805

THE LANCET.

London, Saturday, September 2, 1843.

UNDUE MONOPOLY OF THE " PURES."

11 A PLAGUE upon’t, when thieves cannot

be true to one another!" says Sir JOHN

FALSTAFF, and every one must concur in the

justness of the exclamation from such a mouth,though thieves, to give them their due, gene-rally are true to one another. In fact, thereis found amongst most bodies of men who

follow given vocations,-whether honest or

fraudulent,-a certain esprit de corps, result-ing from a common interest and a consequentfellow-feeling which are by no means incom-

patible with the rivalry of individuals.An exception to the rule of fidelity to a

common interest is, however, presented by ourown profession, although, generally speaking,no class of men is less influenced by the

spirit of personal rivalry. Regarding medi-cal practitioners as individuals, we find

among them much good nature and libera-lity, and a disposition to aid rather than toretard the progress of their professionalbrethren. But, by a miracle of legislativewisdom, the profession constituted of thesebenevolent individuals has been so organisedin this country as to range under one bannerseveral orders of men, differing utterly intheir feelings and interests, so that the worstenemies of the profession may be found in itsown ranks. Unhappily the largest and most

respectable of these orders, to wit, the sur-

geons in general practice, is the one which ,,has suffered most severely from this mis-

chievous state of things. Among the manyfacts that might be adduced in proof of thisposition there is one so monstrous that wereit related instead of being witnessed, it wouldnot receive belief.

Public medical " charities" afford to their

officers many opportunities of professionalimprovement, and sometimes considerable

aids to advancement in private practice.The appointments that they hold out are,consequently, objects which the professionn general desire to attain. But in nineteen

cases out of twenty, if the rules and l’egula-tions of such " charities" be consulted, it isfound that no gentleman practising phar-macy or midwifery is allowed to receive the

appointment of surgeon to the institution ;that is to say, the surgeons in general prac-tice throughout this realm are pronouncedto be ineligible to fill the office, none

being suffered to occupy it but those

grotesque specimens of professional mon-

strosity in which only one half of a practi-tioner is developed, namely, the " PURES."The cause of this we have developed over

and over again in our pages during the last

twenty years, and as often have shown thatthe principle of the exclusion is contemptiblyabsurd and outrageously unjust. But once

again let us revive attention to the fact, foranother long period of repose has been left

us by the lazy and imbecile Parliament to

bring to public view the old grievances ofthe profession, of which this is one. It is

wonderful, indeed, that a reform in the lawof medicine should have to be waited for to

effect a cure of such an evil, because the

governors of the 11 charities" have the remedy

in their own hands, and the Legislature hasnever told them that they shall do this wrong,or compelled them to give ear to the knavishindividuals who persuade them to adoptsuch a mischievous rule. What is equallystrange, however, is that the profession em-bodying the " ineligibles," do not combine toconvince them how unfair and injurious isits operation. Alas! the quantity of reformwhich medical men expect other persons to

do for them while they stand by with crossed

hands, is both remarkable and alarming.Those who in their own conceit form the

IWÀOL ∈ of the profession (GoD helpthe men !) are not so indolent. They havethe merit of the busy bee, and constantlyimprove "each shining hour," gatheringsweet "honey all the day, from every openingflower"—of charity. But the surgeons in

general practice, with an apathy which the

advocates of passive submission may ap-

plaud, but which every independent manmust regard as abject to the last degree, have

