- Email: [email protected]
THE NEEDS OF LONDON MEDICAL STUDENTS.
1566 Imperial Institute would be a grave breach of the contract entered into between the University and this hospital, and they feel assured that the Senate will refuse, when all the facts are considered, to countenance any such breach of faith.
combined income from St. George’s and St. Thomas’s students would be
only jB360 per annum. The fee paid at this hospital by students doing anatomy and physiology is 50 guineas per annum; .E26 5s. is charged for the Preliminary Scientific course of the University of London, and 20 guineas for that of the Conjoint Board. The sum paid in fees to the University in 1905-06 from St. George’s Hospital students was over
This letter was acknowledged, and since that date the Senate has fully considered the whole matter and has :2500 instead of the :280 per annum allowed for in Mr. Hill’s estimate. Mr. Hill also assumes that a student would only stay at the institute arrived at the conclusions which have already been comtwo years. Under the present regulations it would be difficult for a municated to the press. These conclusions were forwarded man to pass his intermediate examination in less than three years to St. George’s Hospital with the statement that, while the from commencing his medical studies. E. I. SPRIGGS, Senate regret any inconvenience that may be occasioned to Dean of the Medical School, St. George’s Hospital. St. George’s Hospital Medical School by the decisions at which the Senate have been compelled to arrive, they cannot To the Editors of THE LANCET. accept the interpretation of their action as set out in the last paragraph of the letter of April 22nd which was addressed to do not think it is necessary to reply at length to SIRS,-I the Vice-Chancellor. The receipt of this letter has been the letter from the authorities of St. George’s Hospital acknowledged with an expression of regret at the decision Medical School which appeared in your issue of Nov. 23rd. arrived at by the Senate. Your were instructed to " take no steps unless correspondents I am, Sirs, yours faithfully, [they] were assured that a third centre was to be erected in ARTHUR W. RÜCKER, Principal, the immediate future in the near neighbourhood of the of Nov. South 26th, 1997. University London, Kensington, S.W., As I have already shown, they failed to make University." [INCLOSURE.] this clear to the University representatives. Had they done OFFICIAL STATEMENT FURNISHED TO THE PRESS ON Nov. 20TH, 1907. so we should at once have refused the necessary assurance. A report was received from the committee specially appointed to also took no steps to include that assurance in the advise the Senate on the course to be pursued in regard to the proposed They There is, therefore, no Institute of Medical Sciences. The committee came to the following agreement with the University. conclusions :question of a breach of faith on the part of the Senate. (a) That, owing tc the lack of adequate financial support, the scheme They now fall back upon the general conversation which for the establishment of an Institute of Medical Scionces, as set forth in took place and in particular upon a phrase, which may have the original appeal, and (in a modified form) in the appeal of June, been used by one of us, to the effect that it was the "settled 1905, has proved abortive ; which in the opinion of the policy " of the University to establish a third centre. They (b) That, apart from the money committee is of itself fatal, the scheme has also become impracticable themselves point out that we had given every proof of for other reasons. The Medical Faculty, which formerly reported in favour of the scheme, has now reported against it. Several of the bonafides by raising money for that specific ubject. It was medical schools have changed their opinions in the same sense. and she intention of the University to establish such a centre. some of them have made arrangements involving considerable outlay Unfortunately circumstances have arisen which, in the for providing more efficient instruction in preliminary’ and interopinion of the Senate, make it impossible to carry that mediate medical studies; (c) That, in the above circumstances, the University has no claim intention into execution. Thus, no question arises of a breach to the money which has been already paid by subscribers, or to the )f faith or of avoiding moral responsibilities. The dispute is fulfilment of promises by subscribers who have not yet paid their narrowed to a difference of opinion as to whether it is subscriptions; and (d) That, in the absence of any special directions in anv particular possible for the University to carry out the original intention so which its "settled policy"was directed. In discussing case, all subscriptions already paid ought at once to be returned to the donors (including in that term the executors or legal representatives