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of the second winter session. The result is, that first year’smen, having before them " the looming horror" of their firstexamination, instead of confining their studies, as they should,to dissection and practical anatomy, the only true introductionto physiology, occupy a considerable part of their time withthe latter. The Apothecaries’ Company avoid this error, buttheir curriculum is defective by omitting" Dissections" fromthe requirements of the first year, whilst they entirely banishphysiology from the third and fourth year.

It is further conceived, that to allow the student to set aside,as it were, all concern for anatomy and physiology oa passingthe primary examination at the College of Surgeons, at thetermination of the second winter session, is a fundamentalerror: the last, or "Pass Examination," ought surely to testthe whole knowledge of the student, or what is the good of theextended period of study, four years.

3. As to the much-complained-of examinations, all who areacquainted with the practical working of the present systemmust agree with Mr, Syme, that what with the four examina-tions of the College of Surgeons and of the Apothecaries’Society, and the School examinations at the end of eachsession, the student is liable to be somewhat " distracted,"and is further withdrawn from practical studies. To this- essential point I shall again revert, inasmuch as it would seemthat the existing examining system is not only objectionable as- to its multiplicity, but in the equally essential point regarding’the mode in which it is conducted.

The second great charge is the neglect of " hospital instruc-tion," the supreme importance of which it is impossible tooverrate, being in very deed " the first and the last." Andhere, again, notwithstanding the zealous and persistent effortsof the ruling powers, it is to be confessed that there is muchrequiring amendment. We have plenty of clinical lectures,medical and surgical; but formal discourses, differing but littlefrom the regular lectures, and often, it must be confessed, morecalculated, as indeed they are frequently designed, for themedical journals than for young students, will not give thatpractical, and, so to say, technical familiarity with the multi-tudinous and involved phenomena of medical and surgicaldiseases which is indispensable to successful practice. It isthorough, repeated, and real instruction by the bedside whichis demanded, where the student can freely question his teacher,and compare the oral description with the physical objectsand indications before his eyes ; thus combining the evidenceof the senses with the reflections of the mind, by which alonedurable impressions are made.

It is rather delicate ground to tread on, but somehow orother, either owing to haste, indifference, or manner on thepart of the teacher, our students do not seem to get that insightinto the indications and discrimination of disease which theample means of illustration afforded by our great hospitalsought to secure. A gentleman, now himself a metropolitanteacher, and who had a most distinguished career as a student,writes : " I have known clinical clerks, and attentive ones too,after six months of case-taking, know next to nothing of thephysical diagnosis of cnest affections." Of course a great dealmust in all teaching depend on the teacher himself; and uponthis point the observations of Mr. Syme are well deserving ofattention.* * Where so much depends on personal qualifications,it is difficult for the authorities to prescribe a remedy ; but allwho are familiar with the system of practical instruction in.some of the continental schools must be aware that there is inthe English system room for great improvement, and it is im-possible to doubt that an enlightened review of the whole of- this department would produce a successful result.

Having thus noticed the main points of complaint advancedagainst the existing system of medical teaching, I propose tooffer some remarks in the next number of THE LANCET on theremedies suggested.

THE DISTRIBUTION OF MORTALITY INENGLAND.

A RETURN has just been laid before the House of Commons,the importance of which can hardly be duly estimated whilethe sheets are still scarcely dry from the press. It appearswithout preliminary comment, and is simply headed " AReturn of the Average Annual Proportion of Deaths from

Specified Causes, at Specified Ages, in England generally, and

* Observations, p. 14.

