- Email: [email protected]
MEDICAL PROTECTION ASSEMBLY. BY-LAWS.
316
published May 4th, page 204. We have read it attenHaving given immediate insertion to the communiforwarded to us by the Association, and by the cations as also an which additional we rehave tively, report, cently received from the association, of their proceedings medical staff of the Infirmary, and thus allowed both at a meeting which took place on the 21st. parties a fair hearing, although at the time much cramped We feel much regret in having to state that the first for room, we are under the necessity of stating that any impression created on our mind by the perusal of the other communications on the subject must appear in the Association’s report, and which we then gave firmly, columns of our Journal which are appropriated to aaveralthough cautiously, has not been effaced by the reply of the hospital physicians and surgeons. They have made "STATEMENT" OF THE ROYAL COLLEGE out a case, but it is a weak one ; and, in our opinion, is, OF SURGEONS. we repeat, far from justifying the course which they TUE confession and defence of the council of the Coladopted, or the consequences by which it has been fol- lege of Surgeons, printed at page 320, shall receive ample lowed. We, however, do them the credit to believe they consideration in our columns. we
tisements.
did not then foresee the result of their conduct. Mr. WILTON, the President of the Association, would have acted, probably, with greater propriety had he intimated
MEDICAL TRIAL AT CARLISLE.
THE next number of THE LANCET will contain
a
report
at Carlisle.
applying to the board of a trial which has recently taken place for the use of the committee-room ; but, on the other The cause is one of considerable importance, as it involves hand, the excuses which he tendered ought to have the question of the right of Scottish graduates to recover been at once accepted. The demand which was made of for medical attendance in England. Mr. KERR, a graMr. WILTON, that he should apply to the board to duate of the College of Surgeons of Edinburgh, was suspend the permission previously granted to the asso- the plaintiff; the executors of a Miss REAY, the deciation, was certainly most unreasonable, and he was fendants. The amount claimed for attendance was 171. quite justified in refusing to accede to it. What he The jury awarded to Mr. KERR 121. refused to do was then done by the five medical HOUSE OF COMMONS, gentlemen who, with the exception of Mr. WILTON, conTHURSDAY, MAY 30, 1844. stitute the staff of the Gloucester Thus a to his
colleagues
question,
which
his intention of
was
Infirmary. obviously merely one of medical
SIR JAMES GRAHAM had
given
notice of his intention
etiquette, for there can be no doubt but that Mr. WILTON’S to movethis evening for leave to introduce a Bill for opponents were as anxious for the advancement of the regulating the profession of physic and surgery throughscience of medicine as the members of the Association itself, became a subject of board-room debate. The what might have been anticipated, and does think, to the good sense of the governors. Not wishing to act in opposition to the principal part of their medical staff on the one hand, or to bind the Association to submit to rules imposed by gentlemen who did not belong to it on the other, they solved the problem at their quarterly meeting by, very properly, withdrawing all power from the weekly board "to dispose of any part of " the hospital for purposes not directly connected with <’ the objects of the institution." Finally, we think the medical functionaries of the Gloucester Infirmary have erred in judgment, perhaps more than in intention. Believing themselves slighted by their colleague and the Association, and perhaps justly so, they refused to accept the, it appears, ample satisfaction offered ; and in order to obtain a still greater one, applied to a non-medical body. By that body the question has been treated as a professional squabble ; that is, as one too delicate or too disagreeable to be handled, and
result
was
credit,
we
has been at
once
thrown overboard.
Can we be
surprised
result? Certainly not; the public has no sympathy for us when we fall out among ourselves, and all we get by making known our grievances are taunts and derision. We trust this exposé in Gloucestershire will be a lesson both to the parties concerned, and to at such
a
professional
brethren at
large.
our
out the United Kingdom; and also for a bill to enable her Majesty to grant Charters to certain Colleges of Physicians and Surgeons. In consequence of the great number of motions which preceded that of the Right Hon. Baronet, he was obliged to postpone the consideration of the subject of Medical Reform until TUESDAY next, JUNE 4th. Even then it may be further postponed, as a motion on the "Coal Duties" stands first on the paper for that evening.
MEDICAL PROTECTION ASSEMBLY. BY-LAWS. 1. THAT theMEDICAL PROTECTION ASSEMBLY shall consist of the legally-qualified medical practitioners and registered students in medicine whose names, for the time being, stand in the enrolment books of the As-
sembly.
legally-qualified medical practitioners and students in medicine may demand, as a right, that their names shall be enrolled in the books of the 2. That all
registered
Assembly. 3. That the enrolment of the names of members be made that the charge for making it be a nominal fee of one shilling. 4. That the FIRST day of January, in every year, be the date of the commencement of the enrolment for that
annually, and
year. 5. That no enrolled member shall be entitled to attend
meetings of the Assembly the renewal of whose enrolexpiration of the month of January in any year. 6. That the chief objects of the Assembly shall be,the
ment has not been effected before the
317 First. To obtain for every legally-qualified member of the profession the right of voting at the elections of the governing body of the institution from which he has obtained, or shall obtain, his diploma or licence. Secondly. To secure the efficient qualification of all medical practitioners by means of a system of scientific and practical examinations. Thirdly. To procure the public registration of all legally-qualified medical practitioners. Fourthly. To protect all legally-qualified medical practitioners in the just discharge of their professional duties.
20. That all monies due to the Assembly shall be paid to the Treasurers, or to one of them, or to the Secretary. 21. That all payments on behalf of the Assembly shall be made by the Treasurers, or two of them, through the Secretary, who shall be required to furnish the auditors with vouchers for such payments. 22. That a special meeting of the Assembly may be called at any time by the Secretary, on a requisition being presented to him for that purpose, signed by two of the Treasurers and seven enrolled members, or by one of the Treasurers and fourteen enrolled members, or on a requisition signed by twenty-one enrolled members.
