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Medical Registration Committee.
MINUTES OF EVIDENCE BEFORE THE PARLIAMENTARY COMMITTEE. of any plan for admitting a medical man to the Board of Health by a side-door. We object upon principle to any humble entrance of medicine to the councils of the Board of Health by way of the Bill for the prevention of Nuisances. We would not havemedicine made a mere postscript, an appendix, or supplement, in the administration of public ’ health. If a second paid medical member can be introduced to the Board of Health in this way, very good, but the first entry of medicine should be honourable, otherwise let us stay without altogether, and not share in the odium of the probable failure of Lord MonpETii’s measure. We would do everything which lies in our power to avert such a consummation ; we are most anxious that his Lordship should be preeminently successful, so as to reap the deserved applause of the present and future generations. It is therefore that We have no hostilities or we pen the present remarks. enmities, but a single desire for the promotion of the public health. We can only observe, in conclusion, that if the Government Board of Health should not include at least one member of the medical profession, the constitution of such a body will be regarded as a deliberate insult offered by the Government to the medical profession of this country. 0
wheat.
351
Really those parties who oppose medical reform frightful responsibility. Upon them much of the
assume a
I criminality
of the
present system
must rest.
Medical Registration Committee. MINUTES OF EVIDENCE. Tuesday, March 21st, 1848. MEMBERS PRESENT.
Mr. Lascelles. Mr. Grogan. Mr. Wakley. Sir H. Halford. Mr. Hamilton. Colonel Mure. THE LORD ADVOCATE IN THE CHAIR. (Continued from p. 324.)
John Ridout, Esq., further examined. 6’7ta rman.]-Did you contemplate, in your discussions. in the joint committee, that there should be previous exaamination before the College of Physicians, or previous fines 696.
paid, or whether any other difficulty existed in being admitted, in those cases, to the College of Physicians, to enable him to get upon the register as a physician ?-The consideration has been confined exclusively, in the first instance, to England and Wales; and it was wished that no person should practise either as physician or as surgeon, or as a general practitioner, wherever his qualification may have been derived, but subsequently to his enrolment in the one college or
to be
the other. 697. In short, these colleges respectively were to be vestibules through which he was to enter the register?-Assuredly. 698. What must he pay in order to pass that vestibule ?— The payment was not fixed. 699. What satisfaction was he to give after the evidence of education which he was to produce; if that was not sufficient, what examination was he to undergo ?-The point was, that there should be established, in Scotland and in Ireland, education and examination, corresponding to that which would exist in England, and so soon as that was made to correspond there should be a perfect reciprocity; that the qualification to practise in Scotland or in Ireland, on being produced in England, should admit the party to enrolment, either to one college or the other, according to the particular department in which he had obtained his authority to practise in either
THE correspondence published in another part of the present number of THE LANCET respecting W. HARDING FLINT is a curious sequel to a singular history. It appears that this individual succeeded in imposing himself on the people of Longnor as a qualified practitioner, and went so far as to persuade the guardians and poor-law commissioners of his competency and qualification to hold office under the New Poor Law. It appears that this obstetric culprit was medical officer to the Bakewell district, the village distinguished for being the birth-place of Dr. DENMAN, the celebratedaccoucheur! The miserable trial which recently occurred at the Staffordshire assizes will be fresh in the recollection of our readers. When we gave an account of the trial in which FLINT was concerned, we stated ourselves to be puzzled by the contradictory evidence of the " London and Provincial Medical Directory," and the speech of the counsel for the prosecution. The editors of the useful work in question have, with the most praiseworthy zeal, followed up the matter, and the correspondence contained in their communication reveal the doublings of the author of the Sbffordshire tragedy. The assertion that his qualification was like that of many othergentlemen" from Ireland, will amuse. Now that he has successively been drummed out of the halls and colleges of England and Ireland, we suppose he will take refuge in Scotland or elsewhere. What a commentary does the whole of this case present upon the laws relating to medicine as they at present stand. Any adventurer may make any pretension to any title or qualification he may select, and no notice whatever is taken of him by the college or licensing body whom he outrages. But for the death of the unfortunate woman, and the subsequent trial, W. II. FLINT might have gone on to the end of his days in undisturbed possession of his M.R.C.S. and L.A,C.; neither college nor hall would have interfered. We dare to say this case is not a solitary specimen. Doubtless, others of the same kind exist; and some stringent ]4w5 are imperatively required to sift the tares from the
country.