in each Registration Division and Registration District of

England during the Decennial Period 1851-61." Thirty-fivefolio pages of closely printed figures compose this paper; andwe may well be pardoned attempting to pioneer our readersthrough the bristling thicket of numerals within twenty-fourhours after they have sprung into type. There is, however, ahistory attached to this Return which may usefully occupy atten.tion for the present, and which will serve in some measure toindicate the unusual importance of the document which hasthus unobtrusively been given to the public. It was preparedat the instance of Mr. Simon, and forms (to use the wordsof that gentleman, when referring to its compilation in hisfourth Report to the Privy Council), "a digest of all the

mortuary returns elating to the intercensual period 1851-1861,with such distinction of age and sex, and such classification ofcauses of death, as would enable the student to estimate, atleast with approximate precision, how far each district of

England is affected by the several sorts of morbific influence."The extraordinary value of a digest of this character must beobvious on a moment’s consideration. It will furnish at a

glance a knowledge, more or less perfect, of the health-conditionof every district of the kingdom. It will give coherence anduniformity to those investigations which must of necessity pre.cede all sound and comprehensive measures of sanitary improve.ment. It will supply a trustworthy basis for comparing thevarying conditions of health in different localities at differentperiods, and thus will afford an invaluable guide to local health.government. It vitalizes, so to speak, the periodical reportsof the Registrar-General, by yielding that standard of com-parison for the want of which those reports have hitherto failedlargely in immediate utility. Finally, it offers for the firsttime a satisfactory substratum for research into the epi.demiology of the kingdom -into the localization and diffusion ofthe great epidemic disorders. The publication of this digestconstitutes a new epoch for sanitary studies in England. Sucha digest should accompany, and it is to be presumed will infuture accompany, every Census. It is the legitimate, andindeed, it may be said necessary, complement of a Census.The great value we assign to this return is no fanciful or

strained deduction. What the return effects for the whole ofEngland, Dr. E. Headlam Greenhow had already effected forseveral districts, in a paper on the different prevalence of cer-tain diseases in England and Wales, laid by Mr. Simon beforethe General Board of Health in 1858." This paper, togetherwith Mr. Simon’s report upon it, and the reports of the localinvestigations to which, under the directions of the PrivyCouncil, it gave rise, constitute probably the most valuablecontributions to the sanitary and social history of a people inrecent times. They taught the vast excess of severity where-with certain habitual disorders press upon certain parts of thepopulation. They taught that " certain diseases, which amongstthem make up fully half of our annual mortality, are fatal inwidely different degrees in different districts of England."They taught, in fact, with a precision never before approached,the frightful waste of life, and more particularly of adult life,which was constantly occurring in many districts; and howthis waste was largely to be attributed, if it were not entirelydependent upon, local and removable causes.

The form of the present return is at once simple yet compre-hensive. It has been especially devised to meet public needs.It aims at setting before the reader, in the briefest space andclearest manner, the most fatal diseases of infancy and adultlife, classified in the least complex fashion. To have donemore would doubtless, to speak paradoxically, have been todo less. Highly elaborated classifications and a profusionof figures repel most men. It is important that in a workessentially practical in its nature, in which the scientificelement is subordinate to the public want, and which at thebest must present a formidable array of numerals, the arrange-ment should be of the least repulsive character. This has beenmost happily achieved. But it must not be imagined for amoment that, in adapting the return to the public need, it hasbeen thus divested of a strictly scientific character. That thisis not the case will become apparent when we proceed to ana-lyze its contents.

* See " Papers relating to the Sanitary State of England."

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The return gives the population, at all ages, in each regis-tration district, in 1851 and 1861 ; the number and name ofthe division or district; the deaths, at all ages, from all causes,from fever (" typhus" of the Registrar-General), from " diar- rhoea, dysentery, and cholera" (in one category), from scarlatina, ’,and from diphtheria. It also gives the deaths from " all causes"at less than one year of age ; also, at less than five years of age,the deaths from " all causes," from "diarrhoea., dysentery, andcholera," from "diseases of the respiratory organs (excludingphthisis)," from "diseases of the brain (including hydro-cephalus)," from " small pox," "scarlatina," "measles," and"whooping cough." At ages between 15 and 55, the returnshows the deaths, in each sex, from phthisis pulmonalis, alsofrom "other diseases of the respiratory organs;" and at agesbetween 35 anl 55, it shows, for each sex, the deaths from" diseases of the brain."In subsequent numbers we shall proceed to an analysis of

this return.

