59

THE LANCET.

LONDON: SATURDAY, JULY 16, 1853.

MR. HEYWOOD’S BILL ON THE UNIVERSITIES’.

IT is well known that the Universities of Oxford and Cam-

bridge are ecclesiastical institutions, and that the advantages,honours, and emoluments in their gift are only dispensed tothose who are prepared to prove their orthodoxy by subscrip-tion to certain tests. But although the ruling principle is thesame, there is a marked difference in the practice of the twoUniversities. At Oxford the schismatic is arrested in limine;he cannot so much as proceed to matriculation without sub-scribing to the Thirty-nine Articles. At Cambridge no oathor subscription to the Thirty-nine Articles is required untilthe period of proceeding to the first or Bachelor’s degree.There is nothing therefore to prevent a man from pursuinghis education at Cambridge, although he may not be a memberof the Established Church; but he cannot take a degree, oracquire the civil rights which are attached to its possession.

It is not our present purpose to discuss whether these

restrictions are based on justice or good policy, but to callattention to the nature of the changes which Mr. HEYWOODproposes to effect, and to some circumstances bearing upon thisquestion. Mr. HEYWOOD has given notice of his intention tobring a Bill into Parliament for the purpose of effecting thefollowing modifications in University procedure:-

" Subscription to the Thirty-nine Articles, and the takingof the Oath of Supremacy, not to be compulsory at matricula-tion in Oxford.

" Declaration of allegiance to the Crown, and of obedienceto the authorities of the University, to be substituted for theoaths of allegiance and supremacy, for subscription to thethree articles of the thirty-sixth canon, containing a declara-tion of the Royal supremacy in all spiritual things, a promiseto use the Book of Common Prayer, and an acknowledgmentof the Thirty-nine Articles, in Oxford, and for the subscriptionto a declaration of bond fide membership with the Church ofEngland in Cambridge, as well as for the declaration ofobedience to University statutes, &c., on taking the firstdegrees in arts, law, and medicine, both at Oxford and Cam-bridge."The effect of the above modifications is obvious. Should

the Bill be carried, every obstacle, founded upon -religiousscruples, to taking degrees at the old Universities would be 1

removed. They would no longer be the fortresses of the

orthodox, but free seminaries for the members of every com-munity, on the simple condition of declaring fealty to QueenVICTORIA.

Such is the aim of Mr. HEYWOOD’S Bill. Let us advert to

some of the circumstances bearing upon the question. There

can be no doubt whatever that the foundation of the Univer-

sity of London is owing to the exclusion of Dissenters andothers from the older universities. Oxford and Cambridgemight make good a legal title to preserve their exclusive

rights. At any rate they stood strongly entrenched behindthe authority of ancient custom, of possession, and of theopinions or prejudices of an immense proportion of the in-fluential classes of the country. From this positloa it wouldhave been difficult to dislodge them. But it was competentfor the aggrieved parties to urge that, inasmuch as they wereexcluded from all the benefits of academical education, andthe privileges attendant upon university degrees, they had an

indefeasible right to have an University of their own. Aftera, struggle in which the advocates of religious equality wereopposed by ’the bigots of the old universities, and warmlyand honourably seconded by the liberal and far-seeing, theprinciple of founding a new University, free from all religiousdistinctions and disabilities, was carried.The University of London, then, must be regarded as a

compromise. In it the non-orthodox classes of the communitywere to find full compensation for the damage they sustainedby exclusion from Oxford and Cambridge. We believe thatthis arrangement has received the general assent of the

injured parties; and it must be conceded that the successiveGovernments and Parliaments, since the creation of the new

University, have not been slow to recognise the compact, orto give effect to the terms of the arrangement, as occasionshave offered. Colleges open to the votaries of every religiousfaith are spread throughout the length and breadth of theland; an academical education is within the reach of everyone; degrees in Arts, Law, and Medicine are attainable bythose who can satisfy the examiners as to their competency;and lastly, the Legislature has from time to time attached tothe degrees of the University of London those civil privilegeswhich are enjoyed by the graduates of Oxford and Cambridge.We believe there is no instance of a right or an exemptionbeing accorded of late years to the Universities of Oxfordand Cambridge by Parliament, which was not at the sametime extended to the Metropolitan University in fulfilment ofthe pledge of equality. The London degrees in Arts nowlabour under no legal or civil disadvantages as compared withthose of Oxford and Cambridge; and in addition to the weightof accumulated precedents, a Ministerial acknowledgment hasbeen made that " the contract is morally binding upon the"Government to consent to no Medical Bill which does not

"place the graduates of London upon an equality with those" of Oxford and Cambridge."

