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T H E LANCET.

LONDON: SATURDAY, JULY 12, 1856.

POSTPONEMENT OF THE MEDICAL PROFESSION BILL.

THE postponement of the Medical Profession Bill till nextsession will hardly create surprise. The late period of thesession at which the Select Committee was enabled to bring upits Report scarcely left any available time for discussion oreven compliance with the forms of the House, should any oppo-sition have to be encountered. But long and often as hope hasbeen deferred, we still do not despair of the satisfactory ad-justment of a question of such vast importance to the publicand the medical profession in the next session of Parliament.There are many most favourable circumstances connected with

the Bill now before the House, which have been combined infavour of a Medical Reform Bill. In the first place, becausethe most necessary to success, the Bill has the support ofGovernment and a very large proportion of the indepen-dent members of the House. In the next place, the mea-

sure itself is based upon large principles of public justiceand public requirements ; it obliterates many of those grossanomalies which so often tend to bring the profession intopublic contempt, and which have so long been the source ofjealousies and disunion amongst us; it provides most satisfac-torily for the efficient preliminary and professional education ofmedical practitioners; it gives the profession of medicine aTecognised status in connexion with the State; it draws a broadand intelligible boundary between qualified practitioners andimpostors; it provides for the publication of a State Registerof qualified practitioners-itself an object of incalculable im-portance to the profession; it happily reconciles the just claimsof medical corporations, without permitting these bodies toretain an injurious monopoly; it gives the public the full ad-vantage of free competition between the Universities and theColleges-a competition that will work, not as heretofore inattracting diploma-fees by lowering the standard of examina-tion, but in stimulating a more honourable rivalry to makedegrees and diplomas objects of ambition through the highcharacter of the acquirements necessary to obtain them. No

institution, whether University or College, that is entitled toplace a just confidence in its own merits, or the honesty of itsintentions, will shrink from a competition of this sort. Nor do

we think that the close and small governing bodies of our cor-porations ought to be confounded with the masses of the pro-fession who, under existing regulations, have received diplomasfrom these corporations. When it is said, for instance, thatthe present Medical Bill is opposed by the College of Surgeons,this simply means that the Bill is opposed by that small section,which is interested in maintaining its actual monopoly ofgovernment and the attendant professional advantages. It

does not mean that the Bill is opposed by the great body ofthe members of the College, who are simply diplomatized bythe Council, without possessing any status in the College itself.The sympathies of the thousands of so-called members of theCollege must be warmly engaged in support of a measure

which will tend to raise their position in public esteem, andconfer upon them tangible rights of an important character,which they do not at present enjoy.

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It was therefore only the ruling dynasty of the College thatleagued together to overthrow this measure. When Par-

liament and the public are told that the Bill was opposed bythe Colleges of Surgeons of London, of Edinburgh and Dublin,and the Glasgow Faculty, they must understand that it wasonly the governing powers of those corporations that enteredinto articles of agreement to procure the rejection or modifica-tion of a Bill that threatened not the real detriment of the

Colleges, but the abolition of privileges held by a few to theinjury of the many.During the recess, ample time will be afforded for the mature

discussion ef the merits of the Bill. We commend it to the

candid consideration of our readers, and urge upon them the

expediency of omitting no effort to ensure its being passed intolaw during the next session of Parliament, with such modifica-tions as may appear to them to be right and beneficial.

