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ON THE PRESENT STATE OF THE MEDICAL REFORM QUESTION.
414 on the lateral and inferior surfaces of the same viscus, vascularity of the peritoneal coat, and sub-peritoneal exudations o blood and lymph, were traced to a short distance. The folds of the intestine were not agglutinated together by lymph, nO! were there any traces of it in the peritoneal sac. We need not a more demonstrative proof of the deleterious, poisonous, fatal effects produced by the intermixture of verdigris with the food, and its introduction into the stomach, than the case under consideration. The symptoms indicated poisoning ; the inspection of the copper vessels confirmed us in the opinion expressed;-the post-mortem examination cleared
away from our minds any doubt which may have existed. In England, these cases are not often met with; the servants are careful, cleanly, and in general very particular in using copper vessels. Not so in India. In Calcutta, in particular, I have met with cases amongst Europeans, which in their symptoms bore so striking a similarity to those already mentioned, that little doubt has remained on my mind that the attack had originated in the intermixture of verdigris with their food, and its introduction into the stomach. The Bengalee baboorchees, khansamahs, khitmudgars, and musalchees, to whom almost everything connected with the kitchen is entrusted, are not at all times very particular in cooking the Sahib’s khanaw in bright, unstained copper vessels. I have little doubt that if more attention were paid by the inhabitants of Calcutta to the carelessness of their servants in this respect, and if the kitchen utensils were more frequently inspected by some trustworthy servant in the establishment, we should hear of fewer instances of several members of the same family being attacked on the same evening, or in the same night, with violent symptoms, resembling those of cholera or acute dysentery; fewer families (in consequence of a little precaution against such occurrences) would be placed in mourning, from some one member having fallen a victim to it. Thus did this man elude the strictest vigilance on our part, disobey positive orders, and forfeit his life in consequence. It was now found necessary, to prevent a recurrence of similar cases, to substitute plates, bowls, and wooden platters, as many On as could be collected in the ship, for these copper dishes. board ship they are doubly objectionable; first, from the lazy habits of the coolies in neglecting to clean them for several successive days; and secondly, from the action of the muriatic acid contained in salt water on the copper, tending to produce a muriate of copper, a salt equally deleterious as verdi-
giis.
The mortality amongst the coolies sent as emigrants from this port (Calcutta) to Mauritius, British Guiana, and the West India Islands, is caused principally by cholera and dysentery. The coolies are liable to be attacked by cholera from the time they embark on board the vessel at Cooley Bazaar, during the time the ship remains at anchor in the river, and during her passage down the river to the Sandheads, until she is cast off by the steamer. From this period it has been observed, not only by me, but by many other medical men who have had charge of these coolie emigrants, to decline, if not to disappear suddenly. On the third or fourth day, after quitting the Sand-heads, when fairly in possession of a stiff sea-breeze, the ship appears to be totally freed from the noxious, pestilential, deadly influence of this disease. A few solitary cases may occur in the interval of the three days, but the symptoms do not present the same virulence of
character, nor rapid tendency to a fatal termination, observed Calcutta, and when treated promptly they generally recover. in those attacked off Gwalior, India, 1846.
ON THE PRESENT STATE OF THE MEDICAL REFORM QUESTION. By JOHN GROVE. Esq., Surgeon, Wandsworth. WHAT are the present obstacles to medical reform ? 1st. The opposition offered by the College of Physicians. 2nd. The impenetrability of the College of Surgeons. 3rd. The want of unanimity and determination among general practitioners. The opposition offered by the College of Physicians to an extensive and salutary reform in medicine, possesses features of particular interest to an observer, and stimulates reflection in the thoughtful. If we go back to the time of the foundation of the College of Physicians in 1518, we find that the Bishop of London and the Dean of St. Paul’s had at that time the power of granting licences to practise medicine, that other
claimed the like privilege, and that there was such a host of incompetent practitioners, that Linacre, to rescue the public from the dominion of quackery, and the well-educated practitioners from association with such men as quacks under the same honourable title as they themselves possessed, "suggested the foundation of a college, to be composed of men professionally capable of determining upon the qualifications of the various candidates, and the degree of their fitness to undertake the medical care of their fellow-subjects." In 1518, the College of Physicians was incorporated under a charter which gave them the exclusive privilege of admitting persons to practise, and the power of examining pre-
bishops
scriptions.