Convocation cannot much longer be delayed; and it is un-derstood that the extension of the franchise to the Universityof London will be one of the features of the Reform Bill ofnext Session.

That the University of London has been practically r-4-garded as the equivalent for exclusion on religious groundsfrom Oxford and-Cambridge is further illustrated by the

history of the Supplemental Charter granted in 1849. One of

the provisions was expressly framed to meet the objection ofMr. HEYWOOD. Any student at Oxford who may have seenreason after matriculation, and before graduating, to abandonthe Church, and any student at Cambridge who, having gonethrough his academical course, may demur to subscribing tothe Thirty-nine Articles, is empowered to present himselfbefore the examiners of the University of London for hisdegree.

-

,

That the University of London has flourished beyond,pre.cedent is well known; that the Dissenters, as a body, havelinked their cause to the new University is equally true. Itmust therefore be an anxious question whether Mr. HEYWOOD’Sproposal be well-timed-whether it be likely to bear any otherfruit than that of discord and bitterness-whether it be notcalculated to retard the settlement of a contest which is nowin a fair way of being determined by the generous rivalry andfree competition of the old and new Universities.Some thirty years ago, indeed, before the foundation of the

60 THE DISINGENUOUS CONDUCT OF THE AUTHORITIES AT ST. THOMAS’S.

University of London, the impediments to graduation at

Oxford and Cambridge, which it is Mr. HEYWooD’s object toremove, were peculiarly oppressive and injurious to the pro-fession of medicine. At the period we refer to, none butOxford and Cambridge graduates could become Fellows ofthe College of Physicians, and the monstrous result was this:that no Dissenter could be a Fellow, that a monopoly of the

highest medical honours were secured to the Church. The

College of Physicians was no less Episcopal and Æsculapian.But the College has been forced to abandon this position, andis now glad to admit into her bosom the London graduate,without inquiring whether he be of orthodox faith or not.

.

We have been prompted to make the foregoing remarks bythe consideration that Mr. HEYWOOD is, or was, the chairmanof the committee for obtaining the franchise for the Universityof London. From this circumstance it might possibly beinferred that the Senate and the Graduates were parties toMr. IIEywoon’s scheme. We believe that nothing is furtherfrom the truth. Mr. HEYWOOD’s association with the franchise

movement of the University in no way renders him responsiblefor the opinions of those with whom he is associated; stillless does it imply that Mr. HEYWOOD is the exponent of theviews of the Graduates. The Graduates appear to havewisely and steadily kept in view the single purpose of

developing and perfecting their own University. They havenever evinced the slightest desire to attack the constitutionof the older Universities. The conciliatory policy they haveadopted cannot fail to be attended with the happiest results.The sense of justice, no less than the suggestions of prudence,will prompt the Universities of Oxford and Cambridge, tolend their hearty co-operation in abolishing every restriction

upon the development of their younger sister. They will notbe slow to perceive that it is in the extension of every rightto the University of London which they themselves enjoythat they will find the greatest security for the preservationof their own.

IT is a curious and very remarkable fact- that influence and

not talent-that wealth and not position, have of late yearsguided in many instances the choice which governors of

hospitals have made in the appointment of individuals to fillthe vacancies that from time to time have occurred in their

establishments. And it is more curious still to find how, not-withstanding these disparaging circumstances, those institu-tions have managed to acquire so many gentlemen of reallycommanding talents and undoubted skill. It has, however,long been a subject of regret, that the personal bias of aworking governor, or the undue influence of a treasurer orpresident, or the " worked-up" patronage of the managingcommittee, have so often brought in a less able or juniorcolleague, to the prejudice and injury of another, who withoutthe same personal power, had, by his longer services at theinstitution, gained a more commanding and just claim on theconsideration of the authorities. Indeed, we witnessed our-selves a few years since, a gentleman, of very inferior mentalcapacity, a junior surgeon at a hospital, who through thepossession of some very unamiable qualities was treated withextreme coldness by his colleagues, while he was the laughing-stock of a large school, who yet was able to triumph overevery obstacle, and to defeat, through personal wealth, alecturer, who was an older officer-a man most popular

