232

THE GENERAL COUNCIL OFMEDICAL EDUCATION AND

REGISTRATION.0

THE extraordinary session of the General Medical Councilresumed its sitting on Thursday, July 16th, when the

proceedings were brought to a close.WEDNESDAY, JULY 15TH.

The Council, with Sir WILLIAM TURNER, the President,in the chair, towards the close of the first day’s sitting ofthe special session held to consider, among other matters, therelations between it and the English Royal Colleges respect-ing examination in the primary subjects of the medical

coarse, proceeded with the following notice of motion bySir Victor Horsley, seconded by Sir William Thomson :-That inasmuch as :-(a) The examination in chemistry, physics, and

biology of the Examining Board in England is, in the opinion of theGeneral Medical Council, insufficient; (b) the synopses and require-ments of the Examining Board in England for its examination inchemistry, physics, and biology, are, in the opinion of the GeneralMedical Council, insufficient; (c) the courses of study in chemistry,physics, and biology in the majority of the teaching institutionsrecognised by the Examining Board in England, but not approvedby the Council, are, in the opinion of the General Medical Council,insufficient;The Council do represent to His Majesty’s most Honourable Privy

Council that the courses of study and examination to be gone through,in order to obtain qualifications for registration from the ExaminingBoard in England of the Royal College of Physicians of London andthe Royal College of Surgeons of England, are not such as to securethe possession by persons obtaining such qualification of the requisiteknowledge and skill for the efficient practice of their profession.The PRESIDENT suggested that (a), (b), and (<?) should be

dealt with separately, and when they came to the final partthere would be opportunity of proposing something else.

Sir VICTOR HORSLEY moved (a). He regretted the absenceof his seconder, Sir William Thomson, but remarked that, aDr. McVail had very properly pointed out, this question inregard to the teaching institutions had already beenanswered-had been answered in the affirmative, and henow asked the Council to complete the answer by declaringthat the examination itself was insufficient. The GeneralMedical Council had appointed visitors to inspect theexamination in question. These visitors had reported andin accordance with precedent the report had been sent to thelicensing bodies concerned for their comments. Thesecomments ought to have been before the General MedicalCouncil at this meeting, but they were not ; they hadcomments from only one of the two. And why hadthey not comments from the two which were said tobe conjoint ? The reason was that the attitude of thesebodies towards one another and towards the GeneralMedical Council was not the same. Dr. Norman Mooresaid that they worked together but that was not the case.As regards the Royal College of Physicians, it not furnishingcomments was an unintentional discourtesy towards theGeneral Medical Council, for if they looked at dates theywould see that the Royal College in question had takenpractically six months to consider this matter. But, besides,they knew that the Royal College of Surgeons, havingdetermined that the examination was the best that couldbe devised, asked the Royal College of Physicians to confirmits view. But it did not. Therefore to say that the two

Colleges worked together was saying something which wasnot the fact. In the circumstances they must consequentlydisregard the Royal College of Physicians and deal only withwhat they had before them-namely, the comments of theRoyal College of Surgeons. He believed that the RoyalCollege of Physicians was desirous of considering thismatter in a fair way ; he was sorry to say that itwas not the case with his own College (the Royal Collegeof Surgeons). Was the examination of the Conjoint Boardadequate ? They had it stated in the report of the visitorsthat the examination was wholly insufficient. The con-

cluding remarks, signed by Sir Henry G. Howse, the latePresident of the Royal College of Surgeons, focussed thewhole thing. Speaking for the Council, Sir Henry Howsesaid :-

We are of opinion that the visitor and inspector are in error in snp-posing that the examination is not sufficient for the purpose for whichit is intended. This purpose is the testing of such knowledge ofchemistry, physics, and biology as a student may acquire in proper

laboratories and under sound teachers in the first year of his medicalstudies.

"For the purpose for which it is intended " had nothing todo with the matter. All the Council had to do was to putforward its opinion, and all he asked was that it shouldsupport its visitor and inspector.

Dr. BRUCE seconded the motion which was carriedunanimously.On the suggestion of Dr. MACKAY, supported by Dr.

McVAm., paragraph (b) was withdrawn as superfluous.Sir VICTOR HORSLEY moved paragraph (c).Dr. BRUCE seconded the proposition.Dr. NORMAN MOORE cautioned the Council against doing

great injustice by adopting this paragraph which, he said,referred only to institutions which the Royal Colleges hadafter visitation recognised as teaching institutions. Thecandidates received from these were, in amount and com-paratively, microscopical.

