work of the physician. It was far more important to have precise knowledge over a limited than superficial knowledge over a large extent."

The third resolution had reference to the conduct of examinations. It was moved by Dr. Humphry, and seconded by Sir William Gull-"That it is important that two examiners, or an examiner and assessor, should be present at every clinical as well as oral examination"; and this too was agreed to, though Sir Dominic Corrigan, in noticing a similar recommendation by the visitors to the examinations of the Queen's University in Ireland-" because, among other reasons, in the investigation of patients there is not unfrequently room for some difference of opinion,"-had added the comment, so that they suggest that there should be a row at the patient's bedside." We may be pardoned, we hope, if we express the trust that, in England at any rate, the examiners, or the examiner and assessor, should they differ in opinion about a case, will be able to restrain their eagerness for a "row" till they shall have left the patient's bedside.

By a fourth resolution it was agreed that in "no case ought a candidate to be examined, wholly or in great part, in any subject, "by the lecturer or teacher in that subject in the school in which the candidate has been educated." Dr. Humphry, who moved this resolution, observed that the subject affected especially the universities of the United Kingdom. "Within a comparatively recent period all the universities were teaching bodies and examining bodies; and not only so, but the teaching and examining in each subject were conducted by the same person in each university." In Cambridge it was found that this system did not work well, and a few years ago it was altered, and other examiners were associated with the professors. He pointed out some of the objections to the system, one being that it is "likely to have the effect of limiting the area of teaching, seeing that the professor, as being the regulator of the examination, was the only check upon his own teaching." And another, that "each teacher indicates more or less to his students what would be the subjects and the manner of his examination. He could not possibly avoid doing so, and, unconscious as he might be of the fact, there could be no doubt that the students were apt to learn from his teaching what would be the prominent points of his examination." Dr. Thomson and Professor Turner pointed out that in Scotland the difficulty was how to find funds to meet the expense of non-professorial examiners, but that attempts were being made to effect the desired changes; and Dr. Sharpey very shrewdly suggested, "as a way of getting over the financial difficulty mentioned, that the universities, whilst continuing to confer degrees, each upon its own alumni, should combine together for the purpose of having examinations in common." A fifth resolution-" That it is desirable that observation with the microscope should form part of the examinations of candidates for a licence"-did not excite discussion even in the General Medical Council, and was agreed to.

Dr. Storrar then moved, and Dr. Stokes seconded-"That in the opinion of the Council all examinations should, as far as possible, be objective, and conducted by persons who are experts in the subjects of the examination assigned to them; and that in all examinations, excepting those for degrees and fellowships, the questions put should be chiefly such as have a bearing on practice." The chief part of Dr. Storrar's speech in moving the resolution was in defence of the employment of "experts" as examiners. He argued that teachers of subjects made the best examiners in them, and that the ablest teachers made the most skilful examiners. "The most eminent men, who were the most distinguished for their knowledge of any subject, were the most judicious and efficient examiners. Cranky questions were almost invariably the refuge of bad examiners. One of the greatest miseries which teachers and

candidates had to contend with arose from having to do with examiners who literally had to grind up for their own examinations, which had been notoriously-and he suspected was still to a certain extent-a fact." As a broad rule, most people will, we imagine, agree with him; but the expression "experts" was objected to, and for that, among other reasons, the motion was negatived.

It was resolved-"That the visitations of examinations be continued," and, in seconding the resolution, Mr. Macnamara begged that the College of Surgeons in Ireland might be visited again within the ensuing year, "because that body was by no means satisfied that justice had been accorded to its examinations."

A considerable part of the day-the seventh day of the session was taken up by the consideration of the "Report of the Committee on the Adulteration of Food Act," which will be found in our report of the proceedings of the Council. On Friday, the eighth day, the President informed the Council that the deputation appointed on the previous day had obtained an interview with the President of the Local Government Board, had placed in his hands a copy of the resolutions of the Council with reference to the examinations and qualifications of public analysts and officers of health, and had expressed to him the desire of the Council to co-operate with the Government "for the development of the best means of education and examination in the various departments of knowledge which bear on the public health." We have no information as to what the President of the Local Government Board said to the deputation from the Council.

