ON THE MEDICAL EXAMINATIONS, CHARACTER, AND REPUTATION, OF THE SCOTCH UNIVERSITIES.

536 and one retired member, actually refused boards be not in any case less, and in the cases hereinafter protheir signatures. Two are too ill to entertain the subject, two vided be superior, in extent and duration, to that which shall be are from home, and one has not been waited upon. Now, let determined on as necessary for obtaining a licence ; and, secondly, three of the five latter-mentioned gentlemen be considered as that the examining boards of these institutions be so constituted not, and two as, signing, the proportion may be stated as ninety as to afford a sufficient security that the members of whom they per cent. of the entire members, and eighty per cent. of the are composed possess the qualifications necessary to fit them for fellows. If petitions of a similar nature were to issue, equally ascertaining by examination the proficiency of candidates." " Clause 8.-That evidence should likewise be required from supported by the fellows and members throughout England and Wales, surely their united voices so harmoniously blended candidates for licences, who have not previously obtained the together would secure the good aimed at, the embodiment of degree of A.B. or A.M., of their possessing an adequate acquaintall in their own college on equitable principles, and prevent the ance with Latin, and of their having received instruction in the evil which otherwise will inevitably ensue-a new incorporation. elements of mathematics and in natural philosophy; and that it is I hope your call on the members to activity without delay. highly desirable these branches should be studied previously to at this crisis of the struggle between the council of twenty and commencing the professional education." "Clause 10.-That the final examination for the licence to the body of thousands, may be responded to with an energy and unanimity equal to what has occurred here; and if so, our practise should be divided into at least two parts, to be held on present hopes and wishes will be changed into a substantial different days ; and that in Edinburgh these examinations maybe realization. advantageously conducted by a joint board of fellows of the Might it not be advisable for each party petitioning to inform Royal Colleges of Physicians and Surgeons." "Clause 13.-That the course of study and the examinations the medical press of the numbers? So doing, the aggregate of for any degree in medicine granted by a university, ought to petitioners may be known. I am, Sir, comprehend all the branches of knowledge stated above, and to Your most obedient servant, imply a more extended education than is prescribed for the medical practitioner." P. BALLANTINE FERGUSSON, M.D. general " Clause 16.ŃThat the superiority of university medical degrees should be further secured by the course of study required ON THE MEDICAL EXAMINATIONS, CHARACTER, for it, embracing additional branches of science connected with AND medicine, and by enjoining repeated attendance on the more REPUTATION, OF THE SCOTCH UNIVERSITIES. important departments." To the Editor of THE LANCET. "Clause 17.-That a certain portion of the study qualifying SIR,-I find from the perusal of a letter addressed to Sir James for the honour of a medical degree, should be prosecuted in some grants that degree, and that any such university Graham,’ and from other sources, that reports prevail rather ex- university which on attendance therein during a winter session, as tensively, more particularly among the medical teachers of ought to insist and requisite to examination." London, that in the event of the Medical Bill being passed into preliminary " Clause 22.-That the examinations should be held partly law in its present state, a less amount of preliminary and professional education will be required of those educated at the medical viva voce, and partly by exercises or themes; and that, in both respects, it shouid be made as searching as possible." school of Edinburgh than elsewhere. It is not my intention to enter into any argument or discussion This report, which has been very generally and industriously circulated in London, seems to be founded, in a great measure, as to the important information contained in this document, it being my intention merely to state facts, and I shall only add, on a particular clause of the Bill, (Clause 22,) which seems rather or resolutions were adopted by the vaguely worded; and also upon evidence given a good many that the propositions the College of Physicians, and the College of SurUniversity, before the Scottish Commissioners for the years ago Visiting Universities-evidence which is quoted by Professor Quain in geons, of Edinburgh, in 1839, with the view of agreeing upon general principles upon which a medical Bill should be his pamphlet. It is to be regretted that no allusion has been made the great that framed; they are binding on all those bodies; and that no to a document and this printed by gentleman pretty generally circulated in the year 1839, in which are fully stated the views disposition or wish has ever been shown or expressed by any of and opinions of the three medical bodies of Edinburgh-viz., the them to withdraw from that agreement, but, on the contrary, they are all anxious and willing to give full effect to the University, the Royal College of Physicians, and the Royal Col- that resolutions, on a Bill being passed for regulating the education, lege of Surgeons, with regard to the education, general and examination, professional, of candidates for the licence of general practitioners the United and right of practice of medical men throughout Kingdom. and for the medical degree, entertained by them at that time, and At the time these resolutions were agreed to, it was thought which the bodies intend to act. upon I take the liberty of requesting that you will have the goodness by all the parties who concurred in them, that, general principles the details of education, general as well as publicity, in your widely-circulated journal, to the follow- being thus settled, be to give professional, might advantageously postponed until the estawith the view from the document alluded of extracts to, ing blishment of some competent authority, by means of which a giving a contradiction to the reports now industriously circulating methodical system might be laid down for the whole United to the prejudice of the Edinburgh medical school. The document is entitled, " Propositions relative to the Educa- Kingdom. To the opinion then entertained they still adhere; tion and Privileges of Practitioners in the several branches of and they are glad to find that the medical Bill of Sir James of a general board for Medicine, and of Chemists and Druggists; agreed on by the Graham contemplates the establishment I am, Sir, your obedient servant, Medical and Surgical Professors in the University, the Royal this very purpose. S. C. of College of Physicians, and the Royal College of Edinburgh, April 28, 1845. 1839." Edinburgh. March, P.S.-I have been astonished to learn, since writing the above, Extracts from Section 1. of Practitioners. by letters from London, and from articles which have appeared " Clause 3.-That no person ought to obtain a licence entitling in some of the English medical journals, as well as in one of the - him to act as a general medical practitioner, who has not received newspapers, that a report has been circulating in London ina competent education in literature and science, studied in a jurious to the character and reputation of the Scotch universities, recognised school of medicine or surgery, and undergone examina- to the effect, that it would be in their power, under the medical tion before a competent board or boards, on all the branches of Bill, to confer medical degrees on candidates who had studied medical education mentioned in the curriculum hereinafter for only two years in a university, a power which, it is said, they : would act specified." upon. This report seems to me to have arisen from a I " Clause 4.-That the degrees or licences granted by all misapprehension of a part of the 22nd clause of the Bill, in which institutions which have heretofore been engaged in regulating the it is stated that it shall not be lawful for any university of the education, and ascertaining the qualifications, of those intended United Kingdom to confer any degree in the faculty of medicine for the medical profession, (or by such new boards as it may be upon any person unless he shall have been matriculated in the found expedient to establish for the same purpose,) should confer same university, and shall have duly attended the courses of the right of actingas general medical practitioners, and of dis- public lectures prescribed by the same university to students in pensing medicines in all parts of the British dominions : provided, medicine at the seat of the same university, during at least two first, the course of education required by these institutions or years after he shall have been matriculated in the same university," &c. * Observations on the Education and Examinations for Degrees in Now I have reason to know that it was never for a moment Medicine, as affected by the new Medical Bill &c., in a Letter to the Right supposed by the universities of Scotland that a power was to be Hon. Sir James Graham, Bart. By Richard Quain, F.R.S., Professor of 1845. Anatomy in University College, London, &c. given to them by this clause, to confer degrees on any person,

