Street, Manchester,] in the [county of Lancaster,] has been duly registered according to the provisions of the said Act, as a person who is qualified to practise medicine in any part of England and Wales, and that he is entitled to exercise all the powers and privileges conferred by the said Act.

25

of December, [1848,] and no longer.

Presented to the RT. HON. SIR GEORGE GREY, Bart., M.P., Her Majesty's Principal Secretary of State for the Home Department, by the ROYAL COLLEGE OF PHYSICIANS OF LONDON, August 8, 1816.

The President and Fellows of the Royal College of Physicians are induced respectfully to address Sir George Grey, as Her Majesty's Secretary of State for the Home Department, because they are unable, with out the aid of the Legislature, to complete certain changes in their constitution which appear to be called for by the state of the Profession and of society, and which they have long contemplated and desire to carry into effect.

The College is bound by its charter of incorporation, granted by Henry VIII, and subsequently confirmed by Act of Parliament, to examine and to license, if found competent, all persons who desire to practise as Physicians in London and within seven miles round. But the office of examining and licensing those who wish to practise beyond seven miles from London was given by the Act which confirmed the Charter, not to the College at large, but to a small Body composed of eight of its Members, termed Elects. The Elects not having been chosen, even at first by the Members at large, are endowed with separate functions, which they exercise independently of the College, the constitution of their Body being such, that all vacancies occurring in it are required to be filled up by the survivors.

As might be expected, inconveniences have arisen from this divided jurisdiction. And it is worthy of observation, that amongst all the grievances complained of in the Petitions for Medical Reform which were presented at one time, in great number, to Parliament, none were complained of more than the existence of local and exclusive jurisdictions; and the exercise, by numerous independent Bodies, of the power of examining and licensing Medical Practitioners. The latter circumstance, it was alleged, had caused a want of uniformity in the education and qualifications of Practitioners passing under the same denomination; and from the former circumstance it has resulted, that Licenses valid in one part of the Country are invalid in another, a restriction which proves most detrimental to the good of the Profession, and even leads frequently to an infringement of the Laws.

Of late years it has happened that the demand by Physicians for Licenses to practise in the Country

Moreover, the Act of Parliament, already referred to, has also given to the Elects the function of choosing annually one of themselves to be the President of the College. It has been thought that this part of the constitution of the College is susceptible of improvement; for that the choice of the President ought not to be deputed to so small a body, which is neither elected by the Fellows at large, nor under their control.

For the reasons which have been stated, the College is desirous that a short Act of Parliament should be passed, enabling it to accept a Charter modifying its former Charter, as regards the Elects, and transferring their functions to the general Corporation. An Act for this purpose was in fact prepared, with the sanction and co-operation of the late Government, and laid before Parliament. But it proceeded no farther, because it was introduced in conjunction with other measures affecting the Profession more widely, which were subsequently abandoned.

There are other improvements, lying more within its own power, to which the College has of late years directed its earnest attention.

In particular, it has extended, and greatly improved the examinations of those whom it licenses to practise as Physicians.

With respect to those who are admitted as Fellows or Members of the Corporation, during very nearly two centuries, they were required, by the Bye-Laws of the College, almost exclusively to have been educated at the English Universities; so that by long prescription the Graduates of Oxford and Cambridge were admitted nearly as a matter of course into the order of Fellows; and, beside them, few indeed either were, or could be elected.

The object of this regulation was to ensure in the Fellows of the College the best and highest education. And it had, confessedly, the effect of raising highly the character of the College, and, through its influence, that of all orders of the Profession in this country.

Nevertheless the exclusiveness of the rule excited jealousy and discontent, and became a cause of frequent litigation, until, by repeated decisions of the Courts of Law, the right of the College to be the sole judge of the qualifications of those whom it would elect as Fellows had been established beyond dispute.

In the present century, a high standard of education being adopted more generally, the restriction in favour of the Universities of Oxford and Cambridge, which had been enforced so long by the College, became proportionately less requisite and proper.

Wherefore the College, although still retaining a conviction of the superior advantages to be derived from an education in those Universities with which it had been so long connected, has, nevertheless, rescinded its exclusive Bye-Laws.

For several years the Fellows have been selected out of the Order of Licentiates; solely from regard to their character and attainments, and without distinc. tion as to the place of their education.