PROFESSOR BENTLEY’S LECTUREON

THE ORGANIC MATERIA MEDICA OF THEBRITISH PHARMACOPŒIA.*

IN his preliminary observations the lecturer pointed out theincreased importance given to the materia medica in the presentPharmacopoeia as a great improvement and material advanceover the plan pursued in preceding Pharmaeopceias, and onewhich would be sure to be appreciated. Although thus cor-dially .welcoming this improvement in the materia medica,there is, he thinks, one great omission which will mar its use-fulness-viz., the complete absence of any reference to the dosesof the crude drugs and their different preparations. Some ac-count of the doses of the various substances was more especiallycalled for in a work which introduces to notice many new, andin some cases but comparatively little known and powerfuldrugs, and in which old and familiar preparations have beenaltered materially in strength. He trusted to see this omissionrectified in a future issue, so that the Pharmacopoeia may con-tain in itself all that prescribers and dispensers are absolutelyrequired to know. He should also like to see more care takenin succeeding editions in enumerating the different prepara-tions of each article of the materia medica, for in the presentPharmacopoeia there are many important ones omitted.There was one result which he feared would to some extent

,

be brought about by this enlargement of the materia medica,and that was, its use by students as a multum in parvo, a kindof "cram." Should such be the case, it would be a great evil;for, important and useful as the short notices of the materiamedica were, they could only serve as a foundation for furtherstudies, or as an abstract of what is essential for future use.He would, indeed, possess but a superficial knowledge whowould refuse to proceed further than the Pharmacopoeia taughthim of materia medica, and to such a student a large amountof most important and interesting matter would be entirelyunknown.The following is a list of organic substances which were

officinal in the last London Pharmacopoeia, but which are ex-cluded from the British Pharmacopoeia :-Absinthium, acetum(Britannicum), aloe hepatica, althæa, amygdala amara, anisum,avena, canella, carota (radix), chimaphila, cornu, eydonium,cyminum, granatum (rind of fruit), helleborus, inula, juniperus(fructus), lactuca sativa, laurus, maranta, mentha piperita(herba), mentha viridis (herba), morphiæ acetas, mucuna,oleum fceniculi, ovi vitellus, petroleum, piper longum, pix,pulegium, pulegii oleum, pyrethrum, rhamni succus, ruta

(folium), sago, sagapenum, spiritus vini gallici staphysagria,terebinthina chia, terebinthina vulgaris, tormentilla, veratrum,viola.

Professor Bentley stated that some few, such as morphiasacetas, helleborus, and lactuca might have been retained; whileothers now retained might have been excised. Thus, whatmaterial advantage has been gained by retaining all the follow-ing fruits, possessing as they do nearly identical properties-namely, anethum, carai, coriandrum, and fœniculum; or, inlike manner, oleum anethi, oleum anisi, oleum carui, and oleumcoriandri; or all the following balsamic substances—benzoioum,

* Delivered at the Pharmaceutical Society on the 24th of February, 1864,

styrax, balsamum peruvianum, and balsamum tolutanum ; orall the following astringents-catechu nigrum, catechupallidum,kino, and krameria? What particular virtues oleum coriandripossesses over some other oils belonging to the same naturalorder as the plant from which it is derived, he was unable toimagine ; but as it is an entirely new substance in a BritishPharmacopoeia,, he had no reason to doubt that its claims forsuch an especial recognition were very strong in the opinion ofthe Medical Committee of the Pharmacopoeia.