Dr. MACALISTER said that if Dr. Norman Moore could tellthe Council the numbers that had come from the institutionsembraced in paragraph (e) he thought that they wouldhave before them the crucial figures required in thisdiscussion, for he had always maintained that the ConjointBoard was in this matter simply fighting a shadow. Thenumber of candidates coming from the institutions in ques-tion was, in his opinion, so small that it ought not to form anobstacle to the Council arriving at a proper understandingin the matter.

Sir VICTOR HORSLEY : I myself have no doubt that thenumber is small.

Dr. NORMAN MooRE : You should not, then, cast a slurupon us by condemning the whole body.

Dr. MCVAIL : If the number of candidates is so micro-scopical it is a pity that we should have been fighting overthe matter for ten years. It is quite delightful to have Dr.Norman Moore taking that view now-only now.

Dr. ATTHILL quite agreed that the General MedicalCouncil had been trying to fight a shadow. He was entirelyin favour of revision, but he considered that it must bedecided first whether the English Royal Culleges were tomaintain their legal rights or whether the Council was to goto the supreme tribunal to determine its powers.

After more discussion the words "the majority " were sub-

stituted by "many," and the words "which have been" "

were inserted before "recognised." " The paragraph then

read :-

(c) The courses of study in chemistry, physics, and biology in manyof the teaching institutions which have been recognised by theExamining Board in England, but not approved by the Council, are, inthe opinion of the General Medical Council, insufficient.

’ This was adopted by 20 votes to two.Sir VICTOR HoRSLEY rose to propose the last part of his

motion but he doubted if it should be proceeded with at solate a period of the sitting.

Dr. MACKAY was willing to second the proposition.The PRESIDENT mentioned that there had been put into

his hands this amendment-moved by Dr. Windle andseconded by Sir Christopher Nixon:-That a committee be appointed to confer with the representatives of

all the licensing corporations with the view of ascertaining whethersome agreement can be arrived at as to the following matters inconnexion with the first year of medical study-viz : (a) the subjectsin which instruction should be given ; (b) the places in which instruc-tion may be received ; (c) the examinations which should be held andthe standard thereof ; and (d) whether any of the subjects now includedin that year might be made subjects of the preliminary examination.

Dr. MoVAlL : Put that on the programme for to-morrow soas to give Dr. Norman Moore and Mr. Bryant an opportunityof putting a further statement or views before the Council.We have come to the crucial point : I think we should not

go further to-night.Dr. NORMAN MOORE : It is quite obvious that neither Mr.

Bryant nor myself can express to the Council any absolutepledge as to the bodies we represent. The only kind ofpledge I can give is a pledge to bring the matter before myCollege and to endeavour to get it to adopt the course theCouncil wishes.

Mr. BRYANT : My position is parallel.Further discussion was postponed and the Council

adjourned. ------

THURSDAY, JULY 16TH.The Council resumed to-day, Sir W]ILLIAM TURNER, the

President, being in the chair.After the confirmation of the minutes of Wednesday’s pro-

ceedings the Council as a whole went again into committee

233

for, the PRESIDENT explained, the further considera-tion of the subject before them, and the first item on theprogramme of business, he said, was the adjourned con-sideration of the motion by Sir Victor Horsley, secondedby Dr. Mackay.

Proposed Representation to the Privy Council.The motion was as follows :-That the Council do represent to His Majesty’s most honourable

Privy Council that the courses ot study and examination in chemistry,physics, and biology to be gone through, in order to obtain qualifica-tions for registration from the Examining Board in England of theRoyal College of Physicians of London and the Royal College ofSurgeons of England, are not such as to secure the possession by personsobtaining such qualification of the requisite knowledge and skill forthe efficient practice of their profession.

