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guidance in actual life and was taking so long to leadto any palpable benefit, he for one would answer thatwhatever experience he possessed in the matter pointedfor him to one circumstance-to the want of organisation inthe studies and laboratories of Europe. Was it not true thatfor knowledge to be useful it must not only comprise a largenumber of facts, but that all those facts must be such as tofind themselves connected in one particular central pointwhich then appears as a real, concrete lever whereby tomove and to direct the course of events in nature ? ? Notonly in such a vast complex of phenomena as that repre-sented by an epidemic, but upon one square yard of gardensoil, every one of them would be able to point out quite adefinite set of associated or dissociated objects of investi-gation such as might keep occupied all the institutions of theworld for physical, chemical, mineralogical, zoological,botanical, even sociological, and many other researches duringa period of time-if they wished only to limit it there-of a century to come. It was clear that the good applicationwhich man could make of his intellectual gifts consisted notin taking in all the infinity of facts and phenomena whichhappened to pass around him, but in discerning and selectingamong them such as were combined by an intimate, concrete,palpable relation of cause and effect, or of common causeor of combined effect or of any other clearly conceived rela-tion and of which at the existing stage of his power andknowledge the best use for the benefit of the livinggenerations could be made. There was hardly any need forhim to qualify that conclusion by adding that the recognitionof that kind of facts was not always easy or possible ; that,secondly, if they were to systematically neglect th 1 cord-ing of information which they came across, but forwhich there happened to be no recognised demand in theforum of science, great losses for that science would

ultimately result; and that, lastly, the natural develop-ment of thought necessitated the investigation of subjectswhich found themselves in logical sequence with alreadyexisting information, whether those subjects be or benot of a character leading to benefit to man. Thosemaxims were irrefutable and should be accepted as such.But when setting out upon an investigation immense import-ance belonged to the general plan, to a judicious selectionof problems, to the recognition of essential and unessential,important and secondary, points; and it remained truethat the secret of obtaining useful knowledge lay in that

necessity of collecting in a short space of time and while thestudy is guided by one leading and discriminating purposeof a large amount of correlative facts. In experimentalscience, however, every bit of knowledge is to be gatheredby direct exploration, by seeing, feeling, analysing, inter-

preting every single act and object at work in the factory ofnature. And the scientist, be he as greatly gifted as hemay, has no more than one set of eyes, ears, hands, one

brain to work with, and it is not more possible for him todivine knowledge or to effect many things at one time thanit is for any other worker in any other field of activity.An organisation of studies is evidently necessary. Itmust be rendered universally known and understoodthat problems of scientific inquiry necessitate the main- tenance of not less strict and combined a serviceof trained workers than even a military organisation, or

a mill or factory, or an enterprise of any kind wherecomplicated work is to be done and divided amongst anumber of coordinate agencies. The scientist from whomuseful teaching is expected must be able to know well everycollaborator with whom he is sharing a given part of hisprogramme of work; must be well aware of the extent ofhis abilities, of his fitness for special tasks ; must understandand be able to rightly appreciate the meaning of his reports,the value of his observations; must be able, so to say, tolook through the instruments and eyes of his staff of co-workers, to listen through their ears, as well as to reckon atevery given moment on their loyal cooperation in the commontask of research. It is only by introducing a whole service ofstudents into a coordinate machinery of inquiry, by trans-forming a scientific school into one collective investigator,animated with trust in their teacher and guided by one ideathat important knowledge as to the things in nature-usefultruth-can be gathered, and that the study of calamitousphenomena such as are represented by epidemics can yieldeffective information for the benefit of a country and ofmankind as a whole.