806 DEMANDS ON GENERAL PRACTITIONERS.

tamely sufferod the insult and injury the state or a generous public has created.thus inflicted upon them. How dif- By crafty exceptions against pharmacy andferent a state of things would obtain if sur- midwifery they partly effect this ; bygeons in general practice were as diligent in intrigue and nepotism, and the absence

vindicating their own rights as a profession, of good laws to keep clear the roads of ire-as their adversaries in the colleges are in de- dical advancement, they accomplish the rest;stroying them! They possess the amplest for even were surgeons in general practiceopportunities of advocating them. No permitted to hold office in the hospitals, theyclass possesses so intimate and extensive an must, in the absence of the concours, work

intercourse with the various members of so- under ground to obtain success,-must mole

ciety,-the rich and influential as well as the and burrow, and come up through traps in the

poor and powerless. How numerous are floors, instead of entering honourably bythe means and occasions of showing and con- the open gates. Does not this demand a

vincingthem that the whole profession should remedy ? And from whom should it emanate ?be amalgamated, and made to constitute ONE Think ye, brother surgeons, that if ye ask it

FACULTY, governed by bodies elected on the not yourselves the Legislature will ever grantprinciple of REPRESENTATION,-that medical it to you, beset and earwigged as the mem.education should be free,—unfettered by the bers of cabinets, one and all, invariably are

system of tickets and certificates, the know- by the very men who occupy these close

ledge of science being attainable anytehere boroughs" of medicine ? Idle, indolent,and any how, so long as it be obtained, the foolish expectation 1 The greediness of the mu-

proof of which should afterwards be tested nopolists is too great for passive opposition.by practical and clinical examinations, in There is but a single wonder connected withHalls and wards open to the whole profes- it, and that is that they have left to the profes.sion,-and that appointments to the endowed sion even one means of distinction. They doand other public medical charities should be allow surgeons in general practice to write

made from among the best men, proved to be and publish books, profitless privilegethe best by the mental trial of the concours, though it be, to the authors themselves. It is

all such appointments being accompanied by astonishing, however, that no copyright in

ample and generous salaries ! Thus would medical facts has been sought by them atthe sick poor, in those establishments, in- the hands of Parliament,—no Act of the

stead of being regarded as mere stepping- Legislature making it felony for every manstones for the mounting of " neveys" and JACK" of the whole tribe of " subordinates"noodles to the high places of medicine, come to print works on medicine. They have ac-to be treated as suffering beings who,-oc- complished many things that are not less

cupying wards in their own institutions, astounding to common apprehensions.equally with dukes who fill beds in their Quite certain it is that they have monopolisedown palaces,—should receive the kindest and the great bulk of the facts to themselves onmost skilful attention that can there be be- which alone a true medical science can be

stowed upon them. What glorious opportu- based ; for it is in the hospitals only that wenities for medical officers of gaining golden expect to obtain those certain statistical

reputations where now the reputations are but events on which successful attempts can be

gilt ! What honourable paths would then made to erect theories and principles ofbe opened to industrious students and dili- practice.gent cultivators of the remedial art. At pre- What is the profession prepared to do o:

sent, by astounding contrivances of impu- its own behalf between this and the next

dence and intrigue, the few—the half- session of Parliament?

educated PURES—keep from the profession A correspondent, taking notice of the

every post of dignity’and profit that either proceedings at the dinner of the Medical

807UNIVERSITY AND KING’S COLLEGES.

Association, reported in THE LANCET of last

week, page 781, expresses a fear that

nothing will be done by the profession to

promote a wholesome change in medical

law during the recess. He founds his opi-nion on the fact that Mr. CROSSE was permit-ted at that dinner to denounce the agitationof medical reform in Parliament without

opposition on the part of any member of the

assembly. Our correspondent considers theomen to be a bad one. It is more likely,however, either that the subject was re-

garded as mal-apropos at dinner, and there-fore not then proper to be debated, or thatthe speaker, although a little elevated (in one

sense), was not exactly worth worrying, foralthough we did ourselves once give him agood and useful caning in his own kennel

for some impertinent yelps on a like occa-

sion, yet it would be a great waste of exer-tion to inflict castigation on him oftener

than once in half a dozen years, for he

grows no larger nor any worthier of notice,however big or influential in his own esteem." My mother," says an old nursery rhyme-

" My mother had a little dog,They TINY did him call,Sometimes the little TINY wouldImpurity the wall.And when he saw a little smokeHe’d think it was a fire,And then turn round the other leg,And reach a little higher."

