THE RIVAL BILLS, AND THEIR CLAIMS TO SUPPORT.

Sir J. Ramsden said they would be paid according to the rate in the regulations of 1854. On going into Committee of Supply, Lord Palmer:ston himself moved the Army Estimates (a balance of about fivemillions in addition to former grants) in a long and lucid speech. He alluded to the recent formation of an entirely new corps of hospital orderlies for attendance on the sick. Mr. Stafford reminded the Premier that he had not mentioned the grievances of the Army Medical Department, and complained that Government had neglected the suggestions of the committee which had sat on the subject. He condemned, with a warmth that deserves the thanks of the profession, the present uncertain condition of army surgeons, and pointed out the inefficiency of any scheme of reforming the army whilst those on whom its health depends were left without sufficient He pointed out the necessity of giving the remuneration. Medical Army Department more power, and to make it worth the while of good men even to take the appointments now

granted to existing practitioners are by

no means

easily

ascer.

tained. Lord Elcho does not propose to disfranchise the Apothecaries’ Hall of Dublin, until the year 1865, when it is to die out with the London Apothecaries’ Society. The registration fee for existing practitioners is to be £ 2; registration is to confer the same right of recovery upon physicians, surgeons, and apothecaries. Persons registered under these provisions are to enjoy the right of practising, according to the nature of their qualifications, in every part of the United Kingdom. Persons entitled to register as sacrgeons and apothecaries, in of qualifications existing prior to December 1st, 1857, may require to be registered as " Licentiate in Medicine and Surgery."’’ And persons only entitled to register as apothecaries or szcrgeons separately, in respect of qualifications existing before Dec. 1, 1857, may, upon passing a complementary examination, also be registered as " Licentiates in Medicine and Surgery," upon payment of a fee not exceeding twelve pounds. The provisions for Students are to be subject to the will of the Council. going a-begging. These are the provisions of each Bill for existing practitioners Sir De Lacy Evans expressed his accordance in the coinand students. made Mr. the Medical that Stafford, believing plaints DepartThe prospective differences in the Bills are greater. ment does not yet occupy its proper status, and that its 1 a. Mr. HEADLAM proposes that a council shall be formed position ought to be raised for the benefit of the army. The Under-Secretary-of-War said that whfn the new com- for the regulation of all affairs of medical education, of regisThese persons are to bf twenty-four in mission had made its report, steps would be immediately taken tration, &c., &c., &c. to place the Army Medical Department on the most efficient number: eighteen chosen by the various English, Irish, and Scotch universities and corporations; and six by the Crown. footing. The president to be elected by the council. The quorum is to be eight. All members of council must be persons qualified to THE RIVAL BILLS, AND THEIR CLAIMS TO under the of this Act.

SUPPORT.

respect

register

provisions

1 ci. Lord ELCHO proposes that the Council shall be composed of the President of the General Board of Health for the time being, and twelve other persons chosen by the Crown. The President of the Council to be the President of the General Board of Health. Nine of the members of Council are to be persons qualified to register under the provisions of the Act. Two at least are to be persons resident in Ireland, and two at least resident in Scotland. Five are to form a quorum. The Council may appoint committees out of its number to undertake certain duties, and if these relate to Scotland or Ireland,

