239

last, at 4 P.M. The committee was a fall one, Lords

Cranbrook, Selborne, Basing, Monk-Bretton and Sandford,being all present. Their lordships desired that the Chartershould be so amended as to at once constitute the ten MedicalSchools into Colleges of Medicine in the new University,and also made an alteration in the paragraph in Section 3referring to the examination of schools. No further sug-gestion was made, except that if any other name than thatof Albert (which Lord Selborne intimated was not open toobjection) could be jointly agreed on, which did not bearthe word "London," and was not obviously misleading, as,for instance, Westminster, their lordships would offer noobjection. It has been decided by the Royal Colleges todecline to be represented on the Council of the University ;and the medical veto suggested by Lord Selborne on aformer occasion, whereby a majority of the Medical Boardof Studies, if backed by half the representatives of theRoyal Colleges on the Council, was to be allowed to over-rule a majority of the Council, accordingly falls to the

ground. The number of medical representatives on theCouncil will now be at least fourteen, the full number ofmembers being thirty-nine. The Charter has therefore

passed the Lords of the Privy Council. It must now besubmitted to the law officers of the Crown for their approval,and then be placed on the tables of both Houses ofParliament for thirty days. The text of the Charter asamended will be found in extenso on page 262.

THE FIVE YEARS’ CURRICULUM.

THE committee of the Council of the Royal College ofPhysicians has framed another report on the five years’curriculum of medical study, and this was discussed at themeeting of the comitia on Thursday last, but its further con-sideration was postponed. The recommendations of the com-mittee were :-" 1. That the number of examinations be four.2. That, in addition to giving the student the option ofspending six months of the final year with a registered prac-titioner, he have (sic) the option of spending a similar periodof study in attendance on two (at the least) special hospitalswhich are to be approved and recognised for the purpose.3. That an option be given to the student of studying, beforeregistration at some recognised institution, all the subjectsof the first examination except elementary anacomy. 4. Thatthe student be admitted to examination in practical phar-macy at the first, or, at a later examination at his option,pharmacology and therapeutics to be postponed to the thirdexamination. 5. That, with a view to enlarging the periodfor the study of midwifery and diseases peculiar to women,there be required: (a) Lectures on systematic midwiferyfor three months. (b) Practical instruction in midwiferyand obstetric operations. (c) At least twelve lectures,clinical or otherwise, with practical instruction on dis-eages peculiar to women (these might be attended inthe fifth year). (d) Attendance on twenty labours. 6. Thatattendance on a course of practical pathology, includingmorbid histology, extending over three months, be re-

quired. 7. That the proposal be approved to requirecertificates of a short course of lectures on insanity, inconnexion with the lectures on forensic medicine, but bya teacher specially versed in the subject of insanity. Alsoa certificate is to be produced before the final examinationof having attended clinical demonstrations at a recognisedlunatic asylum; the number of lectures and demonstrationstogether to be not less than twelve." A scheme embodyingthese recommendations was drawn up by the committee.Several points would seem to be open to criticism. Is there

any necessity for a special examination in elementary humananatomy at the end of the first year? One examination in

physiology is deemed sufficient, and we see no reason whyanatomy should be differently treated. The division of the

examination in materia medica into two parts is perhaps amore satisfactory arrangement than the present one, butwe hope that the practical pharmacy will be strictlywhat its name implies, and that the candidate’s know-

ledge of therapeutics will be tested by practical phy-sicians, and not by pharmacologists. If pharmacy, chemis-try, physics, and biology can be studied before registration,the curriculum will really be one of six, and not of five,years’duration. The lengthening of the period for the studyof midwifery and gynaecology is only apparent; for as ageneral rule at all hospitals three months’ lectures on

systematic midwifery with practical instruction, and asmany as twelve clinical lectures on diseases peculiar towomen, are now given. The proposals with regard topractical pathology and insanity are much better; but whyshould a student have an option between attending at twospecial hospitals for six months and being a pupil to aregistered practitioner for that period? The informationwhich he would acquire in the two cases would be radicallydifferent, and if there be, as there should be, specialdepartments in good working order at his own school, whereis the necessity for advising him to go to a special hospital?In THE LANCET of May 2nd we pointed out that theschemes then suggested differed greatly from the ideaswhich the advocates of a fifth year of medical studyadvanced in the Medical Council, and we querotion whetherthese proposals come any nearer to their views.

