45

known as the vascular albugo of oculists ; also of

Egyptian and other virulent purulent ophthalmias; incases of severe corneitis, with effusion of blood and lymphbetween the layers, and, in certain of those cases ofviolent inflammation, induced by the introduction of limeand such matters, which, by their chemical action, almostimmediately destroy the superficial layers of the mem-brane, and penetrate to a certain but limited extent."

In many of these cases it has been found that the

opacity is confined to the superficial layers of the cornea,and that they may be removed to a sufficient extent toallow of the free passage of light through the deeper andstill transparent layers of this membrane. The followingis the mode of procedure, described by Dr. Gulz, ofVienna : -" The instruments employed were the cataract-knife,

with a double cutting edge of Rosas, and the pyramidalknife of Beer, together with a small toothed forceps, anda delicate pair of scissors. The eyelids of the patientwere conveniently fixed by the fingers of an assistant,and the cutting consisted in the continuous and repeatedintroduction of the knife, following the motion of the eye-ball, through the external layers, so gradually approach-ing the internal parts of the cornea. The manocuvre re-

quired to be repeatedly and adroitly performed, until thetransparent part was at length reached ; it was then, bythe help of the different instruments, bared to the extentof a line and a half in diameter, the innermost layers ofthe cornea being, fortunately, uninjured throughout, andconsequently the anterior chamber of the aqueous hu-mour remaining unopened. The operation occupiedabout a quarter of an hour in its performance, and afterits completion the vision was improved to such an extentthat the patient could perceive different shades of colours,and the smallest objects, such as the hands of a watch,with facility." The subsequent treatment consisted in the applica-

tion of plasters over the eyelids, so preventing theirmotion ; these again were covered with cold and ice-water, to moderate everything like excess of action ; thepatient was placed in a dark room, and the strongestregimen was enjoined. All appeared to progress favour-ably, and no alteration was made during the first eightdays. At the end of that time the plasters were removed,and a collyrium, first of a solution of hydriodate ofpotash (one grain to the ounce), and subsequently of thesolution of muriate of ammonia, was used."The case.on which the operation here described was

performed, had a most successful termination, notwith-standing the occurrence of a severe attack of inflamma-tion, implicating even the iris. It must be borne in mind

that the operation is not equally applicable in all cases ofopacity of the cornea. On the one hand, "the sentientportions of the eye must be in their normal condition,the perception of light must never be destroyed." The

object being simply to admit the rays of light through thecornea, whatever interferes with their subsequent progressto the retina contraindicates the performance of theoperation; as examples, may be mentioned-adhesion ofthe iris to the cornea, or as it is called anterior synechia,and closure of the pupil. On the other hand, as Dr.Hamilton remarks-

66 The obscurity of the cornea, arising from the thick-ening of its conjunctival covering, constituting the properpannus of oculists; the slighter varieties of opacity,whether of general cloudiness or of local film, and eventhe more obstinate forms of albugo and leucoma, must betreated upon other principles ; and hence the fitting casesfor this operation come to be those in which there is avery considerable obscuration of the cornea proper, cover-ing the whole surface of the membrane, but not extendingthroughout its entire thickness, without synechia, andwith the integrity of the sentient apparatus ; and suchcases are unfortunately too common."

It should be mentioned, that the credit of having insti-tuted this operation is due to Dr.Von Rosas, of Vienna.

THE LANCET.LONDON, MARCH 30TH, 1844.

MEDICAL PROTECTION ASSEMBLY.

We refer with no ordinary feeling of satisfaction to the

report, at page 21, of the proceedings at the AGGREGATEMEETING of members of the Medical Profession. The

utmost enthusiasm prevailed on the occasion, and a more

perfect unanimity of opinion on the propriety of the

measures which had been, and are to be, adopted, wasnever exhibited by a body of intelligent gentlemen.* "

It will be perceived that a committee has been ap-pointed, consisting of enrolled members, for making thenecessary preparations for holding frequent and regularmeetings of the PROTECTION ASSEMBLY, a body which

ought to consist, and will consist, if the profession be true to

itself, of a vast majority of the members of the profession.In that ASSEMBLY all the practitioners of the empire willmeet on equal terms, and be at perfect liberty to take partin the proceedings and discussions.An attempt is thus made, for thefirst time, to afford to

the members of the profession an ample opportunity forconducting their own business, and protecting their own

interests, in their own way. The assembly, in fact, will

constitute A CONVOCATION OF THE MEDICAL PRACTI-

TIONERS OF GREAT BRITAIN AND IRELAND. That it will

prove successful is our fervent and confident hope.It should be distinctly understood. that there is no

system of ballot or election into the assembly, but thatevery legally-qualified medical practitioner, all the

holders of diplomas and licences from the medical col-

leges, halls, and universities, are entitled to enrolment asa right.

