663THE ARMY, NAVY, AND INDIAN MEDICAL SERVICES.

provided this second appearance be in the course of the sameacademical year (October lst to June 30th), otherwise theymust renew the payment of the matriculation fee of E8 12.!.There are three examinations, viz.-1st Part : General Medi-cine ; Pathology and Morbid Anatomy; General Therapeutics;Materia Medica and Pharmacology ; Special Therapeuticsand Mental Diseases. 2nd Part : Surgery ; Midwifery ;Hygiene; and Medical Jurisprudence. 3rd Part : ClinicalExamination in Medicine at the Hospital ; Clinical SurgicalExamination; Examination in Midwifery, consisting of ob-stetrical operations on the mannequin (doll and model ofpelvis) ; Examination in Operative Surgery, consisting ofsome Qf the usual operations on the dead subject, such asAmputation, Ligature of an Artery, &c. ; Regional Anatomyon the Dead Body, with Dissections ; and Ophthalmology.The first and second parts are theoretical and the third ismainly practical and clinical. The time required for thethree examinations seldom exceeds ten days, and is usuallyless. Candidates have the option of passing each partseparately or of taking the three together, and the latter isthe usual course ; also of demanding a written examinationon payment of an additional fee of one guinea for each part,a rule of which candidates rarely or never avail themselves.The examinations, which are vivi voce, take place on the,first Tuesday in November, December, February, May, andJune. Candidates should appear with their diplomas at theSecretary’s office not later than 2 P.M. on the day precedingthe examination. Most of the examiners speak English andthose who do not examine through the medium of an inter-preter. Great importance is attached to practical knowledge,but candidates must also possess sound theoretical know-ledge, the standard required varying with the subject. Patho-logical and other specimens are not usually shown. Thereare in England at present over 600 graduates holding thisdegree, and an English Association of Brussels MedicalGraduates has been in existence many years.

Further information may be obtained from Dr. WalterReeve, 38, Manchester-street, Manchester-square, W.

THE ARMY, NAVY, AND INDIAN MEDICALSERVICES.

Consequent upon the issue of the Royal Warrantpublished in Army Orders dated July l"t, 1898, the

Army Medical Staff and the Medical Staff Corps were

formed into the Royal Army Medical Corps. Medicalofficers also have been placed, as regards sick leave ofabsence on full pay, on the same footing as thatlaid down for regimental officers. By a Roval Warrant,dated Nov. 10th, 1891, Art. 1208b of the Pay Warrantwas revised by inserting the words "an officer of our RoyalArmy Medical Corps" after the words ’’combatant officer," thus giving medical officers an equal title with combatantofficers to reckon time on half-pay towards retirement, whenthe half-pay has been due to ill-health contracted in the

performance of military duty. Under the R)yal Warrantof July, 1895, time on half-pay not exceeding a year mayunder similar circumstances also reckon towards promotion.In the New Royal Warrant it is announced that the Qaeenhas been pleased to approve of the following ranks for theofficers of the Royal Army Medical CcrpR :-Colonel, Lieu-tenant-Colonel, Major, Captain, and Lieutenant. TheWarrant also states that the Medical Staff of the Armyshall in future consist of Sargeon-Generals (ranking as

Major-Generals). Officers of the Royal Army MedicalCorps holding appointments in the Household Troops areto be borne as seconded officers on the establishment of the

Royal Army Medical Coros. The substantive rank of theDirector-General of the Army Medical Service is that ofSurgeon-General.Admission into the Royal Army Medical Corps and

Indian Medical Services is gained as the result of com-petitive examination. Under special conditions the admissionmay take place by nomination under the authority of theSecretary of State for War. The number of nominatedcandidates for the Royal Army Medical Corps is not toexceed in number those admitted for the corps to the ArmyMedical School by examination. The candidates are nomi-nated by the Secretary of State for War, wh invites suchgoverning bodies of pablic schools of medicine in the UnitedKingdom or Colonies, as he may think proper, to proposeprobationers. The Secretary of State for War will from timeto time fix the order of precedence and the proportion in

which the several schools of medicine shall be offered thenomination of candidates. Candidates for both servicesmust, before being admitted to examination, possess adouble qualification to practise Medicine and Surgery andbe registered under the Medical Act. They are also nowrequired to produce certificates of having acted as a medicalclinical clerk for six months, as surgical dresser foranother six months, and of having had not less thanthree months’ instruction at an ophthalmic hospital or

the ophthalmic department of a general hospital, includinga course on errors of refraction. They must also furnish

satisfactory certificates of moral character. A candidatefor the Royal Army Medical Corps must be between 21and 28 years of age, in good mental and bodily health,and must sign a declaration upon honour that he is of

pure European descent ; he must also state whetherhe holds, or has held, any commission or appointment inthe public services ; for the Indian Service a candidate mustbe between 21 and 28 years of age, of sound bodilyhealth, and a natural-born subject of Her Majesty. Bothare examined as to physical fitness by a Board of MedicalOfficers. The standard of fitness is set forth in Appendix I.of the regulations for admission to the Royal Army MedicalCorp. These conditions being satisfied, the candidateis admitted to the competitive examination, which is

