442

THE LANCET.

LONDON: SATURDAY, APRIL 19, 1851.

THE CONCESSIONS OF THE COUNCIL OF THE COLLEGE OF SURGEONS.

IN our last we took the opportunity of placing side by sidethe concessions demanded of the College of Surgeons by theinfluential parties who met Sir GEORGE GREY on the 2nd 01May, 1850, and the concessions which are positively offered bythe Council of the College of Surgeons. We now proceed toexamine how far the Council have yielded to the demandsthen preferred, and in what points thay have refused toconcede them.

The Associated Surgeons averred, in the first place, that theColleges of Physicians and Surgeons, placed on a proper

footing, were amply sufficient for the requirements of the pro-fession, without the institution of a new College. The same

points were urged at still greater length by the ProvincialAssociation, through the President, Sir CHARLES HASTINGS.These points are, as might be expected, amply recognised

by the Council.The Associated Surgeons claimed uniformity and sufficiency

of education for all members of the profession under the two

existing Colleges. The Provincial Surgeons urged, that afterbeing remodelled, the Colleges of Physicians and Surgeonsshould form a joint board to examine in medicine and surgery,with the aid, if necessary, of competent examiners in midwiferyand pharmacy.The Council have, with reference to these proposals, given

it as their opinion that the College of Physicians should ofthemselves test all persons proposing to practise surgery, orto engage in general practice, as to their knowledge of medi-cine ; and the Council offer either to form a board for the purposeof testing the qualifications of candidates in midwifery, or they Iare willing to co-operate with the College of Physicians in theinstitution of examinations for testing the qualifications ofthose intending to practise midwifery. It is not said whether

the board of examiners in midwifery should be formed fromthe Council of the College, or whether it should consist ofobstetric practitioners not having seats in the Council. At

present, as is well known, there are no obstetricians upon theCouncil, but the proposed regulations contemplate the elec-tion of two or, three practitioners in midwifery to the

Council.The Associated Surgeons contended that all who were mem-

bers of the College of Surgeons in 1843, the date of the ob-noxious Charter, should be admitted to the Fellowship asthey attain respectively a standing of fifteen years.In the new resolutions, nothing is said about the standing

at which members prior to 1843 shall be made Fellows. We ebelieve, however, that this subject has been the source of muchdiscussion in the Council. At one of the meetings, the fifteen

years was only lost by a single vote. The discussion has

since been renewed, and we hope the fifteen years will beadopted by the Council, indeed, we cannot doubt it. We areonly surprised that it should have been refused at all.One of the propositions of the Associated Surgeons set forth

that as no fee was demanded of those termed honoraryfellows, there were members in 1843 who claimed to be ad-mitted to the fellowship after fifteen years of membership, Ion the same terms. I

On this point the resolutions of the Council are silent; butthe silence is ominous; and we do not believe there is anyintention of adopting a proposition so liberal and so perfectlyjust. On the contrary, while giving every credit to theCouncil for what they have done, we still fear that the

wish to obtain "a good round sum" for the enlargementof the museum is one of the motives of the Council

in making the recent concessions. The Council say it i

true the honorary fellows were admitted without fees, buta number of fellows have since been admitted to the fel.

lowship by examination, and have all paid fees, and that itwould be unjust to this class to admit new fellows without

the payment of fees. To this it may be replied that an in-justice has already been committed in demanding fees fromthe fellows by examination, and that it will be no more unjustto them to create new fellows from members of from fifteen

to forty years’ standing, than it was to make them pay afterthe creation of the purely honorary fellows. We are curiousto learn what will be the opinions of the great body ofsurgeons respecting the payment of a heavy fine for thehonour conferred in 1843 as a gratuity.The Associated Surgeons claim that fellows resident in the

provinces shall be eligible to the Council, and that they shallconstitute one-third of the Council, and also that fellows

residing in the country shall have the privilege of voting forthe Council by balloting-papers.As regards the first of these points, the resolutions of the

