16

THE LANCET.

SATURDAY, JANUARY 3,BEING THE

FIRST NUMBER

OF THAT JOURNAL FOR THE YEAR 1852.

THE COLLEGES OF PHYSICIANS AND SURGEONS AND REFORM.

THE Readers of THE LANCET, especially those

thousands of the Profession who ardently support the

principles which we have always strenuously, and often

successfully, advocated, will learn with much satis-

faction that the Editor enters upon the Tws72ty-ninth year of his labours with a larger circulation

than the journal ever before enjoyed at any periodof its existence.

The bonâ fide sale of THE LANCET, at this time, ismore than double that of any other medical periodicalnow published in Europe.

One result arising from the greatly augmented dis-tribution of THE LANCET, is forced so prominently onthe attention, that we should be without a justificationfor omitting to notice it at this period. We refer to the

fact, that a considerable portion of our increased circu-lation having extended to the ARISTOCRACY, to themembers of the LEARNED PROFESSIONS OF DIVINITY

AND LAW, and to the EDUCATED CLASSES generally,THE LANCET has been enabled to exercise an in-

fluence in checking the fraudulent and infamous

efforts of quacks and their abettors, and consequentlyin’upholding and advancing the cause of legitimatemedicine, which was never before at the command of

any medical periodical.It is, therefore, gratifying to know, that Science and

Truth have been effectually heard in quarters whereF1’aud and Falsehood have made prodigious, but un-

availing, efforts to obtain both votaries and victims.

EVERY reflecting person conversant with the affairs of theprofession, must think that our next step in advance must bethe reform of the London College of Physicians. The state of

the law respecting practising physicians throughout Englandand Wales is so full of anomalies and contradictions, thateven the officials of the London College, as we have seen ona recent occasion, put aside its strict letter as impracticableand absurd. We do not hesitate to affirm that in consequenceof the loose and obsolete regulations under which they prac-

tise their profession, there is not in the kingdom any class ofmen, having the elightest pretension to equal personal andmoral influence, whose public weight and status are of suchperfect insignificance as the body of English physicians. Anindividual physician is everywhere treated with due respect,but the general public do not know of the existence of aCollege of Physicians, and the other branches of the profes-sion have no sympathy or community whatever with the Col-lege as a public institution. The profession entertains itselffar more with the doings of the College of Surgeons and theApothecaries’ Society, than with the older and higher in-corporation. As for the government, they appear almostentirely to ignore the existence of the College. We saw,on the threatened invasion of cholera, and the arrangementof the necessary means for its prevention and remedy,and on the more recent occasion of the appointment of

a representative of the Sanitary Congress in Paris, the

government officials attended implicitly to the Board of

Health, a non-medical body, with an existence of yesterday,and threw aside all care for the opinions of a learned bodyranking among the oldest and most renowned in the kingdom.In the case of the Health Congress, the Government, in de-fiance of the expressed wishes of the College of Physicians,appointed as its representative on the Continent, at a largesalary, a gentleman of high qualifications no doubt, but who,according to the present laws relating to medicine, is only anillegal practitioner. Nearly all the physicians holding thechief appointments and practices throughout the great townsand cities of England, have no legal right whatever to practiseas physicians, and have no connexion whatever with the Col-lege. This lawless state must be a source of discomfort to these

gentlemen, and a cause of bitter mortification to all who takeany interest in the College. Both parties-the College, andthe involuntary infringers of the obsolete laws under whichthe profession lives-lose strength and character by thisunnatural state of separation. The College want the power,wealth, and influence which an incorporation of all the

physicians in this country would create for them, and pro-vincial physicians would be glad to have that addition to theirprofessional rank, which union with the College would bestow.These things being undeniable, how comes it that an active

agitation for a new Charter for the College of Physicians doesnot occupy the authorities in Pall Mall East ?

There certainly seems to be no objection on the part of suc-cessive Governments and Sovereigns to grant Charters tomedical bodies. During its comparatively short career, threeCharters have been granted to the University of London. The

last Charter given to the College of Surgeons is not ten yearsold, and yet the terms of a new Charter are now almost defini-tively settled. Within the last few years three Colleges anda University have been founded in the sister kingdom, andendowed by Her Majesty Queen Victoria.