usually held in London twice a year, in the monthsof February and August. An entrance fee of El is requiredfrom each candidate admitted to the competition, and is pay-able at the conclusion of the candidate’s physical examina-tion, if he be pronounced fit. No candidate for the IndianService will be allowed to compete on more than threeoccasions. The subjects of examination are divided intocompulsory and voluntary. The former comprise Surgery(1200 marks), Medicine, including Therapeutics and theDiseases of Women and Children (1200 marks), Anatomyand Physiology (600 marks), Chemistry and Pharmacy, anda practical knowledge of Drugs (600 marks). The examina-tion in Medicine and Surgery will be in part practical, andwill include operations on the dead body, the applicationof surgical apprratus, and the examination of medicaland surgical patients at the bedside. The eligi-bility of the candidate for admission into the service isdetermined by the result of this part of the examination.By an Army Order dated May lst, 1895, no candidate shallbe considered eligible who shall not have obtained atleast one-third of the marks obtainable in each of thecompulsory subjects, and at least one-half of the aggregateof marks for all the compulsory subjects. The voluntarysubjects are French (200 marks), German (200 marks),Hindustani (200 marks), and Natural Sciences : (a) Physics(300 marks) ; (b) Zoology (300 marks) ; (c) Geologyand Physical Geography (300 marks) ; and (d) Botany(300 marks). A candidate may not present himself forexamination in more than two of the subjects includedunder the term "Natural Sciences." A number lessthan one-third of the marks obtainable in each of the

voluntary subjects will not be allowed to count in favour ofa candidate who has qualified in the compulsory subjects.Although the results of the examination in voluntary subjectsdo not affect the question of the eligibility of the candidatefor a commission, tney influence his position on the list, whichis determined by the numbers obtained under the two headsconjointly. A candidate for the Royal Army Medical Corpswhen submitting his application may also enter for the IndianMedical Service (and vice versâ), subject to his satisfyingthe Secretary of State for India or War that he is eligibleunder the regulations for that service. The names of thesuccessful candidates for the two services will be placed onone list in order of merit, as determined by the total numberof marks each has obtained in both the compulsory andvoluntary subjects. So far as the number of vacancies willpermit, the successfal candidates will be allotted, accordingto their position on the list, to the service for which theyhave expressed a preference, subject to their having beenaccepted plior to examination as eligible for that service.After having passed this examination the successfulcandidates for both services are sent to the Army MedicalSchool at Netley as "surgeons-on-probation," receivinga daily pay of 8s. and certain allowances, to go througha four months’ conrpc of instruction in the special dutiesrequired of them in the services ; or, in the case of theRoyal Army Medical Corps, such a course at the ArmyMedical School as the Secretary (,f State stall decide on assufficient. They are nqaired to attend tne Royal Army

664 THE ARMY, NAVY, AND INDIAN MEDICAL SERVICES.

Medical Corps mess at Netley and to conform to therules and regulations thereof. The staff of the schoolconsists of four professors, all of them men of highstanding in their special departments. The Professor-ship of Military Medicine is held by Colonel K.Macleod, M.D., LM.S. Colonel W. F. Stevenson, M.B.,is Professor of Military Surgery (as this cfficer is now inS-uth Africa as P.M.O. of the line of communica-tion and consultiog surgeon to the Forces his placein the School is temporarily taken by Major W.Dick, M.B., F.R.C.S. Elin.); Colonel J. L. Notter, MD.,of Military Hygiene ; and Dr. A. E. Wright, of Pathology.There is an Assistant Professor for each of these subjectswho is an officer of the R)yal Army Medical Corps. Thelectures on Military Surgery include gunshot and otherwounds, transport of sick and wounded, duties of armymedical officers in the fie1d, on board troopships and

transports, recruiting, and other duties incident to militaryservice. Those on Military Medicine treat of tropicaland other diseases to which soldiers are exposed in thecourse of their service, the mortality and invalidingby disease, in peace and war, at home and abroad, themanagement of lunatics under the conditions of militaryservice, &c. The course of six lectures on Lunacy andMilitary Asylum work is delivered at the Netlpy LunaticAsylum by Lieutenant-Colonel Chester, M.B. The courseof Hygiene comprises the examinations of water and air,the general principles of diet, with the quality and adul-terations of food and beverages, the sanitary requirementsof barracks, hospitals, and camps, the consideration of the

clothing, duties, and exercises of the soldier, and the cir-cumstances affacting his health, with the best means of

preventing disease, and instruction in the mode of preparingthe various statistical and other returns required of themedical officer. The Pathological course includesbacteriology and demonstrations in physiological chemistry.The surgeons-on-probation are detailed for duty in thewards of the hospital, under the Professors and AssistantProfessors of Medicine and Surgery. Thev, as a rule, spendtwo months in the medical and two months in the surgicaldivision of the hospital, and there they are taughtpractically the details of the management of patientsin a military hospital, the registration of their diseases,the duties of invaliding, the modes of filling up theregulation statistical returns and other service docu-ments. The surgeons-on-probation are provided withquarters and are extra members of the mess at Netley.They are required to provide themselves with the regulationundress and mess uniform of a lieutenant, but without thesword, sword-belt, dress trousers, forage cap, patrol jacket,and badge of rank. After having passed through the courseof instruction they are required to pass a qualifying examina-tion in the subjects taughfi in the school, and their positionon the list of those recommended for commissions isdetermined by the combined results of the competitiveand final examinations. At the close of each session eightprizes are awarded : the Herbert Prize of £20 to the surgeon-on-probation who has obtained the highest number of marksat the Netley examination ; the Parkes Memorial BronzeMedal to tha one who gains the highest numbar of marksin the examination in Hygiene ; the de Chaumont prize ofbooks to the one who takes second place in Hygiene ; thEMartin Memorial Gold Medal for the highest number of marksin the examination on Military Medicine; the MontefiorEMedal and £21, awarded for Milicary Sargery ; the MontefioreSecond Pdze, a revolver to the surgeon-on-probation whcobtains the second highest number of marks in this

branch ; the Maclean prize of books for Clinical Medicineand Surgery and for Ward Work ; and a prize of books forthe highest number of ma,rks gained in Pathology.At the close of the Natley Session those surgeons-on

probation who have obtained one-third of the possible totaof marks in each subject are recommended for commissions as Lieutenants. The surgeons-on-probation of thE