WE shall not attempt to analyse what

grounds of difference exist between Univer-sity College (Gower-street) and King’sCollege (Strand), London, to justify the

general impression that the one college is a

"free," or "liberal," institution, and the

other despotic, as regards the mind and its

education. The feeling universally prevailsthat such a distinction marks them,-that inthe college of the theologians and Conserva-tives there is maintained a net around the

mental energies of teachers and scholars, toprevent them from getting on toofast, becauserapidity of movement and acquirement is

dangerous in society, morally and politi-cally. Our object now is to ask whatresults attends the opposite systems in eachbnilding -the hold-backism of King’s

College, and the freedom from what reallyand truly are political shackles, in Univer-

sity College? We are instigated by no partyor inimical views in referring to the con-

trast, but offer it to public notice simplyfrom its utility as a statistical fact that is

well worthy of consideration ; for King’sCollege was expressly instituted to counter-act the liberalising tendencies of that institu-tion which the Tory press at first endea-voured to reproach with the contemptuousname of" STINKOMALEE," a miserable witti-cism of the writer-in-chief, THEODORE HOOK.From every year downwards, since its for-

mation, to the year 1842, in all literary andscientific competitions, and on all occasionsin which candidates from each establish-ment have met, the best lionours, and thelargest share of prizes, have invariably beencarried off by the students of UniversityCollege. And now that the close of the yearterminating in August, 1843, has also

arrived, what find we ? An amelioration ofthe difference,-an equalisation of the suc-cess,-a reversion of the majorities ? The

following list of candidates who obtained‘ honours" at the recent examination of the

University of London for the bachelorshipof medicine,—reprinted here as it was last

week put forth by the Registrar,—furnishesa reply to these questions:—The names are arranged in the order of

proficiency." ANATOMY AND PHYSIOLOGY.

A. Jackson (exhibition and gold medal),University College.B. L. Jemazett (gold medal), King’s

College.Jas. Hakes, University College.P. Redfern, Queen’s Coll. Edin.B. M. Eyre, University College.N. H. Littleton, University College.

" CHEMISTRY.

Jas. Hakes (ex. and gold med.), Univer-sity College.B. L. Jemmett, King’s College.N. H. Littleton, University College." MATERIA MEDICA AND PHARMACEUTICAL

CHEMISTRY.

Jas. Hakes (ex. and gold med.), Univer-sity College.P. Redfern (gold medal), Queen’s Coll.,

Edin.B. L. Jemmett, King’s College.A. Jackson, University College.N. H. Littleton, University College."The facts speak nothing against King’s

College. They only serve to show that the

808 ASSOCIATION OF OFFICERS OF LUNATIC ASYLUMS.

chief principle of your learned" conserva-tive" institutions does not allow them to bearthe hestfruit.

Previously to the above examinations the

officers of the University of London did usthe honour to forward to our office copies ofthe questions in the various departmentsabove named that were to be submitted to

the candidates. They were too nume-

rous for publication in our columns, consi-dering the limited interest which intelli-gence of that kind possesses beyond thewalls of the examination-rooms. We there-fore content ourselves by observing that thequestions presented excellent tests of know-ledge in medical science,-°-.such, in fact, asno men could answer correctly without de-serving to be regarded as very accom-

pli shed scholars.What a pity is it that the directors of the

University have not sufficient faith in suchexaminations to grant their diplomas for suc-cessful trials, without hampering studentswith those injurious regulations which havebeen borrowed from the authors of the

" ticket-and-certificate system."