Mr. LITHIBY, in the course of an interesting speech,insisted that the epidemiologist must not Icse heart because

his work is not at once taken advantage of by the legis-lature. An Act of Parliament was, as it were, the resultantof many complex and often antagonistic forces, of whichscience was not at present as powerful an one as it shouldbe. There was, however, this consolation to the epidemio-logist : that what he thought to-day the Local GovernmentBoard would not improbably think to-morrow.The toast of " The Epidemiological Society " was proposed

by Dr. CHURCH, President of the Royal College of Physicians,and the CHAIRMAN in returning thanks for the society pointedout that the Epidemiological Society was the oldest of thesocieties dealing with questions of public health, having beenin existence for nearly half a century. Its formation wasfirst mooted by Mr. Tucker, afterwards one of its honorarysecretaries, and it was inaugurated at a meeting held onJuly 30th, 1850, under the chairmanship of Lord Ashley,then a member of the first General Board of Health,and afterwards, as the Earl of Shaftesbury, so wellknown for his labours of practical philanthropy in manydifferent fields. The first President was Dr. Benjamin GuyBabington who held that office for 14 years and who wasfollowed by a line of distinguished successors. It was atfirst expected that the society would be largely supported bythe general public as well as by medical men, but this hopewas not realised although the membership of the societyhad never been limited to the medical profession andvaluable papers had occasionally been contributed bylaymen. Owing to want of funds in its earlier years the

society was unable to carry out one of its original objects-viz, the instituting of investigation on its own behalf intolocal epidemics and the need for such work was latersuperseded by the appointment of a Government medicalstaff and of local medical officers of health. For a similarreason the society was unable at first to publish Transactions,being dependent on the medical press for the insertion ofabstracts of its proceedings, but since 1859 it had publishedTransactions, at first occasionally and now annually. Theearlier labours of the society dealt with small-pox and vac-cination. On this subject it presented in 1853 a report whichwas ordered by the House of Commons to be printed andwhich largely contributed to the passing in that year of thefirst compulsory Vaccination Act. In 1859 it carried out aninvestigation by a committee on the subject of diphtheria.Among the other subjects which had frequently occupied itsattention might be mentioned cholera, plague, fevers, leprosyand tropical diseases, naval and military diseases, and generalquestions relating to epidemics. In 1897 it had founded incommemoration of the centenary of vaccination a Jennermedal which had appropriately been first bestowed on Mr.W. H. Power, F.R.S., whose demonstration that the aggrega-tion of small-pox patients in hospitals in populous placescaused the disease to spread around them had led to theremoval of small-pox hospitals out of towns and thus haddone more, at any rate as regards London, to diminishsmall-pox than anything since the introduction of vaccina-tion. The society differed from other similar societiesin its cosmopolitan character, having correspondents andcontributors not only in British colonies and dependenciesbut also in foreign countries in all quarters of the world, andalso in its dealing with the behaviour of diseases amongcommunities of men rather than with clinical and patho-logical studies on the one hand or with administrativequestions on the other hand. Whatever progress might bemade in bacteriology the need for checking the results oflaboratory experiments by epidemiological observation wouldstill remain.Mr. MALCOLM MORRIS proposed " The Health of the

Chairman," and the reply of Dr. PARSONS concluded aninteresting series of speeches.

THE PROPOSED CONSULTING INSTITU-TION OF THE HOSPITAL SATURDAY

FUND AT BIRMINGHAM.

A MEETING of the medical profession convened byDr. Saundby to consider this matter (to which full referencehas been already made in THE LANCET’) was held at theBirmingham Medical Institute on the afternoon of Friday,