Dr. Parkes then asked the President if he could inform the Council "whether the schemes for conjoint examinations in England and Ireland, which have been sanctioned by the Council, are being carried into effect ?" With regard to England, the President replied by pointing out that in March, 1872, the Council had passed the following resolution :-"That the Council approve of and sanction the conjoint scheme of examination submitted by the Royal College of Physicians of London, and the Royal College of Surgeons of England, to which the Universities of Oxford, Cambridge, and Durham have given their adhesion. The Council has, at the same time, to express its desire that means may be found by which the University of London and the Apothecaries' Society may be enabled to join in the scheme, so as to render it a complete scheme for a Conjoint Board for England." The scheme was so drawn as to admit the other bodies into it by simple adhesion on their part. The Committee of Reference had arranged for carrying into effect all the details of the scheme. The University of London had last year obtained an enabling Act, and had joined the scheme; and during the present session of Parliament the Apothecaries' Society had also obtained an enabling Act, which had just received the Royal assent, so they could now join in the scheme. The only difficulty remaining was a legal difficulty which related to the appointment of examiners by the College of Surgeons, arising from the nature of their charter; but it was not an insuperable difficulty, and he hoped it would be overcome. Later in the day, Mr. Bradford, the representative of the Society of Apothecaries, related the history of the attempts of the Society to obtain an enabling Bill, and the history of the Act which they have this year succeeded in obtaining, from which it appears that some of the peculiarities of that Act, to which we alluded a short time ago, were caused by an amendment to the Act at first introduced by Mr. Stansfeld, who chose to appear as the champion of the would-be medical women. A letter from the Master of the Society to the President of the Medical Council states that the Society is ready to give, if they become part of the Conjoint Board, "a pledge that having joined they will not (except under compulsion of a mandamus) admit anyone to a separate

examination." It appears, therefore, that so far as England is concerned, the complete Conjoint Board scheme is ready for being carried out if the College of Surgeons difficulty can be got over.

With regard to Ireland, a scheme had been prepared, and had been in great part approved by the Council, and the details of a plan for carrying the scheme into effect had been prepared. The Queen's University in Ireland had not joined it, nor the Apothecaries' Hall of Ireland. But the latter body had lately expressed their wish to join; and on Saturday, the last day of the session, the Council passed a resolution" consenting to the proposal that the Apothecaries' Hall of Ireland be allowed to appoint three examiners instead of one in practical pharmacy, under the scheme for the formation of a conjoint examination in Ireland, bearing date June 28, 1872." On the same day Mr. Macnamara, the representative of the Royal College of Surgeons in Ireland, also gave at considerable length an account of the present position of that body with respect to the conjoint scheme, and the reasons why there had been some delay in its fully and completely joining in it; the outcome of which was that the Council expressed themselves as being "glad to find that there is a fair prospect that the Royal College of Surgeons in Ireland will eventually give its influential co-operation in carrying out the Irish scheme of conjoint examination which has been sanctioned by the Medical Council."

In England, then, all the bodies have joined, or are ready and willing to join, in carrying out a conjoint examination scheme; but the Royal College of Surgeons-a somewhat important body--is still hampered by "a legal difficulty." In Ireland the Queen's University stands aloof, and is conspicuous by utter silence on the subject. And as for Scotland, anything may be hoped or feared; for not a word about a conjoint scheme has come from that division of the kingdom during this session of the Council.