700. He would be entitled to registration in virtue of that enrolment ?-Yes, in either country; upon the point of payment of fees, that was a matter subsequently to be settled. 701. Mr. W. Lascelles.]-That was to be on a footing of perfect reciprocity !-Yes; very large pGwers were proposed to to the council; they are to superintend the whole be of the of the different colleges in England, and the bylaws, statutes, and regulations, as regard education and examination, to be subject to the control of that council; the council, also, it was contemplated, would ascertain whether the course of study and examination pursued in Scotland and in Ireland corresponded with that established in England, and so soon as there was an equality there would be
entrusted affairs
perfect reciprocity; parties obtaining qualifications to practise
in one country would obtain, on enrolment in either of the subdivisions of the empire, registrations as a necessary consen uencf*
the formation of a register for or for England, Scotland, and Ireland -It was to be left entirely to the discretion of the Secretary of State, or the council. 703. I ask the question, because the Principles" refer only to a registration for England ?-We did not take up that subject, but we expected that there would be a registration in each country. 704. A separate registration for each country, or a general registration to embrace the United Kingdom ?-I should S1lppose it would be more convenient to have a 8eparatf!- registration. in each country; the subject was not specifically taken up. 705. The object might be different; if a party confined himself to practise only in Scotland, or to practise only in Ireland, there might not be occasion to apply to the College of General Practitioners in England, or the College of Surgeons in England ?-With respect to those principles, we have not considered what modifications may hereafter be made to enable this measure to work with the largest measure of good, with the smallest proportion of inconvenience. 706, You mentioned that you communicated this to the
contemplate 702. Do youseparately Kingdom,
the whole of the United
and
352 of State, with the view of ascertaining generally cians ?-The draft of the charter was not fresh in my recol. might be the views of the Government, and also what lection at that time, nor was the draft of the charter brought might be the views with reference to those principles of the under the consideration of the committee. 720. Were you made fully aware of the state of the law different bodies in Scotland and Ireland; did you receive any answer with respect to the views of the different bodies with regard to extra-licentiates of the College of Physicians, in Scotland and Ireland ?-We have had no communication as they are at present allowed to exercise their functions?from Sir George Grey since the communication was made Yes ; I was perfectly aware of the existing constitution of the
Secretary what
to him. College of Physicians. 721. Was any discussion entered into, as to the propriety 707. Which has been made very recently, I believe ?-In of requiring extra-licentiates to undergo another examination, the latter part of last month. 710. Sir H. Halford.]-Are not the terms upon which the before they should be registered, and to produce testimonials of parties are admitted as members of the College of Physicians character, and also the stipulation with regard to the payment of who have graduated in the universities in Scotland or Ire- X25 Jor being so registered ?-No such subject of consideration land, or in foreign universities, expressed in the draft of the was before us. charter for the College of Physicians ?-I believe it is. 722. Are you aware that the draft Qj’the charter which wo 711. Be so good as refer to No. 6, in the draft of the submitted to the committee in the last session of Parliament concharter, and read it to the committee ?That any person, tains, in its fifth provision, the stipulation that I have now men. who, after regular examination, shall have taken a degree in tioned ?-I was not fully aware, as I am now, of the detail of medicine at any university in the United Kingdom of Great the charter in question. It was before the House, and I unBritain and Ireland, or from any foreign university, to be derstood that it was to be subject to a modification; but the from time to time recognised by the said corporation, and modification I understood was to be made in correspondence who shall have attained the age of twenty-six years, and shall with the proposed basis of the new measure. not be engaged in the practice of pharmacy, and shall have 723. Was that the draft to which reference was made in gone through such course of studies, and who shall have passed your conferences ?-Yes. such examination before the censors of the said corporation, 724. There was no other ?-No; it was as to the proposed touching his knowledge of medical and general science and charter, but the particular charter did not come under the literature, and complied with such other regulations as are consideration of the committee. or shall be required by the by-laws of the said corporation, 725. Was not the draft of that charter produced ?-It was not. shall be entitled to become an associate of the said corpora726. Do you recollect, in the conferences, whether any tion without being subject to any other election." I under- modifications in that charter were specially suggested ?-Not stood generally, with respect to the detailed charter for the specially suggested; we could not consider that the negotia. such modifications tion was sufficiently advanced for that, and did not take it College of Physicians, that it would receive " as would enable it to accord with the Principles" as ex- into consideration. 727. Do you consider, your mind now being directed to the pressed in the paper placed before the committee; I believe the members of the College of Physicians who were exa- subject, that such proposals are just ; for example, that the extra mined before the committee of the House in the last session licentiates who have a right to practise in all England, within expressed an intention of modifying the terms of the charter seven miles of London, should be required, in order to register, as it is expressed. to produce testimonials of character, and that they shcruld undergo 712. Mr. Wakley. you a draft of the charter laid another examination>’ such an examination as the censors may before you ?-Not of the College of Physicians. demand, and also pay each ae25, as stipulated in the provisions, 713. Consequently you were unacquainted with the provi- exclusive of the stamp duty ?-I have not considered that quessions which it contained ?