Sir VICTOR HORSLEY said that since he moved thismotion on the previous day members of the Council hadbeen discussing matters informally and certain alternativeproposals had been put upon the programme of business.He had considered these alternative proposals and he thoughtthat he might put the matter now in a more favourable positionthan he did on Wednesday. The first of the proposals was anamendment to his motion by Dr. Windle. That amendment,however, embodied two propositions, and although he heldthe view that it was not really a competent amendment tohis motion he wished to add that it was not in order at thisCouncil to present two distinct propositions and to take onlyone vote upon the whole. Then there was the notice by Dr.MacAlister. This consisted of two paragraphs. The first ofthese provided that the President should communicate to theEnglish Royal Colleges the resolutions of the Council express-ing its deliberate judgment on the reports by the Educationand Examination Committees in respect to the teaching in-stitutions recognised by the Colleges and the courses of studyand examination in the primary subjects which they acceptedfor qualification for their degrees. If that amendment hadbeen submitted before his motion he should have been veryglad to vote for it, on the understanding, however, that hesimply held over his own motion until the November session.His reason was this-the Council should in its own interestscome to a decision on this matter in a constitutional way asearly as possible. He thought that could be done onlythrough the Privy Council, but the General Medical Councilhad not, he thought, communicated to the Royal Collegesthat the General Medical Council considered their examina-tions insufficient and it would be only proper that theyshould inform them and give them a few months to makestatements on that intimation if made and if they thoughtfit. When the Council met in November he should proposehis motion.The PRESIDENT : I do not think you should formally

commit yourself.Sir VICTOR HORSLEY : I am much obliged to you. I am

quite willing to withdraw my motion until November on theunderstanding that the first paragraph of Dr. MacAlister’samendment is adopted.The notices referred to by Sir Victor Horsley were :&mdash;

Notice of amendment by Dr. Windle, seconded by SirChristopher Nixon :-That in view of the conclusions arrived at in Resolutions 8 and 11 of

the minutes of Wednesday and before proceeding further in relationthereto, a committee be appointed to confer with representatives of allthe licensing corporations with the view of ascertaining whether someagreement can be arrived at as to the following matters in connexionwith the first year of medical study: (a) the subjects in which instruc-tion should be given; (b) the places at which instruction may be re-ceived ; (c) the examination which should be held and the standardthereof; and (d) whether any of the subjects now included in thatyear might with advantage be made subjects of the preliminaryexamination.

Notice of amendment by Dr. MacAlister :-1. That the President be requested to forward to the Royal College

of Physicians of London and the Royal College of Surgeons of Englandcopies of the reports of the Education Committee and of the Examina-tion Committee now adopted, together with the resolutions expressingthe deliberate judgment of the Council thereupon.

2. That the President be further requested to call the seriousattention of the Royal Colleges to the unsatisfactory state of mattersin regard to the course of study and examinations in chemistry,physics, and biology which these reports disclose, and to urge that inthe interest of medical education immediate steps should be taken toremedy the defects in the regulations of the Royal Colleges whichhave led thereto.

Dr. MACALISTER was very glad to hear that Sir VictorHorsley realised that there was still a step to be taken beforethe General Medical Council went to the Privy Council onthe matter in question. The General Medical Council hadpassed two very important resolutions-one declaring thathe examination of the English Conjoint Board in the

primary subjects of the medical curriculum was insufficient

and the other that the courses of study in the primarysubjects in many of the teaching institutions recognisedby the English Conjoint Board were insufficient. Theseresolutions had not been before the Royal Colleges at all.If, then, the General Medical Council went-he should sayprematurely-to the Privy Council and reported its decisionsthe first thing the Privy Council would do would be toask if the resolutions had been communicated to thebodies concerned. The General Medical Council wouldbe in a false position if it had not done so. As aFellow of the Royal College of Physicians of London heclaimed the right to have the facts put before him at or bythe College. He thought these facts must come as&aring; surpriseto many of the Fellows of the Royal College of Physicians. Itwas not only fair, but it was almost a statutory necessity, thatthey should give not only the Royal College of Physicians butalso the Royal College of Surgeons an opportunity of discussingthe matter. No doubt some of the Fellows would feel thatthe thing had now been reduced to such small proportionsthat the Royal College of Physicians must think it ridiculouson its part to strive to continue the absurdity, for owingin some degree to the dispute of the last ten years they hadnot improved the education given in the scientific schools.In view of the very guarded and respectful answer of theRoyal College of Physicians to the inspectors’ report-viz.,that it would carefully consider it-he thought that the

Royal College of Physicians at least might be fairly expectedto give its consideration to important facts put beforeit for the first time and he should be surprised if thatconsideration did not result in the benefit of medicaleducation, the profession, and the public. He moved theacceptance of the first paragraph of his proposal.The PRESIDENT suggested that it might be advantageous

if consent could be obtained to a combination of Dr. Windle’sand Dr. MacAlister’s proposals.

