BMJ

On the Objects of the Provincial Medical and Surgical AssociationAuthor(s): David BellSource: Provincial Medical and Surgical Journal (1844-1852), Vol. 10, No. 29 (Jul. 22, 1846), pp.338-340Published by: BMJStable URL: http://www.jstor.org/stable/25499367 .

Accessed: 13/06/2014 16:17

Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .http://www.jstor.org/page/info/about/policies/terms.jsp

.JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range ofcontent in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new formsof scholarship. For more information about JSTOR, please contact support@jstor.org.

.

BMJ is collaborating with JSTOR to digitize, preserve and extend access to Provincial Medical and SurgicalJournal (1844-1852).

http://www.jstor.org

This content downloaded from 195.34.79.253 on Fri, 13 Jun 2014 16:17:05 PMAll use subject to JSTOR Terms and Conditions

338O . ON THE OBJECtS 0P THE ASSOCIATION.

conduct of the Council of the College of Surgeons, and the abottive attempts of our worthy representative in Parliament, Sir James Graham, to legislate for the

profession, has not a little conduced to render our

peactil profession the arena for jealous party feeling for discord and animosity, stirring up the most at'idy

feelings amongst those whose aim and object should be

the same. But even these things will not have been'

unprofitable, if they shall encourage us more to seek, in ourselves, and from our own exertions, that con

sideration, respect, and esteem which neither the titles

of a College, nor the unjust favour of a Minister of

State, can bestow upon us. We are, perhaps, too

prone to look to legislative enactments to remedy evils

which, by a little more exertion, might be remediedby ourselves. The Association of which we are a branch, is producing a very salutary reform. Our meeting

together thus tends to encourage greater harmony and

right feeling, and to change the jealousy and illiberality which too often disgrace our profession, into mutual

regard and esteem. Let us endeavour to remedy the

defects which arise from ourselves. Let us strive that

there may be greater unanimity amongst us. Let there be a greater honesty of purpose one towards another;

and, above all, let us avoid endeavouring to build our

fame on the ruins of our brethren-we may rest

assured it is an unstable foundation, and will, sooner

or later, deceive the person who trusts in it. Legis lation alone could never advance our profession. In

itself, it is one of the best and most ennobling of the

sciences; and let us only be true to ourselves-let us

be determined that no incentive shall lead us from the

straight path of rectitude and honour, and if we do not

obtain the reform we have been seeking, and the reform

of parchment titles and tables of precedence, we shall

find that which is of far greater consequence, the

approbation of our own conscience, and the approval of every one who knows how rightly to estimate the

true character of mankind. I had hoped to have been

enabled to give a concise retrospect of the modern

improvements in surgery; but time has failed me, and I have now only to thank you for the kindness

and patience with which you have heard my observations. Mr. Winzar, one of the Secretaries of the Branch

was then called upon to read the report; but that

gentleman intimated that this document, which had

been drawn up and left in the hands of his brother

Secretary, unfortunately had not yet reached him. He

regretted that, from some cause with which he was

unacquainted-in all probability accident-he was unable to read the report to them; but in order that

they might not be altogether disappointed, he had

hastiliy drawn up a short sketch of the substance of what would have been reported, which, with their

permission, he would read.

Mr. Spooner, of Blandford, read a most able and'

interesting paper on medical subjects generally, dwell

ing much upon Mesmerism. Mr. Sweeting, in the absence of Mr. Fox, of Wey

mouth, presented a case of melanosis of the posterior part of the eye, which was extracted by the latter

gentleman. Mr. H. A. Arden presented a preparation of a

tumour, which had been attached to the ribs of an old patient, and entered into a minute description respecting it.

Mr. Sweeting introduced the question of education,

noticing the advantages held out by the course of

tuition in the Birmingham College, the education

being very superior, and the expense much reduced:

he considered that the acquisition of knowledge was

the best means of obtaining salutary reforms.

It was resolved, that the next place of meeting shall

be Winchester; E. Lydford, Esq., President.