Council are perfectly satisfactory; as regards the second,nothing is said about the mode of voting by fellows residentin the provinces. To be efficient, the voting should un-doubtedly be by balloting-papers, otherwise a large proportionof the provincial fellows would necessarily be disfranchised.One other point, of great consequence, remains to be referred

to. The memorial of the Provincial Medical and SurgicalAssociation declared that nothing would be satisfactory to theprofession short of the complete adoption of the representa-tive principle in the formation of the Council or governingbody of the College, and insisted that a vote in the electionof officers, and in the general management of affairs, should be

given " to all members, without any other restriction than thatof respectability and good character."Here the resolutions of the Council of the College of Sur-

geons fall infinitely short of what was required. The idea of

giving votes to members has not been entertained. It will be

necessary for the Provincial Association to speak out againupon this subject. For ourselves, we hold the principle ofrepresentation to be so sacred, and so accordant with all theinstitutions of this great country, that we would contend forits extension to the greatest possible extent among an edu-cated class, like the members of the Colleges of Physiciansand Surgeons.We have thus entered into a comparison of the chief points

in the official demands of the important bodies who conferredwith Sir GEORGE GREY in May last, and the points of conces-sion proffered by the Council of the College. The matter is

placed thoroughly before the profession, and we trust therewill be no hesitation in the expression of individual or collec-tive opinion on the present state of the medical reform ques-tion.

443THE ASSOCIATED AND PROVINCIAL SURGEONS—PR. SEMPLE AND DB. VIUSPRATT.AT the present moment, when there is much upon which to

felicitate our brethren, in the conciliatory spirit evinced

by the Council of the College of Surgeons, we cannot helpreverting a little to the past. We do so especially for thepurpose of congratulating the Associated Surgeons and theProvincial Surgeons, the men who, after a long and up-hillfight, have been mainly instrumental in bringing about thestate of affairs we now witness.

At one moment all was nearly lost-namely, when the coa-lition of the corporate bodies with the National Institute, inconference assembled, had almost gained over the Ministryand the Lord Advocate. The summons of THE LANCET, andthe efforts it made to have delegates from the AssociatedSurgeons examined before Parliament, turned the scale.These examinations pointed to the real grievance, that no ireform could be satisfactory which did not first adjust the idifferences between the College of Surgeons and its members, iand materially alter the obnoxious clauses and arrangementsof the Charter of 1843. In the evidence of Mr. DREWRY

OTTLEY, the secretary of the Associated Surgeons, were I

traced the benefits that would arise from the adoption,by the

College of Surgeons, of the resolutions which they have nowagreed upon, and it was there shown how unnecessary any newinstitution would become if the College of Surgeonsamended its Charter. The Shropshire petition, which washanded in by that indefatigable reformer, Mr. CnRTavFrGrT, inthe commencement of his examination, expressly stated in itsfirst clause, " that no adjustment of the grievances underwhich the profession has so long laboured can be satisfactory,unless the obnoxious charter of the College of Surgeons befirst rescinded." Since this period, the Associated and Provin-cial Surgeons have fought a double fight, with the NationalInstitute, on the one hand, and with the College of Surgeons,on the other: they have all but annihilated the National

Institute, and the proposed College of General Practi-

tioners ; and they may now pride themselves, that bythe powerful demonstration they made before the Home

Secretary in May last, they have obtained those conciliatoryconcessions from the College, which, though tardy, are never-theless honourable, and to a considerable extent satisfactory.The Memorial which we published in our last, signed by

Mr. WATSON BEEVEB, the Chairman of the Deputation, andthe secretaries, accords entirely with the sentiments of THmLANCET, and points out very clearly what has been judiciouslyconceded,and what should not have been ungraciously withheld.Now that a new prospect dawns upon us, with a chance oflegitimate medical reform, we recommend our friends, the As-sociated and Provincial Surgeons, to be watchful, and to keepup a lively communication with Sir GEORGE GREY.