THERE is so much misapprehension abroad as to the provisions of the two Medical Bills before Parliament, that we will endeavour to represent, in as few words as possible, the main features of each. Legislation, on such a subject, naturally divides itself into provisions for those who are already members of the profession, and for those who will hereafter become members of the medical body politic. We will glance at the retrospective enactments the members of Council for Scotland and Ireland respectively first. 1 a. Mr. HEADLAM proposes that all persons who, at the are to be members of such committees. 2 a. Mr. HEADLAMS Bill provides that in future (i. e., excommencement of his Act, are twenty-four years of age, and are licentiates or fellows of a college of physicians, or graduates cepting present students, for whom special provisions will be in medicine of an English, Irish, or Scotch university, and do made) no one shall be entitled to present himself before any not practise pharmacy, may, upon the payment of ten shil- College of Physicians or Surgeons for the purpose of procuring lings, be registered as physicians. Such diplomas must have letters testimonial as a physician or surgeon, without having . been obtained prior to the passing of the Act. The Archbishop first graduated in Arts, or passed the examinations for the deof Canterbury’s diploma is retained in the schedule of quali- grees in Arts in a British University, or graduated in a Foreign fications admitting existing practitioners to registration as University, or passed some examination deemed equivalent by physicians. Surgeons or apothecaries already qualified may the Council. register as surgeons, with the exception of the Irish apothe- 2 ic. Lord ELCHO proposes that there shall be a general prelicaries, who are to be kept down to their strictly etymological minary board to examine all persons as to their general educafunctions. Registration gives the legal right of recovery for tion, before they present themselves before the professional medicine, advice, attendance, and aid-except in the case of board, which he proposes to constitute in a manner to be dephysicians, whose fees are to remain as before-quiddam laorzo- scribed presently. Graduates in Arts of a British University rarium. Persons in practice prior to 1815, and army, navy, or in an approved Foreign University to be exempt from the and East India Company’s surgeons, whose warrants bear date preliminary examination. The fee for the certificate of apprior to August 1st, 1826, may also register as surgeons. The proval by the preliminary board to be not more than five. provisions for students who have commenced their studies be- pounds. 3 a. Mr. HEADLA.AM’S Bill provides that all persons, after fore the passing of the Act, are to emanate from the Council. 1 à. Lord ELdio’s Bill proposes, that persons possessed of the passing of the Act, who desire to be registered as physidiplomas before the 1st of December, 1857, may be registered cians, shall produce proof of being twenty-fou years of age; of caccording to tlzeir qualification or qualifications. And a sche- having graduated in Arts and Medicine, or in Medicine after dule of qualifications is referred to, by which it appears that having passed the examinations for an Arts’ degree in some Unithose who possess degrees in medicine, or diplomas of a col- versity of the United Kingdom, or in some Foreign University lege of physicians, may register as physicians; that those who approved by the General Council; and of having received letters possess diplomas or degrees in surgery, may register as sur- testimonial from one of the Iloyal Colleges of Physicians, and geons ; and those who have apothecaries’ licences, may register of having been enrolled a member thereof. These provisions as apothecaries; and that such registration shall be a title to to hold, unless certain exceptions are proved. Surgeons are to practise. But this is so badly worded, that the privileges be twenty-one years of age, and are to possess letters testimonial

