ROYAL COLLEGE OF SURGEONS OF ENGLAND.

1159 ( the medical side. In short, Mr. Booth is not anxious togrouped under Poor-law boards. A Poor-law board to on i His scheme is one havingbe formed for each group of unions, but with difference ofmake any drastic change. J its object the utilisation of existing agencies and constitution as between the great urban groups and the for 1 increase of their efficiency rather than the subothers. The Local Government Board to be represented on the the Poor-law boards by nominees proportionate in numbersstitution of new ones for them, and he does not

to be

exchequer grants given, otherwise the boards to con-aim at or favour the enlargement of the sphere of i Poor-law either in the matter of aid to the sick or of the sist (1) in the urban groups, of members elected for the the purpose, the existing union areas being accepted as electoralother subjects with which it is concerned. Coming as they areas ; and (2) in non-urban groups, the chairman or vice-do now, after the public has accustomed itself to the demands chairman of each union, with one other guardian (if the for drastic change made in the Majority Report, and still total number to compose the board will permit of it) to con- more so in that of the Minority, Mr. Booth’s proposals will stitute the joint Poor-law board of the group. Mr. Booth not, perhaps, meet with the amount of attention which is-in favour of the boards being as small in numbers as may assuredly they would have enjoyed if they had been incorbe consistent with efficiency. In urban unions the manage- porated in the original Blue-book. In their retention of much ment of all institutions to be centralised, and detailed that has been vigorously denounced, in their claim for the administration of relief to be by local committees composed adaptation of existing machinery and their obvious tendency of members of the board, and of co-opted nominees. In to render unnecessary "the breaking up of the Poor-law," non-urban areas the institutions to be classified and they would meet in the form of a Bill presented to Parliament managed by the joint board, and the out-relief to be with a very hostile reception from a large section of the administered by the guardians of the individual union political world. In their present form, moreover, they areunder rules made by the joint board and approved by the perhaps undesirably destitute of detail and free from elaboLocal Government Board. Under the jurisdiction of the ration of fact and argument. They constitute, however, a. Poor-law boards of the grouped unions Mr. Booth would notable contribution to the great question at issue and one bring all the destitute now dealt with by the unions acting particularly interesting to the medical profession, when the singly, with the exception of those mentally deranged or more radical changes proposed in the other two schemes are suffering from any degree of feeble-mindedness that results taken into consideration. in destitution. These, he suggests, might be removed from the Poor-law, but he questions whether any such course need have been contemplated if a strong and uniform ROYAL COLLEGE OF SURGEONS OF administration of the Poor-law extended over large areas ENGLAND. could have been relied upon. This outline will suffice to indicate the nature of Mr. Booth’s MEETING OF COUNCIL. scheme and to enable members of the Poor-law medical A QUARTERLY meeting of the Council was held on service to form opinions as to how it would be likely to develop in matters of detail. The author of it himself April 14th. the PRESIDENT. Mr. BUTLIN, being in the chair. A letter, dated March 3rd, 1910, from the Privy Council presents it briefly and without any of the elaboration to be It communicated a resolution of the found in the Majority Report or of the advocacy which dis- was considered. tinguishes that of the Minority. He puts it forward, as he says, Executive Committee of the General Medical Council adverse in the form of suggestions only, republishing memoranda to the proposal of this College to omit certain words from already included in Vol. XII. of the Appendix to the report of the conclusions adopted by the General Medical Council in the Royal Commission with the addition of a few notes. We regard to the Anaesthetics Bill, 1909. It was resolved to have not referred to the elaborate table of statistics included reply as follows :That the receipt of the letter from the Privy Council communicating in the volume now before us, which, we understand, of the Executive Committee of the General Medical will not be found in the shilling volume already mentioned. the resolution Council be acknowledged, and that the Lord President be informed that They are instructive and of great value in making a complete the Council of the Royal College of Surgeons of England do not regard the put forward by the Executive Committee of the General study of the points dealt with in them, but are not necessary contingency as likely to arise. The Cotmcil of the College does not to those seeking to grasp the general principle of the plan Medical Council contemplate. and their experience as opaftting surgeons does not lpc1 t.hnm tn ennmneP that. -ill ’loP, a.clrPri tn arlminiahaw proposed. With regard to the treatment of the sick, Mr. Booth an an2esthetic in general surgical practice other than in slight and on rare occasions, but they do think it will is not inclined to support the recommendation that they operations be to the advantage of the public and prejudicial to, should be removed from the Poor-law and should be entrusted the opposed convenience of medical practitioners, especially in country if it is made illegal for dentists to administer nitrous-oxide entirely to the authority already responsible for the publicdistricts, the other anaesthetics, if any, to be specified as employable by health. He asks whether treatment by the public health gas (and them’ for operations performed by qualified medical practitioners. The and the authorities is to be entirely gratuitous, suggests that Council desire to draw the attention of the Lord President to the fact of surgeons actively engaged in operative system of aid apparently desired should be compulsory if it that their body consists practice, whereas the Executive Committee of the General is to be effective, calling attention to the sacrifice of liberty surgical Medical Council, which dissented from the alteration proposed by the which it would demand and the difficulty of recovering Council of the Royal College of Surgeons, consisted, with only two payment for the treatment afforded. Mr. Booth is of the exceptions, of members not engaged in the practice of surgery. The Jacksonian Prize for the year 1909 was awarded to opinion that whatever it may be possible to do in the direction of assigning the sick poor to the public health Mr. W. Girling Ball, F. R. C. S. , for his dissertation on " The authority, and so preventing destitution and eliminating the Treatment of Surgical Affections by Vaccines and AntiPoor-law, a residue will remain that cannot properly be thus toxins." It was resolved that the subject for the Jacksonian dealt with ; that there must be Poor-law institutions, and Prize for the year 1911 should be "The Diseases of the that if there is to be only one authority it must be that of Pancreas, with Special Reference to their Surgical Treatthe Poor-law reorganied in sufficiently large areas and able ment." to deal with every kind of need according to its character. The Triennial Prize was not awarded. It was resolved that. He questions the material advantages claimed for a single the subject for the next Triennial Prize should be "The authority, and asks whether the divided action of the three Anatomy and Physiology of the Pituitary Body, and thesystems (Public Health, Poor-law, and voluntary effort) is Relationship with Disease of its Abnormal and Morbid Connecessarily injurious, expressing the hope of a harmonious ditions." coordination of them. In a memorandum which follows his The two following Members of 20 years’ standing were statistical tables (Memorandum C. I.) Mr. Booth observes elected Fellows. Mr. John Reuben Lunn, resident medical that it is in supplementing the general medical system of superintendent of the St. Marylebone Infirmary; and Mr. the country and not in supplanting it that the Poor-law Andrew Melville Paterson, professor of anatomy, University. finds its proper sphere, and he suggests that organisation College, Liverpool. and cooperation will meet difficulties of overlapping between It was resolved to award the honorary medal of the Collegethe Poor-law, voluntary agencies, provident dispensaries, to Dr. RobertFletcher, M.R.C.S., of Washington, U.S.A., in and sick clubs. He considers that the Poor-law must give recognition of his distinguished labours in connexion with relief to those who, needing it, fail to obtain assistance the publication of the Index Medicus and the Index in any other way, and that conferences between the repre- Catalogue of the Library of the Surgeon-General’s Office,. sentatives of voluntary institutions and Poor-law representa- Washington. The PRESIDENT reported the delivery of two Hunteriana tives would tend to make clear the position of the Poor-law