among his equals, and the idol of his school. It would beinvidious to say more than that we sincerely hope suchanother instance of hospital tactics may never occur again.No doubt it was the recollection of some circumstance like

this, and a knowledge of how injuriously and perniciously itacted upon the status of the school, that has led the authoritiesof St. Thomas’s to issue the announcement we are about

to notice. On the 15th of last month, we read in the dailypapers an advertisement stating that a vacancy had occurredin the surgical staff of St. Thomas’s Hospital, which was openfor " free competition" to all who by talent and positionin the medical world were qualified to be candidates.

The governors asserted that they took this course becausethey were desirous of maintaining and increasing the efficiencyof their staff, by the election of men who were known to bepossessed of " distinguished talent, character, and acquire-ments;" and also in order that all considerations of a purelypersonal nature should be dismissed from their minds. What

statement, at a primâ facie view, could be more frank andliberal ? But only thirteen days-a very brief period for ahospital election-was to be permitted to elapse between theannouncement of the vacancy and the selection of a candidate.

We acknowledge that we read this proposal with

extreme surprise, not because it was a proceeding diametri-cally opposed to the conduct of all other hospital authorities,but because it was extremely improbable that candidates ofthe high position and talents the Committee desired, wouldbe able to come forward in the few days allotted; and, also,because we considered that the elder assistant-surgeon-Mr. SOLLY-was a gentleman, who by rank and talent, andlong and zealous service, was pre-eminently entitled in everyrespect to be unanimously elected to the vacant appointment.Our view was correct. But it appears that Mr. SOLLY is in a

very peculiar position with reference to the surgical staff ofSt. Thomis’s Hospital; and that he has a still stronger claimthan that with which his long and able services furnish him,to the confidence and support of the authorities. Some years

ago, Mr. GREEN resigned his hospital duties to Mr. SOLLY, andalthough he retained his title as one of the surgeons, hasin reality been only the consulting-surgeon. The reason of

this no doubt being referable to the hospital committee, whowere glad to retain Mr. GREEN’S high name on their staff.Thus, Mr. SOLLY has for a long time been for all purposesone of the surgeons of the hospital. Nor, singularly enough,has he stood alone in this particular, for Mr. LE GRos CLARKalso, we are informed, performs the same friendly offices forMr. SOUTH, while Mr. SIMON, a gentleman who holds no officein the hospital, but is the professor of pathology in the medicalschool, has had forty hospital beds under his control. Could

any system of bad management be worse than this ? What

ill-consequences naturally followed ? Why, that Messrs. SOLLYand CLARK’S time was wholly occupied in fulfilling the dutiesof the surgeons, and that their own proper department, thatof visiting and prescribing for the " out-patients," was neces-sarily neglected. It was delegated to the house-surgeons, andthey in turn left it to their dressers, or even to some of thepupils as the case might be; for house-surgeons at the metro-politan hospitals generally have duties of their own sufficientlyarduous and laborious, without being called upon to performthe work of the assistant’surgeons.The whole system pursued at St. Thomas’s is in every de-

61DR. HUE AND THE COMMITTEE OF ST. BARTHOLOMEW’S HOSPITAL.

