458

THE LANCET.

LONDON: SATURDAY, APRIL 29, 1865.

THE GENERAL MEDICAL COUNCIL.

THE final reports of the Medical Council in session for the Ipresent year are published in our columns this week. Theybear upon matters not less interesting and important than thediscussions during the earlier days of sitting. We hope never

again to be called upon to devote so large a space to these de-liberations : but it is unlikely that the necessity will recur.The Council cannot again find it necessary to sit for fourteendays discussing at large questions involving first principles ofeducation, of registration, of examination, and of legislation.This seventh session has been by far the most important yetheld. In recording at length the proceedings, we are writinga history of the most radical changes yet made in the constitu-tion of the profession, and the motives which influenced theirpromoters. Of this a brief review of their transactions will

afford evidence.

The Council has at last sent up to Sir GEORGE GREY an

amended Bill for his consideration, containing an improved Iform of the 40th Clause, which will enable the public effec- ztually to distinguish between qualified and unqualified prac-titioners, and will render it impossible for a person not pos-sessing a qualification to practise under the false pretence ofholding a qualification, or to call himself by those titles con-

secrated by time and custom to the use of men duly educated I,,and qualified. It has adopted this amendment in its most

stringent form, that which is undoubtedly the most effective,and which could be worked most simply and certainly. The

clause, as amended, requires that all persons who practisemedicine or surgery, and assume medical or surgical titles,shall register those titles. This compulsory registrationsolves all the greatest difficulties, and thus recommends itselfin the interest alike of the public and the profession. But

then it is an instrument of great power ; it arms the Councilwith an authority which may be abused for a purpose verydifferent from that intended. And one of the last acts of the

Council this year has been of a character to show that it

would use this power, not only to distinguish unqualifiedfrom qualified persons, but to secure a practical mono-

poly of degrees to the existing corporations, and to pre-vent any other bodies from entering into competition withthem. Dr. STORRAR’S motion, to introduce the new degreeof Bachelor in Surgery of the University of London into

Schedule A, was opposed, on grounds the most transparentlyinterested and avowedly selfish, by Mr. ApNOTT, who wasbacked in his opposition by Mr. HARGEAVE, the represen-tative of the Irish College of Surgeons, and by Mr. COOPER,of the London Society of Apothecaries. That which was a

public question was converted into a faction fight. The right ofthe University of London to have its diplomas registered isso plain that only the judicial blindness arising out of selfish-ness could have prevailed over the simple equity of the claim.Mr. ARNOTT pleaded the cause of monopoly with a sort of

lachrymose despair, which impressed his comrades in the surgical

interest with the notion that their destiny was involved in his,.and that a common fate threatened to involve them in ruin. By amarvellous second-sight he foresaw the discouragement of " the

great schools of medicine in the metropolis." He threatened

the Universities of Oxford and Cambridge, the various Collegesof Surgeons and the Societies of Apothecaries, with that terriblewoe-a cheap competition of other universities. He ignored

the fact that the great business of the Council is to regulatethe competition from the scientific point of view, by makingknown what they consider requisite as a sufficient course ofeducation and examination, and representing cases of deficiencyto the Privy Council for correction, and that this is the verylanguage of the resolution adopted by the Council as a

reason for not requiring any amendment of the 20th Sec.

tion of the Act. Mr. ARNOTT passed over the abstract

consideration of the general duty of the Council to the pro-fession and the public. He spoke as a suffering corporator, andappealed to the pity while he inflamed the passions of hisfellow-corporators, for whom he predicted a common fate.

Mr. CoopER, in the same strain, observed that the examina-

tions of the Apothecaries’ Hall were sufficient, and he saw nonecessity for any new qualification. Dr. CoRRmnrr "could

not but sympathize with Mr. CoopER, and he agreed with himin thinking that this was an efforts on the part of the Univer-sity of London to extinguish the Apothecaries’ Company"!Thus the question of corporate interests predominated, andpublic rights were stifled. It is a curious fact that the Dublin

University has acquired the right of registering its licentiatesin surgery, and that several licentiates appear on the Register;their number, however, is so limited that it might well havesuggested to the representatives of the Colleges and Societiesthat, after all, the " shop" might not be so much threatened,and that this move of the University of London boded no

such direful consequences as were conjured up. At any rate

it is evident that the Council has greatly weakened its

chance of prevailing on Government to grant parliamentary! powers for making registration compulsory, seeing that theCouncil has shown itself capable of abusing those powers byan act of selfish oppression. We augur from this an alterationof the amended 40th Clause in its passage through the House.