to the

"

1160 i student might occupy. Dr. Macfie added that the by Dr. C. Bolton and two by Mr. George Coats, and medical (only argument he had heard against women doctors, or one Arris and Gale Lecture by Mr. Sidney Scott. t the few that had attracted his attention, was based on the Diplomas of Member were conferred upon the under- of of the neurotic element"in women.. He fully mentioned gentlemen, who have now complied with the ground I the admission of women doctors to all positions I necessary byelaws, having previously passed the examina- supported 1 men doctors might occupy, but he thought it was a fact tions of the Conjoint Board :-Noel Leicester Clarke, that B.A. Cantab., Cambridge University and London Hospital ;1that women were less able to rise to an emergency than Andrew Samuel Moorhead, M.B. Toronto, Toronto Universitymen. and London Hospital; and George Ernest Vilvandré, A.C.P., Dr. C. G. L. SKINNER thought that where the highest courage London Hospital. was wanted women were the equal of men, though they might not show up so well in minor emergencies. History supported his contention. Calmness in emergency was

Lectures one

acquired thing-acquired by training, experience, and heredity even. With the greater opportunities for development that women now had he did not doubt that they would soon be in every way man’s equal in this respect, if not his

WOMEN RESIDENTS IN GENERAL

an

HOSPITALS. A MANCHESTER DISCUSSION.

superior.