562

surgeon from one of the Royal Colleges of Surgeons or Lord ELCHO’S provides that the President of the Board of from the Faculty of Glasgow, having first passed examina- Health shall have the appointments vested with him. 5. Both Bills provide that none but registered practitioners tions in Medicine, Surgery, Midwifery, and the Collateral Sciences. The examinations in England are to be conducted can hold any public appointments; that none but registered as follows :--Those in Medicine at the College of Physicians, practitioners can recover, and that any assumption of a medical half the examiners to be duly registered physicians, and title by unregistered persons shall be an offence punishable by half to be persons duly registered as practitioners in medi- fine, or in default of the payment thereof, by imprisonment. cine and surgery, and chosen by the Apothecaries’ Society. 6. A British 1’harmacopeeia is proposed in both Bills. The chairman of the board to be a physician. The surgical 7. Various exemptions from military and municipal duties examination to be conducted at the College of Surgeons; the are provided for in the same manner by each Bill. midwifery examinations to be conducted at the College of Surgeons, by a board composed, one-third of examiners appointed by the College of Physicians, one-third by the College of Surgeons, and one-third by the Apothecaries’ Society. In Scotland there are to be three examinations also: one in medicine, " Audi alteram partem:’ one in surgery, and one in midwifery, and in the sciences collateral to each. In Edinburgh they are to be conducted by LORD ELCHO’S MEDICAL REFORM BILL. the College of Physicians of Scotland, (on the supposition of a In new charter,) and the College of Surgeons of Scotland. MR. SvME presents his compliments to the Editor of THE the of and the Physicians, Faculty of LANCET, and begs to request insertion of the enclosed stateGlasgow, by College Physicians and Surgeons. In like manner, there are to be three ment. examinations in Ireland: the examinations in medicine by the Mr. Syme begs at the same time to notice an error which Royal College of Physicians (as amended by charter) in Ireland, has been copied from THE LANCET of last week, in regard to those in Surgery by the Royal College of Surgeons, and those in Lord Elcho’s Bill allowing " physicians" to practise on the midwifery by the two Colleges jointly. qualification of a degree alone, while that measure proposes to 3 a. Lord ELCHO’s Eill provides that all persons who desire require that every member of the medical profession shall in to practise in any branch of the profession shall (having first the first instance obtain the "licence." passed the preliminary examination) pass a professional examiEdinburgh, May, 1857. nation, conducted by boards of examiners chosen thus :" The objects of Medical Reform are :---1. That the right of In England, by the College of Physicians, the College of practice in one part of her Majesty’s dominions should extend Surgeons, and until the year 1865, the Apothecaries’ Society; to the whole of them, and not be restricted as at present, it’ the Universities of Oxford, Cambridge, and London. being impossible by any amount of education or examination in In Scotland, by the College of Physicians of Edinburgh, the Scotland to obtain the right of practice in England. 2. That the conditions of entering upon medical practice, in regard to College of Surgeons of Edinburgh, the Faculty of Physicians education and examination, should be similar in all the three and Surgeons of Glasgow; by the Universities of Edinburgh kingdoms, access to higher grades of the profession being and Glasgow respectively, and the two Universities of Aber- gained as the reward of individual exertion or public confi- dence. deen conjointly. " In 1856, two Medical Bills were introduced into Parliament In Ireland by the College of Physicians, the College of one restricting the power of Ifcensing for general practice to Surgeons, and the Apothecaries’ Society until 1865; by the the Corporations, the other extending this privilege to the University of Dublin and the Queen’s University respec- Universities. Both Bills were referred to a Select Committee,. tively. composed of members who had expressed interest in the matter. The certificates of these various boards are to entitle to re- They rejected both Bills, and unanimously proposed a third. is this Bill which L01’d Elcho has now introduced, while Mr. gistration as " Licentiates in Medicine and Surgery." The ex- It Headlam has resuscitated one of those condenaned by the Comaminations are to be uniform. Registration, as before specified, mittee. is to confer the right to practise medicine, surgery, pharmacy, " The latter Bill still restricts the power of licensing excluand midwifery, in every part of the United Kingdom. The sively to the Corporations, so that the twelve self-elected exafee to be not more than .625. miners of the London College of Surgeons would continue as New charters may be granted to the Royal College of Phy- heretofore to divide amongst themselves five thousand pounds sicians of London, to the Royal College of Physicians of Ediu- a year at least. It also arranges the members of the medical in two ranks of physicians and surgeons, which is burgh, and to the Royal College of Surgeons of Edindurgh, so profession not less absurd than it would be to determine, by education as to include the Glasgow Faculty. But no provisions of such and examination, whether a theological student should be a charters are to interfere with the provisions of this act. bishop, or a rector, or curate. " It further compels all members of the profession to be conFrom these specifications it would appear that no one pracnected with a College of Physicians or Surgeons, so that what medicine or will be to a tising join college should be an honour would be compelled surgery merely a pretext for taxation. of physicians or surgeons. That everyone practising medicine " The Bill of the Committee (Lord Elcho’s), with a single or surgery, however, will be approved by these colleges, and view to the interest of the public and the profession, proposes also by the universities. That all monopolies will be destroyed. that three examining boards should be selected from the UniIt does not, however, appear that anyone can register as a sU1’geon versities and Corporations of England, Scotland, and Ireland ; who does not belong to a college of surgeons; or as a physician, that the licence of these boards should be given on similar that wherever got, it should convey the right of pracwho does not belong to a college of physicians-alwaysexcepting terms; tice in every part of her Majesty’s dominions; and that all persons already in practice. The university graduates, how- other titles should be left to the choice or success of individual ever, retaining their titular doctorate and the universal licence, disposition or exertion. " This Bill also proposes to elevate the status of the Corporawill be practically legal physicians, although there is no provision for enabling them to register as such. Lord ELCHO’S tions, so as to render their fellowship more desirable. "It further provides for the maintenance of museums and Bill is deficient throughout in definition, and in some parts is other establishments for which the funds of Corporations, under wholly unintelligible without a most laborious comparison of the new system, might proveinadequate."—
Correspondence.

,

&mid ot;

&mid ot;

563