I In the matter of education and registration the Councilhas completed a code which is in most respects highly satis-factory. A preliminary examination in letters is declared

essential at the one end, and final examinations before the ageof twenty-one proscribed at the otiier. The professionalexaminations are to consist of two parts-one in the middle,the other at the close of the professional education, and theyare to be made as practical as possible. To ensure the good

! working of the examinations, to obtain the means of com-’ paring them, and for their systematic supervision, the ex-cellent proposition of visitations was this year for the first

, time affirn-ieft in principle. It seems to be the fate of the

Council to be incapable of affirming a proposition and carryingit into due effect in the same session; and a very efficient

, means has been taken of preventing the visitations from

being effectually carried out by passing a resolution on thei last day that they should not be paid for. They would thus. become peculiarly odious. In lieu of appointing paid inspec-’

tors, officers of the Council, having a strict duty to perform in, all openness, honour, and impartiality-the duty of observingL and comparing methods and ways of examining throughout

459THE REPORT OF THE CORONER FOR CENTRAL MIDDLESEX.

each country,-this resolution substitutes amateur unpaidvisitors, any member of the Council, in fact, who pleases forthe nonce to assume the office ; and in the performance of hisunpaid duties he is of course at liberty to indulge more orless his own dilettante notions of how such a duty is to beperformed, with what regularity, to what extent, and in whatlocalities. As we have said, this resolution is destined tocrash out the life of the visitations for this year ; but the propo-sition has been affirmed, and probably even the present absurdarrangement will yield so much of good result as will showthat the visitation of examinations is a good thing, which onlyrequires to be developed with order, system, and complete-ness. It may be hoped that Dr. CoRRiGAN’s motion for

opening the oral examinations to the attendance of an in-structed p-ti’olic will be renewed. The experience of the

English universities and of the foreign medical schools has

proved practically that this is free from inconvenience, whileit affords safeguards and guarantees, both to the examined andthe examiners, which no other plan can give. This, however,the Council, if it have the will, has not the power to enforce; it

could only recommend, and the licensing bodies are singularlyrecalcitrant to recommendations. On the whole the Council

and the profession may he congratulated on the codificationof the principles which are to govern the admission, education,registration, and examination of candidates for medical quali-fication to practise. Beyond doubt one great effect of the passingof the Medical Act, and the subsequent labours of the Council,has been a general elevation of the educational standard, and anassimilation of the modes of educating and testing the fit-

ness of candidates. The returns received from the licensingbodies show a gradually decreasing number of exemptions frompreliminary education. These various returns are very useful,and the lists of rejections, ivhen compared with the reports of Ivisitors as to the character of the examinations, will afford the

,Imost valuable tests of the action of the various licensingbodies, and will do away with any facilities for lowering thescientific stringency of examinations in view of enlarged com-petition which some of the older corporations (themselvesnotorious sinners) affect to fear. The Medical Council haveshown a becoming public spirit in considering the PharmacyBills now before Parliament. The report of Dr. AcLAND’s

Committee was a very able document; and the profession andthe public will owe something to the Council if they succeedin introducing into the Pharmacy Bill a clause directly dis-couraging that bastard medical practice at present carried on

by unlicensed chemists and druggists, and which is fraughtwith danger to life and health. It is especially the poor,and above all the infant children of the poor, who are

the sufferers by this kind of parody on prescribing;and there is no doubt that the coloured bottles of

the chemists in poor neighbourhoods are false lights whichhave brought many a poor creature to woe. The Council will

be heard with attention and respect by the Committee on theBill; and the modifications which they propose will, we be-lieve, be adopted either in their present or a slightly alteredform.

