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proposes to raise 2,000,000 dollars for the Commission by meansof a great fair. This fair was opened on the 4th ult.; and if

varieties are to be a measure of its success, this will be greatindeed. Barnum himself might envy the curious collection ofarticles brought together to attract crowds and induce an addi-tional shower of dollars. Let us, after the manner of Speed,enumerate some of the attractions of the Fair. Item The

flag under which Washington was inaugurated first Presidentof the United States. Item Washington’s sword. Item: Thebelt taken from the body of Captain Lawrence when he was-killed on board the Chesapelce in her engagement with theShannon in 1813. Item: The first bowie-knife made by Capt.Bowie, " and with which he killed Dr. Wright at Nashville in1838." Item A Yankee skull taken at Bull-Run and manu-factured by the Confederates into a drinking-cap. Ite1n: Amermaic’t’s hand with ring on a finger. Item: A Japanesemerman. Item: Trays used by Martin Luther. Item: Avase made of a hickory stump severed by the British duringthe Revolution in Long Island. Item: A spread eagle, pre-sented by the wife of the Governor of Indiana, and made ofthe hair of President Lincoln, the Vice-President, the Secre-taries of State, and some seventy of the principal Senators,all contributing portions of their locks-" black, brown, grey,and red, curly, wiry, straight, and otherwise." Item: The" Knickerbocker kitchen," intended to show the New Yorkerhow his great-grettt-gmndparents lived. Everything is in thestyle of the 17th century, and most of the furniture was actuallybrought from Holland at that time. The visitor, on entering,slips back 200 years, and the 17th century, in the person of apretty Dutch girl, stands before him. The tables are super-intended by the representatives of the oldest Dutch families inthe State-the "blue blood" of the Knickerbockers in the cos-tume of their great-grand mothers ; and the negroes who serveare in appropriate costume. Here may be had the dishes that

delighted the capacious stomach of the old Dutch burgher-the unctuous olykoek, the crisp kroller, the rich mince pie, thesavory head-cheese, the well-smoked ham, and waffles, wafers,pickles, and rollitjes. Amongst the most ingenious modes ofreceiving the dollars of the public is the exhibition of two

splendid swords, to be presented respectively to the militaryand the naval officer who receive most votes-no one to votewithout paying his dollar for the privilege. At the end of thesecond day, 257 votes had been cast for the army sword-111of them for General Grant, and 95 for General M’Clellan; forthe naval sword Admiral Farragut was ahead, but CommodoreS. C. Rowan was very nearly up to him.

GENERAL COUNCIL OF

MEDICAL EDUCATION & REGISTRATION.Session 1864.

THE Medical Council closed its session on Saturday. Wewish we could add that it had completed the business which ittook in hand : this, we regret to say, is very far from being thecase. If, in the course of sittings which only last four hours,every one of the twenty-four members insists upon stating hisviews at length, the result is likely to be pretty much whathas now occurred : long and able debates, a considerable dis-play of oratory, and ample discussion of general principles,with a very small amount of business done. Looking back uponthe work of the session we see little accomplished, spite of allthe ability and power which were brought to bear upon thequestions taken up. The single practical bit of work is the

appointment of a committee to superintend the re-editing ofthe Pharmacopoeia, under the direction of one competent per-son. We are well satisfied that the opinion we have expressedthroughout on this subject is that which the Council has now

ultimately adopted; and, leaving the Pharmacopoeia Committeeto enjoy any such laudations as they can extract from theirfriends for the part which they have taken in the disgracefulpillage of the profession to the tune of X5000 for a book whichany firm of publishers would have had better edited for a tenthof that sum, we may express our satisfaction that the practicalrevision of the book will now be placed in the hands of one fitperson, and that thus an improved result may be anticipated at acomparatively small cost. At any rate we hope to hear nomore of the perennial and costly tea, meetings at which thepresent failure was concocted; and, with a due sense of theresponsibility attaching to his work, it is not probable that thenew editor will show the foolish desire for secrecy, or the reck-less disregard of modern pharmaceutical research, which ourcommentators and those of the Pharmaceutical Society haveshown to characterize the present edition.Beyond this the Council has not finished any of their work

in hand. The discussion on Medical Education has been con-ducted with great ability, but has been protracted to such anextent that any decision is delayed. Mr. Syme has notshown himself equal to the task which he undertook; heabdicated the command of the discussion, and although com-mendably brief, what he said was by no means accurate orsuggestive. He destroyed without reconstructing. On the

whole, the discussion on Medical Education is not creditableto the administrative power of the Council. Reporting will,we venture to say, bring about one good result very quickly.The profession will already mark more than one memberas unduly lcquacious, and others as mere advocates of in-dividual interests. Some unusual latitude must of necessityhave been permitted to the debates on this wide subject ofeducation, nor need we grudge an ample expenditure of timeand money upon the deliberations which are to end in its regu.ation. But the Medical Council has sat for a fortnight, at acost of some £2000, and the conclusion has been lame, if notimpotent.Unable to find room for the debates which have taken place

throughout the week, we here present those of Monday,Friday, and Saturday, in order to give a connected view of thediscussion on Education, which occupied these three days. Wereserve till next week the intervening debates of Tuesday,Wednesday, and Thursday, on the amendment of the MedicalAct and other subjects.

ROYAL COLLEGE OF PHYSICIANS.

MONDAY, MAY 2ND, 1864.

DR. BURROWS IN THE CHAIR.

THE BRITISH PHARMACOPOEIA.

THE first business that came before the Council to-day wasthe appointment of the Pharmacopoeia Committee.

Dr. ALEX. WOOD wished to know if any opportunity wouldbe given for discussing the report of the Pharmacopoeia. Com-mittee which was adopted at the rising of the Council onSaturday. Not that he was one of those who condemned the

, Pharmacopoeia., but a great deal of undeserved comment hadbeen passed upon it, and he thought it absolutely essential thatthere should be some discussion upon the Pharmacopoeia itselfThe PRESIDENT suggested that the proper time would be

when the payments on account of the Pharmacopoeia came upfor consideration.

Dr. QuAIN moved that the committee should consist of fourmembers and the President. The committee was intended forsupervision, not for work ; therefore the more limited and themore restricted it was the better. It was proposed that itshould consist of one member for Scotland, one for Ireland, andtwo for England. The duty of the committee would be to drawup a plan as to the extent to which the present Pharmacopoeia.should receive modifications; he hoped they would not be verygreat or very material. It would be their endeavour to findone or two editors to whom the task of revising the work wouldbe assigned, under the supervision of the committee; and be-fore it was printed it would be finally submitted to the Council

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for further suggestion or alteration, so that the Pharmacopoeia They served to introduce to the student a subject that wasshould go forth as a national work, with the impress of the new to him, and to give him a good start in it-nothing more;highest authority upon it. He nominated Dr. Christison for and the more advanced students were best employed in teach-Scotland, Dr. Apjohn for Ireland, and Dr. Sharpey and himself ing themselves. It would require strong proof of the superiorityfor England, it having been suggested that, as he had taken an of the professorial system to justify any scheme that would callactive part in the matter, he should be one of the committee, upon the student to devote the greater part of his four yearsMr. SvME seconded the motion. of study to that kind of teaching. With the exception ofDr. SHARPEY said he had long ceased to take much practical clinical lectures, the professorial system, although quite neces-

interest in the Pharmacopoeia, but if the Council thought he sary in medical education, was in many branches almost super-could really be of service he should be happy to give his time seded by the tutorial system. Yet, for all that, he shouldand trouble. deprecate any interference with the mode of teaching at pre-

Dr. CHRISTISON reminded the Council that last year he un- sent in force in the medical schools. The teachers were mendertook charge of the changes and improvements that are of very great ability, and it would be better to leave them totaking place in the processes of pharmacy, and he had thought their own free action. He thought the Council would be betterit his duty to consider whether he could, consistently with this employed in fixing a minimum standard of instruction than induty and with other avocations which he could not abandon, talking about a maximum. The standard would have to bebecome a member of this committee. Dr. Quain had kindly determined in some way by examinations. The disadvantagesundertaken to satisfy all his scruples on this head ; and if, as of examinations were, that they interfered with the betterhe understood, the duty of the committee was to be limited to kind of study that a man got from observation and reflection;considering the defects which exist in the present Pharma- but the advantages of the system preponderated enormously.copceia, with a view to a reprint rather than to a new edition, Without examinations a man’s knowledge would be loose andwith certain supplements of importance, then he should with inexact; and it was a great advantage to a man to have agreat pleasure take his part in the work. strong inducement for getting his knowledge precise and exact,

Dr. CORRIGAN called attention to two things which do not even though the preparing for examination went by the op-exist in the present Pharmacopceia. The first is a posological probrious name of "grinding." He thought Mr. Syme wenttable’for the use of the chemist ; the other is a table showing too far in condemning the present system of examinations; northe preparations of any particular medicine. Take camphor could he agree with that gentleman in his objections to clinicalfor instance. If he wanted to know where or what was the examinations. In every hospital there were many patientsform under which the preparations of it are now given, after a who might be examined without detriment to themselves ;great deal of hunting in the index, he found the preparation there would be no necessity to resort to patients who would bewas under" aqua oamphorse." So again with iodine, he found in likely to suffer. With a comparatively large number of can"’ithe index only the word "iodine." What he wished was all the didates, the system had been employed at Cambridge for thepreparations of iodine indicated so that he could at once lay his last twenty-two years to the entire satisfaction of the examinefinger on what he wanted. In the same way, if he turned to ners. Class examinations had been proposed as a substitute"plumbum," he had to turn to two or three preparations before for the present system of examination, to be used as tests ofhe found the one he wanted. efficiency. In themselves, class examinations were of greatDr. ANDREW WOOD also spoke in favour of inserting a poso- value in making a man attend to his studies, but as tests of

logical table, and in support of what Dr. Corrigan had said proficiency he believed they would turn out to be fallacious.with regard to the index. Another thing was, they had not Students could in twenty-four hours " cram" for the class ex-sufficiently marked in the Pharmacop03ia the changes that had aminations ; and he could not find a better example than that.been introduced. Were these points attended to, many of the of the student mentioned in Mr. Syme’s pamphlet-pluckedobjections to the Pharmacopoeia would cease. in botany one day by two professors, and passed by another

Dr. CHRISTISON said it might be considered as settled that the very next day.the two points mentioned by Dr. Corrigan and the additional Mr. SYME said that instance was used for an illustration of apoint spoken to by Dr. Wood would be attended to. different kind, and if Dr. Paget would read the book he would

Dr. ALEX. WOOD said after the condemnation passed upon see the meaning of it. The student was first examined by twothe work from very high quarters, it would be reassuring to the persons who were not professors of botany, but when he appliedpublic to hear from Dr. Christison that certain objections to to the professor of botany he passed. He did not cram in thethe Pharmacopoeia would be remedied in a future edition. At interval.the same time there had been an excess of criticism on the Dr. PAGET, continuing, said the suggestion that the exami-Pharmacopoeia. Many practitioners seemed to have expected nation should take place at the end of a course of lectures wasfrom the Council a Dispensatory, and the sooner any intention less objectionable than the plan proposed by Dr. Christison,of that kind was disavowed the better. He thought the Phar- that there should be three or four examinations in the coursemacopceia a most admirable book, and he was assured by the of each session, which would have the effect of splitting up thefirst chemists and druggists in Edinburgh that, with one or two subject into fragments. The certificate the man would getexceptions, the formulae for the preparations are unexcep- would simply prove that he had passed examinations at inter-tionable. vals in certain fractions of different subjects-a very differentIn reply to Dr. Apjohn, the PRESIDENT said he understood thing from proving that he had become possessed of such a

the committee would report to the Council, knowledge of principles and facts as to be able to apply themDr. QUAIN said that would be quite impossible. The fact in practice. Class-examinations would be fallacious in this

that there were three editions of the Pharmacopceia before the respect, and they ought to be most jealously watched. In the

profession called for an authorized revised copy; therefore, so general terms of Dr. Thomson’s amendment he could agree, butfar as this committee was concerned, he hoped there would be no with parts of it he could not agree so far as to vote for it as ainquiry about the past, as the labours of the committee had whole. There seemed to be almost a positive contradictionreference to the future. When the payments on account of between paragraphs two and four ; and with reference to thethe past Pharmacopoeia came up, then would be the time to recommendation, that the first two examinations, embracingraise any discussion. preparatory branches of study, should not be undergone beforeThe motion was put and carried unanimously, the second sessional year, he thought it would be unwise for

the Council to lay down any regulations that would interfereMEDICAL EDUCATION. with an earlier examination in those subjects. Botany, and

The Council then resolved itself into a Committee on Educa- perhaps chemistry, might well be disposed of sooner than thetion, and resumed the adjourned debate on this subject. beginning of the second year.