It has happened most unfortunately for the Collegeof Physicians, that its old Charters have been regu-lated by a defective Act of Parliament; and before

any new Charter can be obtained, this Act of Parliamentmust be repealed. The College of Physicians have not

simply, then, to deal with the Crown and the Home Secre-tary, but they must pass a law through Parliament. The

House of Commons is no stranger to squabbles, but it willhave nothing to do with medical disagreements; and the

17

constant observation of the Secretary of State, when appliedto on the subject, has been, " First agree amongst yourselves,"and then apply to Parliament; but do not come until you’’ are quite agreed." It is said that it has been found, prac-tically, that the College of Physicians have not hitherto beenable to appear in the House of Commons, without the certaintyof opposition from some of the other public bodies. The Collegehave the difficulty of reconciling their own interests with theinterests of the public, the Universities of Oxford, Cambridge,and London, not to speak of Irish and Scotch Universities, theCollege of Surgeons, and the Apothecaries’ Society. With all

these breakers ahead, it is a very difficult thing to settle aCharter in the private cabinet of a Minister, or to pass an Actformally and leisurely through the two Houses of Parliament.

Still, for the sake of the profession, weakened by its presentloose organization, and the College, isolated and impoverished,the attempt should be made. We believe the College mightobtain, even during the present session, all it can reasonablyask for. The College of Surgeons cannot, being on the eve ofreceiving their own Charter, quarrel with the just require-ments of the College of Physicians. The interests of Oxford

and Cambridge need not be meddled with; and there onlyremains the University of London to offer any really for-midable opposition. WTe believe it would have been greatly ’iconducive to the interests of the College of Physicians andthe University of London, if an alliance, once all but com-pleted, had been carried out. Some mere formality wasallowed, we believe, to hinder the perfect union and accordwhich should exist between the two great institutions un-

doubtedly at the head of the medical profession in thismetropolis. But that possibility is passed. Still the failure

of a former negotiation of alliance need not now interferewith the legitimate development of both the College and theUniversity.We know it is often said that the University of London

would oppose, and that successfully, any attempt to obtain anew Charter for the College of Physicians; but we cannotbelieve the governing power, the Senate, would oppose anyjust requirements on the part of the College. There can be no

differences between the two bodies, which, if discussed in aspirit of candour and concession, might not readily be over-come. There ought to be mutual concession and perfect accordbetween the College and the University. Let the matter fairlycome into the light, and we are sure that, before the professionand the medical press, neither of these bodies could safelymaintain any unjust encroachment upon the equitable rightsof the other. The interests of both are, indeed, almost identical.Let any one look down the list of the last one hundred licen-

tiates of the College of Physicians, and he will find that a greatportion, as compared with any other University,of those joiningthe College, are graduates of the University of London. Everyyear this proportion seems to increase; and it is extremelyprobable, that before another generation has passed away, amajority of the College of Physicians will consist of graduatesof the youngest English University. At all events, take thefacts as they stand at present, and there are abundant reasonswhy the two metropolitan incorporations should unite, insteadof quarrel, and prove sources of mutual strength, instead, asnow, ef mutual weakness. It must be a source of pain tc

every right-minded graduate of the University of London whc

may be also a fellow or member of the College of Physicians

that the two bodies with whom their highest aspirations areconnected should be in a state of antagonism.We shall criticise any measure which may come before the

profession, and we have on more than one occasion pointedout the defects of the Charter last proposed by the College;still our criticism will be directed to the improvement of themeasures proposed by the College, and not to their destruction.But anything is better than the present torpidity into whichthe College appears to be plunged. Let the College of PallMall take a hint from the organization of the College inLincoln’s-inn-fields, which certainly shows no lack of activity-an activity mainly due to the representative principle.

THE ANALYTICAL SANITAILY COMMISSION having completedthe first year of its existence, and being now about to enter ona second, we propose briefly to review what it has effectedduring the last twelve months, and to consider what still re-mains for it to accomplish.The Commission contemplated the fulfilment of three

objects :-First, to record the results of actual analysesof samples of the various solids and fluids consumed in

the metropolis; second, to do the same for those sold inthe chief provincial cities and towns; and third, to extend

its investigations to medicines and drugs of all descriptions.The field of inauirv thus sketched out is wide and varied.and involves for its successful investigation, much time, greatlabour, and a considerable outlay.