We learn that the result of this was a great diminution in the number of practitioners, and that the dignity and emolu. ments of the profession were greatly augmented. Let us now examine the relative position of the College of Physicians, and how it is fulfilling the duties required by the charter. In the course of a century after its foundation, a body of men, named apothecaries, had acquired (for the times) some respectable knowledge of the practice of medicine, and the reign of James I. they were incorporated under a charter, which gave them the power, as apothecaries, to examine all practised the art and mystery of apothecaries, as to the capability and due performance of the duties they were called on by their profession to fulfil. Now previously to the formation of this body under Act of the members of it must have been practising medicine to its fullest extent without any licence; they did so. the eyes of the College of Physicians; and though not under unnoticed by them, were certainly unchecked in their career. apothecaries were now becoming what the physicians had been a century before; they were men who knew the properties of the drugs and chemicals they prepared; they knew also how to use them as remedies in disease; their profession became a lucrative one; and they found it necessary, for their own benefit, as well as for that of the public, to exclude allthose who were incapable or unfit to exercise their art and mystery. The only real difference which existed between these two bodies of men-the physicians and apothecaries, was, that the former excelled in a knowledge of the dead languages, and had more money in their pockets. In this, as in all professions and trades, there must be an aristocracy, not only of government, but of wealth. With this I do not quarrel. The question which naturally arises is, why did not the College of Physicians endeavour to make the apothecaries a branch of, their institution ’ It might have been an inferior branch, and still not have taken from the dignity of the College; besides, what better school at that time could have been imagined for good physicians, than that in which the apothecary was being brought up ? In the earlier years of his professional career, he became familiar with the implements of his profession, and the mode of using them; he acquired much practical knowledge as to their powers, and in after years he came to know how and when they were to be applied : in fact, his knowledge of medicines was extensive, and he knew, in the majority of cases, how to use them. Of course, I allude to the well-educated apothecaries. If the welfareof the public had been the chief consideration with the College, which it should have been, according to the terms on which they received their Charter, they would (if a lower grade of practitioners must exist) have secured to themselves, as they could have done, the power of licensing men, who, though with knowledge below their own standard, might still have possessed professional acquirements quite compatible with the safety of the public; and I cannot but express it as my firm conviction, that an apothecary, with ordinary ability, having practised his profession for ten or fifteen years, is much more capable of treating disease than a young physician. If the College had then established an examination for graduates in medicine, and aftera time had admitted them as physicians, when they should have proved themselves worthy, either by great attainments or great practical experience, there need have been but one faculty of medicine having its grades; the College would have lost nothing in dignity; it would have gained much in general esteem, infinitely in utility, and enormously in revenue. This, it appears to me, is a subject worthy of consideration at the present crisis. The origin of the College of Surgeons bears so close a resemblance to that of the Apothecaries Company, that it is unnecessary now to enter on the history of its establishment. I will only repeat what Mr. Lawrence says in his Oration, that "the College of Surgeons in England owes its origin to a charter granted by George III., in the year 1800." The impenetrability of the College of Surgeons, so great an’
in
who
Parliament, The
,
415 It now remains to show upon what grounds it may plausibly obstacle to medical reform, is unwarrantable, and not to be endured with patience. Our position, with regard to this be demanded, and practically carried out. I believe it has been clearly shown, that the College of institution, is of a different nature from our position with regard to the College of Physicians. We are legally, and to Physicians had power to license all persons to practise medicine within a certain jurisdiction; that while having that all intents and purposes, surgeons. If the examiners have tested the candidates as they ought. power, a medical body grew up, and obtained a charter, perare the latter unfit to become 7-eal members of the fraternity j mitting them to practise quite independently of the College. Upon what do the Council pride themselves as superior men, I believe it has also been clearly shown, that the governing that