-The provisions of the new charter tion with sufficient care to be enabled to answer it. would be modified by the terms of the measure now in con728. Was it discussed at all, whether it was just, in making templation ; it is a measure not sufficiently matured for the any new arrangement with regard to the law, that the present charter of the college to be definitively decided upon. standing of gentlemen who are in the exercise of their pro714. In one of the paragraphs appended’to the fourth con- fessional functions should be disturbed ?—These negotiations dition of the " Principles," I find it stated at the end, " That were not considered to be sufficiently advanced to take that the charter has been submitted to the Government, which subject into deliberate consideration. charter it is expedient should be granted to the College of 72.1). You are aware that, according to the eighth provision Physicians;" did you determine that it was expedient that of your " Principles," penalties should be imposed by sumsuch a charter should be granted to the College of Physicians mary process on all unregistered persons practising medicine without being aware of the provisions it contained ?’—It was and surgery; do you think that a good provision ?-I think it considered expedient that the charter should be granted, but a necessary one for the protection of the public. with such modifications in the charter as would make that 730. Was that unanimously agreed to by the committee !’— charter correspond with those particular " Principles." Yes. 715. You will observe in the paragraph to which I refer 731. You fully agreed in its justice and in its expediency that the definite article is mentioned, that " the" charter has I Most assuredly. been submitted to the Government, and it is expedient that 732. You have observed by the provisions of the charter, as the charter should be granted to the College of Physicians; exhibited in the fifth clause of the draft to which I have you had not a draft of the charter officially laid before you referred, that the extra-licentiate, the gentleman who is now at your conferences ? -We had not; we had not advanced practising as an extra-licentiate of the College of Physicians, is compelled to submit to the requirement contained in that sufficiently for the purpose. 716. Chairman. committee understand that this provision, unless he registers; consequently he would be means nothing except as the determination of the joint comexcluded by the law from practising his profession, and would mittee that there should be a new charter ?-We understood, be subjected to summary penalties, which you intend to prowith respect to the charter that appeared before the Govern- vide by the eighth provision of the " Principles" ?-The imment and this House, that an opinion has been expressed by pression on my mind was, that the extra-licentiate would be adthe fellows of the college that that charter required modifi- mitted in the College of Physicians, and as such would be adcation, and that the particular modification that would be mitted to a registration in connexion with the College of make it correspond with the Physicians. required would be such as would " measures resulting from those 735. Will you state who were present on the occasion, on Principles." 717. Mr. Wakley.]-Probably it would not be assuming too the part of the College of Physicians ?-The members of the much to consider, that in the conferences which you had you College of Physicians were, Dr. Paris, the president of the were applying your mind chiefly to that department of the College; Dr. Todd, the censor; Dr. Clendinning, Dr. Burrows, profession to which you considered you belonged ?—No; in Dr. Nairne, and Dr. Francis Hawkins, the registrar; six general I applied myself to the consideration of every sub- altogether. 736. Will you state the constitution of the joint committee?t ject that came before the conference. 718. Did you specially direct your attention to the proposed -It consisted of the president, two censors, Dr. Burrows, Dr. arrangements with regard to the College of Physicians ?- Nairne, and Dr. Hawkins, the registrar; Mr. Travers, the So far as they were the subject of consideration, certainly, I president of the College of Surgeons, Mr. Stanley, and Mr. applied my mind to the consideration of them. Green, the vice-president of the College of Surgeons, were 719. Had you before you, in entering upon those considera- members on the part of the-College of Surgeons. 737. There were only three from the College of Surgeonst tions, the entire provisions of the law which regulated the College of Physicians, and also a draft of the charter which -No; and Mr. Bean, the master of the Society of Apotheit was proposed should be granted to the College of Physi- caries, myself, and Mr. Bacot, were on the part of the Society .
353 of
Apothecaries; and Mr. Pennington, Mr. Bird, and Mr. Ancell, were on the committee, as representing the National Institute. When questions were put to the vote, they were not put to the vote per capite; each question was put to the College, or to the Society, and on consideration they expressed
paper you have produced: it states, referring to the principles, " That they have met with the unanimous assent of the different classes of the profession, as represented in the committee" ?—We considered, in the committee, that all classes
Grey, considering that it represented the interests of a large body ofpractitioners, required that some individuals, members of that
surgeons, and general practitioners were represented. 756. You came to the conclusion that it would be advantageous to the profession, and useful to the public, provided medical practitioners were registered in three different and distinct classes-namely, physicians, surgeons, and general practitioners ?-That was the general opinion of the gentlemen present; and it seems, as far as I am able to learn, to be the opinion of parties in the profession generally. 757. You, as one, approved of that classification?—Certainly. 758. Do you consider that it is necessary for the protection of the profession or for the protection of the public, that the classification should be carried farther, and that there should be divisions and subdivisions of the respective classes ?—Not subdivisions ; there should be a division of the physicians, surgeons, and general practitioners; that is a division which has existed for very many years, and which it is desirable should still be continued, as being in accordance with the public wishes, and apparently with public convenience. 760. My question does not refer to a division of the profession into physicians, surgeons, and apothecaries, but whether it is expedient for the public welfare or the protection of the profession, that there should be divisions of those classes ?That does seem to be contemplated in these " Principles," that. there should be afurther subdivision than the three enumerated. 