Oldalképek
PDF
ePub

tation was thrown upon the College rather than ourselves; and leaving it to his discretion to take any steps which he might think the interests of that body required on the occasion. This was accordingly done; and the President has replied through the medium of the Registrar, that "he thinks the statement perfectly satisfactory," and recommended its being made public. I have felt some difficulty about the best method to be adopted for that purpose. Of course, the London Medical and Physical Journal was entirely out of the question: but thinking it particularly important, that these transactions should be fully known to the Members of the College, I have determined to distribute a Circular Letter among them, and a few other friends. JOSEPH AGER.

Statement of Facts.

When the Hunterian Museum was presented to the late Corporation of Surgeons, a Treasury-Minute of the Conditions was drawn up, and certain Trustees were appointed to see them enforced; among whom are the President and four Censors of the College of Physicians. The first condition is, that "the Collection shall be open four hours in the forenoon, two days every week, for inspection and consultation of the Fellows of the College of Physicians, the Members of the Company of Surgeons, and persons properly introduced by them; a Catalogue of the preparations, and a proper person to explain it, being at those times always in the room.' The number of days of admission had been diminished, to give more time for proceeding with the Catalogue; and a general complaint was made among the Members of the College of Surgeons, that the Museum was not sufficiently open and useful to them.

At the Quarterly Meeting of the Trustees on the 6th of May last, there were present, the Duke of Somerset, Mr. Davies Gilbert, Dr. Ager, Dr. Elliotson, and Dr. Ramadge. The last Gentleman suggested to the Board the propriety of making the days of admission more frequent, in which all the other Trustees concurred; but it was thought advisable, that an extraordinary meeting should be called, and the Curators summoned to attend on the 20th May, to enable the Board to decide finally upon that subject, as well as the means of completing the Catalogue as soon as possible.

At this second meeting, besides the Trustees present at the preceding, Lord Colchester and Sir Everard Home attended; but the latter Gentleman withdrew on the introduction of the Curators. Arrangements were made for expediting the preparation of the Catalogue, and it was determined unanimously, that the original conditions should be strictly enforced.

At the next Quarterly Meeting, on the 5th of August, there assembled Lord St. Helens, Sir E. Home, Dr. Ager, and Dr. Ramadge. A communication was received from a Meeting of Members of the College of Surgeons, conveying their thanks for what had been already done; and requesting, that the times of admission to the Museum should be increased, and the Licentiates of the College of Physicians, as well as other respectable Medical and Scientific Persons, privileged to attend. These regulations had indeed been suggested to the Board by the Censors present at the former Meetings; but it was seen with regret, on referring to the original conditions, that the Trustees had no power to enforce them. The only arrangement then made respected the interpretation of the terms "properly introduced." A personal introduction had previously been required; but it was unanimously agreed, that a Letter should be thenceforth considered sufficient, and that the regulation thus interpreted should be communicated to those Gentlemen who had applied to the Board.

2. Dr. M'Leod's Circular.

To Sir HENRY HALFORD, Bart.

Henrietta-street, Cavendish-square; :
November 10th, 1826.

SIR, Some public discussion having taken place with regard to the line, of conduct adopted by the late Censors of the College of Physicians, in the questions which have recently been agitated in the College of Surgeons; and the part which I have taken on this occasion having been represented as disrespectful towards that body, of which I am a Licentiate, I take the liberty of soliciting your attention to the following observations.

On a recent occasion, a circumstance occurred at a meeting of the Trustees of the Hunterian Museum, by which the feelings of the Licentiates were hurt, as (till it was explained) it appeared to place in a conspicuous, point of view the preference given to the Fellows. That the impression produced by this occurrence was of the nature I have stated, is well known; and several letters were addressed to me upon the subject, as Editor of a Medical Journal. One of these being more temperate than the others, I published, appending to it a note, in which I remarked that the letter proceeded upon the "assumption" that the Trustees had unlimited power to admit whom they pleased; adding, that I should like to hear what the Censors had to say in explanation. It is quite obvious that an opportunity, was thus afforded to the Censors of conciliating the Licentiates, by explaining the circumstance which had given rise to the misunderstanding. A month, however, elapsed, but no communication was made; and it was not till the ensuing Number of the "Medical and Physical Journal" had been completed, and was on the eve of being struck off, that a letter was received, not, indeed, from the Censors, but from one individual among them, who expressly stated it to be on his own part. This letter reflected on me as requiring what no "liberal and intelligent" person would have deemed necessary; but, as it seemed intended to explain the circumstance which had prevented the Licentiates from being, in this instance, placed on the same footing with the Fellows, I was induced to stop the press for its insertion; having stated in the preceding paragraph, that, if the Censors had not the power to grant what was desired, "no impartial person" would "blame them."