general practitioners (as they are called) are unfit to be body of the College, as at present constituted, has committed associated with them ? Is it on their knowledge ? They have suicide with the very instruments destined to annihilate the tested us by their own attainments, and signed a deed to cer- bulk of the members. At the present time there is no real between the physician and the apothecary; or the tify that we are not wanting. Is it on their practical skill in surgery ? We answer, that there are but few operations which surgeon and the apothecary, except that the apothecary pracare not performed equally well by general practitioners as by tises both arts, (or, as they are sometimes styled, the science of pure surgeons: Mr. Lawrence, in 1827, said, "meet with medicine, and the art of surgery.) The public acknowledge, and the physician and pure surgeon cannot deny, that the none better acquainted with disease and its treatment, than those who, after a good education, enjoy large opportunities of apothecary performs his duties with great skill and address. observation as general practitioners." It may be as well to re- The apothecary, then, clearly is universally acknowledged to mark, that general practitioners, whose diplomas bear date be capable of performing all the duties required of the physiwithin the last ten years, have received a superior education in cian, all required of the surgeon, for the community at large. comparison with those to whom Mr. Lawrence alluded, and we If the pure surgeon be honestly attached to the principles he may therefore safely include nearly all the general practi- maintains, he can have but a limited sphere ofutility in comtioners of the present time in his category. When it is consi- parison with the apothecary; ay, so limited, as in such a comdered that surgery in its highest branches, medicine in its parison to be hardly worthy mention: for if the pure surgeons of the accoucheur, could all be swept off to-morrow, I very much doubt if, in a intricacies, and the delicate are daily practised with the greatest skill, and to the utmost professional point of view, the country would long haveany satisfaction of the public, by these men, shall we any longer real cause to regret their departure. submit ourselves to unworthy rulers, or yield to an ignominious Let me ask the surgeons, let me ask the physicians, with banishment ?1 these facts before them, why the former should not admit us Let us not, however, take our style from a late Address ; on an equality with themselves ? why the latter should not contempt and ridicule should not escape our lips-our bearing recognise us as an integral portion of their body ?1 Have we should be characterized by firmness, not tinctured with not all studied under equally competent masters Have we not obstinacy; clothed with dignity, not powdered by vanity. We all consulted the same authors, ancient and moderns1 Do we are evidently now in a position, not to take, but to set, the not all read the same journals of science and literature? Where then, I ask, is the intellectual obscurity with which example. Let us inquire how far the Council are justified in holding weare taunted, that we cannot avail ourselves of the object of our inquiries ?1 We are, I say, perpetual students in the their office. In section seven of the by-laws of the College of Surgeons, theatre of Nature,-we are incessant workers in her laborawe read, " That no member of the Council whose professional tory of art. In the inquiry proposed by Mr. Wakley, we have the practice is not confined to surgery, shall be elected as a member of the Council." Can the members of the Council elements of all that is good in medical reform: its principles make oath that they observe this by-law?1 I say that the have to be developed, its details canvassed, and I feel convery purest surgeon in existence will prescribe for any in- vinced that every man who does not exert himself to the ternal malady, from a stomach-ach to a fever. utmost in securing an Act of Parliament founded on this By-law iv., section 7, says, " Every member of the Council basis, will have to regret (if any other measure be adopted) shall, prior to his admission, subscribe his name to a copy of that he has lost a golden opportunity, and will ever be rethe by-laws, and of the ordinances, in testimony of having proa.ched, bv the succeeding generations of his calling, with engaged himself to the observance thereof, ahd upon his wanton indifference, or a littleness of mind, which could so exalt trifling obstacles into an impregnable barrier between neglect or refusal so to do, his election shall be void." The intention of this law is evidently that, if any member his petty prejudices and an enlightened policy. of the Council shall fail to observe the by-laws, his election Wandsworth, March, 1846. shall be void. I say, then, according to their own laws, the Council is a defunct body. Section viii., law 2.-" Any member of the Council who ON A NEWLY-DISCOVERED shall not confine his professional practice to surgery shall be CHARACTERISTIC OF ALBUMEN, liable to removal from the Council." To whom is this Council amenable They cannot all expel themselves, yet they are all WITH PARTICULAR REFERENCE TO THE POSSIBILITY OF ITS BEING liable to be expelled. MISTAKEN FOR CASEINE. Section xviii.