Dr. PAGET, alluding to the statements of Dr. Parkes, observed Dr. ACLAND said he had differed at the outset as to theirthat the gentlemen rejected by the Army Medical Board were mode of procedure, and he had endeavoured to avert it as muchprobably now in practice, learning experience at the cost of as possible. He saw no hope of bringing Mr. Syme’s resolutionthe paupers of some union. It was not a pleasant thought for to a practical issue, and all that had passed, with the excep-the Council; for though the first responsibility rested with the tion of the statements of Dr. Parkes, was very well known tolicensing bodies, yet some of the responsibility must be shared all of them. They had now reached the second week, and upby the Medical Council; and it pointed out to them plainly to the present time they had not framed a single resolution ;the direction of their duties. Happily he had had no ex- and if they were to proceed to discuss the resolutions of Dr.perience of the effect of excessive lecturing, such as that Thomson, in detail, certainly as much time would be occupiedwhich Dr. Andrew Wood had mentioned as having fallen to upon them as they had already spent. He should vote againsthis lot in his student days. He had not so high an opinion of the amendment, and for the reason he had indicated he shouldsystematic courses of lectures as some gentlemen had expressed. vote against the original motion. He saw but one way out of

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their difficulties, and that was by referring the several subjects tures had been multiplied, and the time extended from twounder discussion to committees, to report not at the present years to four years. During the last three or four years, how-meeting but as in the first case pecified. ever, the number of lectures in England had diminished, chiefly

Dr. CORRIGAN appealed to the President whether it was through the influence of the Apothecaries’ Society and of thepermissible to Dr. Acland to speak to a motion of which he College of Surgeons; and he would take that opportunity ofhad given notice, instead of discussing the motion and amend- stating his belief that, in the matter of medical education, thement before them. Apothecaries’ Society deserved the highest praise. He thoughtThe PRESIDENT thought great latitude had been allowed pupilage to a surgeon in considerable practice an excellent com-

hitherto, and that Dr. Acland was quite in order. mencement for a student; and he would suggest that it be re-Dr. ACLAND said he placed himself in the hands of the Pre- commended as part of the curriculum. He could not join in

sident. The amendment of Dr. Thomson threw upon them the the outcry that lectures are too numerous. In the school towhole question of medical study, and he would make a few which he is attached, the number is on the average less thanobservations upon the subject as a whole. With regard to the two a day; and he thought he could answer for the professionalsubjects to be required as a minimum from students before schools of England that the lectures are not in excess. Thecommencing their professional study, he felt it to be so difficult pupil ought to be provided with a sufficient amount of pre-for the Council at the present moment to express with safety liminary education before commencing his medical studies; butany opinion upon this point, that, instead of giving his own with regard to the extent and character of that preliminaryopinions, he would refer to the evidence of Mr. Bradley in the education, he should deprecate along with Dr. Acland any at-report of the Public School Commission, which would show tempt to stir the question at present beyond what they hadhow dangerous it would be to lay down any scheme of profes- already settled. Arithmetic, the ancient and modern lan-sional studies without due deliberation. In dealing with the guages, and natural philosophy, would seem to be a very excellentquestion of preliminary education, it would be necessary to fix preparation; and, in his opinion, it would be desirable if theupon what studies the students should be examined in, and to rudiments of botany and chemistry could be learned as well;determine whether they would relegate to the early period of nor ought moral training to be lost sight of. With regard tostudy such subjects as physics or botany or chemistry, or whe- the course of medical study, the Council should put forth whatther they would allow them to be passed at a medical school. they considered the minimum standard of professional eduea-He would also recommend the Council to read the evidence of tion, to be varied from time to time according to circumstances.Dr. Hooker and other persons upon this subject. He would They should define the age at which medical education shouldadd that any step which would deprive our medical students begin, the subjects of education, the number of courses of lec-of the chance of being educated at Eton or Rugby, or any of tures, the length of the winter and summer sessions, and thethe public schools, would be one of the most injurious things amount of hospital practice which students ought to attend.that could happen to the medical profession. If they were to It would not be a bad plan to appoint a committee to considerdecide upon the subjects for the preliminary education, they the matter, and for each member of the Council to send in awould then have to consider what was meant by the commence. curriculum of his own, so that the committee would be in pos-ment of studies at medical schools. At the last meeting of the session of the views of the whole Council, and thus be enabledCouncil, his motion ca.lling upon them to define what was a to draw up a scheme which would probably suit all. In Eng.medical school provoked laughter. But great part of their dis- land he did not think it would be advisable to change the ses-cussions had arisen from the diversity of persons who, with all sions. Class examinations he considered most important, butmanner of objects and expectations, were preparing themselves not to supersede board examinations, and they ought to befor what was called the medical profession; and also from the compulsory. The board examinations should be made as prac-manner in which, in different parts of the country, they were tical as possible, carried on by printed questions, by viva vocecompelled by circumstances to pursue them : and until they examinations, and by practical examinations in the dissecting-settled with more accuracy what they meant by these terms, room, the laboratory, and the hospital. He did not agree withthe question of medical education could never be decided. A Mr. Syme that bedside examinations would be injurious to themedical school in London was a different thing from a medical patients, unless they were in such a state of disease that itschool in Edinburgh. Edinburgh considered itself a medical would be obviously improper to meddle with them. Examina-school, but it was really a university, with all its appliances. tions of this kind are the best that could be followed; and inIn London, a certain number of teachers collected round an Durham and Newcastle the system is carried out with greathospital, and then it might be to their interest, their profit, or efficiency. He thought the visitation examination exceedinglyimprovement to take pupils; and in this way our great hos- necessary ; the only difficulty was as to the mode in which itpitals in London had become a sort of scientific universities, should be carried out-whether it should be delegated to theand they had been compelled to undertake the teaching, directly Branch Councils, or whether they should appoint a single personand indirectly, of branches of study which had nothing to do in each division of the kingdom to visit the examinations. Thewith their primary business-that of teaching physic. Not- purpose might be answered by the plan of requiring from thewithstanding that great and unjust fault had been found with examining bodies copies of the printed questions and answers,these schools, and with many of their courses of lectures, one and a written account of the other parts of the examination.consequence of this real English energy had been that we had He cordially approved of Mr. Syme’s motion; but he thoughtbad put before the students that which it was proper they the subject could be more speedily and effectively dealt with byshould learn, or which it is proper the scientific physicians and a small committee.surgeons attached to the school should learn and be willing to Dr. FLEMING said he had listened to the debate with pleasure;teach. Therefore, instead of ridiculing these teachers, they and although it had been long, it would do good out of doors,ought to be an object of pride, and nothing should be further for it would show the medical profession that the attention offrom the Council than to take away these sources of study from the Council had been directed to this important subject. Onethe student. From this there followed a second point: the point in the debate had struck him, and it had long been im-Council would have to decide the actual subjects which examin- pressed on his mind, that medical students, as a rule, pursueing boards are bound to require before they give a certificate of their studies too much as a matter of routine. The objectcompetency, or else they must relegate the duty to the educa- should be to draw out the reasoning powers; and he knew oftional and licensing bodies. With regard to the examinations, no method so efficient as a well-arranged course of class ex-the Council had the responsibility upon their shoulders; wfie- aminations, written and vivâ voce. Without examinations ofther they appointed the examiners, or whether they inspected this kind students went on cramming their heads with factsthe examinations, the Council were responsible for them at the without giving themselves the trouble to discover the groundspresent moment. Having expressed his opinion with regard to on which those facts were founded. He agreed with Dr.all these points, he thought they could not do better than Sharpey that the class examinations might be made availableremit the whole question to a small committee of the most to some extent for the final examination. With respect to thecompetent persons to bring up a report at the next meeting of double examination, the eloquent address of Dr. Parkes mustthe Council. ("No, no.") He contended that a subject of this convince them of the necessity of a special examination for thegrave and serious character could not be settled by four-and- army at least. It might be that inferior candidates had gonetwenty gentlemen in public debate, and he should look upon up; but whether it were so or not, the fact that all these gentle-any such attempt with alarm, both for the welfare of the men had previously passed the examination of two boardsCouncil and the welfare of the profession. showed that the system at present in force did not answer the

Dr. EMBLETON said he had had twenty five years’ experience end in view. The question must at no distant day engage theas a public teacher of anatomy and physiology, and during that serious attention of the Council; and he believed it would beperiod he had seen many changes in the medical curriculum, found preferable to ’have one comprehensive examination, in-and in the 1ength of time given to study. The courses of lee- stead of having two examinations conducted by different boards,

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with a divided responsibility. In reference to the proposal to Wood and others-that the preliminary education should, inhold the examinations in public, he thought it would be attended addition to the ordinary branches of a general education, in-with disadvantage. As it was, students approached the ex- clude botany, chemistry, and physics-would have the effectaminers with a feeling of dread; and if in addition to this they of practically excluding all the youth of England educated atfound themselves surrounded by an audience of professional the great public schools, who would be found deficient in justmen, some of them would be so overcome that they would be those particular subjects, if in no others. Such a scheme mightunable to concentrate their minds upon the subjects before them. be practicable in Scotland, but not in England ; therefore thatIn Ireland the system might answer. The whole question of was another reason why it would be unwise to draw up anyeducation and examination called for the adoption of some sys- definite scheme at present. In reference to the second point-tem, which he hoped the Council would be able to devise ; and, the period to be given to professional study-it might be de-in the meantime, he thought they ought not to separate with- sirable, if the pecuniary means of parents admitted of it, toout sending down to the licensing boards some general recom- extend the period from four to five years. Yet, on the othermendations upon the subject. hand, from suggestions which had been thrown out, there ap-Mr. HARGRAVE stated that the system of public examination peared to be an inducement to curtail the period of four years.

had been found to answer in Ireland. Publicity he thought Various proposals had been made with respect to the length andessential to the protection of the candidate. division of the sessions at the medical schoo!s; but he thought