1 THE LANCET, May 13th and 20th, 1899.

44

June 23rd. There were present: Sir James Sawyer, Mr.Alfred Stanley, Dr. T. W. Brown, Dr. Parkes, Mr. Thomas Salt, Mr. Henton White, Dr. Maclean, Dr. Gibbs Blake, Dr. Parsey, Dr. Thomas Wilson, Mr. Garvey, Dr. Kauffmann,Dr. Carter, Dr. Adamson, Dr. Kirby, Dr. De Blaquiere, Dr.Dain, Dr. Leslie Phillips, Dr. Powell, Dr. Sturge, Dr. Huxley, Dr. Walter R. Jordan, Mr. Clark, Dr. Herbert Perry, Dr. Melson, Dr. Short, Dr. James W. Russell, Dr. Lewis,Dr. Lamb, Dr. Warden, Dr. Foxwell, Dr. Branson, Dr.Suckling, Dr. Nelson, Dr. McCardie, Dr. Line, Dr. Drury,Dr. Martin Young. Mr. Donovan, Dr. Foxcroft, Dr.Strathy, Dr. Oswald Lewis, Mr. John Tighe, Mr. Pooler,Mr. Boyton, Mr. Furneaux Jordan, Mr. D. LlewellynThomas, Mr. Thomas Thomson, Mr. Robertson, Mr. Baldwin,Mr. Bennett, Mr. Weeks, Mr. Clarke Haslam, Mr. Blakenev,Mr. Lawrie, Mr. Wilkinson, Mr. Chadwick, Mr. Gifford,Mr. Pepper, Mr. Leedham-Green, Mr. Priestley Smith, Mr.Griffin, Mr. Lunn, Mr. Round, Mr. Hancock, Mr. BennettMay, Mr. Campbell, Mr. Legge, Mr. Hall, Mr. Downing, Mr.Thompson, Mr. George Thomas, Mr. Sutton, Mr. Johnson,Mr. Bygott, Mr. Mann, Mr. Turner, Mr. Elkington, Mr.

Perry, Mr. Yuill, Mr. Murray, Mr. Buckley, Dr. Lydall,Mr. Smallwood Savage, Mr. Lucas, Mr. Sandison Crabbe,Mr. Wright Wilson, Mr. McCall, Dr. Wood White, Mr.Prosser, Mr. Garner, Mr. Newton, Mr. Trout, Dr. Morton,Mr. Gordon, Mr. John W. Taylor, Mr. Gilbert Smith, Dr.Charles MacNaught, Mr. Wykes, Mr. Vokes, Mr. Burges, Mr.Oakes, Mr. Motteram, Mr. Leech, Mr. Eales, Mr. Milligan,Mr. Burton, Mr. Weston, Mr. Bodkin, Mr. Shillito, Mr.Marsh, Mr. Whitcombe, Mr. J. James Evans, Mr. Harmar,Dr. Mackay, and Mr. Christopher Martin.

Dr. THOMAS WILSON announced the unavoidable absenceof Dr. Saundby through illness.

It was proposed by Mr. BARLING, seconded by Dr. CARTER,and resolved that Mr. Priestley Smith should take thechair and the proceedings were opened by an explanation ofthe reasons which had made it necessary to summon themeeting. Dr. THOMAS WILSON then read the notes of theconference which had taken place between himself, Dr.

Saundby, Mr. Priestley Smith, and six delegates of theHospital Saturday Fund Executive held under the presidencyof the Lord Mayor on June 12th. These notes and thesubsequent correspondence between the Lord Mayor andDr. Saundby having been read the CHAIRMAN proposed thefollowing motion:

That this meeting of registered medical practitioners residing in ornear Birmingham objects to the proposed Consulting Institution on thefollowing grounds : 1. That it is proposed that non-medical employersshall exploit the services of medical men ; in other words shall employmedical men to earn fees, pay them by salary, and deal with theproceeds at their own pleasure. 2. That no restriction is proposedas to the class of persons to be received as patients, so thatpersons well able to afford the usual consultation fees wouldobtain a concession to which they have no claim. 3. Thatit is proposed to incorporate the institution as a limited companyto carry on the business of physicians and surgeons and thatthis is contrary to the Bill which has passed the House of Lordsentitled "An Act to amend the Companies Acts," which has receivedthe support of the General Medical Council and the British MedicalAssociation. 4. That such an institution would assuredly seek toprocure patients by advertising and canvassing in contravention of pro-fessional rules and any practitioner holding service in it would renderhimself liable to the censure of the General Medical Council.

This was seconded by Dr. CARTER, Clause 3 beingaltered to read " the Bill which is now before the House ofLords " instead of the Bill which has passed the House ofLords."Upon the motion of Dr. KAUFFMANN, seconded by Dr.

MELSON, Clause 4 was altered to read :That in the event of the proposed institution seeking to procure

patients by advertising and canvassing in contravention of professionalrules any practitioner holding service in it would render himself liableto the censure of the General Medical Council.