partment worthy of severe reprehension. It is unjust to the

junior surgeons, who perform the work of their elder colleagues,that they should not be recognised in the position to whichthey are clearly entitled; it is unfair to the house-surgeons ordressers that the severe labour of the out-patients’ departmentshould be thrown upon their shoulders; it is very exception-able conduct to all the pupils who are educated at the School.And now the authorities, as if they were not satisfied that

their conduct in every respect was very culpable-unconvinced,we suppose, that in advertising the high name of Mr. GREENas one of their surgeons, when he had long been nothingmore than an occasional " consultant"-unconvinced that theywere displaying a false and glittering bauble to lure pupils totheir School-heedless how their proceedings were alreadyopen to the severest criticisms-actually go out of their wayto gain credit for a generous statement, when it turns out

to be only an empty vaunt! Is it not clear to every one, that

when the authorities advertised the vacancy that had occurred

in the surgical staff of St. Thomas’s-when they declared thatthe appointment was open to all for the freest competition-tS it not clear to every one that at the time they made thatannouncement they were pledged by every principle of equity-by every tie of gratitude-to acknowledge the faithful

services of the man who for years had been, in all but name,one of the surgeons of their hospital-to elect him to theappointment without opposition ! This, we need not say, theGovernors have done. Their statement of the 15th of June

was therefore most disingenuous, for it had the effect of

deceiving some of the first men in the profession, and ofleading the public to believe in a, promise on which theGovernors could not in the present instance act with pro-priety. Such proceedings bring great discredit on any School,and if repeated will be fraught with considerable injury tothat of St. Thomas’s Hospital.

THE annual meeting of the Committee of Governors, for thepurpose of considering the re-election of the present membersof the hospital staff at St. Bartholomew’s, will very shortlytake place. The grave statements that in the course of the

last few months we have been called upon to publish, thesevere and welf-established accusations that have appearedin our columns, and the weighty and important interests thatare at stake,-all urge us to direct the attention of the pro- ’’,fession and public in general to the detailed facts of the case.There is not a more painful task in the whole range of oureditorial duties than that of being compelled to call publicattention to the decrepitude of age. Now the position ofDr. HuE, and his conduct with regard- to the students of

St. Bartholomew’s, may be very briefly explained. He has,we believe, been connected with the hospital, either as

teacher, or assistant, or principal physician, for about fiftyyears. But it has been recently stated and proved on all sidesthat for nearly a fourth of that period, natural infirmities

have interfered with the satisfactory discharge of the arduousand responsible duties of his-post. The emoluments, however,of his office are considerable; and as he still continues toenjoy them without the slightest reduction, we think thestudents have every principle of equity and common fair-

ness on their side when they demand that if he cannot un-

dbrgo the labour of his hospital duties he shall resign his

officer and that if he does not afford them instruction as a

teacher, he s7tall give up the emoluments he derives from thatposition. With these proposals, however, Dr. HUE disagrees.The aged doctor feels that he has got a " snug berth." But the

responsibilities that devolve on a man who holds the honourableand coveted position of head of the medical staff of a greathospital are very serious. For surely, if to any one, it wouldbe he to whom pupils would look for the practised diagnosis,the finished tact, and the consummate skill, which the lesserexperience of junior teachers often does not enable them tocommand in an equal degree; surely it would be he whomthey would treat with the greatest deference, and regardwith sincere respect ? But it is au often repeated statementthat Dr. HuE’s hospital work is discharged in a dilatory andan inefficient manner; and that though he receives from themedical pupils a large sum, yet he ignores the duties of ateacher. These are the plain facts, that a host of the studentsof St. Bartholomew’s have communicated to us. But for the

present we refrain from expressing our views. We merelydesire at this moment to impress upon the governors thatcomplaints of a most weighty nature have been made againstDr. HUE; and that we are only performing our duty whenwe demand that a searching inquiry be immediately instituted,before they consider the propriety of re-electing him to hispost. We advise, too, our young friends at St. Bartholomew’sto trust in the candour and justice of the governors, for amongstthem are some of the highest and most influential personagesin the realm-men of spotless character and untainted in-tegrity. For our own parts, we feel sure that the governorswill gladly take advantage of this opportune moment, eitherof vindicating the character of a faithful servant, or of dis-missing from their staff an inefficient officer.

