THE PHARMACY BILL.

412 I

solitary beengravamen—the ludicrously

these remarks will be received as they are meant to and conciliatory. My attention having directed to your injurious remarks by members of the body to which I am honorary secretary, I felt I could not do less than communicate with you. I am Sir your obedient servant.

hope

be—explanatory

Hon.

York, April,

1852.

visit to the chamber. Dr. Ranking deal of consequence. But men who arrogate for themselves so much, are always in danger lest carping people should set about to investigate the pretensions of such egotists, naturally inquiring whence he grew who thinks himself the Lord knows who ? These are not the daysfor physicians to lord it over surgeons. Whatever passivity may have been shown by general practi. tioners elsewhere, the Norfo!k surgeons are plain, practical, persons, who can see somewhat deeper-below the superficies of things and men-than this unknown stranger may imagine. I remain, Sir, vour obliged, obedient, servant, assumes a

T. LAYCOCK, Secretary to Associated Extra-Urban Licentiates.

yo the Editor of THE LANCET.

SIR,—I have read with much regret some observations in the two last numbers of THE LANCET, respecting the Extralicentiates of the College of Physicians. In your advocacy of an extensive change in the organization of that learned body, such as may bring it into accordance with the times, and place it in its proper position as the head of the medical profession in England, I cordially concur; nor am I at all disposed to underrate the claims of many distinguished men who are prac’ising as provincial physicians against the letter of the law at all events, from not being associa".ed with the College. But, surely, it was not necessary, in order to do justice to these gentlemen, to speak in terms of disparagement and injustice of those who, holding the provincial licence of the College, are presumed to be, by qualification, as well as legally, physicians ; and I own that I am surprised to find you, the avowed and strenous advocate of the great body of general pracritioners, speaking thus contemptuously of a set of men who have been drawn in a great proportion from their ranks. As to their examination, it must be borne in mind that it never was intended to be a scholastic one, fitted for the tyro just fresh from the schools and too often crammed from books, but practical-such as would test the capabilities of men who have passed many years of hard work in acquiring judgment and experience, and have occupied an honourable post in their profession ; and for myself, I can confidently assert, as no doubt can many others, that I presented myself for that examination fully prepared for a. fair and searching scrutiny into my fitness for the position which

HORACE HOWARD. New

Buckenham, Norfolk, April,

1852.

To the Editor of THE LANCET.

,

SIR,—I have just perused, in THE LAKCET of the 10th, the defensive reply of Dr. Ranking, of Norwich, to the allegations of Mr. Howard, in reference to the circumstances of their professional consultation, and treatment of the case of a patient, a few miles from that city; and I cannot but lament to witness the multiplied instances of published misunderstandings, (especially amongst respectable practitioners,) and that too upon the assumed ground of violated etiquette. It must indeed be admitted, that mutual resp
SIR,—My controversy with Dr. Ranking has not been personal, but on professional matter involving the rules of consultations. He cannot, it seems, understand the rules for consultation, as laid down by Dr. Baillie, obeyed by all physicians, lauded by yourself. The verbiage of his last (!efensive note to you cannot divert any logical reader from the view of the only fact which is worthy He had no professional right to be one a place in the discussion. moment in that consultation chamber alone, unless fresh and urgent summons from the bed-side had reached him-and this he does not plead, for obvious reason. I will grant him, for the sake of argument, the magnanimity to confess an error if he saw it. But he cannot see one, and it will be impossible for intelligent surgeons, fraught with proper self-respect, to consult with so dense a person, whose code differs so entirely from the acknowledged. He still, and doggedly, makes me saying what I have denied that I said. Such a controversial will go on for ever-’, mere last words." But all is irrelevant to the essential

THE PHARMACY BILL. To the Editor of THE LANCET. much

surprised at the apathy which seems to pergeneral practitioners, both in London and provincial towns, respecting the " Pharmacy Bill." That

