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729 Mr. TURNER said that Dr. Humphry’s proposals ought I not to be interpreted by former recommendations which had to be reconsidered. ! Dr. THOMSON said that students were very apt to enter on the study of practical subjects before they had thoroughly mastered the elementary subjects of study, and a line of demarcation between them would be very desirable. He quite agreed that a longer time than three years was required for medical study. It might, he thought, be an advantage to begin with a summer course on ele- mentary subjects before entering upon the regular winter session. Dr. WOOD agreed with Dr. Humphry, that students should so carry on their studies as not to be obliged to have recourse to a large amount of cramming at the end, but he was not sure whether the Council ought to lay down so definite a scheme as that proposed in the resolu- tion. He should prefer the suggestion of the Committee of Recommendations, which did not, like the resolution, tie down the bodies to three examinations. In the Edinburgh colleges, if a student came from a university with a certifi- cate for anatomy, physiology, and chemistry, he was not examined again upon those subjects, but only upon the practical branches. That, he thought, was a useful step in the direction of conjoint examinations, in which the uni. versities bore an important part. Mr. LISTER thought that the proposed regulation should be permissive only. When a man had acquired a com- petent knowledge in the elementary subjects he should be allowed to pass in them ; other subjects, however, should be deferred till the end of the course. He should have no objection to a regulation that no student should be allowed to come up for the final subjects within two years, having passed the more fundamental subjects. Mr. SIMON said he warmly concurred in the general in- tention of the resolution as explained by Dr. Humphry. Its intention was that the curriculum was to be in two parts, and that study in the latter part was not to be recognised until the student had passed an examination in the earlier part. That would be the greatest reform ever made in me- dical education, and if it could br carried out it would be an incalculable advantage to the medical schools, whose great - difficu1t.y was the confusion of studies, against which so little precaution was taken. It was, however, of great importance not to press unduly on the authorities in matter of detail. He would not, for instance, say that the study of anatomy should not count until the student had passed his first ex- amination. He thought the time was not distant when the preliminary examination would relieve the medical cur- riculum of all elements of natural historv. Dr. ROLLESTON proposed the following amendment :- "That these examinations be passed in a certain order approved by the Council, a student being allowed to present himself foreithercf tbetwo later examinations on a certificate of having passed the preceding examination or examina- tions." It would be an injury to medical students not to allow those who were able to pass the previous examinations dealing with fundamental subjects to gain so much time for their clinical studies as they could gain by superior dili- gence, and to pass their examination at an earlier period. It was necessary to legislate both for the stupid and the clever, the idle and the diligent. He approved of the regula- tion of not allowiog any subsequent time to count unless the first examination was passed, but if a student could pass two examinations sooner than others he should be allowed to do so, and thus gain so much time for his clinical work. He quite agreed that a licence should not be granted before the expiration of four years. Dr. HUMPHRY said he was willing to divide the resolution into two parts, the first stating that there should be three examinations, and the second dealing with the order of those examinations. Dr. STORRAR objected to anything like over-regulation, but said he concurred in the general design of Dr. Hum. phry’s resolution. After some further discussion, the first part of the re- solution was put and carried. The consideration of the remaining part of the resolution, together with the amendment of Dr. Rolleston, was deferred. The Council then resumed, and shortly afterwards ad- journed. TUESDAY, MAY 15TH. The PRESIDENT, in reply to Mr. Teale, stated that the Government had asked the opinion of the Council on the question of foreign and colonial degrees, and on the education and registration of midwives. Af,er the reception of various memorials and other documents, the Council was ma1nly occu- pied during the remainder of the day in fulfilling its judicial functions, with regard to the erasure of names from, and the restoration of names to, the Register. The name of John Joseph Mullen was ordered to be restored. The name of Thomas Richardson, of Millom (who was represented by a solicitor), was ordered to be erased. He held and was regis- tered on a diploma of the Metropolitan Medical College of New York, stating that he had attended the lectures, &c., of the College, he not having been in America at the time. The names of Michael Manus Sheedy and James Meehan (which had been erased in consequence of a conviction for misde- meanor) were ordered to be restored. Mr Butt, Q.C., ap- peared in their behalf. With regard to the application of J. Samuel Leverston, to have his name restored, the Council declined to accede to it, unless he should furnish to the Exe- cutive Committee satisfactory evidence of character. An application to restore the name of Henry Pearson was refused. WEDNESDAY, MAY 16TH. The Council resolved itself into committee, and resumed the consideration of Dr. Humphry’s report. After a long discussion the motion was altered as follows : "That the first examination be passed before the commencement of the second year of professional study, it being hereby intended that no time which may elapse after the first year of professional study shall count until the first professional examination shall have been passed." To this Dr. Andrew Wood moved as an amendment:— "That the professional examination be arranged in two divi. sions, the first division to embrace the more elementary sub. jects. The second division may be completed at or before the close of the second year of professional study, but the second division not till the expiration of two years after the passing of the first division, nor before the completion of the fomth year of study." This was seconded by Dr. Thomson, and ultimately, on being put as a substantive motion, Dr. Humphry’s motion being postponed, was carried by a large majority. Dr. Humphry’s motion was afterwards negatived, only five members voting in its favour. Recommendations five, six, ten, and eleven were remitted to the Committee on Recommendations, which was reappointed for the purpose of considering them. At five o’clock the Medical Acts Amendment Committee retired, and after a short adjournment, the remaining members ordered the returns from the Army and Navy Department, communications from the Royal College of Surgeons of Eng- land and the Umversity of Edinburgh on the subject of certificates of proficiency in vaccination, a report by the Executive Committee with reference to a resolution of the Branch Council for England in regard to the Lunacy Laws, and correspondence between the Royal College of Surgeons, and the Senior Lecturer of Trinity College, Dublin, on pre- liminary education and examination, to be entered on the Minutes. __ THURSDAY, MAY 17TH. I The Council went into committee to-day on a Report of the Medical Acts Committee respecting the several points remitted to it for consideration. The first of these points was the registration of foreign and colonial degrees, on which, after some discussion, the Council passed resolutions in favour of the following amendments of the Medical Act:—* That the medical qualifications granted under legal authority in any part of Her Majesty’s dominions outside the United Kingdom, and entitling to practise in such parts, should be registrable within the United Kingdom on the same terms as qualifications which are granted in the United Kingdom, but in a separate and alphabetically arranged section of the Register." " That the General Medical Council should have authority to establish, under conditions, in the Medical Register, a distinct alphahetical section for foreigners practising in the United Kingdom with qualifications granted in foreign countries and entitling to practise in those countries."