NoTHiM can more strongly indicate the necessity of somemode of determining with accuracy who are, and who are not,qualified members of the profession, than the late disgracefulabortion case. In this, upon the mere ipse dixit of the

prisoners, it is stated that they are legally-qualified prac*titioners, and, upon the assumption that this statement is

correct, the- character of the profession generally has beenassailed. Had the police magistrate, in the first instance,or the judge at the trial, had an authorized list of qualifiedmen to refer to, such a mistake could not have occurred, andsuch a stigma would not have been placed upon the honourand respectability of a noble profession. Even the opponentsto registration admit the evils of the present systen, whilstthey doubt the efficacy of the remedy. But what would be

thought of the physician who, acknowledging the severity of adisease, and the necessity for prompt treatment, stands idlyby and sees the patient sink without an effort to save him tA person unqualified, who calls himself an attorney or

solicitor, and who practises in any way as such, is liable to beprosecuted for a misdemeanour, and if found guilty is punishedwith severity. This stringent law has been found most effec-tive in protecting the public from the harpies who used toinfest our courts of law, falsely calling themselves lawyers.Is the health of our citizens of less importance than theirpocket If the distich quoted so triumphantly by SiR JAMBSGrBAHAN be right-

That the pleasure is as great,In being cheated as to cheat,"

62 ROYAL MEDICAL AND CHIRURGICAL SOCIETY: SMALL-POX AND VACCINATION.

it holds equally good with a man’s property as a man’s health,a bankruptcy in the latter being at least as disastrous as thatof the former. Are we then to have " shameless men," with-out the slightest pretence to the titles, to parade themselvesbefore the public in obscene advertisements, pamphlets, andflimsy pieces of paper, as professors, doctors, and surgeons ?Or, on the contrary, are we to have such protection fromthese knaves and pickpockets as a wholesome Registration Billwill afford ? To the opponent of such a measure we recom-mend the inspection of the advertising columns of a countrynewspaper, and the pamphlets daily paraded, or the perusal ofthe filthy bills which will be thrust into his hand on any dayof the week between Charing-cross and Hyde-park-corner !

.

THREE men contract with the Board of Works to cast in

bronze the bas-reliefs for the Nelson column. They under-take that each bas-relief shall contain three tons and a half

of bronze, the bronze to consist of one part tin, and ten

copper. The temptation is great. They supply about twotons of bronze, and make up the complement of weight withiron and plaster of Paris. A mechanic goes into a shop inTottenham-court-road, and contracts for a pound of coffee. I

The temptation is small. The shop-keeper supplies half-a- I

pound of coffee, and makes up the complement of weight withchicory.The Board of Works regard the offence against them in a

criminal light. The men who sell iron for bronze are indicted,found guilty by a jury, and imprisoned for two months. The

man who sells chicory, or other trash, for coffee, is patted onthe back by the Treasury, and protected. Is there fraud in

the one case and not in the other ? Is it penal to rob thepublic purse, and laudable to pick the pocket of the individualcitizen, and to poison his health ? Will our dialectic Chan-

cellor of the Exchequer help us to reconcile this apparentcontradiction ? We have a coalition-Ministry; have we alsoa coalition between right and wrong ? Assuredly an explana-tion is called for. The public will be anxious to learn whetherthey are to take the Board of Works or the Treasury for astandard in morals. They can hardly adopt both.

Medical Societies.

ROYAL MEDICAL AND CHIRURGICAL SOCIETY.

TUESDAY, JUNE 28, 1853.—DR. COPLAND, PRESIDENT.

ON SMALL-POX AND VACCINATION : ANALYTICAL EXAMINATIONOF ALL THE CASES ADMITTED, DURING SIXTEEN YEARS, ATTHE SMALL-POX AND VACCINATION HOSPITAL, LONDON; WITHA VIEW TO ILLUSTRATE THE PATHOLOGY OF SMALL-POX, ANDTHE PROTECTIVE INFLUENCE OF VACCINATION, IN DEGREESVARYING ACCORDING AS THE VACCINATION HAS BEEN PER-FECTLY OR IMPERFECTLY PERFORMED. By J. F. MARSON,Resident-Surgeon to the Small-Pox and Vaccination I3os· Ipital, London.

(Communicated by DR. CfiowNE.)

I

(Communicated by DR. CaoWNE.)

DURING the period comprised within this analysis small-poxhad been epidemic four times-in 1838, 1844,1848,1861; andrather more than half of the patients admitted into the hos-pital had been previously vaccinated. Much anxiety aboutthe degree of security afforded by vaccination had begun tobe felt, and the author thought the profession would be inte-rested ; and much useful information perhaps might beelicited by classifying and arranging the patients admittedduring the above-named period. The analysis referredprincipally to the following points:-

I. Natural small-pox.II. Small-pox after small-pox.

a. After natural small-pox.b. After iuoculation.

