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more than ten or fifteen minutes’ duration. I should haveliked to trace out in more detail the directions in which itseems to me the medicine of the future will mainly tend;but under the special circumstances of this occasion I forbearto tax your patience or my powers in the pursuit of what afterall would be mere fanciful speculations. I therefore hastento turn to a more prosaic, but to all of us a more immediatelypressing, question, that of medical edncation in general and inthis city in particular. The aim of our profession being, as Ihave indicated, of a twofold nature—namely, to prevent diseaseon the one hand and to assist the natural powers of recupe-ration in the deranged or injured organism on the other-it isplain that the basis of all our study must be founded on athorough knowledge of the laws and conditions of life and ofthe structure and functions of the body. Starting from thisfoundation, the next superstructure in the edifice of our artis that of pathology, the sum of all the ascertained factsconcerning the mechanism by which diseases are broughtabout and the effects they produce on the organism. Inits fullest sense, then, pathology embraces not only thechanges to be ascertained by dissection and microscopicand chemical analysis of the dead body, but also the perversionof the natural vital processes and even the causes or condi-tions antecedent to the departure from a state of health.It is not for me here and now to criticise the scheme of studywhich in conformity with the revised regulations of the

Conjoint Board we have adopted here. In very manyrespects it is a decided benefit to the student, who will findthat even five years is all too brief to enable him to assimilateall the subjects that are now demanded from him. But Icannot avoid expressing my own conviction that the next stepin the improvement of the curriculum must be the relegationto a period antecedent to the strictly medical course of thepurely scientific subjects-physics, chemistry and biology.The great merit of the new scheme of study is undoubtedlythe prominence it gives to practical work. In almost everyone of the branches there are now classes and arrangementsto enable each student to find out for himself most of thefacts about which he reads in his book or learns from the lipsof the lecturer. Time was when this kind of work-the mostattractive and the most fruitful-was limited to only one ortwo subjects. But we live under a new reginze, and if onlyit be faithfully carried out it should prove of great advantage.By faithfully sticking to his practical work, whether in thewards, the post-mortem room, the laboratory, or the dissecting-room, his memory will be strengthened, since the avenues toit through the senses will all have been opened up. Thenwhen the examination day comes round the diligent dissectorwill have his anatomical facts almost literally at his fingers’ends, the patient histologist will see in his mind’s

eye what he has perceived through the microscope,and the clinical worker will recall the physical signsof the cases he has observed far more readily thanhe will remember the descriptions which he has merely read.It is surely well in these days, when there is a plethora oftext-books and an almost inordinate amount of oral tuition,to remember that the only knowledge which is really one’sown, that which is of the only real service in practical life, isthe knowledge founded on personal observation, upon whichwe were told of old time that the whole medical art con-sists.’ The institution of a final examination in clinical and

practical medicine and surgery is a feature of the new schemeof the Royal Colleges which deserves especial mention, andthe manner in which the fifth year of study is to be spentshould make that period of your career the most interestingof all. It seems to me to give in a fitting manner a com-pleteness to the curriculum not hitherto secured. With afew modifications, which experience may show to be neces-sary, the course thus laid down by the colleges may withoutexaggeration be said to be as academic as that of anyuniversity, and, this being so, it may seem to be a

hardship that it does not lead to the possession ofacademic distinctions. When thirteen years ago I hadthe honour of acting in a similar capacity to the present Ithink that I was sanguine enough to say that there was noreason at all why the majority of the London medicalstudents should not take London University degrees. I

thought then-when perhaps the memory of my own studentdays was more fresh upon me-that one great reason for thesingular paucity of London graduates lay in the equallysingular ignorance concerning the University which wouldseem to exist in the schools of the country. But I havelearnt since from t wider experience of other universitiesthat this is not the sole reason, for although the number of

London graduates is yearly increasing, they still form a smallminority of the London students ; whereas in Edinburgh thereverse is the case. I take it that the grievance of theLondon medical student is established."

After detailing the history of the various proposals whichhave been made regarding the new London University, thelecturer proceeded : "It matters little what the solution is solong as the true interests of learning are kept in view and thewelfare of the large numbers who come up to London everyyear to enter on the study of medicine. The time is approach.ing when something will be done to relieve the greatest city inthe world of the reproach that it has no local organisation forhigher education ; and to the medical schools in particular oneanticipates nothing but benefit from their union on commongrounds within the (rgis of one university. Thereby medicaleducation itself will be rendered more stable and more

efiicient. It would seem that the spirit of activity and unrestcharacteristic of the progress of the age is touching the sub. !ject in which we are most interested at present. This desirefor improvement and perfection is a healthy sign, andalthough we may be living in the turmoil of transi.tion we can look forward to a more peaceful periodwhen under the new order the training demanded of thosewho are fitting themselves to be medical practitioners shallbe founded on rational and scientific lines ; for the desire ofall must be that our profession should not fall behind in therace, but should continue as heretofore to lead the van in thegreat work of bettering the conditions of human existence. ;,And for the individual practitioner a well-conceived andsystematic course of training is of much more value thanacademic honours. If to knowledge he adds the commonvirtues of sympathy, of gentleness and of strength he will goforth to his daily contact with misery and suffering not onlyfully equipped for all emergencies and all trials, but with theconsciousness that in his little corner of the earth he is doingsomething to brighten life and to assuage its woes. Whathigher vocation could be set before him-what could make tohim life more worth living ? That is the career which openson many of you to-day, to which we welcome you, and iswhich we wish you all prosperity and honour."