761. Are there not to be associates and fellows of the College of Physicians; is not that division contemplated ?That is a subordinate division, and depends upon the organization of the particular college, and not as to the registration. 762. Is it not contemplated that there shall be fellows of the College of Surgeons, and members of the College of Surgeons, and that there shall be members of the College of Surgeons, and general practitioners ?-The charter of the College of Surgeons authorizes the distinction, and creates the distinction of members and fellows. 763. Do you consider those distinctions essential ?-I think that those distinctions are desirable, inasmuch as they promote a higher education on the part of the individuals desirous of obtaining those titular distinctions. 765. Chairman.]-As far as the registration goes, it is not intended to introduce more than three denominations: physicians, surgeons, and general practitioners ?-No. 766. You do not intend in the register to subdivide those denominations into different classes ?-No. 767. Mr. W. Lascelles.]-So that any licentiate or extralicentiate may be placed on the register ?-Yes; I infer from the scope of the charter of the College of Surgeons, and from what they have already announced, that the fellowship of the College of Surgeons, eventually, will be granted only to indi. viduals who have passed a literary examination prior to their being subjected to a professional examination, the object of the college being to promote a higher general as well as a professional education in those to whom the fellowship of the college will be granted. 768. Chairman.]-Still the object of the registration is a registration with reference to the right to practise ?-Yes. 770. Sir Henry Hatford.]-Do you consider that the term " associate," applied to the College of Physicians, establishes a new distinction ?—My own opinion is, that the term "associate" is open to some objection, and I have expressed my opinion to the members of the college; but I have not heard yet what decision they have come to upon that subject.
of medical
practitioners were represented.
752. Was there a single member, or, at least, a single extratheir assent. 738. Mr. Grogan.]- What is the National Institute, which licentiate of the College of Physicians, in that committee ?-No. 753. Is it not stated here that the proposal had obtained you put third; is that any distinct or combined body, or what does the term exactly convey ?-It is a body that has no chartered" the unanimous assent of the different classes of the profesor legalized existence at the present moment, but Sir George sion" ? " As represented by the committee;" the physicians,
Institute, should be upon
this committee. name of "general practitioners" ? i -The members of the Institute, I believe, are all general
739. Would it deserve the
practitioners.
740. Mr. Wakley.]-When did your conferences commence ? There was a preliminary meeting, for the first time, on the 1st of December last year. 741. Do you recollect with whom ?-It was composed of the same individuals whose names I have mentioned, with the exception of the members of the National Institute. 742. How many meetings had you without the presence of the members of the National Institute ?-I cannot mention
precisely
the
number;
there
was a
preliminary meeting
on
the 1st of December, and a succeeding meeting took place on the 8th of December, when a communication was made to Sir
George Grey.
743. Did Sir George Grey make any suggestion that it would be well to communicate at the same time with the medical authorities of Scotland and Ireland ?-No, he did not. 744. Did the same parties continue to meet throughout ?Yes, with the subsequent addition of the members from the National Institute, at the request of Sir George Grey. 745. When did that accession to your numbers take place ? -In a letter dated the 10th December, in answer to the first letter addressed to Sir George Grey, Mr. Phillips says, "I am directed by Secretary Sir George Grey to acknowledge the receipt of the letter of the Presidents of the Royal Colleges of Physicians and Surgeons and the Master of the Society of Apothecaries, dated the 8th inst., and to express Sir George Grey’s satisfaction at the course proposed to be adopted by them, which, he trusts, may lead to some satisfactory settlement of the questions affecting the medical profession. I am to state that, with a view to this object, it appears to Sir George Grey of importance that the interests of the general practitioners should be considered, and he would suggest whether some representative of that body could not be included in the proposed conference. Sir George Grey requests that you will communicate this letter to the President of the Royal College of Surgeons and the Master of the Society of Apothecaries." 746. After that time the requirements of the National Institute of Medicine appeared ?—Yes. 747. And they were received as parties to the conference ?2 - yes, and a communication that the conference was so constituted was forwarded to Sir George Grey. ’74$. Before they appeared, had the question been considered whether it was advisable to grant a charter of incorporation to the general practitioners ?-That was not a subject of consideration tiZZ the union took pluce;. the committee was not considered as fully constituted until they joined the body. 749. Until they joined the body, had you considered whether it would be expedient to make any modification of the 55th of George III ?-The subject generally was not taken into consideration until the committee was considered to be fully constituted in the estimation of Sir George Grey, and that did not take place until the’representatives of the National Institute joined the committee. 750. Are you aware whether any one of the bodies appearing on that occasion had made an appeal to the department profession to which they belonged, with respect to the conditions which it would be advisable to adopt at any such conference ?-For some years past, the subject of incorporation of the general practitioners has been matter of very frequent disCU8sion, and the Society of Apothecaries has had, at diferent times, correspondence wtth associations of general practitioners in parts of the kingdom, and the Society became aware, different in consequence of that correspondence, that there was an earnest desire entertained generally that the general practitioners of the country should obtain an incorporation of a collegiate character. 751. I put the last question in consequence of a sentence, or a portion of a sentence, which appears in the remarks introductory to the "Principles," which,are embodied in the
of the
(To be co72tit2,ued.)
