498

ADDRESS BY THE PHARMACEUTICAL SOCIETY ON THE SALE OF POISONS.

Photography is now definitely made ancillary to science.The recent work of Dr. Draper, professor in the New YorkUniversity, on "Human Physiology," is illustrated by draw-ings from photographs; and the publication of the originalresearches of Dr. Lionel Beale on the anatomy of the liver isaccompanied by photographs of the author’s drawings. Our

knowledge of the anatomy of the prostate-hitherto consideredas a gland---will be enhanced by a valuable paper contributedby Mr. Ellis to the forthcoming volume of the " Medico-Chirurgical Transactions." On its diseases there are severalnew works announced, one by Mr. Henry Thompson.The original views of Dr. Richardson on the cause of the

coagulation of the blood are also to be submitted to the

profession by the immediate publication of the essay whichgained the Astley Cooper prize. A new biennial publicationis to appear in January, the " Liverpool Medico-ChirurgicalJournal;" and Mr. Churchill intimates the preparation of afresh addition to the indispensable books on our shelves in theform of a Medical Topographical Dictionary," to enable usreadily to answer those embarrassing questions, which patientsare so fond of propounding, concerning the salubrity of placesthey are about to visit-from Timbuctoo to that Welch water-ing-place with the euphonious name of Tuh-wynt-ir-Bwlch.

A MAN has recently committed suicide by hanging himselfin a padded room at the St. Pancras Workhouse. The pos-

sibility of this occurrence involves, perhaps, the most pre-posterous absurdity ever committed. Pidded rooms are

provided for the express purpose of preventing patientsinjuring themselves or committing suicide. Yet in thisroom there was an iron staple above the wire-work of thewindow, to which the lunatic could gain access, and might-asin this case occurred—manage to affix a noose whereby to hanghimself.

MR. LISTON’S MODE OF PERFORMINGLITHOTOMY.

(NOTE FROM MR. FERGUSSON.)

WM. FERGUSSON.

To the Eclttor of THE LANCET.

SiE,—I shall feel obliged if you will correct an error into

which you have fallen in your leading article of last week con-cerning my paper about Mr. Liston’s method of performinglithotomy.You represent me as having " assisted" Mr. Liston in the

operations to which my paper referred, but the expression inmy paper is, that I "witnessed" all his public practice inEdinburgh. It was not my fortune to assist him in any of his

operations, nor was I his pupil in any other way or sense thanbeing a pupil at the Royal Infirmary during the period that hewas assistant-surgeon and surgeon to that institution. For

some time t sat, as other students did, on the ordinary benches;but from 1829 until Mr. Liston left for London-near the endof 1834, I think-I had the privilege, as a Fellow of theCollege of Surgeons, of taking a place in the front row, where,as stated in my paper, "I was a close and zealous observer,"and from which I was rarely absent when operations were per-formed, either by Mr. Liston or the other surgeons of the day.

I am, Sir, your obedient servant,George-street, Hanover-square, Oct. 1856. WM. FERGUSSON.

ROYAL COLLEGE OF SURGEONS, IRELAND.—On Monday,the inaugural lecture, introductory to the winter session 1856-57, was delivered in the Examination Hall of the Royal Collegeof Surgeons, Dublin, by Dr. Jacob, F.R.C.S. I., Professor of

Anatomy and Physiology; Dr. Hans Irvine, V.P., presiding.The lecture consisted of sound, important hints to both pro-fessors and students, the Doctor at the same time commentingupon the necessity for a preliminary examination before enter-ing upon the more minute studies of the profession, and insist-ing on the importance of a solid educational course for all thoseintended to be disciples of .êE8cubpius. There was a verylarge attendance during the lecture, and at its close the learnedDoctor received the plaudits of his auditory.

> 498

THE SALE OF POISONS.

THE following address has been issued by the Council of thePharmaceutical Society of Great Britain :-

" Public attention having been directed, by numerous

editorial articles and letters, to the necessity of some legislativeenactment for preventing the dispensing of medicines and thesale of poisons by incompetent persons, the Council of thePharmaceutical Society of Great Britain consider it their dutyto offer a few observations, with a statement of facts, necessaryto a clear understanding of the subject.

" More than fifteen years have elapsed since the chemistsand druggists projected a society for the purpose of introducingan efficient system of education and an examination for thefuture members of their body. Experience had shown that thescience of the physician can be of no avail unless seconded bythe requisite skill and knowledge in the dispenser of his pre-scriptions ; that the variable quality of drugs, as usually foundin the market, occasioned frequent disappointment to medicalpractitioners, and their patients - that the public were exposedto danger from the unrestricted sale of strong medicines, in-cluding poisons, by uneducated persons ; and that the mosteffectual remedy for the existing defects would be a legislativeenactment for regulating the qualifications of pharmaceuticalchemists." The Pharmaceutical Society was established in 1S41, as a

means of laying the foundation of the desired improvement,through the instrumentality of a voluntary association. Theoriginal members or founders of this Society consisted of thosechemists and druggists in the metropolis and provincial townswho, feeling interested in its objects, volunteerecl their co-opera-tion, and a board of examiners was appointed to test thequalifications of future candidates for admission. While it wasa fundamental principle of the Society that the passing of anexamination should eventually be an imperative condition ofmembership, it was necessary, in the first instance, to makeallowance for the position of the existing race of chemists anddruggists, to avoid any unjust interference with vested interests,and to direct the operations of the Society chiefly to the im-provement of the rising generation.