Royal Army Medical Corp? who pass out of the ArmjMedical School at one qualifying examination will take pre.cedence among each other ag lieutenants, as follows :-(a)Those appointed by ccmpetition according to the order omerit as determined by the combined results of the competitive and qaalif3ing examinations, with priority over anjoining under paragraph (b). (b) Those appointed ot

nomination, according to the number of marks thev individually obtain at the final examination at the Army MedicaSchool, but junior to all those appointed by competition

Commissions will bear the date of the day of passing out of £ ’

the Army Medical School. The Lieutenants of the BritishMedical Service pass on from Netley to Aldershot, wherethey go through a systematic course of instruction in com.pany and ambulance drill and equitation. The officersof the Indian Medical Service do not go to Aldershot, butundergo, whilst at Netley, a course of instruction in

company and ambulance drill and in other military duties.The position of the officers of the Indian Service on

the list of Lieutenants is determined by the combinedresults of the London and Netley examinations, and, as faras the requirtments of the service permit, they have thechoice of commands in India-i.e., Bengal, Punjab, Madras,or Bombay-according to their position in that list. Allofficers appointed to the Indian Medical Service are now

placed on one list. Though ordinarily employed within the °

limits of the command to which they are posted, they are ’

liable for employment in anv part of India. In the Gazettedated India Office, August 26th, 1898, it is announced thatHer Majesty has deemed it expedient to alter the ranks ofthe officeri of the Indian Medical Service. The samemilitary titles as those conferred on the officers of the RoyalArmy Medical Corps are announced for the officers of theIndian Medical Service.

The Royal Army Medical Corps.-Lieutenants, if dulyrecommended, are promoted to be Captains on completingthree years’ full-pay service.

Captains, if recommended by the Director. General, are

promoted to be Majors on completing twelve years’ full-pay sarvioa, of which three must have been passedabroad. Before being promoted they will be required to

pass an examination. This examination may be takenat any time after their seventh year of service. Itwill embrace the following subjects : (a) Surgery andSurgical Anatomy ; (b) Medicine and Pathology; and (e)the theory and practice of Hygiene, especially in relationto military r(quirements, also the regulations regardingthe sanitation ot garrisons, quarters, hospitals, &c., as wellas of camps and hospitals in the field, and of trans-

ports, troop and hospital ships; (d) duties of medicalofficers at home and abroad and at sea, as defined in theregulations, also hospital organisation and administrationin peace and war, including the transport of sick andwounded by land and sea; (e) and the administration, interior

, economy, command, and aiscipline of the Ro3al ArmyMedical Corps, together with a knowledge of the principlesoc military law and their practical application (a certificatet of proficiency in military law obtained at a garrison class! will exempt the holder from examination in the latter).

A certificate will be required from a recognised teacher3of surgery in any medical school, at home or abroad, in. which operative surgery is taught, showing that the2officer has gone satisfactorily through a complete course ofI operative surgery during the period within which the: examination must be taken, and that he is a competenttoperator.

A report on any subject of a practical professional3 character, to be selected by the officer himself, anda certified to be his own composition and in his own hand-s writing, wil also be required. Considerable importancef will be attached to the literary and scientific merits of thia3 report, which must be furnished before the officer completess twelve years’ service.3 The examinations will be conducted by printed questions,8 which will enter so far into the subject matter of each heado selected for examination as to show that the officer’s know-s ledge has been fully tested.e The questions and answers will be forwarded, under ar sealed confidential cover, to the Director-General for

transmission to the examiners, who will report to the- Director-General as to the competence of the officer,1 examined.

The examination in Medicine and Surgery will be held bye two gentlemen appointed by the Secretary of State ; thatyin Hygiene by the Professor of Hygiene, Army Medical- School, Netley ; and that in Regulations, Daties, Military) Law, &c., by an administrative medical officer, nominatedf for the purpose by the Director-General.

Any higher qualification, such as M.D., F.R.C.S, &c., (X

y any diploma in Hygiene and State Medicine, taken after May 1st, 1890, will not exempt Captains from this examina-l- tion.

