69

gest the union of a botanical collection ofthe individuals of the vegetable kingdomwith the zoological department of the gar-dens, convinced that the attractions of ieach would be thus mutually heightenedby combination. The difficulties of theproject are not worthy of discussion.

Only give that most savant of all land-scape architects, Mr. NEVIN of the DublinSociety’s garden, the means and the op-portunity, and if he do not throw up rock-works and grottos, spread out his walksand parterres, collect the scattered chil-dren of the sun of every clime into naturalfamilies, and make his fountains sparkleamong them, " like pillars of diamond inthe sunshine," with greater rapidity thancities ever rose, or satyrs danced to themusic of the lyre of Orpheus, we have noskill in the appreciation of human abili-ties.To keep pace with the progression of

science, and to develop, to the fullest ex.-

tent, the capabilities of the establishment,the Zoological Society should not limit itsexertions to the accomplishment of thisobvious improvement. They should ad-vance another step, and institute a pro-fessorship of natural history, and a mu-seum in connexion with these gardens,and place HIM above their contents, whoalone can explain their structure, traceout their relations, and demonstratethe objects and design of their crea-

tion,-give HIM his proper place in theinstitution, whose tongue alone can makeeloquent the muteness of these beings,and translate into the noble and intelligi-ble medium of science, the vital and or-ganic dialects of animated nature.

ERINENSIS.Dublin, Sept. 21st, 1834.

THE LANCET.

London, Saturday, Oct. 4, 1834.

ADVICE OF THE LANCET TO STUDENTS.

SEVERAL communications which we

have received since the last number of

this journal went to press, induce us toresume the subject of MEDICAL. EDU-CATIONT.

If we could discover any sufficient

excuse for those breaches of engagementof which medical students are generallythe victims, we should not withhold from

the officers of our hospitals, or the lec-turers, a statement of those facts, which

I amount, in their estimation, to a justifica-tion of their conduct.

Unconnected as we are, publicly, withthe whole of the teachers, and unac-

quainted, as we are privately, with nine-teen twentieths of those gentlemen, it

cannot be supposed that we are influencedin our conduct by feelings of partiality ordislike, and we know that it will be ad-

mitted by all whose opinion is worth

having, that our pen is guided under astrict and imperative sense of public duty.That we have condemned, and repeatedlytoo, in very severe terms, the irregularitiesexhibited in several of our schools and

hospitals, we willingly, proudly, acknow-

ledge, and as freely do we confess that wehave often made the authors of those

enormities writhe under the castigationswhich it has been our painful office to

inflict. Were we to imitate the course

which the truckling hirelings of the

press have pursued, and bespatter with

praise every stupid book-maker, every

lazy hospital physician and surgeon, and

every negligent and incompetent lecturer,the stream of adulation would, in return,

incessantly flow back upon us from all

those impure sources. We covet the appro-bation only of independent minds, thoughwe shall not condescend to inform the

corruptionists with what success our ap-petite for that species of applause has beengratified. It is enough for the opponentsof every improvement in medical govern-ment and education to know, that we areresolved that no efforts of ours shall be

wanting to protect the medical student

from the frauds which might otherwise bepractised upon him in this metropolis.The tone in which some of the lecturershave complained of our admonitory ad-dresses would be a displeasing manifes-tation of their own guilt, were it not that

we observe in it the best evidence of the

70 EFFECT OF THE FRAUDULENT CERTIFICATE SYSTEM

success of our labours. The admonitions,for instance, which we offered to studentslast week, were so general in their con-struction and bearing, that they could

have no particular application except in Ithose directions where the practical re- isults of knavish designs had contributed

