678

THE LANCET.

LONDON, SATURDAY, JUNE 26, 1847.

POSTPONEMENT OF THE REGISTRATION BILL.

THE abrupt and early termination of the present session ofParliament has rendered it incumbent on the Government to

withdraw from the House of Commons many Bills, some ofwhich had been under consideration during several months.Among them is the Railway Bill, to which great importancewas attached by the Ministers. We believe that it is now

determined that in less than twenty-one days the presentsession shall close its labours, and nearly at the same time theexistence of the present Parliament will end.

Finding, in this state of things, that it would be utterly im- I

possible to pass the MEDICAL REGISTRATION BILL in the present session, Mr. WAKLEY has considered it to be a duty to with- draw it for this session. This was due to those members ofthe House who had promised to support the measure in itsvarious stages, and who had repeatedly attended for thatpurpose; and also to the Medical Registration Committee, I,whose labours have been so well-timed, energetic, and

valuable; as well as to the many hundreds of medical

practitioners who have supported that Committee, and peti- Itioned in favour of the Bill. The hour of the triumph of theprofession is delayed, but only delayed. Come it must, and

decidedly in the first session of the new Parliament. The

opponents of a measure which has received the almost una- z,

nimous support of the profession throughout England, Ireland,and Scotland, are now stating the grounds of their opposition ’,before a Committee of the House of Commons. In that Com-

mittee five witnesses from the College of Physicians, includingthe President, the Senior Censor, and the Registrar, have beenexamined. From the Council of the College of Surgeons onlyone witness has yet stated his objections, that one being the Pre-sident. In the next week, the evidence from the Council of the

College of Surgeons will certainly be concluded, and-it is hopedła portion, if not the whole, of the witnesses called from theSociety of Apothecaries will by that time have been examined.These are the three corporations which have petitionedagainst a Bill that provides, throughout Great Britain andIreland, for equality of education, equality of qualifeation, andequality in the amount offees to be paid, by all future medicalpractitioners.Such being the state of the case, it may truly be alleged

that the cause of the medical profession has at last assumed,notonly a prominent, but a splendid attitude; for the just com-plaints of the legally-qualified members of the profession areno longer disputed, and, by the appointment of the MedicalRegistration Committee of the House of Commons, the

necessity of legislation on their behalf is admitted.On Monday evening last, after the Government had

abandoned the Railway Bill, and so many other of theirmeasures, Mr. WAKLEY, seeing the impossibility of carryingthe Medical Registration Bill, announced that he had deter-mined to withdraw it. He, at the same time, stated that,should he occupy a seat in the House of Commons in the

next Parliament, it was his fixed resolution to give notice ofa motion for the re-appointment of the Medical Committeein the very Brst week of the session.

The subject must now be prosecuted to a successful con-

clusion. It cannot, and will not, be allowed to rest, until thefate of quacks and quackery, and that of all denominations ofunqualified practitioners, has been settled by the enactmentof a just medical statute.We hope that the MEDICAL REGISTRATION COMMITTEE,

which has held its sittings at the FREEMASONS’ TAVERN, andwhich has laboured so admirably in the good cause, will notdissolve, or discontinue its exertions. We trust that at the

very next meeting the members will come to an unanimousresolution to continue their sittings until a MEDICAL REGIS-TRATION BILL has been enacted into a statute of the realm.Time will now be afforded also to those friends of the cause

who reside in distant counties, to organize district Com-

mittees. In a few days, the evidence which has been givenby the five witnesses from the College of Physicians againstthe just system of registration which is proposed in the Bill,will be printed, and in the hands of the profession. Theevidence yet to be taken will also be printed. Ample timewill be obtained for an examination of the grounds of thehostility which has been exhibited by the old medical corpo-rations of London against what we deem to be a strictly justmeasure; and, after maturely weighing all the objectionswhich have been offered, the profession will determine

whether Parliament ought to be influenced by them, andreject a just measure of policy, or whether the very founda-tion and principles of the opposition which has beep exhi-bited do not offer sufficient inducements to the great bodyof the profession not to relax in their exertions until therights of all the legally-qualified medical practitioners ofthese kingdoms are placed, by the law of the land, on a just,clearly-defined, and equable basis.