Dr. WINDLE was willing and he thought his seconder,Sir C. Nixon, would also be willing to accept Dr. Mac-Alister’s two propositions.The PRESIDENT : That would leave you entirely free to

move for the appointment of a committee.Sir VICTOR HORSLEY : If Dr. Windle withdraws his pro-

posal as it stands on the paper I would ask Dr. Mackaywhether we should not withdraw our motion in order to havethe first part of Dr. MacAlister’s notice passed.

Dr. MACKAY thought that it was the absolutely logicalconclusion to proceed with the motion after the resolutionsthat had been passed on Wednesday. He should, however, bevery willing indeed that the motion should stand over untilthe last and, if necessary, until the November session. But

they should show the Privy Council that the General MedicalCouncil delayed matters in the hope that something mightarise by which this unfortunate dispute with the RoyalColleges might finally be brought to an end.The PRESIDENT : You will ask leave, Dr. Windle, to

modify your proposal. Then you, Sir Victor, will postponeyour motion.

Sir VICTOR HORSLEY : Yes.The necessary leave to modify was given to Dr. Windle.Dr. NORMAN MOORE did not know whether he would now

be in order in saying anything about Sir Victor Horsley’smotion.

Sir VICTOR HORSLEY : The motion is postponed.The PRESIDENT : I must ask the Council about that.Dr. NORMAN MOORE only wished to point out this to the

Council. They were all trying with their utmost to put anend to a state of things which they regretted. They all hadtheir own views as to how it had arisen. He did not thinkthe Royal Colleges had any share at all in causing it, butthat was a matter of opinion no doubt. Yet it added to thedifficulties of discussing the subject to have a sort of minatoryclause held above them. The Council would not part withany of its statutory powers by not having the particularclause or motion on its paper, but it was quite clear thatno one could fairly discuss a subject when a threat was heldover him.

Sir VICTOR HORSLEY said that he had not asked for thepostponement of his motion in order to get a bargain of such asort. He had asked for postponement on the ground that theRoyal Colleges had not received any intimation of the GeneralMedical Council’s decision. On that ground he had asked topostpone his motion until November.

, Dr. NORMAN MOORE maintained that Sir Victor Horsley’sexplanation did not affect in the least what he had been

saying, for he thought that as the motion had been publishedin the press and had been discussed by the General Medical

234

Council in public it ought now to be carried, rejected,or for the time entirely withdrawn-the withdrawal not

committing Sir Victor Horsley to any principle. As to whatDr. MacAlister had paid, he only wished that gentlemanvould always attend at the Royal College of Physicians andgive them the advantage of the clear intellect and the

powers of speech which he displayed at the meetings of theGeneral Medical Council, and if he did so attend he wouldsee that it was the duty of the representative of the Collegeat this Council to report everything in writing to the College.He certainly should communicate to the College these reportsof the Education and Examination Committees.The PRESIDENT : Not officially.Dr. NORMAN MOORE : It is my duty to inform them

officially.The PRESIDENT : No, it is the duty of this Council.Dr. NORMAN MOORE: I only wish that a formal vote should

be taken in one direction or another on Sir Victor Horsley’smotion or that he should say that he withdraws it in theinterests of the transaction of business.

Dr. BRUCE : I do not see any particular reason why weshould not now dispose of Sir Victor Horsley’s motion.

Sir VICTOR HORSLEY : I ask leave to withdraw the motionuntil November.

Dr. McV AIL: If Dr. MacAlister’s motion is put, and if Ivote for it, I am not to be taken as excluding myself fromvoting at some future time for Sir Victor Horsley’s proposal.

Dr. PYE-SMITH insisted upon the withdrawal of Sir Victor

Horsley’s motion as such withdrawal would leave the Councilfree to discuss Dr. Windle’s proposal.The PRESIDENT put the question that leave be given to

Sir Victor Horsley to postpone his motion until November.Dr. MACALISTER wished to speak against that. If leave

were given to postpone that became an act of the Council.He suggested that the motion and amendment should be put,and if the amendment were carried then Sir Victor Horsley’smotion would be lost.