7. That the Assembly be empowered to appoint committees of its enrolled members, who may reside in distant places, for the purpose of inquiring into any medical abuses existing in particular localities, or into the nature
Monday, May 27th.-Mr. Ross in the Chair.-Letters parts of the kingdom were read, promising ener-
from all
objects of the assembly. A commuvery interesting nature was read from Jersey, detailing the origin and progress of the auxiliary of any alleged invasion of professional rights which may association recently formed in that island, and the zeal manifested for the cause in which the assembly is enappear to demand the PROTECTION of the ASSEMBLY. in London. gaged 8. That the Assembly shall be empowered to appoint comIt was resolved that the secretary do write to the semittees of its enrolled members, from time to time, as cretary of the College of Surgeons of England, to learn occasion may require, for the performance of special on what day (after Monday next) it would be convenient for the council to receive a deputation, with an address duties. 9. That all meetings of the Assembly shall consist only of from the surgical section of the Medical Protection Asand other members of the college by whom that enrolled members, with the exception of members of the sembly, address has been signed. legislature, foreigners, or the authorised and recognised A letter was read from Mr. Wakley, M.P., regretting his inability to attend the committee on the present reporters of the PUBLIC PRESS. 10. That the business of the Assembly, in all its depart- evening, and stating that Sir James Graham intended to introduce his Medical Reform Bill on Thursday, the 30th ments, shall be controlled by the Assembly. of May, into the House of Commons, and offering to 11. That at each meeting a President shall be chosen the committee a suggestion; on which it was resolved, that in case Sir James Graham’s Bill be so brought in on from amongst the enrolled members then present. 12. That if there be not thirty members in attendance Thursday next, the secretary do summon the committee on Friday, at the expiration of fifteen minutes after the time ap- to attend at the committee-room, Exeter-hall, the 31 sit of May, at the usual hour of meeting. pointed for holding any MEETING OF THE ASSEMBLY, [The postponement of the motion of Sir JAMES GRAthe Secretary shall announce that the Assembly is HAM has been noticed at page 316.] getic support nication of
to the
a
adjourned.
13. That
privilege, and
on
or
all
disputed questions having reference to government of the Assembly,
to the internal
all other questions, appeal being made
on
the decision of the President, to him by the Assembly, shall
GLOUCESTER INFIRMARY.
MEDICAL BOARD, May 10, 1844:-Present: Dr. Evans, Dr. Fletcher, Mr. Wilton, Mr. Fletcher, Mr. Buchanan, be final. Mr. Wood. 14. That the mover of any original resolution be entitled On the consideration of the published report of certain to make a reply ; that any other member be not entitled proceedings of the Gloucestershire Medical and Surgical Association, it was resolved, " That the following answer to speak more than once on the same question, to the statement therein contained, be adopted and pubthe Assembly be resolved into a committee of the whole!, lished, to circulate through the same channels in which Assembly, when this restraint shall no longer exist. the report appeared." The President, and Chairman of committees, when preIn reference to certain proceedings of the Gloucestersiding, to determine as to which speaker is in possession shire Medical and Surgical Association recently published, we beg to present the following reply :of the Assembly. Attached to our hospital are two physicians and four 15. That in taking the votes of the Assembly the President who form the medical board. surgeons, may decide by a show of hands, or direct, on the demand Our senior surgeon, who is also the president of the of two members, that the numbers be counted. In the Gloucestershire Medical and Surgical Association, aplatter case the President shall name the tellers, two for plied in that capacity, some months ago, to the weekly each party. That when the numbers of votes are equal board of governors, for the use of the board-room of the the President shall give a casting vote; but not vote on infirmary for the meetings of the association, and a meeting was accordingly held there; but no minute of other occasions. leave to use the room for this purpose having been entered 16. That the order of taking motions at each meeting of on the books of the weekly board, on the approach of the Assembly shall be regulated by ballot. the next meeting of the association the following pro17. That motions left undiscussed at one meeting shall ceedings took place :take precedence of other motions at the next meeting of Extract from the Minutes of the Weekly Board, Feb. 8, 1844. the Assembly, unless the President shall decide that any « An intimation of relates to a motion particular having been made to this board that question privilege. 18. That the only standing officers of the Assembly shall a meeting of the Gloucestershire Medical and Surgical Association is proposed to be held at this infirmary, be two Treasurers and a Secretary. " Resolved,-That Mr. Wilton, senior surgeon to the 19. That the accounts of the Assembly shall be audited institution, be requested to attend the board on Thursday half-yearly, and that three auditors of such accounts next, and that he will be kind enough on that occasion to explain such particulars as may enable the board to shall be appointed by the Assembly.