A Lieutenant in the Royal Army Medical Corps pro-moted to the rank of Captain on account of distinguished

665THE ARMY, NAVY, AND INDIAN MEDICAL SERVICES.

seivice in the field, shall be eligible for further promotion tothe rank of Major, and subsequently to that of Lieutenant-Colonel, when the officer next below him in the rank of

Captain or Major respectively becomes eligible by serv!cefor promotion to the next higher rank. A Captain so pro-moted to the rank of Major shall, on the same conditions, beeligible for promotion to the rank of 1/eutenant-ColoneI. Anofficer promoted under this article shall not receive anyincrease cf pay in the rank to which he has been so pro-moted until he becomes entitled thereto by service.Majors are promoted to be Lieutenant-Colonels on com-

pleting twenty years’ full-pay service.The selection of Lieutenant Colonels for advancement to

the grade of Colonel is made on the grounds of ability andmerit (on the recommendation of the Commander-in-Chief),in determining which the following points will be con-

sidered :—The officer to be so selected must have beenfavourably reported on by the several military officers underwhom he may have served, as set forth in their AnnualConfidential reports. He must be physically fit for generalservice and have served abroad for at least eight years.A Lieutenant-Colonel, to be eligible for selection as

Colonel, must have served abroad at least ten years, ofwhich three must have been in India. All promotions fromthe rank of Lieutenant-Colonel to that of Colonel, and fromthe rank of Colonel to that of Surgeon-General, shall begiven for ability and merit, upon the selection of theCommander-in-Chief, with the approval of the Secretary ofState, and the grounds of such selection shall be stated inwriting. In all such cases the amount of service abroadshall be expressly stated. All officers under the rank ofColonel are placed on the retired list at the age of fifty-five,and those of that rank and of the rank of Surgeon-General at the age of sixty, except that in any particularcase in which it may be considered necessary for theinterest of the public service the age of retirement ofa Surgeon-General mav be extended for a period not

exceeding two years. From recent promotions which havebeen made it is evident that Colonels who have passedthe age of fifty-seven before being selected for the rank ofSurgeon General will be passed over in favour of youngerofficers who can, by reason of age, serve a full three yearsin the rank of Surgeon General.

In cases of distinguished service in the field a medicalor departmental officer may, with the concurrence of theLords Commissioners of our Treasury, be promoted from anydepartmental or other rank to that next above it and shall,if promoted to another rank having a fixed establishment,remain supernumerary in that rank until the occurrence ofthe vacancy to which, in the ordinary course, he would havebeen promoted. The recommendation detailing the servicesfor which the officer may be proposed for promotion shall insuch cases be published in the London Gazette. An officerso promoted shall not receive any increase of pay in therank to which he has been promoted until he becomesentitled thereto by service. In a case of distinguishedservice in the field for which an officer may merit specialreward, although there may not be sufficient grounds for hispromotion, Our Secretary of State shall have the power, withthe concurrence of the Lords Commissioners of Our Treasury,to grant him a higher rate of pay in his rank, but withoutalteration of his seniority.Foreign Service.-Army Order 85 of June, 1897, states

that the periods of service abroad, reckoning from the dateof embarkation at home, will (except in the case of a

Surgeon-General or Colonel) be five years for all stationsabroad (except that on the west coast of Africa), unless suchperiod should be incompatible with the interests of thepublic service.

Sick Leave.-An officer of the Royal Army Medical Corpsmay be allowed full pay during sick leave of absence on thesame conditions as those laid down for regimental officers.

Service on the West Coast of Africa. - Officers whoentered the Royal Army Medical Corps, or volunteeredexpressly for service on the West Coast of Africa on orafter the 1st of March, 1873, receive double pay whileactually serving on the coast. Candidates who presentt,hemselves expressly for service in the Royal ArmyMedical Corps on the West Coast enter under the samequalifications as other candidates, except that they maybe admitted up to thirty years of age. After 3 years’ actualservice on the coast they are eligible for general service. If,however, it be certified by a medical board that any suchofficer is unfit for further duty on the coast he shall be

eligible for general service, though he may not have completed3 years’ service there. For each year’s service on the coastan officer is entitled to a year’s leave at home. Each year orportion of a year served on the West Coast reckons doubletowards voluntary retirement or retired pay, provided that anofficer has served 12 months on the coast. An officer volur-teering for, or ordered to, the West Cosst of Aftica receivesdouble pay while actually setvingon the coast..Exchanges.-An officer of Oar Royal Army Medical Corps

shall be permitted to exchange with another officer of suchcorps, or with a medical officer of Oar Household Troops,under such conditions and regulations as shall from time totime be made by Us. Exchanges between cfficers of OarRoyal Army Medical Corps under the rank of major andmedical officers of Oar Indian Military Forces, and transfersof such officers from either of the above services to theother, shall only be permitted subject to the approval ofOur Secretary of State for India in Council and on the

following conditions :-(1) that the cfficers have less thanseven years’ service ; (2) that the senior officer exchangingtakes the place of the junior on the list and shall not bepromoted under Article 359 until the officer next above himhas been so promoted ; (3) that the junior officer exchangingis placed for seniority next below all medical officers whosecommissions have the same date as his own ; and (4) thatthe officer transferred is placed for seniority below allmedical officers holding the same rank at the time of histransfer, and shall not be promoted under Article 359 untilthe officer next above him has been promoted.Indian Medical Service.-Officers on appointment are,

when possible, provided with passage to India by troop-ship ; when troopship accommodation is not available

passage at the public expense is provided by steamer, or

a passage allowance granted if preferred. A charge formessing during the voyage is made at the rate of 2s. a day.This payment does not include the cost of liquors, which arecharged for as extras. Any officer who may neglect or refuseto proceed to India under the orders of the Secretary ofState for India within two months from the date of leavingNetley will be considered as having forfeited his appoint-ment, unless special circumstances shall justify a departurefrom this regulation. A Lieutenant’s commission is dateclfrom the day he passes out of the Army Medical School.Lieutenants are promoted to the rank of Captain on