There is not much more to notice here, or at any rate that we can now notice, in the proceedings of the Council during this session of 1874. The Pharmacopoeia Committee presented a satisfactory report, which was adopted with the exception of part of one clause. The report recommended the reappointment of the Committee, and that its duties be to superintend all matters relating to the Pharmacopoeia, more especially to consider the publication hereafter of a new edition of the work, and of the steps which should be taken for its preparation," but the Council struck out "the words from 'more especially' to the end of the paragraph." And by a special resolution the attention of the Committee was requested to "the desirability of correcting, in any future edition of the Pharmacopoeia, the approximate solubility of salts and other substances under the head of Characters and Tests,' instead of the indefinite information afforded in the present Pharmacopæia."

was

On the recommendation of the Executive Committee, "the Oxford and Cambridge Schools' Examination Board" added to the list of examining bodies whose "examinations fulfil the conditions of the Medical Council, as regards preliminary education," but only "provided the subjects examined on shall be such as are required by the General Medical Council." And, on the motion of Drs. Humphry and Storrar, it was agreed that the junior local examinations conducted by the English Universities should also be recognised for the preliminary education of medical students, "provided that Latin and mathematics, and also one of the following optional subjects-viz., Greek, French, German, natural philosophy, including mechanics, hydrostatics, and pneumatics—are among the subjects included in the pass certificate."

The report of the Finance Committee was received, from which it appears that the cost of the visitations of examinations reported on during the session amounted to £900.

The President then tendered his resignation of office, and,

though Sir William Gull presented to him a paper signed by all the members of the Council, expressing the wish that he would retain his office for the full term, Dr. Paget still felt obliged to retire, and took leave of the Council. Dr. Andrew Wood then, in a few warm and eloquent words, proposed the following resolution, which was carried by acclamation :"That this Council cannot part with their late President, Dr. Paget, without expressing to him their great obligations for his services as their President-services which have been so ungrudgingly devoted, at large sacrifices to himself, for the good of the Council and the profession, for the uniform courteousness of his demeanour, for the impartiality of his decisions, for the discretion of his conduct in the chair, which had secured for him the esteem and affection of the members of the Council, and have conduced greatly to the efficiency of the action of the Council in raising the status of the medical profession." These are terms of very high praise; but we venture to add that Dr. Paget has very fully and completely deserved and earned every word of them. The Council then proceeded to the election of a new President, and their choice fell on Dr. Acland, the eminent representative of the University of Oxford. Dr. Acland has been a very active member of the Council ever since its formation, and is, therefore, well acquainted with its duties and its difficulties. It would be impertinent in us to say aught of his distinguished qualifications for the high office to which he has been elected. The fact of his election by his colleagues and fellowworkers is the best possible testimony of his fitness for the honour bestowed on him.

The rest of the business was merely formal.

The Council's house is still unfinished, and of its qualities and capacities it would as yet be unfair to speak. It would, however, be ungracious to omit a due recognition of the services of the permanent officials in connexion with the removal from the old to the new premises. Those gentlemen are always distinguished for courteous behaviour, and it would be, we feel sure, an encouragement to them if the Council took the present opportunity of recognising this spirit in a substantial fashion.

MODERN MIDWIFERY.—No. II.(a)

IN a former article we endeavoured to vindicate the dignity of midwifery, to show how closely it is connected with the higher branches of medical science, and how well it deserves to be made a life study and practice for men. And this not because women are subject to difficulties from which other animals are exempt; for the human female pelvis, with its short symphysis, shallow cavity, and broad sub-pubic arch, seems, so far as the bones are concerned, to provide specially for easy childbirth. We would say with St. Paul, "Doth God care for oxen ?" Undoubtedly, but much more doth He care for women; and God forbid that we should leave the smallest matter uncared for that concerns their comfort or safety iu the hour of peril. Let us, then, see what our three authors say of natural labour; for he that brings a hundred women quickly and safely through this, saves a greater quantity of suffering than he who deals with the few exceptional and morbid cases. to attend a The young practitioner who is "bespoken

(a) "The Complete Handbook of Obstetric Surgery; or, Short Rules of Practice in every Emergency, from the Simplest to the most Formidable Operations connected with the Science of Obstetricy." By Charles Clay, M.D., late Senior Surgeon and Professor of Midwifery, St. Mary's Hospital, Manchester. Third Edition. London. 1874.