this question it is in the first place necessary to make clear of deceased donors’ without any suggestion as to any possible applicawhat that original intention was. tion of the money to any other purpose. The first scheme contemplated the erection of buildings The Senate consequently resolved to communicate with the donors to the Medical Institute Fund in accordance with these conclusions, at the cost of .t160,000 and an annual expenditure of informing them that the money paid would be held at their disposal. E19,500. At a later date it was estimated that the cost of building and equipping the institution on a reduced scale vould be .6130,000. The sum raised is little more than half To the Editors of THE LANCET. ,he reduced estimate for buildings and equipment. It cannot SIRS,-In THE LANCET of Nov. 16bh a letter was published )e honestly said that on this capital it is possible to establish. Mr. Leonard Hill in from which certain statements concernm institute such as that for which the subscriptions were ing this medical school were made. Mr. Hill’s letter was riven. It would have been a, real "breach of faithwith written in connexion with the recent election to the Senate of the University of London, and in order to correct the false he subscribers to attempt it. If the St. George’s delegates to not in this view I can only regret the difference of impression which Mr. Hill’s statements were likely to pro- ’pinion.agree duce I sent a copy of the inclosed reply to each member of For the rest, I have not expressed in public any opinions the Faculty on the eve of the election. As, however, Mr. m the matters at issue other than those forced from me in Hill’s ’letter will not only have been read by those immehis I was told that it was being stated that diately interested in the Faculty election but by the pro- wascorrespondence. when certain present pledges were given. I handed fession at large, I should esteem it a great favour if you could give through your columns the same publicity to my ny repudiation of that statement to Mr. Leonard Hill and wrote to Professor Starling, who I understood more or less I am, Sirs, yours faithfully, reply. ccepted the statement, to tell him what I had done. In E. I. SPRIGGS, hat repudiation I was dealing with a matter of fact, not of of Dean the Medical School, St. George’s Hospital. Nov. 25th, 1907. pinion. I have therefore written this letter as a witness to acts in my personal capacity, and having shown that the [COPY.] eal controversy is about matters of opinion I shall take no St. George’s Hospital, S.W., November 18th, 1907. urther part in the correspondence. In the latest issues of THE LANCET and the British Medical Journal Mr. Leonard Hill asks the following question : "Do St. George’s and I am, Sirs, vours faithfullv. St. Thomas’s propose that the University should prepare students for ARTHUR W. RÜCKER, Principal. the examinations of the Conjoint Board?" University of London, South Kensington, S.W., Nov. 26th, 1907. One of the original conditions laid down in the report from the
difficulty.
-
-
" Concentration" Committee to the Faculty of Medicine for the School of Preliminary and Intermediate Studies in the near neighbourhood of
the University
was:-
THE NEEDS OF LONDON MEDICAL
for teaching all classes of medical for the examinations of the University or for those of other qualifying bodies, so that any existing school of the University should be able at once to abandon altogether the To the Editors of THE LANCET. teaching of the subjects provided for at the new school." [Report from " Concentration Committee, Faculty of Medicine, out SIRS,-In my letter of Oct. 26th I ventured to Dec. 13th, 1901, page 7 (b)]. two matters which I it incumbent upon Mr. Leonard Hill also points out that in the Calendar of the Uniof London to take action. One versity (1906-7) the Preliminary Scientific students of St. George’s the Senate of the of the should be Hospital number two. This statement in the Calendar is, however, was that the medical a misleading one, for in 1906-7 there were no students working at the rendered accessible to all London medical the hospital for the Preliminary or Intermediate examinations of any qualifying bodies, as all had been transferred to King’s and University other, that a certain sum of money, which had been obtained Colleges a year before, in October, 1905. The number of students who for a purpose, should be returned rather than devoted have been so transferred from St. George’s Hospital is 33. All these to another purpose. The latter step has now been taken and would have been sent to an institute at South Kensington had such is clear for the consideration of the been available. Further, Mr. Hill suggests that the students sent to the to this you have several this institute would be charged ,cOO per year, and concludes that theformer. With " That
provision is made students, whether preparing
STUDENTS.