Mr. Curme, and Mr. Aldridge, of Dorchester, were

requested to prepare a Retrospective Address on

Medicine and Surgery. It was also resolved that this meeting strongly dis

approve of the continued hostility of the governing

body of the College of Surgeons, to those reforms in

their constitution which the progress of the age

demands, and that the system which was adopted by the Council without the concurrence of the great body of the members of the College in obtaining the last

Supplemental Charter, evinced a total disregard to

the rights and privileges of the commonality. Thanks were voted to the President and Council,

Secretaries, residents in Dorchester, &c., and the

meeting broke up. The members then visited the Hospital, the Museum,

and other objects of interest in the town and neighbour

hood; and afterwards dined together. In the course

of the evening much valuable and interesting discussion

upon medical subjects took place. 0 ^~~~~~~~~~

ON THE OBJECTS OF THE PROVINCIAL MEDICAL AND SURGICAL ASSOCIATION.

By DAVID BELL, M.D., Physician to the Ludlow

Dispensary.

TO THE EDITOR OF THE PROVINCIAL MEDICAL AND

SURGICAL JOURNAL.

SIR, I am very anxious, especially under the existing state

of things in regard to the regulations of our profession

generally, that "The Provincial Association" should

acquire and maintain a position that would do credit to

the practitioners in the provinces, for unless this should be the case its members will never be able to impress

sufficiently the government of the day with the urgent

necessity that exists for a re-arrangement of the laws

by which we are governed, and which every honourable

member of our profession will, on principle, scrupu.

lously observe, until the much-to-be desired changes are effected. I am not amongst the number who volunteer to say that the Provincial Medical Association has done no good, or rather who significantly ask

"What amount of good has it effected ?" But with

every disposition to approve of the progress that has been made by it towards the attainment of the five

"principal objects" with which it set out, I must

candidly acknowledge it to be my opinion that we

must "buckle on our armour," and shew a more

determined principle of overcoming our enemies, or we shall not accomplish the fifth and last "principal

object." This is the grand-I would say, above all

the others, the cardinal object, and to effect which will

require strong efforts, and very properly so, for once

effected, every thing that human laws could secure

would be secured to us. Such feelings as it embraces,

This content downloaded from 195.34.79.253 on Fri, 13 Jun 2014 16:17:05 PMAll use subject to JSTOR Terms and Conditions

ON THE OBJECTS OF THPI.ASSOCIATION. 339 . 1

once entertained by us, every necessary regulation, in

a legal point of view, would be granted to us.

Since I became a member of the Association, and

more especially of the Council, I have felt it to be my

duty, as far as in me lay, to endeavour to promote its

interests, by talking to the "General Practitioners,"

(surgeons, I prefer to call them,) whom I am in the

habit of meeting in consultation, and in course of

conversation, I am told by them that they fear we

"gain no ground." Two gentlemen, very respectable members of their profession, and having very extensive practices, and who subscribe to our Association, fre quently express dissatisfaction with the condition of

the Journal as compared with others: and I must

acknowledge that there is truth on their side, when we

look at the extreme exertions that have been, and still

are being made, to improve the medical periodicals of

the day. This is no charge from me, let it be distinctly understood, against the Editor, the Council, or the

members generally, and is brought forward for the purpose only of allowing me to draw attention to it, as

one powerful means, if conducted with the same energy as its competitors, of adding to the strength and repu tation of the Association; because I am quite satisfied

that most provincial practitioners would prefer the

Journal, emanating from their own body, to that of

any other, provided it was made to contain the same

amount and kind of information, that is, so far as

their different positions would admit.

It may be thought a trifling reason by some, but I

am nevertheless convinced of its being a good one, when I state that many (very many, I am sorry to

say,) country practitioners, of no mean acquirements, which they daily exercise for the benefit of the com

munity around them, can ill spare the guinea to join the Association, if they have to take in another journal besides our own; and, therefore, unless we can supply them with weekly medical and surgical intelligence

equal to that from any other quarter, we must be with out their co-operation. At the last Annual General

Meeting of the Association, (held at Sheffield,) some of

the members present were inclined to do away with the

Journal, and made, I think, propositions to this effect, but which, I was most happy to find, did not meet with

the approval of the great majority of the members, for, if they had, it would certainly have-been an almost

death blow to the Association-or, at the very least, would have proved a severe shock to its constitution.

