MEDICAL REFORM.

Prize, Mr. E. M. C. Hooker; Certificate, Mr. A. Lawrence.Comparative Anatomy: Prize, Messrs. Dracachis and R. C.

MEDICAL

REFORM.

Price. Sir J. KAY SHUTTLEWORTH then addressed the meeting in an able and eloquent speech, some few points in which only we are able to notice. On a similar occasion, at Manchester, it had fallen to the lot of the Chairman to address an assemblage of medical students; at that time he had spoken principally of the intellectual aspect of medical teaching and medical life; how the science of medicine and medical education were modified by modes of thought and schools of philosophy. On the present occasion it was preferred to speak of the moral aspect of medical life ; to trace out the moral influences which bore upon the individual from studentship to more mature years, and to endeavour to show how they might, by proper guidThere was a high purance, be made to work for good. pose for the physician ; there were priests of the soul, and the physician might be called the priest of the body. It was of the very essence of religion to search out the laws of God, and to obey them, whether these laws were expressed in the moral As exponents of the laws of our psycholoor material world. gical and physiological organization, physicians might truly lay claim to a priesthood. Especial attention was called to the influences which surrounded the student at the commencement of his studies: how he required guidance and counsel, lest sudden familiarity with the arcana of our physical organization should operate to the disadvantage of his moral being. Reference was made to the desirability of guarding against the materialistic tendencies of medical studies when they are confined entirely to the physical aspect of human nature. It was necessary to keep alive the sympathies of the student, and to present to him the moral phenomena of humanity, lest he should look upon his species as a mere result of chemical laws or molecular forces. The study of comparative anatomy and the homologies it displayed: how this arm and hand became a this caudal series of bones, a tail; this hand, a paddle; this tooth, a tusk; and this nose, a prolonged snout; and lastly, how the skull became in man the seat of intelligence

THE following remarks on Mr. Headlam’s " Medical Profession Bill," and Lord Elcho’s opposition, have been forwarded to us for publication :"Surprise, not unmixed with indignation, is the general feeling of the medical profession of the three kingdoms on finding that Lord Elcho, as the advocate of the Scotch Universities, should have come forward to oppose the Medical Bill which was read a first time on Wednesday, (the 13th inst.,) by Mr. Headlam. That Bill has been composed with earnest solicitude, and has been matured at repeated conferences of representatives from all the parties interested in legislation. The Colleges of Physicians of London, Edinburgh, and Ireland; the Colleges of Surgeons of England, of Edinburgh, and of Ireland; the Faculty of Physicians and Surgeons, Glasgow; the Society of Apothecaries of London; the Universities of Oxford and of Dublin; the Queen’s University in Ireland; and the British Medical Association, have deliberated, by their delegates, on the different bearings of the question, and by taking large and liberal views, and by making mutual concessions of particular interests, have arrived, with much labour, at a scheme which has as much the interests of the public as the advantage of their own profession for its leading objects. The University of Cambridge has been in communication with the delegates with a view to arrangements not yet completed, and the University of London will probably pursue the same course. It is scarcely likely that any Select Committee of the House of Commons should be in a position to comprehend the complex bearings of this difficult subject, still less to amend a decision arrived at with so much knowledge and so much care. It is earnestly to be deprecated, therefore, that this Bill should fall under the hands of a Select Committee of the House, by which means it might be so mutilated that it would be impossible for the profession to receive it. and sign of his pre-eminence : was calculated, unless properly The Bill of last Session actually suffered this mutilation in viewed, to lead the student to look upon man as nothing more the Select Committee, and emerged from it in an impracticable than the final result of a great developmental law. Histological form, and therefore inadmissible by the parties to the legislaanatomy and chemistry, too, had their dangers; and the expe- tion. That Bill was withdrawn because the medical profession riments of physiology,- uncorrected by other teaching, might decided not to accept it; and the long and anxious deliberations lead hasty youth to look upon the mind as a mere collection which haveintervened during the past winter haveestablished of cerebral functions. Contact with vice, extreme poverty, their views still more firmly against the obnoxious innovations squalor, and every species of physical and moral degradation, it contained. And this is the Bill Lord Elcho would now press such as fell to the share of the young student, would affect his upon the reluctant profession. moral welfare, either for good or evil. A graceful tribute of Lord Elcho’s Bill, or that mutilated offspring of the Select affection was here paid to the Chairman’s former instructor, Committee which he has adopted, is a mere Bill for a Scotch Professor Alison, and the value of such a guide was shown. University legislation. It proposes to remodel the system now How necessary it was to keep alive the finer sympathies of the prevailing in the English medical profession to such an extent student amongst such scenes, to point out how violation of as to render it wholly inefficient for the public wants, whilst physical laws becomes connected with moral degradation; how the object to be effected by such revolution is simply the the converse is true, that the highest step of physical health is pecuniary benefit of the Scotch Universities. declared in a high moral tone; and how grave questions of It is important thus to notice how extremely narrow is the social philosophy were involved in infractions of physical laws. source whence Lord Elcho’s opposition arises. Scotch professors It was specially insisted that he was only half a physician who alone are the persons interested; and it is proposed that a only saw physical disease, and he only comprehended the full whole profession of a great kingdom, and the public convenil scope of his mission who took cognizance of moral as well as ence, should be sacrificed to the gains of a few professors of a material disorders. In passing on to the maturer relations of single division of the country. It is proposed to render the licence of the Scotch ’professors the medical practitioner, reference was made to the devotion, self-sacrifice, love of scientific truth, and large sympathy for effective by the invention of that which has been termed a onemankind, which those must possess who hope to arrive at great portal scheme. This scheme being an experiment, and which and beneficial results. Great patience was required of those would be a violent disruption of the established order of things who would penetrate the arcana of Nature. There was a love in the medical profession, is wholly inadmissible in England, of scientific truth almost equal to love of moral truth, and because the wants of the public could not be served by it. The present organization works well. The need of a large science had her martyrs and devotees, but still sympathy was necessary to perfection of motive. Greater simplicity of life! body of sufficiently educated men, ready to act on all occasions, was urged upon those who occupied the first ranks in the proand on such terms as could be afforded by all classes of the fession. Man, with such a mission as the physician, and public, is a manifest fact. The need of surgeons more carefully educated, who have atviewing humanity from such an advantageous stand-point, should be superior to the exigencies of an artificial social sys- tained higher skill in the more important acts of surgery, by tem. In conclusion, the operation of physical causes in bring- constant practice, is also a fact. The need also of physicians, of men who have been trained ing about moral progress was adverted to, and an indignant protest was made against that imperfect philosophy which re- to the highest point of mental education, as in the English fused to recognise the intellectual and moral elevation of man- Universities of Oxford, and Cambridge, and Dublin, who have been thereby prepared to solve difficult questions in medical kind in the past, or to hope for it in the future. A vote of thanks to Mr. Spencer Smith for his unwearied science, and who afterwards by exclusive practice in medical exertions on behalf of the school, and the manner in which hei treatment have attained superior experience, is no less a fact. The eventual working of Lord Elcho’s Bill would be to exerted his deserved influenoe over the students, was proposedl by Mr. Lane, and passed amidst great applause. Another abolish the two last of these branches. Were all to be educated alike, all to enter the profession at vote of thanks to Sir J. K. Shuttleworth having been proposedL by Dr. Sibson, passed with the same unanimity, and replied to,, a minimum standard,-all to spend their early years in learning minor duties, the present classes of surgeon and physician the proceedings terminated.