The resolution as amended was then put to the meeting andcarried unanimously.The CHAIRMAN then moved :That this meeting records its opinion that no registered medical

practitioner should take office in an institution open to theseobjections.This motion was seconded by Mr. BARLING, supported

by Sir JAMES SAWYER, Mr. OAKES, and Mr. FURNEAUXJORDAN and was carried unanimously.

Mr. BARLIXG asked the chairman to explain to the meet-ing what the position was of those who had representedthe profession in the conference with the Hospital SaturdayFund delegates upon the matter of the question raised by thethird resolution 2

The CHAIRMAN replied that the representatives had givenno pledges and that the meeting was free to deal with thisquestion as it pleased.The CHAIRMAN then moved :

That this meeting approves of the proposal submitted to the execu-tive of the Hospital Saturday Fund on behalf of the profession-viz.,that many of the consultants should agree to see Hospital Saturdaypatients for the reduced fee of half a guinea, provided that arrange-ments can be made for preventing abuse of this privilege.

This was seconded by Mr. BARLING.The previous question was moved by Sir JAMES SAWYER,

seconded by Mr. MORRISON, and carried by a large majority,70 hands being held up for it and 15 against.

After some further discussion it was decided by show ofhands to continue the discussion of the general principlesunderlying the third resolution. After remarks had beenmade by Mr. NEWTON, Mr. WHITCOMBE, Mr. MORRISON, Dr.ADAMSON, Dr. KAUFFMANN, Dr. MELSON, Dr. CARTER, andMr. RICKARDS the following motion was proposed by theCHAIRMAN :

That this meeting desires to remind the promoters of the scheme inquestion that many of the recognised consultants of Birmingham arein the habit of charging a reduced fee to those who satisfy them thatthe usual fee is beyond their means.

This was seconded by Mr. BARLING and carried nem. con.,75 hands being held up in its favour.The meeting terminated with a vote of thanks to the

chairman.

ANNUAL DINNER OF THE ASSOCIATIONOF BRITISH POSTAL MEDICAL

OFFICERS.

THE annual dinner of this association was held at theWhitehall Rooms of the Hòtel Metropole, London, on

June 22nd, when Dr. WILLIAM DOUGAN of Glasgow pre-sided. There was a large attendance of members of theassociation and guests and a very pleasant evening wasspent,

After the loyal toasts had been honoured, that of " TheNavy, Army, and Reserve Forces" was proposed byDr. ARNISON and responded to by Lieutenant-ColonelRAYMENT who remarked that while we admired the braveryof our soldiers we must not forget the great zeal of our

medical officers in the field who added incomparable zeal tomarvellous skill in the performance of their duties during acampaign. The numerous Victoria Crosses awarded to themembers of the Medical Services during recent years testifiedto the courage which they had always shown on the battle-field."The Houses of Parliament" was proposed by Mr. NOBLE

SMITH.Sir WALTER FOSTER, M.P., in replying, said that the rela-

tion of the House of Commons to the medical profession wasa difficult question. There were in the House of Commons acertain number of people anxious to promote the interests ofthe medical profession. If the medical profession combinedit would have as much influence over Parliament as otherbodies who were less educated and less numerous thanthe medical profession. The medical profession shouldcombine, irrespectively of politics, in order to force what-ever party might be in power to legislate for the generalinterests of the community. A distinguished friend of hishad suggested the appropriateness of a quotation from HolyScripture. In Chronicles it was recorded that Asa trustednot in the Lord, but in the physician, and in the next verseit was recorded that Asa slept with his fathers. Thatseemed to be still the popular opinion concerning the pro-fession. It was high time that that idea was eradicated andhe was sure that if the profession were united it might correctthat impression. In respect to vaccination he felt sure thatthose who had voted as he had voted on the last measure inParliament respecting vaccination would be justified in

finding that vaccination would increase rather than decreasethroughout the country as a result of the measure. As longas the medical profession maintained the high standardwhich it now associated with itself it would gain the respectof the public. In conclusion he held that the efficiency ofthe Postal Department was in no small measure due to themedical profession.