Session 1877

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729

Mr. TURNER said that Dr. Humphry’s proposals ought Inot to be interpreted by former recommendations whichhad to be reconsidered. !

Dr. THOMSON said that students were very apt to enter onthe study of practical subjects before they had thoroughlymastered the elementary subjects of study, and a line ofdemarcation between them would be very desirable. He

quite agreed that a longer time than three years wasrequired for medical study. It might, he thought, bean advantage to begin with a summer course on ele-mentary subjects before entering upon the regular wintersession.

Dr. WOOD agreed with Dr. Humphry, that studentsshould so carry on their studies as not to be obliged tohave recourse to a large amount of cramming at the end,but he was not sure whether the Council ought to laydown so definite a scheme as that proposed in the resolu-tion. He should prefer the suggestion of the Committeeof Recommendations, which did not, like the resolution, tiedown the bodies to three examinations. In the Edinburghcolleges, if a student came from a university with a certifi-cate for anatomy, physiology, and chemistry, he was notexamined again upon those subjects, but only upon thepractical branches. That, he thought, was a useful stepin the direction of conjoint examinations, in which the uni.versities bore an important part.Mr. LISTER thought that the proposed regulation should

be permissive only. When a man had acquired a com-petent knowledge in the elementary subjects he should beallowed to pass in them ; other subjects, however, shouldbe deferred till the end of the course. He should have no

objection to a regulation that no student should be allowedto come up for the final subjects within two years, havingpassed the more fundamental subjects.Mr. SIMON said he warmly concurred in the general in-

tention of the resolution as explained by Dr. Humphry. Itsintention was that the curriculum was to be in two parts,and that study in the latter part was not to be recogniseduntil the student had passed an examination in the earlierpart. That would be the greatest reform ever made in me-dical education, and if it could br carried out it would be anincalculable advantage to the medical schools, whose great- difficu1t.y was the confusion of studies, against which so littleprecaution was taken. It was, however, of great importancenot to press unduly on the authorities in matter of detail.He would not, for instance, say that the study of anatomyshould not count until the student had passed his first ex-amination. He thought the time was not distant when thepreliminary examination would relieve the medical cur-

riculum of all elements of natural historv.Dr. ROLLESTON proposed the following amendment :-