completing three years’ full-pay service, Captains to therank of Major after twelve years’ service, and Majorsto the rank of Lieutenant-Colonel after twenty years’service. No examination to qualify for promotion is required.All promotions to higher grades are to be given by selectionfor ability and merit. In case of distinguished servicein the field a medical officer may be at once promotedfrom any rank to the one next above it, remaining super-numerary in the higher rank until he would have beenpromoted in ordinary course or until selected for further

promotion for which he is eligible. The ages for com-pulsory retirement are the same as those for the RoyalArmy Medical Corps. Officers of the Indian MedicalService below the rank of Colonel may be granted :1. Privilege leave under such regulations as may fromtime to time be in force. 2. Leave out of India for nolonger period than one year, capable of extension to twoyears’ absence from duty, on the following pay :-Afterarrival in India, on first appointment, £200 a year ; after thecommencement of the fifth year’s service for pension, L250a year ; after the commencement of the tenth year’s servicefor pension, L300 a year; after the commencement of thefifteenth year’s service for pension, f,400 a year ; after thecommencement of the twentieth year’s service for pen-sion, f,450 a year ; and after the commencement of thetwenty-fifth year’s service for pension, E500 a year.3. Leave in India, but for the period of one year only, onfull military pay and half the staff salary of appointment,No extension of leave involving absence from dutyfor more than two years, whether taken in or out ofIndia, can be granted except on specially urgent groundsand without pay. An officer unable on account of thestate of his health to return to duty within the maximumperiod of two years’ absence, unless he is specially grantedan extension of leave without pay, is placed on temporaryhalf-psy or the retired list, as the circumstances of the casemay require. An officer is also liable to be placed on half-pay or the retired list should his health require an undueamount of leave, whether in or out of India. Leave may be

granted at any time, but solely at the discretion of theI 3

666 THE ARMY, NAVY, AND INDIAN MEDICAL SERVICES.

Commanders-in-Chief or of the Local Governments in Indiain the case of officers not under the direct orders of aCommander-in-Chief. Officers of the Administrative gradesmay be granted one period of leave not exceeding eightmonths during their tenure of appointment. An officer onleave is required to join at once on being recalled to dutyunless certified by a medical board as unfit to do so.Naval Medical Service.-A candidate must be between the

ages of twenty-one and twenty-eight, and must be the sonof parents of pure Earopean blood. He must declare hisreadiness for general service at home or abroad. Candidateswill be examined by the Board in the following compulsorysubjects : (a) Medicine, including Therapeutics and Diseasesof Women and Children, 1200 marks ; (b) Surgery, 1200marks; (c) Anatomy and Physiology. 600 marks ; and(d) Chemistry and Materia Medica, 600 marks. No can-didate is considered eligible who does not obtain one-third of the maximum marks in each of the com-

pulsory subjects. The attention of candidates is especi-ally drawn to the importance of the section of Opera-tive Surgery as a competent knowledge in this subjectis essential in order to qualify for a commission.Candidates may be examined in the following voluntarysubjects : Zoology, 300 marks; Botany, 300 marks; Physics,300 marks; Geology and Physical Geography, 300 marks(no candidate will be allowed to present himself for exa-mination in more than two of these subjects) ; French andGerman (200 each), 400 marks. A number less than one-third of the marks obtainable in each of these voluntary sub-jects will not be allowed to count in favour of a candidatewho has qualified in the compulsory subjects. The appoint-ments announced for competition will be filled up from thelist of qualified candidates, arranged in the order of merit,as finally determined by the total number of marks each hasobtained in both the compulsory and voluntary subjects, butshould it at any time be considered expedient to grant com-missions beyond those periodically competed for it will becompetent for the Board of Admiralty to admit annually onecandidate proposed by the governing oodies of public schoolsof medicine in the United Kingdom, or attached to suchColonial Universities as they may think proper, the candi-date so proposed to be approved by the Director-General ofthe Medical Department of the Navy and to be certified bythe governing body proposing him to be duly qualifiedaccording to the regulations in force fcr the entry of candi.dates. Candidates from schools at home will be required topass a physical and test examination in London wbich willoe arranged for by the Medical Director. General. Colonialcandidates will have to pass a physical and test examina-tion before a Board of Naval Medical Officers on thestation. Successful candidates immediately after pass.ing the examination will receive commissions as sur-geons in the Royal Navy and will undergo a course of

practical instruction in Naval Hygiene, &c., at Haslar

Hospital. Three prizes of the approximate value of £10each will be awarded at the close of each session at Haslarto the students who have shown the greatest proficiency.The seniority of surgeons on entry will be determined by thesum total of the marks they obtain at the London examina-tion and those at the conclusion of the Haslar course, andtheir names will then be placed in the Official Navy List.Surgeons entered without competition will take senioritynext after the last surgeon entered at the same time by com-petition. Surgeons are promoted to be Staff Surgeonsafter twelve years from date of entry, provided they passthe requisite examination after completion of eight years’service from the date of entry ; and Staff Surgeons tcFleet Surgeons after twenty years’ service if recommendedby the Director-General. Deputy Inspectors-General art

promoted by selection for ability and merit from theFleet Surgeons, and Inspectors-General from the DeputeInspectors-General having three years’ foreign service, four years’ mixed, of which not less than two mus1have been abroad, or five years’ home service in suclappointments as preclude foreign service, provided the]have not refused to go abroad when called upon to d(so. Inspectors and Deputy Inspectors-General are retireecompulsorily at 60 years of age (except that if in any particular case the Lords Commissioners of the Admiralty mayconsider that the interests of the public service will bE

materially advanced by the further retention of an InspectorGeneral on the active list, the age for retirement of suclInspector-General may be extended to 62 years of age) ancother grades at 55 years of age, and all ranks at any time ij

an officer has not served for five years. In calculating servicefor retired pay time on half-pay will be taken as equivalent to