To a considerable extent this plan has proved satis. factory to the Profession. Yet a system of selection is attended always with some invidiousness. Therefore the College has resolved to adopt another principle in the admission of Fellows, not liable to the foregoing objections, which will be perfectly equitable in its operation, and most honorable to those who avail themselves of it: viz., that the ordinary mode of admission to the Fellowship shall be through an examination, high in character, comprehensive in extent, and open to all Licentiates who may submit themselves voluntarily to it. Whilst, at the same time, a limited power shall be preserved to the College of admitting as Fellows, without examination, those persons who may have greatly distinguished themselves by scientific pursuits and discoveries; who, not having enjoyed the advantage of the best early education, may have made up for this deficiency by superior talents and energy, but whose age may be such, as well as their known attainments, that they ought to be exempted from the examination intended for younger men.

As far as the College is concerned, the changes and improvements which have been mentioned might have been effected earlier, had they not been retarded by circumstances over which the College could have no control. An outline of the Reforms contemplated by the College was submitted to the Marquis of Normanby when Secretary of State, and was favourably entertained by his Lordship. A change, however, in the Government followed soon afterwards, and delayed further progress.

The subject of these Reforms was repeatedly brought under the consideration of Sir James Graham, and they met with his approval; but it seemed to him expedient that they should be brought forward simultaneously with the general measures which he contemplated for the regulation of the whole Medical Profession.

In consequence of the desire then expressed by the Government, the College proceeded, with the assistance of its own legal advisers and those of the Crown, and with considerable pains and expense, to prepare the Draft of a new Charter, modifying its former Charter in the way which has been already explained. The title of the College of Physicians of London was to be changed by the new Charter to that of the "Royal College of Physicians of England;" and, by one of its clauses, the College offered, for one year after its acceptance, to admit as Members, without examination, all Graduates of British Universities of a certain standing, now practising throughout England and

Wales.

possessed of a License from the College of Physicians of London.

Therefore the College proposed this measure as the commencement of a more regular and effective system, and in order that it might, more perfectly than is possible at present, represent and regulate the interests of all Physicians in this country.

The College will be ready to abide by the offer and concession which it then thought right to make, provided means can be devised whereby all Physicians practising in England and Wales shall henceforward (reserving the rights of the Universities of Oxford and Cambridge,) be required to submit their pretensions to the Censors' Board, (to which the College deputes the Examination of those whom it licenses,) in order that their competency may be properly tested, and that they may be enrolled as Members of the College.

By another Clause in the new Charter, power was given to the College, in certain specified cases, to expel unworthy Members. As circumstances sometimes arise requiring the exercise of such a power, the College believes that it would be expedient that A similar power has recently it should possess it. been given by Charter to the College of Surgeons. It was also provided by the new Charter, that persons who having exceeded the age of forty years, and, having been duly examined by the College, are found competent to practise as Physicians, shall be entitled to use the designation of Doctor of Medicine, although not Graduates of any University. Whereas, for all Candidates who present themselves for the License under the age of forty, it is made an indispensable requisite that they should have obtained the Degree of Doctor of Medicine in some recognised University, before they can be admitted to examination by the College.

The reason of this distinction is, that in a practical Profession, like that of Medicine, it is always right that those who, by superior talents and industry, have raised themselves in public estimation, should have the power of rising from a lower even to the highest rank in the Profession. It seems reasonable that the College, to which such persons must apply for Legal Authority to practise as Physicians, should be empowered to confer the title, which through common usage is necessary to render the License intelligible by the Public and useful therefore to the possessor of it. In this way a want which is occasionally felt in the Profession might be supplied; without detriment to the Universities, and without material infringement of the rule, which ought to be upheld, that those who intend to be Physicians, should resort to the Universities for preliminary and general Education.

Such being the objects and principal enactments of the new Charter which has been prepared for the College, the salutary changes which it would effect are calculated, in the opinion of the College, to render it an Institution more generally acceptable to the Physicians of this Country, and more useful to the Profession and the Public.

Therefore, the College respectfully but earnestly requests the assistance of Government, in order that

The apparatus used at Bristol is described by Mr. Herapath as follows:

"A common, but very large, bladder should be fitted with a collar to which an ivory mouth-piece with a large bore can be screwed. Without the intervention of any stopcock pour in about an ounce of good com mon æther, and blow up the bladder with the mouth till it is nearly full; place the thumb on the mouthpiece, and agitate the bladder so as to saturate the air in it with the vapour. As soon as the patient is ready for the operation, close his nostrils, introduce the mouth-piece, and close the lips round it with the fingers. He must now breathe into and out of the bladder, and in about one or two minutes the muscles of his lips will lose their hold. This is the moment for the first cut to be made. In two or three minutes the effect will begin to disappear; the mouth-piece should be again introduced, and this repeated as often as required. If the pulse should indicate a sinking of the patient, a little wine will restore him. I have no doubt but the inspiration of nitrous oxide (laughing gas,) would have a similar effect upon the nerves of sensation as the vapour of æther, as I have noticed that persons under its influence are totally insensible to pain; but I do not think it would be advisable to use it in surgical cases, from its frequently producing an ungovernable disposition to muscular exertion, which would render the patient unsteady, and embarass the operator. "The administrator of the vapour will of course take great care that no fluid æther shall be allowed to be drawn into the lungs, otherwise suffocation would result, or at the best a violent cough, which must protract the operation, and considerably distress the patient."

NEW VEGETABLE ALKALI.

At a recent meeting of the Chemical Society, Mr. Porrett read a paper "On the existence of a new Vegetable Alkali in Gun-Cotton," to which he has given the name "Lignea." He obtained it by the solution of gun cotton in nitric acid, heated to between 1000 and 180° Fahrenheit. On dropping this solution into water a white precipitate formed, having all the characters of gun-cotton, without fibre. Bicarbonate of potash effectually neutralized the solution, giving rise to nitrate of potash, and a copious whitish-grey precipitate,—a carbonate, probably, of the new alkali. When hyponitrous acid was made to act on an aqueous solution of the alkali, a synthetical proof of its existence was obtained, by the reproduction of hyponitrite of the oxide of lignin (gun-cotton.) Mr. Porrett conceives that lignea may by formed by the decay of woody fibre, and may thus be found to exist as an acetate in the sap of vegetables. Its chemical composition would be one equivalent of lignin, two of oxygen.

MEDICAL APPOINTMENT.

Mr. Benjamin Phillips has been elected Surgeon to the Westminster Hospital, in the room of Mr. Anthony White, resigned; and, Mr. Barnard Holt, Assistant Surgeon, in the room of Mr. Phillips. Mr. Anthony White has been appointed Consulting Surgeon to the Hospital.

ROYAL COLLEGE OF SURGEONS Gentlemen admitted Members on Tuesday, Dec. 29, 1846-E. Archer; W. L. Dudley; R. B. Roscow; J. White; W. Morgan; F. W. Richardson.

SOCIETY OF APOTHECARIES.

Gentlemen admitted Licentiates, Thursday, Dec. 24th, 1816:-Joshua Lever, Bolton le Moors; Henry Turner Lane Rook, Barnstaple ; Richard Budd Painter, Westminster; Robert Allen, Cartmel; Francis Sibery, Long Clawson; James Edmund Clutterbuck, Newark Park, Gloucestershire.

Thursday, December 31st, 1816:-Cornelius Black, Chesterfield; Charles Thompson, Leicester.

OBITUARY.

Died, November 26th, at Parma, aged 76, the celebrated Italian Professor Tommasini. Dec. 14th, in Charles Street, Manchester Square, London, John Foley, Esq., M.D.

17th, aged 80, M. Broussonet, Professor of Clinical Medicine in the School of Montpellier.

23rd, in Dublin, aged 61, John Bickerson Flanagan Esq., late Surgeon of the 4th Dragoon Guards. 26th, at Lower Garthmyl, Montgomeryshire, aged 73, Edward Johnes, Esq., M.D.

Jan. 1st, at Hereford, F. B. Glaspole, Esq., M.D. Lately, Peter Milner, Esq., Surgeon, of Mirfield, near Dewsbury, Yorkshire.

BOOKS RECEIVED.

A Treatise on the Plague: more especially on the Police Management of that Disease, &c.; with Hints on Quarantine. By A. White, M.D., Deputy Inspector-General of Military Hospitals, and late Superintendent of the Plague in Corfu, &c. London: Churchill. 1846. 8vo. pp. 342.

Practical Remarks on Near Sight, Aged Sight, and Impaired Vision, &c. By William White Cooper, F.R.C.S., Senior Surgeon to the North London Ophthalmic Institution, &c., &c. London: Churchill. 1847. Post. 8vo. pp. 216.

Report of Henry Austen, Esq, C.E., Honorary Secretary to the Health of Towns' Association, on the Sanatory Condition of the City of Worcester: with an Appendix, by Edwin Chadwick, Esq., Barrister-at-Law, and Secretary to the Board of Poor-Law Commissioners. Worcester: Eaton and Son. 1847. 8vo. pp. 46.