To the Editor.-Sir: Allow me to ask inTHE LANCET, with reference to the late exa-mination at the University of London,-ifbotany be of such importance as to causethe rejection of men who have been compli-mented by all the other examiners on themanner in which they had answered theEeveral questions put to them by those exa-miners ? How is it that the examination forthat subject, and the examination for materiamedica, are held in the same afternoon, it

teing quite impossible for any one to answerthe questions put by Dr. Pereira, and theRev. Professor Henslow, as they ought tobe answered, in the space of three hours?And, in fact, several of the men who wererejected had not sufficient time to answer thequestions put by Professor Henslow, havingfirst of all answered those of Dr. Pereira,thinking that materia medica and therapeu.tics were of more importance than botany,and, therefore, first of all paying attention ito them, and finishing them before they com-menced answering botany. It would like-wise give great satisfaction to be informedhow it is that Professor Henslow, at Cam.bridge, or, at any rate, not at SomersetHouse, is able to examine and reject the menat the London University.Allow me, likewise, to call attention to

the nature of the questions put by ProfessorHenslow, the examination purporting to beon physiological and structural botany, only,and not on systematical, and to ask whetherthe questions ,; Have rosaceee, leguminosae,

and cruciferæ, stipules, or not?" "Have theseeds of the pisum,ranunculus, geranium, pri-mula, and sinapis, albumen, or not?" belongmore properly to the one or the other of thesedepartments of botany. I am, Sir, yourtruly obliged,

A MEDICAL STUDEXT.August 23, 1843.

" THE ASSOCIATION OF MEDICAL OFFICERSOF HOSPITALS FOR THE INSANE," was formedin 1841, by several medical officers of pub-lic lunatic asylums, and designed to consistof all the medical officers of such institutions

in Great Britain, as ordinary members, andof such medical gentlemen having the privatecare of the insane, of such persons not medi-cal who were known to take an interest in

patients afflicted with insanity, and of suchdistinguished foreigners as the society at anytime should think proper to elect, as honorarymembers. The objects of the association

are,-

1. " To improve the management of luna.tic asylums.

2. " To improve the treatment of the in.sane.

3. " To acquire a more correct knowledgeof insanity."To effect these intentions the members

meet annually at some town or place inwhich there is a public lunatic asylum.They solicit the permission of the governorsor visitors to visit the asylum, and to inspectit thoroughly, and afterwards to assemble inthe committee-room of the asylum to speakfreely, and in good faith, upon its merits or

defects, and the treatment of the patients.On the same occasions such members asthink proper read papers on subjects con-nected with insanity ; and all compare theirexperience, the governors or visitors attend.

ing, if they desire. The association has

adopted a register for the use of its members,whereby the leading features in every case,under the care of each member, may be uni.formly recorded, in order to collect a greatmass of facts from all parts of the kingdom,as a general record of insanity. The asso.

ciation is collecting plans of all the asylumsat present erected and projected, and the

printed reports of different asylums. Theassociation has already prosecuted its objectsat the Gloucester, Nottingham, Lancaster,Middlesex, and Surrey county asylums, andat St. Luke’s, hi London ; and it has beeninvited to the Kent, Wakefield, Northamp.ton, Belfast, and Glasgow asylums. The

809

objects of the association are in no degreeconnected with a private end, and thereforeits members feel assured that it will secure the

encouragement of all governors or visitors ofasylums for the insane. The honorary se-cretary is Dr. SAMUEL HITCH, of Gloucester,to whom communications on the subjectshould be addressed.

THE EASTERN PROVINCIALASSOCIATION.

