greathospitals on the Continent, lest it shoulddiminish the amount of money exacted atthe hospitals of which they are officers, andlest any man, however great his ability, un-connected with their institutions, shouldseek to introduce a more liberal policy, or tooppose the system of extortion, they invari-ably pass over his name and reject him fromtheir council-who had invested themselveswith all the attributes of arbitrary power-who had injured and insulted the members-who had treated them as slaves and aliens- who refuse to allow them a voice in theelection of their officers or in the manage-ment of their own property-of whom oneof the council* declared that they had longshown themselves unworthy to preside overthe science of surgery-who retain all theworst features of municipal corruption-whohave destroyed emulation, and monopolisedall the honours amongst men of very mediocreattainments, by the unjust system of favouri-tism and family influence which they havecontrived, and thus abused the power in-trusted to them by the Sovereign.

Into their hands have fallen all the medicaloffices of the metropolitan hospitals, to theexclusion of the great body of the membersof the profession, and, as might be expected,those institutions which, from their num-ber, maguitude, and resources, surpass all

others, have contributed, with slight excep-tions, comparatively nothing to our commonstock of knowledge. The contrast betweenthe information to be gained at the Londonhospitals and that afforded by similar esta-blishments in other capitals is deeply morti-fying to our national character.

This pernicious system, by means of re-prehensible by-laws, is likely, without Yar-liamentary interposition, to be perpetuatedfor generations yet to come. Those hospitals,which might be made of such inconceivablebenefit to the public, present no evidence ofzeal for science, of fidelity to the interestsof humanity, of great skill or superiority inthe profession. Histories of cases, as

means of reference or instruction, werewisely suspended in the temples of Æscula-

pius ; they formed the materials for thewritings of Hippocrates.

’" Mr. Lawrence.

In our hospitals we have no repositories,no archives; if there be any, we have noaccess to them. ’While nations struggle fora free interchange of commercial advantages,we are not allowed, in our studies, to availourselves of the instruction of the great menof the Continent, whose fame hath filled theearth, and are cultivating the same exaltedpursuits as ourselves. With the liberalityworthy of their reputation they throw openthe highest honours to British students.A self-elected, irresponsible council, cannotcomprehend, imitate, or reciprocate, thisenlarged and generous policy.The requirement of certificates by the

council from recogaised schools of whichthey were proprietors—then sitting in judg-ment upon the competency of candidates forthe diploma who had purchased their favouras pupils-have no parallel in the annals ofcorporate depravity. " Show me any govern-ment," said the illustrious Burke, " and yousee the proposed interest of the governed.Power constituted otherwise is a monster."The submission of a free people to authorityis no more than a compliance with the lawswhich they themselves have enacterl. Inmedical corporations this principle is re-

versed : however absurd or oppressive theirmeasures may be, we are compelled to sub.mit without the power of appeal. Thenew charters, without removing the evils wesuffer, add to our injuries and indignities;they alter the positton of every man who

happens to be a member of the Colleges.By raising the few to titles of at least nomi-nal distinction, it conveys to the public theimpression that the other members constitutea subordinate class, are men of inferior edu-cation, attainments, and skill. This alonewould be a legitimate ground of objection,and must prove a serious injury to the greatbody of the members, especially those prac-tising in the country. Already some of theinstitutions in the metropolis, following upthe attacks on the interest of the generalpractitioners, have given notice that in futureno surgeon will be eligible who is not afellow of the College. Abernethy oftenaffirmed that medicine and surgery wereindivisible. The knowledge of diseases,ofthe laws which govern them, and of thederangements which they occasion, is thetrue foundation of the practice of medicine,The external elements, mechanical appli-ances, therapeutic and chemical agents, areits instruments. The prevention and cure ofsickness, and the alleviation of suffering, areits great objects. The structure, functions,and diseases of an organ, whether externalor internal, can only be understood by refer-ence to the whole. Ninety-five out of a

hundred medical men are called upon to treatexternal and internal affections indiscrimi-nately.