Dr. LEET felt that the Council were indebted to Mr. Syme all would agree that study, in order to be profitable, must befor having placed the discussion on the broadest basis. He spread over a given period of time, inasmuch as it is impossiblethought a professional education ought to be preceded by a to force into the human mind knowledge more rapidly than itpreliminary education, to include English, Latin, mathematics, can be received. It is absurd to suppose that students canand the natural sciences ; the course of study to extend over a master all the various subjects that are required of them unlessperiod of five years; and that the shortest period for the pro- their attendance is spread over a considerable period of time-fessional education should be four years -the first two to be four years he should say at the least. He had observed through-devoted to the fundamental, and the last two to the more out the discussion, that the delicate question as to what shouldpractical branches : hospital attendance not to commence till be regarded as the commencement of a professional education,the second year. In respect to lectures, they could not dis- had been avoided. At former meetings of the Council theypense with any of the subjects now included in the curricula had laid down the recommendation, that the professional edu-of different bodies; but the number of lectures might be abridged, cation should commence at a medical school. But what is aand some even omitted, with advantage, if class examinations medical school? Did they mean by a medical school such anwere to be introduced. He did not think class examinations institution as the University of Edinburgh, the University ofshould supersede the final examination, which should be as Glasgow, or King’s College, or University College, or St. Bar-practical as possible, in order to test tha fitness of the candi- tholomew’s Hospital, where there are courses of lectures deli-date for the efficient exercise of his profession. Bedside exami- vered in conjunction with practical instruction in medicine andnations being in many cases impracticable, he would suggest surgery ? Or did they mean an institution where there is clinicalrecourse to cjinical lectures on medicine and surgery; c;3rtifi- instruction given-where there are ample fields for practicalcates of proficiency to be granted, both in the diagnosis of dis- observation and improvement, and where the medical officersease and the taking down reports of cases in hospitals. If these attached to the institution are men of the highest eminence incertificates were handed to the examiners at the examination, their locality ? Although he should prefer that a studentthey would overcome a great existing difficulty in the way of should commence his professional career at some institutiongranting licences to practise. where he could hear the elementary courses of lectures before

Dr. CHRISTISON wished to offer a word of explanation in he went to his hospital practice, yet he thought the personalregard to examinations for the public service. If it had been details which they had heard from Dr. Christison, Mr. Syme,supposed that he meant to imply that there ought to be no and Mr. Arnott, would be of immense value to medical studentssuch examinations, it was necessary for him to explain that throughout the country, telling them that it is not by followingwhat he wished to express was that the examinations, as now servilely a curriculum laid down for them that they will arriveconducted, are a formidable reason why so few applications are at distinction, but by stepping out of the prescribed course, andmade for entrance into the public services. He distinctly stated providing work for themselves. His own experience of thirtythat the public services are entitled to make as severe an exa- years, as one of the principal medical teachers in St. Bartho-mination as they please upon every practical subject connected lomew’s Hospital, bore out the truth of this observation, for hewith medicine and surgery; and what the Council had heard found that many of the distinguished men in the professionfrom Dr. Parkes showed that an examination in practical know- came up from country hospitals to St. Bartholomew’s withoutledge is required. having had any elementary instruction in the sciences. There.The PRESIDENT said that, after the extended and discursive fore, in the face of such facts, he thought it would be wrong to

discussion which had been held upon the subject of medical lay down any absolutely stringent rule as to how medicaleducation, and which he did not think had tended to advance students should commence their education. Much had beenthe business in hand in a practical point of view, it would be said for and against lectures. For his part he thought thereunbecoming on his part if he did not say a few words. After were certain subjects which can only be taught in lectures, suchthe important information which had been communicated to as anatomy, physiology, and chemistry. There were otherthe Council by various professors of eminence in different parts branches where lectures are not so essential, such as the prac-of the kingdom, he had come to the conclusion that at the tice of physic and surgery, where, at any rate, one course ofpresent moment the Council is not in a position to draw up lectures would be amply sufficient. He did not know the prac-anything like a scheme of education, either preliminary or pro- tice in other institutions, but at St. Bartholomew’s the studentfessional. Though members of branch councils might think is required to attend two lectures daily. Now, if a student hasthemselves in a position to draw up a scheme suitable to their not a mind of sufficient capacity to allow him to listen twoown division of the kingdom, he was sure it would be inappli- hours in one day to lectures, he is not fit to enter the professioncable to other parts of the kingdom. As a gentleman near him at all, unless he be a man of original genius and immensehad facetiously remarked, it was impossible to make a shoe to mental powers, who can work out his own course; but for thefit every foot; and in his (the President’s) opinion any attempt generality of students, he did not think two hours’ attendanceto draw up a scheme of education applicable to the whole of at lectures too great a demand upon them. This would allowthe kingdom would be found equally impracticable. They ample time for practical study either in the dissecting-room ormust go back to what he ventured to suggest in his opening in the wards, and for private reading afterwards. The minds ofaddress: endeavour to establish and enforce certain funda- students are differently constituted, and some can receivemental principles with respect to education and examinations, knowledge best through lectures, while others prefer to acquireand leave the details-at any rate for the present-to the dif- it in their own way; but to the majority of those who come upferent educational bodies and licensing boards. The four car- to the medical schools of the metropolis, having had a very littledinal points involved in the question before them were prelimi- mental training, lectures, he thought, would be found of greatnary education, professional education, the age at which a advantage. Upon the third point-the question of age-helicence should be granted, and the mode in which the individual should say no yourg man should be allowed to come up for ex-should be tested. With respect to preliminary education, they amination for his licence until he had attained twenty-one yearsmust be content at present to accept the certificates of the of age. Dr. Burrows then took up the subject of examinations.different educational bodies ; beyond this he did not think they He considered class examinations and sessional examinations ofwere in a position to go, although if he were called upon to immense value, as urging the student forward in the acqui-express an opinion, he should give his assent to the subjects sition of knowledge, and enabling him to ascertain how farproposed by Dr. Corrigan. The proposition made by Dr. Andrew he has made himself acquainted with the particular subjects

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which he has to study. Twenty years ago he adopted the bougie for stricture ? Or is he to pass the practical examinationsystem of weekly examination in his classes at St. Bartho- in show and do nothing ?-for a thing of this kind must be showlomew’s, but he found, like Dr. Christison, because he could unless it be attended with injury to the patient. With twonot enforce the attendance of the students, that the number, or three students it might be done, but with a hundred studentswhich at the beginning of the session was about 120, dwindled to pass annually it would be impracticable ; and he should pro-down to ten or a dozen at the last, and these were just the test against patients being made use of for such a purpose. He

young men who were most diligent and the best informed, and also denied that students crammed for class examinations. Inwho least required assistance. The consequence was, he was his own class, the plan he pursued (which he explained) ren-obliged to give up the plan. The same result attended ses- dered it impossible for students to cram ; and it was surprisingsional examinations. Yet he was convinced that class exami- how many of them showed that they thoroughly understoodnations and sessional examinations would be found of immense not only the principles of the cases brought before them, butadvantage, and he was glad the subject had been brought for- the principal features connected with them. He did not meanward. The final examination should be made, as far as pos- that the class examinations should be substituted for the finalsible, practical, in addition to examining upon the general examination; but they are a most important means of deter-subjects upon which the student is supposed to be informed. mining the progress of the student and fixing his attention onHe need say very little more upon the subject, because it had the subject in hand. With respect to the Military Medicalbeen ably discussed on all sides. But before he sat down, he Service, there was formerly a chair of Military Surgery inmust advert to the statements made by Dr. Parkes, to which Edinburgh. It always appeared to him an absurdity, becausethey had all listened with a certain degree of pain and a certain he did not see any difference between civil and military sur-degree of amusement. Dr. Parkes had thoroughly vindicated gery; but he saw that a military medical officer required tothe Army Medical Board as to the absolute necessity of an en- know many things that a civil surgeon did not, and that thetrance examination into the public service. When they looked proper thing was that when young men are admitted into theat the responsibility of the army surgeon, with the lives of 800 army they should study for a period in some large military hos-or 1000 men committed to his care, without the possibility of pital. If he had done any good to the University of Edin-calling in a friend or colleague to assist him, it was of the utmost burgh, it was in getting that chair abolished; and when heimportance that he should be well versed in the practical subjects heard of the establishment of the Netley Hospital, he thoughtof his profession. But while admitting the necessity for such his object was about to be accomplished. But the scheme ofan examination, he must, on the part of medical students, and competitive examination which had since come upon them, inon the part of those who had passed the various licensing his view, destroyed all the good that had been achieved. Toboards, vindicate them from the opprobrium of supposing that the cases of ignorance mentioned by Dr. Parkes, he could addthe individuals mentioned by Dr. Parkes were specimens of the another, which had been told to him by an examiner of theaverage attainments of candidates. Army Medical Board. A candidate was asked to mention some

Dr. PARKES said he quite agreed with the President in that of the ruminants, and he at once named the grasshopper. (Arespect, and he was exceedingly glad that attention had been laugh.) Well, but what did all this amount to? Dr. Parkescalled to the subject. He had simply stated the fact that cer- stated that, with the exception of Oxford and Cambridge, nottain men did present themselves, and that they had not been a single licensing body was free from censure. If, then, theallowed to pass. licensing bodies had failed in their duty, what had the :MedicalThe PRESIDENT said his only object was to let the public Council been about ? This is the sixth session in which they

know that these glaring instances are not fair examples of had met, and had they ever once expressed to the medical pro-young men entering the profession. The teachers of the great fession what they thought necessary for the purpose ? Theypublic schools are perfectly convinced that the young men who had never done so. Had they availed themselves of the privi.go up to the Army Medical Board are not average specimens lege given by the Act personally to inquire into the examina-of those who have passed their examinations. The fact is that tions ? They had done actually nothing, except to deceive thethe public service is at a discount, owing to circumstances con- public by publishing year after year a list of persons supposednected with it at the present time, which disincline young men to be qualified, but many of whom are really not qualified toof intelligence and attaintments to present themselves as can- practise their profession. The list contained the names of somedidates. With reference to the question of public examina- who had been educated as surgeons, and some who had beention, the President said it was of the utmost importance that educated as apothecaries; so that a person suffering from athe examinations of the various licensing bodies should be con- broken arm might call in an apothecary, and another sufferingducted efficiently, and with fairness; and if any means could from inflammation of the lungs might send for a surgeon. Inbe devised for making the examinations public, without the in- this awful state of things he would advise the Council not tourious consequences to the student which had been so strongly trust too much to the patience of the public. He was only sur-put, he should be glad of it. But, after all, it is only the oral prised that their patience had lasted so long. To return to theexaminations in which publicity could be had; and there were question of competitive examinations for the army, he contendedgreat objections to that. Beyond laying down some rules as to that they were absolutely useless in distinguishing the goodthe final examinations, the Council was not, he thought, in a from the bad, because they take no cognizance of the qualitiesposition to act. The subject was beset with difficulty. And specially required in a military medical officer-his physicalwith respect to the resolution and amendment before them, he qualities, strength, and power of undergoing fatigue.thought Mr. Syme would feel he had attained his object even Dr. PARKES observed that every man before he comes in forif his motion was not carried, and that the business of the examination is examined by a board of medical officers with aCouncil would not be materially facilitated by passing the view to ascertain his physical qualifications.amendment, notwithstanding it showed the great care and Mr. SYME added: Nor were the candidates’ moral qualitiesthought which Dr. Thomson bestowed upon everything he taken into account; and when they came to his intellectualproduced. faculties, they took no notice of his power of comparison and