I. During the past year the Commission has occupied itselfonly with the first of these objects, and this even it has notyet brought to a completion. It has, however, gone overmany of the most important articles of consumption-asSugar, Tea, Coffee, Chicory,Cocoa, Chocolate, Mustard,Pepper,Bread, Flour, Arrowroot, Farinaceous Foods, including thecompounds Ervalenta and Revalenta, Oatmeal, Isinglass,Water, and Milk.The results of these inquiries have brought to light deep

and wide-spread systems of adulteration, commencing oftenwith the manufacturer, and terminating only with the retaildealer.

It has shown, that in purchasing any article of food or drink,the rule is, that you obtain an adulterated one, the genuinecommodity being the exception.

T?n’rfht:n" that the arfirlna ncu).,.l fnr adulteration are

always of inferior quality, often worthless, frequently posi-always of inferior quality, often worthless, frequently posi-tively injurious, and not uncommonly even deleterious andpoisonous.The labours of the Analytical Sanitary Commission are

characterized by three very distinct features :-The first and great peculiarity is, that they record the

results of the actual examination of samples as purchased fromdealers, and, therefore, in the exact condition in which theyreach the consumer. Much has been written from time to

time on adulteration, but comparatively to little purpose, sincethe writings hitherto published contain less the results of the

experience of the several authors than the statements andopinions of others, often extremely erroneous, handed down

i from year to year, and from book to book.

. The second great feature is, that the investigations have all) been carried on with the aid of the microscope-an instrument

, up to this time scarcely at all used in this kind of inquiry,

18 NAVAL ASSISTANT-SURGEONS AND THEIR POSITION.

although it is the most useful and important application yet have also taken other means to secure a supply of unadul-made of that valuable means of discrimination. z terated goods.The third peculiarity consists in the publication of the names 4th. That many unions and other public and charitable in-

of all the parties of whom purchases have been made, whether stitutions are now furnished with purer and more wholesome

the articles were found on examination to be genuine or adul- provisions.terated. 5th. That the public being "forewarned are forearmed,"In the course of our Reports we have already given to the and, in self-defence, will resort only where they are sure of

world the names and addresses of some hundreds of manufac- obtaining, in exchange for unalloyed money, genuine andturers and tradesmen of all conditions and circumstances, wholesome commodities.

omitting none, however high their position, or ample their Such have been some of the principal results of the investi-means, upon any consideration whatever. We were led to gations of the Analytical Sanitary Commission; and that aadopt this proceeding from the desire-first, that the honest continuance of the inquiries will render such importanttrader should reap the reward due to his integrity; and advantages permanent, a doubt cannot be entertained.secondly, from the conviction that publicity afforded the only .means of checking the prevalelJCe of the scandalous practiceof adulteration, and of bringing home to each party his proper AFTER perusing the disclosures by our naval corre-

share of responsibility. spondents of the bad faith and bad temper of Admiral Sir

In thus acting, we adopted a bold and daring course, WILLIAM PARKER, no one can feel otherwise than delighted

and that we took upon ourselves an immense amount of re- that he has been superseded in the command of the

and that we took upon ourse I. ves an immense amount of re- he has been superseded in the command of the

sponsibility, will be readily conceded. We are glad, however, Mediterranean fleet. It is to be hoped that Admiral DuNDAS.

to have it in our power to state that we have seen no reason who goes out fresh from the Admiralty, and the resnonsibility

to regret the course we have taken, but much to encourage of Parliament, may treat the circular awarding cabins to

in it; and this chiefly ow ing

to the extraordinaire accuracy assistant-surgeons with more respect than his predecessor.in it; and this chiefly, owing to the extraordinary accuracy assistant-surgeons with rnore respect tlxan his predecessor.

and ,..., which have characterized the labours of our The discioline exacted by the First Lord, Sir FRANCIS

and ability which have characterized the labours oi our BARING, cannot be very precise, when he permits those inCommission.Commission. Notwithstanding the great number of names which we have authority under him to bring his department into public

published, there .’ now nat a single action pending against discussion. We suppose another debate in the House ofpublished, there is now not a single action pending against

Commons is required. Two or three votes of censure are notn, Lancet,

arising now of flxeproc2edings of the Commission. Commons Is required. Two or three votes of censure are not

THE LANCET, arising out of the pi,oceedi3igs oi the Commission. , .