But, in the remarks alluded to, and which have given so much offence to the late Censors, I commented on the questionable policy of their interfering with the Hunterian Museum at all at such a time; because I regarded their co-operation with those surgeons whose avowed object was the abrogation of the Charter of their College, as calculated to embroil the two corporate bodies, and therefore as injudicious; as contrary to all established etiquette in the profession, and therefore as in bad taste. And, I ask, in the event of public meetings being held by the Licentiates to overthrow the authority, and destroy the Charter, of that learned body over which you preside,-I ask whether, under such circumstances, it would not be regarded as a most ungracious act, were the Council, or any other officers of the College of Surgeons, to avail themselves of any influence their official situations might accidentally give them, and to volunteer their services on the side of the Licentiates?

But, so far was I from wishing to implicate the College generally in the disapprobation, bestowed upon the Censors, that I expressly stated my remarks to be applicable to the latter "alone;" adding my belief that their interference at such a juncture was condemned by the members of their own body. This belief, which I still entertain, was founded on the infor

this discussion. It would, indeed, be endless, were the Editor of a Journal liable to be drawn into a controversy with every one from whom he differed in opinion. Both sides of the question have now been stated, and those who feel any interest about it will form their own judgment on the subject. I have the honour to be, Sir, your most obedient humble Servant,

RODERICK MACLEOD,

Licentiate of the Royal College of Physicians, and Editor of the "London Medical and Physical Journal."

To SIR HENRY HALFORD, Bart.

President of the Royal College of Physicians.

P. S. (Saturday, Nov. 11th.)—I have just been informed that the anonymous letter, so frequently alluded to, has been acknowledged, in the Lancet of to-day, as having proceeded from one of the late Censors. I take this opportunity of stating that it is not my intention to read, and consequently that I cannot answer, any thing which may hereafter appear in that publication.

R. M.

Remarks.

The above documents sufficiently explain the feelings, and set forth the arguments of the two parties. It would ill befit us to interfere, or give any opinion on the question, when every reader has the same data to ground his opinion on that we have.

In respect to the observations which we made on this subject, in our last number, we have but little to add. We distinctly stated that, “we knew not how, where, or why this invidious prohibition started into existence,” but that we had no hesitation in designating it a foul blot on the medical annals of England. We withdraw not one iota of the above sentiment. It is now clearly proved that the late Censors had no hand in originating this regulation respecting the admission of licentiates, and therefore they are absolved from all blame. That it was a dormant regulation, we appeal to the fellows and licentiates themselves. Did the latter require personal introductions from the former? We never heard of such a thing; and we can attest that we were never questioned as to our claim to admission, on proper days, in the character of licentiate. It is clear then that the treasury minute was a dead-letter till the late proceedings, when it was revived, unavoidably no doubt, with the other parts of the treasury minute which had not been complied with by the Curators. For this we do not blame the late censors, and are bound to believe that they did their best to rescind the regulation entirely.

But it becomes necessary to notice the letter of Socius, in the November Medical and Physical Journal. This gentleman alludes to the "unkind feelings" which are alledged by us as existing in the minds of the Licentiates towards the Fellows of the College. We never made any such assertion. We said that the marked degradation which meets the eye of the Licentiate, would be likely to transmute into open hostility what now exists in the shape of smothered indignation. This indignation arises from the state of degradation, (we repeat the word) in which the Licentiate is placed by the anomaly of his situation, without any reflection on the Fellows of the College, who cannot alter the existing state of things. We ask SOCIUS if the document produced by Dr. Ager does not prove the degradation of the Licentiate. The very Government itself degrades him, by either not recognizing such a being in the profession, or excluding him from a privilege ceded to every member of the College of Surgeons. If Socius will attempt to persuade the Licentiates that they have no reason in the world to be

discontented with their lot, he knows little of human nature. Can a Blane, a Babington, a Philip, an Armstrong, and fifty others of this metropolis, proceed to the house of Socius, cap in hand, to ask permission to visit the Hunterian Museum without feelings of smothered indignation? If they can, they are not men.

We have, on several occasions, exhorted every father in the British dominions, who has a son destined to practise as physician in England, and especially in the metropolis, to give him his classical and scientific education at Oxford or Cambridge, and his medical education in London, Dublin, Edinburgh, or Paris, as he may think fit. By this plan his son wil become a Fellow of the College of Physicians, and evade the degradation of the Licentiate. This plan is also, in our opinion, infinitely preferable to any other, in every point of view. We know that our observations on this subject, on a former occasion, have produced a strong impression on the minds of those who are bringing up their sons as physicians.