In respect to the Pharmacopaeia, we understand that theultimate changes will be such as we have called for in thename of the profession, and as will, we believe, entitle the

next edition to be considered a real standard which may be

uniformly adopted with convenience and safety throughout

the three kingdoms. The errors which have been pointed outwill be carefully corrected. The whole of the sheets are under-going thorough revision. Every new preparation in vogueand esteem will be added ; none at present in the book willbe omitted. The familiar names expunged will be restored ;and the dose of each article will be indicated under its properheading. The suggestion, too, which we made before the pub-lication of the last volume, and which was not then adopted,will be carried out this time. The sheets of the new editionwill have a limited private circulation given to them to enable

suggestions and corrections to be sent into the committee

before the final touch is given, instead-as happened last time-of their being carefully locked up and scrupulously concealedfrom the profane view until they were issued only to provokea savage and destructive criticism.

Thus the twelve days’ work of the Council, although bear-ing the stamp of indecision and of factious interests inseparablefrom the vices of its composition and the peculiar incapacityof individual members, presents enough of important progressand of earnest reform to justify the great interest which the.

profession take in its proceedings, and to vindicate its cha-

racter as our highest directing power. If it were less nume-

rous, less difficult to assemble, less directly and distinctivelyrepresentative of the individual interests.of licensing bodies,it would more easily rise to the height of its importantmission.

THE Second Annual Report of the Coroner for the CentralDistrict of Middlesex is well deserving of public and profes-sional attention. Dr. LANKESTER discusses in a practical,philosophic spirit the results of his official observations duringthe year ending July 31st, 1864. It appears that in the course

of one year the number of inquests had increased by 191. This

startling fact is stated in the Report to be attributable to twocauses : First, the natural increase of population ; and secondly,the increased vigilance of the summoning officers. The increaseof the population in Dr. LANKE8TER’S district during the yearis estimated at 25,000, which, according to the average of pre-vious calculations, would account for but 40 of the total increaseof inquests held, leaving the larger number of 151 to be

attributable to the better supervision exercised by those officers

appointed by Dr. LANKESTER. The knowledge that in all

instances where death is surrounded or accompanied by ex-

cpptional circumstances, a complete inquiry must ensue, cannot bfail to exercise important influence on the conduct of thosewho may be submitted to the examination such inquiry entails.True, that where an inquest is anticipated, much that is crime.nal may be concealed, but not less true is it that such antici-

pation frequently leads to precautions, the practical operationsof which are greater care and attention to the dying. For the

closer scrutiny instituted under his régime Dr. LANKESTER is,therefore, justly entitled to public thanks.

In this Report particular attention is direct6d to the

increase of inquests under the head of accidental deaths.

Within the year 70 additional inquests have resulted in

that verdict. This Dr. LANKESTER attributes, first, to theincreased traffic in the streets of London; and secondly,to the enormous development of building interests in the

centre of the metropolis. The amount of injury whichI results, as matters of every-day occurrence, in consequence

460 THE REPORT OF THE CORONER FOR CENTRAL MIDDLESEX.

of the crowded state of our thoroughfares, is scarcely suf-

ficiently estimated. Within the district presided over byDr. LANKESTER sixty-four deaths were occasioned duringthe year by injuries from cabs, omnibuses, vans, and bykicks from horses. The Report points out that one-half ofthese accidents occur to persons above forty, and a largenumber to those above sixty years of age, where the powers of

activity are impaired. Dr. LANKESTER suggests, for the

diminution if not prevention of such calamities, that a lessrapid rate of transit be insisted on over recognised crossings,and on turning the corners from one street to another. He

believes that by such an arrangement much life would be

saved. The mortality from these causes can scarcely be con-sidered as an index of the amount of injury they occasion.Dr. LANKESTER states, as the result of his observation and in-

quiry, that where one person is thus killed and becomes thesubject of a coroner’s inquest, at least ten are more or lessseriously injured, and are unfitted for a time for active life, ormaimed for the rest of their lives. We have already directedattention to this matter. It needs but a moment’s reflection

to see the vast difficulties which beset the question. The

street accommodation of London is in every respect unequal tothe requirements of its traffic. The rapid transit of heavily-laden waggons and vans at all hours of the day is now almosta commercial necessity. If their course be for a moment in-