One party did indeed commence legal proceedings, but the enough for the proud stomach of Admiral BERKELEY.It is a troublesome ordeal through which they have to pass,

question in dispute is now the subject of an arbitration. Several assistant-surgeone of the fear for their have troubled us

with letters from their solicitors, or have but the assistant-surgeons of the navy need not fear for theirhave troubled us with letters from their solicitors, or have but the assistant-surgeons of the navy need not fear for their

themselves written, threatening all sorts of consequences. cause. So long as they have pens and thoughts, and a pressthemselves written, threatening all sorts of consequences...

It now being apparent that we are not easily deterred from for their employment and dissemination, they may laugh at

maintaining a position when we are conscious of being the best of the adnirals hastening to superannuation. In the

maintaining a, position when we are conscious of beingright, this kind of effort at intimidation is of less frequent present time, botli the land and sea services are likely to meet

right, this kind of effort at intimidation is of less frequent with plenty of overhauling, and they will have enough to do

occurrence. plenty of overhauling will

Nor have the labours of the Commission been unattended to place themselves fit to meet the eventualities of foreign war

with many important results. Thus we know,— and home criticism. With the chances of the casualties ofwith many important results. Thus we know,—

war;—chances which we trust may be averted,—surgical skill1st. That the announcement of the names of the dealers cannot but become more valuable than ever in our fleet and

from whom genuine commodities have been obtained has been armies.followed by a great and most encouraging increase in their The acts of Sir WILLIAM PARKER towards Messrs. DUIGANbusiness. and PEARCE, of the Queen and Modeste, were sufficiently scan-

2nd. That a different feeling with respect to adulteration dalous and mortifying, but they were not less contemptiblegenerally now prevails throughout the mercantile community. and ridiculous. In the matter of Lieutenant STIRLING, truthTo deal in adulterated goods is now regarded as not quite so seems to have been unreservedly sacrificed to gratify an un-innocent a thing as it was formerly. That those who in their worthy and cowardly pique. The story of the feminine

trading capacities dabble in adulteration cannot be quite what appendinges of the venerable admiral would tell well in the

they ought to be in their social or moral relations; in other House of Commons. With respect to the representation ofwords, that a dishonest tradesman can hardly be an honest the boroughs of Greenwich and Woolwich, we do trust theman. medical electors and non-electors will feel bound to use their

3rd. That a sense of security no longer prevails, and each interest to advance the cause of their brethren in the service

individual selling sophisticated articles now dwells in daily of her Majesty. A vote at an election is more effective thandread of exposure by our Commission. any other variety of argument.

So clearly has the evil of adulteration been brought home to the minds of many, that they have been induced to alter THE letter of Mr. BURY, of Whetstone, opens a field oftheir system of business altogether, and now take every extensive and somewhat painful reflection. It appears that

means to prevent an adulterated article from finding its way the names of distinguished hospital surgeons, both in Londoninto their establishments. We could, if it were desirable, and the country, which adorn the list of contributors to themention the names of many persons who have, since the pub- Medical College, form a very inconsiderable fraction of thelication of our Reports, abandoned the use of chicory, and whole body. Mr. BURY asks whether Sir ASTLEY COOPER

19THE NEW MEDICAL COLLEGE.-THE COMMITTEE ON SMALL-POX AND VACCINATION.

had he been alive, would have suffered such a list to appear rwithout containing his own name ? BVe agree with our

respected correspondent, that he would not. It would have

been so inconsistent with his habitual acknowledgment ofwhat was due from him to his quondam pupils and medicalbrethren in general, as having been the helpers of his successin his profession, that we cannot conceive of his refusing to

help them in their need. But is any distinguished surgeonnow living proportionably less Indebted to his profe&sion thanwas the worthy baronet? Not one would arrogate this tohimself. Why then are there so few who have availed

themselves of the fine opportunity now afforded them to

acknowledge it handsomely ? This question will force itselfinvoluntarily upon every member of the profession, and it is

not Incumbent upon us to reply to it. Our present conviction

is, however, that one cause of the omission is inadvertence.In men much engaged in practice, intentions must too oftenbe taken for acts. The published list of donors may have

been the first thing to have recalled the recollection of manyto an unintentional neglect; and the second list may possiblycontain the names of the whole Council of the College, andall the hospital surgeons in the kingdom. Another mode of