"
point
concerning University
thought
degrees
University
students ;
specific
ground
adequate
regard
published
’
1567 letters and I may add that some prominent members of the profession have spoken to me in the same general sense. The one serious objection is that voiced by Dr. A. Percy Allan in your issue of Nov. 9th. With regard to this I must freely concede that to grant the London degree tout court to all Conjoint diplomates would be an injustice to those who have passed the multiplicity of examinations now entailed in that degree. But I would submit that it will be quite easy to earmark the degreeseither along the lines suggested by Sir William Gowers or by calling the present M.D. M.D. Honours-in such a way as to point out the distinction, while at the same time removing the handicap which our London students have as compared with those in the provinces. The Royal Colleges alone have neither the power nor, I believe, the desire to grant medical degrees. If these are to be accessible to all London students either the London University must render them so or a new university must be called into being. The latter course would be difficult and expensive; for the former all the materials are ready to hand in the shape of a University which can grant degrees and a Conjoint Board success in whose final examination is justly considered the standard English qualification to practise. If the cooperation of these bodies could be secured the London medical student would receive a full return for his industry and the London medical schools would no longer be depleted by provincial competition. In common fairness, too, the degree should be given, so to speak, retrospectively, to all Conjoint diplomates who had studied for, say, four years in London and who should pass an examination on the lines of the M.D. Durham (Practitioners). If there is to be any chance of carrying through this reform united action must, as Mr. R. Denison Pedley remarks, be taken by those whom it would benefit. If a committee is formed for the purpose the Conjoint diplomates will, I think, be both surprised and pleased to find how many of the teachers in the medical schools of London will be willing to
interesting
hnlr, fhnm
T
o..,
.GVae
faithfully
BERTRAM ABRAHAMS.
London, W., Nov. 25th, 1937.
To the Editors of THE LANCET. SIRS,-At the meeting held this afternoon at the Royal College of Surgeons sufficient emphasis did not seem to be placed on the suicidal policy of the Royal Colleges in not doing something to improve the status of their diplomates in the face of the multiplication of degree-granting bodies in other parts of the United Kingdom. If opposed to any alteration respecting their existing Members and Licentiatef they should not therefore neglect the future, otherwise London, which ought to be far ahead, will find itself in time left behind in the race as far as medical students are con. cerned. The Council object to raise the standard of eithei the preliminary or intermediate science part of their ex. aminations, giving as a reason that the changes already made have led to a diminution of candidates. But is this not aE much due to the loss of attraction in the diplomas compared to the degrees to be got elsewhere, and would not an improve. ment in the status of the diploma be a counter attraction leading to an increase instead of a diminution of candidatee for the Conjoint ? I fear the teachers in the London schools of medicine as well as the Council are short-sighted. I am, Sirs, yours faithfully, MEMBER. Nov. 21st, 1907. -
To the Editors of THE LANCET. R. SIRS.-Mr. Denison Pedley in THE LANCET of Nov. 16th, p. 1420, makes a very common error which should, I think, be corrected. He states that "the Conjoint Board can at any time help" its diplomates to obtain the title of " doctor," by which he presumably means the degree of M.D. If he reads the charters of the two Royal Colleges he will find that this is not the case; indeed, for the Colleges to confer the degree of M.D. an Act of Parliament would be necessary. There are only two bodies which can give degrees, the Universities and the
State, and, in addition, the Archbishop
of
Canterbury, by
of his remnant of Legatine authority, can recommend the Crown to confer degrees, a right which, save in the Faculty of Divinity and Music, is not now exercised. Should fresh legislation take place on the subject, as is to be hoped, I think most of us are agreed that it would be desirable to introduce the " oneportal" "system of a State M.D. conferred by the different examining bodies under State control, but as the law
right
stands this is, of course, impossible. I should like to add that I think your correspondent overstates the grievance of If they wanted a degree they the College diplomates. should have taken the London course, but as both a London graduate and a College diplomate I can testify that they would have had to work considerably harder for the two letters than for the eight. I should personally, however, welcome any legislation which would restrospectively confer a doctorate on my fellow collegiates, as this would obviously do much to promote good feeling in the profession, which is more to be desired than many titles. I am, Sirs, yours faithfully, Nov. 25th, 1907. M.B., L.R.C.P.