In conversation with an intelligent " General Prac

titioner" a short time ago, I mentioned to him, in

connection with some statements that he made to me, that I really thought it would be advisable to sacrifice the volume set apart annually for the publication of the" Transactions," and push the Journal in preference; and that I could not see why "Supplements" to the Journal might not be published occasionally, for the

purpose of bringing before the members the papers read, and matters of business transacted, at the annual

meetings; and also that at those periods other. materials for the Journal might stand over for a time, as is the custom with periodicals generally, from time

to time, when pressing natters come upon them. This

seemed to meet my friend's approval, who has been a steady member of the Association from its con-s.

mencement. Unwilling to stake my own opinions until tested by others, I thus hope that a spirit of

egotism will not be considered as bearing upon my coming forward at this proper period with my remarks.

Another gentleman of considerable importance in

general practice, has frequently urged upon me, as a reason why he did not join our Association, that it

app~eed to him the admission of members depended as much, if not more, upon their subscription than their qualification, and that until he could be assured that properly qualified men only were admitted to the list of members, lie could not possibly sanction it by his name. Now, I must admit, that this is a valid

objection, if there be just grounds for it; and it

certainly behoves the Association to l)e careful to

admit none other than qualified members-in these

tinmi especially, when we are so urgently decrying every thing like illegal and enfpirical practice. For

my own part, my dislike to even every approach to

quackery is so strong, that I would not allow my name to remain with any Association that did not use every effort to discountenance it, whether in its direct or indirect operation; and here it might not be

improper to allude to "The National Association," that has been recently formed, and which is pursuing

with so much zeal, a course, that I cannot help thinking, will prove most detrimental to the profession; for I

suppose it must, if it attain its object, legalize many persons who have not had a proper professional education, and effect the further consequence offirmly establishing a third grade in the profession, which, in our advanced state of education, general and pro fessional, should not exist, and which, in fact, we have been endeavouring for some time to throw off. It will readily be understood that I also here allude to "The Apothecaries' Company," which (with every respect be it spoken,) has, I should hope, nearly lived its time, and should not certainly be re-established

under a different name; and it will be an important part of its duty, in my humble opinion, for the Pro vincial Medical Association to prevent this, if it be

possible, and to use every effort to elevate the members of the profession, by insisting upon the maintenance of two grades only, the physician and surgeon. If the

Apothecaries' Company still wish to exist, however, ii some shape, (for they seem to be very tenacious of

life,) I would suggest to them what appears to me to be a very proper, and what I would call their only legitimate, duty-viz., that they should ask for powers to enable them to take under their guidance and

direction the chemists and druggists, and see that

none of this class of men are allowed to commence

in. usiness until they have undergone an examination, and thus given proof of their capability to engage in the important duties that devolve upon them, and for

;te proper performance of which the medical pro fession and the public have at present no sufficient

guarantee. There is indeed a great deal to be done before men

6f high and honourable feelings can have anything like pleasure and comfort in the practice of our at

once dignified and truly useful calling; and unless

there should be a beginning made somewhere, nothing but dissatisfaction can be the daily portion of every man of moral rectitude, and correct professional

principles, practising medicine, especially in the pro vinces. I mean, then, with all humility, to suggest that the Provincial Association do at once adopt such

This content downloaded from 195.34.79.253 on Fri, 13 Jun 2014 16:17:05 PMAll use subject to JSTOR Terms and Conditions

340 _ ON THE OBJECT OP THE ASSOCIATION.

measures as will enable its members, (who are qualified to practise their profession, each in his proper depart

ment,) to calculate upon that support from it which

they may need in the defence of their characters as

men, and as members of a liberal profession. Regula tions, of which the following are, of course, Iuere

outlines or suggestions, might be made:

First-That a physician, who has been elected to a

public institution as such, and wishes it to be

understood that in his private practice lie acts in

the capacity of a physician only, should not be

allowed to meddle, in any way, with general practice, to the injury or disadvantage of the surgeon or

general practitioner, (which last name, by the way, I very much dislike'to use.)

Secondly-That a surgeon, practising generally, having the degree of M.D. from a University, or a license

from the College of Physicians, should not be

allowed to call himself physician, and practice in the

double capacity, any more than that the physician

ought not to be permitted to interfere with surgical or general practice.