on an
unless
318 decision as to the propriety of affording the use ofalso a note from Mr. Wilton, disclaiming any part in in the establishment for such purpose." their report :" Ordered,—That a. copy of the foregoing resolutions Extract from the Minutes of the Weekly Board, Feb. 29. be forwarded to Mr. Wilton." " Gloucester Infirmary, Feb. 27, 1844. Extract from the Minutes of the Weekly Board, Feb. 15. To the Governors of the Infirmary assembled at the " Mr. Wilton attended this board, as requested by the Weekly Board. governors, on Thursday last, and having satisfied them The medical board beg respectfully to express their that an assent had been given some time since, to the occasional use of the committee-room for the accommo- opinion that should the governors allow the use of the dation of the Gloucestershire Medical and Surgical Asso- infirmary, or any part of it, to the Gloucestershire Mediciation, whose purposes are the improvement of pro- cal and Surgical Association, the meetings of such assofessional knowledge, by reading papers on subjects con- ciation, being held for purposes connected with the medinected with medical and surgical science, the exhibition cal profession, shall take place under such regulations as the medical board may decide to be advisable, a privilege of specimens (anorbid and natural), drawings, &e. " Resolved,—That the board now assembled readily to which, with submission, they think themselves fairly assent to the use of the committee-room for the purposes entitled. 11 The medical board feel, and have always felt, great specified, and regret that a minute was not ordered to be made on their records that such assent had been obtained pleasure, in rendering this hospital available for the promotion of the objects of medical science, and have ever by Mr. Wilton on a former occasion." made it of easy access to the members of their profesOn the day on which this assent was obtained, three of sion." the medical officers, who were not members of the assoThe above letters having been considered, it was reciation, having casually met in the receiving-room for solved (two dissentients), "That it is the opinion of this patients, expressed mutual surprise at having been that meeting that the weekly board have not the power to to be invited an to attend address, introductory morning the use of this committee-room, or any part of the grant board-room on the same read before the association in the for any purposes not directly or immediately evening. On being joined by Mr. Wilton, they stated to hospital, institution." him that they felt aggrieved that he should have pro- connected with the objects of this officers were preOn this occasion of the medical two ceedecl thus far, without once conferring with his colbut did uot rote. leagues on a matter in which they considered themselves sent, The question was again introduced at the quarterly meetentitled to be consulted, and in which they were, on of the governors. ing many accounts, materially interested, and Mr. Wilton On the occasion of this discussion none of the medical his at his want of regret expressed apparent courtesy, officers were present, and the question was negatived in which he said was inadvertent. a most decided manner, only its proposer and seconder A meeting of the medical board was summoned for the in its favour. voting at which all the members thereof following Tuesday, Wilton’s Mr. colleagues did, and do, feel themselves attended (two, besides Mr. Wilton, being members of the ’ aggrieved by the course pursued towards them by him, association). At this meeting all blr. Wilton’s colleagues which, however inadvertent, was carried on consistently joined in requesting him to obtain from the weekly and for a considerable period. board, in any way that he might think proper, a suspenIt has exposed them to an unjust charge of illiberality sion of the confirmation of their minute allowing the use of the hospital for the purposes of the association, until and want of generous feeling, for claiming to themselves and the subject should have been discussed by the medical what they believe every right-thinking person would ought to claim, the privileges of a voice and an opinion in board. Mr. Wilton having positively declined to do this, his the administration of that department of the institution which is their peculiar province. colleagues presented the following minute at the next As to their having instigated and promoted the deciboard :weekly sion of the governors upon the question, they reply, that Extract from the Minutes of the Weekly Board, Feb. 22. the subject was discussed on three several occasions, " Gloucester Infirmary, Feb. 21, 1844. twice by the weekly board and once at a quarterly meetthe "We, undersigned, members of the medical board, ing, and on two of these occasions the attendance of beg respectfully to request of the weekly board that they governors was much more numerous than usual. will suspend the confirmation of their minute allowing That the statement made by Mr. Wilton that his colthe use of the committee-room for the purposes of the leagues, or any of them, voted at two of those meetings, is Gloucestershire Medical and Surgical Association. We utterly incorrect, and they now individually declare that make this request, because the application having been they did not on any occasion induce or endearour to induce the made, and the assent of the weekly board obtained, with- attendance or the vote 4pf a single governor, nor did they inout our knowledge, we feel that some time may fairly be stigate the decision at which the governors did ultimately required for deliberation, thereby to enable us to present arrive, or take any part in the proceedings, further than our opinion to the board upon a measure of such imwas in strict accordance with, and limited by, the terms of their written report; in fact, at the second meeting, portance. (Signed) "THOMAS EVANS, M.D. only two of the medical officers were present, and during RALPH FLETCHER, M.D. the discussion at the quarterly meeting not one. " W. H. FLETCHER. What, then, are the simple facts ? Five out of the six ‘ T. C. BUCHANAN. medical officers of the infirmary, finding that the privilege " ALFRED JOSHUA WOOD." had been granted to one of their colleagues, without their The following address having been considered, it was knowledge or consent, to introduce a medical association proposed by Dr. Evans, and seconded by Mr. Fulljames, to the infirmary, for the purpose of holding periodical "That the confirmation of the minute in question be sus- meetings at short intervals, request of the weekly board, pended until the further opinion of the above-named in the first place, that they will afford them an opportumedical gentlemen shall have been obtained." nity of deliberating on a measure of such importance, An amendment having been moved by Mr. Sage, and and finally, that such meetings, if allowed at the infirseconded by Mr. Turner, " That the said minute be this mary, may take place under the regulations of the mediday confirmed," and the chairman having taken the sense cal board of the institution. These, neither more nor less, are the grounds upon of the board upon the respective propositions, that gentleman declared the previous question to have been which a statement has been made, and proceedings published and circulated to the profession, the governors of carried. The five medical officers, whose signatures are attached the infirmary, and the association, the evident and to the above minute, attended the meeting of the weekly almost avowed object of which, whatever its effect may be, is to draw down upon the medical board, with one board, but did not vote. At the succeeding meeting of the weekly board the exception, the reprobation of the public and of their profollowing minute of the medical board was presented, and fessional brethren.
form
a
a room
,
319 They pledge themselves that what they have stated is the truth, and the whole truth, and they fear not to ask the profession, the governors, and the association, whether the conduct they have pursued is not what any one of them would have adopted under similar circumstances. (Signed) THOMAS EvANS, M.D. RALPH FLETCHER, M.D. W. H. FLETCHER. T. C. BUCHANAN. ALFRED JOSHUA WOOD. ’;* Dr. Ralph Fletcher and Mr. W. H. Fletcher request us to state that they have thought proper to withdraw from the Gloucestershire Medical and Surgical Association on account of the recent proceedings.
private practice, and which would tend so greatly advantage. trust that these great disadvantages will shortly be
their to
our
I
and that physicians and surgeons will consider it their duty, as well as their interest, to explain. every case to the students, and push them forward as much as possible in their studies. We shall then have fewer rejected at the different boards of examination, and I am, Sir, yours a greater body of eminent men.
remedied,
respectfully, A STUDENT.