—" Rights of members." " The College will BY J. UNDERWOOD, Esq., Colchester. at all times protect and defend every member who may be disIN Number 24, vol. ii., of THE LANCET for 1845, (new series,) turbed in the exercise and enjoyment of the rights, privileges, I and immunities acquired by him as a member there is an article, by Dr. Ure, upon the potato malady, and exemptions, thereof."" It would be very interesting to know what are the to the following paragraph, extracted therefrom, I would beg rights, privileges, and exemptions we have the power of exer- to call particular attention, as it is very likely to mislead those who are not conversant with the late discoveries in organic cising and enjoying. Section xxvi., law 2.-" All investments shall be made in the chemistry. name of the Royal College of Surgeons in London." Of what " Liebig imagines the essence of the disease to consist in does this Royal College of Surgeons consist? A Council, the conversion of the albumine, a usual constituent of healthy fellows, and members. It is a curious anomaly that we, the potatoes, into caseine-a principle which, byits great instability of composition, is supposed to cause the potato to putrefy mass of that College, have not a single voice in the management of those investments which are made in our name. rapidly. I have subjected this opinion to the test of experiSince we are driven from the doors of our own legal home, ment. Perfectly sound potatoes, as also diseased ones, were since we are denied a voice in the disbursement ofour own sliced or grated, and separately digested in a very dilute alkawhen cool, being filfunds, the question arises—What are we to do ? Whatever line ley at a blood heat. The infusions, acetic tered and faintly acidulated with dilute we do must be done quickly, with determination, with unaniacid, afforded flakes. It mity. A parliamentary inquiry into the management of the respectively a like proportion of caseine-looking appear, from this mode of testing, as prescribed by College, as proposed by Mr. Wil.ley, on the 15th of May, 1845, would thus would go far to bring the foregoing particulars prominently Dumas, in the seventh volume of hisTraite de Chimie,’ that before the public, in a more tangible and enlarged sense, and sound potatoes contain as much caseine as unsound." But I suppose Dumas and Ure, both of them, forget that would fully expose the absurdity of an institution governed by laws to which its rulers are in no way bound, and which they Miilder, of Amsterdam, some time back, discovered that when either albumen, caseine, or flbrine were dissolved in caustic do not observe. As to the justice, practicability, and public advantage of the alkali, these solutions precipitated, upon the addition of a little one-faculty system of medical government, there cannot be a excess of acid, a substance in appearance identical with caseine, doubt. i but differing chemically therefrom in being a compound simply
distinction
manipulations
away from our minds any doubt which may have existed. In England, these cases are not often met with; the servants are careful, cleanly, and in general very particular in using copper vessels. Not so in India. In Calcutta, in particular, I have met with cases amongst Europeans, which in their symptoms bore so striking a similarity to those already mentioned, that little doubt has remained on my mind that the attack had originated in the intermixture of verdigris with their food, and its introduction into the stomach. The Bengalee baboorchees, khansamahs, khitmudgars, and musalchees, to whom almost everything connected with the kitchen is entrusted, are not at all times very particular in cooking the Sahib’s khanaw in bright, unstained copper vessels. I have little doubt that if more attention were paid by the inhabitants of Calcutta to the carelessness of their servants in this respect, and if the kitchen utensils were more frequently inspected by some trustworthy servant in the establishment, we should hear of fewer instances of several members of the same family being attacked on the same evening, or in the same night, with violent symptoms, resembling those of cholera or acute dysentery; fewer families (in consequence of a little precaution against such occurrences) would be placed in mourning, from some one member having fallen a victim to it. Thus did this man elude the strictest vigilance on our part, disobey positive orders, and forfeit his life in consequence. It was now found necessary, to prevent a recurrence of similar cases, to substitute plates, bowls, and wooden platters, as many On as could be collected in the ship, for these copper dishes. board ship they are doubly objectionable; first, from the lazy habits of the coolies in neglecting to clean them for several successive days; and secondly, from the action of the muriatic acid contained in salt water on the copper, tending to produce a muriate of copper, a salt equally deleterious as verdi-
giis.