EXTIRPATION OF OVARIA.

THE excision of dropsical ovaria, by what is calledthe large abdominal section, having lately attracted

considerable attention in the surgical world, we propose,by a reference to general experience, and a numericalreview of such facts as have been put on record, to exa-mine the question whether that operation be justifiableunder ordinary circumstances ? Such a question with

respect to any operation for the removal of a diseased

part, hinges mainly on the following considerations :-1, the degree of danger or suffering entailed on the patientby the disease; 2ndly, the degree of danger to life atten-dant on the operation ; 3rdly, the sufficiency of the

operation for the desired end; 4thly, ‘the sufficiency ofother means, comparatively unattended with danger, forthe alleviation of the symptoms; and, lastly, the certaintywith which the disease can be diagnosticated, a veryimportant consideration in every case supposed to demanda capital operation in surgery.

* Mr. Baxter, the landlord of the Crown and Anchorstates that twelve hundred and forty gentlemen werecounted as they passed up the stairs to the meeting. Wehad heard the numbers present at the meeting variouslyestimated, but the’ authority of Mr. Baxter settles thequestion.

46

First, then, of the danger or suffering entailed on tht

patient by ovarian disease. Such disease is seldom of a

malignant nature, for although most ovarian tumourscontain masses of matter of a scirrhous hardness, thesemasses are usually of a sarcomatous rather than of a

truly scirrhous kind, and do not pass into ulceration.The disease in a few instances advances rapidly, but, in a

great majority, is of an indolent character. In many

cases it never increases to any great size, though inothers it attains an immense magnitude, contracts exten-sive adhesions, and, by its mere pressure, causes severe

constitutional irritation, peritoneal inflammation, andother disastrous or fatal effects. Till the tumour has

attained a large size it very rarely occasions any seriousconstitutional disturbance, and a vast number of women

carry such tumours through a considerable portion of

their lives, without material derangement of their health,and finally die of some other disease. On the whole,then, we believe that general experience will bear us outin affirming, 1st, that ovarian disease is frequently fatal;2ndly, that more frequently it exerts but little appreciableinfluence on the duration of life ; 3rdly, that it is seldomattended with severe suffering except in a very advanced

stage of its progress, which progress, in most cases, is

extended through many years; lastly, that in a consider-able number of cases it neither perceptibly curtails life,nor attains such a magnitude as to occasion severe suffer-

ing to the patient, or to impair her general health in anyremarkable degree. It is perfectly evident that, in sucha disease, no operation which greatly endangers life

would, in a general way, be justifiable. Let us therefore

consider,

Secondly, the degree of danger to life attendant on the

excision of diseased ovaria. On this subject a just conclu-sion can only be arrived at by a numerical reference toall the cases in which the result of the operation has beenrecorded. There are now on record, as far as we know,thirty-three cases in which the large abdominal sectionhas been practised with the intention of extracting adiseased ovarium. In ten out of these thirty-threecases the operation has been fatal, giving a mor-

tality of not much less than one in three. We mighthere terminate our inquiry, since it is quite clear that an

operation which affords the patient not much more thantwo chances out of three of escaping with life ought,generally speaking, to be considered as entirely out of the

question for the cure of a disease which, in a majority of

instances, neither very materially shortens life nor occa-sions intolerable suffering. But we will proceed with ourinvestigation, because, unfavourable to the operation asthe facts above stated may be, the view of it that mightbe deduced from those facts simply, without any further

details, would still be far too favourable. We proceed,therefore, to remark,

Thirdly, on the stifflciency of the operation for the desiredend, namely, the removal of the disease. Let us here

again have recourse to numbers. In seven out of the

thirty-three cases adverted to above, either no ovarian

e tumour existed, or the extraction of the tumour was

1 prevented by insurmountable obstacles; so that, from3 these data, setting aside the chance of being killed by the, operation, the patient has rather more than one chance in

five of undergoing all the torture to no purpose whatever.. Further, it might naturally be expected that such ineffec-L tual attempts would be attended with greater mortality

than the actual performance of the operation, and accord-

ingly we find that, of the seven cases in which the opera-- tion has been attempted but not accomplished, either

i through absence of the presumed disease, or the presenceof insurmountable obstacles, no less than three have died.

