The General Medical Council.

1611

public, and no better opportunity of practical suggest or skilful and humane treatment could provide was help could possibly be afforded than the collection for the forthcoming for the man who was suffering for his country. In the earlier days of the South African war this was the Metropolitan Hospital Sunday Fund. satisfactory position of the service rendered by the medical men, civil and military, to the sick and wounded of our borne by the

The Civil

Surgeons

at

the War.

army. We may be sure that the treatment that the wounded received will never be forgotten by them ; but after events, when the war was going well, so over-shadowed the

reference to another column of THE LANCET, a representative body of successful medical administration that marked the earlier the civil surgeons who have been ’employed with the forces and more unlucky phases of our contest with the Boers, that in South Africa, and who have returned home, dined many people can be found to believe and to state that the .together at the Hotel Cecil under the presidency of Sir whole of our military medical administration in South WILLIAM MAC COBMAC. The occasion was a particularly Africa from beginning to end was a chaotic and criminal interesting one, inasmuch as the aid of civilian medical men muddle. This is an unfair view and one that is not held in time of war has never before, we believe, been sought by thoughtful people. The report of the Royal Commission by the War Office. Civilian medical men have been able on the South African Hospitals has shown where the fallacy to find employment in connexion with ambulance work lies. The Commissioners, speaking of the campaign as a on previous occasions, and have improved those occasions whole, stated that the medical arrangements could not be to the great benefit of the suffering sick, but the said to have broken down, in spite of the fierce indictments services thus rendered to the army have been those against them. They found that there was no general or of individual volunteers. In the South African war the widespread neglect of the sick and wounded and that the War Office, embarrassed by the unexpected strength of the conduct and capacity of the medical officers deserved great foe, unprepared in many directions, and in particular ON

Wednesday last,

as

will be

seen

on

praise.

medical staff that was anything This praise the civil medical officers share with the the proper numerical strength, appealed to the Royal Army Medical Corps. Each body suffered in public dvilian medical practitioners to come to the help of the opinion partly because they were undermanned and partly country. How that appeal was answered we all know. because the conditions of warfare were such that From desire to be useful, from thirst of experience, from medical care could not prevent terrible sickness. But they lust of adventure, and, with each and all of these, from love were not responsible for the undermanning or for the fact of country, applications poured in for medical appointments that at one time in the campaign a vast section of our army in connexion either with the Royal Army Medical Corps out-marched its supplies. It cannot be laid to their door or with one of the numerous private hospitals. A system that Johannesburg is a long way from Cape Town. These of rigorous selection, in the opinion of the rejected candifacts have now become apparent to all thoughtful members dates not always discreetly applied, had to be put in force, of the public who appreciate the good work that was done and there is no doubt that had the country required three by the medical men during the campaign. The Government times the medical assistance that was asked for it would may not understand where those whose opinion is worth have been forthcoming. having consider the blame to rest, but everyone else knows. How well those who were chosen comported themselves And we can assure the civil surgeons who accompanied our has been admitted on all hands. Amid the bitter disap- South African field force that their professional brethren are pointments and heart-wrenching suspenses of the first few proud of them. months of our military operations in Natal and Cape Colony there were always two bright spots-the splendid bravery The General Medical Council. of our troops and the excellent manner in which the THE seventy-first session of the General Council of Medical medical service of the war was carried out. Never were greater courage and more self-sacrificing devotion to Education and Registration was opened on Tuesday, Halt June in the of the Council, when a commendable 4th, duty under trying circumstances in the battle-field displayed than by the medical men, both civil and military, who desire to get to work was manifested by the disciplinary accompanied our South African army ; in the earlier days of body of the medical profession. So marked was the rapidity the campaign it can also be truthfully said that never was with which the Council disposed of the subjects which came there a finer exhibition of administrative resource and pro- up for the first day’s discussion that the PRESIDENT, a sound -fessional skill than in the care of the sick and wounded in judge in such matters, was moved to say at the end of the sitthe hospitals at the theatre of war. In those terrible days, ting that the Qouncil had got through more business than he when all our hearts were wrung with the bloody repulses of had ever previously seen disposed of in so short a time as an our troops in their attempts to relieve the beleaguered cities, hour and three-quarters. We trust that the Council will keep the nation had the satisfaction of knowing that all which untarnished this fair fame, for the Council board is not the technical skill and personal exposure to danger could do place for unnecessary declamation, and certainly not the was being done to afford prompt aid to the soldier place for recrimination, while the members are supposed to on the battle-field. In rescuing the wounded man from hold their places for the good of the profession as a whole, the enemy’s fire and in relegating him to a place of and not that they may "keep up the end " of their particular safety where his wounds could be dressed and his sufferings corporations in any dispute. Before now we have seen much time spent in the saying .alleviated, everything that professional foresight could

unprovided approaching

with

a

1612 of things that would have been better leftunsaid. Idle debate has cost the Council much money and will do so again unless every member resolves only to say what will be of practical assistance to his colleagues. But over and above economy there is a very distinct reason why at this session of the Council the members should show themselves at one with regard to great questions and able to differ over smaller ones with cordiality. It seems to us possible that the General Medical Council may find itself compelled to come into collision with the Privy Council, and we need hardly say that in that case it is essential that the members should themselves be solid in the course which they propose to take. An Order of His Majesty in Council has been received by the General Medical Council, the gist of which is that " the kingdom of Italy afEords to the registered medical

the

part of the

appreciated.