May,
1844.
MEDICAL PRACTITIONERS AND THE LAW GUARDIANS.
ON DISSECTION AND CLINICAL LECTURES.
’
POOR-
To the Editor Of THE LANCET. almost wonder that you continue to encumber SIR,—I To the Edilor of THE LANCET. your valuable pages with complaints of medical men SIR,—In reading your publication of this week, which against government, the poor-law commissioners, guaralways forms a part of my Saturday morning’s work, my dians, the college and the hall, seeing that these powerattention was chiefly called to the remarks contained ful bodies have all combined against us, and break therein, made by a Student, on the " Dissecting-rooms through the laws themselves have made. What can we, and Want of Clinical Lectures in Hospitals." Although poor devils, do ? and why should we add to our toil and I have, as I may say, completed my studies, having gone troubles by writing long letters of complaint to Somerset through the required curriculum, still I am but a student, House, since the big wigs there have but one principle of and take great interest in any remarks made by my action common to them and the country guardians and fellow-labourers respecting anything which is neglected landlords, namely, to " do" the poor at the least cost. by their professors, and which is calculated to extend Why, where can Mr. Pinching, of Cheltenham (about their knowledge. Speaking for myself, during the time I whom a statement appears in the last number of THE One would attended my lectures and hospital practice, which was LANCET), have been spending his days ? at one of the first (if not the first) provincial schools in really fancy he must just have alighted from some UtoEngland, I can say that there was a short supply of sub- pian region where laws are made on principles and jects in the dissecting-rooms, the number rarely exceed- honestly followed out; perhaps he may have been ing half a dozen during the whole session, and for which amongst our Gallic neighbours who are so superficial and we had to pay 10s. 6d. a part. There was, also, great lost to their own interest as rigidly to enforce their mediwant of energy on the part of the physicians of the hos- cal and hygienic laws? or, perhaps, in the dominions of pital to push the students on in their studies ; we might the barbarous Russian autocrat who positively (will it be walk round the house with them and never hear a word believed ?) will not allow his slavish population to take from them, except what questions they asked the physic or have their wounds dressed by any except those patients. All they had to say respecting the case they appointed by the medical authorities ? But we manage would mention to their clerk, in walking from one ward things better in happy, enlightened Albion! Our poputo another ; whilst we, who were not in-door pupils lation throughout all classes is so highly ,educated that (though pupils and dressers of the surgeons), had to walk our magistrates and farmers are as competent judges of behind, and hear nothing. As for clinical lectures, they medical science as the council of our college and hall, were never delivered, though professed to be given. For for government ratifies the appointments, and our medithe first two years that I attended, during The whole of cal parliament (and protectors !) in Lincoln’s-Inn-Fields which time I was a dresser, being a pupil of one of the does not gainsay them. surgeons, clinical lectures were never delivered by the Why, Mr. Pinching, you do not see things at all in the physicians, but every Tuesday morning, after any opera- proper light ! You should congratulate yourself in having tions that there might be, during the winter session, we appointed Gloucestershire as the region of your career! had a lecture from one surgeon, as they took it in turn, for here enlightenedfi-ee trade medical principles flourish each giving a lecture once a month. practically! The guardians can tell better than the colWe certainly could get our necessary certificates with- lege who are fit and competent! "they always go when. out the lectures being given, but that did not forward us they are sent for, and we never hear any complaint" in a scientific point of view; and, as we considered they (which argument cannot be gainsayed quoad ’l:alet). But would be advantageous to us, we petitioned the physicians Mr. P. should look around him, and if his hive is not ranto give, at least, one lecture a week, as the surgeons did. sacked by the " robbers" and interlopers, and he can get This, after some time, they consented to do, but they did honey enough to live through his winter, he must not not perform their promise. We consequently considered complain; for in this county are many practitioners it a task to go round with them ; we knew, however, grandly flourishing, who not only have no certificates, but whom are that if we did not show ourselves, and walk after them, are grossly ignorant and illiterate, some we should not get our certificates for medical practice, appointed by the guardians to attend the poor. Around and that it was alone that induced us to follow them. If Cheltenham, Gloucester, and Stroud, are many unqualithey had taken any interest in us, and explained the fied practitioners ; the Tewkesbury Union was long adcases, instead of leaving us to find them out for ourselves, vertised, and I know that there are highly qualified mediwe should not have been more regular in our cal men there who would readily undertake the duties if attendance, but also much further advanced in the they could have done so creditably. Amongst the four knowledge of our profession. One would naturally medical men having the care of the Cirencester Union, fancy that when a gentlemen is elected physician or sur- only one has the diploma of the hall or college (the sine geon to a hospital he would use every eiJ:’Jrt to pash for- quâ non of government) ; another has only the Edinburgh ward the students atteiictli-ig it, in order to make it as diploma of M.D., the other two are literally nowhere ; popular as possible. For my own part, I consider thatt buL formerly the poor in this district were attended to by clinical lectures are as important, and equally as bene- qualified and respectable practitioners, who may now, ficial to us, as any other part of our studies ; and, as perhaps, shrink from inglorious competition. At Newent, we are required to have certificates of having attended too, the same llon-observance of the laws prevail, and, them, those certificates oug’ht noi to be given to us with- with a little inquiry, such instances could easily be mulSo that, out lectures being delivered. Surely the physicians tiplied. considering the state of the times, little the mode of a an in glorious old England, and devote extra hour occalaws contrivance, by making might, sionally to us, which could not make much difference to the Irish way of making them known by breaking them,
of
only
Sir,
published May 4th, page 204. We have read it attenHaving given immediate insertion to the communiforwarded to us by the Association, and by the cations as also an which additional we rehave tively, report, cently received from the association, of their proceedings medical staff of the Infirmary, and thus allowed both at a meeting which took place on the 21st. parties a fair hearing, although at the time much cramped We feel much regret in having to state that the first for room, we are under the necessity of stating that any impression created on our mind by the perusal of the other communications on the subject must appear in the Association’s report, and which we then gave firmly, columns of our Journal which are appropriated to aaveralthough cautiously, has not been effaced by the reply of the hospital physicians and surgeons. They have made "STATEMENT" OF THE ROYAL COLLEGE out a case, but it is a weak one ; and, in our opinion, is, OF SURGEONS. we repeat, far from justifying the course which they TUE confession and defence of the council of the Coladopted, or the consequences by which it has been fol- lege of Surgeons, printed at page 320, shall receive ample lowed. We, however, do them the credit to believe they consideration in our columns. we
tisements.