! But we will now comment,’ Fourthly, on the sufficiency of other means, comparatively

‘ unattended with danger,for the alleviation of the symptoms..

A common ovarian tumour, in the earlier stages of its

progress, causes no immediate danger to life, and there

is, in a large proportion of cases, ground to hope that it

may never do so. Under such circumstances, it would

appear to us an act of insanity, if not worse, to undertakean operation for its removal, which has been shown to

bring the life of the patient into the most imminent peril.On the other hand, when the tumour has attained a greatmagnitude, and occasions suffering and danger to the

patient, relief may generally be obtained by tapping todiminish the distention of the tumour, leeches and

counter-irritation to obviate inflammatory action, and

anodynes and other appropriate means to allay constitu-tional irritation. These means will, indeed, require to be

frequently repeated, but is not that preferable to an ope-ration which offers little more than two chances in three

of escaping with life, and that operation resorted to undercircumstances which render the possibility of detachingthe tumonr very problematical, on account of the likeli-hood of extensive adhesions having formed? We hold,then, that in the case of such a tumour, palliativemeasures are to be preferred ; and we entirely subscribeto the opinion Of WILLIAM HUNTER « that a patient willhave the best chance of living longest under it who does" the least to get rid of it."

But, lastly, of the certainty of the diagnosis in ovarian

disease. We find, in surgical writings, ample directionsfor discriminating between ovarian dropsy and ascites,and this, doubtless, is not difficult; there are, however,various encysted and other abdominal tumours, between

which, and the disease of which we are treating, the

diagnosis is by no means easy, while the diagnosisbetween ovarian and some uterine tumours is to the last

degree difficult; Dr. HENRY LEE pronounces it impossi-ble. We think, therefore, on the whole, that they whohave hitherto undertaken the perilous operation of extir-

pating diseased ovaria, have been more fortunate in their

diagnosis than future operators are likely to be. Mr.

LIZARS candidly records one case in which he operated,where no tumour at all was to be found, yet that gentle-man is an able and experienced surgeon.To conclude; in expressing our decided conviction that

the extirpation of diseased ovaria ought not to be ad-

47

mitted among the commonly recognised operations of

surgery, we do so less on the ground of what is called

general experience, which, after all, may be consideredas merely synonymous with general opinion, than on thestatistical ground afforded by a review of the results of

the cases on record. We would ask any reasoning man,whose mind is unbiassed by a personal interest in theoperation, are those results such as to justify its repetitionunder ordinary circumstances ? The writings that havebeen published on this subject are of a very mixed cha-racter. Dr. CLAY’S work is a mere piece of specialpleading for the operation, conducted at the expense of a

complete, though, we trust, unintentional, mis-statementof recorded facts. Thus he states the number of cases

that had been operated on up to the time of his publica-tion, as thirteen, of which twelve were successful, andone fatal; whereas the real number of operations thenon record was twenty-eight, whereof nine had been fatal.

Among the successful cases, also, he reckons two by Mr.LIZARS, in one of which there was no tumour at all, and inthe other the tumour could not be removed; and a case byM.L’AuMONiER, in which an abscess within the Fallopiantube was mistaken for a dropsical ovary. Pretty success,truly, where a woman runs the risk of her life simply forthe honour of being made the subject of an experiment in

surgery! Some of the cases recorded by different writersare very unsatisfactory in their details. Mr. LIZARS,Mr. WALNE, and others, have evinced the most perfectcandour in their statements, and a surgical boldness andskill in the treatment of their patients, which are highlycreditable to them. We cannot, however, but regretthat skill and daring should be thrown away on an under-

taking which is discountenanced by the plainest appealto facts. We do not assert it to be impossible that a case

might occur presenting a catenation of circumstanceswhich would render the operation warrantable; but whatthose circumstances could be, it would, we apprehend,not be easy, à priori, to predicate, and, in a general way,the operation’ cannot, in our opinion, be too stronglycondemned.