terrupted, whole streets become at once blockaded, vehicles

interlocked, and injuries of a more or less serious character arethe usual result. It may be that the metropolitan improve-ments in progress will somewhat mitigate these evils. The

proposed conjunction of the metropolitan lines of railway,affording a means of transmission from station to station, mustdiminish the number of those carriers’ vans that tower above

all other vehicles, and seem each moment to threaten theirdestruction. The question of mortality from street injury hasnever been sufficiently discussed. Within the London district

a larger number of lives are lost from these causes than fromrailway accidents throughout the entire kingdom. The latter,being more or less referable to the management of directingboards, are rarely lost sight of; while the former, being ques-tions of police jurisdiction, are seldom heard of beyond thedistricts in which they occur. Whatever steps may be mostadvisable, one thing is certain, that no provisions have

been made by the authorities to meet the requirements of theincreased traffic ; but the same narrow alleys, sharp corners,and removable obstructions remain as were sources of incon-

venience when trade was but half of its present extent.

The enormous development of building industry in the centreof London is considered as having largely increased thenumber of deaths from accidental causes. Dr. LANKESTER

has no hesitation in ascribing the large majority of acci-

dents in building operations to the rashness and carelessness of the workmen, who in many instances deliberately set

at nought the precautions of their masters, and not unfre-quently receive their injuries while in a state of intoxication.

In his observations on deaths arising from accidental causes,Dr. LANKESTER directs attention to the fact that some forms

of accident appear to be susceptible of little alteration, theincrease of the second year not being greater than is explainedby increase of population. Thus, the number of children suf-focated while in bed with their mothers was 90 in the first

year, and 92 in the second. The cases of drowning were 21 in

the first year, and 26 in the second. The cases of burning inthe first year were 4S, in the second 51; of scalding, 23 in thefirst, and 25 in the second. These numbers afford interestingproof of the habitual routine of the labouring classes. The

same habits and practices are continued, notwithstanding thefatal consequences to which it is known their indulgence leads,and the same results follow. Each one hopes that theirs willbe an exceptional case, and no one admits the danger till thefatal issue has occurred. Certain forms of these accidents

admit of prevention entailing neither trouble nor expense.

Thus an examination of the details of deaths from burningshows that amongst both children and women in nine casesout of ten the constant use of a fire-guard would prevent theseaccidents. Dr. LANKESTER observes that amongst the poorthis article of household use is regarded as one of the thingswhich may be dispensed with, and consequently it is not

bought till some alarming accident warns them of the dangerof living without one. On this ground, Dr. LANKESTER urgesupon those persons who are connected with societies for the

promotion of comfort amongst the poor, and who distributearticles of clothing, to include fire-guards in their gifts, andthereby diminish the hazard and loss of life as well as of

clothes by fire.Dr. LAXKESTER discusses the question of infanticide as

one deserving of the most serious consideration by the Legis-lature. The late Mr. WAKLEY is known to have devoted

special attention to this important subject. His tables of the

inquests held on newly-born children are, if any necessityexists for further proof, confirmatory of the statement of

Dr. LANKESTER that infant life is a matter considered of

little moment in the metropolis of this Christian country. In

the year 1862-3 Dr. LANKESTER held 68 inquests on newly-born children. In 1863-4 there were 56 verdicts of " Wilful

murder" returned, 8 open verdicts, and 5 of " Accidental

death;" giving in all 69 deaths of new-born infants. In everyinstance the mothers were acquitted of the capital crime,and this frequently against evidence of the most obvious and

convincing kind. "The fact is," observes Dr. LANKESTER,66 the prosecutor, judge, and jury are all anxious to avoid averdict which consigns to death a woman who, in nine casesout of ten, has been more sinned against than sinning." This

will probably be the case as long as the law inflicts or threatensdeath for infant murder. In the whole range of legal andsocial inquiry we know of no question more important thanthat which revelations of this character suggest. It was

urged against institutions for foundlings that they affordedfacilities for debauchery. Their want seems to act as a stronginducement to crime. Which alternative offers the least of

evils : the support by the State of forsaken infants; or thesupport by the State of those mothers found guilty of theminor offence ? The result to which Dr. LANKESTER’s re-

searches and reflections lead him are worthy of the mostserious consideration of both legislators and philanthropists.He observes : " Our legislation was at one time ferocious withregard to the destruction of infant life. A reaction took

place, which has placed us in our present position, in whichupwards of 150 dead children are annually found in the

streets of London. It is not too much to suppose that where

one child is found, another is necessarily hidden for ever. In

cases where the mothers have been discovered, their ageshave averaged about twenty years. As it is not to be sup-

