739

THE LANCET.

LONDON: SATURDAY, MAY 21, 1870.

THE GOVERNMENT BILL AND ITS AMENDMENTS.

THE more the Medical Bill is considered, and the more itis amended, the less do critics seem to think of it, and themore necessary does it appear for the profession to opposeit as an altogether unsatisfactory and incomplete measure.

Everybody has been considered in this Bill and its amend-ments, except the profession which it is to regulate. The

examining bodies, both universities and corporations, the

present 1‘,Zedica,I Council, homaeopathists, and men with

foreign diplomas, are all able to point out clauses intro-duced into the Bill or its amendments for their specialbenefit. But the voice of the profession at large is regardedwith a contempt that is complete. If the profession allowsthis Bill to pass in its present form, it will be more power-less than ever. As it is, Government simply disregards itswishes, and scarcely deigns to give any reasons for doingso. But if Bill should become law, and virtually givea new lease to a Medical Council which does not recognisethe great body of general practitioners, and which is fullof corporations whose individual licensing powers the Billterminates, we may bid adieu to public spirit in the pro-fession, and to any attempts to increase the interest in andthe respect for the doings of the General Medical Council.Henceforth we shall be under the joint governance of theMedical Council and the Privy Council.The Bill has its origin in the scandal of nineteen rival

licensing bodies. But while abolishing this scandal, it

leaves these bodies exactly where they were in the GeneralMedical Council, with the same representation, with more

temptation than ever to talk and haggle over their materialinterests, and with only the most unsatisfactory control i

over the examinations, which are likely to be mainly con-ducted by the same bodies as heretofore.Let us consider for a little the principal amendments

which the Lord President laid upon the table on the occa-

sion of the second reading of the Bill. The nrst of these

is the amendment of the seventh clause, which gives up,for the Privy Council, any power of modifying the schemessubmitted to it by the General Medical Council. It retains

for the Privy Council the power of confirming the schemes.If the Privy Council docs not see fit to do this, " if it refuseto confirm any scheme, the General Medical Council mayframe and propose a new scheme." We have already e::-pressed our objections to the Privy Council having eventhis much power. The power is, in the first place, a deepreflection on the ability and independence of the GeneralMedical Council. The Privy Council virtually means itsmedical officer. Is it to be admitted that one man, even

Mr. SiMON, has any right to claim a power to set aside ascheme agreed on by a number, a large number, of the mostdistinguished members of the medical profession assembledin Council? This seventh clause makes the Privy Councilthe receiver and considerer of all objections to schemes; and

it gives a month for the reception of objections from allquarters. It requires little imagination to conjecture whata plentiful crop of objections would spring up in the courseof the month from without, to say nothing of objections toschemes which would be likely to arise in the Privy Councilitself. We protest that no Medical Council, rightly con-

stituted, would need a check of this kind. Then supposingthe Privy Council to object to a scheme, the whole " pan-tomime," to use Lord SALISBURY’S word, has to be acted overagain. The scheme has to be withdrawn, and anotherscheme has to be presented. This means that the General

Medical Council must be called together again, at a cost ofnearly a thousand pounds per week. If the Government

had faced the question of the constitution of the MedicalCouncil, as any Government undertaking the amendmentof the Act of 1858 was bound to do, there would have beenno need to do this. A Council could easily have been de-vised in which the Crown and the profession should havebeen so equally represented with the corporations thatthere would have been perfect confidence in its decisions.The Government have incourageously refused to touch theconstitution of the Medical Council, though every memorial

they have received has complained of it, and asked for somemodification. The letter of "Index" in our own columns

last week showed how, consistently with a principle alreadyrecognised in the Act of 1858, the representatives of cor-porations may be reduced to one-half, by grouping twobodies together so as to be represented by one. person, asthe four Scotch universities are now represented by twogentlemen. If the Council were thus shorn of half of its

present representatives of medical bodies, two good conse-quences might result: first, its decisions would be more

respected as being presumably more independent and dis-interested than at present; and, secondly, room would bemade for a few members directly to represent the pro-fession. Apart from some reduction in the size of the pre-sent Council, it is idle to talk of a direct representation of

the profession. The idea of adding twelve new membersto the present bulky Council is simply absurd and imprac-ticable. Last year the Council exceeded its income by sevenor eight hundred pounds. The excess this year will pro-