THE UNIVERSITY OF LONDON GRADUATES’ ASSOCIATION. To the Editors of THE LANCET. SIRS,-Referring to the London Graduates’ Union in your last issue you say that you are informed that the London University Graduates’ Association "has constituted itself into an association for promoting the election by convocation to the Senate of candidates representing the views of external students alone and of opposing the election of any recognised teacher." Both these statements are false. As the editor of a medical journal myself, I am perfectly aware of the difficulty of keeping au courant with medical and university politics, and of the error one sometimes falls into in accepting statements on questions one has not had the time or opportunity of mastering, but I hope in justice both to the Union and the Association you will allow me to put this matter right. For while it is clear that a mis-statement of this character is calculated to damage the Graduates’ Association, it is clearer still that an untrue statement of this kind must be still more damaging to the Union, on the behalf of which, presumably, it has been made public. Being secretary of the Medical Faculty of the London University Graduates’ Association, it has been my duty to promote the election of two candidates for the Senate, one successfully the other unsuccessfully ; and I was under the impression that the names of these two gentlemen, Dr. Graham Little and Professor Ernest White were sufficiently well known to make the statement of your misinformant ludicrous. However, I suppose it is necessary, since the statement has been seriously put forward, that I must point out that Dr. Graham Little is a member of the Faculty of Medicine of the University of London, and as physician attached to St. Mary’s Hospital (London University), is an internal teacher. Professor Ernest White is also a member of the Faculty of Medicine of the London University, and what is still more remarkable in the face of the above allegation, is actually a professor in one of the colleges of the London University, holding the chair of Psychological
Medicine at King’s College. After this statement it scarcely seems worth while to rebut the mis-statement that our Association exists"for promoting the election by convocation of candidates representing the views of external students alone." which is equally stupid and untrue. We do, however, think that external students have a right to representation on the Senate. Does the Union differ from us in this respect ?-Yours faithfullv. A. PERCY ALLAN. 2, Hare Court, Temple, Nov. 24th, 1907. not find the difficulty which Dr. Allan experi*** We do or university politics, nor medical in ences understanding do we believe that rudeness helps much in a controversy.ED.L.
PLEURAL
EFFUSION
AND
ITS
TREATMENT. To the Editors
of THE LANCET.
SIRS,-Sir James Barr in the Bradshaw lecture on Pleural Effusion and it-s Treatment, reported in your journal of Nov. 9th, expresses himself very unfavourably on the present surgical treatment of empyema of the thorax: he says that the surgeons have taken this disease under their own special care but have done nothing to advance its treatment. He adds that he is anxious that they should remove" this blur from their fair escutcheon," and very considerately gives them details of a new operation which he would do if he were a surgeon. I think that the choice of the word " blur"was
combined income from St. George’s and St. Thomas’s students would be
only jB360 per annum. The fee paid at this hospital by students doing anatomy and physiology is 50 guineas per annum; .E26 5s. is charged for the Preliminary Scientific course of the University of London, and 20 guineas for that of the Conjoint Board. The sum paid in fees to the University in 1905-06 from St. George’s Hospital students was over
This letter was acknowledged, and since that date the Senate has fully considered the whole matter and has :2500 instead of the :280 per annum allowed for in Mr. Hill’s estimate. Mr. Hill also assumes that a student would only stay at the institute arrived at the conclusions which have already been comtwo years. Under the present regulations it would be difficult for a municated to the press. These conclusions were forwarded man to pass his intermediate examination in less than three years to St. George’s Hospital with the statement that, while the from commencing his medical studies. E. I. SPRIGGS, Senate regret any inconvenience that may be occasioned to Dean of the Medical School, St. George’s Hospital. St. George’s Hospital Medical School by the decisions at which the Senate have been compelled to arrive, they cannot To the Editors of THE LANCET. accept the interpretation of their action as set out in the last paragraph of the letter of April 22nd which was addressed to do not think it is necessary to reply at length to SIRS,-I the Vice-Chancellor. The receipt of this letter has been the letter from the authorities of St. George’s Hospital acknowledged with an expression of regret at the decision Medical School which appeared in your issue of Nov. 23rd. arrived at by the Senate. Your were instructed to " take no steps unless correspondents I am, Sirs, yours faithfully, [they] were assured that a third centre was to be erected in ARTHUR W. RÜCKER, Principal, the immediate future in the near neighbourhood of the of Nov. South 26th, 1997. University London, Kensington, S.W., As I have already shown, they failed to make University." [INCLOSURE.] this clear to the University representatives. Had they done