AMONGST the worst evils to which medical practitioners areexposed in Scotland, and which would doubtless be remediedby a properly-constituted Medical Council for that division ofthe kingdom, are-First, the penal clause in the new

Registration Act, subjecting any physician or surgeon in

attendance upon a patient who dies to the fine of "fortyshilling8," if he fails to forward, within fourteen days afterthat event, the required notice of death to the district registrar,notwithstanding he receives no remuneration as a set-off tosuch unjust treatment. Secondly, when any member of the

profession writes a certificate as to the mental condition of alunatic, whom it is proposed to place in an asylum, he mustdeclare his medical opinion " on soul and conscience;" in fact,an oath is virtually taken when signing this formula; whilstthe same is often required, although only certifying much lessimportant professional matters.The former of these objectionable proceedings was promi-

nently pointed out by an experienced physician in a paper onthe Sanitary Condition of Scotland, of which an abstract ap-peared in a previous number* of THE LANCET; while the latterregulation, demanding all medical certificates regarding insanepatients to contain the solemn words " soul and conscience," isalso noticed, by the same authority, amongst his Notes on thePublic Asylums of Scotland, just published in the pages of apsychological contemporary. Employing these expressionswhen a simple professional duty is performed is surely un-

necessary and offensive. Well may the writer now quotedremark, it ought to suffice if the party signing " certifies any" fact like a man of honour and a gentleman. He always ex-" presses truth, whether simply by word of mouth, or in litera

" scripta. " ’

The Lord Advocate would act wisely, were he to alter thepenal clause in the lately-passed Registration Act; and alsorelease medical practitioners from being compelled, under a

penalty, to state always, " on soul and conscience," that par-ticular circumstances came within their own knowledge. In

both procedures, the mode so long followed in England withadvantage ought to be adopted. Such system answers south-ward. Hence it would require the most subtile casuist todemonstrate that an analogous course of proceeding was inap-plicable to northern residents.Amongst other changes which ought to be effected, not the

* No. 1711, p. 658, published June 14th, 1856.

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ACTING ASSISTANT-SURGEONS OF THE ARMY.least beneficial would be the appointment of Coroners throughout 1

every county, so as to assimilate the practice with that ofEngland, where it is attended by many advantages. Althoughthis office is now altogether unknown in Scotland, there seemsgood ground for believing these judicial functionaries existedduring bygone times. Thus, in the record of the Justice-

Ayres, begun at Jedburgh, 31st October, 1502, an entryappears concerning the " Coronatores de Ledworth ;" and inthe same book a precept is mentioned, under the King’s hand,dated April 12th, 1504, which was directed to the " Crownarof Twedaile." The above notices would imply that suchpublic officials formerly existed. Doubtless the Sheriff or

Procurator-Fiscal can order an inquiry wherever violence mayhave been committed, ending in the death of a human being,or when a serious crime is suspected, but as these investiga-tions are usually instituted only in very urgent cases, whilst

very many pass without notice, or remain in oblivion, it

becomes almost impossible to arrive at correct conclusions,whether, for instance, a dead body found on the sea-shore haddied through fair means or foul. A very remarkable illustra-

tion of this dilemma was recently communicated by Mr. I.CRAIG, of Ratho, in a pamphlet which he published, to showthe necessity of coroners’ inquests in North Britain. Amongstother examples, he mentions especially that of a corpse foundon the eastern coast, apparently some time after death, " whichwas actually buried as the wife of a certain gentleman,though the said lady turned up alive thereafter!" Consider-

ing the large number of still-born infants annually reported,without strict inquiry being made how such frequent casualtiesoccurred, and as nearly 600 persons every year lose their livesthrough violent means in the eight chief towns of Scotland,having an estimated population of, at present, about 855,000inhabitants, these events afford ample ground for judicial exa-mination. The fatal cases by violence are quite as numerousamongst the urban population of North Britain as in London,where all will allow that an inquiry respecting the mode ofdeath, if it does not prove crime to have been committed, isoften highly satisfactory, by removing suspicion of criminalconduct; whilst the careful sifting of causes producing anyserious disaster frequently suggests remedies for the preventionof like occurrences. Amongst other improvements required,the restoration of the Coroner’s Court in Scotland appears, for

many cogent reasons, exceedingly desirable.