SIR,—I

am

vade the ranks of the

the

has been read a second time in the House of Commons, and is now in Committee, and if not strenuously opposed, has every prospect of passing both Houses of Parliament, and becoming the law of the land. You, Sir, are a member of the Select Committee now sitting on the Bill, and I cannot help thinking that you are either deceived as to its probable effects, or that you are not, as usual, sensitively alive to the interests of the public and of surgeons in general practice. I am strongly of opinion, that, should the Pharmacy Bill pass into a law, it will most injuriously affect the public, and seriously interfere with the legal practitioner. No man knows better than you do the frightful extent to which chemists at present assume the functions of medical men, and the fearful consequences which result from counter practice" and even domiciliary visits. The measure

413 gives full power to the Pharmaceutical Society miserable model, and all tenanted by the self-same class-viz., under a Royal Charter) to regulate, with that of the better-paid labourer and the well-paid artisan. With incorporated (already all the machinery of a Royal College, the affairs and government very few (if any) exceptions, all the men are medically attended of the chemists and druggists of England and Wales; and not by club contract, and in one or two instances very large establishcontented with this, they wish to assume the same powers over ments have a surgeon appointed to the care of the families entire, the chemists of Scotland! They contend, not only for registra- even including the midwifery. This district at the recent census tion, and full power to make such by-laws as they may think gave a population of about 20,000 souls. Its rapidly-increasing proper, without any control, but also for the sole regulation of sizeand importance is the consequence of the prosperity which the education or examination of all their future members. And has arisen from free-trade, and there is correspondingly but a what is to be the course of their examination? Why, in the trifling call on parochial relief; for when the men are ill, they Classics, in Dispensing and Prescriptions, in Botany, in Che- have a comfortable allowance from their clubs. The district, mistry, in Materia Medica, in Pharmacy, and in Toxicology ! although near a large town, is in a different county, and forms which last word may include almost anything pertaining to the part of a rural union. There is only one public vaccinator, and practice of medicine. I am rather surprised, indeed, that Mid- he, at the time to which I am alluding, did not reside in the diswifery was not also included, which some chemists now boldly trict, which became a sort of neutral ground, surrounding practitioners cutting in, whilst at the same time there were three or assume the right of practising. Now, Sir, I ask my medical brethren, and I ask you-whether, four fresh local adventurers.