LAST week we directed attention to the plain duty of theCouncil of the College of Surgeons towards those foolish or

unprincipled Members of the College, who practise the globu-listic imposture. We have now to remark on another pointconnected with that form of quackery, equally involving theduties of medical men towards the profession and the public.’Ve could, if we pleased, name the time, circumstances, and

persons, which gave this form of quackery a considerable im-petus two or three years ago. But for a longer period thanthis complaints have reached us, that certain persons, high in

rank and influence, were not unfavourable to homceopathy.At one time we heard that an eminent physician of orthodoxrepute had prescribed as nearly as possible homaeopathically;then we heard that another was in the frequent habit ofmeeting the homoeopathic quacks in formal and serious con.sultation ; or we were told that orthodox physicians consentedto be called in to give a diagnosis, knowing that, after thediagnosis had been made, the treatment would be committedto the hands of the quack. Occasionally it was statedthat some honourable and public - spirited physician hadrefused to meet the homceopaths; but it generally cameout that the homoaopaths wrote of this as a great hardship,because Sir Something This, or Dr. That, did not refuse tomeet Dr. So-and-So in consultation upon the case of suchand such a Duke or Marquis. From matters of this kind

we have gradually become aware that there is in this metro-polis a set of physicians, high in fashionable practice, butnevertheless resting greatly for their reputation upon thesuffrages of the profession, who habitually stoop to fellowshipwith the homoeopathic quacks rather than offend their aristo-cratic patients. We regret to say, that we have undeniableevidence that this practice is increasing to a most mischievousextent. But we have also come to the determination to puta stop to it, so far as our own influence extends. We cannotremain passive while such a disgraceful injury to our profes-sion exists.

If there could be such a thing as an honest homoeopathicquack, he would be obliged to regard the practitioners ofregular medicine as infatuated fools and murderers. He

must entertain the most supreme contempt for that whichthe true physician holds as true science and legitimate expe-rience. Upon what ground can two such persons meet? Clearlynot upon any honourable basis. There can be no professionaltrust between two such parties. An orthodox physician, bymeeting the quack, surrenders the dignity of his own calling.The only common points are the money, and the pandering tothe foolish caprice and fashion of aristocratic men and

women.

This should not, and must not be. We know of no meansof preventing it, but publicity. We do not wish to revivethe past. But for the future, we beg to say, that we willpublish the particulars of every meeting between quacksand those who pander to them in the sense we have

been expressing. We invite our correspondents, particularlyin London, to give us notice of such proceedings wheneverthey come to their knowledge. Every man who will do thisconfers a service upon the profession-upon all honest menwithin its ranks. Every man who disguises such turpitude isin some degree a participator in the offence. Let us then

receive facts relating to this monster alliance; and whomso-ever they may affect, high or low, they shall go forth pub-licly to the profession. Neither name nor rank should, fromany false delicacy, be hidden. Our desire and our intention

are to sift and expose this matter thoroughly.

WE trust that on a re-perusal of the letter at page 441,Dr. SEMPLE will see that he produces very cogent arguments in

favour of the recognition of Dr. SIIERIDAN MusrRATT’s lecturesby the Examiners of the Apothecaries’ Society. We quiteaccede to the propositions of Dr. SEMPLE as to the general rule,

444 THE NEW EQUITABLE ASSURANCE OFFICE.-ANALYTICAL SANITARY COMMISSION.

but such an exception as that of Dr. MUSPRATT would only goto prove the rule. The teacher is confessedly unexceptionable.If proof can be given that the lectures certified have reallybeen delivered and attended, it matters little whether theywere delivered at a medical school or not. There is nothingspecial in the course of medical chemistry, and we believethere are few medical men, professors of chemistry, in anyof the great schools of medicine. One point in Dr. SEMPLE’Sargument particularly strikes us. Dr. MuspRATT considers the

recognition of his lectures by the University of London andby the College of Surgeons a reason why the Apothecaries’Society should also recognise him. Dr. SEMPLE sweeps awaythis argument because the University of London conductssevere examinations in chemistry, and because the College ofSurgeons does not conduct such examinations ! We trust weshall have to congratulate both Dr. MUSPRATT and the Societyof Apothecaries on the recognition of his lectures deliveredin the Liverpool College of Chemistry.