NEWHAVEN HARBOUR.

THE outbreak of cholera among the pilgrims of Meccamust once more direct attention to the measures whichour port sanitary authorities take, and are able to take, toprevent the importation into this country of epidemicdisease. We fear that if inquiries were instituted at allthe different ports of England grave deficiencies would befound. In any case, we can at once give one surprisinginstance of such neglect. The Port of Newhaven is almostwithout means of checking an invasion of epidemicdisease. It is true that nearly all the passengers landinghere come from Dieppe. The majority are tourists andholiday seekers, and are about as safe a set of passengersas could be met with anywhere; but there is nowhereabsolute security. Also some among these passengers aretravellers from a long distance. Arriving from Spain orfrom the Far East viâ Brindisi, some may be coming fromthe Red Sea and other cholera centres ; yet, it will scarcelybe believed, there is no disinfecting apparatus at New-haven. Should a case of infectious disease break out onboard a ship bound for Newhaven, fumigation or completedestruction by fire would be the only means of purifi-cation available. But, worse than this, we cannotin fairness expect any serious sanitary supervision ofthe habour, since the port medical officer does not re-

ceive more than £10 a year. Out of this absurdly smallsum he must pay his own expenses, which sometimes areconsiderable. A ship with a suspicious case of sickness onboard is ordered to remain outside the port. The medicalofficer is compelled to hire a boat at his own expense,and row out to the ship to see the patient. A visit of thisdescription takes up a considerable amount of time, and theboatman has to be paid. Were such service frequently re-quired the ridiculously small salary of £10 would beswallowed up in these journeys to and fro. The number of

passengers travelling vid Newhaven and Dieppe is yearlyincreasing, and during the Paris Exhibition year (1889)amounted to 179,099. Putting aside the passengerscoming from Honfieur, Bordeaux, and other ports,and presuming that half the passengers were leavingEngland, we can, nevertheless, say that during that yearabout 90,000 persons landed at Newhaven from abroad. To

240

watch, to take all the necessary measures to prevent these 90,000 persons introducing epidemic disease into this country, the sanitary authority paid the port medical officerthe munificent salary of .610. In other words, the medicalofficer received the sum of about one penny for everyforty passengers that landed. Yet if any one oi these

passengers had during the journey suffered from in-fectious disease, and had been allowed to land and spreadthat disease, certainly the port medical officer wouldhave been blamed; or, again, if the passenger possessedvaluable luggage, this luggage could not be disinfectedin a satisfactory manner. It seems to us self-evidentthat every port should possess a proper disinfecting apparatus,where suspected objects could be purified by superheatedsteam under pressure. Also, the medical ufficer responsiblefor the organisation of this important service should receivea salary in keeping with his position.

NATIVE RACES AND THE LIQUOR TRAFFIC.WE have been asked to publish the Address of the Native

Races and the Liquor Traffic United Committee to theChief Gugunhana, Chief of Gazaland, with whose mes-sengers, Huluhulu Umleti and Umfeti Intem, the dis-

tinguished officials of the committee have had interviews.These officials were-the Duke of Westminster, the Bishop ofLondon, the Hon. T. H. W. Pelham, and the Rev. J.Grant Mille. We have not room for the whole memorial,but we sympathise entirely with its sentiments and its

purpose. It assures the chief of the united efforts of

European Governments to forestall the base attempts ofsome of their subjects, for personal and commercial objects,to deluge new territories with demoralising and intoxicatingdrinks, and of the perfect right of every chief to forbid theintroduction of such drinks into his own province. It goesfurther, and assures Gugunhana that in such action he willhave the approval of all good men in this country, and ofthe European Governments generally. It explains thateven in these enlightened countries such drinks are a causeof wide ruin and disaster. We cannot imagine any serviceto the African races in near touch with Europe which ourleading men can render more benevolent than this effortto coöperate with them and their chiefs in this matter.European races contrive somehow or other to maintain agreat strength in spite of alcoholic excesses. But to races

inhabiting tropical or semi-tropical countries they will besurely destructive. Even from the point of view of com-merce the importation should be forbidden, for the liquortraffic in such countries would be the enemy of all othertraffic, and, as the committee rightly points out, Europehas other articles to offer Africa besides drink.