"That these examinations be passed in a certain order

approved by the Council, a student being allowed to presenthimself foreithercf tbetwo later examinations on a certificateof having passed the preceding examination or examina-tions." It would be an injury to medical students not toallow those who were able to pass the previous examinationsdealing with fundamental subjects to gain so much time fortheir clinical studies as they could gain by superior dili-gence, and to pass their examination at an earlier period.It was necessary to legislate both for the stupid and theclever, the idle and the diligent. He approved of the regula-tion of not allowiog any subsequent time to count unless thefirst examination was passed, but if a student could passtwo examinations sooner than others he should be allowedto do so, and thus gain so much time for his clinical work.He quite agreed that a licence should not be granted beforethe expiration of four years.

Dr. HUMPHRY said he was willing to divide the resolutioninto two parts, the first stating that there should be threeexaminations, and the second dealing with the order of thoseexaminations.

Dr. STORRAR objected to anything like over-regulation,but said he concurred in the general design of Dr. Hum.phry’s resolution.After some further discussion, the first part of the re-

solution was put and carried.The consideration of the remaining part of the resolution,

together with the amendment of Dr. Rolleston, was

deferred.The Council then resumed, and shortly afterwards ad-

journed.

TUESDAY, MAY 15TH.

The PRESIDENT, in reply to Mr. Teale, stated that theGovernment had asked the opinion of the Council on thequestion of foreign and colonial degrees, and on the educationand registration of midwives. Af,er the reception of variousmemorials and other documents, the Council was ma1nly occu-pied during the remainder of the day in fulfilling its judicialfunctions, with regard to the erasure of names from, and therestoration of names to, the Register. The name of JohnJoseph Mullen was ordered to be restored. The name ofThomas Richardson, of Millom (who was represented by asolicitor), was ordered to be erased. He held and was regis-tered on a diploma of the Metropolitan Medical College ofNew York, stating that he had attended the lectures, &c., ofthe College, he not having been in America at the time. Thenames of Michael Manus Sheedy and James Meehan (whichhad been erased in consequence of a conviction for misde-meanor) were ordered to be restored. Mr Butt, Q.C., ap-peared in their behalf. With regard to the application ofJ. Samuel Leverston, to have his name restored, the Councildeclined to accede to it, unless he should furnish to the Exe-cutive Committee satisfactory evidence of character. An

application to restore the name of Henry Pearson was refused.

WEDNESDAY, MAY 16TH.The Council resolved itself into committee, and resumed

the consideration of Dr. Humphry’s report. After a longdiscussion the motion was altered as follows : "That the firstexamination be passed before the commencement of the secondyear of professional study, it being hereby intended that notime which may elapse after the first year of professionalstudy shall count until the first professional examination shallhave been passed."To this Dr. Andrew Wood moved as an amendment:—

"That the professional examination be arranged in two divi.sions, the first division to embrace the more elementary sub.jects. The second division may be completed at or beforethe close of the second year of professional study, but thesecond division not till the expiration of two years after thepassing of the first division, nor before the completion of thefomth year of study." This was seconded by Dr. Thomson,and ultimately, on being put as a substantive motion, Dr.Humphry’s motion being postponed, was carried by a largemajority.

Dr. Humphry’s motion was afterwards negatived, only fivemembers voting in its favour.

Recommendations five, six, ten, and eleven were remitted tothe Committee on Recommendations, which was reappointedfor the purpose of considering them.At five o’clock the Medical Acts Amendment Committee

retired, and after a short adjournment, the remaining membersordered the returns from the Army and Navy Department,communications from the Royal College of Surgeons of Eng-land and the Umversity of Edinburgh on the subject ofcertificates of proficiency in vaccination, a report by theExecutive Committee with reference to a resolution of theBranch Council for England in regard to the Lunacy Laws,and correspondence between the Royal College of Surgeons,and the Senior Lecturer of Trinity College, Dublin, on pre-liminary education and examination, to be entered on theMinutes.