UNIVERSITY COLLEGE, LONDON.INTRODUCTORY ADDRESS BY MR. S. J. HUTCHINSON,

"LOOKING at the long roll of my distinguished pre’decessors, and at all the good and wise things they havesaid, I feel how difficult it is for me to deliver an address

worthy of the occasion. To you I would most cordiallysay how we all are thoroughly in earnest in our desireto make your career here a pleasant and a successfulone, and let me say in all friendliness that I personally, incommon with many who have gone before me, look back

upon the years I spent here as a student as perhaps thehappiest portion of my life. It is a time when there are no

responsibilities to speak of and few anxieties, except perhaps, exams.’ The simplest and best way to prepare for diplomaexaminations is to go in for class examinations. Of course Ido not mean simply attending class examinations without pre-vious preparation; but the whole ladder of medical educationis arranged in such a manner now that by constant attendanceon lectures and demonstrations and by careful note-taking,by working up the notes from text-books afterwards and bya rigorous attendance on the class examinations, the wholething is made much simpler ; the subjects, despite their in-creased number and extent, are more easily mastered andtake a firmer hold on the memory, and are thus more avail-able when wanted than when acquired by that pernicioussystem of spasmodic work, and still more by the popularbut fallacious system of I cramn3ino, ’ during the last fewweeks before an examination. Since we met here last yea?many most important events have happened, not only in ourcollege and hospital, but in the medical world generally.First of all, let me say that the building of the new hospitalover the way may before long be confidently expected. A

portion of the new hospital will probably be erected in therear of the present buildings, and when completed patientswould be transferred to it and a part of the old hospitalremoved to make room for further buildings. It will thus baseen that the number of beds will at no time be diminishednor the work of the school retarded in any way. Now, I dothink all of us who are interested in University College,particularly those to whom the future belongs, must rejoiceat this prospect and must feel a debt of gratitude to the

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hospital committee, Ly whose zeal and untiring devotion thisgreat work is so nearly consummated."The next important events which have happened since lastyear at this time are the reports of the Lords’ Committee onHospitals, and secondly the coming into force of the fiveyears’ curriculum for the Conjoint Board, and again themountain has gone on labouring, but it has not yet broughtforth the M.D. degree for London medical students. Let me

urge upon every one of you the importance of striving for the’best possible,’ that is to say, make up your minds that youwill take the highest degrees attainable-the M. D. or M. S. ,

London, or the M.R.C.P. or F.R.C.S. Those of you whohave had the incalculable advantage of a University careercannot be too thankful to your parents whose generosity andwisdom have given you this privilege, and you cannot bettershow and prove your gratitude than by turning such a trainingto its greatest advantage. There is always a certain fear ofmedical students acquiring a hospital manner, which howeverefficacious it may be in the exigencies of hospital practice,certainly does not suit in private practice. And this leadsme to take advantage of this occasion to recommend you,gentlemen, at the outset of your career to cultivate a spiritof consideration towards the patients whom you are calledupon to deal with during your studentship, and to behavetowards them as far as possible as you would towards yourown patients in private practice. You must forgive me if Iallude to this, because I know from my own experience howeasy it is to acquire certain little acerbities of manner whichare meekly borne by the hospital patient, but which wouldbe effectually resented by a private patient. Martial, theLatin poet, has said-

’ I had, oh! Symmachus, a simple pain-You came, a hundred students in your train;A hundred probing flngers felt my brow ;I had no fever then-I have it now !’

Besides all this, there are certain things to which it is worthyour while to pay special attention. Need I say that Imean anatomy and physiology ? To these I would addpathology in its widest sense. Without a thorough knowledgeof these, the sciences of medicine and surgery are simply the’baseless fabric of a vision.’ It is well also to pay specialattention to the art of prescribing. I say art’ advisedly,for whilst brilliant skill in surgery-the tactus eruditus ofthe master-is the fine art of surgery, so is an efficient and