WE revert to the subject of the ill treatment of the surgeonsof the army and navy for many reasons. We feel that an

injury done to so large and so meritorious a class is to preju-dice the whole body of the profession. This feeling becomesa settled and rooted conviction, when we consider the mannerin which the character of the entire profession has been up-held in the field and in cantonment-in peace and in war

- boy our military surgeons. They have ever shown know-ledge, judgment, energy, indefatigable industry, resolution,address, and untiring patience. To all these they have addeda courage that has not looked to rewards -a courageof the highest order. Their cause, we regret to say, is newto public discussion, although, from the works of our greatmilitary surgeons, it is evident that the iron code of class

restriction, and of pseudo-economical rule, has always beenwritten deep on their hearts.ROBERT JACKsoN--as truly brave a man as he was un-

equalled as a military physician-felt all this; but he lived intimes when studied exclusion and neglect cast their dark slia-dows over him-when, in short, they constituted the law. Hewrote, therefore, as a man whose condition had never beenillumined with hope. He saw his class pass through theirofficial lives unrepresented in the councils of the State, thoughall other interests and classes are there represented. He saw

that in the hard campaign, and in the hour of battle, thesurgeons of the army were lauded to the skies as the finest

fellbws in the world, risking their lives for nothing; but whenpeace came round, their lives became a sad routine-they

679HONOURS TO NAVAL AND MILITARY SURGEONS.

remained uncared for-their services were unchronicled andunrewarded.We will now refer to a few recent personal examples of

army surgeons who have served and suffered for nothing, sofar as regards military rewards or distinction ?-Mr. GUTHRIEwas severely wounded in the ordinary discharge of his duty.He has conferred great benefits on the fleets and armies of

England by his improvements in military surgery. The late

Dr.1 THEODORE GORDON was thrice wounded-once severelythrough the neck, when called to the front to save his com-manding officer. The officer whose remarkable course of

service we now record died lately in Bengal-a climate wheremany a brave man has died, like him-" not by the sword, but

by the fever." DONALD MACLEOD was a native of the Isle of

Skye-the most suffering, but most patiently enduring, portionof the British empire during this calamitous year of famine.He served with the Duke of YORK in Holland in 1799; in the

Mediterranean, to the end of the war, in 1802; at the captureof the Cape of Good Hope; at Monte Video, under SirSAMUEL AUCHMUTY; and at Buenos Ayres, under GeneralWHITELOCK. He went to Portugal under Sir ARTHUR WEL-LESLEY, and was in all the operations of that campaign, to thebattle and embarkation at Corunna, under MOORE, BAIRD, andHoPE. He served during the whole of the disastrous campaignof Walcheren, and returned to Spain in 1811. He was in the

battles of Salamanca and Vittoria, the siege and retreat fromBurgos, the siege of St. Sebastian, and in the actions foughtin the neighbourhood of Bayonne and Orthes. He embarked

for Canada, and was present at Platsburgh, and in all theoperations on the lower frontier. He then returned to

Europe, and joined the army in France. He served in the

colonies of New South Wales and Van Dieman’s Lnd—in

the presidences of Bombay, Madras, and Bengal, in which lasthe attained to the station of inspector of hospitals.A circumstance is related of this brave and experienced

officer that aroused the sympathies, while it shocked the feel-

ings, of the army: At the siege of St. Sebastian, the subjectof this notice was conversing with a younger brother-a cap-tain, like himself, on duty in the trenches,-when a cannon-shot literally knocked the younger to pieces, covering theelder with his blood and brains.

Referring to the instances here briefly recited, (and to

which we could add by the score,) we declare that for govern-ments to grant military commissions, and to employ an highlyeducated class of officers in the manner so well described bythe gallant Sir HOWARD DOUGLAS,-giving nothing in return butpay,-is wilfully to put a stigma on one of the most importantand most deserving branches of the public service.