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would be abolished. convert the

Time and

experience

general practitioner either into

alone could never the skilful surgeon

the accomplished physician. A preliminary lengthened education must be wanting, and the experience to decide in medical cases, or to act in surgical ones, could not be attained in a life spent in the mixed avocations of pharmacy, midwifery, surgery, and medicine. It is not denied that there might be master minds which could form exceptions, but this obviously would never constitute a class. Lord Elcho has stated, if correctly reported, that the education and degrees of the Scotch Universities and of the London University are in higher estimation than those of the College of Physicians. The House ought to be more correctly told that the London University is not an educating body; it is only an or

- examining body. The comparison made by Lord Elcho between the degrees of the College of Physicians and the Scottish and London Universities, supposes a parallel which does not exist. The College of Physicians grants no degrees, but grants licenses to practise, which they have the exclusive privilege of granting for London and seven miles round it, and equal privilege with all the English Universities for all England. The duty of the College of Physicians is to examine into the attainments of men holding all degrees, whether English, Irish, or Scotch. To revert once more to Lord Elcho’s one-portal scheme : it is not only novel, but at variance with the principle adopted in the other learned professions. It is exactly analogous with what the legal profession would be if all barristers were obliged to commence as attorneys, and no period in the course of their education rister.

were

allowed for the liberal attainments of the bar-

poisonous drugs, and herbs. The under-mentioned compounds, prepared according to the directions of the Pharmacopoeias of London, Edinburgh, or Dublin, or any of them, are excepted, —viz.: Sulphuric, nitric, and muriatic acids diluted according to the formulae of the British Pharmacopœias or with a larger proportion of water; cerate, ointment, and plaster of cantharides, blistering cloth, plaster and ointment of belladonna, compound pill of hemlock of the London Pharmacopoeia; compound pill of soap of the London and Dublin Pharmacopœias ; pill of calomel and opium (Edinburgh Pharmacopoeia); pill of lead and opium (Edinburgh Pharmacopoeia); compound powder of chalk with opium (London Pharmacopoeia); electuary of opium (Edinburgh Pharmacopoeia.); confection of opium (London Pharmacopoeia); plaster of opium (London, Edinburgh, and Dublin Pharmacopoeias) ; liniment of opium (London and Edinburgh Pharmacopoeias) ; ammoniated tincture of opium (Edinburgh Pharmacopœia); ointment of opium (London Pharmacopoeia); compound ointment of the gall-nut (London and Edinburgh Pharmacopœias); compound pill of storax (London and Edinburgh Pharmacopoeias); compound powder of ipecacuanha [Dover’s powder] (London, Edinburgh, and Dublin Pharmacopoeias); pill of ipecacuanha and opium (Edinburgh Pharmacopoeia); compound powder of kino (London Pharmacopoeia); electuary of catechu (Edinburgh Pharmacopoeia), pill of foxglove and squills (Edinburgh Pharmacopoeia), ointment of tartarized antimony (London, Edinburgh, and Dublin Pharmacopœias), and savin ointment (London, Edinburgh, and Dublin Pharmacopœias). Other substances and preparations may be added to this Index Expzargatorizcs by an Order in Council. It is enacted that no person shall sell any poison, on any pretence whatever, except to a person of full age, and in the presence of a