palatable prescription the fine art of a skilful physician. Ihave alluded already to the burning question of a degree inmedicine for London medical students. Now, the solution ofthis difficulty appears very simple, and I submit the sug-gestion for your earnest consideration, for probably the con-summation will be in your hands, and not in ours. I say thesolution is simply this : Let every medical practitioner whohas duly gone through the curriculum ordained by theMedical Council and who has passed finally in medicine,surgery, and midwifery be thereafter legally entitled to stylehimself ’Doctor,’ just as every clergyman or minister whohas fulfilled the prescribed ordinances is styled I Reverend.’The case is absolutely on all fours, and it would save animmense amount of trouble. I am aware that this schemedoes not provide a university degree for London medicalstudents, but it does provide a title for them, which theywould not have to go away from London to procure.The State insists upon the medical student undergoing a fiveyears’ curriculum of severe study ; it compels him to passdifficult examinations at all periods of his career, and then,when he has done everything and satisfied everybody and gothis degree or diploma, what does the State do for him ? Doesit protect him in any way against the bonesetter, theherbalist, the medical electrician, the mesmerist, the mid-wife, or prescribing chemist, or the legion of American andother foreign gentlemen with a maybe bogus degree ? Doesit give him one single advantage over these gentlemen beyondallowing him the privilege of suing for his fee in the countycourt or being exempt from juries, of being placed on theMedical Register, of holding certain public offices and, mostglorious privilege of all, it allows him to sign the death cer-tificate when, I at the last stage of all,’ he is called in withthe forlorn hope of restoring new life to the victim maybe ofone or other of the practitioners I have named above. Now,I maintain that this is carrying the liberty of the subject atrifle too far, and I think the day is not far distant when itwill be impossible for any of these gentry to practise anyform of the healing art unless they are entitled to register.

"It would be well now to consider what the medical studenthad best do when he shall have duly and fully qualified, and

t

he will probably by that time have discovered whether he hasdeveloped any particular taste for, or proficiency in, anybranch of the science of medicine or surgery, or if he prefers towork at some scientific subject, such as anatomy, physiology,or bacteriology. To those of you who desire or determine,to become general practitioners, and such it is to be pre-sumed the majority of you do, I should like to refer to theintroductory address given here by Professor Victor Horsleyin October, 1891, for you will there find some very practicaland useful advice bearing on this subject, which it would besuperfluous to reiterate. But there is one branch of practicewhich provides at this time a very satisfactory opening forsuch of you as are possessed of manual dexterity. Theopening is afforded in dental surgery, a diploma being grantedby the Royal College of Surgeons throughout the kingdom.Now, gentlemen, students of this college, you are singularlyfavoured in your opportunities for acquiring a knowledgeof dental surgery on account of our proximity to two dentalhospitals, one in Leicester-square and one in Great Portland-street. In face of these advantages it does not seem desir-able for University College to follow the example of Guy’sHospital and establish a dental school within our halls, forwhilst Guy’s Hospital was more than two miles from any dentalschool, we are less than a mile from two. Perhaps enoughhas now been said about the student’s work ; let us devote ashort time to the student’s play. The advantages of a judiciousadmixture of play and work are so obvious that it is needlessto dilate upon them. It is, however, the judicious admixturewhich is so important, for, like Mr. Pickwick’s punch, it is

possible to have too much of a good thing, and all I wouldventure to ask of you is this : do not neglect healthy exer-cise, but do not let it encroach on your work too much ; go infor cricket, football, tennis, cycling, boating, anything youlike, but play them for the love of them, not for cups’ and’pewters,’ and, above all, do not in your games overtax yourstrength.

"I should like before I conclude to say one word about theinvaluable help which physician and surgeon alike derives inthe successful practice of their profession from skilful andattentive nursing, and whether in the hospital or the home,the nurse is almost as essential as the doctor, but only so faras she understands how to properly fulfil the instructions ofthe medical men. With regard to the social position of themedical man I am convinced that it depends entirely uponthe man himself in the first place, for his education and hisdegrees or diplomas place him in the order of gentlemen, andit is his conduct and demeanour alone, which will enablehim to remain in that honourable position or not, and toenjoy all its privileges or to be ostracised. Sir ThomasWatson once said on an occasion like this : The professionof medicine having for its end the common good of mankind,knows nothing of national enmities, of political strife, ofsectarian divisions. Disease and pain, the sole conditions ofits ministry, it is disquieted by no misgivings as to the justiceor honesty of its client’s cause, but dispenses its peculiarbenefits without stint or scruple, to men of every countryand party, and rank and religion, and to men ofno religion at all ; and like the quality of mercy, of which itis the handmaid, "it blesseth him that gives and him thattakes," reading continually to our hearts the most impressivelessons, the most solemn warnings.’ Surely you will notdare without adequate preparation to embark in such acalling as this, so capable of good if rightly used, so full ofperil to yourselves and to mankind if administered ignorantlyor unfaithfully. If you should be successful let it not makeyou presumptuous, but remember that in your most success-ful efforts you are but the honoured instrument of a MightierPower-that, after all, it is ‘God who healeth our diseases,and redeemeth our life from destruction.’ In conclusion,let me again offer in the name of the Faculty of Medicine ofUniversity College a hearty welcome to those who join usto-day, good wishes to those who are in the midst of their work,and Godspeed to those who are going out into the world. "

WESTMINSTER HOSPITAL.

INTRODUCTORY ADDRESS BY DR. MERCIER.

DR. MERCIER reviewed the altered relations of the medical

profession to the public, first in regard to the relations of theindividual doctor to each patient and then the relation of theprofession as a whole to the rest of the community. In thefirst relation he remarked how the intercourse of doctor andpatient had become less oracular and more confidential ; how