The mortality amongst the coolies sent as emigrants from this port (Calcutta) to Mauritius, British Guiana, and the West India Islands, is caused principally by cholera and dysentery. The coolies are liable to be attacked by cholera from the time they embark on board the vessel at Cooley Bazaar, during the time the ship remains at anchor in the river, and during her passage down the river to the Sandheads, until she is cast off by the steamer. From this period it has been observed, not only by me, but by many other medical men who have had charge of these coolie emigrants, to decline, if not to disappear suddenly. On the third or fourth day, after quitting the Sand-heads, when fairly in possession of a stiff sea-breeze, the ship appears to be totally freed from the noxious, pestilential, deadly influence of this disease. A few solitary cases may occur in the interval of the three days, but the symptoms do not present the same virulence of
character, nor rapid tendency to a fatal termination, observed Calcutta, and when treated promptly they generally recover. in those attacked off Gwalior, India, 1846.
ON THE PRESENT STATE OF THE MEDICAL REFORM QUESTION. By JOHN GROVE. Esq., Surgeon, Wandsworth. WHAT are the present obstacles to medical reform ? 1st. The opposition offered by the College of Physicians. 2nd. The impenetrability of the College of Surgeons. 3rd. The want of unanimity and determination among general practitioners. The opposition offered by the College of Physicians to an extensive and salutary reform in medicine, possesses features of particular interest to an observer, and stimulates reflection in the thoughtful. If we go back to the time of the foundation of the College of Physicians in 1518, we find that the Bishop of London and the Dean of St. Paul’s had at that time the power of granting licences to practise medicine, that other
claimed the like privilege, and that there was such a host of incompetent practitioners, that Linacre, to rescue the public from the dominion of quackery, and the well-educated practitioners from association with such men as quacks under the same honourable title as they themselves possessed, "suggested the foundation of a college, to be composed of men professionally capable of determining upon the qualifications of the various candidates, and the degree of their fitness to undertake the medical care of their fellow-subjects." In 1518, the College of Physicians was incorporated under a charter which gave them the exclusive privilege of admitting persons to practise, and the power of examining pre-
bishops
scriptions.
We learn that the result of this was a great diminution in the number of practitioners, and that the dignity and emolu. ments of the profession were greatly augmented. Let us now examine the relative position of the College of Physicians, and how it is fulfilling the duties required by the charter. In the course of a century after its foundation, a body of men, named apothecaries, had acquired (for the times) some respectable knowledge of the practice of medicine, and the reign of James I. they were incorporated under a charter, which gave them the power, as apothecaries, to examine all practised the art and mystery of apothecaries, as to the capability and due performance of the duties they were called on by their profession to fulfil. Now previously to the formation of this body under Act of the members of it must have been practising medicine to its fullest extent without any licence; they did so. the eyes of the College of Physicians; and though not under unnoticed by them, were certainly unchecked in their career. apothecaries were now becoming what the physicians had been a century before; they were men who knew the properties of the drugs and chemicals they prepared; they knew also how to use them as remedies in disease; their profession became a lucrative one; and they found it necessary, for their own benefit, as well as for that of the public, to exclude allthose who were incapable or unfit to exercise their art and mystery. The only real difference which existed between these two bodies of men-the physicians and apothecaries, was, that the former excelled in a knowledge of the dead languages, and had more money in their pockets. In this, as in all professions and trades, there must be an aristocracy, not only of government, but of wealth. With this I do not quarrel. The question which naturally arises is, why did not the College of Physicians endeavour to make the apothecaries a branch of, their institution ’ It might have been an inferior branch, and still not have taken from the dignity of the College; besides, what better school at that time could have been imagined for good physicians, than that in which the apothecary was being brought up ? In the earlier years of his professional career, he became familiar with the implements of his profession, and the mode of using them; he acquired much practical knowledge as to their powers, and in after years he came to know how and when they were to be applied : in fact, his knowledge of medicines was extensive, and he knew, in the majority of cases, how to use them. Of course, I allude to the well-educated apothecaries. If the welfareof the public had been the chief consideration with the College, which it should have been, according to the terms on which they received their