Ito illustrate our arguments.If the officers of our hospitals were to

attend as they ought to the interests ofthe pupils, very few remarks on the subject Iwould appear in the pages of this journal,and those few would be couched in the

terms of eulogy. Having observed duringmany years, that the promises set forth in Ithe prospectuses have been falsified, andthat the students, after paying enormous isums of money, and wasting eighteen imonths of their time, have been com-

pelled at last to apply to the privateteachers in order to have a sufficient

portion of information ground into theirbrains to enable them to undergo eventhe insignificant examinations of the Halland College,-inclination as well as dutyexcited us to a performance of that taskwhich we hope and believe we have onmore than one occasion executed to the

great advantage of the parties on whom itwas our object to confer benefit. When themedical session commences, the students

are everywhere received with the utmost

courtesy. Even the dram-drinking stiff-backed beadles can doff their castors and

bend their heads when a new set of gentle-men appears at their gates. In the wards of

the hospitals, in the museums, during the Ilast week of September and the first andsecond week of October, signs of polite-ness are every-where manifested. If a

question be asked of a physician or a sur-geon, the cunning officar instantly inclineshis body towards the querist with all theanxiety of a usurer in quest of pelf; butthe entrance fees being once completelysecured, it has too often happenedthat the dulcorated promises in the

hospital prospectuses, have received no

nearer fulfilment than could be affordedby the acetic demeanor and irregular at-tendances of the persons by whom they

were made. Important questions remain

unanswered; clinical lectures, paid for ina fee of twenty-five guineas, are omitted;

no minutes of the cases are recorded; post-mortem examinations are no longer in-stituted ; and notices of operations are

not posted. Yet it is alleged, that the

complaints of the students are 11 unfound-ed," and the animadversions of THE

LANCET " undeserved!"

When the admonitions addressed to the

pupils in the last number of THE LANCETwere written, our office table was lite-

rally covered with letters couched in termsof complaint against the management ofthe hospitals. From the number of those

documents, it was quite impossible to

publish a twentieth part of them ; but wewill now make an extract from one of

them because it exhibits a perfectly fair spe-cimen of the accusations which are made

against the general mode of conductingthe hospitals. Although the first and

fourth paragraphs refer to the medical in-stitutions generally, the remaining pas-sages point distinctly to abuses in St.

GeorJe’s Hospital.The neglect which prevails in relation

to giving notice of surgical operations andpost-mortem examinations at the LondonHospitals is a most serious evil to the stu-dent, and the neglect of performing themat the time specified, when notice is given,is no less injurious to his interests.At St. George’s Hospital the visits ofall the physicians and surgeons, post-

mortem examinations, surgical operations,and generally the clinical lectures, are ap-pointed to be done at the same hour, sothat if notices were regularly given, oneonly of these important matters could beattended to by the student, although hepays fees to be instructed in all, and re-ceives certificates, declaring that he hasdiligently done so.’ On Thursday last Mr. Babington re-moved a scirrhous tumour from a woman’sbreast of which no notice was given, andeven the house-surgeon was ignorant of

71ON THE INTERESTS OF STUDENTS.

his intention until Mr. B. came into thehospital after one o’clock for the purposeof performing the operation.Another evil, which I believe is com-

mon to a large proportion, if not to all,of the hospitals, is the private manner inwhich the minor operations of surgeryare performed, such as removing fingers,toes, and the smaller tumours, and also.operations for the relief of strictures, fis-tulæ, &c. These are far more importantto the young practitioner than what arecalled the great operations, and often re-quire more skill in their performance. Infact, only those operations are exhibitedto the student which are suited for dis-play, and for making him an ambulatorycard for spreading the fame of the opera-,tors, who, as hospital surgeons, are gene-rally called in when such operations arerequired by those who are wealthy enoughto pay for them.

Whilst on the subject, I cannot passover the inefficient information displayedon the cards that are placed above thebeds at St. George’s Hospital. That Lordso-and-so recommended the patient, andthat this or that surgeon attends him, is

conspicuous enough, but the name of theinjury or disease is not even hinted at;neither is it mentioned when a prescrip-tion is discontinued, or when " house

physic" is given, as if scouring men’sbowels, or discontinuing injurious medi-cines, had no influence on the case.If these apparently trifling matters were

attended to, the card would be an usefulepitome of the case, and the student would’be enabled to form some judgment as to!which cases were most likely to merit hisespecial attention. The value of such aregulation will bo apparent when it is Iconsidered how impossible it is, from theregulations above referred to, that he can ’attend the practice of more than one phy-sician or surgeon, even if he had time, andthere may be cases in the practice of theothers, of the highest importance, eitherfrom their rarity, or as valuable subjects incomparison with those under the care ofhis own teacher.The hospital pharmacopoeia and diet- i

table ought also to be published for the .information of the students, for withoutthem much of the treatment is quite un-intelligible. D. R.