This is felt in an especial manner by the surgeons of theIndian army, whose pay and allowances are on a high footingof respectability. The exclusion from rewards lavished re-

cently on the most ordinary persons, for the most ordinaryservices, and sometimes for no services at all, galls their feel-ings, and damps their zeal. Within a few years, four com- imissariat officers of the Bengal army have received thehonour of the Bath. A captain is stated in the Indian news-papers to have been made C.B., major, and lieutenant-colonel,for services purely civil; and the last honour is reported tohave been conferred for the battle of Ferozshah, in which he" was not even present." After this, we might reasonablyurge the plea of advancement for the surgeons who actually

went through the hard service of those battles. But we onlyclaim, that they be no longer left behind all other classes. Whenwe regard the numbers of medical officers, on the other hand,wounded and killed in the recent campaigns in India, we areforcibly struck with the absurdity and injustice of their treat-ment. The numbers wounded amongst the surgeons em-

ployed in the Affghan campaigns we have no means of know-ing ; but there were eight killed; and if we take the usualproportion of wounded to killed, we shall, for one particularservice, reckon a goodly proportion of officers" who haveserved and suffered for nothing."No men are more alive to the fact, that honour is the vital

principle of armies, than our military and naval surgeons.But let them remember, that while concert, confidence, andunion, aided by firm but respectful remonstrance, will securethe objects in view, there is nothing, on the other hand, soreally weak as numbers devoid of energy, or benumbed byselfishness, mistaken in its aim.We would also have them remember, that it is the merest

weakness and folly to suppose that any Government, now-a-

days, can declare any other ultimatum than a fair and justequality of reward to its public servants. To act on the con-

trary view-to suppose an inflexibility-is to give up all

chance of doing good. Courts, and even cold courtly generals," without passions or prsecordia," must give way to experi-ence, truth, and reason. Lastly, we would assure our friendsof the army and navy, that only a few minutes’ discussionof their cause is now required, in the House of Commons, tosettle the question of their grievances for ever; and that dis-cussion may take place ere long.ROBERT JACKSON looked, fifty years ago, for improvement in

military medicine, to " the legislative branch of the Govern-ment," there being then, as now, a " presumption, amountingalmost to proof, that there is no chance of obtaining it from

the executive."

These prophetic words receive vast additional force fromthe different character and constitution given to the " legisla-tive branch" of our day, by the withdrawal, by Lord GREY, of" the bearing-rein from the English people."We live no longer in benighted times, when Government

was deemed an amusement and an inheritance of the

aristocratic classes, rather than a trust for the benefit of

the people.

A CIRCULAR has, within the last few days, been forwardedto the Fellows of the Royal College of Surgeons of England,worded thus :-

"SiR,-I beg to inform you that the ANNUAL DINNER of theFELLOWS of the ROYAL COLLEGE OF SURGEONS OF ENGLAND willtake place on THURSDAY, July 1st, 1847; and that JOHN SlBIITRSODEN, Esq., has kindly consented to preside, and the follow-ing gentlemen to act as stewards. * * * *

" CHAS. HAWKIXS, lion. Sec."

Respecting this document, several communications havereached us. We have been asked, for instance, who fixed the

day of the dinner?-who appointed Mr. CHARLES HAWKINS tothe post of honorary secretary? -by whom, or on what

principle, were the stewards selected?-and, above all, onwhat principle is such a dinner to be held? Several of our

correspondents are of opinion that it is an offensive proceed-ing with respect to upwards of thirteen thousand members ofthe College-highly and particularly offensive, considering the

680 FELLOWSHIP DINNER.-DEGRADATION OF NAVAL SURGEONS.

manner in which more than four-fifths of the present Fellowswere chosen by a corrupt and condemned council. It cer-

tainly is notorious that many of the Fellows were not chosenin consequence of their merits, although, beyond doubt, theyare a body of very respectable gentlemen. But are not the

members of the College equally respectable? Confining a

professional dinner to a particular class in a College,savours of vanity, of conceit, and of empty boasting. If

there be not in it the evidence of an attempt to attach

importance to a thing which in itself is worthless, andwhich renders, therefore, the whole affair a species of quackerythat ought to be scouted, there is, avowedly, in it a sign of

diqueism, that calls for the stern reprobation of the great bodyof the profession. As the arrangements for the dinner for the