MEDICAL RELIEF IN UNIONS.

OuR attention has again been drawn, by a correspondent,to the manner in which medical assistance is administered

to the poor in poor-law unions. Before a person entitled

to relief can claim attendance from the medical officer of

the union an order has to be obtained from the relieving-officer. The necessity for this order, without which themedical practitioner can, and, we believe, generally does,refuse to attend, often occasions great delay, even in

urgent cases, and is thus the cause of much misery. In

addition to this evil, in itself sufficiently great to requirea change, the present state of things exposes the

afflicted poor to another of an equally painful character.The relieving-officer, a non-medical man, often a mereDOGBERRY, actually becomes the arbiter as to the state ofhealth or disease of the applicant, or of the members ofMs family for whom he seeks medical assistance. We

have every reason to believe that, throughout the entire

country, great discontent is felt by the poor, and veryjustly so, with reference to the operation of the medical

department of the poor-law on these grounds. The

medical attendants on the poor are, in reality, the

only fit and proper judges of the necessity for medical

assistance, and by delivering up the latter to the tendermercies of a relieving-officer, whose interest it is, as the

representative of the rate-payers, to deliver as few ordersas possible, legislators have increased the amount of

physical suffering which the lowly born have to bear.Medical practitioners are aware of the great advantage

which is derived in practice by early attention to morbid

symptoms. They are aware that the early treatment ofdisease is half the battle won ; and they well know thatthe physician who shows the greatest skill in detectingthe incipient signs of bodily ailment is always the mostsuccessful in practice. Such, however, are not the

sentiments of the non-medical relieving-officer, whoseattention is always directed to the detection of idlenessand fraud, and who is, consequently, callous, in manycases, to the demands of those whom disease has

attacked, but has not absolutely prostrated.We trust that Lord AsHLEY’s committee will not lose

sight of this important feature in the administration of

poor-law medical relief, and that the evil which we pointout will be effectively remedied by measures that are cal-culated to bring the union medical officers and theirnatients directlv in view of each other.

CHAIR OF CHEMISTRY, EDINBURGH.

THE election of a successor to Professor HOPE, whohas retired from the Chair of Chemistry in the Universityof Edinburgh, is exciting great interest in the scientific

world. Professor HOPE was a distinguished man, and

ably discharged the duties of his important office. His

retirement had been expected for some time. The chairhas now been vacant during several months, and theLord Provost, the Magistrates, and the Town Council, inwhom is vested the right of election, appear to be con-ducting their scrutiny into the qualifications of thecandidates with extreme caution and severity. They areright, and the students of the University, the profession,and the public, will not be slow in expressing their grati-tude for so important a service as the selection, fromamongst the candidates, of the best and most highly-qualified competitor for the vacant office. We should

rejoice if the mode of election were by concours, but asthat system is not yet admissible in the University ofEdinburgh, the Town Council must resort to the moreusual method of discovering the qualifications of thecandidates. Amongst the competitors for the unoccupiedchair Dr. WILLIANI GREGORY, Professor of Medicineand Chemistry in King’s College, Aberdeen, holds aprominent, we think we may say, almost a commandingposition. A pamphlet from the press of NEiL and Co.,Edinburgh, labelled" Testimonials in Favour of Dr.

WILLIAM GREGORY," is now before us, and during the

twenty years that we have conducted this Journal we donot remember having had an opportunity of examininganother such record of testimony in favour of the scientificand mental capability and power of any candidate for a

48

public office. We know not who are the other compe-titors for the vacant chair, but this we hope, that none oithem have any local interests, or connections, which canoperate to the prejudice of the just and honourable claimsof any one of the candidates. The number of testimo-nials (signed with some of the most celebrated names inthe scientific community) amount to thirty-five. We

have always, in contests of this kind, advocated the

CoNCOURS,-that is, election bymental contest, subjectingthe different candidates to a fair, open, honourable trialof their capabilities. That system we still earnestlyuphold, and should rejoice to hear that the Town Councilhad resolved to put it in force in the pending election.In the absence of any such scheme of operation they mustnecessarily resort to testimonials,-instruments which,we regret to state, have but too frequently proved deceit-ful in character. But Dr. GREGORY does not found hisclaims to support entirely or merely upon such evidence.He refers to his own labours in the science of chemistry-the successful operations of his own mind, which have,in fact, obtained for him a reputation as a first-ratechemist, not only in this country but throughout theEuropean continent. In describing his progress whilstengaged in the practical study of chemistry, before hewas elected to the chair which he now holds in the Uni-

versity of Aberdeen, Dr. GREGORY refers to the time spentby him in the laboratory of Professor LIEBIG, in theUniversity of Giessen, whither he repaired, he states, in1841, in order to make himself acquainted with the mostrecent improvements in Organic Analysis. Professor