__

THURSDAY, MAY 17TH.

I The Council went into committee to-day on a Report ofthe Medical Acts Committee respecting the several pointsremitted to it for consideration. The first of these pointswas the registration of foreign and colonial degrees, onwhich, after some discussion, the Council passed resolutionsin favour of the following amendments of the MedicalAct:—* That the medical qualifications granted underlegal authority in any part of Her Majesty’s dominionsoutside the United Kingdom, and entitling to practisein such parts, should be registrable within the UnitedKingdom on the same terms as qualifications whichare granted in the United Kingdom, but in a separateand alphabetically arranged section of the Register."" That the General Medical Council should have authorityto establish, under conditions, in the Medical Register, adistinct alphahetical section for foreigners practising in theUnited Kingdom with qualifications granted in foreigncountries and entitling to practise in those countries."

730

" That the Council should have authority to cause to beregistered, in this section of the Register, such qualificationsas it may, in its discretion, having regard to conditionsunder which they are granted, judge to be sufficient guaran-tees for the possession of the requisite knowledge and skillfor the practice of their profession." " That the Councilwould not approve, as a general rule, that British subjectsshould be allowed registration in the United Kingdom onthe basis of foreign qualifications; but the Council wouldpermit, in particular exceptional cases, and by way of

special grace, the registration of persons lon established inpractice in foreign parts and of approved character andattainments, but not possessed of registrable qual fications."" That the Council would not approve that foreign qualifica-tions should be registrable as additional qualifications underthe Medical Act by persons primarily registered underBritish qualifications."The next point dealt with in the Report of the Medical

Acts Committee way that of the legal difticu’ties underRussell Gurney’s Ad, and under the Medical (Royal Collegeof Surgeons) Act of 1875. It was proposed to alter, as follows,the objectionable proviso to Russell Gurney’s- Act, cap. 41,clause 1:-" That if any university or medical corporationwhich has not before the passing of this Act examinedwomen for q’ alifications as aforesaid, shall at any time afterthe passing of the Act see fit so to examine women, nowoman obtaining such qualification shall, in respect of it,except at the further discretion of the university or

medical corporation granting the same, be entitled to takepart in the government, management, or proceedings ofthe university or corporation." The proposal was adopted,subject to the opinion of the solicitor of the Council as tothe precise wording of the proviso. A resolution was alsopassed to the effect that the Council concurred in theopinion of the Royal College of Surgeons that the Act of1875 required amendment; and that it should be amendedin connexion with Russell Gurney’s Act. A deputation wasappointed to wait upon the Duke of Richmond on the sub-ject on Friday (this day).

POISON OF THE VIPER.

PROF. G. VALENTIN records, in an interesting paper con-tained in the Zeitschrift fUr Biologie (Band xiii., Heft 1,1877), the results of an extensive series of researches he hasmade with the poison of the viper during the summer oflast year. The particular species he employed was theViper aspera of Linnasas or Echidua aspis of Risso. Prof.

Valentin states that he could only get one out of twentyvipers to bite on external irritation. Frogs placed in thesame box often leaped on the heads of the vipers, and heteased them with the frogs by tying a string to the latterand striking the vipers with them. Rabbits, too, remainedunharmed; exposure to a burning sun did not appear toirritate the vipers, though they sought the shady side of thebox. He arranged an electric apparatus so that shocks ofconsiderable intensity could be given. When these were

passed through frogs, the animals went at once into a

state of tetanus, but the vipers only responded with someslight wavy movements, even when the sponge forming oneof the electrodes was firmly pressed down upon the roughskin of the animal. The introduction of ether vapour madethe vipers lively, but they still had no inclination to bite.One which was thus etherised became quite insensible,and he took the oppoitunity of squeezing out some of thepoison upon small squares of Swedish filtering paper. Healso obtained some of the transparent mucus whichhad collected on the palate near the apices of the

poison fangs. On placing a fragment of this papera few millimetres square under the skin of the backof a frog, he found that death generally but not

always took place in a period varying from six to twentyhours, the cause of the fatal results, he thinks, beingdue to the admixture of some of the yellow oily secretion ofthe poison gland with the saliva. The quantity of the oilypoison was very variable, and it was small in those animals