THE TREATMENT OF GRAVES’ DISEASE.

THE New York Medical Record, in the report of thePractitioners’ Society of N ew York, prints some good remarksof Dr. William H. Draper, on the Treatment of Graves’disease, which is likely for long to be an interesting anddifficult study for pathologists and physicians. Dr. Draperthinks that the disease often presents itself in partial and,so to speak, rudimentary forms, in which one or two onlyof the characteristic phenomena may be present, and inwhich especially other neurotic symptoms appear. Amongpsychical conditions melancholia is the most common.

In some cases other nervous symptoms of spinal originare, great muscular tremor, fibrillary contractions of thefacial muscles, feebleness and paresis of muscles leadingto falls, choreic movements, local congestion and sweatings, Iunilateral sweatings, &c. All these, he thought, pointedto a general neurosis, of the cause of which we yet knewnothing, and not to be explained by sclerosis in thecervical sympathetic, which has been observed in some

cases. Rest, change of surroundings, and nutritiousdiet were important from a therapeutical point of view.Among drugs, the cardiac tonic he had found mosb

useful was digitalis. This medicine requires to be givenwith care and attention to its action, but Dr. Draper givesit "frequently, and in pretty large doses." But the remedyfrom which he has in some instances seen the most beneficial

results, used on the principle that it markedly affects theheart’s action, is iodide of potassium. He has seen ex-cellent results in a considerable number of cases. Dr.Francis Delafield thought that we treated these cases muchas we treat hysteria; but, after all, it is a very differentand much more fixed set of phenomena that we have todeal with. As to iodide, he thought the best results wereobtained in cases which had the rapid heart alone, and thesewere cases which we could not be sure were Graves’ diseaseat all.

___

BISLEY RIFLE MEETING.

CAMP life is as a rule a healthy and enjoyable one if theweather be only fine, and we are glad to learn that theBisley Rifle Meeting passed off satisfactorily in this respect.Of course, where a number of people are encamped for afortnight under conditions to which most of them were

probably unaccustomed, the occurrence of a certain amountof sickness of a trifling character and slight accidental

injuries may be anticipated. It seems that, according tothe report of Surgeon-Major Campbell, the general averagehealth was very good. Some serious cases occurred, how-ever-notably those of the Military Camp Adjutant, Lieut.Pretyman, who died of diphtheria shortly after his returnto his own home, and Surgeon Warren of the VictoriaMounted Rifles, who was attacked with peritonitis, andrequired of course an exceptional amount of medical careand skilful nursing.

-

SUCCESS OF THE INTERNATIONAL HYGIENECONGRESS.

THE latest news concerning the International Congress ofHygiene shows that the chief danger which now faces theorganisers is the possibility of exaggerated popularity.Already more than eleven hundred members and delegatesare inscribed, and have paid their subscriptions. The Con-

gress can do well with two thousand members, but if thisnumber is exceeded, then it will become unwieldy and verydifficult to manage. A large measure of hospitality canbe shown to many hundred delegates, but this is not soeasy when the number amounts to thousands. Perhapswhat will be as useful as the debates of the Congress isthe personal study of practical hygiene involved in theexcursions and visits to be made. But, again, to visitwater-works, sewage-works, hospitals, artisans’ dwell-

ings, &c., small parties should be made up. Thisthe reception committee are giving themselves great painsto organise, and all that is necessary is that they should notbe overflooded with applicants, all wanting to go on thesame day to the same place, and, above all, in every instancepreference should be given to the foreign members. Oneof the most pleasant excursions will be that to Cambridge,where honorary degrees will be conferred on some of our mostdistinguished foreign visitors. Then there is an excursionto Bournemouth, which will be most interesting to thosewho are interested in winter health stations, and several verypleasant expeditions will take place on the river Thames.In spite of the attractive, practical, and useful characterof all these entertainments, we must, nevertheless, againinsist that this portion of the programme should be cur-tailed so as to permit the sections to sit longer than sixteenhours in all. The sections might meet at 9.30 in the morn-ing, and thus the reading of minutes and other formalities