461THE PENALTIES OF MIDWIFERY PRACTICE.

posed the same woman commits this crime a second time, andas the expectancy of a woman’s life at twenty is forty years,this would give the large number of 12,000 women living inLondon alone who have thus secretly destroyed their off-

spring." That these facts are sufficiently extensive and

alarming to. demand special inquiry, cannot for a moment bedoubted. That the poor women induced to commit such

crimes are, in the great majority of cases, without means of

supporting the infants so destroyed, is too true. Dr. LAN-

KESTER states that in an institution in London, where the

illegitimate offspring of poor girls are supported, it has beenstated that, of seventy-five children provided for, there wereonly two instances where the father had contributed anythingto their support. Under such circumstances it is that crime

is resorted to as a means of getting free from an incumbrancethat, in many cases, precludes the mother from obtainingthe means of support.We shall return to a consideration of the further matters

contained in Dr. LANEESTER’S valuable report, inasmuch

as we believe that there is an imperious necessity for someefforts on the part of the Legislature to meet those obligationswhich a practical examination of the operation of our presentlegal and social system proves to be essential for the preventionof crime and the protection of life.

. __- I

CoRONERs’ jurymen and others, who sleep soundly in bedunconscious of the inexorable summons of the "night-bell," "

are apt to think lightly of the wear and tear which is the lotof the poor doctor. If a wretched creature famishing ofhunger be tempted to steal a penny loaf from a baker’s win-dow, we do not find that the baker is denounced as a monsterbecause he prosecutes the thief. Nor do we remember a case

in which any baker or butcher has been dragged before acoroner’s jury, branded with an indignation-verdict, and

hissed at in foaming newspaper-leaders for having denied astarving fellow-being the loaf or the bit of meat that mighthave saved his life. It is only the doctor who lives underthis sort of tyranny. A loaf of bread is sacred property;professional skill, the rest that tired Nature craves, the reposeof a family, if the case be a doctor’s, are not property-thatis, not his own property but that of the public. Verily, apleasant thing is vicarious virtue—twice blessed is the benevo-lence that is exerted at the doctor’s cost-comfortable is it to

dispense charity riding on the doctor’s back, and noble to digthe spurs well in the doctor’s side if he prove restive or falter

under the burden ! ’.

The most recent practical illustration of this well-recognisedsubjection of the medical profession is afforded by an inquestat Holloway. The facts, as accepted by the jury, are as

follows :—MARY GREEN’, expecting her sixth child, engagedMr. GARDNER for a fee of 15s. Prior to the confinement this

gentleman disposed of his practice to Dr. ALFRED BUTLER.Upon this, Mrs. GREEN, being in labour, sent for Dr. BUTLERin the night, when the arrangement stated was explained tohim ; part of the fee was offered to him at the time, and pay-ment of the rest promised by instalments. This Dr. BUTLER

declined, and advised the friends to "go to the parish," orseek other assistance. The husband applied to the IslingtonWorkhouse, where he was told that to entitle his wife torelief he must bring the marriage certificate. Time wearing

on, the husband applied again at Dr. BUTLER’S house, but tono purpose. At last, at eleven A.JB1., the assistant of another

surgeon attended ; the poor woman was delivered by turningof a dead child, and soon after sank. The uterus was found

ruptured. The jury found the following verdict :-" That

the deceased, MARY GREEN, was found dying, and did die,from the mortal effects of a rupture of the womb during child-

birth ; and the said jurors further say that the said death wasaccelerated by the refusal of assistance by the surgeon to thesaid MARY GREEN after having commenced his professionalservices. "