III. Small-pox after vaccination.a. Number of cicatrices.b. Character of cicatrices.c. Vaccinated, but without cicatrices.

IV. Febrile eruptive diseases mistaken for small-pox.A remarkable difference was observed between the vac

cinated and unvaccinated patients, and also between thevaccinated cases themselves,-some patients having thesmall-pox in a mild form, wholly devoid of danger, whilstothers had it in great severity, scarcely if at all lessened bythe previous vaccination. Under these circumstances theauthor thought that the causes of this remarkable differencemight be sought for among the antecedents in respect to thevaccination of each individual admitted, with a view to explainthe extreme mildness of some cases-the danger, unmitigatedcourse, and even death of others. Small-pox in the unpro-tected remains to this day as virulent as it ever was. Vaccina-tion, when performed in infancy, affords almost completesecurity against the fatality of small-pox up to the period ofpuberty; and the general experience of the Small-PoxHospital shows that small-pox did not usually occur aftervaccination until several years had elapsed. The most trust-worthy evidence of the perfection of vaccination was to beobtained from the cicatrices, and this evidence he would beable to show was a very good guide to the general amount ofprotection conferred by vaccination.The analytical series consisted of six tables. The first table

showed the number of patients admitted at the hospital in eachyear, distinguishing males from females, whether vaccinatedor otherwise, and gave the outline of the disease under whicheach was suffering; it included 185 cases of febrile diseases,

principally eruptive but not variolous, and it furnished theresult of the whole, with the rate per cent. of the mortality.The second table gave an analysis of all the cases of small-pox, 5797, classed under nine different headings, the form ofthe disease in each case, and the result, with the rate percent. of mortality under each division. He there gave theages of the unprotected patients, and the rate per cent. of £mortality calculated at different periods of life, for every fiveyears up to thirty, and even ten years afterwards. The fourthtable exhibited, separately, the leading particulars of 3094cases of small-pox after vaccination, showing from a carefulexamination of each patient, the number and character of thevaccine cicatrices, the form of the variolous disease and theresult, with the rate per cent. of the mortality from small-poxafter deducting the cases of superadded disease. It alsoshowed the rate of mortality from small-pox in patientshaving one vaccine cicatrix, particularizing whether good orindifferent., and the average. The fifth table showed, inquinquennial periods, the ages of the vaccinated patients whenattacked by small-pox, when they were vaccinated, and therate of mortality. The sixth table stated, in periods of fiveyears, the ages of the patients at the time they were vacci-nated, who had subsequently been admitted with small-poxinto the Small-pox Hospital. Observations on the resultsaccompanied each table; and in relation to Table IV., it ap-peared that 3094 patients with small-pox, reported themselvesto have been vaccinated at some period of their lives. 1357had one vaccine cicatrix; and of these four and a quarter percent. died with a good cicatrix, and twelve per cent. with anindifferent cicatrix: mean, seven and a half per cent. 888 hadtwo cicatrices; two and a half per cent. died with good cica-trices, seven and a quarter with indifferent cicatrices: meanmortality, four per cent. and a fraction. 274 patients hadthree cicatrices: average mortality, one and three-quarters.268 patients had four cicatrices; and there died with goodcicatrices under one per cent.; with indifferent cicatrices,none, the average being only three-fourths of one per cent.The author described a good vaccine cicatrix as distinct,foveated, dotted or indented, in some instances radiated, andhaving a well, or tolerably well, defined edge. An indifferentcicatrix as indistinct, smooth, without indentation, and withan irregular and well-defined edge.’ The author’s opportuni-ties of examining, with regard to previous vaccination, theforeigners admitted with small-pox at the hospital, and com-paring them with each other, and with the same class ofpersons in this country, had led him to the conclusion, thatvaccination was performed in the best manner generally bythe Danes, Swedes, Norwegians, and Germans, judging themby the standard shown in Table IV., to afford the most effi-cient security. Then came the Italians; and from the few he