explaining the anomaly has occurred to us. In the outset of

the scheme we know that many doubted its final success, and

therefore declined to attach their names to what they con-ceived to be a failing cause. But as no one can now doubt

the issue, we shall hope to see in this second list the names ofa host of men who have altered their opinion on this point,and resolved accordingly to lend a helping hand. One thingwe entreat of our readers: do not judge hastily or harshlymen who have as yet given no absolute proof that they areunfriendly to the College. The time may come when the

able and prosperous, and at the same time unwilling, membersof the profession, will form so small and so deplorable a

minority, that even they will be compelled, in self-defence, tobecome reluctant supporters of the good cause.We had cherished, and we will cherish, the hope that a

scheme emanating, not from one department of the profession,but from one who practises every branch, and therefore not

capable of exciting the jealousy of colleges-a scheme whichaffects no political or party interests, but which appeals atonce and directly to all the best feelings of human nature:will so unite and harmonize the conflicting elements

which have long divided and degraded the profession that,like oil upon the wave, it will at length soften down ourasperities and bring us peace. Whatever of injustice or

selfishness may affect corporate bodies of men, we will notbelieve that the ornaments of our profession are capableindividually of suffering themselves to be influenced by a pettyjealousy, for which a child, guilty of the like, would be sentinto a corner, to pout its grievances to the wall. Human

nature, in her mature development, is not so puerile as that.But there is no time to be lost: the second list will soon

appear., Besides, the season of Christmas reminds us of theannual privilege with which the prosperous are blessed-thatof making happy their less fortunate neighbours, by thinkingof their necessities and relieving them.

THE value of the Report of the Small-pox and VaccinationCommittee of the Epidemiological Society must mainly depend

on the accuracy and extent of the information suppliedin answer to the circular which they have issued. The

appeal which was lately made in THE LANCET, to thosegentlemen who had not returned answers to the querieswhich had been forwarded to them, was not without its goodeffect. Nearly one hundred responded to it in the followingweek. Still, however, there must be many who, from acci-dent or forgetfulness, have hitherto failed to comply withthe very reasonable request of the Committee. It is to be

hoped that no further delay may take place, and that

the Report of the Committee may not be postponed bythe neglect of those who can and ought to furnish in-

formation for their guidance. The queries were printedat page 517 of the last volume of " THE LANCET." It

will be obvious, on an inspection of these queries, thata reply, even to some one of them, will not be unattendedwith advantage to the inquiry, which is by far the

most comprehensive which has been hitherto instituted inGreat Britain. It is satisfactory to state that the strangeand unaccountable dictum of Dr. COPLAND respectingvaccination, in the last number of his Dictionary, is proved,by the returns already received, to be as untrue as it is reck-less. The Committee have corresponded with upwards of 500individuals, and there is not one who expresses any doubt onthe subject! Had the inquiries made produced no otherresult than this, they would not have been useless. On

a subject so important in its bearings, not only to the medicalprofession, but to the public at large, and to the best interestsof humanity, we feel certain that the Committee will not haveeventually to complain of the negligence of their brethren ofthe profession.

THE

ANALYTICAL SANITARYCOMMISSION.

RECORDS OF THE RESULTS OF

MICROSCOPICAL AND CHEMICAL ANALYSESOF THE

SOLIDS AND FLUIDS

CONSUMED BY ALL CLASSES OF THE PUBLIC.

VINEGAR,AND ITS

ADULTERATIONS.

GENERAL REMARKS ON ACETIFICATION.

ACETIC acid is the volatile principle, to the presence ofwhich, diluted with variable proportions of water, vinegarowes its aroma and pungency.

This acid, according to Dr. Ure,* exists, ready formed, innoteable quantity in certain plants, as the Sambucus niger orblack elder, the Phœenix dactylifera or Date tree, and the Rhustyphenus.

It may be readily generated by the fermentation of variousvegetable and animal substances, especially the former.For commercial purposes, it is almost entirely prepared

from certain vegetable and spirituous infusions, as those ofthe grape, malt, and the sugar-cane; but any vegetable infu-sion capable of yielding alcohol will also, when exposed to thenecessary conditions, furnish vinegar. In most cases, and in-

* Dictionary of Arts, Manufactures, and Mines, vol. i. p. 1.