present year seem to be completed, and as, we presume, it mustnow be held, we forbear offering any further remarks on it atthis time; but should the offensive project be repeated;should such a proposition again be made, we shall feel it to bea duty to hold up the active agents in the proceeding, viz.,the Chairman and Stewards, to the observation, and, we be-lieve, the consequent indignation of our professional brethren.From the names which we observe in the list of stewards, weare inclined to believe that several gentlemen have consentedto act in that capacity, without reflection on the character ofthe project in which they are engaged. If the gentlemenwho became Fellows by examination had thought it right toset such a scheme in motion, infinitely less insulting andobnoxious would have been the proposal; for in that

case it would have emanated from a body of persons whomay have thought that they had just grounds for consideringthat by merit, and by that alone, they had been enabled toobtain what they regarded as a superior title and a superiorposition. But, with respect to the nominated fellows, whowere pitcliforked into their position, there is no foundation fortheir pretensions; and for such persons to arrogate to them-selves that they belong to a higher class of practitioners thantheir neighbours, and that they are better qualified, andentitled to more public respect and confidence, than themembers generally, the claim is too preposterous to be

tolerated; in fact, if it be renewed in another year, its authorsshall receive precisely that kind of notice which their pre-sumption will deserve.

___-

IN another column will be found a letter from " An Assis-

tant-Surgeon, R.N.," describing the position of the youngmedical man on shipboard. The details are not less disgrace-ful to the entire naval service than it is a stigma to the medicalprofession. On a former occasion we pointed out the highqualifications demanded of the medical man before he entersthe navy, and the treatment to which lie is afterwards obligedto submit. In age he must be from twenty to twenty-four, onhis admission; in intellect and professional acquirement lie

must be ripe and cultivated; yet the moment he gets hiscommission, he is made the companion and equal of boys bothin years and education. He is obliged, before his admissionto the service, to have learned his profession, and to have ob-tained his full professional diploma, (for the second examina-tion, on becoming full surgeon, is little but matter of form,)yet he his herded with youths who are learning the alphabetof theirs. In the navy regulations, much is said about the im-portance of extra-certificates and diplomas, and the preference

accorded to their possessors, but as regards treatment theyhave to submit to exactly that which an apprentice or medicalpupil might expect. The navy demands a maximum of quali.fication, and then treats it with a minimum of respect. Those

in authority do their best to quench all self-respect andhonourable feeling in the young medical officers, and then

they look for such noble and devoted services as those rendered

by M’WILLIAM on the Niger, and at Bona Vista, and bySIDNEY BERNARD on board the Eclair.

On every side, the just rights of professional men aretrampled on, but this state of things in the navy cannot last,it will not bear public exposure, and that, at least, we are de.termined it shall have.

The higher men in the medical department of the navy oughtto exert themselves to remove the gross injustice practisedtowards the assistant-surgeons. Not a single medical manwho has been, or who now is, connected with the service, butwould be the more respectable for the removal of this evil.We should have thought the men of our profession, who eitherare or have been in the naval service, sufficiently influential tohave brought about so just and necessary a reform withoutpublic discussion. Surely such men as Sir JAMES CLARK, SirWILLIAM BURNETT, Sir D. DICKSON, and Sir RICHARD DoBSON,might, we should imagine, do much towards remedying thejust complaints of the assistant-surgeons. Their present po-sition ought not to render them indifferent to the welfare andcredit of their younger brethren.

No excuse can be drawn from the class of men who form

the body of assistant-surgeons. They are such as to deserveliberal treatment from Government, and from the naval ser.vice. As our correspondent remarks, " they are all membersof some of the Royal Colleges of Surgeons, and many of them,in addition, have obtained the degree of doctor of medicine."Some of the best educated young men in the profession areat present acting as naval assistant-surgeons, and " denizensof the midshipmen’s berth," if their service is on shipboard.On looking over the navy list, we find, that such men as theyounger HOOKER, the botanist, and HARRY D. GoODS1,R, are

assistant-surgeons ; and also several graduates and under-graduates of the University of London. Among these, wemay mention, T. H. IIUXLFY, a medallist of 1845; ALFRED