Sept. 22nd, 1834.

Are these complaints of a trivial na-

ture ? For what, we ask, is the money of

the student paid, if it be not that he mayreceive instruction sufficient to qualifyhim to practise his profession, from the

individual who pockets the fee ? Let the

reader examine the statements in the se-

cond paragraph. The certificate systemis, evidently, one of the grossest, one ofthe vilest frauds that ever was practisedon the community. Two of the surgeonsof this hospital (KEATE and BRODIE) areMembers of the Council of the College of

Surgeons, and in their official capacity inthis latter institution, they require stu-

dents to produce certificates of attendance(the demand is IMPERATIVE) on the sur-gical practice of one of the London hos-pitals, thus, of course, taking care of theirown interests at their own institution. In

another corporate institution it is enactedthat certificates on the medical attendance

of hospitals or dispensaries shall be pro-duced ; and of both kinds of certificatesjust so many are sold at St. George’s Flos-pital as the medical officers of that esta-blishment can find ninnies to purchasethem. We cannot use a milder term,

because, with the exception of Guy’s hos-

pital, there is not, we believe, a worse

. hospital for students in London.With regard to the attendances, at the

,same hour, of all the medical officers, aconfirmation of this statement is to be

found in the hospital prospectus ; and we

! will here display what we there find.Mr. KEATE attends or, Mondays and

Fridays.-At what hour ?......ONE O’CLOCK.

Sir B. BRODIE attends on Mondays and

Fridays.-At what hour ? ......ONE O’CLOCK.

Mr. WALKER sees the out-patients ofthe above surgeons on Mondays and Fri-

days.-At what hour ? ........ONE O’CLOCK.

Dr. CHAMBERS attends on Mondays and

. ; Fridays.-At what hour ? .....’ ONE O’CLOCK.

Dr. SEYMOUR attends on Mondays and

Fridays.—At what hour? .....ONE O’CLOCK.

72 ONE O’CLOCK AT ST. GEORGE’S HOSPITAL.

Mr. HAWKINS attends on Tuesdays andSaturdays.-At what hour?...

ONE O’CLOCK.

Mr. BABINGTON attends on Tuesdaysand Saturdays.—At what hour?..

ONE O’CLOCK.

Mr. WALKER attends to see the eye-

patients on Tuesdays and Saturdays.- Atwhat hour ? ........ - ONE O’CLOCK.

Dr. WILSON attends on Tuesdays and

Saturdays.—At what hour ? ...ONE O’CLOCK.

Dr. MACLEOD attends on Tuesdays and

Saturdays.—At what hour ? ....ONE O’CLOCK.

OPERATIONS are performed on Thurs-

days and Saturdays.—At what hour? ,ONE O’CLOCK.

POST-MORTEM EXAMINATIONS takepjace (daily, we presume !).-At whathour? ............... ONE O’CLOCK.

And in order to render this arrange-ment sti1l more perfect, the HOUSE SUR-GEONS are ordered to take their walks

(’4,-,ily through the wards every morning ateleven o’clock; and the apothecary is

ordered to take his hop or his run at thesame hour!

The student, then, who pays his moneyfor the opportunity of witnessing the

whole of the medical or surgical practiceof the hospital, is not cheated, is not plun-dered, because, forsooth, the entire knavish

system is carried on in strict conformitywith the "regulations" of the College, theHall, and the Hospital! The students, on

applying to the medical officers at the endcf the session, receive certificates, de-

claring that they have diligently attendedthe medical practice of the institution,signed by the physicians; and certificatesthat they have attended the surgical prac -tice of the institution, signed by the sur- Igeons ; and such certificates are instantly" recognised by the corporations whichhave assisted in inventing and carrying Ion the fraud.