present

Bill

Now what was the consequence when small-pox broke out?( who know the habits of this cla.ss know also their utter want of providence, and the extreme laxity of their morals in any debt they can possibly incur. How did the medical the vaccination question individually? They who took wholefamilies by contract not having this operation included in their bargains, did not care to impose an additional duty upon themselves, for which no additional recompence was In other instances the surgeons declined the task altogether, knowing that if they made a charge they would never public. and with great injury to medical men. Even the present get it. Now, even supposing the public vaccinator had been ever so energetic, how could he, in such a district, hope to vaccinate race of chemists will, I presume, be entitled, nnder the Act, to another flaring diploma, and will consider themselves as bettet one tithe of the children, one twentieth part of whom he himself qualified, by such a licence, to pursue their present dangerous from the nature of his position could onlyat best have met with, and having thereby the very questionable good wishes of his career. 1 clo not tor a moment mean to charge the more respectablemedical comrades in his favour? houses in London and in the larger towns with resorting to such I will take another instance-this time in the pure country. virtue of powerful interest at the board of guardians, a dangerous practices ; and I am convinced that Mr. Jacob and you, Sir, and others, may believe that this Bill is calculated young man gets elected to a district, in which he not only does to prevent, rather than to promote, the evils of which I complain. not reside, but is four miles from his nearest village, and the I regret that, after much consideration of the subject, I cannot other villages of his district three or four miles apart. In all entertain this view; and I know that many of my medical friends these villages other surgeons attend, not only the most respectable fully agree with me in the opinion which I have thus expressed. families, but the more independent class of labourers, which latter It will naturally be asked what remedy I propose. Let me class very frequently will not employ the parish surgeon, simply say at once, that I would not object to the education of chemists, because he is the parish-surgeon. In one or two of these villages under proper regulations. I simply object to their assumption ofthe small-pox makes its appearance, and, after it has well estafunctions for which they are not educated. They may dispense blished itself, it is discovered that several years have elapsed since the prescriptions of physicians and surgeons, and they may vend there was a general vaccination, as it has never been worth all the usual medicines ad libitum, except the strong poisons, while for the parish surgeon to keep it up, he perhaps presuming such as arsenic, (already guarded.) prussic acid, oxalic acid, that the other medical practitioners of the district have taken care opium and its preparations, chloroform, &c., which ought to have of their own patients. And this is true, perhaps, of the respective been included in the Arsenic Bill. I would not prevent their families of the squire, clergy man, steward, and so forth. But of doing anything which belongs legitimately to the trade or the humbler class no notice has been taken for such a trifle, as it business of a chemist ; but I would propose that a clause should is assumed they have been, or shortly will be, vaccinated in due be introduced into the Bill,,making it penal for a chemist to course by the parish surgeon, who, it is thought, may as well prescribe for or treat diseases, or to act in any way as a legally- have the fee, such as it is, instead of a charge being made, which, qualified medical practitioner. I would restrict the chemists of to be proportionate to the trouble, must be very disproportionate this country as the pharmaciens of France and other parts of the to what it is known is allowed. I think, Sir, it must be evident that, however energetically and continent are restricted ; and I would despise the maudlin nonsense respecting "the liberty of the subject in this free faithfully the poor-law medical officers may do their duties, it is country," and would consider that as salutary and requisite topographically and statistically impossible for universal vaccinawhich should evidently prevent the destruction of life or health. tion to be accomplished by them alone, setting prejudice either as If it If Mr. Jacob Bell should object to such a clause, 1 would call against the operator or the operation out of the question. be felony to inoculate, the law can with equal ease make it felony on you, Sir, and on my medical brethren, to oppose the Pharmacy Bill by every means within their reach. to neglect vaccination; if to tolerate and sustain a nuisance deThere are other objections to the Bill, such as its inappro- trimental to the health of our neighbours be illegal, the neglect priateness pending a general measure of medical reform. I of a prophylactic is equally so. To be universal, or nearly approaching it, vaccination must be object, also, to the creation of a new corporation with par liamentary powers, when, in fact, the chemists ought to be compulsory, with a special fund to meet the expense, with proper joined to the Society of Apothecaries, whose present functions supervision, and every legally qualified medical practitioner a (which they are seriously neglecting, if they assent to th( public vaccinator.* The law as it now stands retards vaccinaPharmacy Bill) must soon necessarily cease. But your Epac, tion. and my time are both exhausted. I am, Sir, your very obedient servant, I remain, Sir, vours faithfully. LY1IIPII. April, 1852. GEO. WEBSTER, M.D. Dtilwich, April, 1852. P.S.-The metropolitan surgeons can, no doubt, further illustrate this matter.

with these considerable fragments of a medical education, the future race of chemists will not, on the strength of their examination, and a showy diploma placed in their windows, most egregiously deceive themselves as to their amount of medical knowledge, and also sadly deceive the public into a belief that they are perfectly qualified to treat and cure diseases ? My firm conviction is, that by the passing of the Pharmacy Bill, "counter practice," and the treatment of diseases by chemists, which now obtain to such an extent, will be increased at least tenfold ; and I look upon the measure as being fraught with great danger to the

They

paying men argue provided.

Bell.’By

l

,

,

UNIVERSAL VACCINATION. To the Editor of THE LANCET.

SIR,—As

the present appears a favourable period for giving question a fair investigation, I will, with your permission, draw attention to a few facts connected with the present working of the law, for which I can vouch from experience. I will, in the first instance, take the case of a densely-populated district in the neighbourhood of one of our large manufacturing towns. It is a district rapidly and daily expanding. Rows of streets, run up by houses built fifty at a time, all on the same

the vaccination

DEATH FROM HÆMORRHAGE CONSEQUENT UPON LANCING THE GUMS. To the Editor of THE LANCET. cases of severe haemorrhage from the gums reSIR,—The corded in THE LANCET of last Saturday recall to mind a case An infant was brought to me on& as far as I know unique. Gentlemen solicitous of notoriety, through the medium of vaccination can then head their notices with the royal coat of arms, and conclude the same with ° God save the Queen." *

publications,