JACKSON, rLB., and University Exhibitioner of 1843; and F.J. BROWN, M.D., both of London and Edinburgh ; and manyothers, with different diplomas, who have distinguished them-selves during their educational career, might be mentioned.When the matter is thoroughly exposed, the interests of

the navy will demand a reform in this matter. After its

public discussion, young medical men of spirit and acquire-ment, such as are needed for the navy, will not enter theservice so freely as they have hitherto done. There is some-

thing which would be positively grotesque, if it were not aninsult to our profession, in the disparity between the official

announcement from the " medical department of the navy,"that in the selection of assistant-surgeons " a favourable con-sideration will be given to the cases of those who have ob-tained the degree of M.D. at either of the universities ofOxford, Cambridge, Edinburgh, Dublin, or London," and therules of the naval service, which, after the said M.D.s are

caught, shut them out from the ward-room and the society ofofficers equal to them in rank, consigning them to the noisymidshipmen’s berth, and the luxury of " a chest of three feet

681MEDICAL REFORM IN FRANCE.

six in length," to serve for " library and wardrobe;" while acabin is given to the gunner, boatswain, carpenter, and

engineer.Expediency, no less than justice, imperatively demands

that such disgraceful anomalies should be amended.

MEDICAL REFORM IN FRANCE.IT has often happened in general politics that similar prin-

ciples have at the same time agitat.ed different nations; andin the records of philosophy many instances are enumeratedof the discovery, or of the elucidation, by different indivi-duals, of some great fact or phenomenon, independently ofeach other, but simultaneously. During the present year,when a Bill has been introduced in this country to amend andregulate the profession of medicine, and when the minds ofall the medical practitioners in the realm are earnestlydirected to the subject, our medical brethren in France areequally interested in the fate of a measure brought beforethe French legislature, to improve the medical profession inFrance. The French Project of a law for the teaching andpractice of medicine in France," appeared on the 15th ofJanuary in the present year, and, consequently, almost at thesame time as the Registration and Medical Law AmendmentBill, as published in THE LANCET, and subsequently intro-duced into parliament.Now, as many of the evils infesting the profession in France

are similar to those which exist in our own country, weshould inform ourselves as to the remedies which our Gallicneighbours propose, both those which are comprehended intheir "Project," and those contained in any reports or re-marks on them which have been published.Of the chiefs evils affecting the medical profession in

France, we may obtain an account from the Report madeupon the 11 project de Loi," by the Count Benguot, before theChamber of Peers. The first is, that the law now in opera-tion having been framed in former times, and adapted to cir-cumstances differing from the present, is replete with errorand omissions, neither providing for the general interests ofsociety, nor for the particular interests of those immediatelyaffected by it. Again: medical men have accumulated toan extent injurious to their own interests in large towns,leaving the country as an open field for ignorance and em-piricism. Further : although practitioners enjoy equal rightsand privileges, yet this equality is injurious, from the fact thatsome have not entered into the practice of their professionuntil they have made great sacrifices, after a lengthenedcourse of study, and the subjecting of themselves to the mostperfect tests of qualification, and to the most rigorous exami-nations, whilst others have done the same only after morelimited studies, incomplete tests, and valueless examinations.Lastly: however well-informed, however laborious, the phy-sician may be, he cannot reckon upon a favourable career, forthe law extends him but an ineffectual protection, with whichthe quack may sport without fear or shame; and the legisla-ture, alive to the welfare of other liberal professions, seemsindifferent to that of medicine, whose influence on the well-being of society is so extensive and powerful.The law in force was promulgated during the Revolution,

and admitted two orders of medical practitioners - viz.,doctors in medicine or in surgery, and " officiers de sante,"the latter being an inferior grade, admitted to practice (butthis only in the department in which they were examined)after a less extended course of study than that required ofcandidates for the doctorate, who were to be four years at aschool, to undergo five examinations, and to produce a thesis.The same law also established a school of pharmacy in eachtown where there then existed schools of medicine. ]n 1808,the schools were constituted faculties of medicine, and theUniversity founded.With this sketch of the state of the profession in France,

and of the laws relating to it, the account we proceed to add ofthe chief clauses of the Bill now before the French Chamber,will be better understood. The " Projet" was introduced bythe Count de Salvandy, the secretary of state for the depart-ment of public instruction, and grand master of the University.It contains five headings and forty clauses. The first headingconcerns " the conditions for the practice of medicine." Itsprovisions are to the effect that no one shall practise medicinein France, unless furnished with a regular diploma of doctorin medicine, and duly registered; that none shall be admittedas doctor in medicine unless he have a, degree of bachelor inarts, and possess the certificates of study required by the pre-