When it is considered that under the

above arrangement four medical officers

at the same moment attend at different

parts of the hospital to four sets of patients,the climax of the iniquity will be reachedin that mind which knows how to estimate

the loss which a young man, on enteringlife, must thus sustain in his prospects.He purchases a thing consisting of four

parts, and he receives hut one of them inreturn for his money, and on the use of

that commodity which he spends his

wealth and his time in the attempt to

acquire, the fate of his professional careermust be determined. It is for the exposure

of such nefarious practices that this jour-nal is systematically slandered by the

guilty parties. Clinical lectures, attend-

ances, operations, post-mortem examina_

tions, out-patients, eye-patients, and eye-’ less patients,—all accomplished and waitedon at one o’clock. Under this arrange-

ment a plurality of the organs of seeingand hearing is more than provided for.The two eyes of each student are requiredto behold the movements of four officers,through sundry wooden floors and stonewalls ; and the two ears are provided, atone and the same time, with four sets of

explanatory clinical remarks:

Such is a portion of the certificate sys-

tem, and we are by no means sure that itis the worst portion of it. In several of thelarge recognised schools the students arerequired to pay for, if not to attend, lec-tures, the delivery of which occupies fromten to twelve hours of cathedral gabble,scarcely relieved by one interruption, savethe momentary silence which is occasioned

by the change of one gabbler for another.The worthies who rule in medical affairs

have taken it into their wise heads that

man has far too many senses, and, that inorder to acquire a knowledge of the scienceof medicine, it is of importance to dis-

pense with the use of those of sight andI ’touch, Accordingly, provision is made

73LONDON UNIVERSITY.-PARLIAMENTARY EVIDENCE.

for the full occupation of the sense of

hearing, and thus the student is to be

bored from one end of the week to the

other with trashy talk which can neverreach the understanding or the memoryexcept through the operation of the sight,or the medium of the touch. A jarringdiscordant din is to make him acquaintedwith anatomy when he is so situated thathe cannot see the structure of the partswhich are described; he is to be talked

into a knowledge of chemistry without

sharing in the labours of the labyrinth,and he is to be furnished with a knowledgeof the principles and practice of medicineand surgery, by scarcely hearing read those

essays and treatises which he might studyby his own fire-side, or by attending four

physicians and surgeons at one time,-allmoving in different places at the samehour.

Convinced, therefore, as we long havebeen, that the certificate system is foundedin delusion and is productive of fraud, wehave endeavoured by every possible meansto promote its destruction. But, so longas it lasts,-so long as the medical cor-

porations, under the sanction of existingActs and Charters, empower those bodiesto interfere with the rights of privateteachers, and infringe the privileges of

the students, we shall endeavour to pointout to the pupils in what manner theyshould conduct themselves so as to derive

the greatest portion of benefit, attendedby the smallest degree of injury, in pur-suing their studies in this metropolis.

THE medical department of the London

University was opened on Wednesday last, ’,when an admirable introductory addresswas delivered by Professor LINDLEY. The I’ilarge theatre was thronged with auditors ; ’iand there were present, besides the pro-fessors of the institution, many distin-

guished men of science. Want of space

compels us to postpone the address of Pro-fessor LINDLEY until next week. The

University Hospital will be open for thereception of patients within a short pe-riod ; but probably it will notbe in full

operation until the beginning of January.As the terms are much lower than at the

other hospitals, and as it is expected, fromthe great medical reputation of the Uni-

versity, that the clinical instruction of the

hospital will be conducted regularly, andprove of a very high order, it may be pru-dent in students to defer entering to theother hospitals of the metropolis. When

it is operating, however, a few weeks willenable them to determine as to the pro-

priety of the selection.Is it true, as reported, that the Council,

or the Senate, are in search of an operatorfor this hospital,—a mere mechanical cut-

ter,-a person who delights in blood ? It

cannot be ; for such has been the progress

of medical science within the last fe-.v

years, that the power of operating is nowdeemed the most insignificant part of ascientific surgeon’s capabilities. Once

obtain for this hospital a reputation for its

being a cutting and slaughtering esta-

blishment, and the directors of it will

search in vain for cases of disease where-

with to instruct the students.