OFFICIAL STATEMENT FURNISHED TO THE PRESS ON Nov. 20TH, 1907. so we should at once have refused the necessary assurance. A report was received from the committee specially appointed to also took no steps to include that assurance in the advise the Senate on the course to be pursued in regard to the proposed They There is, therefore, no Institute of Medical Sciences. The committee came to the following agreement with the University. conclusions :question of a breach of faith on the part of the Senate. (a) That, owing tc the lack of adequate financial support, the scheme They now fall back upon the general conversation which for the establishment of an Institute of Medical Scionces, as set forth in took place and in particular upon a phrase, which may have the original appeal, and (in a modified form) in the appeal of June, been used by one of us, to the effect that it was the "settled 1905, has proved abortive ; which in the opinion of the policy " of the University to establish a third centre. They (b) That, apart from the money committee is of itself fatal, the scheme has also become impracticable themselves point out that we had given every proof of for other reasons. The Medical Faculty, which formerly reported in favour of the scheme, has now reported against it. Several of the bonafides by raising money for that specific ubject. It was medical schools have changed their opinions in the same sense. and she intention of the University to establish such a centre. some of them have made arrangements involving considerable outlay Unfortunately circumstances have arisen which, in the for providing more efficient instruction in preliminary’ and interopinion of the Senate, make it impossible to carry that mediate medical studies; (c) That, in the above circumstances, the University has no claim intention into execution. Thus, no question arises of a breach to the money which has been already paid by subscribers, or to the )f faith or of avoiding moral responsibilities. The dispute is fulfilment of promises by subscribers who have not yet paid their narrowed to a difference of opinion as to whether it is subscriptions; and (d) That, in the absence of any special directions in anv particular possible for the University to carry out the original intention so which its "settled policy"was directed. In discussing case, all subscriptions already paid ought at once to be returned to the donors (including in that term the executors or legal representatives this question it is in the first place necessary to make clear of deceased donors’ without any suggestion as to any possible applicawhat that original intention was. tion of the money to any other purpose. The first scheme contemplated the erection of buildings The Senate consequently resolved to communicate with the donors to the Medical Institute Fund in accordance with these conclusions, at the cost of .t160,000 and an annual expenditure of informing them that the money paid would be held at their disposal. E19,500. At a later date it was estimated that the cost of building and equipping the institution on a reduced scale vould be .6130,000. The sum raised is little more than half To the Editors of THE LANCET. ,he reduced estimate for buildings and equipment. It cannot SIRS,-In THE LANCET of Nov. 16bh a letter was published )e honestly said that on this capital it is possible to establish. Mr. Leonard Hill in from which certain statements concernm institute such as that for which the subscriptions were ing this medical school were made. Mr. Hill’s letter was riven. It would have been a, real "breach of faithwith written in connexion with the recent election to the Senate of the University of London, and in order to correct the false he subscribers to attempt it. If the St. George’s delegates to not in this view I can only regret the difference of impression which Mr. Hill’s statements were likely to pro- ’pinion.agree duce I sent a copy of the inclosed reply to each member of For the rest, I have not expressed in public any opinions the Faculty on the eve of the election. As, however, Mr. m the matters at issue other than those forced from me in Hill’s ’letter will not only have been read by those immehis I was told that it was being stated that diately interested in the Faculty election but by the pro- wascorrespondence. when certain present pledges were given. I handed fession at large, I should esteem it a great favour if you could give through your columns the same publicity to my ny repudiation of that statement to Mr. Leonard Hill and wrote to Professor Starling, who I understood more or less I am, Sirs, yours faithfully, reply. ccepted the statement, to tell him what I had done. In E. I. SPRIGGS, hat repudiation I was dealing with a matter of fact, not of of Dean the Medical School, St. George’s Hospital. Nov. 25th, 1907. pinion. I have therefore written this letter as a witness to acts in my personal capacity, and having shown that the [COPY.] eal controversy is about matters of opinion I shall take no St. George’s Hospital, S.W., November 18th, 1907. urther part in the correspondence. In the latest issues of THE LANCET and the British Medical Journal Mr. Leonard Hill asks the following question : "Do St. George’s and I am, Sirs, vours faithfullv. St. Thomas’s propose that the University should prepare students for ARTHUR W. RÜCKER, Principal. the examinations of the Conjoint Board?" University of London, South Kensington, S.W., Nov. 26th, 1907. One of the original conditions laid down in the report from the
difficulty.