To the Editor of THE LANCET.SIR,—Can any of your readers inform me

who was the originator or founder of theEastern Medical Provincial Association;for, unless I have been misinformed, anddates and memory fail me, the gentle-man who has been toasted and laudedand lauded and toasted, until he has been,’done quite brown," has but small preten-sions to that distinction. To the best of myrecollection the first time I ever heard ofMedical Provincial Associations was in aproposal for establishing one in the countyof Suffolk, in 1827, by Mr. Bedingfield, ofStowmarket, which he again brought for-ward at the first Costello meeting, in 1833 ;and, although Mr. Bedingfield was in bothinstances strongly opposed by the late Mr.King, of Saxmundham, a committee wasappointed to carry it into effect. The follow.ing is a copy of the minutes of the proceed-ings of that committee :-"Monday, Dec. 9, 1833.-A meeting of

the committee appointed by a numerous

assemblage of medical practitioners residingin the counties of Suffolk and Essex, on thelOth of Oct. 1833, was this day held at the

Literary Institution, Ipswich. Present,-Mr. Bedingfield, of Stowmarket, in theehair; Dr. Baird; Mr. H. Bartlett; Mr.Bullen; Mr. Francis.-Resolved, lst. Thatit appears to this committee desirable thatan association of medical practitioners,residing in this and the adjoining counties,should be formed, and designated theEastern Provincial Medical and SurgicalAssociation.-Resolved, 2nd. That in orderto effect this object letters should be ad-dressed to the practitioners of Cambridge,Norwich, Yarmouth, Bury, and Colchester,and the intervening places, requesting themto co-operate in its views and plans, and toenrol themselves members thereof. (Signed)J. 0. FRANCIS, Secretary."Mr. Crosse, of Norwich, was amongst

tho;e who were solicited to assist in carryingout the second resolution.

In 1834 the necessity of carrying theseresolutions into active operation was againurged by Mr. Bedingfield, and so effectivelythat only a favourable opportunity was

awaited for calling the profession together.In this intention, however, the Ipswich com-

mittee was anticipated by Mr. Crosse, who,in 1835, took the business out of their handsinto his own. How far this was courteous

towards the Ipswich committee and theirchairman I shall not pretend to determine ; ;but unless some one be aware of a priorclaim, and I am inaccurate in the statementof facts and dates, I think I shall be war-ranted in drawing the conclusion that thehonour of being the founders of the EasternProvincial Association belongs to Dr.Bedingfield and the Ipswich committee, acircumstance which has never hitherto beenacknowledged. I am far from wishing todetract from the real merits of Mr. Crosse,who has proved himself to be an active andefficient secretary to the association, and itis but justice to admit that he, in conjunc-tion with other gentlemen, was instrumentalin effecting a junction of the Eastern withthe Western Association, that is to say, ofconverting a trunk into a branch, an inde-pendent into a dependent association. This,perhaps, will be regarded, by some, as anegative kind of honour, of which not manywill be covetous, and it certainly doessound strangely to hear a man designatedthe founder of an association which he onlyhelped to metamorphose into a branch. Sucha foundation was probably first laid in thesister kingdom.

Once upon a time, as the story goes, acertain divine clapped a sort of extinguisherupon the top of a fine gothic steeple, whichlittle toad’s-cup excrescence the modest manand some of his admiring parishionersdesignated a spire; but others, in their zealto do honour to the splendid architecturaldevice of their worthy rector, declared thathe was the founder of the steeple. Mr.Crosse helped to clap a sort of extinguisherupon the Eastern Provincial Association,and he is now most sensibly eulogised byhis admirers as the founder of a branch f Ihave the honour to remain, Sir, very respect-fully your’s,

A MEM. OF THE E. P. ASSOCIATION.Ipswich, Aug. 22, 1843.

CASE RELATED BY MR. SAMPSON.

To the Editor of THE LANCET.SIR,—In your report of the meeting of the

Provincial Association at Stowmarket, Iobserve that you have marked with a noteof admiration (exclamation) the word insec-tii7ora, as applied to Mr. Sampson’s case.As that part of the report was drawn up bymyself I will briefly state why I designatedthe case as I did. The case, as related byMr. Sampson, appeared to the medical menpresent to be one of ingenious but gross de-ception on the part of the patient. He statedthat the patient was reported by herfriends, who were very respectable, to haverepeatedly passed per anum numerous speci-mens of cockroaches, beetles, swifts, locusts