We shall say no more on this subject at

present; but it is one of extreme im-

portance, not only to the hospital, but tothe medical department of the university.

AMONGST other articles we have been

compelled to postpone some farther re-marks on the parliamentary medical

evidence until next Saturday. What wehave already said does not, we find, pleasethe enemies of medical reform; this is sa-

tisfactory. Probably they will be still less

pleased when they ascertain that the me-dical practitioners throughout the empireare to have an opportunity of reading every

74 MINISTERIAL MEDICAL APPOINTMENTS.

syllable of the evidence, and of decidingfor themselves on all the great questionswhich the testimony of the witnesses hasexposed to view. The evidence thus col-

lected is of such a nature that everymedical man should become thoroughlyacquainted with it. It embraces the his-

tory and mode of government of our

medical corporations; the mode of edu-

cating " doctors ’’ in the various English,Irish, and Scotch Universities; and the

system of medical education pursuedthroughout the continent, blending in

one work a more interesting and valuablecollection of facts than were ever before

united relative to the science and practiceof medicine. The following extract fromthe advertisement will make our readers

acquainted with the time and mode of

publication of the evidence :-

" THE LANCET edition of the Parlia-

mentary Evidence will be published inNumbers (price Sixpence each), andissued immediately after the Official Copyof each part is placed in the hands of theMembers of the Committee. By actingin strict conformity with this plan, theutmost dispatch will he maintained whilethe entire work is proceeding from the

press." As it is particularly desirable that the

whole of the Medical Evidence should hein the hands of the Members of the Pro-fession, by the time that the Official

Report founded on that evidence is pre-sented to the House of Commans, theexertions of the printer will be made tocorrespond, as nearly as possible, withthose of the parliamentary press. Con-

sequently, those gentlemen who are de-sirous of possessing the evidence, shoulddirect their booksellers to furnish theNumbers AS THEY ARE PUBLISHED, as itwill frequently happen that more thanone Number will be issued during theWeek. Already we are enabled to state,that Nos. 2 and 3 will be ready for de-livery on Saturday, October the 11 tho" THE LANCET edition of the Parlia-

mentary Medical Evidence may be ob-tained through the medium of any of thebooksellers of the United Kingdom."

’, OuR Edinburgh Correspondent has re-quested us to correct an error into whichhe inadvertently fell, when he describedthe appointment of Dr. CRAIGIE to the In-spectorship of Anatomy in Edinburgh as aWhig job. So far was this from being acorrect statement, that it was one of the

many instances in which the Government

sought to favour and promote an invete-rate Tory opponent. He was, in a word,a chairman of the Committee of Mr. HuN-

TER BLAIR, the Tory opponent of the

Whig Lord Advocate. We advert to this

subject with regret, because Lord MEL-

BOURNE, as Secretary of State for the

Home Department, has so conducted him-self in medical affairs, as to merit to be

spoken of, uniformly, in this journal, interms of respect and commendation. He

was undeviatingly attentive to the wishesof the profession, and exhibited invinci-ble firmness in resisting the intriguingagents of that faction who incessantlybuzzed about him, and who succeeded in

controlling and embarrassing every one ofhis predecessors.