" In 1843 the Society was incorporated by royal charter, anda bye-law was passed requiring all persons, except those whowere in business on their own account before the date of thecharter, to pass an examination prior to admission, and fixinga date after which even this exemption should not be granted.

" The subjects of examination are chemistry, pharmacy,materia medica, and botany, including the practical manipula-tions of the laboratory and the dispensing-counter, the modesof ascertaining the strength and purity of drugs, the tests andantidotes for poisons, the doses of ordinary medicines, and anacquaintance with prescriptions. A school of pharmacy wasfounded in Bloomsbury-square, where lectures on the abovesubjects were delivered by eminent professors, a library, and avery extensive museum were established, and a laboratory wasfitted up with all the apparatus required for practical instruc-tion in the processes of the Pharmacopoeia, and in chemicalanalysis. The late Dr. Anthony Todd Thomson, Dr. Pereira,and Professor Fownes gave the school the benefit of theirvaluable services, assisted by Mr. Redwood, who is the presentProfessor of Chemistry, Mr. Bentley having succeeded to thechair of Botany and Materia Medica. A considerable numberof students have availed themselves of these opportunities ofimprovement, and their progress has bcen highly satisfactory.

" At the time of the incorporation of the Society, thenumber of members amounted to 1662, consisting of the leadingchemists and druggists in the metropolis, as well as in Liverpool,Manchester, and many other provincial towns. It subsequentlyobtained a very considerable accession of members. A branchof the Society is in active operation in Scotland, and a. Boardof Examiners sits in Edinburgh. Auxiliary schools of pharmacyhave also been established in Liverpool and Manchester, witha view of preparing young men for the examination.The expenditure of the Society, for purposes of education

and scientific improvement, has, from the time of its commence-ment, exceeded an average of X3000 per annum. -

" 1t was the original object of the founders of the Society toprovide for the education of the entire body of chemists anddruggists, and to procure the passing of an Act of Parliamentrequiring all future members of the trade to pass the examina-tion. In June, 185l, a Bill in accordance with this object wasintroduced into Parliament by a member of the Society, aftermature consideration by the Council. The Bill contemplated,

499

first, the registration of all persons at that time in business whoshould apply to be registered within twelve months; secondly,the recognition of the Board of Examiners of the PharmaceuticalSociety; thirdly, the examination of all future members (withthe exception above stated) prior to registration; and, fourthly,the prohibition of unregistered persons from carrying on thebusiness of a chemist and druggist. If the Bill had been passedin its original form, all the successors of the chemists and

druggists of that date would have been of necessity regularlyeducated and examined, and the entire change of the pharma-ceutical body from the condition of a mere trade, without anyregular education, to the status of a recognised and qualifiedprofession, would have been effected within the space of from twenty to thirty years."The Council, supported by the members of the society

throughout the country and by the leading members of themedical profession, petitioned Parliament, and appealed to thepublic for assistance in promoting the passing of the Bill. Plainstatements of facts were published, pointing out the danger towhich the public were exposed from the incompetence of manyof those who dispensed medicines and sold poisons, and draw-ing attention to the state of the law in all other civilized coun-tries, where the education and examination of pharmaciens areprovided for under stringent regulations. These appeals, andthe facts and arguments advanced by the PharmaceuticalSociety produced at the time but little influence on the publicmind. The truth of the proposition was not disputed, the pro- ’,,priety of the proposed reformation was admitted, and themedical profession generally expressed favourable opinions ; but the subject excited little or no public interest until its import- ance was demonstrated by a succession of fatal accidents fromthe sale of poison by unqualified persons, and by the publicationof the evidence adduced before the Parliamentary committee onthe adulteration of food and drugs. The attention of the presshaving now been forcibly directed to the subject, the publicappear to have suddenly passed from a state of apathy to theopposite extreme of excitement and alarm. A variety of ex-aggerated statements have been circulated, and projects moreor less chimerical have been proposed by persons not practicallyacquainted with the facts of the case or with the business withwhich they desire to interfere. Some of the authors of elaboratetheoretical communications in the public papers ignore the factthat the object they have in view has been anticipated by thePharmaceutical Society, which has already accomplished as

much as the powers conferred by Parliament have enabled it toeffect, and would have done much more if the original plan ofits founders had been sanctioned by the Legislature."It may be useful to explain the exact state of the law