sent Act. Every Frenchman having the diploma of doctor,and being registered, may freely practise his profession in anypart of the kingdom, and bear the title of physician or of sur-geon ; but whoever shall assume either of those titles withouthaving fulfilled the required conditions, shall be punished byimprisonment for six months or two years; and for a secondoffence, for two or five years. A Frenchman or foreigner,with a foreign diploma of doctor, cannot practise in France,except by royal authority, and after a declaration to the effectof the equal value of that diploma and of his qualifications,has been pronounced by the council of the University, withthose required by this Bill. With regard to the foreigner, theauthority to practise is always revocable, and may be limitedto a department or to an arrondissement, or to his countrymenin France. All infringements of this article to be punishedin the same manner as before laid down. " Officiers de sante,"regularly qualified according to the old law, may continue topractise, but may not assume any other title; but they maypresent themselves for the doctorate if they possess a degreein arts, and may count one year of practice antecedent forsix months of study. The profession of medicine is incom-patible with the employment of apothecary, (pharmacien;)and every association, secret or open with it, is liable to thepreceding penalties. But one practising in a place wherethere is no apothecary within two miles, may keep medicinesby him; but shall then submit to all the laws regulating theemployment of pharmacy. Lastly, all those tainted by crimecannot practise medicine.The next heading refers to the conditions of study, and

provides for two classes of schools-viz., preparatory schoolsand faculties of medicine. The degree of bachelor in medicinemay be conferred by either; but the licence in medicine andthe degree of doctor only by the latter. The duration ofstudy for the degree of bachelor is two years; for a licence,four years; and for the doctorate, five years. In order toenter on the medical classes the pupil must have a degree inletters, (bacheliers-lettres;) and before his fourth year, musthave become a bachelor of arts, (bacheliers-sciences.) Someclauses follow to provide for those who have already enteredon their studies; and the third heading respects the teach-ing of medicine." The first two years are to be passed in thepreparatory schools, which are to impart instruction in thosebranches of knowledge which are fixed by the University pro-gramme ; the preparatory schools to be placed under the juris-diction of the State, and the necessary finances to be providedby the several communes. The instruction is to be afforded byprofessors and assistants, belonging to the medical faculties.The assistants (agreges) are appointed for ten years, afterwhich their engagement ceases. The professors and aJsist-ants, both of the preparatory schools and of the faculties, areto be elected by concours, and appointed by the minister ofpublic instruction. No one can become a professor in a pre-paratory scliool unless a doctor in medicine, and twenty-fiveyears old; nor a professor in a faculty unless he be one pre-viously in a preparatory school, or at least, a member of theInstitute, or of the Royal Academy of Medicine, or a chiefphysician to a city or chief town of 20,000 inhabitants.The next heading is concerning the foundation of scholar-

ships, or bursaries for deserving students, to be held on thecondition to practise in any department ordered them for tenyears, and the institution of provincial (cantonaux) physicians.The duties of the latter are specified as being, to visit the in-digent ; to succour those suffering from epidemics; to attendto all the departments of medical jurisprudence, everythingconcerning which is to be referred to them; to transmit tomedical councils to be established, or to competent ministers,such facts and documents as may serve the interests of scienceand those of public hygiene. The clauses of which the aboveis a brief analysis are those which more particularly concernthe medical profession, the twenty-two remaining ones arecomprehended under the fifth heading-viz., " Instruction inPharmacy, and Conditions of Study," and, as the title indicates,refer to the study and qualifications for an apothecary (phar-macien) chiefly; but two or three clauses provide for the pre-paration of a pharmacopaeia and its publication, and for itsrevision every third year.Such is an outline of the Bill as brought forward by the

French minister of public instruction, one which certainlyseemed to fulfil, in an effectual manner, the objects contem-

plated. When the Bill was introduced, a commission of theChamber of Peers was appointed to consider it, and to makea report suggesting any amendments which might occur tothem or be advanced by others. During its sittings, the com-mission received various deputations and letters from differentbodies and individuals; and in a short time prepared a report