Sir VICTOR HORSLEY : If there is to be a false issue I askleave to withdraw the motion.Leave to withdraw was at once granted.The PRESIDENT explained that that cleared the ground so

far. He understood that Dr. Windle with consent wouldtake up Dr. MacAlister’s notice and would also propose amodification of his own notice. He asked Dr. Windle to

propose the series in its several parts.Dr. WINDLE then moved Dr. MacAlister’s (1), viz. :&mdash;

(1) That the President be requested to forward to the Royal Collegeof Physicians of London and the Royal College of Surgeons of Englandcopies of the reports of the Education Committee and of the Examina-tion Committee now adopted, together with the resolutions expressingthe deliberate jndgment of the Council thereupon.

Sir C. NIXON seconded the motion which was at oncecarried.

Dr. WINDLE next moved Dr. MacAlister’s (2), viz :&mdash;

(2) That the President be further requested to call the seriousattention of the Royal Colleges to the unsatisfactory state of mattersin regard to the course of study and examinations in chemistry,physics, and biology which these reports disclose, and to urge that inthe interest of medical education immediate steps should be taken toremedy the defects in the regulations of the Royal Colleges which haveled thereto.

He thought what was proposed in this was a step whichshould be taken in consequence of (1).

Sir C. NixoN seconded the motion.Dr. NORMAN MoORE: I think it is quite right that the

Council should forward this resolution, but I cannot helpfeeling that it contains too many adjectives.The motion was agreed to.Dr. WINDLE then proceeded with the modification he

wished to present of his own notice. He movedThat the President be authorised to appoint a committee, consisting

of two members from each of the three Branch Councils, to join withhim in conferring with representatives of the Royal Colleges should itappear that a conference on the questions raised thereon is desired.

He was glad that Sir Victor Horsley’s motion had beenwithdrawn, for he did not wish to go into any confer-ence with any menace hanging over their heads. Hedesired that the conference should be of a friendlycharacter and for the improvement of medical educa-tion and the settlement of a difficulty which had beenfar too long before the General Medical Council. The objectof this committee was, of course, to adjust differences withthe Royal Colleges.

Dr. ATTHILL hoped that Dr. Windle would then proceedwith his notice as in print, or the latter part of that notice, so asto give some instructions-some guidance-to the committee.

Dr. MACALISTER: Dr. Windle’s original motion would be

premature just now. It might be put forward when we havethe Scotch and Irish reports before us.

Dr. LINDSAY STEVEN was very sorry that Dr. Windle hadseen fit to substitute something else for his original motion,as he thought that that motion promised a way out of thedifficulty more securely than the way contemplated by themodification he had now proposed. Dr. Windle had toldthem that his reason for putting forward the modificationwas that the Council was not in a position to confer withall the licensing bodies, but to limit the matter in the wayin which he had now done did not seem to him conduciveto a speedy settlement of it. He was afraid that the changeof attitude simply meant this-tbat the work done at thisspecial meeting of the Council would prove to have been

absolutely useless and that they would have to go over thewhole ground again in November.

Dr. WiNDLE : The report of the Scotch inspection is notbefore us yet. The report of the Irish inspection was handedin, I believe, only two hours ago. Therefore the motion I

originally intended to propose must necessarily have led togreater delay.

Sir C. NIXON regarded Dr. Windle’s modified proposal as astep in the right direction.On a vote Dr. Windle’s motion obtained the support of

22 members and accordingly it was declared to have beencarried.

Sir VICTOR HORSLEY moved that the committee should berequested to report to the November session of the Council.This matter, he thought, was one which ought no longer tobe discussed at the cost of the profession, and it would be sodiscussed, he imagined, unless it were settled in November.

Sir C. NIXON seconded the proposal.Dr. MACALISTER : It is a committee of negotiations ; the

President will report the result.The PRESIDENT : The motion is in rather an unusual form,

as it throws a great deal of responsibility upon the President;the committee would be a President’s committee. I do notknow that the President is called upon to consult theCouncil as to who the members of the committee should beand it therefore seems to me that the President would haveto report; but it is anotber matter how much progress canbe made between this and November if we take intoaccount the fact that two holiday months come in.

Sir VICTOR HORSLEY : We should at least have the know-ledge by November whether the Royal Colleges would enterupon such negotiations.The PRESIDENT : That, at least.Sir VICTOR HORSLEY : I understand then that you, Sir,

will report. I do not press the proposal.The Council resumed and the resolutions adopted in com-

mittee were confirmed.The PRESIDENT, at a later stage, said that he had selected

the following members to form the committee-viz., EnglishBranch, Dr. Windle and Mr. Young ; Scottish Branch, Dr.Finlay and Dr. Bruce ; and Irish Branch, Sir C. Nixon andSir Charles Ball.On the motion of Dr. MACALISTER it was agreed to enter

on the minutes the tabulated statement on next page.