"A Manual of Midwifery, including the Pathology of Pregnancy and the Puerperal State." By Dr. Karl Schroeder, Professor of Midwifery, and Director of the Lying-in Institution in the University of Erlangen. Translated into English from the Third German Edition by Charles H. Carter, B.A., M.D., B.S. Lond., M.R.C.P., Physician-Accoucheur to St. George's, Hanover-square, Dispensary. With twenty-six engravings on wood. London. 1873. 8vo. Pp. 388.

"A System of Midwifery, including the Diseases of Pregnancy and the Puerperal State." By William Leishman, M.D., Regius Professor of Midwifery in the University of Glasgow, etc. Glasgow. 1873. 8vo. Pp. 835.

patient must always be prepared for the question, "How do you know that the patient is pregnant?" This is generally assumed on the faith of the patient's statement; but the practitioner must be aware that many oldish women deceive themselves, and that, unfortunately, a good many young women have very strong grounds for deceiving him. Hence the necessity for a thorough knowledge of the signs of pregnancy. No student will be complained of on this point if he masters the very full and complete description either of Schroeder or of Leishman; yet so large is the subject, that each book contains much worth reading which the other does not; and in comparing both with Rigby's System, published thirty-three years ago, it is curious to see how much good stuff there is in that which is omitted in the more recent works. Leishman is particularly full and clear, and, by the aid of his profuse illustrations, shows the differences between the womb of a multipara and a primipara at each month of pregnancy.

Now, since the problem is to determine-first, Is the uterus enlarged? secondly, If so, does it contain a fœtus ?—we are glad to see that Leishman notices one diagnostic mark of the uterus which was mentioned in the Medical Times and Gazette some years since, but has not received much notice since. It is thus in Leishman's words. The womb, he says, yields a certain feeling of elasticity, which is different from that which is communicated by any other form of abdominal tumour. "Besides this, the practice of palpation seems in some cases actually to cause a certain amount of feeble painless contraction in the womb, which is of the highest diagnostic value; but it must be remembered that these symptoms prove only that it is the uterus which we are touching, and are no evidence of pregnancy. If, however, we are convinced that the elastic tumour contains a solid movable body, there is scarcely any room for doubt." Here we venture to say that Leishman would have been more exact had he said-If a tumour presenting the peculiar contractility of the womb contains a movable substance, that substance is a foetus. For an ovarian tumour may exhibit ballottement, and other signs of a movable body within, but its walls cannot be got to contract.

Then, again, why separate the uterus from the other hollow viscera ? or suppose that it does not do as they do. The bowels have their recurrent peristaltic contractions every three, five, or six minutes, which in health slightly propel and regulate the position of their contents-periodic contractions which are acutely enough felt in colic, and which may be seen through the abdominal walls in cases of prolonged obstruction. These are purely peristaltic, and not expulsive. By day and night during pregnancy the womb executes a series of gentle vermicular movements, sometimes confounded with the movements of the fœtus, and felt very painfully at times in the shape of cramps, provoked by rheumatism or by sexual irritation. The womb performs its full functions not half a dozen times in a lifetime, the bladder half a dozen times a day, and the bowels once a day; but all three are intestines alike-the womb, a short double intestine, ending in a common cavity. It is as wrong to divide parturient women from the whole animal creation-as a being apart as it is to regard the womb as an exceptional organ. Whoever will go into St. James's-park, take a bucket of water from the pond, and carefully watch under the microscope the intestinal movements of the cyclops, or of the larva of the gnat, will soon see the model of uterine action.