While on the subject of medical ap-

pointments, what shall we say of the predi-lections of the LORD CHANCELLOR)—the" liberal-minded" Lord BROUGHAM? Has

his Lordship been so thoroughly inocu-lated with Toryism, that he cannot breatheor live except in the presence of Tory doc-tors ? Had he no old associates who could

have filled the office of Chancery Commis-sioners in preference to those rank Toriesand opponents of medical reform, SOUTHEYand MACMicHATSL ? Had his Lordshipno old friends whose attainments were

equal to those Tory Doctors, SEYMOUR,J. R. HUME, and BpiRHT, for occupyingthe places of Metropolitan Commissionersof Lunacy? The members of the medical

profession know not what to think of

these appointments, and we dare not re-

peat what is said. Lord BROUGHAM, it

75HOLLAND’S PRINCIPLES OF MEDICINE.

would appear, has thrown all his medical

patronage into the hands of that ultra-that most ultra o f Tories, Sir HENRY HAL-

.FORD, that chief of the most Tory insti-

tution in England, in reference to whoseconduct during the illness of his late Ma-

jesty GEORGE the FOURTH, Mr. BROUGHAMthus expressed himself in the House ofCommons :-" He defied any man to put his finger

on a single bulletin from which it would

appear that the King was in a state ofserious danger. Even when his Majestywas at the point of death, no such intima-tion was conveyed in those documents.He would advise those who had pursuedthat course to recollect that this countrycould not long be governed by a systemof fraud and deception. Disguise, andfalsehood, and treachery, had never suc-ceeded, and never could succeed, for anylength of time, more especially in a mat-ter of such universal interest."

Was, then, the head bulletin-signer thefittest person the CHANCELLOR could find

on whom to bestow the patronage of his

high office? There is a mystery envelop-ing the actions of Lord BROUGHAM in this

respect which we cannot penetrate.

An Inquiry into the Principles and Practice of Medicine, founded on Original Phy-siological Investigations. By G. CALVERTHOLLAND, M.D., Phys. to the SheffieldGen. Inf. Vol. I. London, Longman,1834, 8vo. pp. 540.

OuR readers call out so lustily for our

opinions on books, that we are unwillingto let any number of THE LANCET between-the 4th of October and the end of timeissue from the press unaccompanied by areview. Space for analyses and criti-

cism has hitherto been wanting in ourpages ; but henceforth it shall be created,and, then, doubling the length of our days,and redoubling our industry, the publicdemand shall be met, and the cry for

reviews no longer be heard, unsatisfied,issuing from the mouths of ten thousandopen letters in the editorial recess.

Several volumes lie before us whose

contents we have examined, and whosefates we have decided, but the decrees

cannot yet go forth. Amongst others, wehad prepared an analysis of the interest-

ing volume which is quoted above. The

writings of Dr. Holland are entitled to therespect of all journalists, and we shall do

justice to his new production. This week,however, our intention cannot be fulfilled,and we therefore simply introduce it to

the notice of our readers, with a few re-marks preliminary to an analysis of hisviews respecting the principles and prac-tice of medicine.Men are so apt to call crude theories

" principles," that we can hardly wonderat Dr. Holland’s describing his own prin-ciples " as " sounder principles than thoseof his predecessors. It is a designation,however, which he could not have meantto use. One set of principles cannot besounder than another set. Principles aretruths. The proof that the positions as-surned by philosophers really are principles,is to be tested by experiments made inconformity therewith. Will the principleslaid down by Dr. Holland lead us to " a" mode of practice in the treatment of" disease, more simple, decisive, and ef-" fective, than that which is commonly" adopted ?"-and lead us, not only to that,but to a mode of practice which will bealtogether effective ? This shall be the

subject of our inquiry on another occasion.Dr. Holland himself entertains an opinionthat he has at least approached the latterdesideraturn. Because he cannot do with-

out the word more in the sentence we have

quoted, he, with less correctness than

modesty, speaks of his positions merelyas being " sounder" " than those of other

theorists.

The author retains fellowship with nonethat have speculated before him, and

accordingly devotes the first portion of hisvolume to the destruction of the humor-ists, the solidists, the Cullenites, and thenervinites,-dragons which have most ac-tively guarded the Hesperian fruit ofmedical science It is easier, however, todestroy than, create, and this we suspectto be the case with the Dr. very soonafter he has levelled his blows at the first

set of his opponents in the road to the gar-dens of the golden growth. He seems to

have damaged his adversaries without aconsciousness of his own competency to