did not then foresee the result of their conduct. Mr. WILTON, the President of the Association, would have acted, probably, with greater propriety had he intimated
MEDICAL TRIAL AT CARLISLE.
THE next number of THE LANCET will contain
a
report
at Carlisle.
applying to the board of a trial which has recently taken place for the use of the committee-room ; but, on the other The cause is one of considerable importance, as it involves hand, the excuses which he tendered ought to have the question of the right of Scottish graduates to recover been at once accepted. The demand which was made of for medical attendance in England. Mr. KERR, a graMr. WILTON, that he should apply to the board to duate of the College of Surgeons of Edinburgh, was suspend the permission previously granted to the asso- the plaintiff; the executors of a Miss REAY, the deciation, was certainly most unreasonable, and he was fendants. The amount claimed for attendance was 171. quite justified in refusing to accede to it. What he The jury awarded to Mr. KERR 121. refused to do was then done by the five medical HOUSE OF COMMONS, gentlemen who, with the exception of Mr. WILTON, conTHURSDAY, MAY 30, 1844. stitute the staff of the Gloucester Thus a to his
colleagues
question,
which
his intention of
was
Infirmary. obviously merely one of medical
SIR JAMES GRAHAM had
given
notice of his intention
etiquette, for there can be no doubt but that Mr. WILTON’S to movethis evening for leave to introduce a Bill for opponents were as anxious for the advancement of the regulating the profession of physic and surgery throughscience of medicine as the members of the Association itself, became a subject of board-room debate. The what might have been anticipated, and does think, to the good sense of the governors. Not wishing to act in opposition to the principal part of their medical staff on the one hand, or to bind the Association to submit to rules imposed by gentlemen who did not belong to it on the other, they solved the problem at their quarterly meeting by, very properly, withdrawing all power from the weekly board "to dispose of any part of " the hospital for purposes not directly connected with <’ the objects of the institution." Finally, we think the medical functionaries of the Gloucester Infirmary have erred in judgment, perhaps more than in intention. Believing themselves slighted by their colleague and the Association, and perhaps justly so, they refused to accept the, it appears, ample satisfaction offered ; and in order to obtain a still greater one, applied to a non-medical body. By that body the question has been treated as a professional squabble ; that is, as one too delicate or too disagreeable to be handled, and
result
was
credit,
we
has been at
once
thrown overboard.
Can we be
surprised
result? Certainly not; the public has no sympathy for us when we fall out among ourselves, and all we get by making known our grievances are taunts and derision. We trust this exposé in Gloucestershire will be a lesson both to the parties concerned, and to at such
a
professional
brethren at
large.
our
out the United Kingdom; and also for a bill to enable her Majesty to grant Charters to certain Colleges of Physicians and Surgeons. In consequence of the great number of motions which preceded that of the Right Hon. Baronet, he was obliged to postpone the consideration of the subject of Medical Reform until TUESDAY next, JUNE 4th. Even then it may be further postponed, as a motion on the "Coal Duties" stands first on the paper for that evening.
MEDICAL PROTECTION ASSEMBLY. BY-LAWS. 1. THAT theMEDICAL PROTECTION ASSEMBLY shall consist of the legally-qualified medical practitioners and registered students in medicine whose names, for the time being, stand in the enrolment books of the As-
sembly.
legally-qualified medical practitioners and students in medicine may demand, as a right, that their names shall be enrolled in the books of the 2. That all
registered
Assembly. 3. That the enrolment of the names of members be made that the charge for making it be a nominal fee of one shilling. 4. That the FIRST day of January, in every year, be the date of the commencement of the enrolment for that
annually, and
year. 5. That no enrolled member shall be entitled to attend
meetings of the Assembly the renewal of whose enrolexpiration of the month of January in any year. 6. That the chief objects of the Assembly shall be,the
ment has not been effected before the
317 First. To obtain for every legally-qualified member of the profession the right of voting at the elections of the governing body of the institution from which he has obtained, or shall obtain, his diploma or licence. Secondly. To secure the efficient qualification of all medical practitioners by means of a system of scientific and practical examinations. Thirdly. To procure the public registration of all legally-qualified medical practitioners. Fourthly. To protect all legally-qualified medical practitioners in the just discharge of their professional duties.
20. That all monies due to the Assembly shall be paid to the Treasurers, or to one of them, or to the Secretary. 21. That all payments on behalf of the Assembly shall be made by the Treasurers, or two of them, through the Secretary, who shall be required to furnish the auditors with vouchers for such payments. 22. That a special meeting of the Assembly may be called at any time by the Secretary, on a requisition being presented to him for that purpose, signed by two of the Treasurers and seven enrolled members, or by one of the Treasurers and fourteen enrolled members, or on a requisition signed by twenty-one enrolled members.