Having settled the question, "Are you sure you are pregnant?" (on which, and on the diagnosis of plural and extra-uterine pregnancy, Schroeder and Leishman are both full), the next is, "When do you expect?" the answer to which involves the doctrine of the duration of pregnancy, the mode of calculating the time of its completion, and the

causes of labour. These points Schroeder dismisses in a dozen lines. He states the average duration as 271 days, and the cause of parturition to be the fatty degeneration of the decidua, whereby it becomes a foreign body, and excites reflex actions for expulsion. Leishman treats it at far greater length, and so does Clay, but without saying much that is not to be found in Rigby, or that differs from the summary conclusion of Schroeder. All organic processes, the length of life, and of each stage of life, of childhood, and maturity, all the natural bodily actions, have a time laid down for them; and the recurrence of menstruation shows the human female to be governed by the general laws of the cosmos. The condition of a fully-developed foetus at birth shows that it could not long continue in its present state without disease, for liver, intestines, and all the glands of the skin are choked with secretion. The decidua is degenerate. The cervix uteri begins to be distended, with the same effect that distension has on any other sphincter. The recurrence of a lunar period, the maturity of the foetus, and the complete distension and irritation of the womb are, we suppose, three adequate causes; and if there be any variation in the length of pregnancy, it fairly arises from the fact that some of these causes may control others, and that the date of the beginning of pregnancy is seldom given, or, if given, to be relied upon. The ovum may be ripe, or the womb irritated at a time that does not coincide with the menstrual nisus. Moreover, the exact time when parturition begins is often as difficult to fix as the time when pregnancy begins. Certainly impregnation may occur at any time, before, during, after, and between the monthly periods, and hence the time of mature parturition may vary from the 270th to the 293rd day after it. Clay lays great stress on the doctrine that the duration of pregnancy is ruled by the age, or joint age of the parentsthat the young wife of a young husband will have a short pregnancy, the young wife of an old husband a longer one, and the oldish wife of an oldish man a longer one still. This seems to be the rule in animals, and we need not doubt that it is amongst the causes which regulate the length of human pregnancy.

FREEDOM IN MEDICAL EDUCATION. DR. ARLIDGE, Physician to the North Staffordshire Infirmary, has addressed a letter to the General Medical Council, entitled "A Plea for Liberty of Medical Teaching," which for various reasons is well worthy of attention. It contains much with which we heartily agree, and some things from which we as strongly dissent. His main argument is this-"There are scattered all over England many hospitals-county and otherwise-officered by skilful gentlemen; the hospitals afford a vast amount of teaching material, and these gentlemen are both able and willing to teach, but the opportunity is refused them, because the regulations now in force demand that the student's time shall be passed during a certain number of years in a properly constituted medical school, and few fully organised schools pay in the country. Why should not these gentlemen be allowed to do what they can in the way of teaching which will be recognised by the licensing bodies?" Dr. Arlidge would like to see these hospitals converted into secondary schools, the large schools now existing to be primary, and in both of these that the student should pass a certain number of years. We are quite of the same opinion as Dr. Arlidge, that it is a pity that so much good material for instruction should be wasted, and, if possible, a still greater pity that the teaching powers of many clever men should not be utilised. But after all the question comes to be this: the time at our disposal for training men to the practice of medicine is very limited; were it not so, the expense of a medical education-even now greater than the subsequent remuneration will in many cases warrant-would be

enormously increased. Where, therefore, is it best for the student to spend his time? There are certain subjects which a student should know before he joins a medical school -physics, botany, and some idea of chemistry are among these. So far we agree with Dr. Arlidge; but when we come to such subjects as anatomy, it is better that the student should be taught in a properly regulated school than to leave him to such chance opportunities as country hospitals afford. Under existing regulations it is possible for a young man to secure a certificate for dressing, etc., in these and such-like hospitals, which would otherwise only be obtainable by undergoing a sharp course of discipline in a regular school; and as a consequence, in some of the smaller schools in London, it is hardly possible to get a due supply of clinical clerks and dressers. We should be the last to undervalue the advantages of the kind of learning to be acquired in country hospitals; we ourselves well remember the valuable stores of knowledge we there acquired; but no one will, we think, contend that this mode of acquiring knowledge is preferable to that implied by the strict discipline of a well-regulated hospital.