bably be much greater. And we tremble to think of the

financial consequences which may result if this Bill should

become law, and the 11 pantom;.mes" should be as frequentas may be anticipated.There are indications that the opposition to the Govern-

ment Bill will be principally narrowed to these two points-the subjection of the schemes of the Medical Council to theconfirmation of the Privy Council, and the constitution ofthe General Medical Council, at once so costly and so un-

satisfactory to the medical profession.There are other points however, and these of no slight

importance. Clause 18 being omitted by the amendmentsof the Lord President, there is nothing to prevent themedical authorities granting various and valuable medica.1titles and degrees to persons not licensed by the ConjointBoard. As W0 Litve already pointed out, men will practiseon the strength of such titles and degrees, although theybe not licensed. And it would be impossible and absurd to

speak of or to prosecute such men as unqualified practi-"

740 WOMEN AS SOCIAL REFORMERS.

tioners. If all bodies were as careful of their honours as spicuous for other qualities than for wisdom. The same

the London University is, there would be little objection to law of nature that produces the rancour of a renegade, orthis concession. But it is notoriously otherwise. And the eagerness of a pervert to proselytise, operates in in-there would be the same fatal temptation to impecunious ducing women who have once forgotten modesty to rushbodies to sell their titles as heretofore; and a greater, for into frantic transgressions against propriety. And it has

the passer of the Conjoint Board is to have a severe exami- happened that the female social reformers of our own time,nation and only a tame title, whereas the passer of the instead of being content to feel their way from easy ques-examinations of the other boards may have a high-sounding tions to difficult ones-instead of being content to traintitle with, possibly, a very inferior examination. The omis- their faculties and exercise their powers upon matters in-

sion of Clause 18 is tantamount to driving a coach and six disputably within their province, and upon which men canthrough the Bill. If this omission is to hold good we shall meet them without shame and help them without embar-have two classes of practitioners-the qualified, and the rassment,-have rushed at once to pour forth their un-

licensed ; so that it will be more difficult than ever for informed and impulsive sentiments about problems of thethe public to understand true medical qualification; and, very existence of which the more decent members of their

as now, it will happen that the best title will not necessarily sex are absolutely ignorant, and of the conditions of whichimply the best examination. those who speak the most are hardly better informed. One

We allude elsewhere to a clause that is inserted clearly result of this activity has been to give us an energeticin the interest of homoeopaths, female demonstration in connexion with prostitution andWe advise medical men in every town to communicate as the Contagious Diseases Act. We do not hear that this

a body with their representatives in the House of Commons, demonstration has taken any practical or useful form. Weand to urge on them to insist upon two points-a re- do not hear that hospitals or refuges have been increasedformed Medical Council, and an independent one. If the in number, or that efforts have been made to provide womenGovernment will concede a new Medical Council, with more with such education and such employment as may assistof the profession and less of the corporations in it, will con- them to earn their bread otherwise than by their reproductivetent itself with a representation in the Council, and agree organs. We hear only of an outcry for free trade in theseto the insertion of a modified Clause 18, then the Bill organs-an outcry similar, in its morality and in its regardmay possibly do good and raise the tone of professional for truth and right, to the arguments that are used to defendeducation. If not, it should be decidedly rejected. The the adulteration of food, or any like abuse with which

profession is not so powerless as the Government seems to commercial interests are bound up. And as soon as women

think. At any rate let us hope not. If it does not exert have had the hardihood to assume this position, men whoseitself to a contest with the Government on this Bill, it is vices are of the feminine type have been found ready to

powerless indeed. ally themselves with them, and to abet them in publishing,. and in distributing broadcast in English homes, and among

THE appearance of women in the character of public re- decent people, leaflets and pamphlets which may fairly takeformers may almost be said to date from the commencement their places side by side with the literature of Holywell-of the Social Science Association in 1857; such prior action street. We have known instances in which virtuous and

as that of ELIZABETH FRY and a few others being mani- pure-minded ladies have heard for the first time of the

festly exceptional, and being moreover, as a rule, the result existence of an organised trade of prostitution, and of theof extraordinary personal fitness for the special work that evils springing from it, by means of papers sent to themwas performed by them. The Association, however, took through the post by some Association of women apparentlythe initiative in marshaling women into organised batta- lost to all sense of decency, and written for their perusallions, and in encouraging them, independently of any per- by men whose compositions add no lustre to the ministerialsonal fitness, to enter upon the active discussion of public office. And the worst of these publications is their care-