7. That the Assembly be empowered to appoint committees of its enrolled members, who may reside in distant places, for the purpose of inquiring into any medical abuses existing in particular localities, or into the nature
Monday, May 27th.-Mr. Ross in the Chair.-Letters parts of the kingdom were read, promising ener-
from all
objects of the assembly. A commuvery interesting nature was read from Jersey, detailing the origin and progress of the auxiliary of any alleged invasion of professional rights which may association recently formed in that island, and the zeal manifested for the cause in which the assembly is enappear to demand the PROTECTION of the ASSEMBLY. in London. gaged 8. That the Assembly shall be empowered to appoint comIt was resolved that the secretary do write to the semittees of its enrolled members, from time to time, as cretary of the College of Surgeons of England, to learn occasion may require, for the performance of special on what day (after Monday next) it would be convenient for the council to receive a deputation, with an address duties. 9. That all meetings of the Assembly shall consist only of from the surgical section of the Medical Protection Asand other members of the college by whom that enrolled members, with the exception of members of the sembly, address has been signed. legislature, foreigners, or the authorised and recognised A letter was read from Mr. Wakley, M.P., regretting his inability to attend the committee on the present reporters of the PUBLIC PRESS. 10. That the business of the Assembly, in all its depart- evening, and stating that Sir James Graham intended to introduce his Medical Reform Bill on Thursday, the 30th ments, shall be controlled by the Assembly. of May, into the House of Commons, and offering to 11. That at each meeting a President shall be chosen the committee a suggestion; on which it was resolved, that in case Sir James Graham’s Bill be so brought in on from amongst the enrolled members then present. 12. That if there be not thirty members in attendance Thursday next, the secretary do summon the committee on Friday, at the expiration of fifteen minutes after the time ap- to attend at the committee-room, Exeter-hall, the 31 sit of May, at the usual hour of meeting. pointed for holding any MEETING OF THE ASSEMBLY, [The postponement of the motion of Sir JAMES GRAthe Secretary shall announce that the Assembly is HAM has been noticed at page 316.] getic support nication of
to the
a
adjourned.
13. That
privilege, and
on
or
all
disputed questions having reference to government of the Assembly,
to the internal
all other questions, appeal being made
on
the decision of the President, to him by the Assembly, shall
GLOUCESTER INFIRMARY.
MEDICAL BOARD, May 10, 1844:-Present: Dr. Evans, Dr. Fletcher, Mr. Wilton, Mr. Fletcher, Mr. Buchanan, be final. Mr. Wood. 14. That the mover of any original resolution be entitled On the consideration of the published report of certain to make a reply ; that any other member be not entitled proceedings of the Gloucestershire Medical and Surgical Association, it was resolved, " That the following answer to speak more than once on the same question, to the statement therein contained, be adopted and pubthe Assembly be resolved into a committee of the whole!, lished, to circulate through the same channels in which Assembly, when this restraint shall no longer exist. the report appeared." The President, and Chairman of committees, when preIn reference to certain proceedings of the Gloucestersiding, to determine as to which speaker is in possession shire Medical and Surgical Association recently published, we beg to present the following reply :of the Assembly. Attached to our hospital are two physicians and four 15. That in taking the votes of the Assembly the President who form the medical board. surgeons, may decide by a show of hands, or direct, on the demand Our senior surgeon, who is also the president of the of two members, that the numbers be counted. In the Gloucestershire Medical and Surgical Association, aplatter case the President shall name the tellers, two for plied in that capacity, some months ago, to the weekly each party. That when the numbers of votes are equal board of governors, for the use of the board-room of the the President shall give a casting vote; but not vote on infirmary for the meetings of the association, and a meeting was accordingly held there; but no minute of other occasions. leave to use the room for this purpose having been entered 16. That the order of taking motions at each meeting of on the books of the weekly board, on the approach of the Assembly shall be regulated by ballot. the next meeting of the association the following pro17. That motions left undiscussed at one meeting shall ceedings took place :take precedence of other motions at the next meeting of Extract from the Minutes of the Weekly Board, Feb. 8, 1844. the Assembly, unless the President shall decide that any « An intimation of relates to a motion particular having been made to this board that question privilege. 18. That the only standing officers of the Assembly shall a meeting of the Gloucestershire Medical and Surgical Association is proposed to be held at this infirmary, be two Treasurers and a Secretary. " Resolved,-That Mr. Wilton, senior surgeon to the 19. That the accounts of the Assembly shall be audited institution, be requested to attend the board on Thursday half-yearly, and that three auditors of such accounts next, and that he will be kind enough on that occasion to explain such particulars as may enable the board to shall be appointed by the Assembly.
