A . Subscriber, (Camberwell.)-1. No time is fixed fur the publication of the first Register. It will be in the form of a book, and may be purchased.-. He To Correspondents. will receive a certificate of being registered, which certificate will entitle him to all the privileges conferred by the Act. IT would greatly facilitate our labours if gentlemen, who kindly forward to us Mr. M. G. Evans.-No prosecutor has been appointed under the Act. Any could the information. newspapers or other periodicals, would be good enough to mark the articles person lay 3fr. Fredervek Collins.-Inquiry should be made into the subject. to which they wish to direct our attention. Brevity and condensation in R. W.-1. There is no direct statute to prevent it.-2. Not of surgeon.-3. It communications forwarded for publication are especial recommendations to might admit of question. our favour. It is, moreover, desirable that our correspondents should assume C. W. S.-It will depend upon the bye-laws of the Club. definite and easily-recognisable signatures. We have occasionally on our THE ROYAL COLLEGE OF PHYSICIANS. table at the same time half a dozen letters, each signed "A Surgeon;" the To the Editor of THE LANCET. *’ Subscribers" are too numerous to mention; whilst those who merely attach SIR,-Since the Medical Act has passed, the members of the various univer- " N.D." or "M.R.C.S." to their communications are legion. It would remove sities and other public medical colleges and institutions naturally look forward to progressive improvements in the constitution of those establishments, either much and confusion if some more distinct and less common difficulty signa- in the amendment of some of their laws or rules, or in some organic change of tures were to be adopted. their charters. I desire on the present occasion to bring forward a few suggestions for the THE LONDON MEDICAL REGISTRATION ASSOCIATION. consideration of the London Royal College of Physicians, in the hope that they WE have been requested by the Honorary Secretary of the London Medical may be pleased to modify or eradicate those laws or rules which are obnoxious to the welfare of its members. The with Association to state that, on medical practi- College has, enlightened liberality, Registration legally-qualified opened its portals to Scotch and Irish doctols of medicine, and made them tioners members of that on the becoming body, they may, furnishing proper licentiates and fellows of their own body. It has given equal advantages and information to the Secretary, together with the amount of the registration position to them as to graduates of Oxford and Cambridge. The College has fee, secure the services of himself to effect their due registration. Such gen- opened its doors to practitioners in the country, as well as to those who have obtained But there are anomalies in the distinctions and tlemen are also the to furnish him with the names foreign degrees. requested by Secretary honours of the at variance with the of and both of the of the College quite spirit progress, repug- legally-qualifiedand (in a aeparate list) unqualified persons nant to justice, and which certainly demand alteration. It would be well if a practising medicine and surgery in their respective neighbourhoods, so that, gentleman of ability in the Council or amongst the fellows would bring all on the information thereby furnished being afforded by him to the Registrar inequalities or complaints of members fairly before the College or before the new Medical Council. under the Act, that officer may be enabled to render the registration as com- I will first of all refer to the mode of electing licentiates into the higher plete and accurate as possible. grade of the fellowship. While I admit that the selection is often judicious, A Brig7tton Subseriber.-1. He can only register his qualifications.-2. There yet there seems no fixed rule nor governing principle publicly known in making the There seems no nor obvious reason for the selection of is no at for such a selection. special arrangement present supply. fellows over several of modest whose unobtrusive at- is not known. many gentlemen merit, Tyro.-It tainments would equally entitle them to the distinction of fellows. A reco- Nemo.-Yes, he might be compelled to do so; but surely no other practitioner, gnised path to the honours of a fellowship, patent to all who aspire to them, under such circumstances, would make a charge. should be clearly chalked out to those ambitious to walk therein. Several of the licentiates who have been made fellows are no means in Mr. J. Johnson.