Mr. SYME said it always appeared to him that a medical judgment, but satisfied themselves with the lowest of all theschool should be considered as a place where there is a large faculties, the memory. The consequence was that they dis-general hospital with ample opportunity for pursuing the study missed many a good man. Mr. Syme mentioned instances;of practical anatomy. In reply to Dr. Paget’s arguments, Mr. and in reply to the inquiry of Dr. Parkes as to what otherSyme said the opinion he had expressed upon the subject of mode could be employed to make a proper selection of candi-examinations is one which he had long entertained. He had dates, he would say, let the licensing boards in the first placebeen examiner in a large school for upwards of thirty years, do their duty more efficiently, and let every young man whoand he had become more and more convinced that the conclu- aspired to employment in the army get from any accreditedsions derived from the present system of examinations are teacher a certificate testifying that he was well fitted in everyaltogether deceptive. Again, his objection to practical ex- respect for entering the medical department of the army. Toaminations related, not to practical examinations upon chemical come back to the general question, he had heard with greatsubstances or to the organs of dead bodies, but to practical pleasure the testimony that had been borne in favour of lec-examinations upon living bodies in surgery. He objected on tures; but a good thing might be carried too far, and while hetwo grounds : in the first place, it is not consistent with the looked upon good lectures as the very best means of instruc-principle on which patients are admitted into hospital that tion, he regarded a redundancy of lectures as a most fatal cir-they should be used for purposes of instruction ; in the next cumstance in the course of medical education. It preventedplace, it is impracticable, for you cannot expect a young man the attention which is due to practical study, particularly tocoming from a school to go at once into surgical practice. Is hospital study and practical anatomy, which had assumed ahe to feel at once the crepitus of a broken bone or a dislocated much greater importance in recent times than formerly. Thejoint ? Is he to sound the bladder for stone ? Is he to pass a multiplicity of lectures also had the effect of preventing the

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student exercising his own mind and relying upon his own different boards to grant qualifications. The Poor-law Board did- exertions. With regard to certificates of attendance, he had not understand the position of the Medical Council. They hadalways found that students would attend the lectures if they been asked if they had a right to grant the degree of M.D. Allknew they would receive benefit from doing so; but if they that they contended for was that they were entitled two grantfound a man talking nonsense, why should they not be per- a diploma which conferred in Scotland the power to practisemitted to read a book or take a walk in the country. Mr. medicine and surgery. The Council had not been asked forSyme then expressed himself in favour of a system of registra- their opinion ; and he conceived the question lay between thetion which he had the honour of originating ; and after some Faculty of Physicians and Surgeons of Glasgow and the Poor-remarks upon the system of apprenticeship, he said the motion law Board, or for a court of law to determine.he had put on the table was written on the spur of the moment Mr. SYME said that at an early period of their meetings theto please Dr. Corrigan. Poor-law Board applied for information as to the import of the

Dr. CORRIGAN.--On the contrary, it has caused me displea- titles conferred, and the Medical Council had declined to ex-sure from the moment you placed it on the table, press any opinion on a matter which was more suitable for aMr. SYME said the motion by no means expressed what he court of law. The Faculty of Physicians and Surgeons of

should have deliberately proposed ; but it had answered the Glasgow had always required a complete education and insti-purpose of bringing out the opinions of almost every one pre- tuted a complete examination.sent. He would therefore withdraw it, provided Dr. Thomson Dr. ALEXANDER WOOD said the question was of muchwould withdraw his amendment, and then let a small com- more importance than would at first sight appear. It wasmittee be appointed to make if they could some intelligible a question as to the construction of the 31st clause of

report to the Council. the Medical Act - " That every person registered underDr. THOMSON said his amendment had also answered the this Act shall be entitled according to his qualification or

intention he had in view, and it was only due to Dr. Sharpey qualifications to practise medicine or surgery, or medicineto acknowledge his assistance in bringing it into shape. He and surgery, as the case may be." The law had drawn a dis-very much approved of the proposal which Dr. Acland had tinction, and the Poor-law Board had determined to employbrought forward, that a more extended report upon the whole no man who-had not a qualification to practise both medicinesubject should be laid before the Council; and he was quite and surgery; and with every respect for the Faculty of Glas-willing to withdraw his amendment on the distinct understand- gow, the law did not, in his opinion, give them the power toing that a committee should be appointed to prepare a report, practise medicine, but only the power to practise surgery.so that something might go forth from the meeting which Their charter did not contain a word about physic or medicine;should serve in some measure as a guide to the profession for and therefore, while the law remained in its present state, hethe present. conceived the Medical Council had no power to give to theDr. I’AREES wished it to be distinctly understood that the Faculty of Glasgow a power which their own charter did not

remarks he had made did not apply to the gentlemen who had bestow. With regard to Dr. Fleming’s motion, he thought itbeen admitted into the army medical service, but to those only was scarcely civil to a public Board, asking for information, towho had been rejected. say they were satisfied with the answers already given. HeThe amendment and the original motion were then put, and thought they ought to refer the Poor-law Board to the charter

negatived. of the Glasgow Faculty, and say it is a legal question which itAfter a statement from the PRESIDENT explanatory of the is not competent for the Council to answer.

position in which the Council now stood touching" the recom- Mr. ARNOTT said the Glasgow Faculty stood in the samemendations of the Council relating to general and professional position as the College of Surgeons in Dublin and Edinburgh,education and examination," having a right to grant a qualification in surgery only. He

Dr. STORRAR moved, " That the age of twenty-one be the did not pretend to know the legal bearing of the question.earliest age at which any professional licence shall be obtained." Some discussion took place as to the form in which the

Dr. CHRISTISON seconded the motion, resolution should be worded, and, eventually, the followingMr. SYME moved, as an amendment, " That the various was agreed to :-" That in reply to the inquiry made by the

resolutions on medical education be referred to a select com- Secretary of the Poor-law Board, in regard to the powers con-mittee, in order that they may be considered and brought in a ferred by the licence of the Faculty of Physicians and Surgeonssystematic form before the Council in the present session." of Glasgow, the registrar be instructed to intimate that the

Dr. ALEX. WOOD seconded the amendment. question involving the legal interpretation of a charter, is oneSome discussion ensued on a point of order, raised by Dr. which the Council is not competent to answer."

Corrigan, after which The following letter from the Director-General of the ArmyDr. QuAIN said he had been a listener for the last five days, Medical Department was read :-

and he had asked himself the question, What were they to do Army Medical Department,next ? They must either postpone the question altogether till "April 9th, 1864.next year, or appoint a committee to put it into form. The SIR,-The President and Fellows of the King and Queen’sprofession expected something from them, and it was most College of Physicians in Ireland having applied to the Secre-desirable that something should be done; and he believed the tary of State for War to have the letters ‘‘ Phys." inserted inbest course would be to postpone the consideration of these the Army List, after the names of such medical officers as mayresolutions and refer the whole subject to a committee, possess the qualification of that body, and Lord De Grey havingThe PRESIDENT ruled that he could not put this as an determined to have the subject referred to the General Medical

amendment upon the motion before the Council. Council, with a view of eliciting their’opinion as to the ex-Dr. ANDREW WOOD expressed a hope that a question of form pediency of recognising such a title as a means of distinguish-

would not be allowed to stand in the way of the appointment ing such licentiates from other legally qualified medical practi-of a committee at once, in order to allow of the subject being tioners, I shall feel obliged by your having the matter so

brought forward and finally disposed of on Wednesday. submitted to the General Medical Council at their next meeting.As it was now past six o’clock, the Council adjourned. " have the honour to be, Sir,

’’ Your most obedient humble servant,-

(Signed) 11 J. B. GIllSON, Director-General.

F M 6 The Secretary of the General Council of Medical

FRIDAY, MAY 6TH. "Education, 32, Soho-square."The Council assembled as usual at two o’clock- Dr. BuR- Dr. CORRIGAN said that in the course of the last two or three

Rows, President, in the chair. years several persons who had become licentiates of the CollegeThe Registrar read a correspondence which had taken place of Physicians in Ireland, of the College of Physicians in Lon-

between the Poor-law Board, the Guiltcross Union, the Faculty don, and of the College of Physicians in Edinburgh, complainedof Physicians and Surgeons of Glasgow, and the Registrar of that gentlemen who had obtained the university degree ofthe General Medical Council, in reference to the question M.D. (and it was known that some of the universities grantedwhether the licence of the Faculty of Glasgow confers a quali- degrees very easily indeed) were allowed to place M.D. afterfication both in medicine and surgery. their names in the Army List, and were thus placed at an

Dr. FLEMING said there was no question before the Council. advantage over gentlemen who had gone through a difficultThe Poor-law Board had merely requested Dr. Hawkins, the course of examination. Their medical qualifications wereRegistrar, to give his opinion on the subject, which he had ignored in the Army List, and they said it was not fair thatdone in a very accurate manner, to the effect that the Council the licence or fellowship of the College of Physicians should behad come to no positive decision with regard to the powers of , excluded as a medical qualification while the qualification of

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M.D. was inserted. These complaints having reached them,he and Dr. Smith waited upon the Director-General and uponthe Secretary for War ; and they proposed two ways of settlingthe matter : either that "Phys.,"as indicating physician, orthat all the qualifications, should be inserted after the name.After some time they received a communication from theDirector-General stating that it did not seem expedient toadopt the suggestion, but he was willing to refer the matter.They replied that the question did not affect the College ofPhysicians in Ireland individually, but it affected all the bodiesin the Army List who gave medical qualifications; and thatthey were willing to refer it to the Medical Council.Mr. SYME thought it would be extremely inexpedient to in-

terfere with the arrangements of the Army Medical Board, andpeculiarly so at the present time, when they did not approveentirely of the arrangements made by the Army MedicalDepartment.

Dr. ANDREW WOOD saw great inconvenience in putting"Phys." after "M.D." The next application would be to put ’,"Ap." after Apothecary, and " Surg." after Surgeon ; so that ’,a man might be "Ap.," "Surg.," and " Phys."all at the same i,time, and "11LD." to boot. !

Dr. STORRAR thought it was a question in which the Council ihad no authority to meddle. They had no legal authority to i,solve the question, and even if they were to take upon them-selves to express an opinion, it would lead to no satisfactoryconclusion.

Dr. PARKES said the case of the Army Medical Departmentwas simply this, that the Director-General is extremely anxiousto ascertain what qualifications are inserted in the Register ofthe Medical Council, which he will take to be the legal quali-fications, and insert them in the Army List. He must havesome rule on the subject, and that rule would be to adhere tothe insertion only of legal qualifications as given in the Register.All that he wifhed in the present instance was to know if theCouncil inserted such a title as " Phys. in the Register, becauseif they did, he was prepared to insert it in the Army List.

Dr. CORRIGAN observed that the legal qualification insertedin the Register is either "Licentiate" or follow of the Col-lege of Physicians."

Dr. A. SMITH said the title "Phys." was suggested becausethe Director-General objected to " Licentiate" or " Fellow ofthe College of Physicians" as occupying too much space. Theobject was to get the qualifications inserted in the Army List,and " Phys." was suggested as the briefest mode in which theycould be expressed.

Dr. PARKES said that if the legal qualifications were insertedin the Register he thought it would be sufficient. The Director-General wished to take the Register as his authority, or he maybe urged by dozens of medical officers to put all sorts of titlesafter their names.The following motion-moved by Dr. CORRIGAN, and seconded

by Dr. A. SMITH-was then agreed to :-" That it is the opinionof the General Medical Council that it would not be advisableto insert the letters ’ Phys.’; but that it is the opinion of theGeneral Medical Council that the several medical qualificationswhich army surgeons possess, as inserted in the Medical Re-gister, might be entered after their names in the Army List."

Dr. CORRIGAN moved, "That a letter from the King andQueen’s College of Physicians of Ireland, respecting the licencegranted by the Apothecaries’ Hall of Ireland, be read and en-tered on the minutes."

Dr. A. SMITH seconded the motion.Dr. LEET objected to the letters being read or entered on the

minutes. It would reopen the entire question, and occupy agreat deal of time, for the letters might affect the Apothecaries’Hall, and he should have to enter fully into explanations.

Dr. SMITH said he had no desire to open a discussion.Dr. CORRIGAN suggested, as it would take a long time to read

the letters, that they should be considered as read and enteredon the minutes; and then gentlemen would have an opportunityof reading them in the evening, and the next day they wouldbe in a position to consider them.