General Medical Council will be muen ___

__

Annotations. "Ne

quid nimis."

ARSENIC IN BEER.

THE third report of the Expert Committee appointed by the Manchester Brewers’ Central Association has beenissued. It will be remembered that in their first report, dated Dec. lst, 1900, this committee pointed out that tho materials then in use in brewing in Manchester were free from arsenic with the exception of certain sugars. They recommended, therefore, that all beer brewed with these sugars should be recalled and if found to be arsenicated These measures were effectively should be destroyed. practitioners of the United Kingdom such privileges of prac- carried out, and owing to a commendably prompt action on tising in Italy as to His Majesty seem just," and that the part of the brewers the beer brewed in Manchester sub Italy shall accordingly be deemed a country to which the sequently was soon proved to be free from reproach. In second part of the Medical Act of 1886 applies. Under the second report of the committee, which was issued on this Order Italian medical practitioners can, on complying Dec. 15th, 1900, the committee actually established that the arsenic found in deleterious quantities in the beer was solely with certain conditions, be placed upon the Medical Register due to the contamination by arsenic of certain manufactured of this country and can practise among us without restricsugars, the arsenic being introduced by the use of impure tion or limit, and the Order appears to have been made sulphuric acid. The committee then recommended that a under the idea that English medical men have been offered systematic and adequate testing of beer should be at once a similar position in Italy under a new Act. But no such set on foot in order that the public might be protected from Act exists. It would seem, therefore, that the Privy Council all further mischief. This was to a large extent done, and with good effect. The question of the occurrence of arsenic have made, or at any rate propose to make, a bad bargain in other brewing materials had been brought to the notice of for the medical profession of this country. The Order, when the committee and in their second report they promised to carried out, may relieve certain British medical men in Italy examine more fully into this aspect of the matter. The from anxiety-and we shall be glad if this turns out so; third report just issued is practically the fulfilment but it may also place upon our Medical Register foreign of this promise. We congratulate the members of the commembers of our profession who will find it difficult to mittee on the efficient manner in which they have conducted their task, so far as it relates to the contamination of beer appreciate the professional attitude and standard of this ’with arsenic and to the safeguarding of the beer-drinking country; while the General Medical Council will be com- public. So far, indeed, as the brewing interest is concerned pelled to undertake a dangerous responsibility in enrolling the committee have done all that is necessary. We know how the beer became poisonous and we know how such them. The whole question of international reciprocity in medical contamination can be prevented, and we congratulate the have grappled practice bristles with difficulties. That true medicine is one committee on the able manner in which they them. Yet with the immediate problem placed before science wherever practised is a noble fact; and that an still in have left many points obscurity necessarily they honest man is inspired with honest sentiments whatever his which are of the utmost importance in public health. Since race is another; but in a work-a-day world we should have the beer-poisoning epidemic occurred we have been conmore to go upon than such postulates if we are to devise fronted with the possibility of countless channels through practical measures of medical reciprocity between foreign which arsenic may gain access to food or drink. We are The General Medical Council can advise the face to face also with a point of extreme pathological countries. of the comparatively small quantities moment, that in Privy Council and its opinion ought to be respected. of arsenic found spite in beers yet these small quantities produced Here is where the General Medical Council must be a disturbance out of all proportion to the amount of the strong, united, and business-like. The Privy Council is mineral irritant present. What, then, is the exact nature avowedly careless of medical matters. The Vice-President of the arsenical compound present in beer ?-is it an has said in the House of Commons that neither the organic compound ? And again, what is the effect, if any, President nor he has leisure to read the reports of the of the process of fermentation on arsenic ?-does it possibly elaborate a hitherto unknown compound of arsenic more General Medical Council. The Order in Council has now toxic than arsenic itself ? We learn absolutely nothing on been made-prematurely we think, but still with the know- these points from the report. Again, the validity of various ledge of the General Medical Council-admitting Italian tests for arsenic must also be made the subject of more promedical men to our Medical Register. With the General longed inquiry than this committee were apparently able to Medical Council is left the discretion to decide how far devote to it. They pin their faith to the Reinsch test as a particular individuals possess a sufficient guarantee of suita- qualitative test, while for approximate determinations they recommend the Marsh test, depending upon the production bility for admission to the roll. It must take care that this of metallic mirrors of varying degrees of density. As a discretion is not interfered with or over-ridden by the Privy standard of comparison they recommend a solution of Council who should also be urged to obtain for British arsenious oxide in water which may or may not represent medical men real reciprocity in Italy. A firm stand on the same thing as arsenic in beer. They do not attempt to