-
-
" Concentration" Committee to the Faculty of Medicine for the School of Preliminary and Intermediate Studies in the near neighbourhood of
the University
was:-
THE NEEDS OF LONDON MEDICAL
for teaching all classes of medical for the examinations of the University or for those of other qualifying bodies, so that any existing school of the University should be able at once to abandon altogether the To the Editors of THE LANCET. teaching of the subjects provided for at the new school." [Report from " Concentration Committee, Faculty of Medicine, out SIRS,-In my letter of Oct. 26th I ventured to Dec. 13th, 1901, page 7 (b)]. two matters which I it incumbent upon Mr. Leonard Hill also points out that in the Calendar of the Uniof London to take action. One versity (1906-7) the Preliminary Scientific students of St. George’s the Senate of the of the should be Hospital number two. This statement in the Calendar is, however, was that the medical a misleading one, for in 1906-7 there were no students working at the rendered accessible to all London medical the hospital for the Preliminary or Intermediate examinations of any qualifying bodies, as all had been transferred to King’s and University other, that a certain sum of money, which had been obtained Colleges a year before, in October, 1905. The number of students who for a purpose, should be returned rather than devoted have been so transferred from St. George’s Hospital is 33. All these to another purpose. The latter step has now been taken and would have been sent to an institute at South Kensington had such is clear for the consideration of the been available. Further, Mr. Hill suggests that the students sent to the to this you have several this institute would be charged ,cOO per year, and concludes that theformer. With " That
provision is made students, whether preparing
STUDENTS.
"
point
concerning University
thought
degrees
University
students ;
specific
ground
adequate
regard
published
’
1567 letters and I may add that some prominent members of the profession have spoken to me in the same general sense. The one serious objection is that voiced by Dr. A. Percy Allan in your issue of Nov. 9th. With regard to this I must freely concede that to grant the London degree tout court to all Conjoint diplomates would be an injustice to those who have passed the multiplicity of examinations now entailed in that degree. But I would submit that it will be quite easy to earmark the degreeseither along the lines suggested by Sir William Gowers or by calling the present M.D. M.D. Honours-in such a way as to point out the distinction, while at the same time removing the handicap which our London students have as compared with those in the provinces. The Royal Colleges alone have neither the power nor, I believe, the desire to grant medical degrees. If these are to be accessible to all London students either the London University must render them so or a new university must be called into being. The latter course would be difficult and expensive; for the former all the materials are ready to hand in the shape of a University which can grant degrees and a Conjoint Board success in whose final examination is justly considered the standard English qualification to practise. If the cooperation of these bodies could be secured the London medical student would receive a full return for his industry and the London medical schools would no longer be depleted by provincial competition. In common fairness, too, the degree should be given, so to speak, retrospectively, to all Conjoint diplomates who had studied for, say, four years in London and who should pass an examination on the lines of the M.D. Durham (Practitioners). If there is to be any chance of carrying through this reform united action must, as Mr. R. Denison Pedley remarks, be taken by those whom it would benefit. If a committee is formed for the purpose the Conjoint diplomates will, I think, be both surprised and pleased to find how many of the teachers in the medical schools of London will be willing to
interesting
hnlr, fhnm
T
o..,
.GVae
faithfully
BERTRAM ABRAHAMS.
London, W., Nov. 25th, 1937.