Dr. LEET again objected to their appearing on the minutes,unless he had full opportunity to reply.Mr. SYME said he would second Dr. Leet’s objection, out of

regard for those gentlemen who would be present tomorrow.For five years the question of the Apothecaries’ Company hadbeen discussed in every possible way, and the Council had ex-pressed its opinion on the subject.

Dr. ALEX. WOOD could not assent to the principle that every-thing laid ou the table must of necessity be entered on theminutes. It was possible a discourteous communication mightbe sent; and if they once admitted the principle, they might

have very objectionable matter introduced into the minutes.When documents were not objected to, they were printed onthe minutes for the convenience of the Council; but here thedocuments were objected to, and that put the question in quitea different position.

After some further discussion, Dr. PAGET moved the previousquestion, which, being seconded by Dr. ACLAND, was carriedby 16 against 4.There was some further discussion as to the effect of the pre-

vious question being carried in regard to the original motion.The PRESIDENT decided that the subject next in order on theprogramme must have precedence, and that the question broughtforward by Dr. Corrigan and Dr. Smith might be taken next.On the motion of Dr. ALEX. WOOD, seconded by Mr. Some,

the Council proceeded to consider the report of the Select Com.mittee on Education.The report, which was taken as read, is as follows

REPORT.

The Committee appointed on May 3rd, relative to profes-sional education, have to report that they have carefully con.sidered all the points referred to them by the Council.They understand the object of the Council to be, that this

report should comprise a statement of all recommendations asto professional education, arising from the late discussion incommittee of Council, as to which there appears to be a generalagreement in the Council, and which may be sent forth thissession as recommendations to the several licensing bodies of thekingdom, or suggestions to them for information. The com-mittee trust that they have kept this object steadily in view inthe following recommendations :-

I 1. Registration.—The committee recommend under this head,that the regulations proposed in the report of the sub-committeeon registration be adopted, with a slight change in No. 3 ofthese regulations, which will then stand as follows :—

1. That the registration of medical students be placed underthe charge of the branch registrars.

2. That each student be only once registered-viz., when hefirst enrols himself as a medical student.

3. That each licensing body request from each school of me.dicine under its jurisdiction, a list of all students entering onthe study of medicine for the first time at that school, agreeablyto the subjoined form.

Form of Register oj Medical Students.

4. That the register at each school be closed within fifteendays after the commencement of each session or term.

5. That these lists, as soon as possible thereafter, be trans-mitted, along with the certificates of each student having passedan Arts examination, to the branch registrar of that divisionof the kingdom where the school is situated, and that he fromthem frame an accurate register of medical students of thatdivision of the kingdom of which he is registrar.

6. That the registers of medical students so prepared by theregistrars, after examination by the several Branch Councils, betransmitted to the Registrar of the General Council, who shall,under direction of the Executive Committee, print the same inalphabetical order, and supply a copy of this authorized list toeach of the bodies in Schedule A to the Medical Act.

7. That the several licensing bodies be requested, afterOctober, 1868, to abstain from examining any candidate forlicence or degree whose name does not appear on the authorizedlist of medical students.

8. That the Branch Councils be desired to take means tomake these regulations known to the medical students at thevarious medical schools.

9. That exceptions allowed by the licensing bodies to any ofthe preceding regulations as to registration, together with thereasons for such exceptions, be transmitted to the BranchCouncil of the part of the United Kingdom in which they havebeen granted.

II. Age for Licence to Practise.-The committee, after havingtaken into consideration Mr. Rumsey’s notice of motion, that-

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the earliest age for obtaining any licence to practice medicine orsurgery should be twenty-two, recommend that the seventeenthresolution of the Recommendations of Council in 1863 be ad-hered to in the following shape :-

1. That the age of twenty-one be the earliest age at whichany professional licence shall be obtained ; and that the ageshall, in all instances, be duly certified.

III. pj’ofessional Study. -The committee have taken intoconsideration the notices of motion as to professional study,given by Dr. Thomson, Dr. Parkes, and Dr. Storrar, and havecome to the following recommendations, in which not onlythese gentlemen, but likewise every other member of committeepresent, have concurred :-

1. That no licence be obtained at an earlier period than afterthe close of the last winter session of four years of study, afterthe registration of the candidate as a medical student.

2. That the course of study required for a licence shall com-prehend attendance during not less than four winter sessions, orthree winter and two summer sessions, at a recognised medicalschool; and that evidence shall be produced that the remainingperiod of the four years has been passed in the acquisition ofprofessional knowledge.

3. That in reference specially to Dr. Parkes’s notice of motionas to duration of sessions and of courses of lectures, the regula-tion of the duration of sessions, and the extent and duration ofcourses of lectures and instructions, be left for the present tothe several licensing bodies.

4. That it be recommended to the several licensing bodiesthat the courses of instruction required by them should beframed in such a manner as to secure a due share of attention,both to preparatory branches and to those more strictly con-nected with the practice of medicine and surgery ; and that itbe suggested accordingly to these bodies, that their regulationsshould be such as to prevent attendance upon lectures from in-terfering with hospital and clinical study.

5. That while avoiling for the present all other details bywhich this object may be attained, it be recommended that nosubject of lectures be enforced by regulation to be attendedoftener than once.

6. That the Council intimate that they will view with appro-bation any encouragement held out by the licensing bodies tostudents to prosecute the study of the natural sciences beforethey engage in studies of a strictly professional character.

7. That the several licensing bodies be requested to furnish ashort statement of the mode in which their examinations arenow conducted, whether by written, oral, or practical examina-tion, and of the length of time a candidate is under examinationin each or all of these ways.IV. Examinations.-The committee have considered the

subject of examinations with peculiar care, which was renderedimperative by the proofs brought before the Council in the latediscussion on education, that the examinations of the licensingboards, however conscientiously carried on under the presentsystem, are not always sufficient for their purpose. The subjectis one confessedly of much difficulty. The committee have re-solved to recommend-

1. That the licensing boards be advised to encourage theperiodical examination of students at their several classes.

2. That the final examinations of the licensing boards be socarried on as to be an efficient test of the practical acquaintanceof candidates with the several branches of medical knowledge,and especially with the practice of medicine and surgery.

3. That the professional examination for any licence bedivided into two parts, the first embracing the primary orfundamental branches of medicine, and the second the branchesdirectly connected with the practice of medicine and surgery;that the former be not undergone till after the close of thewinter session of the second year of professional study, and thelatter, or final examination, not till after the close of the wintersession of the fourth year of such study.

4. That the examination in chemistry, botany, and naturalhistory may be undergone at an earlier period.

5. That the professional examinations be conducted both inwriting and orally, and that they be practical in all branchesin which they admit of being made so.

6. That the professional examinations be held by the severallicensing bodies, except in special cases, at stated periods, to bepublicly notified.

7. That returns from the licensing bodies in Schedule A bemade annually on the 1st of January, and in the subjoinedform, to the General Medical Council, stating the number and Inames of the candidates who have passed their first as well astheir second examinations, and the number of those who have

been rejected at the first and second examinations respectively,and that the Registrar forward a sufficient number of forms,with a notice for their being returned, in due time.

11.1

V. Supervision of Examinations.-So much has been trulysaid in the late discussions in the Council as to the duty whichlies with the Council to carry out the enactments of the MedicalAct relative to the supervision of the examinations of thelicensing boards, that the committee have felt a great desire torecommend some definite course which the Council might atonce pursue for establishing such supervision.They fear, however, that the Medical Act is defective in this

respect, inasmuch as it has not contemplated either the greatamount of time and labour required to carry on a really effec-tive supervision of the very numerous examinations of the

licensing boards of the kingdom, some of which do not meet forexamination at the seats of the Branch Councils, or the amountof qualifications and professional position necessary to constitutea staff of efficient visitors of examinations, and, consequently, hasomitted to provide the means of remunerating them for theirimportant services. But notwithstanding this obstacle, thecommittee recommend that a trial of visitation be immediatelymade on such a scale as may be a guide to the Council forfurther regulations on the subject at a future meeting. For thisend they recommend that the Branch Councils be instructedseverally to organize a set of trial visitations on a scale whichmay enable them to report upon their success, the conditionsfor efficiency, and the requisite means for rendering them ade-quately extensive.VI. Suggestionsfor obtaining infm’mation.-To these recom-

mendations, which it seems to them advisable that the Councilresolve now to adopt, the committee think it right to addothers, as to which the opinions of the licensing bodies, and ofthe medical schools connected with them, should be requestedin time for the consideration of the Council at its next session-viz.:

1. Whether, in the opinion of the licensing bodies, the com-mencement of professional study, by which the duration of itmust be regulated, should be held to be only entrance on suchstudy at a recognised medical school.

2. Whether a " medical school" may be better or otherwisedefined than as one where there is an opportunity of studyingat a general hospital containing at least eighty beds for patients,and also a teacher of practical anatomy recognised by a licensingbody.

3. Whether entrance on apprenticeship should be held asanother way of constituting the commencement of professionalstudy.

4. Whether the same privilege be extended to pupilage undera registered practitioner, who has charge of a union workhouse,a dispensary, or an hospital, though destitute of medical orsurgical teachers.

5. Whether any other mode of study may be similarly reco-gnised as the commencement of professional study.

6. Whether, looking to the great extension of the primaryor fundamental sciences of medicine during the last forty years,the subjects embraced in courses of lectures on these sciencesmay not be better arranged and treated than now, so that theymay be made more applicable than they are at present to thepractical instruction of medical students, as distinguished fromgeneral students.

7. Whether it be advisable or not, and if advisable, whetherand how it may be practicable, to adopt, in part at least, theprinciple of ad eundegn examinations ; so that a candidate whohas been satisfactorily examined, in part or completely, for anyprofessional title conveying the right of practice, shall not besubject to re-examination on precisely the same branches byanother examining body before whom he may appear as candi-date for the same or a different qualifying professional title.

S. Whether it be advisable and practicable, for the relief of

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candidates for licences from superfluous examinations, to esta- serious question, What is a medical school ? With regard toblish in England, Scotland, and Ireland severally, a conjunct the difficulty about a student being registered twice, he didexamining board, before whom candidates may be subjected to not think it was likely to occur, because the register woulda single series of examinations for the " double qualification" give his name in full, his age last birthday, the date of hisof physician and surgeon. preliminary examination, the date of his registration, and the

9. Whether it be desirable that the oral and practical parts place of his study; and with all these particulars it would beof the professional examinations should be so conducted as to impossible for a student to be entered two or three times.be open to registered medical practitioners and registered The PRESIDENT said the plan might work well in Irelandmedical students. and Scotland; but in England, with five licensing bodies and

Lastly. In conformity with the notices of motions by Dr. fifteen medical schools, he did not see how it was possible toAcland, the committee recommend the Council to appoint a avoid the appearance of the same names over and over againselect committee to consider and report at the next session of in the lists sent to the registrar. Although they had no powerthe Council what are the subjects of examination which should over the medical schools, yet it was of so much advantage tobe required of all students prior to commencing the prescribed the medical schools to afford registration to their students, thatcourse of professional education, and what are the professional he thought they would be willing to comply with a requestsubjects of examination which should be required of all candi- from the Council to send in their lists to the licensing bodies.dates before they receive the licence to practise medicine or Mr. SYME pointed out the difficulty that would arise in thesurgery, or medicine and surgery. event of the Council deciding that the special education should

R. CHRISTISON, Chairman. commence with an apprenticeship. Who was to send in hisname if he did not put himself in communication with the

Dr. CHRISTISON said, with the view of saving discussion on the registrar ?minute points in the report, it had been suggested that after Dr. ALEX. WOOD said the committee found immense diffi.the Council have gone over the articles of the report seriatim culty in dealing with the question. Two plans were considered.the report should be sent to a small committee to make One was that the branch registrar should appoint a deputysmall verbal alterations. The first head was that of Registra- wherever there was a school. This might answer in Irelandtion, and he begged that the Regulation No. 1 of the committee or Scotland, but there would be a difficulty in England wherebe adopted, " That the registration of medical students be schools were springing up like mushrooms. The other planplaced under the charge of the branch registrars." was that every student should send his name to the registrar.