THE Medico-Ethical Society of Manchester had as visitors at its session of Tuesday (April 12th) some 20 members of the Northern Association of Medical Women (Manchester branch) to discuss the question of the admission of women to resident posts in general hospitals. The topic has a special interest for Manchester, of course, in view of the recent refusal of the Manchester Royal Infirmary Board to admit women graduates to resident posts in that institution-a refusal that has brought upon that body criticisms from many sources, medical and other. Sir WILLIAM J. SINCLAIR presided over a very good muster of members, for it was expected that the debate would prove lively. The case in favour of the admission of women was "led " by Dr. MARGARET MERRY Smith, inspector of midwives in Manchester, who dealt with the subject very fully in a paper. First she outlined the history of medicine as a profession for women, mentioning that there was a woman on the first Medical Register-so far back as 1859. It was no new thing, therefore. Dr. Merry Smith then went on to deal with the present position of women in medicine, first as " students, next as graduates. She described the" facilities" offered at various medical schools for the study of medicine by women, and, summing up, expressed the opinion that on the whole they compared favourably with those open to men. It was not till after graduation that the medical woman’s difficulties began. At this point her opportunities, which so far had been virtually equal to a man’s, became less good, though, fortunately, they were improving. Her attempts to get general experience in the form of general hospital work brought her face to face with such objections as "lack of accommodation," "woman’s inability to agree with ward sisters," and so on-objections which she thought might ue

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whole question as to the admission of a woman to a resident post in a general hospital rested on this : Was she a fit and proper person ? Did she possess the same qualities as would entitle a man to hold such a position ? This depended on three things-record of work, experience, and the personal character of the individual. As to the record of work, women’s college records might be, and were often, just as good as men’s ; as to experience, they were handicapped for senior posts, but for junior posts they had equal experience with men-namely, M,’ and as to personal character, women had the same common-sense, kindness, and physical capacity for the work as men had. Women had been found to get on with their colleagues just as well as men-neither better nor worse. Relations with ward sisters were not always so strained as was suggested. Surely it was personality and not sex that mattered. As to the argument that women themselves object to a woman doctor, it was a fact that however they might do so in theory, in practice they accepted her. And as to the suggestion that for a woman to attend to a male patient was shocking to male modesty, it must not be forgotten that the argument cut both ways. Ability and special skill were, after all, the whole basis upon which medical attendance, by man or woman, depended. Women doctors had come to stay, said Dr. Merry Smith in conclusion, and that being accepted it was only right and proper they should be given ample opportunities for fitting themselves for their work. Dr. C. MACFIE, speaking in support of the principle, made the same point as Sir William Sinclair had made in introducing Dr. Merry Smith. He said that in admitting women to medical schools they admitted them to all positions a maleI

Sir WILLIAM SINCLAIR then called for any-views there might be in opposition to those put forward. None were forthcoming and it was gathered that all the people present, both men and women, were in favour of the proposition. This seemed to take the gathering by surprise and to cause some disappointment, particularly to the ladies, who had come in numbers to champion their cause, some of them well with facts and modern instances. As the debate was in danger of petering out altogether, Sir WILLIAM SINCLAIR called on one member after another

primed by

name, and each under mild

protest attested his full agree-

ment with the case put forward by Dr. Merry Smith. But this they did in various picturesque ways. Dr. E. VIPONT BROWN, whom Sir W. Sinclair facetiously styled "the leader of the opposition," said that to admit women to the fuller training of a general hospital after admitting them to medical schools was the only logical position that anyone could take up. To defy the logic of this was

absolute cheek.""

Mr. W. F. DEARDEN said that if the suggestion that women should be confined to hospitals for women and children was adopted it would be only logical to suggest a similar restriction for men; and that, a subsequent speaker, Mr. F. FARROW, pointed out, would mean the limitation of men to men and, say, old women, who would be about an equivalent for the

children. Sir WILLIAM SINCLAIR here remarked that the suggestion made in I I a certain place " that women doctors should stick to diseases of woman

was to him appalling. Mr. FARROW also attributed the prejudices of lay boards to medical women to the "arrant conservatism " of the nation, and he thought it behoved the medical profession to educate people "out of it." Dr. A. W. W. LEA spoke of that meeting as an instance of the change that had come over medical men in their attitude towards medical women since the day when Sir William Jenner resigned from the Council of the British Medical Association rather than agree to the admittanoe of

women.

Mr. L. SAVATARD differed from Dr. Macfie in thinking the neurotic element was more common in women. For his own part he had come across just as much of it in men. Dr. OLIVE CLAYDON, Dr. CATHERINE CHISHOLM, Mr. C. R. 0. GARRARD, Dr. FRANCES HARPER, and Dr. A. C. GEORGE also spoke.

THE

MEDICAL

CURRICULUM OF THE UNIBRISTOL.-Concurrently with the introduction of examinations for degrees, consequent on the change from a university college to a university, it has been found advisable to make certain changes in the arrangements for teaching medicine and the allied subjects in the Bristol school. Whole-time demonstrators of anatomy and physiology have for the first time been appointed. Arrangements for clinical teaching at the Royal Infirmary and General VERSITY OF

Hospital have been devised in order to bring these two institutions into closer coordination than before, and to provide students with a series of clinical demonstrations in the wards and in the general and special out-patient departments. The practice of these latter departments has been further thrown open to students by the institution of various clerkships and dresserships, and the Children’s Hospital receives a more definite status as a teaching centre than

heretofore.