Again, the Scotch Universities desire that their degrees witness of full age, who is known to the person selling should license to practise throughout the Empire; and pursuing the poison, and to whom the purchaser is known, and on the analogy with other professions, it may be asked-Does a production of a certificate signed by the parish priest, or a - degree from a university license a man to minister in the medical practitioner, or a justice of the peace, to the effect that the poison may be safely supplied to the applicant. Entries of church, or to practise at the bar ? In conclusion, it ought to be pressed on the attention of the the sale of poisons are to be carefully made by the vendors, conmembers of the House, that it is not a section of the medical taining full particulars of the sale of the poison, the name and profession who have laboured on this subject, and whose judg- address of the purchaser, &c. All sold poisons must be covered ment is recorded in Mr. Headlam’s Bill; it is the whole profes- with tinfoil, and distinctly labelled with the address of the sion ; for as stated above, all the corporations of England, Scot- vendor, and the word 11 poison" cast or moulded on the bottle. land, and Ireland, have combined, and, although they may Colourless sold poisons must be mixed with soot or indigo, in have been slightingly spoken of by Lord Elcho, those corpora- the proportion of 1 part by weight of soot to 15 parts of the tions include every legalized practitioner in the Empire. The poison, or 1 part of powdered indigo to 31 parts of the poison. whole profession, therefore, are determined to regulate the Colourless liquid poisons must be coloured with a strong solulaws by which they are to be governed, and they are decided tion of archil. Every gift of poison will be deemed a sale. The not to allow any member of the House, however popular he above provisions will not affect medical prescriptions, or sales may be, to come forward, partially instructed, and biassed, as by wholesale to retail dealers, or sales for lawful purposes of it would seem, by a small and mercenary interest, to interfere trade. All poisons must be kept apart, distinctly labelled, with what they believe to be wise, just, and prudent legisla- in shops and dispensaries. Poisonous medicines for external use must be vended in blue glass bottles, of a quadrangular tion." shape, and properly labelled. The penalty for violating the Act will be a fine of =S20 for the first, and X50 for every subseTHE SALE OF POISONS. quent offence. Druggists will be disqualified from acting as such by a second conviction. No provision appears to be made A BILL has been brought into the House of Lords by the by the Bill for such a contingency as the following :-A reLord President of the Council "to restrict and regulate the spectable person, with some knowledge of drugs, is in. the habit of taking small quantities of laudanum or other poison recites that the existing re- as a sale of poisons." The medicine; he is taken ill in the streets, and at once restrictions on the sale of arsenic have been found to be insufficient, pairs to the nearest apothecary’s shop for a dose of his favourite and that’the unrestricted sale of other poisons facilitates the remedy; but he must be prepared with a witness of full age, commission of crime and occasions frequent fatal accidents. who is known to the druggist, and to whom the purchaser is Clause 3, atternpts the difficult task of defining what "poison" known, or the sale will be illegal. He must also be armed with a certificate. really is. The word is construed to include certain drugs, simple or compounded, mentioned in the schedule A of the Act. These consist of a large number of pharmacopoeial and other preparations, most of which are in common use as medicines. The list is as follows :-Arsenic and its compounds; corrosive sublimate (the bichloride of mercury) and its com*’ Audi ajteram partem." . pounds; the poisonous vegetable alkaloids (as strychnine, &c.); prussic acid; the cyanides of potassium, mercury, and silver; ARMY MEDICAL DEPARTMENT. the chlorides of zinc and antimony; the essential oil of bitter [LETTER FROM DR. JAMES JOHNSTON.] almonds, and any mixture containing it (as " almond flavour"); oantharides and its preparations; belladonna (nightshade) To the Editor of THE LANCET. and its preparations; hemlock and its preparations; aconite and its preparations; opium, in tincture, extract, and SIR,—Permit me, through the columns of your periodical, to powder; foxglove (digitalis) and its preparations; stramo- notice some of the subjects which will come to be considered by nium and its preparations; chloroform and its compounds; the Commissioners on the Medical Department of the Army. oxalic acid and binoxalate of potash; nux vomica seeds and Having ceased to belong to that department, the opinions I bark; tartarized antimony (tartar emetic) and its solution; have formed, based on personal experience, will be unfettered cocculus indicus (used to adulterate beer and porter), ergot by any direct interest in the matter. With regard to admisof rye, savin, lobelia, and all liquids or solids containing or sion into the service, the qualification ought to be such as to consisting wholly or in part of the above-mentioned poisons, render examination, except on points peculiar to the service,

preamble

Correspondence.

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