Dr. STOKES seconded the motion. The result would impose additional work on the branch regis-The motion was agreed to. trars, but that could be met by granting them additionalDr. CHRISTISON said Regulation No. 2 had reference to the remuneration.

period at which the student should be registered. The com- Mr. ARNOTT thought the work might be done by means ofmittee had considered very seriously whether they ought not the present machinery, and it would require very little clerk’sto have the student enrolled every year, but after full consi- work. In the College of Surgeons, it is imperative that everyderation they came to the conclusion that he should be enrolled student should register his name, and other bodies might doonly once, at the commencement of his professional studies, the same. But they would not be likely to take any authorityThe motion, which underwent various verbal amendments, from the Council on the subject, and, therefore, they had

was finally adopted in the following words :-"’]’hat every better employ the machinery of the licensing bodies to get instudent be registered at the commencement of professional the returns.study." " Mr. COOPER said the Apothecaries’ Company pursued the

Dr. CHRISTISON said, with reference to Regulation No. 3, the same course as the College of Surgeons in requiring all thecommittee had a little difficulty in defining the difference students to register their names.between the schools of medicine and the licensing bodies, and Eventually the motion was shaped in the following form,the relation in which they stand towards one another, for there moved by Dr. CHRISTISON, and seconded by Dr. STOKES, andare many schools that did not come under the jurisdiction of agreed to : " That the several licensing bodies be requested toany licensing body. furnish to the branch registrars, at the beginning of January

Dr. SHARPEY said he understood the great object in inter- annually, a list of students who have been registered for thefering with the register was to make it less cumbrous, and to first time during the preceding year, according to the subjoinedavoid the appearance of the same name in several lists. What form." (See page 558.)would be the effect of the recommendation of the committee The following resolution was moved by Dr. CHRISTISON,as it stood? Take Guy’s Hospital, for example; it is under seconded by Dr. STOKES, and agreed to,-" That Regulationno jurisdiction, but is connected with all the licensing bodies in No. 4, Sect. I., be adopted as thus amended-viz., ’That theLondon. The same student would, perhaps, go up to the register of each licensing body be closed within fifteen daysCollege of Physicians, to the College of Surgeons, to the after the commencement of each session or term.’ And thatApothecaries’ Company, and, perhaps, to the University of Regulations 4 and 5 be transposed."London. His name would be returned to every one of these The next resolution, moved by Dr. CHRISTISON, was secondedfour bodies, and four distinct certificates must be obtained by Mr. ARNOTT,-" That these lists, as soon as possible there.by the student to go into the hands of the Branch Council. It after, be transmitted, along with the certificates of each stu-was impolitic, he thought, to offer any opportunity to apply dent having passed an Arts examination, to the branch registrarfor more than one certificate. He saw no objection to the of that division of the kingdom where the school is situated,employment of the agency of licensing bodies, because it was and that he from them frame an accurate register of medicalin accordance with the tenor of the Medical Act. He under- students of that division of the kingdom of which he is regis.stood the register for a special purpose has a different object trar." "from the certificates of attendance ; and he thought the better Dr. CHRISTISON said it appeared to him that the onus ofplan would be that each medical school should transmit to one ascertaining the correctness of the certificate of preliminaryof the licensing bodies in the same division of the kingdom a examination should be thrown entirely on the licensing bodies;list of students who have been registered for the first time the branch councils had not the means of ascertaining it.during the preceding year. Mr. ARNOTT thought that many of the students would notThe PRESIDENT : Not to the registrar ? like to part with their Arts examination certificates, as theyDr. SHARPEY said, not to the registrar, but to the licensing found them useful in obtaining situations.

bodies, which were intended by the Act to serve as an agency Dr. STOKES said that the great object of throwing the dutybetween the Council and the medical schools. The returns of registration on the branch registrar was really to procurecould then be sent to the branch registrar, and the branch the correctness of the certificates. It was not necessary forregistrar would make out a list, which might be called a the student to leave the certificate with the registrar; and the"local register ;" and then the several branch registrars would production of it need only be demanded when the student wastransmit these lists to the General Council, by whom the com- not included in the certified list sent up from such an institu-plete list would be made out and printed. tion as the University of Dublin for instance, that he had

Dr. CHRISTISON said the Council had no direct jurisdiction passed his examination in Arts.over the schools; they could only act through the medium of Dr. THOMSON considered that the list from the licensinthe licensing bodies. The question had been fully considered bodies would be equivalent to the certificates.in committee, and they came to the conclusion that it would Dr. APJOHN would rather that the certificates should bebe far better to leave it to the licensing bodies. The licensing produced.bodies were in the habit of recognising the schools, but the Dr. THOMSON: Do you doubt the veracity of the licensingCouncil could not do so without raising and defining the very bodies ?

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Dr. APJOHN really did not know, but he would rather have adopted as thus amended-viz., ’That exceptions allowed bythe certificates. The object was the security of the registra- the licensing bodies to any of the preceding regulations as totion, and that should not be given up. registration, together with the reasons for such exceptions, be

Dr. CHRISTISON considered that there was no certificate equal transmitted in a separate list to the branch council of the partto that of the licensing body stating that certain students had of the United Kingdom in which they have been granted.’ "

passed their examination. Dr. CHRISTISON said that the next resolution was as to theDr. APJOHN thought it possible that the licensing body age. There was a preamble to this in the report which it was

might not have precise means of information; for the student, necessary to read, "The committee, after having taken intoperhaps, had passed his examination elsewhere. consideration Mr. Rumsey’s notice of motion, that the earliest

Dr. STOKES suggested that the branch registrar should be age for obtaining any licence to practise medicine or surgeryinstructed not to register the name of any one respecting whom should be twenty-two, recommend that the seventeenth resolu-he was not satisfied that his preliminary examination had been tion of the Recommendations of Council in 1863 be adhered to in

passed. the following shape : That the age of twenty-one be the earliestDr. THOMSON said the difficulty which had suggested itself age at which any professional licence shall be obtained." That

evidently arose from a misconception of the first step of the was the shape in which it appeared in the recommendations,proceedings, for no name could be sent up by the licensing but the committee thought it should be added, " and that thebody without an accompanying statement or certificate that age shall in all instances be duly certified." This was thethe student-had passed his examination. subject on which Mr. Rumsey intended to give h motion;

Dr. PAGET held that there was nothing which made it im- but before this was done it was necessary that he, asthe chairperative that the whole of the form of the register should be man of the committee, should make Mr. Rumsey aware thatfilled up by the licensing bodies. If that were imperative it the question engaged the serious consideration of the Councilwould be sufficient; but the registrar would have to accept the when they first took up the subject of professional education inname, even if the third column, as to the preliminary examina- 1859. There was at first a very general feeling that the age shouldtion, were left blank. be twenty-two, but after full consideration they came by a largeThe PRESIDENT.-The question is, whether that form is im- majority to the opinion that the lowest age should be twenty-

perative on the bodies or not. one. It would be out of place for him to enter into all theThe REGISTRAR, in reply to a question from Mr. Arnott, reasons assigned for this, but there was one reason which he

said that last year the form was sent round to the schools, and urged himself ; and as it was a very short one he would statewas returned with the third column filled up. it for Mr. Rumsey’s ’consideration, because it is one whichDr. ALDERSON thought that confidence should be shown in never can come under any person’s cognizauce unless he has

the licensing bodies. The names of the students who passed been both a teacher and an examiner. It was that from his ex-their preliminary examination at the College of Physicians perience, as Dean of their Medical Faculty, he found that inwere sent up to the Council in a certified list, bearing the seal taking a cel1.sus of the graduates at a certain period (there wereof the College. It was taken for granted, however, that about 210 altogether, so that it was a large induction to foundstudents who had been previously examined by another any conclusion upon), he discovered that only twenty per cent.licensing body had passed their preliminary examination, and took their graduation at the age of twenty-one ; but in thatthe College did not certify these afresh. twenty per cent. (and it was to this he would call Mr. Rumsey’sMr. CoorER said the practice at Apothecaries’ Hall was not particular attention) were comprehended a far larger propor-

to allow any certificate without knowing that the preliminary tion of the best of their candidates. Therefore, he came to theexamination had been passed, conclusion, and he thought the Council would do the same,The resolution was eventually amended as follows, and that they ought not by any regulation passed by the Council

agreed to:-" That from the lists of the licensing bodies each to deprive a young man of any of those advantages whichbranch registrar shall frame an accurate register of medical Providence had bestowed upon him.students ot’ the division of the United Kingdom of which he is Mr. RUMSEY said that at this late period of the session heregistrar." " was very sorry to bring forward any subject or make any re-The next resolution passed was the following : -" That marks which could possibly have been shelved. But, notwith-

Regulation No. 6, Sect. L, be adopted as thus amended-viz., standing the explanation which Dr. Christison had given, and’That the register of medical students so prepared by the which contained some remarks of great value, he felt it incum-registrars, after examination by the several branch councils, bent on him to bring this matter once more before the Council,be transmitted to the Registrar of the General Council, who though it had been thoroughly treated of in /former years. If

shall, under direction of the Executive Committee, prepare and it were to be a reason against stating the minimum age atprint an alphabetical list of all registered students, and supply twenty-two, that in the instance Dr. Christison alluded to thea copy of this authorized list to each of the bodies in Schedule A greater proportion of the best students were those who passedto the Medical Act.’ " at twenty-one, the same reason might be applied to a lower

Dr. CHRISTISON moved, and Dr. STOKES seconded,-" That minimum ; and he would answer for it that if they were to fixthe several licensing bodies be requested, after Oct. 1868, to the age at twenty, a certain per-centage of those who passed atabstain from examining any candidate for licence or degree that age would be the best students. He had not the experi-whose name does not appear on the authorized list of medical ence of an examiner either in a university or a college, but hestudents." had read considerably on the subject, and he found that where

Dr. CHRISTISON said that almost all the resolutions of the men had gone thoroughly to work, and had been endued withcommittee were passed unanimously, but upon this they were great natural powers, they mastered the subject at a very earlysomewhat divided. age, and came out great men; while others, after a long courseMr. ARNOTT remarked that men who had been educated en- of study, had remained comparatively ignorant. Therefore he

tirely at a foreign university school might apply to the College did not quite agree with the reasons which Dr. Christison hadof Surgeons for examination; and if they had complied with given for making twenty-one years the minimum. He thought,the regulation as to education, the College could not decline to from what he had heard from the Council before, that it was aexamine them, and would not, notwithstanding this resolution. sort of settled matter that twenty-one was the best minimum

Dr. SHARPEY suggested the case of a surgeon wishing to take they could devise. It was gratifying to him to hear that othersa degree or pass the College of Physicians, who might have in the Council had doubted that, and that an attempt had beenpassed his examination some years ago, when there was no made to get a higher minimum of age introduced. It wouldlegislation. have been strange if it had not been so, for the opinions of the

Dr. STOKES proposed the addition of the words, "as having greatest reformers in the kingdom for the last thirty years hadpassed a preliminary examination in Arts." been in favour of an advance in the minimum of age. He had