Charter, they would (if a lower grade of practitioners must exist) have secured to themselves, as they could have done, the power of licensing men, who, though with knowledge below their own standard, might still have possessed professional acquirements quite compatible with the safety of the public; and I cannot but express it as my firm conviction, that an apothecary, with ordinary ability, having practised his profession for ten or fifteen years, is much more capable of treating disease than a young physician. If the College had then established an examination for graduates in medicine, and aftera time had admitted them as physicians, when they should have proved themselves worthy, either by great attainments or great practical experience, there need have been but one faculty of medicine having its grades; the College would have lost nothing in dignity; it would have gained much in general esteem, infinitely in utility, and enormously in revenue. This, it appears to me, is a subject worthy of consideration at the present crisis. The origin of the College of Surgeons bears so close a resemblance to that of the Apothecaries Company, that it is unnecessary now to enter on the history of its establishment. I will only repeat what Mr. Lawrence says in his Oration, that "the College of Surgeons in England owes its origin to a charter granted by George III., in the year 1800." The impenetrability of the College of Surgeons, so great an’
in
who
Parliament, The
,
415 It now remains to show upon what grounds it may plausibly obstacle to medical reform, is unwarrantable, and not to be endured with patience. Our position, with regard to this be demanded, and practically carried out. I believe it has been clearly shown, that the College of institution, is of a different nature from our position with regard to the College of Physicians. We are legally, and to Physicians had power to license all persons to practise medicine within a certain jurisdiction; that while having that all intents and purposes, surgeons. If the examiners have tested the candidates as they ought. power, a medical body grew up, and obtained a charter, perare the latter unfit to become 7-eal members of the fraternity j mitting them to practise quite independently of the College. Upon what do the Council pride themselves as superior men, I believe it has also been clearly shown, that the governing that general practitioners (as they are called) are unfit to be body of the College, as at present constituted, has committed associated with them ? Is it on their knowledge ? They have suicide with the very instruments destined to annihilate the tested us by their own attainments, and signed a deed to cer- bulk of the members. At the present time there is no real between the physician and the apothecary; or the tify that we are not wanting. Is it on their practical skill in surgery ? We answer, that there are but few operations which surgeon and the apothecary, except that the apothecary pracare not performed equally well by general practitioners as by tises both arts, (or, as they are sometimes styled, the science of pure surgeons: Mr. Lawrence, in 1827, said, "meet with medicine, and the art of surgery.) The public acknowledge, and the physician and pure surgeon cannot deny, that the none better acquainted with disease and its treatment, than those who, after a good education, enjoy large opportunities of apothecary performs his duties with great skill and address. observation as general practitioners." It may be as well to re- The apothecary, then, clearly is universally acknowledged to mark, that general practitioners, whose diplomas bear date be capable of performing all the duties required of the physiwithin the last ten years, have received a superior education in cian, all required of the surgeon, for the community at large. comparison with those to whom Mr. Lawrence alluded, and we If the pure surgeon be honestly attached to the principles he may therefore safely include nearly all the general practi- maintains, he can have but a limited sphere ofutility in comtioners of the present time in his category. When it is consi- parison with the apothecary; ay, so limited, as in such a comdered that surgery in its highest branches, medicine in its parison to be hardly worthy mention: for if the pure surgeons of the accoucheur, could all be swept off to-morrow, I very much doubt if, in a intricacies, and the delicate are daily practised with the greatest skill, and to the utmost professional point of view, the country would long haveany satisfaction of the public, by these men, shall we any longer real cause to regret their departure. submit ourselves to unworthy rulers, or yield to an ignominious Let me ask the surgeons, let me ask the physicians, with banishment ?1 these facts before them, why the former should not admit us Let us not, however, take our style from a late Address ; on an equality with themselves ? why the latter should not contempt and ridicule should not escape our lips-our bearing recognise us as an integral portion of their body ?1 Have we should be characterized by firmness, not tinctured with not all studied under equally competent masters Have we not obstinacy; clothed with dignity, not powdered by vanity. We all consulted the same authors, ancient and moderns1 Do we are evidently now in a position, not