’"

that had been long kept in captivity. Paper impregnatedwith the poison retained its activity for six months or more,and enough was obtained from one animal to saturate twentypieces of filtering paper, presenting from twenty to twenty-five square millimeters of surface. The retention of thehead of vipers in alcohol for some months, and exposure ofothers to temperatures varying from 60° to 90" per cent., didnot cause the poison to become innocuous. When pure theoily fluid presented no morphological elements. Whenscraped from the mouth it was often found to contain ciliatedepithelium cells, which continued to vibrate for some days.Its sp. gr. he estimates at 0 92, and the amount of solidresidue was in two instances 43’3 and 45 per cent. It isacid in its reaction. When a frog is bitten by a viper aspeck of blood may appear, but the point of puncture canonly be discovered with difficulty, or not at all. Some of thefrogs bitten by the above-mentioned vicious viper died, eventhough only once bitten ; whilst others, even after beingbitten several times, remained apparently unaffected. Theprocess of secretion did not appear to be very actively per-formed. By weighing a portion of paper before and afterimpregnation with the poison, and cutting it up intosquares, Professor Valentin found that a quantity not ex.ceeding 0’00037 of a gramme was capable of producing,when inserted beneath the skin of a frog, well marked andpersistent symptoms of poisoning, and death in thirteendays. Quantities varying from half to one milligrammekilled a frog in from eight to twenty hours. The firstsymptom of poisoning in the frog was increased ab-dominal breathing, the number of the respirationsbeing increased ; and there was also increased excitability,the animal leaping forward on being touched. It soon

became restless, and a slight cramp-like extension of thehind legs was observed after each leap. After a time theanimal was unable to recover itself when placed on its back,and its leaps became purposeless. The reflex actions thenbecame interfered with, so that often the toes of one footcould be pinched without exciting movement, whilst onpinching those of the other foot vigorous movements ofextension and flexion of the whole leg took place. Hemi-plegia not unfrequently followed; yet exalted reflex sensi-bility often remained to the last stage. The circulation ofthe blood is often arrested in the vessels of the web of thefoot and of the tongue, whilst the animal can still executelively movements, and they are much congested; it wouldappear therefore that the cardiac impulses are greatly en-feebled. In the early stages of the poisoning, tetanisation ofthe vagus arrests the heart’s action. At a later stage, when theheart has stopped, tetanisation of the vagus produces fre-quent and powerful contractions. The lymph hearts continueto beat (in one case forty-four beats per minute) after theheart has ceased. Valentin made experiments to ascertainthe amount of respiratory exchange that took place beforeand after poisoning, and these demonstrated that the viperpoison belongs to that class of poisons which, like antiar,veratria, muscarine, and atropine, diminish the absorp-tion of oxygen, and do not, like small doses of curara, aug-ment it. At a certain period after death, a time comes whenthe exchange of gases is more lively, and a large relativeproportion of oxygen is absorbed. The action of the poisonin diminishing the absorption of oxygen is consequentlyonly transitory. The muscle curves of poisoned frogs showappreciable differences from those of healthy frogs, and thesehe illustrates by tracings. When the poison has beeneffective no contraction can be induced, even after the lapseof only five hours, with the most powerful coil. The ex-citability of the central nervous system is lost before thatof the lumbar plexus. The application of electricity to thegland .neither caused the secretion to be formed nor to bedischarged. The cilia and spermatozoa of poisoned frogscontinue their movements, as do also the opalina ranarumfound in the large intestine and the filaria in the blood.Very small quantities of the poison introduced into theconjunctival sac of rabbits produced the most violent in-flarnmation. The vipers refused all food whilst in cap-tivity, and all, of course, ultimately died.

VACCINATION GRANT. - Mr. William Yates hasreceived from the Local Government Board a grant of,617 8s. for efficient vaccination in his district-viz., Rich-mond and Petersham.