The Apothecaries’ Society of London.Mr. BRYANT read a report by the Examination Committee

on the report by the visitors of the examinations in

chemistry, physics, and biology of the Apothecaries’Society of London as follows :-This examination is in many respects similar to the examination

held by the English Conjoint Board in the same subjects. Thelatter body does not accept the Apothecaries’ examination in lieu of itsown. The Apothecaries’ Society does accept the examination of theConjoint Board. Certain points of difference between the two areindicated in the report of the visitor.Biology.-There is no paper and no practical test, the examination,

as at the Conjoint Board, being of a purely oral character. Conductedon the sames lines as the last-mentioned examination and, as far asthe visitor could judge from the two candidates who alone presentedthemselves for it, the examination is of a very similar standard. Thevisitors consider that the examination would he much improved bythe addition of a paper and practical work. This committee agreeswith the visitors in the recommendation to add a written and practicalpart to the examination in biology.Physics.-The paper work in connexion with this subject consists of

two questions on the same paper as that dealing with chemistry; ofthese questions one must be answered.In this respect the examination agrees with that of the Conjoint

Board, but in addition there is an oral examination, a feature which islacking in the other case. The oral examination forms a part of thatdealing with chemistry and the report shows that it is of a practicalcharacter. The practice of the Society in requiring an oral examinationis commended by the visitors. They suggest that three questionsshould be set in the physics section of the paper, that the candidatesshould be required to answer at least two of these, and that no candi-date should be allowed to pass in physios should he fail to secure’

235

adequate marks in that subject, even if he should obtain 50 per cent. onthe entire paper. With these recommendations the committee concursand, in addition, desires that the subject of physics should be dealtwith in a separate paper.Chemistry.-This examination closely resembles that of the Conjoint

Results of the First Examincation-Cltemistry and Biology-of the Conjoint Examining Board of the Royal College ofPhysioians of London and the Royal College cf Surgeonsof England for the; Ypars 1893-1902, supplied by the Board.

Board, being, according to the opinion of the visitors, stronger in onerespect and weaker in another. It is stronger in that every candidate isrequired to submit to an oral examination, a test which is only de-manded from those on the line by the regulations of the Conjoint Board.On the other hand, it is reported that the practical examination doesnot include the preparation and exhibition of specimens of compounds.The visitors regard this as the most valuable part of the practicalwork demanded by the Conjoint Board. With respect to the practicalexamination the visitors report that the standard is too low and that"it is of a kind that is of extremely little value either as a trainingfor the student’s intellectual powers, or as a preliminary to the studyof physiology, or as giving him something that would be useful to himin his future career." From what has been said it will be gatheredthat the visitors do not regard this examination as a sufficient test formedical students at the end of their first year in the subjects withwhich it deals. With this view the committee concurs. The courtof examiners in its reply thanks the Council for its report andpromises that it shall have careful consideration. This committeetrusts that the deficiencies to which attention has now for the firsttime been called will not merely be noted by the court but that itwill be rectified by the Society and thus bring its examination up to asufficient standard.The committee is in agreement with the visitors " that the average

training of the candidates is insufficient for men who are commencingmedical studies."

The Society’s reply to this report was-The court of examiners thank the General Medical Council for their

report upon the primary examination in chemistry, physics, andbiology, which will receive their careful consideration.

After some remarks by Sir HUGH BEEVOR the report wasadopted.

Dr. MCVAIL said that there was very little differencebetween this report and that on the Conjoint Board in

England. It was a little better in some respects, a littleworse in others, but as a matter of fact it was on all fourswith that on the Conjoint Board. After what had taken

place, what an extraordinary position the General MedicalCouncil would be in if it had to go to the Privy Council-he hoped it never would have to go-and if counsel actingfor the Royal Colleges were to say that with regard to areport similar in character respecting the Society of Apothe-caries the General Medical Council contented itself withmerely calling the body’s attention to it. It seemed butlogical that in this instance they must take similar actionto that taken with respect to the Conjoint Board. Hetherefore movedThat the examination in chemistry, physics, and biology of the

Apothecaries’ Society of London is, in the opinion of the GeneralMedical Council, insufficient.

