475

THE LANCET.

LONDON: SATURDAY, NOVEMBER 20, 1852.

PRACTICAL EXAMINATIONS OF THE UNIVERSITY OF LONDON.

AT the time of its foundation, the University of Londoninitiated a plan of examination before unknown in this coun-try, or at least unpractised by the various medical ExaminingBoards. A most important feature of the elaborate schemedrawn up by the Senate was the combination of practicaltests with the usual oral and written examinations. To

insist upon the advantages of testing the practical knowledgein anatomy, botany, materia medica, and chemistry, of a manabout to engage in the daily practice of applying the resourcesdrawn from the three kingdoms of nature, and variouslyoperated upon in the laboratories of the chemist and the

human frame, for the alleviation of disease, now appears tobe a superfluous task. But at the time when the metropolitanUniversity was founded, those advantages were disregarded,or the feasibility of subjecting candidates to tests of this

nature was denied. The experience of the University has

proved how feasible is the task, and the high reputationwhich the London medical degree has attained places its

utility on no doubtful ground. The example has, indeed, I

since been imitated with success. While the ancient Uni-versities have recognised the value of the example set themby their younger sister, by extending their somewhat narrowcircle of instruction and examination, so as better to representthe enlarged circumference of modern knowledge, and the in-creased requirements of a progressive age, the medical corpo-rations have on their part adopted, to some extent, theinnovations made by the Senate of the University of

London upon the time-honoured system of conducting theexamination of candidates for medical practice. The

College of Surgeons, in framing the scheme of examinationfor the higher order of fellows, made it necessary to

investigate the practical acquaintance of the candidates inanatomy. From the commencement of the examinations

for the degree of M.B., in the University of London, it

has been the custom to call upon the candidate to dissect in

the presence of the examiners, to demonstrate anatomicalpreparations, to describe specimens of living plants, to desig-nate specimens from the materia medica, and to conductsome elementary chemical analysis; and the candidate for theDoctor’s degree has been required to give a minute com-mentary upon a medical case. The system has worked well.Candidates preparing for the University examinations find itnecessary to acquire something more than book-learning. Forthe Colleges, for the Apothecaries’ Hall, students still derive

the most comfortable assistance from the grinder." Men

aspiring to the University degrees, resort to the fields, to themuseums, to the dissecting-room, to the laboratory, to the

’I clinical wards, as the indispensable means of success. Not-

withstanding a recommendation made some time ago by theExaminer in Chemistry, prompted, we fear, more by indo-lence than by any other motive, to discontinue the practicalexamination in chemistry, the Senate wisely resolved to

accede to no infraction of their fundamental principle. TheyI have recently given fresh proof of their faith by carrying out

still further the system of practical examination. At the

second examination for the degree of M.D., just concluded,the candidates were required to name and describe micro-

scopic specimens. In surgery they were examined by demon-strations from wet and dry preparations, illustrative of varioussurgical diseases and accidents, and of their treatment. The

examiners in medicine required the candidates to examine

patients in the wards of a metropolitan hospital, and afterwardsto report in writing on the cases. It must be obvious that nonebut those extensively and practically conversant with the entirerange of medical knowledge, and with disease at the bed-side,could come out successfully from an ordeal so practical; norcan it be disputed that a man who has come out successfullyhas established his qualifications for the practical duties of hisprofession in the most unimpeachable manner. Some personswe know there are, who, with little consistency, and we fearwith little candour, have been accustomed to contrast theexaminations of the University of London with those of the’College?, by admitting the superior theoretical or speculativemerits of the former, and implying that the special merit ofthe latter is their essentially practical character. How can

we separate the theoretical from the practical in medicine TAll practical knowledge is based upon some theory.Rightly understood, the theory of medicine is accurate know-

ledge of the elementary sciences upon which medicine is con-structed. Those whose duty it is to introduce to the com-

munity men possessed of sound practical knowledge musttake care that the theory is good. This they can only secureby extensive examination in the elementary branches of

medicine, which are the only safe basis for rules of practice.If they neglect this, they will run the risk of stamping a mereempiric. We cordially thank the Senate of the University ofLondon for this new step in their progressive extension of thesystem of practical examinations. We are well assured thatit will tend still further to augment the credit and the valueof the degrees they confer, and to establish the scientific

position of Medicine.

IT is with real satisfaction, grounded on a desire to ad-vance the interests of science, the welfare of the Indian

army, the honour and the interests of its able body of medical

I officers, that we perceive in the recent Indian papers, thepractical manifestation of the sentiments of the Governor-

General of India on these important concerns. The Alar-

quis of DALsousiE is the first Indian statesman who

has shown sufficient care for, and interest in, the weightyresults that attach to efficiency in the management of themedical concerns of the vast Indian army; and for this he

will be honoured now and hereafter.