Correspondence. "Ai-idi alteram
partem."
THE UPTON-ON-SEVERN UNION. To the Editor of THE LANCET. SIR,—Messrs. Braddon and White, in the last number of THE LANCET, place the matter of the " strike" or resignation ofthe medical officers ofthe Upton-on-Severn Union in the
wheat.
351
Really those parties who oppose medical reform frightful responsibility. Upon them much of the
assume a
I criminality
of the
present system
must rest.
Medical Registration Committee. MINUTES OF EVIDENCE. Tuesday, March 21st, 1848. MEMBERS PRESENT.
Mr. Lascelles. Mr. Grogan. Mr. Wakley. Sir H. Halford. Mr. Hamilton. Colonel Mure. THE LORD ADVOCATE IN THE CHAIR. (Continued from p. 324.)
John Ridout, Esq., further examined. 6’7ta rman.]-Did you contemplate, in your discussions. in the joint committee, that there should be previous exaamination before the College of Physicians, or previous fines 696.
paid, or whether any other difficulty existed in being admitted, in those cases, to the College of Physicians, to enable him to get upon the register as a physician ?-The consideration has been confined exclusively, in the first instance, to England and Wales; and it was wished that no person should practise either as physician or as surgeon, or as a general practitioner, wherever his qualification may have been derived, but subsequently to his enrolment in the one college or
to be
the other. 697. In short, these colleges respectively were to be vestibules through which he was to enter the register?-Assuredly. 698. What must he pay in order to pass that vestibule ?— The payment was not fixed. 699. What satisfaction was he to give after the evidence of education which he was to produce; if that was not sufficient, what examination was he to undergo ?-The point was, that there should be established, in Scotland and in Ireland, education and examination, corresponding to that which would exist in England, and so soon as that was made to correspond there should be a perfect reciprocity; that the qualification to practise in Scotland or in Ireland, on being produced in England, should admit the party to enrolment, either to one college or the other, according to the particular department in which he had obtained his authority to practise in either
THE correspondence published in another part of the present number of THE LANCET respecting W. HARDING FLINT is a curious sequel to a singular history. It appears that this individual succeeded in imposing himself on the people of Longnor as a qualified practitioner, and went so far as to persuade the guardians and poor-law commissioners of his competency and qualification to hold office under the New Poor Law. It appears that this obstetric culprit was medical officer to the Bakewell district, the village distinguished for being the birth-place of Dr. DENMAN, the celebratedaccoucheur! The miserable trial which recently occurred at the Staffordshire assizes will be fresh in the recollection of our readers. When we gave an account of the trial in which FLINT was concerned, we stated ourselves to be puzzled by the contradictory evidence of the " London and Provincial Medical Directory," and the speech of the counsel for the prosecution. The editors of the useful work in question have, with the most praiseworthy zeal, followed up the matter, and the correspondence contained in their communication reveal the doublings of the author of the Sbffordshire tragedy. The assertion that his qualification was like that of many othergentlemen" from Ireland, will amuse. Now that he has successively been drummed out of the halls and colleges of England and Ireland, we suppose he will take refuge in Scotland or elsewhere. What a commentary does the whole of this case present upon the laws relating to medicine as they at present stand. Any adventurer may make any pretension to any title or qualification he may select, and no notice whatever is taken of him by the college or licensing body whom he outrages. But for the death of the unfortunate woman, and the subsequent trial, W. II. FLINT might have gone on to the end of his days in undisturbed possession of his M.R.C.S. and L.A,C.; neither college nor hall would have interfered. We dare to say this case is not a solitary specimen. Doubtless, others of the same kind exist; and some stringent ]4w5 are imperatively required to sift the tares from the
country.