’

one-third service on full-pay. All retired officers are liable,till the age of 55 years, to serve in time of declared nationalemergency in a rank not lower than that held on retirement,The following tables, showing the rates of pay and

half-pay of the three branches, will probably be acceptableto students who entertain any intention of entering thepublic service :-

A lieutenant-colonel in the Royal Army Medical Corps may )?specially selected for increased pay from lieutenant-coloneis who haveserved at least eight years abroad.

SCALE OF RETIRED PAY.

Army Medical 8ta.tJ.

DIRECTOR-GENERAL, ARMY MEDICAL SERVICE-Yearly.

After 5 years’ service as Director-General, and not less Etban 30 years’ service ..... 1000

After 3 years’ service as Director-General, in addition tothe retired pay of a Surgeon-General ....., ... 100

*

Daily.SURGEON-GENERAL— E s. d.

After 3 years’ service as Euch............... 2 0 C’

Royal Army Medical Corps,COLONEL-

After 3 years’ service as such............... 115 CLlEUTENANT-COLONEL—

After 20 years’ service .................. 1 0 CAfter 25 .................. 1 2 6After 30 " .................. 1 5 0

LIEUTENANT-COLONEL, after being in receipt of the in-creased pay allowed by Article 362 for 3 years-Under 30 years’ service ............... 1 7 6After 30 11 ............... 110 0

MAJOR, after 3 years’ service as such--Aftf r 20 years’ service .................. 1 0 CAfter 25 years’ service if his service reckoning forpromotion is insufficient to qualify him for promotionto the rank of Lieutenant- Colonel under Article 359 ,.. 1 2 E

LIEUTENANT-COLONEL, MAJOR, CAPTAIN, OR LIEUTENANT--

Gratuity£

After 10 years’ service .................. 1250After 15 .................. J800After 18 " .................. 2500

Director-General of the Army Medical Service, E1500 yearly; retiredpay from B1125 to .8830, according to length of service as Director-General.

Under Army Order 63 of May, 1897, officers of the Royal ArmyMedical Corps attached to a militia unit during preliminary drill andtraining are entitled to an allowance in aid of mess at the rate of 4q.a day.An officer who, on voluntary retirement, has served for less than

three years in the rank from which he retires is only entitled to thegratuity or retirect pay assigned to the next lower rank.Half-pay is also applicable to officers having less than twenty

years’service, as follows ;-

Lieutenant-Colonel, Major, Captain, or Lieutenant ;Daily.

Under 5 years’ service .0 6 0After 6 " .... 0 8 0After 10 " ...., 0 10 0After 15 " ,, ... ... 0 13 6

667THE ARMY, NAVY, AND INDIAN MEDICAL SERVICES.

Rates of Retirement for Officers not qualified for Retired Pay onVoluntary Retirement.

If the unfitness was caused by military service retired pay equal tothe half pay of his rank. If not so caused, provided the officer has atleast 12 years’ service, retired pay equal to the half. pay of his rank,for such period only, not exceeding five years from the date of theofficer’s retirement from the army, after five years on half-pay underArticle 306, as the Secretary of State shall determine according to themerits of the case.

Pay of officers in India:Rs. per mensem.

Lieutenant- Colonel ........................ 1150" after 25 years .................. 1093" .............................. 1056

Major, after 15 years ..................... 825.............................. 789

Captain, after 10 years ................... 500" 5 ..................... 450

or Lieutenant ..................... 350

ROYAL NAVY.

"If the health of a surgeon breaks down before he completes eightyears’ service, even if his disability be contracted in the service or bedue to climatic causes, he is liable to be at once placed on the retiredlist, receiving a gratuity at the rate of £125 for each year of completedservice.

t Including proportion of half-pay time.The half-pay, retired pay, and gratuities on retirement are liable

to reduction in cases of misconduct.When an offieer retires or withdraws on a gratuity his widow and

,children will have no claim to pension or compassionate allowance.

The hospital allowances for Medical Officers at home and abroadin lieu of provisions for themselves and servants and for fuel andlight are as follows:-

iiedical officers serving afloat receive an allowance of ls. 6l. a dayin lieu of provisions, fuel, and lights, as laid down in the Queen’sRegulations.The allowance of 5s. a day, in addition to full pay, at present granted

to the Fleet Surgeon of a flag-ship bearing the flag of a Commander-in-{;hief on a foreign station, will be given to the senior medical officer ofsuch ship, being a Fleet or Staff Surgeon; and an allowance of 2s. 6d. aday to the senior medical officer, being a Fleet or St3-ff Surgeon, of theship of a Commodore or of a senior officer commanding a foreignstation.Candidates will do well to notice that the regulations issued to

applicants do not put any limit on the amount of half-pay servicewhich they may be compelled to undergo.Surgeons who have Deen kept awav from England and from naval

hospitals in consequence of lengthened periods of service abroad may,1f the convenience of the service will admit, be allowed to attend metro-pohtan hospitals for three months to improve their professional know-ledge, anJ while so employed they will be borne on ships’ books andreceise the ordinary pay of their rank; but the number is not to exceed20 in each year.