LIEBIG, who had thus a personal opportunity of observ-ing the powers of mind which Dr. GREGORY could exhi-bit, thus writes, in reply to a letter which Dr. GREGORYhad addressed to him, announcing that he was a can-didate for the vacant chair in the University of Bdin- Iburgh :-

" Gratz, in Styria, Sept. 20th, 1843.« MY DEAR GREGORY,-Your letter has just reached

me, at this place, where the German Scientific Associa-tion is at present assembled. The information which

you give me, that the venerable and excellent veteranof our science, Dr. Hope, has resigned his office of pro-fessor of chemistry, in order to enjoy the repose which, athis advanced age, is so desirable, induces me to urge youto become a candidate for the vacant chair, which youare well qualified to fill, and the duties of which you willperform with distinction, and to the honour of the re-nowned school of Edinburgb. Indeed, were I to be

consulted, I do not know whom I could recommend withmore entire conviction than yourself, since you have erendered distinguished services to organic chemistry, andno one is more familiarly acquainted with this depart-ment of science, which has recently exerted so markedan influence on physiology and medicine. In additionto this, you are most accurately acquainted with inorga-nic or mineral chemistry, as you have proved by yourlate edition of I Turner’s Elements of Chemistry.’

" A chemist who, at the present day, does not make

organic chemistry the chief subject of his lectures,makes himself a stranger to the scientific movement ofhis time, and cannot satisfy the expectations entertainedof him by a whole generation of young and ardentstudents. Your natural inclinations, the tendency of allyour studies, and the familiarity with the subject whichyou have exhibited in the editing and revisal of my twoworks on the applications of organic chemistry, pointyou out, in preference to all others, as qualified to aid incompleting the great work now commenced, which musteffect a salutary and most advantageous revolution inphysiology and agriculture.

11 The university which chooses you to teach thisscience will, in my opinion, be truly fortunate; and Ishall especially rejoice to see you employed, in yournative city, to which you are so strongly attached in so

extended a sphere of usefulness, scattering the goodseed, and promoting the diffusion of knowledge. Fare-

well, my dear Gregory ; let me soon hear that the result’of this election has been favourable to you, of which Ican hardly entertain a doubt.

" JUSTUS LIEBIG."

Higher testimony could not be obtained, and in otherparts of the pamphlet Professor LIEBIG speaks of thecapabilities of his friend in equally strong terms. -

We have not sufficient space to furnish a list of thetitles of the "contributions to chemistry" which Dr. GRE-GORY has published, and we might altogether have re-frained from noticing the election had not we receivedseveral communications which denounce with much acri-

mony the "procrastination" of the town council of Edin-burgh. We are of opinion that the electors have acted withprudence and deliberation in closely scrutinizing theclaims of the candidates for the vacant office, and weunhesitatingly, in opposition to the clamour by whichthey are beset, pronounce a decided opinion in favourof the conduct they have pursued. Earnestly would weadvise them to follow the same honourable and praise-worthy course throughout the contest.Whoever may be the successful candidate, we doubt

not that the electors will have the satisfaction of knowingthat they have elected a man whose reputation will giveadditional reputation to the university, and whose

labours must be productive of the greatest advantage tothe students who may have the happiness of receiving hisinstructions. The caution which they have already ex-hibited in their proceedings leads us to the conclusion

that they will not be swayed by private or local interests,but that they are resolutely determined to elect the best-qualified candidate.

RELIEF OF THE SICK-POOR IN UNIONS.