retiring from practice,

.

Surgeons

"

public

537 lieve that in

a short time the elected body would reflect only the constituent body, and that the governing body of the surgeons of London would, ere long, be nothing but a reflected image of the general practitioners. Upon former occasions I have spoken of

years’ course of study, and I know that it was by the framers of the Bill to confer such a power, the object of the words of the clause above quoted being only to secure, that, of the course of study required of candidates for degrees by the universities, under the control of the Colleges of Physicians and of the Council of Health, by clause 27th, two years should be passed at the particular university by which the degree was to be given. after only

two never intended

"

ON THE CONSTITUTION OF BEBEERINE. To the Editor of THE LANCET. remarkable circumstance that bebeerine, which such marked properties as an antiperiodic medicine, is possesses isomeric with morphia, a pure narcotic; and as Dr. Maclagan I and myself have now completed the analysis of bebeerine, I think it would not be uninteresting to your readers to mention the general results of our analyses. Bebeerine is now manufactured for sale by Mr. Macfarlane, of Edinburgh; and from the sulphate as obtained from him, the pure base is easily procured. The sulphate is precipitated with ammonia; it is then mixed with recently precipitated hydrated oxide of lead and water sufficient to form a paste; this is dried and treated with absolute alcohol: the alcohol dissolves the bebeerine. It is not yet quite chemically pure, but is obtained so by treating the alcoholic residue with ether, and distilling the latter. When bebeerine thus obtained in a state of purity is burned with oxide of copper in the usual manner, the following is found to be its

SiR,ŃIt is

a

,

composition:C 72.22

O

H

...

35 40

...

N 4.30... 2 Found

6.62

...

17.02

...

...

...

6 ...

72.11 6.77

16.30

Calculated. 4.82 calculated.

Its formula is, then, the same as that of morphia; its atomic weight is also the same as that of the latter. The number found by us for the atomic weight of the platinum compound of bebeerine is 6330.2; that of morphia (calculated) is 6255.7; a close approximation for bodies of such high atomic weights. It appears, then, that bebeerine, a powerful tonic, and morphia, an active narcotic, are strictly isomeric; and it would seem from this that the number and nature of the elements of which organic bodies are composed does not account for the manner in which they act physiologically; in this case, the difference of action is evidently owing to the manner in which the atoms are grouped. I am, Sir, your obedient servant, THOMAS GEORGE TILLEY. THOMAS Queen’s College, Birmingham.

H O U S E

OF

C O M M O N S.

Wednesday, May 7th,

1845.