But as the change which may be effected thus, in the proportion between Fellows and Licentiates, must be very slow, and can never entirely cure the invidious distinction which now exists, we think that an act of liberality on the part of the College, which would be perfectly compatible with the safety and stability of its charter, and eminently calculated to disarm the medico-radicals, while it cemented the bond of union among all the more distinguished physicians of the kingdom, is highly worthy of attention from the present enlightened president of the College. We mean an annual admission of a certain number of physicians (of other Universities than Oxford or Cambridge) who may have acquired the esteem of the public and the profession at large, by their probity, talents, learning, and medical science. Such a prospect or premium for merit would prove an unceasing stimulus to the whole body of physicians, while the annual influx of talent into the fellowship would soon render it the most distinguished College in Europe. No change, in our humble opinion, should be made in the path which now leads to the right of a fellowship; but the grace of admission should be liberal, and accorded only to merit. The parsimonious exercise of this prerogative, once in three or four years, towards an individual, is really calculated to engender jealousy and discontent, instead of emulation, hope, and concord, between the two classes of physicians.

IV.

PATHOLOGY AND TREATMENT OF CROUP..

Spreull's Court, Glasgow, 5th Oct. 1826.

Sir,-In reply to some remarks which you have introduced into your Journal for Oct. 1826, page 436, I beg leave to say, that I had neither seen nor heard of M. Guersent's Articles on Croup, nor of Dr. Bretonneau's Memoirs on that subject, when I published my remarks in the Edinburgh Journal for April, 1825. I have also reason to believe, that these authors and their opinions were quite unknown to those practitioners, who, in this town, first introduced the practice of applying lunar caustic in what was called Sore Throat ending in Croup.

As for the pathological fact, that the fibrinous effusion in croup, at least in some cases, commences on the tonsils, and thence spreads to the velum, phaVOL. VI. No. 11.

U

rynx, larynx, windpipe, and oesophagus, this was so strikingly the case in more than one fatal case which occurred under my own care, that I could not omit to observe it. The coincidence in pathology between Dr. Bretonneau and myself, has been purely the result of two individuals attending to the same disease, without any knowledge of the labours of each other; and of course it confirms the observations of both.

The coincidence in practice between Dr. Bretonneau and the practitioners in this town, who, some 7 years ago, tried lunar caustic in the sore throat, as it was styled, which so frequently ended in croup, is, I believe, as purely accidental; and also highly confirmative of the utility of this application of escharotic remedies. It was to these gentlemen I referred in my paper, when I stated that I had received this practice from others, in whose hands, as well as in my own, it had proved successful.

The following is the progress of my knowledge of the subject.

In 1812 or 1813, I had occasion to see two cases of what was called Sore Throat ending in Croup. They were under the care of the late Mr. Stenhouse of this town, and in one of them I repeatedly applied, under his direction, a strong infusion of capsicum to the tonsils, by means of a bit of rag mounted on a pencil. Both cases terminated fatally; and of course indelibly impressed my mind with the alledged fact, that putrid sore throat was liable to end in croup.

In 1819, the same disease prevailed very much in this place, and I had an opportunity of inspecting the bodies of several children who died of it. In May, 1820, Dr. Thomas Brown read a valuable paper on this disease, in the Glasgow Medical Society, and related, amongst other cases, one in which the application of solid lunar caustic appeared to be successful in preventing the extension of this disease to the larynx. I afterwards understood that Mr. James Watson had found a solution of the saine substance successful in one or more cases.

In 1821, this disease proved fatal to two children under my own care. In both, the fetor of the breath and the sloughy appearance of the effused lymph, were remarkable. In the first case, indeed, I was surprised, on dissection, to find the tonsils and uvula entire, and coated over only with an effusion; for I had laid my account to find a gangrenous loss of substance in these parts. My opinions regarding this Sore Throat ending in Croup, had till this period been wavering; but I now announced to several of my medical brethren, that what had been considered ulcers and sloughs in this disease were nothing else than effused lymph, the progress of which over the velum and uvula, and towards the alimentary and respiratory passages, I had distinctly observed.

In the 2d of these two cases, I called in Mr. James Watson, who applied the solution of lunar caustic, but without success. In two subsequent cases, however, (one of which was also seen by Mr. W. along with me,) having found the solution effectual in procuring the detachment of the effused lymph, and apparently in preventing the extension of the disease to the larynx, I judged that I ought not to allow a remedy, which promised to be useful in so terrible a disease, to remain unknown; and accordingly I published my remarks in the Edinburgh Journal. Whatever motives others might have to let their observations pass sub silentio, I had none; and, therefore, published what I thought, and what I had seen of this disease and of this mode of treatment, taking credit, no doubt, to myself for what belonged to me regarding the pathology, but ascribing to others the invention of the escharotic practice, without touching on the delicate question of priority. Notwithstanding this, a sort of an attack was made upon me in the Glasgow Medical Society, not by Dr. Brown nor

« ElőzőTovább »