questions. The change was nothing less than a revolution; lessness about truth. Those who write and who circulate

and, like many other changes, its full effects were not at them have no object but to gain a victory on a point onfirst, and probably are not yet, entirely disclosed to view. which their emotions or their interests are engaged; andIt is of course possible that these effects may ultimately be their statements are dictated either by the blindness ofsuch as all mankind will welcome, and that a time may passion or by the recklessness of venality and ignorance.come at which women will publicly exercise an influence In the storm of words the poor prostitute is in much dangerupon questions of law and morals that shall be of advan- of being simply used as a counter by her self-styled friends;tage alike to their sex and to the community. At present and her health and welfare are staked, without hesitation

this prospect has not been realised, and we are passing or concern, in a game in which party prizes are open to the

through a transition period of cloud and storm. Women, players. All this is not unnatural, but still it seems hard.

as we had occasion lately to observe, must emancipate It seems hard that wise men should have gone on labouring,themselves from many trammels before they can take part year after year, at the toilsome work of sanitary reform,in public questions at all; and it follows, almost of neces- gradually winning the ear and the attention of the public,sity, that this emancipation will usually be first effected by and slowly forcing upon the minds of the thoughtfulthose who may be described as persons of more determina- the conviction that health is something at once worth

tion than delicacy. It equally follows that those who are securing and capable of being secured; and that thenthe first to copy such ringleaders will often be more con- there should arise a tempest that threatens to endanger the

741THE COURT OF EXAMINERS OF THE COLLEGE OF SURGEONS.

stability of one part of the edifice that was being raised so Mr. QuAiN’s resignation is already in the President’s

carefully-a tempest in which truth is disregarded, in which hands; and we understand (though no notice was given tothe voice of reason is drowned, and in which the unscrupu- the Council of the fact) that Mr. HILTON does not intendlousness engendered by absolute want of knowledge is to put himself forward for re-election when his quinquen-deemed to be the best possible qualification for a champion- nial period expires in July, and we are glad that he willship in the fray. Of course there can be no doubt about thus follow the example of Mr. KIERNAN, and give the pro-the ultimate issue; although there may be doubt about the visions of the charter their full effect. There will thus be

steps by which that issue may be reached. Emotional three vacancies to be filled up, which might readily be in-clamour tends surely and necessarily to self-exhaustion. creased to four at any moment, since Mr. SKEY’s period ofThose who now raise it may possibly, at some critical time, office will expire in October, before the winter examinationswhen there is a thin House of Commons, or when parties begin. That these vacancies should be filled up by the ap-are balanced, snatch a brief and delusive victory; but in pointment of examiners in Anatomy and Physiology not onthe long run they will be defeated-to be remembered only the Council cannot be doubted; and as the confirmation ofin the same category with the opponents of gaslight or of the resolutions affecting the number of these examiners wasvaccination. About this we have no concern; but we have a second time postponed last week, we would again urgedeep concern that, in this matter, women should be so the desirability of limiting the number to four, and thusconspicuously, as Mr. KINGSLEY says they have always leavine, 11 six examiners of surgeons," as required by charter,been, "the slaves and tools of quacks and priests." Upon for the final or pass examination.

’

the question of the Contagious Diseases Act a few women Sir WM. FERGUSSON’S step in resigning his examinershipare displaying a disregard of accuracy and truth that is will give a highly eligible opportunity of patting in force,much a result of faulty education, and a disregard of de- for the first time, the 21st section of the charter of 1843,

cency that is painful to witness. They bring the capabilities which provides "that the president and vice-presidentsand qualifications of their whole sex into disrepute, and shall no longer be chosen exclusively from and out of thedelay the attainment of that equality of privilege with men examiners, but from and out of all the members of the

which they so loudly claim. It is much to be desired that Council indifferently, and whether exa7zin.ea-s of the College orthey would study the history of thought ; and would learn not." ’ We do not anticipate that the conservatism even ofthat, in social philosophy, as in all other matters, it is the College Council will venture to pass over a gentlemannecessary to begin at the beginning, to collect and arrange of Sir WILLIAM’S distinction on account of his not beingdata, to eliminate errors, to cultivate exactness, to subject still an examiner. When a surgeon rises to the eminence