to take, but to set, the not all read the same journals of science and literature? Where then, I ask, is the intellectual obscurity with which example. Let us inquire how far the Council are justified in holding weare taunted, that we cannot avail ourselves of the object of our inquiries ?1 We are, I say, perpetual students in the their office. In section seven of the by-laws of the College of Surgeons, theatre of Nature,-we are incessant workers in her laborawe read, " That no member of the Council whose professional tory of art. In the inquiry proposed by Mr. Wakley, we have the practice is not confined to surgery, shall be elected as a member of the Council." Can the members of the Council elements of all that is good in medical reform: its principles make oath that they observe this by-law?1 I say that the have to be developed, its details canvassed, and I feel convery purest surgeon in existence will prescribe for any in- vinced that every man who does not exert himself to the ternal malady, from a stomach-ach to a fever. utmost in securing an Act of Parliament founded on this By-law iv., section 7, says, " Every member of the Council basis, will have to regret (if any other measure be adopted) shall, prior to his admission, subscribe his name to a copy of that he has lost a golden opportunity, and will ever be rethe by-laws, and of the ordinances, in testimony of having proa.ched, bv the succeeding generations of his calling, with engaged himself to the observance thereof, ahd upon his wanton indifference, or a littleness of mind, which could so exalt trifling obstacles into an impregnable barrier between neglect or refusal so to do, his election shall be void." The intention of this law is evidently that, if any member his petty prejudices and an enlightened policy. of the Council shall fail to observe the by-laws, his election Wandsworth, March, 1846. shall be void. I say, then, according to their own laws, the Council is a defunct body. Section viii., law 2.-" Any member of the Council who ON A NEWLY-DISCOVERED shall not confine his professional practice to surgery shall be CHARACTERISTIC OF ALBUMEN, liable to removal from the Council." To whom is this Council amenable They cannot all expel themselves, yet they are all WITH PARTICULAR REFERENCE TO THE POSSIBILITY OF ITS BEING liable to be expelled. MISTAKEN FOR CASEINE. Section xviii.—" Rights of members." " The College will BY J. UNDERWOOD, Esq., Colchester. at all times protect and defend every member who may be disIN Number 24, vol. ii., of THE LANCET for 1845, (new series,) turbed in the exercise and enjoyment of the rights, privileges, I and immunities acquired by him as a member there is an article, by Dr. Ure, upon the potato malady, and exemptions, thereof."" It would be very interesting to know what are the to the following paragraph, extracted therefrom, I would beg rights, privileges, and exemptions we have the power of exer- to call particular attention, as it is very likely to mislead those who are not conversant with the late discoveries in organic cising and enjoying. Section xxvi., law 2.-" All investments shall be made in the chemistry. name of the Royal College of Surgeons in London." Of what " Liebig imagines the essence of the disease to consist in does this Royal College of Surgeons consist? A Council, the conversion of the albumine, a usual constituent of healthy fellows, and members. It is a curious anomaly that we, the potatoes, into caseine-a principle which, byits great instability of composition, is supposed to cause the potato to putrefy mass of that College, have not a single voice in the management of those investments which are made in our name. rapidly. I have subjected this opinion to the test of experiSince we are driven from the doors of our own legal home, ment. Perfectly sound potatoes, as also diseased ones, were since we are denied a voice in the disbursement ofour own sliced or grated, and separately digested in a very dilute alkawhen cool, being filfunds, the question arises—What are we to do ? Whatever line ley at a blood heat. The infusions, acetic tered and faintly acidulated with dilute we do must be done quickly, with determination, with unaniacid, afforded flakes. It mity. A parliamentary inquiry into the management of the respectively a like proportion of caseine-looking appear, from this mode of testing, as prescribed by College, as proposed by Mr. Wil.ley, on the 15th of May, 1845, would thus would go far to bring the foregoing particulars prominently Dumas, in the seventh volume of hisTraite de Chimie,’ that before the public, in a more tangible and enlarged sense, and sound potatoes contain as much caseine as unsound." But I suppose Dumas and Ure, both of them, forget that would fully expose the absurdity of an institution governed by laws to which its rulers are in no way bound, and which they Miilder, of Amsterdam, some time back, discovered that when either albumen, caseine, or flbrine were dissolved in caustic do not observe. As to the justice, practicability, and public advantage of the alkali, these solutions precipitated, upon the addition of a little one-faculty system of medical government, there cannot be a excess of acid, a substance in appearance identical with caseine, doubt. i but differing chemically therefrom in being a compound simply
distinction
manipulations