THE Directors and Managers of a very considerable portionof the Life Assurance Offices of London are suffering severelyfrom an intermittent fever. At one time the symptoms runvery high, and exhibit much of violent action and excessiveheat; at another time they are of a low typhoid character,and indications of despair are strongly manifested. The pri-mary cause of all this severe suffering is to be found in theterrific shock to their nervous systems which was produced bythe establishment of the New Equitable Company, and themental depression which was subsequently entailed by theConscience-stricken reflections that irresistibly resulted fromthe great injustice which for a long series of years had beenpractised by them towards the members of a noble profession.They now find that the day of retribution has come, and thatthey are plunged into a purgatory of their own creation, fromwhich it is somewhat difficult to escape.The success of the New Equitable is the source of the

present torment. The annoyance is so severe and distracting,and interferes so much with the quiet and rational operationsof once sober minds, that the sufferers are resorting to in-sane manoeuvres to counteract the influence which the scheme

of the New Equitable is everywhere producing in the ranksof the medical profession-that profession which has been solong injured and insulted—and also amongst a very numerousportion of the respectable classes of society. Whining andsubmissive circulars can now be addressed to the profession;offers of paying a guinea fee can now be made, in quarterswhere no acknowledgment that anything was due could bebefore obtained. Civility can now be practised, and goodmanners rendered apparent, in other situations, where pre-viously the members of the medical profession encounterednothing but contumely and insult. How is this?-Simplybecause the discovery has been made, and men have beenfound with sufficient resolution and foresight to carry it intopractical operation, that in conducting the important socialbusiness of life-assurance, the members of the medical profes-sion are entitled to receive, and can be awarded, a satisfac-tory remuneration for their services.Thus, then, the question stands at this moment. In theory

the old offices contend that medical referees ought not toreceive any fees for their professional reports, and they furnish

a practical illustration of their belief in the soundness of thattheory, by refusing all payments accordingly. Some offices,yielding to a sense of justice, award a fee of one guinea to themedical referee of the party whose life is proposed forassurance. The New Equitable, broadly acknowledging theimportance of medical testimony, honestly, and at once,

acknowledges the medical referee of the assurer to be theirown medical adviser in the case, and considers that he is

entitled to at least two guineas for an elaborate carefully-prepared medical report.What, then, will be the result of the conflict between

justice and injustice! 1 Clearly, that the example furnishedby the establishment of the New Equitable will have theeffect of obtaining for the profession an ultimate recognition,that the fee awarded by that Company is a just one, and mustbe conceded.

Already an actuary of the highest distinction has acknow-ledged that the plan of the New Equitable is perfectly sound,and that its practice with respect to medical referees can bepursued with complete safety and-he might have added-withunparalleled success.

THE

ANALYTICAL SANITARYCOMMISSION.

RECORDS OF THE RESULTS OF

MICROSCOPICAL AND CHEMICAL ANALYSESOF THE

SOLIDS AND FLUIDSCONSUMED BY ALL CLASSES OF THE PUBLICS

BREAD,AND

ITS ADULTERATIONS.(Concluded from p. 425.)

IN that Section of our Report on Bread which appeared inTHE LANCET of the 5th inst., we announced the discovery ofthe true development of the YEAST FuNGUs, and gave a de-scription of that curious production.

Its development, as we stated, is divisible into three verydistinct and natural stages, as follows :-

First Stage, or that of Sporules.-In this, the ordinary statein which the yeast-plant is met with, it consists entirely ofsporules; these are for the most part separate, but sometimesfeebly united in twos, threes, and even in greater numbers;they vary in size and form; some are several times smallerthan others, and nearly all contain one or two nuclei, whichare the germs of future sporules.

Second stage, or that of Thallus.-After the lapse of somedays, and under favourable circumstances, the sporules becomemuch elongated; a division or partition appears in each, andit now consists of two distinct cells; the extension still con-tinuing, other septa appear, until at length jointed threads, atfirst simple and undivided, afterwards jointed, are formed, andthe plant now exists in the form of root-like threads or

thallus.The yeast-plant in the state of thallus constitutes theMyco-

dernaa Oerevisiae of Desmagières.Third Stage, or that of A ërial Fructifeation.-After the lapse

of a further time, vertical threads spring up from the thallus;these, when the plant has reached its complete development,become branched, each branch bearing at its extremity a rowof rounded and beaded corpuscles.These corpuscles are about the size of the larger sporules,

but differ from those bodies in their darker colour and firmertexture.

Occasionally in the rows of beaded corpuscles one cellseveral times larger than the rest is seen.To this description we now add engravings illustrative of

the structure and development of the Yeast Fungus.