Dr. Arlidge goes very far on what we hold to be a most dangerous path. He hints that it would not be displeasing to him to see the whole field of medical education made free; that attendance on all lectures should be made voluntary; and that the student should be left to gain his knowledge where and how he pleases. We who have been engaged in teaching, we may say, during the whole of our professional life, look upon such a scheme with profound distrust. Were it possible to make examinations absolutely perfect-actually to put a man in all kinds of emergencies to see how he would extricate himself,-something might be said for the system. But, in truth, the examination system has been worked to death, even as regards the highest and most severe kind of test of this kind now applied-we mean the Indian Civil Service. Even there it has admittedly failed, as it is bound to fail if tried alone. We must supplement the system of examination somehow. Undoubtedly the best mode of supplementing it is by insuring that the training which precedes the examination shall be as perfect as possible; and the suggestion of Dr. Arlidge would hardly, we think, conduce to this end. Since, however, the days of apprenticeship are now no more, it has been increasingly observed that men are less prepared to assume the practical duties of their everyday calling than before. In Germany, the difficulty is partly overcome by the system of policlinics; but here we have no such seasoning, if one may call it so, except a man become resident medical officer in some institution, and even then his attention is generally directed in one special way instead of all round him. Could by any means our provincial hospitals be converted into schools of probation, we think they would be utilised to far greater advantage than they are now, or would be under Dr. Arlidge's scheme.

THE WEEK.

TOPICS OF THE DAY.

YESTERDAY Week the Crown Prince of Germany, accompanied by Count Münster and Captain Liebenau, visited the German Hospital, Dalston. The distinguished visitors were conducted over the building by Drs. Lichtenberg, Port, and Hessel. His Imperial Highness spoke very kindly to all the patients, and, on leaving, expressed himself as being highly satisfied with the excellent manner in which the Hospital was conducted.

Mr. John Simon, F.R.S., as Medical Officer of the Privy Council and of the Local Government Board, in his last annual report submits that for the past two years and a half, and particularly during the last year, the circumstances of official and administrative transition, consequent on the Acts of Parliament of 1871 and 1872, have been such that no consistent

scheme of report in general relation to the sanitary interests which are under the Board's superintendence has been possible to him, and the present report, which regards the year 1873, must necessarily, even more than its two predecessors, illustrate the difficulty of the unsettled circumstances. The report also gives interesting and valuable information as to-(1) Inquiries by inspectors with regard to local administration of the sanitary laws; (2) list of unions inspected as to vaccination, and account of awards to public vaccinators; (3) statistics of the National Vaccine Establishment; (4) order as to detention and examination of ships suspected of cholera; (5) memorandum on precautions against cholera. Mr. Simon, speaking of bringing the Board's Medical Department into direct relation with the local officers of health, and giving the department opportunity to contribute any assistance in its power to the success of the local institution, concludes with the following observations. "He need hardly say that to any holder of his office it must always be among the highest of ambitions to be able to see the experience of this department really conducive to the information and influence of younger fellow-labourers in other parts of the same great field of public service; and it would be affectation in him to deny that, during many early years of the new organisation, relations in that sense between the central and local services may often be of important, and sometimes of indispensable, use to the latter. He would, however, also express his confident expectation that, though from the nature of the case the relation in these earlier years must chiefly consist in assistance which the central office can so render, succeeding years will more and more bring the central office under obligation to local contributors of knowledge and to local illustrations of progress. And year by year it will surely grow to be among the most useful, as it must also be among the happiest, duties of the annual reporter under the Public Health Act, 1858, to represent, for the information of all the officers of health of the kingdom,. such additional fruits of scientific observation, and such new evidences of practical success, as will have come to the Board's knowledge from among their number."