the passions to the reason, and then to test the conclusions of being serjeant-surgeon to the QDEEN, and a baronet, itof the mind by experience. They would object that if they can matter little to him, perhaps, whether he occupies thewere to take the necessary time for the implied research president’s chair or not; but the corporation which shouldand reflection, a great wrong would in the meanwhile be refuse to avail itself of the prestige which would accrue to it

perpetrated. On this score they may be easy. If the Con- from association with so honoured a name would inevitablytagious Diseases Act be what its opponents describe it, the stultify itself in the eyes of all thinking men. Whether

great object of those opponents should be to procure its the honour should be bestowed at once, or be postponed forextension-as the certain prelude to its utter and absolute a time in deference to other claims, is a matter which must

repeal. If it produced only a tenth part of the evils which be left to the Council’s consideration.

we are told would flow from it, it would be swept away .in a month by the unanimous voice of the English people. THE special meeting of the British Medical Association,It is precisely because it would produce no evils at all, that held in Willis’s Rooms, to consider the Medical Bill, con-a few fanatics are eager to throw difficulties in its way, and firms what we have elsewhere hinted, that the dangersthat they have stirred up to their aid so large an amount ahead in the course of the Medical Bill of the Government

of the wrongheadedness of their countrywomen. are represented in the two questions of the constitution of0 the Medical Council and its independence of the Privy

AT the last meeting of the Council of the College of Council. A very lively discussion arose in the meeting onSurgeons Sir WM. FERQussoN’s resignation of the office of the subject of one Board versus three Boards, and ended inExaminer was received and accepted. This step, which, so a very excited division, which showed a great majority infar as we know, is without precedent in one of the Court favour of one Board for the whole kingdom. Professor

who has not attained the President’s chair, must not be HAUGHTON contributed principally to this result by advo-attributed to any failing of power on the part of the emi- cating, with his usual eloquence, one Board, as the only waynent surgeon who has thus set an example of self-abnega- of securing true uniformity of examination, and removingtion, but is doubtless the result of a long-cherished design- once and for ever the objectionable distinctions betweenthat of separating the examiners in Anatomy and Physiology Irish, Scotch, and English qualifications. Dr. Sissorr, Dr.

from those in Surgery. Sir WM. FERGUSSON has, we believe, STEWART, and others spoke very earnestly against the one-long entertained the idea that eminent surgeons in large Board arrangement. Dr. Sii3soN reasoned that, in the

practice are not, of necessity, the best examiners in subjects practical and clinical nature of the examination required,taught in the schools and constantly open to fresh research there was a sufficient argument against a mode of examina-and investigation ; and we congratulate him on now in tion practised by the University of London very efficientlyproprio, persons setting an example worthy of all imitation. in those subjects which admitted of examination by papers.

742 THE BRITISH MEDICAL ASSOCIATION AND THE BILL.

But this objection is not forcible, inasmuch as there are

ample means, as was well said, of practically testing thechemical or the clinical knowledge of students either in

Dublin or Edinburgh, or even in Birmingham or Newcastle.There was more reason in the objection that good examinerscould not be got to conduct examinations peripatetically.But the truth of even this statement is very doubtful. The

remuneration would be gool, and the work not unpleasant.At any rate it would be possible to have in each place acertain number of the same examiners. This is an almost

indispensable guarantee of uniformity in the examinations.Whatever the practical difficulties, the decided feeling ofthe meeting was in favour of one Board for the whole

kingdom ; and this feeling seemed not-a little to discon.,

cert the traditional leaders of the Association.

The vote on the other points was unanimous. First, that

no Medical Bill can be satisfactory which does not providefor the direct representation of the medical profession; and,secondly, that the Association objects to the concession of

any other power to the Privy Council than was given in theAct of 1858.

The British Medical, Association, in regard to the first Ipoint, is open to the charge of being possessed with oneidea, and that idea rather an impracticable one. It

proposes the addition of a number of medical men to the

present Council to represent general practitioners, withoutmaking any attempt to show how such an enlarged Councilcan either be paid for, or could work. What statesman would

propose to add eight or twelve members to a Council thatis already exceeding its income most seriously, and talkingexcessively. What is wanted is not only the addition ofmembers to the Council to represent the profession, butalso the abatement of the corporation element in the

Council. The British Medical Association may o$’er very

powerful opposition to this most unsatisfactory Bill. But if

it will throw its influence into an attempt to reduce thenumber of representatives of medical bodies in the Council,it will deserve yet higher praise, and perhaps. contributematerially to the passing of a satisfactory and statesman-like measure.