Dr. BRUCE seconded the motion.Sir VICTOR HoRSLEY asked the Council to remember that

the Apothecaries’ Society of London had accepted the reportof the visitors and, in fact, had expressed appreciation of it,whereas the Royal College of Surgeons did not accept thevisitors’ report, and then there were no comments at all fromthe Royal College of Physicians. So the cases were not quiteparallel.

Dr. McV AIL: You do not oppose ? 7Sir VICTOR HoRSLEY : Oh, no.Dr. MCVAIL : The reply of the Apothecaries’ Society is

very much like the reply of the Royal College of Surgeons ofEngland; the reports are so similar that we must pass asimilar motion.

Dr. NORMAN MOORE could not help thinking that theCouncil should not go on expressing censure on a singleexamination. It was not a very wise thing to do.

Sir HuGI3 BEEVOR wished to know what more Dr. McVailwanted than the reply which the Apothecaries’ Society hadtransmitted to the Council. It was in order that the Societymight consider the situation fully that the reply sent was allthe answer that could be got. It would be impossible for theSociety at one meeting to put in a full answer. He beggedthat the Council would believe that the reply which theSociety had sent was a reply which involved very carefuland full consideration on its part of the Council’s visitors’report and it was not possible for it to send more.

On a vote the motion was carried by 13 votes to 2.Dr. MACALISTER then moved-That the President be requested to forward to the Society of

Apothecaries of London copies of the report of the Examination Com-mittee, now adopted, and the resolution of the Council thereupon, andto urge upon them the importance of improving the scope and standardof education in chemistry, physics, and biology.

This motion was at once agreed to.The University of Oxford.

The next business was the consideration of a report by theExamination Committee on the final examination for the

degree of Bachelor of Medicine of the University of Oxford,the visitor being Sir Christopher Nixon and the inspector SirGeorge Duffey. This report was received and entered on theminutes of the ordinary session in May last.

236

Sir VICTOR HORSLEY : May I ask that this report be takenas read ? ’1 Mr. Bryant reads all reports.

Mr. BRYANT was quite willing to take the report as read.He did not mean to say much as to what it contained but hewould say that he did not approve of all that was stated init by the committee. He had told the members of thecommittee that he should probably explain matters in regardto which he differed from them and they had found no faultwith the suggestion, so "I I came to the conclusion that thiscommittee is ready to recognise the fact that everycandidate-" "

Several Members : What are you reading from ? 7Mr. BRYANT : I am reading from a draft report which I

prepared. I stated to the committee that I would bringforward any parts of my own draft instead of what is pre-sented to the Council.Mr. BROWN and other members objected.Mr. BRYANT : In these circumstances I keep the personal

remarks to myself and I simply ask for the adoption of thereport.

Dr. MCVAIL thought it was peculiar to have a chairman ofcommittee moving the adoption of a report the terms ofwhich he disapproved. Mr. Bryant had only moved formallyas chairman and he quite thought that Mr. Bryant wasentitled so to move and then in the course of the ensuingdebate he could show reasons why the report should not beadopted.

Mr. BRYANT : I do not wish to speak again ; the Councilwill not listen to me.The PRESIDENT : Go on, Mr. Bryant.Mr. BRYANT : I point out the necessity of having some

scheme.Dr. FINLAY seconded the motion for the adoption of the

report.Dr. PAYNE explained that the Examination Committee’s

report had been under the consideration of the University ofOxford and certain changes had been agreed to, while otherswere still under consideration. When these were settled thenew regulations would be submitted to the Council asregulations for examinations to be held in the future.

Dr. NORMAN MOORE;hoped that the Council would notadopt the report. It would be very undesirable to censurethe University of Oxford in such a way. The report was notat all, in his opinion, a judicious one. It must be remem-bered that the University of Oxford had done much tomaintain medical education, although it was not alwaysdone in accordance with the regulations of the GeneralMedical Council.

Sir C. NixoN, the visitor, stated that after careful con-sideration he and Sir George Duffey were obliged to reportto the Council that the Oxford University examination wasinsufficient. It was a great misfortune that a universitylike Oxford should have no fixed medical curriculum.