Dr. Dudfield, in a letter on the 14th inst., addressed to the Times, on the subject of London slaughter-houses, states that the Bill now before Parliament has yet to pass the ordeal of the Lords, to whom it has gone without a single beneficial amendment. He entreats their Lordships to well consider the consequences of passing this measure, and he cannot think it too late even now to urge upon the Ministry itself the desirability of delay, seeing how deeply the Bill concerns the health and comfort of the inhabitants of the metropolis; and for the sake of consistency, moreover, more deliberate consideration may reasonably be asked from the Cabinet of the author of the apothegm," Sanitas sanitatum, omnia sanitas."

The magistrates in administering the law under the Adulteration of Food Act do not, we are glad to observe, flinch to enforce, in certain cases, some of the more severe penalties of the Act. In a case of selling adulterated milk brought before the magistrate of the Lambeth Police-court last week, a previous conviction for a similar offence was proved. The defendant, George Bailey, of New Church-road, Camberwell, was now ordered to pay a penalty of £6 and costs, and the magistrate further directed that the conviction, under the Act of Parliament, be advertised in the newspapers at the cost of the defendant.

The Zanesville Academy of Medicine passed the following resolution on the death of Dr. John G. F. Holston, which took place at Washington on May 1 last:-"That in the death of Dr. Holston the Zanesville Academy of Medicine loses one of its prominent members, and the profession at large an eminent physician and surgeon of extensive professional and literary culture, ripe experience, and accurate judgment; and society

a warm-hearted, genial, and generous member, whose life has been mainly devoted to the good of his fellow-beings."

An International Pharmaceutical Congress will be opened at St. Petersburg on August 13. One of the questions proposed for discussion will be the formation of an international and universal pharmacopoeia.

We are informed that a death from chloroform occurred in the General Infirmary, Leeds, on the 16th inst. We hope to be able to publish the details of the case next week.

THE PRESIDENCY OF THE GENERAL MEDICAL COUNCIL.

ONE of the last items of business, not purely formal, before the Council was the election of a President, Dr. Paget having persisted in his determination not to hold the office longer than during the present session; and the action of the Council herein will much surprise the outside world. It was believed that the Council generally felt that their President ought to reside in London, and that though Dr. Paget had, at no slight sacrifice, admirably discharged all the duties of the office, great inconvenience might arise in the transaction of business if the President resided out of town. It was rumoured that Mr. Cæsar Hawkins could be persuaded to take the President's chair, and it was thought that it would be highly fortunate could the deliberations of the Council be guided by a man of such high position in the profession, of such excellent judgment, and such courtesy, and one who, having formerly been a member of the Council, was practically acquainted with the responsibilities, duties, traditions, and rules of business of that august body. The outside world, then, imagined that, failing Dr. Paget, Mr. Cesar Hawkins would be the next President. But the outside world was mistaken. The Council have again chosen a provincial member; and feeling, we may suppose, that as Cambridge had occupied the President's chair, the sister University of Oxford had in turn a claim to that honour, have elected Dr. Acland. There cannot be two opinions about Dr. Acland's eminence, his high sense of duty, and his readiness to meet, like Dr. Paget, at any cost to himself, all claims that the office he has accepted may make on him; but we may be allowed to feel some surprise that the Council have thought it fair to again ask for such sacrifices of time and labour from any provincial member of their body. We have heard a rumour that members of the Council were pressingly canvassed to support Dr. Acland's nomination; but rumour is nearly as great a liar as is "very good authority," and we confess that we are most unwilling to believe that anything that can fairly be called canvassing can have been resorted to in the appointment to an office of so much dignity and importance as that of President to the General Medical Council. And we feel sure that if any friend of Dr. Acland's can have been so led away by a conviction of his pre-eminent fitness for the office as to canvass for votes for him, Dr. Acland was himself utterly ignorant of any such proceedings. He will, we doubt not, fully justify the election of the Council, though we do venture to think that it would have been wiser to elect a London President.