The speeches on the question of the Privy Council hadthe same one-idea. ring about them. We entirely agree in

objecting to the independent power of the Privy Council. z’

But the proper course is to show the Government howwithout retaining this power, to make the Council authori-tative and absolute. This can only be done by diminishingthe power in it of interested bodies. But no suggestion iuthis direction came from the meeting.We concur with the Association in urging the refusal

of this Bill, unless very radical changes are made in it.

We hope it will concur with us in thinking that it must

conjoin its demand for a direct representation of the pro-fession with an equally urgent demand for reducing thenumber of representatives of corporations. In this jointdemand, it seems to us, lies the solution of the presentdit6cultics.

IN the sub-district of High Wycombe 113 deaths occurredlast quarter, and out of these 18 were the result of small-

pog, 10 of scarlet fever, and 2 of fever.

Medical Annotations."Ne quid nimis;’

THE LATE SiR JAMES SIMPSON, BART.

SINCE the death of Dr. Chalmers, in 1847, Edinburgh hasnot witnessed a more numerously or variously attendedfuneral than that of Sir J. Y. Simpson, on Friday, the 13th.The procession itself cannot have numbered fewer thanseventeen hundred persons, including, as it did, representa-tives of nearly every society, sect, or corporation of anyimportance in the city. The various learned bodies withwhich the deceased was connected, from the Universityand the Royal Society to the humblest associations for theadvancement of medical, literary, and antiquarian research,contributed to swell the multitude of mourners; while

the array of students and delegates of the different re-ligious denominations in which Edinburgh abounds wasalmost a host in itself. Along the line of route, from SirJames Simpson’s residence to Warriston Cemetery, a dis-tance of about a mile and a half, the general public wasdrawn up in dense and decently disposed ranks, and inthe cemetery itself a numerous company, consisting chieflyof ladies, was assembled on a knoll in the centre of theground, commanding an excellent view of the solemn cere-mony. The grave was in the family burying-ground, on thenorth slope, and Sir James, amid deep and impressivesilence,was laid beside several members of his family whosenames are inscribed on a handsome pyramidal tombstone.No more fitting place could have been chosen for a mauso*leum which will always remain a point of pilgrimage for the -.

visitor to Edinburgh. From the ridge that runs from east to-west through the cemetery can be obtained, on the southern,aspect, one of the finest views of Edinburgh-the C:astle li,ock,,and the lofty houses of the Old Town, as it slopes to the baseof Arthur’s Seat, being seen to great advantage. On the

northern, again, the spectator enjoys a splendid view of the-Frith of Forth, with the Ochill Hills far to the left, and theBass Rock in the distance rising solidly and grimly on theright. The scene was one of which Sir James Simpson waspeculiarly fond, and to which he doubtless had the sad yetproud consciousness that his grave would attract the steps ofthe stranger for generations to come. It will be long beforeEdinburgh ceases to take a pensive pleasure in hauntingthe spot. There is hardly a public interest within her gatesthat does not feel the loss of her most brilliant citizen.Even in the lowest view of all, she has experienced a pri-vation which she will not speedily repair; indeed, we learn,from one who had the best opportunities of knowing, thatsuch was Sir James Simpson’s power of attracting to thecity the high-born and the wealthy as patients, that 80,000a year would hardly cover the aggregate loss individuallyborne by hotel proprietors, lodging-house keepers, andtradesmen! What she will miss in other and nobler

respects we have already tried to indicate. But she still

enjoys the memory of his life, and the bequest of his exam-ple, and steps, we believe, are being taken to perpetuatehis sculptured presence in the city which was privileged toreap the immediate benefit of his genius and his humanity.

PHYSICAL SCIENCE AT CAMBRIDGE.

OXFORD is not superior to her sister of the Cain in phy-sical exercises. Is she to her undoubted superiorityin physical science ? This is a question which was answeredin the negative at a meeting in the Arts School of Cam-bridge on Saturclay, the 30th ult., under the presidency ofthe Vice-Chancellor. A Professor and Demonstrator of

I