Turning from the consideration of the excluded organicbodies to those which have been newly introduced, it wasfound that, although there are but twenty-three entirely newto the Pharmacopoeias of the United Kingdom,- yet, whencompared with the last London Pharmacopoeia, the number ofnew bodies is increased to forty-three, as may be seen by thefollowing :-New organic substances in the British Pharmacopœia as

compared with the last London Pharmacopœia -Acidum aceti.cum glaciale. *aconitia, *aconitum (flowering tops), *arnica,*beberiae sulphas, ’bela (or bael), belladonnæ radix, cannabis

indica, chirata, cooculus, *collodium, *conii fructus, cotton,*cusso (or kusso), *digitalinnm, filix, ’fel bovinum, *fel bovinumpurificatum, fousel (or fusel oil, or amylic alcohol), glycerinum,hemidesmus, *indigo, jalapae resina, *kamela, laurocerasus, linifarina, matico, *nectandra, oleum myristicæ, oleum cubebsa,*oleum coriandri, *oxalic acid, *podophylli resina, *podophyl-lum peltatum, *pyroxylin, sabadilla, saccharum lactis, *san-tonica, *santoninum, *scammoniæ radix, *scammoniæ resina,spiritus pyroxylicus rectificatus, terebinthina canadensis.The number of new organic substances introduced into the

British Pharmacopoeia as compared with the last London

Pharmacopoeia, and the number excluded, may thus be seen tobe precisely equal. He felt that some other organic substancesin great demand in certain parts of the country might, withadvantage, have also been introduced ; as physostigma vene-nosum (the plant from which the Calabar bean, now completelyestablished as a most valuable remedial agent, is derived), actæa.racemosa, prunus virginiana, veratrum viride, pepsine, &c.;at all events, these have at least equal claims for insertion assulphate of beberia, nectandra, arnica, oleum coriandri, and felbovinum. He would like to see a similar plan adopted by theframers of the British Pharmacopoeia as has been for a longperiod employed with great advantage in the United States

Pharmacopoeia, that is, to have a secondary list of the MateriaMedica, in which should be inserted substances possessing novery evident medicinal properties, and which do not enter intoany of the preparations and compounds; as also those of recentintroduction which are upon their trial, but not sufficientlyestablished to warrant their being placed in a prominent posi-tion in a national Pharmacopoeia. In such a list, articles asaotasa racemosa, prunus virginiana, pepsine, sulphate of be-beria, cocculus, cusso, hemidesmus, kamela, chirata, terebin-thina canadensis, veratrum viride, tormentilla., and very manyothers might be placed. He felt sure that a list of this kindwould be of great advantage, and he hoped to see the planacted upon in the next edition of the British Pharmacopoeia. *t*

Professor Bentley then proceeded to remark specially uponthe separate articles in the above list.The test for gum arabic in powder (pulv. acacise) was alto-

gether useless. The following should be inserted instead :-Adecoction of the powder when cold, or the mucilage made withboiling water when cold, does not become blue on the additionof a solution of iodine.The tincture of aconite to be "half the strength of tinctura

aconiti, Dub. ; and one-third the strength of tinctura aconiti,Lond." This is an important error, fur it is only one-fourththe strength of the former, and about one-third that of thelatter.The following is given as the test of aconitia :--" Dissolves

entirely in pure ether ; leaves no residue when burned withfree access of air." Upon turning to "a;,ropia," the alkaloiddirected to be obtained from belladonna root, it will be foundthat the same test is given of that alkaloid ; hence it is clearthat the so-câlled test simply contains certain characteristicscommon to both alkaloids, and, therefore, is not a test ofeither.

Aconitum, -"The fresh leaves and flowering-tops; gathered,when about one-third of the flowers are expanded, from plantscultivated in Britain," are directed to be used. The employ-ment of flowering-tops is entirely new to the British Pharma-copœeias, and he doubted the propriety of oraeting them. The botanical characters BBhich are given of both the leaves and

* These are marked with an asteri-k in the hst of new organic substances.t We made this suggestion some time 8:UM.