It was admitted by a late president of the

769

College of Surgeons* that those surgeons who, glory in the name of ° pure," make but asmall portion of their income from puresurgery; they invade the province of boththe physician and apothecary, and try, bythe most unamiable contrivances, to rob ofhis hardly-earned position the general prac-titioner, who, by the improved system ofeducation introduced by the Act of 1815, isslowly, but surely, supplanting him in use-fulness and public estimation. All agreethat the education of the physician and sur-geon should be, in every essential point,precisely the same." The pures," confining themselves strictly

to surgery, have placed themselves far be-hind, rather than in advance, of the generalpractitioner. The mere mechanical depart-ment of surgery, which the council wish toexalt by extraordinary privileges, is thelowest and least intellectual part of thescience. Hunter wisely observed that thetriumph of surgery is to avert the necessityof an operation; and, as science advances,the number of operations diminishes. In

point of general attainments, in extent of

knowledge, in capability to be useful to thecommunity, which ought to be the primaryconsideration with a parental legislature, thegeneral practitioner is much superior to thepure surgeon. The claim of the " pure" todistinction implies, as well as admits, a

lower degree of knowledge and utility whichmust eventually subject him to well-meritedridicule and contempt. That this feeling isprevalent among the public is proved by thefact that to the general practitioner are in-trusted the lives and restoration to health ofnine-tenths of the people of these realms,and that from their ranks arise the menwhose labours advance the science of medi-cine. To the " pure’’ who may consider thesubdivision of labour desirable we willinglyaccord equality ; we, in justice to ourselves,deny superiority.

In the new scheme of legislation all whopractise midwifery, the most indispensableand ditticult branch of surgery, are excludedfrom the council ; and discredit and degrada-tion are thrown upon all those who,from aresi-deuce in the country, or from a solicitude fortheir patients’ welfare, refuse to allow themto be poisoned by the negligence or ignoranceof druggists’ boys. It also denies to talentsor great proficiency any hope of distinction,if beyond a certain distance from Lincoln’s-inn-fields. It would appear that they haddiscovered a geographical standard for

genius, and that mind can be measured bymileage.The profession has frequently urged, and

are still resolved to maintain, that no plan ofreform will satisfy their wants, or will be

accepted, that does not embrace the repre-sentative principle, as is enjoyed by the

* Mr. Guthrie.

members of other corporations. With thissimple and salutary agent we trust, in time,to correct the evils and abuses which have

crept into our institutions. Seven thousandmedical men have petitioned in favour of it ;any bill brought forward without it wouldbe regarded as a mockery, and meet withgeneral and indignant repudiation.A member of the council hag truly ob-

served, in his pamphlet on Medical Reform," the way for the College to permanentlyrest its claim for support is on the esteemand attachment of its members. This canonly be done by allowing to each member avote in the election of the members of thecouncil. Such a measure would make theCollege what it has not been, a representa-tion of the whole body of surgeons, insteadof being, as it now is, a small self-elected

section, taking into its own hands themanagement of its internal concerns and theregulation of the whole of the profession.The council and members would form onepowerful body acting in unison for the com-mon good. The feelings of the members,now diverted from the College, would beconcentrated towards it ; they would join inmeasures for its advancement, and in de-

fending it against attacks, which, if made,would be then few and feeble. Honourableambition would be encouraged, and thosewho work for the profession would replacethose who do nothing for science. The Col-lege is no Alma Mater to the member; hemay long for its honours, but they are beyondhis grasp; he feels that no industry, noexertion, can place them within his reach."The pretext assigned for withholding thosehonours is unjust as it is false, viz., that theelection of the council would cause tumultand confusion. The same argument appliesto parliamentary representation. Everyburgess, who pays five pounds annually inevery corporation in Great Britain, is en-titled to this principle ; it is one of the proudlegacies of our Saxon laws. When SirJames Graham recently gave a charter tothe chemists and druggists of England, hegave not merely the right of representation,but annual election of its councillors, to allits members, and that twenty-one of the coun-cil may be selected from every part of thiscountry and its colonies. On reference tothe secretary we find that the system workswell and harmoniously, and the utmost con-fidence prevails between the council and itsmembers, and that " no confusion or

tumult" is occasioned at the period of elec-tion, save the return of balloting-papersnominating the council. The same principleis employed in the medical societies, in theRoyal Society, in the East India Company,and in all the clubs. It is the very essenceand vitality of just government. To with-hold it constitutes a great cause of grievanceand discontent. The same arguments thatare used against an enlarged suffrage in the

770

political, will not apply in the medical world.We are not a mob, but a well-educated bodyof men, whose avocations make us reflective,and place us beyond the reach of designingpersons, and of unworthy impulses. Wetherefore demand it as a right. We havedevoted our lives to the welfare of society.We are the worst paid, the least privileged,at the same time the most indispensable ofall the learned professions ; yet we presentthe singular anomaly, that in a ratio withour utility and attainments are we degraded,dishonoured, and deemed undeserving of

sharing in the government of our own insti-tutions.