! This is the case as the jury took it, and which, if strictly

true, will appear a justification of their verdict. But the

main facts which would attach responsibility for the care ofthe poor woman upon Dr. BUTLER are formally denied by him,as will be seen by his letter. He did not accept the patientas a part of his transfer from Mr. GARDNER ; when takenout of his bed he went to the patient; he found her a st:-anger ;no fee was offered him ; he saw no likelihood of his beingpaid; that at this time labour was so little advanced that thepresentation could not be made out ; that she -was, therefore,in no instant danger when, thirteen hours before her death, hedischarged himself from all responsibility by advising thehusband to apply to the parish.The two statements widely differ. Taking the facts as set

forth by Dr. BUTLER, the verdict of the jury, which, in terms,is based upon the opposite assumption, could not be justified.We may put aside, as altogether against moral or legal right,the idea that MARY GREEN, being destitute and in labour, had

any claim, on the ground of charity, to call a private medicalpractitioner to her aid. It is the duty of the guardians of thepoor to provide for such a case, and we do not believe that lawany more than humanity would excuse them for letting awoman die in labour because the marriage certificate was notproduced. It clearly appears to us that the jury ought atleast to have included the parish authorities or officials in theircensure. But, then, jurors are often guardians, and guardiansjurors.The question arises-Was Dr. BUTLER bound to accept the

statement of the woman that an engagement had been con-tracted with his predecessor; and if so, to take that engage-ment upon himself ? And, secondly, whether or not this beanswered in the affirmative, was Dr. BUTLER, being in thepresence of the case, warranted in throwing it up ? Could he

then escape from responsibility ? One thing is obvious : thehusband ought to have made a definite arrangement as to thecare of his wife instead of trusting to accident, or presumingupon the much-taxed charity of the medical profession. It

would have been better if Dr. BUTLER had ascertained the

right of the husband to summon him, and his inability to paybefore leaving his own house; although it certainly does notfollow that because a medical man is called to the bedside of a

sick person under the belief that he is to be paid, he is

compelled to see the case out. The same right that enables apatient to dismiss the doctor, enables the doctor to dismisshimself. Still, in a case of labour the emergency is so greatthat it must be admitted, as a general rule, that a medical

practitioner in attendance ought, before withdrawing, to see

the patient placed in other hands. Dr. BUTLER assumed too

much when he concluded that the guardians would im-

mediately take charge of the patient lie had declined.

462

The conclusion we draw from the case is, that there is a

want of adequate provision by the public for taking care of

destitute women in childbed ; and that the public cannot wrapitself up in its benevolence, and shift the blame of its own

laches upon a small section of its body. The only protectionagainst gratuitous demands upon his time and skill that themedical practitioner possesses is the right of refusal. If this

very reasonable right were not exercised, the medical manwould be, even more absolutely than he is at present, thevictim of recklessness and dishonesty ; and he would sink un-pitied, ruined in health and purse, the worn-out drudge ofsociety.

Medical Annotations.

THE MEDICAL SERVICES OF THE ARMYAND NAVY.

"Ne quid nimis."

WE have of late received frequent letters from naval medicalofficers complaining of the disadvantages affecting them rela-tively with their brethren of the army. So greatly has thisspirit of discontent animated that useful body, that the esprit ’

de corps which dignifies a service and attracts ambitious spiritsinto it appears to us to be waning under the shade of which- our correspondents complain. We say this because we havebeen urged to advocate the abolition of the medical departmentof the navy and its amalgamation with that of the army, asformerly existed in the East India Company’s service, whichhad but a single medical staff.The promoters of this change state that since 1805, when,

by order in Council, equality of their class in its several gradeswith the corresponding army grades was guaranteed with theRoyal signature, the Admiralty they serve under has persis-tently declined to carry out the spirit of the Royal grant, andthat the dissatisfaction engendered by it is injurious to H.M.service. They allege also that the army department, possess-ing the machinery of a medical school for training officers inthe specialties of war service, with which the navy is unpro-vided, is in a position to undertake the supply and distributionof the medical service of the State in a manner to ensure con-

tentment, as then the best men of the combined services wouldobtain that equality which the medical officers of the navyhave expected in vain through half a century.-