Dr. CHRISTISON consented to the amendment, and suggested not the documents or pamphlets before him to prove this; butthe further addition of the words, " or whose name is not on those who, like Dr. Sharpey, were aware of what was beingthe Medical Register." done in medical raform twenty or thirty years ago, knew howThe resolution as amended was agreed to. many there were of this opinion. He might mention the namesIt was then moved by Dr. CHRISTISON, seconded by Dr. of the late Dr. Barlow of Bath, and bir Charles Hastings;

STOKES, and agreed to,-" That Regulation No. 8, Sect. L, be and not only was this the opinion of these eminent men and ofadopted-viz., ’That the branch councils be desired to take the bodies for which they acted, but it was introduced into cer-means to make these regulations known to the medical students tain Bills proposed to the Legislature. The last Bill proposedat the various medical schools.’ " before the passing of the Medical Act-the Bill of Mr. Head-

It was also moved by Dr. CHRISTISON, seconded by Dr. lam and Mr. Brady-contained a proposition that the minimumSTOKES, and agreed to,-" That Regulation No. 9, Sect. 1., be age should be twenty-two. He stated these facts as precedents

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to show that this is no new proposition. And not only is it and stuffed, was actually less fit to practise his profession thanno new proposition, but it has actually been the minimum age a man who with a less number of subjects went into practicein the profession before. When he and Mr. Arnott passed the at a later age. He did not propose any sudden change in thisCollege of Surgeons, the minimum age was twenty-two, and it matter. Those who were entering the profession with the dis-continued so for many years. That College which passed the tinct understanding that they are to be admitted at twenty.onegreatest number of medical students found it desirable to raise must be fairly considered; therefore, in his notice of motion hethe age in order to increase the qualification. Now, why had mentioned 1868 as the date at which the change should bethat regulation becn altered ? This brought him to a very recommended. All that they could do was to recommend; theyimportant matter that had been touched upon before in the could not force anything; but he thought it would be highly toCouncil. The plea for altering that regulation-and he stated their credit if, after giving time for the change, they should re-it on the authority of his late esteemed friend, Mr. Guthrie- commend a higher minimum of age. In naming the minimum,was that the public service demanded a reduction of age. That he was aware that it was apt to be taken as a maximum. Butwas the alleged pretext; but what was the real reason ? The there were objections made to the proposed change by thereal reason was the underbidding and the underselling of the cor- heads of certain branches of the public service. His friendporate dealers in licences in the United Kingdom. The Poor-law Dr. Parkes would say, " If you make the age twenty-two, youCommissioners were at that time introducing a new system of would not have a sufficient number of young men ready for themedical relief throughout the country; and when they found army." His answer to that would be one that had alreadythat the established practitioners did not accept exactly the been given : that if the army offered sufficient inducements forterms that were offered, and would not put in tenders to un- highly qualified men to enter, they would no doubt have adertake the care of the poor at the lowest sum at which the sufficient number of candidates, whether the age were twenty-wretched beings could be handed over to a contractor, the Com- one or twenty-two. But he found from inquiry of Dr. Parkesmissioners said that if the surgeons of England would not under- that the average age at which young men went into the armytake the office on their terms they could find men in the other medical service is about twenty-three; so that, practically, thedivisions of the kingdom who would-real M.D. s, and no mis- alteration would do no harm to the service. But if there istake. And the thing was done ; and under that state of things this deficiency of candidates for the army, let them look at thethe College of Surgeons reduced their age. state of our great towns. He could not speak of the metropolis,

Dr. CORRIGAN : I beg to state that they were not M.D. s although he had heard that the glut of unemployed medicalfrom Ireland. Have you any objection to state from what men here is enormous; but he could speak of the great pro-division of the kingdom these M. D. s came, for there are no vincial towns, and there the glut of unemployed medical prac-M.D.s in Ireland at twenty-one? titioners led to the greatest degradation in the profession, toMr. RinMBEY : I believe the M.D.s who undertook the office the most dishonourable expedients to obtain practice, and to a

came from beyond the Tweed. forgetfulness of all those principles of medical ethics in whichDr. THOMSON : Observe, Mr. Rumsey called them real M. D. s. every man who entered the profession should be well instructedMr. RuMSEY said he was aware that the universities of Scot- and by which he ought to be bound. The great injury, how-

land, to their honour, now require a greater age before confer- ever, was not to the profession, but to the public, who werering the degree of M.D. But he was speaking of matters that preyed upon by men of inferior qualifications and inferior prin-occurred long ago. The pecuniary competition for offices of ciples; therefore, the more time they gave to a man to studythat kind was now abolished; and though he was not affected before he entered the profession, the more that particular classby that cursed system in any way, he should never, to his to which he was alluding would be kept out. Further, hedying day, forget his share in endeavouring to abolish it. With protested against the notion that the poorer classes of the com.regard to the Poor-law Commissioners for Ireland, he had to munity might be safely handed over to the unsupervised careremark that, to their honour also, they had adopted a higher of young men, however naturally clever, who had only justminimum. They required for the large and respectable class attained their legal majority. He protested against the notionof surgeons who held appointments under them the age of that a less degree of knowledge and a less degree of experiencetwenty-three. They did not allow a man to attend the poor are required for the poor than for the wealthier classes; andwho had not experience as well as education. From what he he considered that the minimum age of men entering into thehad heard, he believed the English Poor-law Board were will- Poor-law service should be at least twenty-three. He alsoing to make some increase in their standard of age. But they protested against the principle that the extent of their regula-were embarrassed by the indirect sanction given to the mini- tions should be determined by the pecuniary means of themum age by the Medical Act and by the regulations of the young men who entered upon the study of medicine. If theyMedical Council. They did not see, as the Poor-law Commis- sent out properly qualified men, he believed they would besioners for Ireland saw, that they might fix a minimum age, adequately remunerated; and the public, so far from beingeven though it did not accord with that sanctioned by the Act losers, would be very much the gainers by the improvement inof Parliament. He merely mentioned this to show that the the qualification. More highly educated men, though theirMedical Act in this respect, and the regulations of the Medical fees might be larger, would do more for the public in a givenCouncil, were an obstacle to the advance of medical qualifica- time; it was therefore not an advantage, by keeping the mini-tion in the eyes of those who manage some of the great public mum down to a low age, to encourage men of small pecuniaryservices in the country. He would now take up the subject of means to enter the profession. He should be the last man tomedical education, and he would ask, with reference to its two throw any difficulty in the way of poor men rising into highergreat stages, the preliminary and the scholastic, which they grades, but it was not to be dune by lowering the standard ofdid not propose should ever be completed before the age of qualification. Having stated his reasons for raising the age,seventeen, how could a young man go through these, which and pointed out the great importance of it to the public andconsist partly of scientific and collegiate, and partly of practical the profession, he would strongly urge the Council to reconsiderand professional, with anything like care and study before the the question.age of twenty-two ? He was not speaking of those young Mr. HARGRAVE seconded the amendment.men of precocious minds and powerful intellects who were Dr. STOKES said they must all agree in a great deal that hadable to acquire as much in two years as others did in fallen from Mr. Rumsey, and ought to be very much indebtedfour or five; but he was speaking of the great mediocrity of to him for the pains he had taken to investigate the matter;medical students, the class whom they had to consider at but he must repeat that this question of age had been carefullythat council table. The advancing requirements of education discussed in committee, and they had borne in mind the con-which they were proposing rendered it impossible for them clusions come to by the Council at its previous sittings. It wasto retrograde. If they required more subjects and a higher extremely difficult to settle at what year a man should receivestandard of knowledge from the student, they must allow the his diploma. Mr. Rumsey said twenty-two, somebody elsestudent time to get hold of the materials which they wished might say twenty-three, and others nineteen. They must drawhim to grasp. He could not help being struck the other day the line somewhere, and the committee drew it at twenty-one.with the comparison drawn by the President between the mind The PRESIDENT asked if Mr. Rumsey proposed a distinct amend-and the soil. In mental culture, as in agriculture, we could ment, or would he append it as an addition to the resolution?not force the crops: if we did, we weakened the soil, or the Mr. Rumsey replied that he should prefer to put it as anmind in which the forcing or cramming process has taken addition to the resolution.

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place. It did appear to him a most important matter, and not Dr. CHRISTISON said the only way in which Mr. Rumseysufficiently considered in the Council-the debilitating of the could carry out his motion would be by moving that the wordmind which results from the cramming system, which compels two" be substituted for the word " one."the student to master a large number of particulars. He I The PRESIDENT observed that Mr. Rumsey’s motion wasthought a young man at twenty-one, who had been so crammed I prospective with reference to the year 1868.

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Dr. STOKES, resuming, said the committee, after looking at showed that there were for Dr. Sharpey, 22 votes; Mr. Arnott,the difficulties of the question, determined to accept simply 20 ; Dr. Acland, 11; Dr. Storrar, 10; Dr. Quain, 10. Thethe age at which by the law of this country a man arrives at last two names having an equal number of votes, another ballothis majority. A man may fill almost any otnce ica the country, was taken, which resulted in the election of Dr. Quain by ahe can administer his own affairs, be a member of Parliament, majority of one.and so on, at the age of twenty-one. The country assumed The Council then adjourned.that a man who had not got his sense at twenty-one would ____

never get it. The example of the Church had been brought -

forward as fixing the standard of age. He was not himself SATURDAY, MAY 7TH.aware exactly at what age ordination was performed. The Council assembled to-day at twelve o’clock, and theMr. RUMSEY : Twenty-three. chair was occupied by Mr. ARNOTT until the arrival of Dr.Dr. CHRISTISON : Is that the age for taking orders or getting

chair was occupied by Mr. ARNOTT until the arrival of Dr.a living ?

" Burrows.Mr. RuMSEY : For taking orders. After the other business on the agenda paper had been di&-Dr. STOKES would pnt, as an apposite case, that of the pro- posed of (a report of which will be given in a future number),

fession of the law. All that was required was that a man Dr. Storrar brought up the Report of the Select Committee onshould keep certain terms, at any age between puberty and Education.

majority. Mr. Rumsey had spoken of the disadvantage of Dr. ANDREW WOOD moved, and Dr. EMBLETON seconded,-conferring the degree early. It will be easy to show consider- That the Council proceed to consider the Report of the Selectable advantage to the medical student by getting his degree at Commi tee on Education, taking up recommendation No. 3.an early age. We are living in an age of extraordinary transi- Dr. ACLAND said he should move an amendment, as beingtion, and facilities for academical study are much greater now the shortest way of eliciting the opinions of the Council on thethan they were some years ago. When a young man got his present stage of the business. Many members of the Councildegree or licence at twenty-one, he became so far a freed man, were absent. The chairman of the Education Committee, Dr.and by the assistance of steam he could travel over the world Christison, to whom had beea committed the drawing up ofin a few months and study in various places. That is a great the paper; the representative of the University of Edinburgh;advantage to the student, and if an advantage to the student the representative of the University of Cambridge; and severalan advantage to the public. He much doubted whether the of the Scotch members, were absent. It was now within twoconfidence of the public would be influenced by the age of the hours of the close of the last sitting of the Council, and he didpractitioner ; it depended much more upon the individual him- not think it possible in that short time to discuss the wholeself than upon his age. They had all seen instances of young question of professional study-including inspection, visitation,medical men having a large share of confidence, and old men and examination,-which was involved in the recommendationsgetting no confidence at all. The regulations of the Poor-law of the committee. More than once he had endeavoured toBoard did not appear to him to touch the question ; if the draw the attention of his colleagues to what seemed to him theCommissioners did not choose to employ medical men till they only way of bringing this part of their business to a satisfactorywere twenty-three it could not be helped. But it should be conclusion. The course which had been pursued had elicitedremembered that between the period of getting his degree at a most interesting discussion, and he appealed to all presenttwenty-one and the time when the Poor-law authorities chose whether the result had not been to show that they really re-to employ him, the young man had a season which he might quired time to reflect on the many suggestions which had beenadmirably employ in the cultivation of his mind. The question thrown out, before they took the final step of bringing out awas, would it be better to keep the student in the pupillary new code. With many of the recommendations he entirelystate up to twenty-three ? He doubted it very much. In agreed, but there were some which would take him a long timemedicine there is a kind of education which a man acquires as to reflect upon. To save time, he had drawn up three resolu-soon as he gets rid of the terror of one examination. As long tions, which he should propose in the form of an amendment :-as he had an examination hanging over him he would do " That in the absence of the Chairman of the Education Com-nothing but grind; but if he obtained his degree at twenty- mittee (Dr. Christison), of the representative of the Universityone, although the Poor-law Board will not receive him till he of Edinburgh (Mr. Syme), of the representative of the Uni-is twenty-three, he has arrived at the best period for study. versity of Cambridge (Dr. Paget), and at the twelfth day ofThey were not necessarily to suppose that a man would be the session of the Council, it is inexpedient to enter upon thebetter educated at twenty-two than twenty-one. Age had consideration of the details of professional study and examina-nothing to do with it ; it is after all a question of pounds, tion; but instead thereof--That a committee be appointed toshillings, and pence. If the difference of a year would diminish draw up and report to the Council of 1865, what are the sub-the number entering the profession, it would diminish an evil jects of examination which should be required of all studentsthey all deplored. prior to their prescribed course of professional study. That a