Dr. MACALISTER thought it was impossible for the Councilto come to a definite conclusion about this report ; matters offact were in conflict. They were told that the regulations ofthe University of Oxford had not been carried out fully by theexaminers ; on the other hand, they were informed that theregulations were under revision at the present time. Con-

sequently it was quite clear that the Council could not doany more than they could do in the case of the Universityof London which informed them that its future examina-tions would be under new regulations. He thought theCouncil must re-inspect the examinations of both Universitiesand he therefore moved as an amendment :-That the consideration of the report of the Examination Committee

be postponed and that the President be requested to arrange for asecond inspection and visitation of the final examination of theUniversity of Oxford during the ensuing year, and that the reportthereon be considered by the Council before a decision is come to as tothe sufficiency of the examination.

Dr. MCVAIL, who seconded this amendment, asked whatwould become of the report in the meantime.The PRESIDENT replied that if the amendment were carried

the report would remain on the Council’s minutes.Dr. PAYNE mentioned that the next examination at Oxford

University would take place in December.Sir VICTOR HORSLEY said that he must vote against the

amendment.On a vote, 17 members supported the amendment which

thereupon was put as a substantive motion and was imme-diately agreed to.

The University of London.Dr. MACALISTER, seconded by Sir CHARLES BALL, moved a

similar proposal in respect to the University of London.

Dr. PYE-SMITH said that he made no comment upon thismotion except this, that he accepted the proposal, and couldassure the Council that the University of London wouldwelcome any inspection to see if it could help it to

improvements.Dr. MACALISTER’S motion was then agreed to.The Council concluded this special session by dealing

in ca11wr&acirc; with a report from its Office-site Committee.However, before rising till November next it, on themotion of Mr. Bryant, passed a vote of thanks to thePresident for his able conduct of the business which it hadhad to deal with.

Looking Back.FROM

THE LANCET, SATURDAY, JULY 23, 1825.FROM

LECTURES

ON THE PRINCIPLES AND PRACTICE OF PHYSIC,

BY DR. ARMSTRONG.

Theatre of Anatomy, Webb Street.

Chorea.Dr. ARMSTRONG considered chorea to originate in irrita-

tion of the mucous membrane of the stomach, or smallintestines, together with a disordered condition of skin, anda consequent torpid or irregular state of the liver and colon.In the progress of the complaint, the spinal cord and brainbecome distended, so as to affect the motion, and at last theintellect. He spoke highly of the laxative plan recom-mended by Dr. HAMILTON senior, and said that he had neverknown it to fail, except in two cases, where the aperientswere mild, occasionally conjoined with an alterative, wherethe diet was at the same time properly regulated, andthe functions of the skin restored by a tepid showerbath, and the influence of a fresh atmosphere. He relateda curious case, in which not only purgatives, but thearsenical solution, the sulphate of zinc, and various othermeasures failed, but in which music had the effect of pro-curing sleep daily, and at last of removing the disorder

altogether. He cautioned the pupils against the free use ofthe lancet, and adduced a case in which it had nearly provedfatal ; but he asserted, that he had seen moderate leechinguseful in some cases where the intestinal lining was

distinctly in a very irritable condition.Hypochondriasis.

Hypochondriasis, mentally considered, Dr. ARMSTRONG

regarded to be distinguished by an exclusive and selfishattention to the personal feelings, so earnest and undivided,as to be very apparent on the first interview with the hypo-chondriac. To this state of the feelings some persons werestrongly disposed by original structure, but it was frequentlyacquired. Sometimes it was associated with that generaldisturbance of the nervous system which is so apt to beinduced, in sensitive frames, by the worry of the world ;sometimes it was connected with local irritation, especiallyof the mucous membrane of the stomach, accompanied by anoverloaded colon ; and sometimes it was produced by mentaking an erroneous view of their own case, supposing it tobe really serious, a circumstance very common amongstmedical men, when their strength happens to be broken up,and when, at the same time, occasions arise to makethe mind anxious. In some instances, hypochondriasis isconnected with organic affections, but this mostly happensin old persons, and seldom occurs at an early age, the looksof the hypochondriac often belying the woeful tale which heso repeatedly relates. The cure of hypochondriasis is to beaccomplished by rightly managing the mind of the patient,and by removing, by mild means, any bodily irritation whichexists. Dr. ARMSTRONG warned his pupils not to indulgesuch patients in wishes to take a great deal of medicine, butto appeal to their common sense, so that they may, at thecommencement, withdraw the mind from the contempla-tion of themselves, and fix it upon some external objectwith interest sufficiently intense, as a diversion from the

distemper.