on an
unless
318 decision as to the propriety of affording the use ofalso a note from Mr. Wilton, disclaiming any part in in the establishment for such purpose." their report :" Ordered,—That a. copy of the foregoing resolutions Extract from the Minutes of the Weekly Board, Feb. 29. be forwarded to Mr. Wilton." " Gloucester Infirmary, Feb. 27, 1844. Extract from the Minutes of the Weekly Board, Feb. 15. To the Governors of the Infirmary assembled at the " Mr. Wilton attended this board, as requested by the Weekly Board. governors, on Thursday last, and having satisfied them The medical board beg respectfully to express their that an assent had been given some time since, to the occasional use of the committee-room for the accommo- opinion that should the governors allow the use of the dation of the Gloucestershire Medical and Surgical Asso- infirmary, or any part of it, to the Gloucestershire Mediciation, whose purposes are the improvement of pro- cal and Surgical Association, the meetings of such assofessional knowledge, by reading papers on subjects con- ciation, being held for purposes connected with the medinected with medical and surgical science, the exhibition cal profession, shall take place under such regulations as the medical board may decide to be advisable, a privilege of specimens (anorbid and natural), drawings, &e. " Resolved,—That the board now assembled readily to which, with submission, they think themselves fairly assent to the use of the committee-room for the purposes entitled. 11 The medical board feel, and have always felt, great specified, and regret that a minute was not ordered to be made on their records that such assent had been obtained pleasure, in rendering this hospital available for the promotion of the objects of medical science, and have ever by Mr. Wilton on a former occasion." made it of easy access to the members of their profesOn the day on which this assent was obtained, three of sion." the medical officers, who were not members of the assoThe above letters having been considered, it was reciation, having casually met in the receiving-room for solved (two dissentients), "That it is the opinion of this patients, expressed mutual surprise at having been that meeting that the weekly board have not the power to to be invited an to attend address, introductory morning the use of this committee-room, or any part of the grant board-room on the same read before the association in the for any purposes not directly or immediately evening. On being joined by Mr. Wilton, they stated to hospital, institution." him that they felt aggrieved that he should have pro- connected with the objects of this officers were preOn this occasion of the medical two ceedecl thus far, without once conferring with his colbut did uot rote. leagues on a matter in which they considered themselves sent, The question was again introduced at the quarterly meetentitled to be consulted, and in which they were, on of the governors. ing many accounts, materially interested, and Mr. Wilton On the occasion of this discussion none of the medical his at his want of regret expressed apparent courtesy, officers were present, and the question was negatived in which he said was inadvertent. a most decided manner, only its proposer and seconder A meeting of the medical board was summoned for the in its favour. voting at which all the members thereof following Tuesday, Wilton’s Mr. colleagues did, and do, feel themselves attended (two, besides Mr. Wilton, being members of the ’ aggrieved by the course pursued towards them by him, association). At this meeting all blr. Wilton’s colleagues which, however inadvertent, was carried on consistently joined in requesting him to obtain from the weekly and for a considerable period. board, in any way that he might think proper, a suspenIt has exposed them to an unjust charge of illiberality sion of the confirmation of their minute allowing the use of the hospital for the purposes of the association, until and want of generous feeling, for claiming to themselves and the subject should have been discussed by the medical what they believe every right-thinking person would ought to claim, the privileges of a voice and an opinion in board. Mr. Wilton having positively declined to do this, his the administration of that department of the institution which is their peculiar province. colleagues presented the following minute at the next As to their having instigated and promoted the deciboard :weekly sion of the governors upon the question, they reply, that Extract from the Minutes of the Weekly Board, Feb. 22. the subject was discussed on three several occasions, " Gloucester Infirmary, Feb. 21, 1844. twice by the weekly board and once at a quarterly meetthe "We, undersigned, members of the medical board, ing, and on two of these occasions the attendance of beg respectfully to request of the weekly board that they governors was much more numerous than usual. will suspend the confirmation of their minute allowing That the statement made by Mr. Wilton that his colthe use of the committee-room for the purposes of the leagues, or any of them, voted at two of those meetings, is Gloucestershire Medical and Surgical Association. We utterly incorrect, and they now individually declare that make this request, because the application having been they did not on any occasion induce or endearour to induce the made, and the assent of the weekly board obtained, with- attendance or the vote 4pf a single governor, nor did they inout our knowledge, we feel that some time may fairly be stigate the decision at which the governors did ultimately required for deliberation, thereby to enable us to present arrive, or take any part in the proceedings, further than our opinion to the board upon a measure of such imwas in strict accordance with, and limited by, the terms of their written report; in fact, at the second meeting, portance. (Signed) "THOMAS EVANS, M.D. only two of the medical officers were present, and during RALPH FLETCHER, M.D. the discussion at the quarterly meeting not one. " W. H. FLETCHER. What, then, are the simple facts ? Five out of the six ‘ T. C. BUCHANAN. medical officers of the infirmary, finding that the privilege " ALFRED JOSHUA WOOD." had been granted to one of their colleagues, without their The following address having been considered, it was knowledge or consent, to introduce a medical association proposed by Dr. Evans, and seconded by Mr. Fulljames, to the infirmary, for the purpose of holding periodical "That the confirmation of the minute in question be sus- meetings at short intervals, request of the weekly board, pended until the further opinion of the above-named in the first place, that they will afford them an opportumedical gentlemen shall have been obtained." nity of deliberating on a measure of such importance, An amendment having been moved by Mr. Sage, and and finally, that such meetings, if allowed at the infirseconded by Mr. Turner, " That the said minute be this mary, may take place under the regulations of the mediday confirmed," and the chairman having taken the sense cal board of the institution. These, neither more nor less, are the grounds upon of the board upon the respective propositions, that gentleman declared the previous question to have been which a statement has been made, and proceedings published and circulated to the profession, the governors of carried. The five medical officers, whose signatures are attached the infirmary, and the association, the evident and to the above minute, attended the meeting of the weekly almost avowed object of which, whatever its effect may be, is to draw down upon the medical board, with one board, but did not vote. At the succeeding meeting of the weekly board the exception, the reprobation of the public and of their profollowing minute of the medical board was presented, and fessional brethren.
form
a
a room
,
319 They pledge themselves that what they have stated is the truth, and the whole truth, and they fear not to ask the profession, the governors, and the association, whether the conduct they have pursued is not what any one of them would have adopted under similar circumstances. (Signed) THOMAS EvANS, M.D. RALPH FLETCHER, M.D. W. H. FLETCHER. T. C. BUCHANAN. ALFRED JOSHUA WOOD. ’;* Dr. Ralph Fletcher and Mr. W. H. Fletcher request us to state that they have thought proper to withdraw from the Gloucestershire Medical and Surgical Association on account of the recent proceedings.
private practice, and which would tend so greatly advantage. trust that these great disadvantages will shortly be
their to
our
I
and that physicians and surgeons will consider it their duty, as well as their interest, to explain. every case to the students, and push them forward as much as possible in their studies. We shall then have fewer rejected at the different boards of examination, and I am, Sir, yours a greater body of eminent men.
remedied,
respectfully, A STUDENT.