-No charge can be made by a public vaccinator for re-vaccina- by superior age, or to those who have been over in the list of the tion experience, abiiity passed licentiates. What constitutes superiority? or what gives a claim to the higher THE MEDICAL ACT. title uf fellow? Some of these more favoured gentlemen have not written To the Editor of THE LANCET. original or valuable works on Medicine, nor axe they known to have enjoyed SIR,-The Medical Act is a theme upon which every lover of his profession great public repute for enlarged experience, nor to have made scientific investi- must delight to dwell. Its importance and many of its bearings upon the gations, nor to have been successful teachers. Some may lay claim to the privi- future have already been pointed out in various ways in THE LANCET. It cer- lege in consequence of writing a work; but this is a very fallacious test of supe- tainly forms a new era in the history of our profession. It not only recognises riority, for it is well known that many of the ablest physicians have never pub- us as a distinct body professional, but it also grants us the full liberty of lished a work, nor given their lueubrations to the world. I believe that the governing ourselves. In what other country do we find the medical profession late Dr. Chambers, whose knowledge and experience were undoubted, ne’VH stand upon so proud a footing ? We are not placed, by the Act, under the published a single volume; the same niiht be said of others, whose time domination of Government, as the profession is in most, if not all, European was absorbed in the practice of their profession, and who never enjoyed learned countries; but, as may be said, "we have the law in our own hands," and it is leisure. By what test or clear principle, then, are licentiates entitled to the to be hoped that we shall not make a bad use of it. higher grade of the fellowship ? At present it seems an uncertain and arbitrary " In the days of the Institute" the cry was for a. law to enable the profession mode of selection. "to govern itself." We are now possessed of such a law. We have a Council I will now refer to the different titles of licentiates and extra-licentiates,-a consisting wholly of medical men, and its acts up to the present time have distinction at once unreasonable and antiqnated,-founded on the idea that the been such as to deserve approbation. It has done much in a short time. Its lives of people were more precious within ten miles of London than of those appointment of the Registrar was of no small importance, and in discharging beyond that pale or sacred precinct, and therefore that less medical skill was that duty it, I may assume, could not have selected a more befitting person, sufficient for the rural plebeians. I think that the extra-licentiates have just one at whom the finger of disapprobation cannot be pointed, inasmuch as he is ground of complaint of an invidious distinction and presumed inferiority, be- an experienced Medical Registrar, and one of the most respected members of cause they live at Manchester, Leamington, Bath, or Cheltenham. When the the most ancient Medical College in the kingdom. railroads have removed men of wealth further in the country, and the nobility But, Sir, there are many things, which have not yet been brought into notice, and gentry of the kingdom live half of their time in the provinces, and require- that suggest themselves in connexion with the Medical Act. I have already just as much professional lore and experience as when they reside in London, noticed that the new Act biuds us together into a body professional. Ought it it is but just to place the whole profession on an equal basis in rank, honour, not also be made the instrument for forming us into a body political? Will and dignity, and not to make distinctions upon the absurd ground of distance, not the Medical Register furnish a perfect machinery fur enabling us to return of examinations, or fees. Let there be but one fee and one just and rigid exa- members to represent us in Parliament ? mination for all, and bring the members into harmony by equal rights, titles, I believe it has been acknowledged on all hands that, as a principle, educa- and honours. I trust that the College will abolish this useless distinction, and tion and intelligence ought to be represented. The difficulty hitherto has been, give the provincial physicians the same advuntages as those who reside in the absence of any legal bonds of union amongst a sufficient number of that London. class of the community, with the exception of the two ancient universities in Another anomaly, to which I