NOTWITHSTANDING the charge of the Recorder to the GrandJury respecting the case of Mr. SNAPE, who stands accusedof manslaughter, on account of the death of a lunatic shortlyafter the administration of a shower-bath ordered by Mr.SNAPE, a true bill has been found. The trial is adjourned tothe next sessions. We forbear at present from any remarks

beyond those we have already expressed upon the case. Much

popular feeling has been excited, but popular feeling upon aquestion of this kind is often largely tinctured with prejudice,and cannot be based upon that accurate knowledge of all thebearings which is essential to the formation of a just opinion.The postponement of the trial will no doubt tend to secure amore satisfactory judgment than if it had been proceeded withat once.

We print the charge of the Recorder. Justice to Mr. SrrApE

calls for the publication of a judicial statement calculated to

temper the impulsive condemnation prompted by popularfeeling.

" The Recorder said there was only one case to which heconsidered it necessary to direct their attention. It wasdoubtful, he said, whether, in point of fact, any bill would bepreferred in reference to the particular inquiry; but, as thecase appeared in the calendar, although the gentleman whowas accused had been admitted to bail, a bill possibly mightbe brought before them, and he would mention what the lawwas upon the subject. The case to which he referred was thatof a medical gentleman named Snape, who was charged withcausing the death of a patient under his charge in the SurreyLunatic Asylum. It appeared that the patient, who was amold man, sixty-five years of age, had been subjected to a,

shower-bath, which was one of the devices made use of underthe present system in lunatic asylums, instead of chains andother modes of restraint that were formerly employed, for thepurpose of lowering the patients, and which he believed hadbeen found very beneficial. The patient, it appeared, wasordered to be kept in the bath for half an hour, and he didremain there for twenty-eight minutes, and very soon after hecame out he died. The case was certainly one of an important,character, and, if it should come before them, they would have.to inquire if the treatment adopted by Mr. Snape was accom-panied by a reasonable degree of knowledge of his profession,.attention, and caution. It mattered not whether the partycharged was or was not a properly-qualified practitioner;every man who undertook to act in that capacity was boundto use the same degree of caution and knowledge; but it hap-pened that in this case the question would not arise, as Mr.Snape was a properly-qualified person. God forbid. however,"said his Lordship, " that any medical man should be renderedliable to a charge of manslaughter for a mere mistake ! Some-times the boldest surgeon was the best, and it would be mostlamentable if an able surgeon was to suffer for an error in-judgment. It appeared to him that, before they would bejustified in finding the bill in this case, they must be satisfiedthat gross ignorance, gross inattention, or gross rashness had

been exhibited." "

No class of men have done their duty more faithfully to the-country than the acting assistant-surgeons of the army. As.

far as we know not a single complaint has been made againstany one of them during their service in the East. Such men

surely deserve, on retiring from the army, every considerationk3onsistent with justice and propriety. Yet Government in-

tends to dismiss them with the miserable gratuity of twomonths’ pay. Such an act of injustice will surely not be per-mitted. On the disbanding of the militia regiments, the

surgeons had presented to them a full year’s salary. The

medical officers of the Turkish Contingent were similarlytreated. Where, then, is the consistency or justice of the

paltry award made to the acting assistant-surgeons of the-

army ? Let them memorialize the Government firmly but re-

spectfully, and they will succeed in being placed at least on anequal footing with those who have no greater claims to publicconsideration than themselves.

———

AT p. 54 we publish a statement issued by the four SeniorMedical Officers to the late Civil Hospital at Smyrna. No one

can peruse it without being satisfied that these gentlemen havereason to complain of ill-treatment, if not exactly of bad faith,.on the part of the Government. It may be true that the expe-riment of a Civil Hospital at Smyrna did not quite answer theexpectations of those who devised it; but the- penalty of that-mistake ought not in any degree to fall upon those who wereenticed away from important positions and at great personalsacrifices to take charge of the establishment. The case, as

stated by the medical officers, is plain, temperate, and con-vincing. The memorial will, we trust, command the attentionof the House of Commons, and gain redress for its subscribers.53