THE medical officers of the NEWMARKET UNION,whose names are given below, have addressed a memorialto "The Members of the Committee of the House ofCommons appointed to consider the subject of MedicalRelief in the Poor-law Bill now pending in Parliament,"stating that the system of remuneration awarded to themedical officers of that union is regulated upon a pauper-list, by which two shillings and sixpence per head is paidfor medical attendance on patients, and a fixed sum ofseven shillings and sixpence for every special case.They object to this system, not, however, as regards its

principle, because they consider that if fairly carried outit is one of the best plans, if not the best, hithertoadopted between the profession and the public, and inmaking any alteration in it the memorialists say that

they feel assured that " the committee will chiefly haveregard to the comfort and advantage of the sick poor."But the memorialists suggest, that 11 if it were possibleto adopt a system which would facilitate the communica-tion between the union doctor and his patient, in lieu ofthe present objectionable mode of seeking medical relieffirst by means of an order obtained from the relieving-officer, much suffering would be saved to the poor, theprotraction of the case would be averted, and life fre-.quently preserved, besides saving an immense amount oflabour to the ill-paid surgeon. In other words," thememorialists s.ay,

11 the paupers seeking assistance by thespecial-order system are often deterred from applying soearly as they otherwise would, in consequence of the’

difficulty of prevailing on the relieving-officer to consider,their illness to be sufficiently serious to justify his grantingsuch order; the applicants, moreover, often being told’that the order can only be granted as a loan, the conse-’quent delay in obtaining proper attendance thus oftencausing urgent and, in some cases, mortal symptoms to,set in." Pressing these views on the attention of thecommittee, the memorialists add that 11 in the Inde-

49

pendent Labourers’ Medical Club, established in thedistrict of the Newmarket union, under the patronageand sanction of the Duke of Rutland, the Marquis ofBute, and other influential persons of the neighbourhood,members have the privilege of selecting their own doctor,and applying for his assistance at any time when theyfeel to require it, withont losing time by seeking an orderelsewhere." To avoid the evils thus described the memo-rialists earnestly demand a modification of the arrange-ments for supplying medical relief in the new Poor-lawBill, affording to the sick and indigent poor a speedymeans of obtaining assistance when overtaken by acci-dent or disease. They conclude by suggesting that thisdesirable consideration will best be accomplished bystrengthening the power of the poor-law commissioners,as they have altogether ceased to confide in the liberalityof boards of guardians, who are generally actuated byfeelings of miserable economy, or unjustifiable local

advantages, in making their arrangements for providingmedical assistance to the sick poor. The memorial was

signed by Messrs. E. L. Knowles, Alfred Jones, ThomasLucas, Henry Calthrop, Henry Miller, Robert Tyson,W. G. Stutter, Floyd M. Peck, and Richard Faircloth.We are glad to find that the medical officers of the

Newmarket union recognise the propriety of establishingan immediate communication between the sick patientand his surgeon. The proposition, as well as that of

granting the poor permission to select their own " doctor"in the union, first saw the light in this journal, amongstother editorial recommendations for amending rules inparishes and unions. We have this week again alludedto the subject in our editorial remarks.

In a discussion on the poor-law in the House of Com-mons Mr. Wakley proposed and fully described thedetails of the plan that the price 41 per case" having beenfixed, the 11 order" for medical attendance, when obtained,might be always taken by the poor person to a 11 doctor"of his own selection. This recommendation received no Isupport in the House of Commons. I

AGGREGATE MEETINGOF

MEDICAL PRACTITIONERS OF GREAT BRITAINAND IRELAND.

AN aggregate meeting of the profession was held at theCrown and Anchor, Strand, on Monday evening, the 25thinstant, for the purpose of taking into consideration the ne-cessity of medical reform. The number of practitionerspresent was variously estimated to have been from a thou-sand to twelve or thirteen hundred.Mr. ANCELL, on the motion of Mr. DAVIS, of Hampstead,

having been voted into the chair, rose and addressed themeeting as follows:-It is, I believe, generally known toall those present, that a meeting of the profession tookplace on the 29th of January last. The circumstanceswhich led to that meeting were twofold ;-first, a chartergranted by her Majesty to the College of Surgeons, andthe steps taken by the council of that college; and secondly,the declared intention of her Majesty’s Secretary of Statefor the Home Department to introduce into Parliament a