beg to draw your attention, is, that while -the England, and their sister in Ireland. It cannot be said that the medical College grants the power to practise medicine, it has no power to confer the profession is now in that condition. As, in all probability, a Bll for altering title of Ductor of Medicine, so that it is essential to obtain a diploma elsewhere the parliamentary franchise will be introduced during the next session, it is - to go to St. Andrews or to Giessen. This is at once inconvenient and de- our duty, as well as our interest, to put forward our claim as a distinct body grading. I hope the new Medical Council has the power to correct this deti- to be represented in the House of Commons. Surely such a number of educated eiency. But has the College no power to alter this rule, when it has already men, already registered, without the aid of a " revising barrister," could have no! effected great and organic changes in its constitution? A few years ago the reason to be ashamed to urge such a claim. We ought to have, at least, four fellowship was restricted, almost exclusively, to graduates of Oxford and Cam representatives-two for England, one for Ireland, and one for Scotland. bridge, or Dublin ; now it is thrown open to all the licentiates. Surely if the cannot effact reforms to meet the wants of a Now ,Sir, a very few words respecting another subject of some importance., College proper progressive age, am often asked by general practitioners whether the new Act is likely to rid an application to Parliament or to the new Medical Council becomes a primary them of the intrusion of quacks, who daily throw themselves in their way. I can duty on the part of the governing body of the College; and then the Roya only refer them to Clause XL. of the Act. That clause, however, is anything but; College of Physicians of London will command the homage and respect of the satisfactory. It is deficient as far as having any control over the kind of quacks, whole profession, and we shall not see gentlemen flying to Scotland and Ger- who annoy the regular practitioner-namely, fellows who do not assume anyr many for that title now denied by the present constitution of the College. If titles, but who, by audacity and falsehood, do much mischief both to the re-. the College will vindicate its own high character, let it possess the power ofcon- gular practitioner and the public. Many of them cannot even write their_ ferring the title of M.D., as well as enforcing a high standard of examinations names. and a moderate fee, and abolish the terms of licentiates and extra-licentiates. It As it is probable that some amendments may be considered necessary in the is scarcely an honour to be an M.D., since it is assumed by any quack, homœo- Medical Act, a very fewwords added toClauseXL. would bring these gentry into) pathist, hydropathist, et hoe genus omne. Once it was a badge of learning and the meshes of the net, and put a stop to their doings; for instance, in the dignity. It is the duty of the College of Physicians to rescue that dignity seventh line of that clause, (p. 688, line first, of the Government printed Act,)) from abasement and discredit.-I am, Sir, yours obediently, after the word " apothecary’ there should be inserted, " or shall practise medi- December, 1858. ROBERT WoLLAsTox, Ex.-L.R.C.P.L. " cine or surgery for lucre or without being registered under this Act." gain his am, S:r, yours, &c., Ir Dr. Griffith will indicate the advertisement to which he allndes, request Hertfordshire, Dec. I1858. J. D. shall be attended to. X. M.-The case is curable in the hands of any respectable surgeon. If ourr One on Tramp.-Yes, it can be effected. correspondent will forward his name and address, in confidence, he shall re-. - jtfr. Wilhams.-Under the circumstances, the Court of Examiners would permit ceive a private note. you to present yourself for examination. Omega must send his name and address. We could not answer the question Mr, w .: H. Huncox.-Yes, he would be proceeded against if he assumed any in THE LANCET. title or description implying that he was registered. Dr. Francis Cook’s (Cheltenham) letter will probably appear in our next. L.C.P.I.-Not if the examination be unsatisfactdy to the Council. 23 Right is Might.-l. It depends upon the bye-laws which regulate the lodge. Mr. J. Wearne.-No apprenticeship in such a case is necessary. A certificate - 2. The better plan would be, not to grant the certificate unless payment of having "served" for a stated period will be sufficient. The Council will be made at the time.