INDIAN MEDICAL SERVICE. §The rate of pay drawn by Lieutenants from the date of passlng the

tnal examination at the Army Medical School until arrival in India is10s. a (hy.Pay at the above rate is issued in this country up to the date of

embarkation, and an advance of two months’ pay at the same rate isalso m,h1e prior to embarkation, which is adjusted in India.The following are the rates of "Indian pay and allowances " which

will be drawn by officers hereafter appointed to the Indian MedicalService :-

On first appointment they will only come into receipt of " Indian payand allowances" from the date of their arrival in India.

Officers holding the principal administrative appointments and sub-stantive military charges of the Indian Medical Service receive atpresent the following consolidated salaries:-

Rs. per mensem.

Surgeon-General ............... 2700 to 2200

Colonel ... ... ... ...

from ... 2250Colonel ... ... ... ... ... form ...... 1800Lieutenant-Colonel in substantivecharge of a native regiment...... 1000 or 1100 with Rs. 90 horse

allowance in cavalry regi-ments.

Major in substantive charge of ditto 800 with Rs. 90 ditto.Captain above 5 years’ full-payservice in substantive charge of anative regiment............... 600 with Rs. 60 ditto.

Captain or Lieutenant under 5 years’ditto in substantive charge of anative regiment............... 450 with Rs. 60 ditto.The salaries of other substantive medical appointments in the Civil

and Military Departments are consolidated and vary from Rs. 1800 toRs. 400 per mensem.

Qualified officers of the Medical Service are also eligible for appoint-ments in the Assay Department. The salaries of these appointmentsare from Rs. 600 to Rs. 2250 per mensem.

Officers are required to perform two years’ regimental duty in Indiabefore they can be considered eligible for civil employment.Except in the administrative grades and in certain special appoint-

ments officers are not debarred from taking plivace practice as long asit does not interfere with their prcper duties.

RETIRING PENSIONS AND HALF-PAY.

Officers of the Indian Medical Service will be allowed to retire on thefollowing scale of pension, on completion of the required periods ofservice:-After 30 years’ service for pension £700per annum + £ 350 after 5 years’

active employment in India as aSurgeon-General, or + £250 perannum after 5 years’ active em-ployment as a Colonel.

19 25 ’’ ’’ ’’" £500 per annum.20 " " " £365 "

17 " " " £292 "

Time (not exceeding one year) passed on temporary half-pay reckonsas service for promotion and pension, in the case of an officer placedon half-pay on account of ill-health contracted in the performance ofmilitary duty.

Officers of the Indian Medical Service are liable, after retirement onpension before completing 30 years’ service, to recall to military duty in;ase of any great emergency arising, up to 65 years of age.All (fficers of the rank of Lieutenant-Colontl and Major are placed on

the retired list at the age of 55, and all Surgeons-General and Colonelsvt the age of 60.Officers not entitled to pension, when placed on temporary or perma-

hent half-pay, will be granted the British rate of half-pay of theirmilitary rank, as under:-

668 METROPOLITAN MEDICAL SCHOOLS.

INVALID PENSIONS.

An officer who has become incapacitated for further service in Indiaon account of unfitness caused by duty may, after he has been twoyears on temporary half pay, be granted an Invalid Pension on thefollowing scale :-

Per annum.After 16 years’ pension service ........ . JM72" 15 " " " " .... . . 252n 14 " x " .. ’ *-- *-’ 2q2 13 " ........ 212 12 .............. 192

No staff or regimental allowance can be drawn until the lowerstandard examination in Hindustani has bqen passed. As manyLieutenants have been sent to the frontier immediately on arrivingin India they have found it impossible to study and pass thisexamination, and have consequently been doing rk-gimental and otherwork for R-3. 330 a month. Lately a concession has been granted tomedical officers so situated on the frontier, but the rule is still mostilliberal and requires alteration.Officers cannot retire in India on half-pay (No. 46, Feb. 28th, 1865).

WOUND PENSIONS.Officers are entitled to the same allowances on account of wounds and

injuries received in action as are granted to combatant officers of HerMajesty’s Indian Military Forces holding the corresponding militaryrank.

FAMILY PENSIONS.The claims to pension of widows and families of officers are treated

under the provisions of such Royal Warrant regulating the grant ofpensions to the widows and families of British officers as may be inforce at the time being.The widows and families of officers are also entitled to pensions under

the Indian Service Family Pension Regulations, for the benefits ofwhich all officers must, as a condition of their appointment, subscribefrom the date of their arrival in India.

HONOURS AND REWARDS.Officers o’ the Indian Medical Service are eligible for the military

distinction of the Order of the Bath and for othe Orders, British andIndian, and for good service pensions. Six of the most meritoriousofficers are named Honorary Physicians and six are named HonorarySurgeons to Her Majesty.