Thirdly-That any physician or surgeon having been

discharged from a public institution for immoral or

improper professional conduct, should no longer be met in consultation by the members of the Assobia.

tion; and also, if it can be satisfactorily made out

that in private practice their conduct has been

glaringly unprofessional, or immoral, or both, they should be similarly treated.

Fourthly-That no countenance should be given to

the use of titles other than will denote the grade in

which the parties practice, for it is not uncommon, I believe, for men having an M.D. degree, or a

licence from the College of Physicians, practising as

surgeons, &c., to call themselves doctors, and thus

pass off for physician, surgeon, &c. &c., to the

injury alike of the physician, who practises strictly as such, and the "general practitioner."

I am glad to find that Dr. 'Hull, of Norwich, has

drawn your attention to this last particular, and as he

is resident in the town where the annual meeting is to

be held this year, I hope he will attend to this and

similar matters. I am glad also to find that the

meeting of the Bath and Bristol Branch has come to

resolutions likely to bring the affairs of the Association

in review before this meeting. The London College of

Physicians has, I am sorry to say, done itself no credit

by the manner in which it has lately granted extra

licences to surgeons,-general practitioners,-many of

whom still continue to practice as they did before they became licentiates, and in addition usurp the position of consulting men! How unlike the doings of this

exalted body in days gone by, when even too stringent

regulations were firmly adhered to, thus to allow men

practising every department of the profession, to lhavq the sanction of their license, which it has been certainly

understood, was for "pure," physicians only. A question may here be asked-Are these men entitled;

to place MD. after their name ? They hold a license, but it confers no degree !

It cannot but have been observed by all, libw for-,

bearing " the physicians," (strictly practising as such,Y have been during all the agitation that has existed to

secure reform for the medical profession, and it might

not be uninteresting to inquire to what their forbearance can be attributed. Has the different nature of their education any share in it ?-for this certainly is, or at least ought to be, more extended in general as well as

special acquirements, than that of the man who practises with the understanding that he has a second opinion to

resort to; or is there an objection to agitation in their

minds, or do they feel satisfied with things as they are ?

Be their reasons what they may, I would just remark, that their interests have not been much, if at all con

sidered, for the whole cry of late has been in bellalf of

" the general practitioner," and it is painful to many as well as myself, I am quite satisfied, to observe this

latter highly useful class of men, many of whom are

an ornament to society, exerting all their powers to

secure an incorporation on their own behalf, which

can only tend to degrade instead of to benefit them, whilst they ought to be maintaining a constant and

unwearied struggle to gain admission, on fair terms, to the College of Surgeons.

We have just witnessed in the political world what a

"League" has done in our agricultural and commercial

affairs, and without any reference to the politics of

this body, I may venture to say, that if our Association

be true to itself, no reasonable professional reform

will be refused to the medical profession. We need

not fresh institutions. We only want our existing ones properly re-arranged to the existing or present wants of the profession. "Tempora mutantur et nos

mutamur in illis." Very applicable to our condition

this is. We have advanced in knowledge as circum

stances have allowed us, and though our foundation

is still the same, we must have superstructures, with

such compartments and furniture, as will be suitable to

the acquirements of the minds of the day. In conclusion, allow me to state, that I have not

been connected with medicine for a period of nearly

twenty-three years, without being made fully aware,

that many irksome and trying accompaniments are, and

must of necessity be, the daily lot of its professors; but

to lessen the influence of these upon our minds, we

ought certainly to be armed with such securities from

our Colleges and Associations, as will enable us to call

upon them to support us in the defence of our moral

principles, as well as our honourable professional con

duct towards our brethren, whether it may be to promote their good when they deserve this, or to censure their

unprofessional, dishonourable, or immoral practices,

as the case may be.

I am indeed sorry that it will not be in my power

to be at the annual meeting at Norwich, or I certainly would make it my business, if no one better qualified could be found to undertake the duty, to bring these

matters before it; but I trust my remarks may be

published in the Journal, and thus to be the means of

drawing the attention of the Association to what I

consider of very vital importance to its well-being, and

that of the profession. I am, Sir,

Your obedient servant, DAVID BELL,

Ludlow, July, 1846.

This content downloaded from 195.34.79.253 on Fri, 13 Jun 2014 16:17:05 PMAll use subject to JSTOR Terms and Conditions