-3. It would be difficult to fix liability upon any party, not enact retrospective laws. unless a specific contract for payment were previously made. A Reader.-The trash is unworthy of notice. Faugh a Ballagh.-Not legally. Anti-Empiria.-The particulars of the case should be transmitted to Dr. Francis Ulcus slall receive an answer next week. Hawkins. OF IN ITCH. Pecus can only recover from the relieving officer, who, of course, would resist USE NAPRTRALINE payment on the ground of his having issued the order as for attendance upon To the Editor of THE LaNCa2. a pauper. ’ SIR,-Presuming that any contribution, however small, which has for its MEDICAL TITLES. object the advancement of practical medicine, may prove acceptable to your To the Editor ofTHE LANCET. readers, I venture to trouble you with the following communication:- A of trade a consulted me an in number for December patient mine, by joiner, respecting eruption SIR,-The legal opinion published your llth, p. 611, which extended over the arms, and intolerable is and valuable to the at this and entitled to our thighs, legs, accompanied by interesting profession crisis, on warm in bed. I found it to sincere thanks. The is considered and itching, particularly getting Upon examination, subject carefully clearly represented; be a true case of saabies in the first stage of development. He stated that he but in the list of-names or from the 40th section of the as titles, quoted Act, had to a who him with ointment and for insertion in the fourth column of the there occurs applied druggist, supplied sulphur examples Register, which he had used without any benefit. He one which is either erroneous or that of powders, perseveringly deriving superfluous—viz., "general practi- advice. It occurred to me that effica- tioner." requested my naphthaline might prove cious. I, therefore, prepared n ointment, composed of two scruples of naph. however, if an error, is due to the framer of the Act; yet there is no This, thaline to an ounce of lard, directing him to rub the parts affected night and notice of it in the which, nevertheless, states-"Medical legal opinion, practi- for half an hour. To my on the third he called to tioners must now be careful not to assume a title or which morning surprise, day say very designation how he was that after the third the was are not to use." The title of gratified application eruption cured, they strictly and legally empowered "general and even after the first time of it the was relieved. does not is not conferred nor does it emanate using itching considerably ’practitioner’* belong to, by, from, He added that his wife and child had been alike that had used any college or licensing body in the kingdom; therefore it is not one which affected; they the same ointment with equal success. medical men are legally empowered to use." It appears rather to be one of I am not aware that has been used, or even by any those titles which are interdicted in the following sentence:—" Whatever de- naphthaline suggested, one for the cure of this troublesome for, to the work of signations, therefore, may have been heretofore erroneously assumed, through disease; on referring Erasmus Wilson, "On the Diseases of the Skin," 1 find no allusion made to it. previous unchallenged custom, henceforward no person can, strictly speaking, I think that a remedy which has proved so decidedly beneficial (as in these use any title without having been first enabled to do so by the competent legal " three is of a more extended With this I hasten to Where is for the title of cases) worthy trial. object authority." legal authority general practitioner" ? it before the in order that those who are connected "The document or the contains no such lay profession, officially conferring evidencing qualifications" with our workhouses and other may it a more ex- How was it and how came it into use ? Those large public charities give designation. created, physi- tended trial. If found will have at command a cians who also the do not assume those fellows invariably successful, they possess Apothecaries’licence it; and certain and in less and members of the of who are also licentiates of the speedy remedy, one, my opinion, objectionable than, College Surgeons, Hall, and at the same time as as, the old ointment. use but those the licence do assume inexpensive sulphur rarely it; who possess only Apothecaries’ I here add that M. of announced to the French Aca- and it into use as a from the dislike to the title of may Bonnet, Espinal, it, crept refuge growing " that benzine rubbcd on the affected will cure itch in Non-members of the could call them- demy ofmedicilie, parts apothecary. College not-conscientiously five afterwards the take a warm bath." Of this latter selves lmnee a a sort of which a few minutes; patient may surgeons, compromise, courtesy title, I have as had no If’ benzine so successful members of the with both qualifications adopted; but remedy yet experience. prove upon College unwittingly a more extended trial, it must of necessity supersede all other remedies, being those who possessed the alone soon discovered the College diploma question- moderate in am, your obedient able of the and connived at its use as a conventional equally price.