700. He would be entitled to registration in virtue of that enrolment ?-Yes, in either country; upon the point of payment of fees, that was a matter subsequently to be settled. 701. Mr. W. Lascelles.]-That was to be on a footing of perfect reciprocity !-Yes; very large pGwers were proposed to to the council; they are to superintend the whole be of the of the different colleges in England, and the bylaws, statutes, and regulations, as regard education and examination, to be subject to the control of that council; the council, also, it was contemplated, would ascertain whether the course of study and examination pursued in Scotland and in Ireland corresponded with that established in England, and so soon as there was an equality there would be
entrusted affairs
perfect reciprocity; parties obtaining qualifications to practise
in one country would obtain, on enrolment in either of the subdivisions of the empire, registrations as a necessary consen uencf*
the formation of a register for or for England, Scotland, and Ireland -It was to be left entirely to the discretion of the Secretary of State, or the council. 703. I ask the question, because the Principles" refer only to a registration for England ?-We did not take up that subject, but we expected that there would be a registration in each country. 704. A separate registration for each country, or a general registration to embrace the United Kingdom ?-I should S1lppose it would be more convenient to have a 8eparatf!- registration. in each country; the subject was not specifically taken up. 705. The object might be different; if a party confined himself to practise only in Scotland, or to practise only in Ireland, there might not be occasion to apply to the College of General Practitioners in England, or the College of Surgeons in England ?-With respect to those principles, we have not considered what modifications may hereafter be made to enable this measure to work with the largest measure of good, with the smallest proportion of inconvenience. 706, You mentioned that you communicated this to the
contemplate 702. Do youseparately Kingdom,
the whole of the United
and
352 of State, with the view of ascertaining generally cians ?-The draft of the charter was not fresh in my recol. might be the views of the Government, and also what lection at that time, nor was the draft of the charter brought might be the views with reference to those principles of the under the consideration of the committee. 720. Were you made fully aware of the state of the law different bodies in Scotland and Ireland; did you receive any answer with respect to the views of the different bodies with regard to extra-licentiates of the College of Physicians, in Scotland and Ireland ?-We have had no communication as they are at present allowed to exercise their functions?from Sir George Grey since the communication was made Yes ; I was perfectly aware of the existing constitution of the
Secretary what
to him. College of Physicians. 721. Was any discussion entered into, as to the propriety 707. Which has been made very recently, I believe ?-In of requiring extra-licentiates to undergo another examination, the latter part of last month. 710. Sir H. Halford.]-Are not the terms upon which the before they should be registered, and to produce testimonials of parties are admitted as members of the College of Physicians character, and also the stipulation with regard to the payment of who have graduated in the universities in Scotland or Ire- X25 Jor being so registered ?-No such subject of consideration land, or in foreign universities, expressed in the draft of the was before us. charter for the College of Physicians ?-I believe it is. 722. Are you aware that the draft Qj’the charter which wo 711. Be so good as refer to No. 6, in the draft of the submitted to the committee in the last session of Parliament concharter, and read it to the committee ?That any person, tains, in its fifth provision, the stipulation that I have now men. who, after regular examination, shall have taken a degree in tioned ?-I was not fully aware, as I am now, of the detail of medicine at any university in the United Kingdom of Great the charter in question. It was before the House, and I unBritain and Ireland, or from any foreign university, to be derstood that it was to be subject to a modification; but the from time to time recognised by the said corporation, and modification I understood was to be made in correspondence who shall have attained the age of twenty-six years, and shall with the proposed basis of the new measure. not be engaged in the practice of pharmacy, and shall have 723. Was that the draft to which reference was made in gone through such course of studies, and who shall have passed your conferences ?-Yes. such examination before the censors of the said corporation, 724. There was no other ?-No; it was as to the proposed touching his knowledge of medical and general science and charter, but the particular charter did not come under the literature, and complied with such other regulations as are consideration of the committee. or shall be required by the by-laws of the said corporation, 725. Was not the draft of that charter produced ?-It was not. shall be entitled to become an associate of the said corpora726. Do you recollect, in the conferences, whether any tion without being subject to any other election." I under- modifications in that charter were specially suggested ?-Not stood generally, with respect to the detailed charter for the specially suggested; we could not consider that the negotia. such modifications tion was sufficiently advanced for that, and did not take it College of Physicians, that it would receive " as would enable it to accord with the Principles" as ex- into consideration. 727. Do you consider, your mind now being directed to the pressed in the paper placed before the committee; I believe the members of the College of Physicians who were exa- subject, that such proposals are just ; for example, that the extra mined before the committee of the House in the last session licentiates who have a right to practise in all England, within expressed an intention of modifying the terms of the charter seven miles of London, should be required, in order to register, as it is expressed. to produce testimonials of character, and that they shcruld undergo 712. Mr. Wakley. you a draft of the charter laid another examination>’ such an examination as the censors may before you ?-Not of the College of Physicians. demand, and also pay each ae25, as stipulated in the provisions, 713. Consequently you were unacquainted with the provi- exclusive of the stamp duty ?-I have not considered that quessions which it contained ?-The provisions of the new charter tion with sufficient care to be enabled to answer it. would be modified by the terms of the measure now in con728. Was it discussed at all, whether it was just, in making templation ; it is a measure not sufficiently matured for the any new arrangement with regard to the law, that the present charter of the college to be definitively decided upon. standing of gentlemen who are in the exercise of their pro714. In one of the paragraphs appended’to the fourth con- fessional functions should be disturbed ?—These negotiations dition of the " Principles," I find it stated at the end, " That were not considered to be sufficiently advanced to take that the charter has been submitted to the Government, which subject into deliberate consideration. charter it is expedient should be granted to the College of 72.1). You are aware that, according to the eighth provision Physicians;" did you determine that it was expedient that of your " Principles," penalties should be imposed by sumsuch a charter should be granted to the College of Physicians mary process on all unregistered persons practising medicine without being aware of the provisions it contained ?’