METROPOLITAN MEDICAL SCHOOLS.1

ST. BARTHOLOMEW’S HOSPITAL AND COLLEGE. - Theclinical practice of the hospital comprises a service of 744beds, of which 674 are for patients in the hospital at Smithfieldand 70 for convalescent patients at Swanley. Ten house

physicians and ten house surgeons are appointed annually.Daring their first six months of o6ioe they act as " junior "house physicians and house surgeons and receive a salary of£25 a year. During their second six months they become’’ senior’’ house physicians and house surgeons and are pro-vided with rooms by the hospital authorities and receive £ 80a year as salary. A resident midwifery assistant and anophthalmic house surgeon are appointed every six months,and are provided with rooms and receive a salary of :E80 ayear. Two assistant anxsthetists are appointed annually,and receive salaries of £120 and £100 respectively. Anextern midwifery assistant is appointed every three months,and receives a salary of .f:80 a year. Two assistantelectricians are appointed every six months. The clinicalclerks, the obstetric clerks, the clerks to the medical out-

patients, the dressers to the surgical in-patients and to theout-patients, and the dressers in the special departments arechosen from the students. All the appointments are nowfree.A college is attached to the hospital, in which students

can reside, subject to the college regulations.The Medical School Buildings include three large lecture

theatres, a large dissecting room, a spacious library (con-taining 13, 000 volumes), a well-appointed museum of anatomy,physiology, comparative anatomy, materia medica, botany,and pathological anatomy. The pathological museum isthe most complete in the kingdom. There are laboratoriesfor chemistry, physiology, pathology, pharmacology, physics,public health, and biology, giving ample accommodation inevery department.A ground of ten acres has been purchased by the school

committee at Winchmore-hill for the use of the Students’Amalgamated Clubs, and all students are expected tobecome members.

Instruction in Preliminary Science is given to Universityof London students in chemistry, biology, and physicsthroughout the year.

Laboratory Instruction for the D.P.H. is provided duringthe winter and summer sessions, and elementary instructionIn Bacteriology is also given throughout the year.

1 For Scholarships see p. 703 et seq.

CRARING-CROSS HOSPITAL AND COLLEGE.-Total feeE, ,

110 guineas if paid in a single sum on entry, or 121 guineas ifpaid in five instalments ; the sons of Registered MedicalPractitioners pay 100 guineas in one sum or 110 guineas infive sums ; for Dental students, 54 guineas, or 60 guineas intwo equal instalments. General students pay proportionatelylower fees, and are admitted without additional fee to thecourses of Clinical Medicine and Surgery and to the practiceof the Royal Westminster Ophthalmic Hospital. They aloneare entitled to compete for the Scholarships, Gold Medal,Huxley, and Pereira Prizes.

Classes for the Preliminary Scientific Examination of theUniversity of London are held at this Medical School. Thefee for the whole course, which begins in October, is15 guineas. There are also special classes for the practicalwork for the Department of Public Health and a course inthe subject of diseases of tropical climates.

ST. GEORGE’S HOSPITAL.-Students may become Perre’na!Pupils by payment of E150 on entering, or of E160 in fourannual instalments. Perpetual pupils are entitled to per-petual admission to lectures acd demonstrations as well asto the entire medical and surgical practice of the hospital;they may compete for all prizes and exhibitions, may becomeclinical clerks during six months and dressers during anothersix months, or longer if required, without fee, may attendmidwifery practice, and may compete for all hospitaland school appointments without extra charge. Fourhouse surgeoncies and four house physiciancies, andthe salaried offices of obstetric assistant, senior andjunior anaesthetists, medical registrars (2), surgical registrar,curator and assistant curator of the Museum, besidesdemonstratorships and a number of junior hospital appoint-ments, are open to perpetual pupils. Students not beingperpetual pupils are admitted to lectures, demonstrations,and hospital practice on payment of E50 annually for twoyears and f:20 annually for succeeding years. Suchstudentsmay become Perpetual in their third year if they wish and iftheir conduct has been satisfactory.

GUY’s HOSPITAL.-House physicians, house surgeons,assistant house physicians, and assistant house surgeons,obstetric residents, gynaecological assistants, clinical assist-ants, clerks to anaesthetists, surgeons’ and assistantsurgeons’ dressers, surgical ward clerks, clinical clerks,post-mortem clerks, extern obstetric attendants, anddressers and clerks in the special departments are

, appointed from among the students upon the recom-

mendation of the medical staff, according to merit andwithout extra payment. The house physicians, of whom

, there are four, hold office for six months each. Theassistant house physicians, who hold office for three month?,

, attend in the out-patient department four afternoons in

, the week, and see all the cases not seen by the assistantphysician of the day. The house physicians have the careof the patients in the medical wards, and attend to all

. emergencies arising in the absence of the physicians. Theyare provided with board and lodging in the college free of

! expense. The house surgeons, of whom there are four, holdr office for six months each, and are provided with board and

lodging in the college free of expense. The SurgicalCasualty Department is in charge of two assistant home

surgeons. The surgeons’ dressers are selected from thosestudents who have completed their third winter session and

. have been most diligent in the junior appointments. Theyhold office for three or six months. Six are attachedto each surgeon, and during their weeks of special dutythey are provided with board and lodging in the hospital

3free of expense. The obstetric residentP, four in number,are provided with board and lodging in the college free ofexpense.Higher Examinations. -Classes are held throughout the

1 year for the Preliminary Scientific Examination of the, University of London ; and special courses of instruction

are provided for students preparing for the Primary andFinal Fellowship examination and the intermediate M.B.examinations of Oxford, Cambridge, and London. Twocourses of Laboratory instruction for candidates for aDiploma in Public Health are given annually.

The College.-The College stands upon a site fronting the3east gate of the hospital and is connected with it by a

subway. The building serves as a Residential College for-Students and at the same time provides accommodation for

the Students’ Club. The Clubs’ Union ground is less thaa