-I Sir, servant, policy designation, Seymour-street, Liverpool, Dec. 1858. R. T. LODGE, M.D. term of distinction between pures and generals. The objectionable term was soon bestowed, those who had one exami- condescendingly by undergone only Mr. Bogg’s case of " Spontaneous Evolution" shall appear in the next number on those who had passed the same ordeal and another besides. If nation, of THE LANCET. general means anything in the way of qualification, it means more than one; yet it is applied to, and adopted by, those who are solely apothecaries, and not F.S.S.-1. He can register his qualifcation. The title, we believe, could be surgeons. Those who are solely members -of the College repudiate it; those assumed.-2. This is answered by the previous reply.-3. He is not an M.D. who are solely licentiates of the Hall have no claim to it; it is objectionable to - 4. No. those who are bott, because of its indiseriminate application, and because it HARMLESS AMUSEMENT. the title of which every member of the has a supplants "surgeon," College To the Editor THE right to and a respect for; it, moreover, confounds qualifications w1t.ich are of LANCET. not identical, and represents no legal title nor specific designation. SIR,- It has been well said that there is good in all things evil. In proof of A title or designation should be one that a man may use whenever called this, allow me to suggest to your readers a means of obtaining a small good upon to sign his name and quality to any legal document; for instance, in from a large system of evil-viz., homœopathy. Everyone engaged in practice witnessing a will, or registering his vote at an election, does a surgeon ever has felt the difficulty of dealing with little children, of enlisting their sym. sign A. B., General praetitioner" ? Practitioner of what ? It is as applicable i pathy, and of assuaging the alarm they so often feel at our presence. For this to law as to medicine. It is objectionable, however, on other grounds than purpose I have always been accustomed, as I snppose many others have, to bear those of mere nominal import; it suggests a comparative distinction even in about with me a few flags of truce in the form of comfits or small lozenges. public estimation, and introduces a fictitious inequality of status, which is not The effect of these in establishing amity, and so enabling me to investigate only repugnsnt, but injurious to the man who is graciously styled by his one- their ailments, as I could not otherwise do, is very great. Since the Bradford titled brother surgeon-a very respectable general practitioner. Nominal titles poisoning case, however, I find that the parents look rather uncomfortably at acquire value as indications of grade, else why should the late Warrant, which the coloured morsels, and I have occasionally had some qualms of conscience gives the rank ef Taior to the army surgeons, be so acceptable to that body? myself. This led me to look out for a substitute, and it is to be found in Those who bear the small grievances of others with edifying complacency homo’opathy. A very small case contains from 200 to 300 globules of the anay regard this view of the relative value of professional titles as insignificant; purest sugar, so pure as not to contain the billionth of a grain even of" daff" but facts might be easily advanced to confirm its importance. Ifdoubttal. poll Children take them readily, and enjoy them, and there is a little excitement in - our brethren practicing in provincial towrs. How many, possessing both qua- choosing which little bottle they will draw upon, which compensates for the lifications, will sign " A. B., General Practitioner"? Besides, there is no occa- want of injurious colouring matter. The extra expense is the only drawback; sion for it. The third column will show who have acquired the right to prac- but as a shilling’s worth will extend over thirty or forty visits, it can hardly be tise more than one branch of the profession; it need not be repvated in the considered