bill, I know not the title of it, relating to the medical pro.fession. At that meeting the unanimous declaration of dis-approbation was made as to the spirit of some part of thecharter, but more especially as to the proceedings of thecouncil in carrying it into effect. (Cheers.) The meetingheld that it was inimical to the public good to sanction bylaw difference of grades amongst medical practitioners.(Cheers ) In the next place, the list of the favoured few,selected from the great mass of our profession, was onewhich, on the face of it, must give offence to a great andrespectable body. The exclusion of practitioners of mid-wifery was held to be a crying grievance, for it amounts tosaying this,-that he who posesses the usual qualifications,but something more, should be excluded from privileges byvirtue of his superior knowledge. (Loud cries of 11 hear,hear.") Rumour spoke various things regarding the newmedical bill ; on the one hand, it is a bill for the improve-ment of the medical profession upon a wide scale; and onthe other, it is said to be framed upon the principles of the

charter. Upon the latter ground, it is feared that it is in-tended to serve the partial interests of a few. Howeverthis may be, the meeting to which I allude felt itself calledupon to appoint a committee, for the purpose of taking suchmeasures as in the best of their judgment they should thinkproper. That committee has met, I may say, night afternight, and been engaged day after day, by its agents andmembers, and its labours have terminated in calling thismeeting. The committee have thought proper to institutea new society, to be called the Medical Protection Assem.bly-(cheers) ;-the name will in some measure convey toyou the objects of the assembly. The committee purpose tobring before you a report of their proceedings, and the firstquestion you will have to decide will be as to the receptionof that report. It is not for me to enter into details, theywill occur in the progress of the business of the evening;nor is it for me to express to you my individual opinionupon the various points to come before you ; but there isone thing to which I think it is my duty to refer ; I believethere is no dissentient opinion as tc <ne great principle uponwhich we all stand together, I mean the necessity of thefull adoption of the representative principle. (Cheers.)Charters have been recently granted to the chemists anddruggists, and to the veterinary surgeons, in which the re-presentative principle has been fully adopted ; every mem-ber is allowed a voice in the government of his affairs-(cheers),-but the medical gentlemen of this empire havebeen debarred this privilege. The questions which comebefore us are totally irrespective of general bodies. I amassured that we are honoured with the attendance here ofrepresentatives of all the great political parties of the state.Some exception was taken to the former meeting as to itsnumbers ; I apprehend none will be taken to this. (Cheers.)But our cause is not to be measured by the numbers whoattend meetings of this description. It is well known thatmedical gentlemen have a greater difficulty than any otherclass of the community in leaving their homes and theirpractice for business of this nature. Again, we have tobear in mind, that the most respectable names in our pro-fession have called for legal enactments, and for medicalimprovement, by pamphlets, and through the public jour-nals, and in every possible way. I may mention Sir JamesClark, Mr. Aston Key, Mr. Green, Professor Grant, anda host of others. Hundreds of letters have been received,giving, with a few exceptions, the most cordial support toour proceedings. We desire that the resolutions which maybe brought forward this evening, shall be calmly and dis-passionately discussed. It may happen that some of thecouncil of the college of surgeons are present; we hope thatmay be the case, and if there should be any difference ofopinion, I am quite sure you are anxious that every ques-tion should be canvassed with reference to the public good.I know my professional brethren well enough to say that Iam convinced no selfish interest alone would excite them tomeet together in the numbers they have done this evening.(Cheers.) The resolutions which will be brought forward,will be proposed by many gentlemen who have taken nopart in medical politics before. It appears to me that

though many eflbrts have been made to convey to the legis-lature, and to our different colleges, the voice of the profes-sion, that we have now, in fact, arrived at a crisis, and thatthe public medical voice will more than ever make itselfheard. The object of the protection assembly will be towatch over the interests of every class of medical men, butthe circumstance which has more particularly called for itsformation is the bill about to be introduced in Parliament.If that bill be a good one in principle, then it is possiblethat we shall assume an attitude in which we can improveor modify it, according to circumstances, in its details; butif it be a bad bill, inimical to our general interests, and thoseof the community, then we may successfully oppose it.When I say that we would not meet together in such num-bers to promote our private interests, I think it should alsobe remembered that the happiness of our fellow-creaturesis more dependent than a superficial observer will allow,upon the learning, the skill, the true respectability, thedignity, prosperity, and the freedom of our institutions.The medical profession ought, in a civilised community, tobe a great political body. I am satisfied of the honesty ofthe purpose which has called you together, and I shall nowresume my seat, in a full reliance, and most perfect confi.