To the Editors of THE LANCET. SIRS,-At the meeting held this afternoon at the Royal College of Surgeons sufficient emphasis did not seem to be placed on the suicidal policy of the Royal Colleges in not doing something to improve the status of their diplomates in the face of the multiplication of degree-granting bodies in other parts of the United Kingdom. If opposed to any alteration respecting their existing Members and Licentiatef they should not therefore neglect the future, otherwise London, which ought to be far ahead, will find itself in time left behind in the race as far as medical students are con. cerned. The Council object to raise the standard of eithei the preliminary or intermediate science part of their ex. aminations, giving as a reason that the changes already made have led to a diminution of candidates. But is this not aE much due to the loss of attraction in the diplomas compared to the degrees to be got elsewhere, and would not an improve. ment in the status of the diploma be a counter attraction leading to an increase instead of a diminution of candidatee for the Conjoint ? I fear the teachers in the London schools of medicine as well as the Council are short-sighted. I am, Sirs, yours faithfully, MEMBER. Nov. 21st, 1907. -
To the Editors of THE LANCET. R. SIRS.-Mr. Denison Pedley in THE LANCET of Nov. 16th, p. 1420, makes a very common error which should, I think, be corrected. He states that "the Conjoint Board can at any time help" its diplomates to obtain the title of " doctor," by which he presumably means the degree of M.D. If he reads the charters of the two Royal Colleges he will find that this is not the case; indeed, for the Colleges to confer the degree of M.D. an Act of Parliament would be necessary. There are only two bodies which can give degrees, the Universities and the
State, and, in addition, the Archbishop
of
Canterbury, by
of his remnant of Legatine authority, can recommend the Crown to confer degrees, a right which, save in the Faculty of Divinity and Music, is not now exercised. Should fresh legislation take place on the subject, as is to be hoped, I think most of us are agreed that it would be desirable to introduce the " oneportal" "system of a State M.D. conferred by the different examining bodies under State control, but as the law
right
stands this is, of course, impossible. I should like to add that I think your correspondent overstates the grievance of If they wanted a degree they the College diplomates. should have taken the London course, but as both a London graduate and a College diplomate I can testify that they would have had to work considerably harder for the two letters than for the eight. I should personally, however, welcome any legislation which would restrospectively confer a doctorate on my fellow collegiates, as this would obviously do much to promote good feeling in the profession, which is more to be desired than many titles. I am, Sirs, yours faithfully, Nov. 25th, 1907. M.B., L.R.C.P.
THE UNIVERSITY OF LONDON GRADUATES’ ASSOCIATION. To the Editors of THE LANCET. SIRS,-Referring to the London Graduates’ Union in your last issue you say that you are informed that the London University Graduates’ Association "has constituted itself into an association for promoting the election by convocation to the Senate of candidates representing the views of external students alone and of opposing the election of any recognised teacher." Both these statements are false. As the editor of a medical journal myself, I am perfectly aware of the difficulty of keeping au courant with medical and university politics, and of the error one sometimes falls into in accepting statements on questions one has not had the time or opportunity of mastering, but I hope in justice both to the Union and the Association you will allow me to put this matter right. For while it is clear that a mis-statement of this character is calculated to damage the Graduates’ Association, it is clearer still that an untrue statement of this kind must be still more damaging to the Union, on the behalf of which, presumably, it has been made public. Being secretary of the Medical Faculty of the London University Graduates’ Association, it has been my duty to promote the election of two candidates for the Senate, one successfully the other unsuccessfully ; and I was under the impression that the names of these two gentlemen, Dr. Graham Little and Professor Ernest White were sufficiently well known to make the statement of your misinformant ludicrous. However, I suppose it is necessary, since the statement has been seriously put forward, that I must point out that Dr. Graham Little is a member of the Faculty of Medicine of the University of London, and as physician attached to St. Mary’s Hospital (London University), is an internal teacher. Professor Ernest White is also a member of the Faculty of Medicine of the London University, and what is still more remarkable in the face of the above allegation, is actually a professor in one of the colleges of the London University, holding the chair of Psychological
Medicine at King’s College. After this statement it scarcely seems worth while to rebut the mis-statement that our Association exists"for promoting the election by convocation of candidates representing the views of external students alone." which is equally stupid and untrue. We do, however, think that external students have a right to representation on the Senate. Does the Union differ from us in this respect ?-Yours faithfullv. A. PERCY ALLAN. 2, Hare Court, Temple, Nov. 24th, 1907. not find the difficulty which Dr. Allan experi*** We do or university politics, nor medical in ences understanding do we believe that rudeness helps much in a controversy.ED.L.
PLEURAL
EFFUSION
AND
ITS
TREATMENT. To the Editors
of THE LANCET.
SIRS,-Sir James Barr in the Bradshaw lecture on Pleural Effusion and it-s Treatment, reported in your journal of Nov. 9th, expresses himself very unfavourably on the present surgical treatment of empyema of the thorax: he says that the surgeons have taken this disease under their own special care but have done nothing to advance its treatment. He adds that he is anxious that they should remove" this blur from their fair escutcheon," and very considerately gives them details of a new operation which he would do if he were a surgeon. I think that the choice of the word " blur"was