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Correspondence.

THE ROYAL COLLEGE OF SURGEONS OFENGLAND AND DEGREES.

11 Audi alteram partem."

To the Editor of THE LANCET.

SIR,—At the annual meeting of the Royal College ofSurgeons of England in 1911 my resolution to press theCouncil to obtain a degree for the Fellows and Members, afterthe satisfactory discussion, had no need to be, and was not,

. vo’ted on, because it was said the Council had it in hand, asit was then thought. It was therefore a disappointment thatthe President made no allusion to what they intended to dowith it at the yearly meeting of 1912. Neither does the lastreport of the College enter upon the progress towards thechanges expected to accrue to obtain degrees for the Colleges.Of course, the case was not one s2cb judice, because they dotry to refer to this question in regard to the dental diplomas.There they stray to the resuscitated cry for a " one-portal"entrance-as an alternative suppression to a full reform-and there it runs: " It is undesirable that a university dis-tinction shotdd carry the right to practise." Why not ?Surely we have got beyond the medievalism (the Germanmedisevalism, too) of the licentia docendi before the olddegree of disputation and Magistrum. And their chief argu-ment of propriety, too, falls to the ground when the oldercolleges of learning or medicine in Italy, France, andGermany have habitually merged into the ancient ormodern universities, and when in our own universities everydegree in the United Kingdom, as everywhere else, doescarry the right to practise, and apparently always will do so ISo far, and until the last false move for a ’’ one-portal "

has been changed again, it must be said that the generalshipover the Council’s poor ground of action before the RoyalCommission on University Education in London has onlyled to a temporary retreat, a good reason probably being thatthe leading has been carried on under divided counsels andvacillatingly, first from the older (now inadequate) schemesfor a separate College or non-university degree, and then tothis particular "one-portal" " or non-degree scheme. Thatexhausted style of a single collegiate portal to be imposedbefore the degree portal could be approached would justuphold, without purpose, the natural behests of those entirelyuninterested in the reform movement. No specialised repre-sentation has ever been allowed to the body of the Fellowsand Members to make their side of the question effective. Andso as to obtain that standing the Fellows and Members of theConjoint Colleges would be well advised to form a Reform orMedical Colleges’ Society with their special interests and thisreform as the basis, and at the formation of which I wouldgladly assist. The hollowness of the I one-portal " shamwants correcting, or there will be the danger of obtaining noredress whatever for the College men, and only continuing thedead level which persists and has killed all their opportunitiesin the past.Many lecturers at our larger hospitals with schools, up

and down the country, besides those more concerned inLondon, in their inaugural sessional addresses have referredto the unsatisfactory state of the Licence alone in the

Colleges’ qualifications. So, after the years of strenuousagitation, it does seem strange that the aspirations of theFellows and Members, and the natural desire to know howthe Councils of the Colleges intend to realise them, shouldthus be so newly and limply set aside. If the Fellows andMembers accepted such a subservient position, then the otherportals, the university portals, at last more easily avail-able for County College degrees, must inevitably predominateover them, and so end in their exclusion and extinction aspractitioners, or rather as doctors in medicine.

Certain tables in my book, "Medical Reform Measures,’on this subject clearly pointed out how the College candi-dates were being swamped by University students; the

average still remains approximately at 50 per cent. Andmany new points and tables to be seen in my new volume,Vol. II., in print since July, 1912, also show how thisbreaking up of the old Colleges, this splitting faction, tendsto spoil the interests of the collegiate Members, and to play

into the hands of the university possessors of office. Andany further persistence in the unfortunate, if not ungenerous,volte face of the Councils at this juncture, or any disallow.ance displayed against the widely expected desire for adegree by the genuine collegiate Fellows and Members,could only severely shake the best allegiance and confidencein the leaders of the Councils of the Colleges, however muchone may respect them, as I do.The reform of the Medical Colleges advocated by me has

always been to join the University system to our Collegesystem. Any other way of invoking, instead of resisting,the incompatible claims, first of a dominant College hierarchyor governing side, then of a College degree without thereform side, or lastly, the supposed superior inviolability ofthe University of London or other university graduates’ side,must end in total- negation and failure. They ought not tobe touched, and therefore those offsides should be droppedin favour of the only open policy of reform for the Collegesthemselves, and fully explained on the above lines in my twobooks above cited.

Bluntly put, if from none one-half of the collegiatestudents have risen to the stage of degrees, given, or ratherseizing, their due and a reasonable opportunity, the othershave a clear title to possess what the similar half has alreadyrisen to. And if denied, assuredly in time the others woulddo the same ; and both the use and traditions of the Collegesand Members would attenuate to absorption or disappear.ance. This College reform is our reform; infra men ordull-ideal business men notwithstanding, the past or theusually temporary oppositions also notwithstanding. And

surely thus the sign and the needs of the College timesstand forth nlainlv.-I am. Sir. vours faithfully.

H. ELLIOT-BLAKE.

z* Owing to the elliptic nature of the style adopted,the meaning of this letter is not always clear, but we printit because of Mr. Elliot-Blake’s sincere and persistentadvocacy of his reform measures. The arguments for andagainst the one-portal system have been set out over and overagain in the columns of THE LANCET, and it is certain thatits institution is more favourably regarded now than it

was a few years back among those to whom official positionlends influence. The affiliation of the Royal Colleges withthe Universities for the purpose of obtaining degrees is notthe simple matter that Mr. Elliot-Blake thinks. He is

pointing out a possible development which has received theanxious consideration of many men for many years.-ED. L.

THE SENIOR FELLOWS OF THE ROYALCOLLEGE OF PHYSICIANS OF

LONDON.To the Editor of THE LANCET.

SIR,-Please allow me to remind you that Dr. Dickinsonwas the third in seniority of the Fellows of our Royal Collegeof Physicians, not the second, as stated in your admirableobituary notice of Jan. 18th, his Fellowship dating 1865, andSir Herman Weber and Dr. Odling, of Oxford, both being hisseniors with Fellowships of the year 1859.

I am, Sir, yours faithfully,JAMES SAWYER.

A REGISTERED UNION OF MEDICALPRACTITIONERS.

To the Editor of THE LANCET.

SIR,-As there have been many inquiries as to whetherany attempt has been made in Leicestershire to carry out thetrade union policy which I with others advocated at the

Liverpool meeting of the British Medical Association lastyear, may I, through your columns, inform those interestedin the matter that, in accordance with the unanimous resolu-tion of a large meeting of the practitioners of Leicestershireand Rutland, a committee was appointed to take actionthereon. Articles and rules were drafted in consultationwith counsel, and submitted to the registrar ; a certificate of