Plausible as this scheme may appear to some, we cannot

stamp it with our approval, as we are convinced of its ruinousresults to the officers and seamen of her Majesty’s navy; be-cause the discomforts of ship life would tend more than everto render the navy the last resort of every member of the com-bined medical service. But of this we are satisfied, that oneyear’s trial of that system would raise a clamour from everybranch and grade of the sea service that would compel theAdmiralty to re-establish the medical department of the navyin its integrity, and on an equality with that of the army.which is the object sought by its present staff of officers, ancto which they are justly entitled.However much it may be regretted that this state of discon-

tent exists, it indicates the necessity of inquiry how far thereare grounds for it; as the public service is retarded and de-ranged where it demands an ample supply of medical talent,which, in its higher class, is allied with an honest ambition for.distinctions not now attainable by service in the Royal navy.The Active List of the navy presents a body of 600 medicalmen, in which the grades of surgeon and assistant-surgeon arenearly balanced : two-thirds of these surgeons, and all buteleven of the assistant-surgeons, are actively employed. In

fact, the medical officers are, in time of profound peace, at

the lowest number consistent with working condition, the

greatest pressure being in the grade last entered; and, fromthe depreciation of the navy in the medical schools, youngofficers of moderate capacity are not obtainable, on the presentterms, to remedy this great defect. In the event of war, re-course may again be had to the humiliating expedient adoptedduring the Russian war, when first-year students.were eagerlyengaged by the Admiralty to supply the surgical necessities ofthe fleet.

Referring to the correspondence already alluded to, it ap-pears that one of the grievances complained of very generallyis, deficiency of honorary distinctions awarded to naval sur-geons ; and it is shown in a letter published in our columnsnot long since that while army officers had received elevenC.B.s and ten Victoria Crosses, the only distinction awardedto the navy is one C.B., and that to an officer whose equal inthe army in the same war-service had been rewarded with theK.C.B.At that time we regarded this as sufficiently illustrative of

the working of the present system. Relying on this unques-tionable evidence, it is with forebodings of the future in itseffects on the officers and seamen of her Majesty’s navy, andalso as guardians of the honour of the medical profession, thatwe are compelled to notice and to direct in time the attention ofthe Legislature to the lately printed gazette of promotions in,and admissions to, the Order of the Bath, which displays thenames of only two army medical officers-for we could point toothers deserving of honour in that corps,-while we express a

sincere regret that we are unable to enumerate a single navalmedical officer whose services have been deemed worthy ofsimilar recognition.Unless it be the policy of Government to sacrifice everythingelse to gain candidates for the army, we regard this as an ill-timed show of partiality, at the moment when the medicalschools are sending forth their annual supply of young medicalmen seeking professional occupation.SUBURBAN DWELLINGS FOR THE LABOURING POOR.

THE Earl of Shaftesbury recently, in a highly practical speech,brought the condition of the labouring classes under the con-sideration of the House of Lords, with the view of mitigatingthe evils incidental to the many metropolitan improvements inprogress. His Lordship proposes that it be incumbent on those

promoting schemes involving the destruction of dwellings occu-pied by the poor to satisfy the House that other homes are avail-able for the residence of the inmates whom it is intended to dis-

place. He also proposes that ail occupiers receive two months’notice of removal, irrespective of the nature of their tenancy.Official returns show that the number of houses to be removed,or in course of removal, amounts to 3500 ; so compelling 20,000persons to migrate, in many instances, to a distance from thelocality in which they are employed. We have already dwelton the inconvenience of such a course. That in process oftime the vast public works now causing so much inconveniencein their construction will prove beneficial no one doubts. It

is the sufferings of the intermediate generation that commendtheir claims to the consideration of the Legislature. The ques-tion is one deserving of serious attention. In a commercial

point of view, building schemes for the benefit of the workingclasses have not been attended with that success which followson more venturesome speculations. Five per cent., with a smallreserve fund, has hitherto been the maximum of their dividends.The speculator who invests capital for the sake of its returnsgrumbles at this amount as not sufficiently remunerative. Thisis beside the question of its safety. Timid investors love thesecure simplicity of the three per cents. There is no reason

why an equally profitable and safe, but a much more useful; employment for money, might not be found in some well-i organized and largely-conceived scheme for the erection ofsuburban villages as residences for the London artizans.