MEMORIAL BUST OF THE LATE DR. JOHN MURRAY, OF THE MIDDLESEX HOSPITAL, LONDON.

On Tuesday last the bust recently executed by Joseph Durham, Esq., A.R.A., of the late Dr. John Murray, was presented to the Weekly Board of the Middlesex Hospital. It is a fair likeness, the artist having caught the intelligent, genial expression by which so many of the friends of the deceased will best remember him. On the lower portion of the bust his name, with the dates of his birth (November 28, 1843) and death (October 15, 1873) are engraved. On the marble bracket destined to support the bust, the following appropriate inscription is placed :-"This bust testifies the high regard and warm

affection of many professional and private friends for one whose life-alas! too brief-had put forth buds of ample promise, and had already borne much early fruit." A site has been chosen for its erection in the museum attached to the Hospital, the Board considering that, with a view to encourage emulation among the students and junior officers of the Hospital, it was desirable to place the memorial in some place more generally accessible to students than the board-room. The bust may be seen by any subscribers or friends by applying at the Hospital.

POOR-LAW MEDICAL OFFICERS' ASSOCIATION.

Ar a special Council-meeting of this Association held on Thursday, the 16th inst., the following propositions were submitted and unanimously agreed to:

"That, in the judgment of this Council, it is desirable that district poor-law medical officers should be health officers of first instance in their respective poor-law districts, that all reports of insanitary conditions made by them in the performance of such duty should be forwarded to a superintendent health officer, acting as such over a considerable area, such as the whole or part of a county, with whom should rest the authority of putting the law in action.

"That the salaries of poor-law medical officers should be paid wholly from the Consolidated Fund, instead of partially, as at present.

"That the dispensary system of medical relief should be extended to provincial towns and rural districts, the expenditure on drugs, surgical and other appliances, with rent, etc., of dispensary buildings, being left to be defrayed from local sources.

"That the superannuation of poor-law medical officers should, under certain statutory restrictions, be in future compulsory, instead of permissive.

"That the imposition of additional duties, whether sanitary or otherwise, and notably the recent requirement to examine and certify as to the condition of children for the School Board, without any remuneration, be resisted, and that every effort be made to secure reasonable payment for such extra services."

It was also moved, and unanimously agreed to

"That Dr. J. Rogers, chairman of the Council, should attend the forthcoming annual meeting of the British Medical Association at Norwich, for the purpose of submitting the foregoing resolutions to its consideration, with the view of securing its support."

DUBLIN SANITARY ASSOCIATION AND THE PUBLIC HEALTH

(IRELAND) BILL.

Ar the usual weekly meeting of the Executive Committee, held on Thursday, July 16, the Public Health (Ireland) Bill, as amended in Committee of the House of Commons, was considered. The amendments proposed or sanctioned by Sir M. Hicks Beach were generally approved of. Mr. Errington's suggestion to constitute urban sanitary authorities only in towns of 20,000 inhabitants or upwards was regarded as a good but impracticable measure; and a communication was forwarded to the Chief Secretary for Ireland, asking him, if possible, to adopt a modified schedule of seventeen towns proposed by the Sanitary Association in place of that in Clause 3 of the Bill. This important amendment would meet the views of the Chief Secretary, and also those of Mr. Errington to a large extent. Mr. Errington's amendment to Clause 5 was objected to, because it would prevent action being taken by the Local Government Board to include an urban in a rural district unless a majority of the ratepayers present at a meeting specially convened would petition for such action. The clause would work better were action to be taken on the petition of ratepayers representing one-tenth of the rateable property in the district. Clause 18 should be assimilated to Clause 5 as amended, for" it provides that the Local Government Board should have power to unite districts for certain sanitary pur. poses, just as Clause 5 provides for the absorption of an urban into a rural district.