under the provisions of the Pharmacy Act which was passed in1853, and to show the distinction between the Act as it is andthe Bill as originally drawn. The Act recognises the Pharma-ceutical Society as a voluntary association for the examinationand registration of pharmaceutical chemists, and confers uponthe persons so registered the exclusive right to assume or usethe title of ’pharmaceutical chemist,’ ’pharmaceutist, or anyother name, title, or sign implying that they are registered orthat they are members of the Society. No person not alreadyregistered can henceforth be admitted to the privilege of regis-tration or membership without previously passing the eXamina-tion. Consequently, all the apprentices of the present timewho aspire to the status of a pharmaceutical chemist, the onlyone (except that of a medical practitioner) recognised by lawas implying a qualification in pharmacy, must go through a re-gular course of study to enable them to pass the examination.The Act does not interfere with the sale of drugs and the dis-pensing of prescriptions by incompetent persons; but it esta-blishes a distinction between such persons and those who pos-sess a legal qualification and corresponding title. The influenceof the Act must of necessity be gradual. It may partiallyaccomplish in a long series of years what would have been donemuch more speedily and effectually by the Bill in the formoriginally introduced. Instead of directly prohibiting the dis-pensing of prescriptions and the sale of poisons by unregisteredpersons, its operation is indirect through the medium of publicopinion. It is therefore obvious that the success of such a lawmust depend greatly on the will of the public, since the chiefinducement to future chemists to qualify themselves under theprovisions of the Act is the prospect of distinction as a passportto success in business. The Pharmaceutical Society is raisingup a qualified class of dispensers of medicine ; the law conferson such persons a distinctive title-namely, that of pharmaceu-tical chemist or pharmaceutist; but the recognition of this claimto confidence by the public, for whose benefit this law has beenpassed, is necessary to complete its success.

" The indiscriminate and uncontrolled sale of poisons hasengaged the serious attention of the council, and some impor-tant statistical information in reference to the sale of arsenicwas obtained by the intervention of the Pharmaceutical Societyat the time the Sale of Arsenic Act was introduced. Theassistance of the Society and the experience of its memberswould be available on any future occasion in reference to thesale of other poisons, on which numerous suggestions for legis-lative interference have been made by persons practically un-acquainted with the subject, and the difficulties attending theproposed restrictions.

" The Pharmaceutical Society has always taken an activepart in exposing and endeavouring to prevent the adulterationof drugs. The subject is constantly under discussion at themeetings of the Society; and in several instances the publicitythus given to cases of fraud and impurities prevalent in drugsand pharmaceutical preparations has led to considerable im-provement both in the case of foreign products and those ofhome manufacture. The council believe that the exertions of theSociety in elevating the scientific character of pharmaceutical che-mists will have more effect in checking adulteration, imperfec-tions in medicines, and accidents from poison, than any penalenactment that could be passed; and that, however desirableit may be to provide facilities for the summary punishment ofpersons guilty of fraud, it is equally important, and should bethe first object of solicitude, to regulate the qualifications ofthose who dispense medicines, and who ought to be sufficientlyeducated to be able to test the quality of their drugs and pre-parations."The object of the above statement and remarks is to direct

attention to the fact that the reformation which recent eventshave shown to be required, and towards which the force ofpublic opinion is tending, was projected more than fifteen

years ago by the pharmaceutical Society; that great pro-gress has already been made by its voluntary and unassistedagency; and that all that remains to be done may be effectedby means of the Society, if armed with more extended powersand assisted by the public.

" By order of the Council,"GEO. W. SMITH, Secretary and Registrar."

Correspondence.

MR. SYME ON MR. LISTON’S MODE OFPERFORMING LITHOTOMY.

(LETTER FROM PROFESSOR SYME.)

" Audi alteram partem."

To the Editor of THE LANCET.

SIR,—The terms "overhand" and " underhand" being morefamiliar in cricket-playing than in the practice of surgery,many of your readers may suppose that the question which hasbeen raised in regard to Mr. Liston’s mode of holding the knifein cutting the prostate is a matter of curiosity, rather thanof practical importance. But when they understand that thepoint at issue is, whether the knife, at so critical a stage oflithotomy, was held with the forefinger resting on its back, oron the blunt part of its edge, the matter will assume a muchmore serious aspect. When Mr. Fergusson’s paper was readto the Medico-Chirurgical Society, I considered it my duty, bymeans of a letter published in THE LANCET, to enter a protestagainst the allegation that Mr. Liston had been guilty of thereckless procedure imputed to him. I then stated that thefirst time he performed lithotomy, upon which occasion andmany others I held the staff for him, he used a commonscalpel with cord wrapped round the blade, to protect his

finger from being cut while resting upon it; and I pointedout the extreme danger of running a knife along a staff intothe bowels of a living man without being guarded by a fingerto press it into and not out of the groove. The recent publica-tion, Mt extenso, of Mr. Fergusson’s paper would not haveinduced me to say more on the subject; but your editorialarticle in THE LANCET of Saturday last renders it impossiblefor me to maintain silence, whether I regard the posthumous

499 <