Our wrongs have never been sufficientlybrought under the public eye. It will beour duty to urge them on the notice of mem-bers of Parliament and the community. Theywill be surprised to learn that there are nine-teen graduating bodies differing widely fromeach other in their requirements of qualifica- !tions from candidates, as well as in their

power of conferring titles. Not one havingthe power to give authority to practise in allthe branches of medicine, or to protect thepublic from the danger and loss of life con-sequent on reckless ignorance and empiri-cism; instead of being beneficial to the

public or to the profession, they have adirectly opposite effect. They are marts forthe sale of diplomas, pieces of machinerysubservient to the purposes of self interest,usurped by the few to the injury of the many.If such corrupt bodies cannot be abolished,we would insist at least, as a protection forthe public, that the examination in eachshould embrace the whole range of medicalpractice ; that the licence should be uniform,and confer an equal right in every part of theBritish Empire; that the poor, as well asthe rich, should be provided with compe-tent advice in the hour of suffering, It isnot generally known that any man can prac-tise as a surgeon in these dominions. There

iis no law to prevent him, or to protect thepublic from imposition, or loss of life, or in-jury from his ignorance, or protect the regularly educated professional man from com-petition with such pretenders. If the coun-cil of the college had performed that duty,which they professed to hold in trust for thepublic and the profession, legislative enact-ments would long ere this have put an end tothe evil. Pilots, who have proved their com-petency before the Trinity Board, are provided to steerour vessels through the dangersof our coast ; even the engineers on our rail-ways are required to give evidence of a

knowledge of their avocation. Every pre..caution is taken to ensure the safety of pra.perty in this country ; but lij’e, which ought tohe dearer than all, is left at the mercy of

every quack who thinks proper to pursuea lucrative trade at the expense of the hap-piness and safety of the community.You perceive our objects are simple our

principles just, obvious, and incontroverti-ble. Division amongst ourselves has beenthe bane and parent of all the multifariouswrongs which we have endured, and hasemboldened the monopolists in their aggra-vating exclusions and recent aggressionsupon the rights of the members. Admonishedby the fate and failure of previous efforts,we struggle only for what is attainable. Inthe present state of parties we cannot hopeto advance at once from positive wrong topositive right.We stepped not forward until further de.

lay would have been fatal. The chartersplainly indicate the principles of Sir JamesGraham’s intended Medical Bill. We invokethe assistance of the whole profession. Wemust be prepared, if our apprehensions berealised, by simultaneous and combinedexertions, to defeat such an enactment. Weinvite, we entreat, your co-operation; weare ready, most ready, to resign the post ofhonour to more distinguished men, who willconsent to take their proper place at thehead of our movement, and stand forwardas the able and earnest advocates of the dig-nity and rights of their brethren ; or if youprefer it we shall all move together on termsof full equality. Participation in wrong isour bond of union. We invite every legally-qualified practitioner to join us in the workof disenthralment. The enrolment fee willbe merely nominal ; numbers are wantedmore than money.

Finally, the members of the committee re-

spectfully announce that aGREAT AGGREGATE MEETING

OF THE PROFESSIONWILL BE HELD AT THE

CROWN AND ANCHOR,ON MONDAY, THE 25TH OF MARCH, 1844,

JOHN WILSON, Chairman,JORDAN ROCHE LYNCH, Treasurer,WM. SIMPSON, Hon. Secretary.

when the attendance of members of the

profession from every part of the countryis most earnestly solicited.The Committee also announce, that a

SECRETARY is in attendance, daily, at theCOMMITTEE ROOM, CROWN AND ANCHOR TA-VERN, from eleven to five o’clock, for the

purpose of making an enrolment, at a nomi-nal fee of one shilling, of the names of alllegally-qualified physicians, ’surgeons, andapothecaries of the United Kingdom of GreatBritain and Ireland, and of all graduates illmedicine of foreign universities, requiringresidence during the curriculum of study, asmembers of a

MEDICAL PROTECTION ASSEMBLY.The Committee have likewise resolved

that all registered students in medicine, be.longing to the various schools and colleges,shall be entitled to admission and enrolment,gratuitously.

Signed by direction of the committee,JOHN WILSON, Chairman,JORDAN ROCHE LYNCH, Treasurer,WM. SIMPSON, Hon. Secretary.