PHYSIC AND SURGERY BILL. Sir J. GRAHAM.-I am, Sir, about to ask the house to commit this Bill, with the view of introducing into it some important alterations, and I may, perhaps, be excused, when I say, that if I could have anticipated the extensive difficulties of this subject (hear, hear) I should not, probably, have presumed to interfere with it; but having bestowed much labour and attention upon it, and having at the present moment reason to believe, and to entertain the confident hope, that I may be able to effect a practical settlement of this difficult question, I should at this, the eleventh hour, abandon that hope with great reluctance, and I own that I have more hope when I ask you to commit this Bill profornid, for the purpose of introducing those alterations which I am about to state. Now I have, on more than one occasion, in addressing you on this subject, expressed my very earnest desire, if possible, to adjust the differences which unfortunately exist between the general practitioners of England and Wales, and the Council of the College of Surgeons ; and I have stated, that in my opinion a connexion with a body of such eminent superiority for science and ability was a connexion which would reflect honour on the entire profession, and would be most conducive to its dignity and usefulness. I have expressed that opinion openly and frankly. At the same time, I am bound to state, that differences do exist between the two bodies, which I fear, after much reflection, and after the best attention I can give to the subject, appear to me to be irreconcilable. The Council are in possession of a charter giving them exclusive privileges, under which they enjoy property of great value, and power and influence commensurate with that property. The general practitioners are a numerous, and a very strong and powerful body, and if the opinions of a body so numerous and powerful were to have the complete constituent power in returning the representative body, I be-

the general practitioners in those terms of confidence and of praise which I feel to be their due. In the rural districts, where the subdivision of labour is impossible, they both labour as surgeons and in those cases which need the administering of medicines, their exertions are most useful, and the health and life of a great portion of the community depend on their exertions. At the same time, I am bound to say, that in this metropolis, where the subdivision of labour is not only possible, but most conducive to the interests of the community, to the practising surgeons-to the taken in a pure surgeons, if I may use the term without its contemptuous sense-is assigned the great duty of being the teachers of the highest branch of this noble profession ; and it is by the College of Surgeons that the bounds of science are extended. I attach, therefore, great importance to the maintenance of the College of Surgeons in London, for surgeons, as contradistinguished from the general practitioners ; and though I may incur censure for the terms in which I now put this question to the house, I conceive that no greater misfortune could befal the medical world, and no greater evil could befal the community at large, than to degrade the science of surgery, which we should do if the College of Surgeons were transferred to Apothecaries’ Hall; and if we insist on maintaining the connexion between the general practitioners and the College of Surgeons on the same footing, and if the twelve thousand or fourteen thousand general practitioners have each a voice in the nomination of the governing body, this evil will be produced, for the inevitable effect will be, that the general practitioners will supplant the surgeons, and merge the College into a body of their own. Having arrived at this conclusion, not hastily, but after deep reflection, I repeat my fear that the differences between the Council and the general practitioners are of an irreconcilable nature. On the other hand, I will confess, although I do not admit that all the objections taken by the general practitioners against the ruling powers in the College of Surgeons and the College of Physicians are well founded, and although I think that their jealousies are in some respects exaggerated, yet there are certain precautions which they desire, and which they may rightly have. The general practitioners stated, with respect to the examination of persons in their own station being placed in the power of the surgeons, that it is the interest of the surgeons to degrade the general standard of the qualification of general practitioners, and that as the level of the general practitioners was reduced, so the compa rative heads of the profession would be exalted. Some precautions ought to be taken against such an abuse of power and authority on the part of the superior College. Having admitted, then., that some precaution on this point was necessary, and fearing, after the attempts which had been made, that it was in vain to attempt to reconcile the differences between the two bodies, I have come to the conclusion that it is indispensably necessary to maintain the interests of the general practitioners, and to secure the dignity of that portion of the profession, by the maintenance of a high level and standard of qualification for this branch of the profession, and that it is, upon the whole, expedient to incorporate the general practitioners. This decision will give great facilities for attempting to introduce some alterations, and for securing what I think are objects of great public importance. First, I think that, together with the incorporation of the general practitioners, the connexion between the great body of the medical students and the incorporated colleges need not be dissolved; and next, with respect to all the students who shall hereafter enter the profession, a point to which I have always attached great importance may be secured,-namely, that the entrance to the profession shall be by one portal only, whatever may be the future destination of the student. (Hear, hear.) I propose that every person who shall enter the profession, whether it is his intention to become a general practitioner, a surgeon, or a physician, shall undergo an examination by one board, and that the first standard of competency shall be common to all. I contemplate, then, by this Bill, three colleges,-the College of Physicians, the College of Surgeons, and-the College of General Practitioners; and my proposition will be, in the first place, that no person shall be examined as a general practitioner till he has attained the age of twenty-two ; he may now be admitted at twenty-one ; and, with the view of prospectively elevating still higher the general practitioner, that the age for examination in the first instance shall be twenty-two instead of twenty-one. Then,with respect to the College of Physicians and the College of Surgeons, I propose to form a joint board of examiners of those two colleges only. This board of examiners, to which every candidate for admission

being