very material. Of eourse, it is quite unimportant whether china, fourth, which is intended to contain a single specific designation. chamomilla, nux vomica, or other medicine (!) be used; but the most econo- A good example cf title is quoted from the London Gazette in the legal mical plan is to buy a quantity of one sort, and to fill the little labelled phials opinion, where it t says-" Mr. Lawrence is specially described as ’William from the heap. While the effect is thus good on the small children, I have Lawrence, Esq., Surgeon;’ thus showing that it was his connexion with the also found that there is a not less beneficial moral influence on children of a Royal College of Surgeons which entitled him to have the true designation, larger growth, who obtain some little practical insiglit into the value of the * Surgeon,’ added to his name." articles in a therapeutic point of view. Although it should be justly acknowledged that the examination at the Hall Hoping’ that you will not deem t1’e suggestion quite useless, is one which any man may be proud to have passed, as a critical test of his I a,.ii, Sir, yours, &c., proficiency in medienl science and its auxiliary branches, yet it cannot be Oxford-street, Manchester, Dec. 1858. J. THORBURN, M.D., &e. - denied that the tern’’apothecary" is one which, from obvious associations, most men dislike to assume. If the term "apothecary" is to be added to the COMMUNICATIONS, LETTERS, &c., have been received from-Mr. Ranald Martin; names of any members of the College, it is fair to presume that it would be Mr. Solly; Dr. Alfred S. Taylor; Mr. J. C. Wordsworth; Mr. Morrell; Mr. added to all who are also licentiates of the Hall, whatever be their other title. C. W. Izod, Esher; Mr. Duncan, Brightwalton; Mr. Watts, Liverpool, (with Then will it be a goodly Company, for there are many names which would gild the pill for ah. enclosure;) Mr. Evans, Blaenant, (with enclosure;) Mr. Snape, Bolton-le- In the progress of business the following questions must necessarily arise :- Moors; Mr. Devlin, Cork Harbour; Ilr. Harris, Cornwall; Mr. Cantley, How and by whom will the " title" to be inserted in the fourth cut,,:, of the Ripley; Dr. Mackinlay, Isieworth; Dr. Graily Hewitt; Mr. Hartley, Chel- Register be Jet"t’rciiied ? jVill the Council direct all the qnalitications, re- tenham, (with enclosure;) Mr. Southam, Manchester, enclosure;) Mr. turned in the certified to be entered in the third column ? Should every (with lists, Mr. Mr. medical man send up to the Registrar all his qualifications, or only those which Sandford, Bilston, (with enclosure;) Glover, Salop; Alexander, he desires to be registered ? May each individual select from amongst his Dudley; Mr. Bradley, Martley; Mr. Greer, Belfast; Mr. Caldwell, Dreghorn; qualifications t1wt titlc which he prefers for insertion in the fourth column ? Mr. Orange; Mr. Brown, Dorchester; Dr. Ryding, West Ashling; Dr. Cooke, Will the selection depend on the Council ? Or will all which are entered in Aldridge; Mr. Aceringtoii, (with enclosure ;) Royle, Bicester, the third column be in the fourth ? Ve cannot a Arkwright, repeated expect gratuitous Mr. Cocker- answer from the eminent writer rf the "opinion;" but some definite course, (with enclosure;) Mr. Perkins, Snaith, (with enclosure;) Bell, eonsistent with legal precision, should form the basis of registration, and be month, (with enclosure ;) Mr. West, Bridgwater; Mr. Green, St. John’s- made known to the profession. I am, Sir, your obedient servant, wuod; Mr. Jackson, Karls, Ireland ; Mr. May, Tottenham, (with enclosure;) December, 1s58. ALIQUIS. ,kIr. 1 Campion, Huntingdonshire, (with enclosure;) Mr. Roberts, Sheffield; THE gentleman who transmitted to us the article, "Poisoning by Chloride of Dr. May, Ratlifriland, (with enclosure;) Mr. Clarke, Lynton, (with enclo- Bariunz," from Manchester, will oblige by forwarding his name, his cardl sure;) Mr. Andrews, Long Eaton, (with enclosure;) Mr. Cockburn, Blyth, having been mislaid. (with enclosure Mr. Hopson, East Dereham, (with enclosure;) Dr. Cocks, Enguirer.-Apply tu the Registrar. Dundee, (with enclosure;) Mr. Lan;;ston Parker, Birmingham ; Mr. Bennett, M.D., (Pinang.)-’k’lte form of the advertisement is highly objectionable ; but Lymm, (with enclosure;) Mr. Marsh, North Devon Iniirmary, (with enclo- it is donbtf whether the Medical Act will have any infinence in checking, sure;) Mr. Hewitson, Newcastle-on-Tyne; Medieus, (with enclosure ;) Mall- the proceeding! of such persons in the Pinang district. chester School of Medicine, (with enclosure;) Alpha, (with enclosure;) &c. 24