—It was and surgery; do you think that a good provision ?-I think it considered expedient that the charter should be granted, but a necessary one for the protection of the public. with such modifications in the charter as would make that 730. Was that unanimously agreed to by the committee !’— charter correspond with those particular " Principles." Yes. 715. You will observe in the paragraph to which I refer 731. You fully agreed in its justice and in its expediency that the definite article is mentioned, that " the" charter has I Most assuredly. been submitted to the Government, and it is expedient that 732. You have observed by the provisions of the charter, as the charter should be granted to the College of Physicians; exhibited in the fifth clause of the draft to which I have you had not a draft of the charter officially laid before you referred, that the extra-licentiate, the gentleman who is now at your conferences ? -We had not; we had not advanced practising as an extra-licentiate of the College of Physicians, is compelled to submit to the requirement contained in that sufficiently for the purpose. 716. Chairman. committee understand that this provision, unless he registers; consequently he would be means nothing except as the determination of the joint comexcluded by the law from practising his profession, and would mittee that there should be a new charter ?-We understood, be subjected to summary penalties, which you intend to prowith respect to the charter that appeared before the Govern- vide by the eighth provision of the " Principles" ?-The imment and this House, that an opinion has been expressed by pression on my mind was, that the extra-licentiate would be adthe fellows of the college that that charter required modifi- mitted in the College of Physicians, and as such would be adcation, and that the particular modification that would be mitted to a registration in connexion with the College of make it correspond with the Physicians. required would be such as would " measures resulting from those 735. Will you state who were present on the occasion, on Principles." 717. Mr. Wakley.]-Probably it would not be assuming too the part of the College of Physicians ?-The members of the much to consider, that in the conferences which you had you College of Physicians were, Dr. Paris, the president of the were applying your mind chiefly to that department of the College; Dr. Todd, the censor; Dr. Clendinning, Dr. Burrows, profession to which you considered you belonged ?—No; in Dr. Nairne, and Dr. Francis Hawkins, the registrar; six general I applied myself to the consideration of every sub- altogether. 736. Will you state the constitution of the joint committee?t ject that came before the conference. 718. Did you specially direct your attention to the proposed -It consisted of the president, two censors, Dr. Burrows, Dr. arrangements with regard to the College of Physicians ?- Nairne, and Dr. Hawkins, the registrar; Mr. Travers, the So far as they were the subject of consideration, certainly, I president of the College of Surgeons, Mr. Stanley, and Mr. applied my mind to the consideration of them. Green, the vice-president of the College of Surgeons, were 719. Had you before you, in entering upon those considera- members on the part of the-College of Surgeons. 737. There were only three from the College of Surgeonst tions, the entire provisions of the law which regulated the College of Physicians, and also a draft of the charter which -No; and Mr. Bean, the master of the Society of Apotheit was proposed should be granted to the College of Physi- caries, myself, and Mr. Bacot, were on the part of the Society .
353 of
Apothecaries; and Mr. Pennington, Mr. Bird, and Mr. Ancell, were on the committee, as representing the National Institute. When questions were put to the vote, they were not put to the vote per capite; each question was put to the College, or to the Society, and on consideration they expressed
paper you have produced: it states, referring to the principles, " That they have met with the unanimous assent of the different classes of the profession, as represented in the committee" ?—We considered, in the committee, that all classes
Grey, considering that it represented the interests of a large body ofpractitioners, required that some individuals, members of that
surgeons, and general practitioners were represented. 756. You came to the conclusion that it would be advantageous to the profession, and useful to the public, provided medical practitioners were registered in three different and distinct classes-namely, physicians, surgeons, and general practitioners ?-That was the general opinion of the gentlemen present; and it seems, as far as I am able to learn, to be the opinion of parties in the profession generally. 757. You, as one, approved of that classification?—Certainly. 758. Do you consider that it is necessary for the protection of the profession or for the protection of the public, that the classification should be carried farther, and that there should be divisions and subdivisions of the respective classes ?—Not subdivisions ; there should be a division of the physicians, surgeons, and general practitioners; that is a division which has existed for very many years, and which it is desirable should still be continued, as being in accordance with the public wishes, and apparently with public convenience. 760. My question does not refer to a division of the profession into physicians, surgeons, and apothecaries, but whether it is expedient for the public welfare or the protection of the profession, that there should be divisions of those classes ?That does seem to be contemplated in these " Principles," that. there should be afurther subdivision than the three enumerated. 761. Are there not to be associates and fellows of the College of Physicians; is not that division contemplated ?That is a subordinate division, and depends upon the organization of the particular college, and not as to the registration. 762. Is it not contemplated that there shall be fellows of the College of Surgeons, and members of the College of Surgeons, and that there shall be members of the College of Surgeons, and general practitioners ?-The charter of the College of Surgeons authorizes the distinction, and creates the distinction of members and fellows. 763. Do you consider those distinctions essential ?-I think that those distinctions are desirable, inasmuch as they promote a higher education on the part of the individuals desirous of obtaining those titular distinctions. 765. Chairman.]-As far as the registration goes, it is not intended to introduce more than three denominations: physicians, surgeons, and general practitioners ?-No. 766. You do not intend in the register to subdivide those denominations into different classes ?-No. 767. Mr. W. Lascelles.]-So that any licentiate or extralicentiate may be placed on the register ?-Yes; I infer from the scope of the charter of the College of Surgeons, and from what they have already announced, that the fellowship of the College of Surgeons, eventually, will be granted only to indi. viduals who have passed a literary examination prior to their being subjected to a professional examination, the object of the college being to promote a higher general as well as a professional education in those to whom the fellowship of the college will be granted. 768. Chairman.]-Still the object of the registration is a registration with reference to the right to practise ?-Yes. 770. Sir Henry Hatford.]-Do you consider that the term " associate," applied to the College of Physicians, establishes a new distinction ?—My own opinion is, that the term "associate" is open to some objection, and I have expressed my opinion to the members of the college; but I have not heard yet what decision they have come to upon that subject.