Dr. PAGET said if Mr. Rumsey had alone spoken, he should committee be appointed to draw up in detail a scheme of thenot have said a word ; but having been a member of the com- scientific and professional subjects of which knowledge should,mittee, and almost alone agreeing with Mr. Rumsey’s opinion, in the judgment of the Medical Council, be required from everyhe must say he could not agree with Dr. Stokes that this was person before he receives a diploma or qualification testifyinga question of pounds, shillings, and pence. The addition of that he possesses the requisite knowledge and skill for the effi-twelve months to study was a very material point, and would cient practice of his profession; and that the committee reportsolve many of the difficulties which almost every member of at the next meeting of the Medical Council. That a com-the Council had felt in discussing the question of Medical Edu- mittee be appointed to report in detail at the commencementcation. An addition of some months to the general education of the next session of Council as to the best mode of organizingwould make the mental culture better, and upon that mainly an efficient inspection of all examinations conducted by thethe social status of the profession must depend ; and the addi- several licensing bodies, in conformity with section 18 of thetion of a few months also to the professional education must no Medical Act. That the committees (if appointed) be requested todoubt make the man better in a practical sense. Therefore, correspond with each other, to obtain information from such per-for both reasons, he should be disposed to agree with Mr. sons unconnected with the Council as they may see fit, and toRumsey. The question is not between twenty-one and twenty- prepare in type, in such form as may be agreed on with thethree, but between twenty-one and twenty-two. No man Registrar, their respective reports, if possible, before Eastercould be ordained a clergyman until he was twenty-three, or of 1865, or at an earlier period if required by the President."hold a benefice until he was twenty four, therefore he thought Concerning the report of the committee on non-professionaltwenty-two was not too long for a man to wait to enter the studies, he named the meeting of the Council in 1865 as themedical profession. period when that should be produced. It was not so pressingThe amendment was put to the vote :- a matter as the other two, and he anticipated there might be

For the amendment............ 7 another meeting of the Council this year, at which reports onAgainst it .................. 11 these two subjects might be presented. Upon so important a.Declined to vote ....... 5 question as the education of the medical student they ought

The motion was then put and carried. not to be called upon to express their sentiments hastily; andOn the motion of Dr. CHRISTISON, seconded by Dr. STOKES, he conceived that he had offered ample time for the full con.

the further consideration of the Report of the Select Committee sideration of the subject by postponing the preparation of thewas postponed until the following day. report until next year. At present they were entirely dia-A ballot was then taken for the Executive Committee, Dr. agreed as to the amount of scientific study which ought to be

Paget and Mr. Arnott being appointed scrutators. The result introduced into non-professional examinations; even the phy-

564

sicians and scientific men sitting there were not prepared to say;therefore he felt justified in pressing upon them not to cometo any hasty resolution, but to take time in order to be able to,give a matured opinion to the world as the result of their finaldeliberations. The same remark applied to the subjects whichshould be embraced in the four years’ professional study; itwas impossible for them to settle that point until they were- able precisely to state what subjects should be relegated to oneclass and what to another. With respect to the second branchof his amendment, he had used the words " requisite knowledgeand skill for the efficient practice of his profession," in prefer.,-ence to the words " medicine and surgery," because it was

becoming more and more difficult to define the distinction be-tween those two terms. It would be for the Council to saywhat should be the minimum of medical and surgical know.’ledge. In the examinations at Oxford he found it exceedinglydifficult to determine what standard of knowledge should beset up in medicine and surgery; or how much botany, physics,and chemistry should be put into the examination papers. Hebelieved the Council would have to adopt the course pursuediby the London University, and lay down a list of subjectsupon which it is proper to examine a medical student; and hethought this could best be done by the appointment of a com-mittee to mature some plan for the information of the Council.He also begged the appointment of a committee to report in.detail with reference to the best mode of organizing an efficientinspection of the examinations. If they looked into theworking of the clause in the Medical Act which related toexaminations, they would find that it woul not be easy to- carry that clause into practice without a good deal of inquiryand reflection. If the Council intended to undertake any sys-tem of visitation of licensing bodies, or any superintendence ofthe examinations, they ought to have some notion of the extentand character of the visitations, the powers to be exercised,the plan which they should be disposed to adopt as a uniformplan to be put in force by the examining bodies, and also somedear notion with respect to the minimum qualifications to be- required of all persons. Under these circumstances, he believedthat the most useful thing to the public, the fairest to theseveral bodies represented there, and the fairest to the absentmembers, would be to obtain a series of reports on the various- subjects to be submitted to the committees which he asked the- Council to appoint.

Dr. STOKFS seconded the amendment.Dr. ANDREW WOOD said that he introduced his motion with-

out a word, but as Dr. Acland had again gone into the whole- question, he must ask what had they been doing with regardto medical education ? They had selected ten members of theCouncil whom they thought best fitted to give a good reporton the subject, and that committee had fully considered all theresolutions and suggestions that had been laid before theCouncil. It Dr. Acland had read their report with attention,- he would see that the committee had been in no degree regard-less of the very objects which he sought to ob’ain. The com-mittee sat for several days, and they concluded their labourswith a harmony of feeling and a harmony of resolution which<could hardly have been expected in so large a committee. Ifthey carried Dr. Acland’s amendment, it would shelve thewhole question for another year, and they would deserve the’taunt of being a " do nothing Council." Dr. Acland said itwas not fair to go on in the absence of Dr. Christison, the’chairman of the committee. He (Dr. Wood) could imaginethe surprise of Dr. Christison at finding the report upon whichhe had spent so much time shelved in the way now pro-posed. He threw on Dr. Acland the responsibility of the

delay. He did not say they were prepared to come to a deter-mination with regard to some of the recommendations, but hebelieved they were in a condition to take up a great part ofthe report in order that it might be set in action at once. Hewas quite prepared to go on with the report honestly, and en-deavour to adopt as much of it as they could agree upon.

Dr. CORRIGAN said he should vote against both the originalmotion and the amendment. With so many recommendationsto consider, it was useless to go on.

After a brief reply from Dr. ACLAND,The PRFSIDENT said if the Council should decide upon meet-

ing again next week (" No, no") he should be happy to attend ;if Not. he should certainly hold up his hand against disposing- of this important business in the hour and a half that remainedto them.The vote was then taken. The amendment was negatived

by 8 against 4, and the original motion was negatived by 8against 5. The question accordingly goes over to the nextmeeting of the Council.

Correspondence."Audi alteram partem."

THE BRITISH PHARMACOP&OElig;IA.

To the Editor of THE LANCET.

SiR, -The communication published in the last number ofyour journal, and signed by Dr. Apjohn, calls for a reply fromme; and although I can truly say, as he has said, that I I I am

very reluctant to engage in controversy of any kind," yet beingsingled out from among the host of commentators upon theBritish Pharmacopoeia, and summoned before the tribunal ofpublic opinion to answer for statements which I in commonwith others have made, I cannot hesitate to appear to thechallenge, and to justify as best I may the criticisms I havealready ventured to offer, and which you have done me thehonour of publishing.

Dr. Apjohn states at the commencement of his communica.tion that he writes as a member of the Pharmacopoeia Commit-tee, but it might be inferred from observations made throughouthis letter that he writes also in the name of the committee;and his object is to show that the statements made in a lectureI delivered before the members of the Pharmaceutical Societyare so " erroneous and unjust" as to call for "a a public contra-diction," and to raise a doubt as to my qualifications for theoffice I had undertaken in criticizing the Pharmacopoeia.Whether the communication be that of a member of the

committee, or whether it represents the committee itself, itequally commands respect, and I shall not allow the personalremarks which occur throughout the document to draw mefrom the real questions at issue. One observation, however, Imust be allowed to make here once for all: I hold myselfanswerable for what I have said ; but not, in several instances,for what I am represented to have said by Dr. Apjohn.

I have stated in my lecture that Mindererus’s spirit madewith distilled vinegar and carbonate of ammonia is more agree-able than that made with strong acetic acid and caustic ammo-nia, and that it is therefore preferred by many persons. Iexhibited specimens of each, and pointed out their peculiarcharacters, stating especially that, while distilled vinegar, in.addition to the acetic acid it contains, has a faintly vinousethereal flavour which is very agreeable, the strong acetic acidof commerce made by distilling acetate of soda with oil ofvitriol "is rarely entirely free from sulphurous acid." I stilladhere to this statement, coupled with the remark which Imade at the same time, that although many persons prefer theold liquor ammoniae acetatis, yet we may soon become recon.ciled to the new preparation.

I have stated, with reference to glacial acetic acid, that itcannot be produced by the process given in the Pharmacopoeia.This is the result of my experience ; and although I have triedthe process several times within the last few days, carefullyobserving all the possible conditions indicated in the Pharma-copoeia, yet I have failed now, as well as on all former occa-sions, to obtain glacial acid by this process. It is true I havenot used sulphuric acid of the density indicated in the Phar-macopaeia, but I have used acid made strictly according to thePharmacopoeia process. I have not been able either to procureor to prepare distilled sulphuric acid of the specific gravity1 ’846; and I think there must be some mistake in assigningthis specific gravity to acid produced by distillation from Eng-lish oil of vitriol. In order, however, to comply with one ofthe characters given of the sulphuric acid directed to be used,I have tried the process with distilled sulphuric acid, to whichNordhausen oil of vitriol was added so as to bring the gravityup to 1.846 ; and yet, with the acid thus fortified in strength, Ihave not been able to get acetic acid at one operation, as de-scribed in the Pharmacopoeia, that is entitled to be calledglacial. I have obtained in that way a strong acid that willcrystallize at 32&deg; Fahr., or a few degrees below that point; butthe crvstals qnickly melt when the temperature rises above 32..This, I need bartily say, is not glacial acetic acid, much lessmonohydrated acid, although it is capable of yielding glacialacid by a series of fractional congelations and drainings, whichI believe is the method practically adopted by manufacturers.But all this is foreign to the instructions given in the Pharma-copceia; and I repeat, that by the Pharmacopoeia process mono-hydrated glacial acetic acid cannot be obtained. The principal