May,
1844.
MEDICAL PRACTITIONERS AND THE LAW GUARDIANS.
ON DISSECTION AND CLINICAL LECTURES.
’
POOR-
To the Editor Of THE LANCET. almost wonder that you continue to encumber SIR,—I To the Edilor of THE LANCET. your valuable pages with complaints of medical men SIR,—In reading your publication of this week, which against government, the poor-law commissioners, guaralways forms a part of my Saturday morning’s work, my dians, the college and the hall, seeing that these powerattention was chiefly called to the remarks contained ful bodies have all combined against us, and break therein, made by a Student, on the " Dissecting-rooms through the laws themselves have made. What can we, and Want of Clinical Lectures in Hospitals." Although poor devils, do ? and why should we add to our toil and I have, as I may say, completed my studies, having gone troubles by writing long letters of complaint to Somerset through the required curriculum, still I am but a student, House, since the big wigs there have but one principle of and take great interest in any remarks made by my action common to them and the country guardians and fellow-labourers respecting anything which is neglected landlords, namely, to " do" the poor at the least cost. by their professors, and which is calculated to extend Why, where can Mr. Pinching, of Cheltenham (about their knowledge. Speaking for myself, during the time I whom a statement appears in the last number of THE One would attended my lectures and hospital practice, which was LANCET), have been spending his days ? at one of the first (if not the first) provincial schools in really fancy he must just have alighted from some UtoEngland, I can say that there was a short supply of sub- pian region where laws are made on principles and jects in the dissecting-rooms, the number rarely exceed- honestly followed out; perhaps he may have been ing half a dozen during the whole session, and for which amongst our Gallic neighbours who are so superficial and we had to pay 10s. 6d. a part. There was, also, great lost to their own interest as rigidly to enforce their mediwant of energy on the part of the physicians of the hos- cal and hygienic laws? or, perhaps, in the dominions of pital to push the students on in their studies ; we might the barbarous Russian autocrat who positively (will it be walk round the house with them and never hear a word believed ?) will not allow his slavish population to take from them, except what questions they asked the physic or have their wounds dressed by any except those patients. All they had to say respecting the case they appointed by the medical authorities ? But we manage would mention to their clerk, in walking from one ward things better in happy, enlightened Albion! Our poputo another ; whilst we, who were not in-door pupils lation throughout all classes is so highly ,educated that (though pupils and dressers of the surgeons), had to walk our magistrates and farmers are as competent judges of behind, and hear nothing. As for clinical lectures, they medical science as the council of our college and hall, were never delivered, though professed to be given. For for government ratifies the appointments, and our medithe first two years that I attended, during The whole of cal parliament (and protectors !) in Lincoln’s-Inn-Fields which time I was a dresser, being a pupil of one of the does not gainsay them. surgeons, clinical lectures were never delivered by the Why, Mr. Pinching, you do not see things at all in the physicians, but every Tuesday morning, after any opera- proper light ! You should congratulate yourself in having tions that there might be, during the winter session, we appointed Gloucestershire as the region of your career! had a lecture from one surgeon, as they took it in turn, for here enlightenedfi-ee trade medical principles flourish each giving a lecture once a month. practically! The guardians can tell better than the colWe certainly could get our necessary certificates with- lege who are fit and competent! "they always go when. out the lectures being given, but that did not forward us they are sent for, and we never hear any complaint" in a scientific point of view; and, as we considered they (which argument cannot be gainsayed quoad ’l:alet). But would be advantageous to us, we petitioned the physicians Mr. P. should look around him, and if his hive is not ranto give, at least, one lecture a week, as the surgeons did. sacked by the " robbers" and interlopers, and he can get This, after some time, they consented to do, but they did honey enough to live through his winter, he must not not perform their promise. We consequently considered complain; for in this county are many practitioners it a task to go round with them ; we knew, however, grandly flourishing, who not only have no certificates, but whom are that if we did not show ourselves, and walk after them, are grossly ignorant and illiterate, some we should not get our certificates for medical practice, appointed by the guardians to attend the poor. Around and that it was alone that induced us to follow them. If Cheltenham, Gloucester, and Stroud, are many unqualithey had taken any interest in us, and explained the fied practitioners ; the Tewkesbury Union was long adcases, instead of leaving us to find them out for ourselves, vertised, and I know that there are highly qualified mediwe should not have been more regular in our cal men there who would readily undertake the duties if attendance, but also much further advanced in the they could have done so creditably. Amongst the four knowledge of our profession. One would naturally medical men having the care of the Cirencester Union, fancy that when a gentlemen is elected physician or sur- only one has the diploma of the hall or college (the sine geon to a hospital he would use every eiJ:’Jrt to pash for- quâ non of government) ; another has only the Edinburgh ward the students atteiictli-ig it, in order to make it as diploma of M.D., the other two are literally nowhere ; popular as possible. For my own part, I consider thatt buL formerly the poor in this district were attended to by clinical lectures are as important, and equally as bene- qualified and respectable practitioners, who may now, ficial to us, as any other part of our studies ; and, as perhaps, shrink from inglorious competition. At Newent, we are required to have certificates of having attended too, the same llon-observance of the laws prevail, and, them, those certificates oug’ht noi to be given to us with- with a little inquiry, such instances could easily be mulSo that, out lectures being delivered. Surely the physicians tiplied. considering the state of the times, little the mode of a an in glorious old England, and devote extra hour occalaws contrivance, by making might, sionally to us, which could not make much difference to the Irish way of making them known by breaking them,
of
only
Sir,