of medical
practitioners were represented.
752. Was there a single member, or, at least, a single extratheir assent. 738. Mr. Grogan.]- What is the National Institute, which licentiate of the College of Physicians, in that committee ?-No. 753. Is it not stated here that the proposal had obtained you put third; is that any distinct or combined body, or what does the term exactly convey ?-It is a body that has no chartered" the unanimous assent of the different classes of the profesor legalized existence at the present moment, but Sir George sion" ? " As represented by the committee;" the physicians,
Institute, should be upon
this committee. name of "general practitioners" ? i -The members of the Institute, I believe, are all general
739. Would it deserve the
practitioners.
740. Mr. Wakley.]-When did your conferences commence ? There was a preliminary meeting, for the first time, on the 1st of December last year. 741. Do you recollect with whom ?-It was composed of the same individuals whose names I have mentioned, with the exception of the members of the National Institute. 742. How many meetings had you without the presence of the members of the National Institute ?-I cannot mention
precisely
the
number;
there
was a
preliminary meeting
on
the 1st of December, and a succeeding meeting took place on the 8th of December, when a communication was made to Sir
George Grey.
743. Did Sir George Grey make any suggestion that it would be well to communicate at the same time with the medical authorities of Scotland and Ireland ?-No, he did not. 744. Did the same parties continue to meet throughout ?Yes, with the subsequent addition of the members from the National Institute, at the request of Sir George Grey. 745. When did that accession to your numbers take place ? -In a letter dated the 10th December, in answer to the first letter addressed to Sir George Grey, Mr. Phillips says, "I am directed by Secretary Sir George Grey to acknowledge the receipt of the letter of the Presidents of the Royal Colleges of Physicians and Surgeons and the Master of the Society of Apothecaries, dated the 8th inst., and to express Sir George Grey’s satisfaction at the course proposed to be adopted by them, which, he trusts, may lead to some satisfactory settlement of the questions affecting the medical profession. I am to state that, with a view to this object, it appears to Sir George Grey of importance that the interests of the general practitioners should be considered, and he would suggest whether some representative of that body could not be included in the proposed conference. Sir George Grey requests that you will communicate this letter to the President of the Royal College of Surgeons and the Master of the Society of Apothecaries." 746. After that time the requirements of the National Institute of Medicine appeared ?—Yes. 747. And they were received as parties to the conference ?2 - yes, and a communication that the conference was so constituted was forwarded to Sir George Grey. ’74$. Before they appeared, had the question been considered whether it was advisable to grant a charter of incorporation to the general practitioners ?-That was not a subject of consideration tiZZ the union took pluce;. the committee was not considered as fully constituted until they joined the body. 749. Until they joined the body, had you considered whether it would be expedient to make any modification of the 55th of George III ?-The subject generally was not taken into consideration until the committee was considered to be fully constituted in the estimation of Sir George Grey, and that did not take place until the’representatives of the National Institute joined the committee. 750. Are you aware whether any one of the bodies appearing on that occasion had made an appeal to the department profession to which they belonged, with respect to the conditions which it would be advisable to adopt at any such conference ?-For some years past, the subject of incorporation of the general practitioners has been matter of very frequent disCU8sion, and the Society of Apothecaries has had, at diferent times, correspondence wtth associations of general practitioners in parts of the kingdom, and the Society became aware, different in consequence of that correspondence, that there was an earnest desire entertained generally that the general practitioners of the country should obtain an incorporation of a collegiate character. 751. I put the last question in consequence of a sentence, or a portion of a sentence, which appears in the remarks introductory to the "Principles," which,are embodied in the
of the
(To be co72tit2,ued.)
Correspondence. "Ai-idi alteram
partem."
THE UPTON-ON-SEVERN UNION. To the Editor of THE LANCET. SIR,—Messrs. Braddon and White, in the last number of THE LANCET, place the matter of the " strike" or resignation ofthe medical officers ofthe Upton-on-Severn Union in the