It is well known to our naval and military readers that forthe last fifteen years the evils of the absolute rule of " senioritypromotion," in the administrative departments of the medicalcorps of India, have been urged upon the Indian authorities

by Mr. J. R. MARTIN, of the Bengal Medical Service, withthat power, energy, and perseverance, which have crowned

all his measures of sanitary, administrative, and financialimprovement, with complete success. Ten years ago the

Court of Directors ordered that the administrative medical

staff should no longer be taken on the rule of the muster-roll;and the same authority further authorized the Governor-General to place a regimental surgeon in the medical boardif he saw fit; but up to the present time these most salutary

476 : THE MEDICAL DEPARTMENT OF THE INDIAN ARMY.

orders have remained a dead letter. It is not in 1852 necessary ito insist on the evils of the seniority system of promotion; ’,and all we shall say of it is, that it is destructive of ’,exertion in science and in practice. "The efficiency of ,ievery army," says Mr. MARTIN, "depends on tha integrity ’’,of its staff departments; but not all the staff of an army, ’’,united, is more essential to its welfare than is a well-selected

’’

administrative staff to a medical department." The truth of ithis proposition is now stamped by the decree of one of the I

ablest of WELLESLEY’S successors ; and let us hope that

seniority, as a rule of admission into the administrative staff,may never again paralyse the exertions of eight hundredmedical officers. The public necessity for selecting, as thehead of the department in Bengal, an officer distinguished forhis services in the recent Indian campaigns, and for his admi-nistrative talents, is no less manifest than is its public justice;and now that a pension according to length of service hasalso, mainly through Mr. MARTIN’S exertions, been granted toIndian medical officers, such a rule of selection should inva-riably be adhered to. It is necessary and just that a Governor-General should now say to a certain class of army surgeons-

Sir, you are a very respectable person, and I have no desiretwo say a word to the contrary; but all men are not fit for" the administrative departments of your corps. Every man ashe rises to the top of the muster-roll is not possessed of thehighest professional knowledge, far less of the official tact

*’ and knowledge of human nature requisite to an effective

"administrative officer. Go on and serve, and your pensionwill equal your more fortunate brethren, whom I am con-"strained by a sense of duty to prefer." This is said, anddone too, every day in the medical departments at home;and why not abroad t Are the lives of soldiers and civilians

of less value in India than elsewhere t This, and much more,may now be said with perfect justice; and we repeat that itwill be necessary for the future to act as Lord DALHOUSIE has

done, if a semblance of efficiency, scientific and practical, is toattach to the medical departments of the Indian army.We must now congratulate Mr. MARTIN on this his most

recent and crowning success-a success which, even in its com-mencement, more than ten years ago, and when Mr. MARTIN hadbut commanded public opinion to his side, was characterizedby the most competent of professional authorities as follows:The effective blows you have struck at the seniority system" of promotion is a greater service rendered to science, and to"your brother officers in India, than any amount of pension" which it is in the power of any government to grant." This

was the declaration of Sir JAMES MGpieoR.

The success of Mr. MARTIN’S public measures has, indeed,been signal; and, as we took occasion to state in our recent

memoir of that distinguished officer, it is such as rarelycan fall to the lot of any member of our profession. In his greatsanitary regulations for the three Presidencies of India-in hissuggestions for the Sanitary improvement of Calcutta-in hisproposal to construct a great Fever-hospital in Calcutta for thetreatment of the Natives suffering from the endemic diseasesof Bengal-in his proposal to improve and amen 1 the forms of" Hospital Returns" in use all over India-in his endeavours toobtain Pensions according to length of service for the medicalofficers of the Indian army, such as had ten years previously I

been granted to the military officers-in his advocacy of themilitary honours of the Bath for naval an military surgeons-

in each and all of these vastly important measures Mr. MARTINhas been completely successful. Surely this unexampled suc-cess is at once his greatest reward, and his highest honour as a

public man. The late Governor-General of India, Lord

IIARDINGE, has publicly stated that the benefits" of Mr.MARTix’s proposals and suggestions 11 will be ever felt."

This is quite true of them. Be it remembered, too, thatthe last blow struck by Mr. MARTIN was for militaryhonours to naval and military surgeons"-a measure whichmore than any other has raised the class to which he belongsto its just position. We grieve to say it, but the greatDuke of WELLINGTON was stoutly opposed to this most justconcession; yet the arguments of our Indian surgeon succeededin the teeth of the most powerful influence ever possessed byan individual in this country. We need hardly repeat thatof such an amount of success in public life any man might wellbe proud.Returning to the subject of promotion by seniority,

we perceive by the Indian papers that the superseded indi.viduals are supposed again to come into official life in the verystations to which Lord DALHOUSIE now refuses to promotethem. Surely anything so absurd and pernicious never enteredthe mind of any governing authority. If old women are to

rise again to-morrow, why throw a wet blanket over them to-day ? î It were worse than trifling with the public interests.We can say, very advisedly, that were the medical depart-

ments of India allowed to go on in the old seniority routinebut a very few years longer, Directors-general from the medicaldepartment of her Majesty’s army would be sent to each of theIndian Presidencies to regulate and administer their affairs-so rotten have- they become at their respective heads, espe-cially in Bengal. Our brethren in India, therefore, owe adeep debt of gratitude to Lord DALsousiE, for his just andtimely arrangement.

THE Lord Chancellor, in his exposition of his proposedalterations in Chancery affairs, before the House of Lords, onTuesday night, specially referred to the exemption of

Bethlehem from the inspection of the Lunacy Commissioners,as one of the abuses which required amendment. We havebefore given the history of the manoeuvres by which thismost unconstitutional clause found its way into the LunacyAct, and we have unceasingly designated it as one of the

chief causes by which the abuses which have long flourishedin Bethlehem have been enabled to hold their ground. Weshall hail the abolition of this exemption as an useful

reform; but it is impossible to persuade ourselves but that othermeasures are necessary to secure the proper government ofthat institution and the protection of the public liberty.

IN the columns for news is inserted a paragraph from theStamford l1Iercury, which contains an account of the electionof Mr. ROBERT GARDINER HILL as Mayor of Lincoln. Werefer

to this election with feelings of much satisfaction, because itis a tribute of respect to a most worthy member of our pro-fession. For many years the name of Mr. HILL has been iden-tified with the humane treatment of lunatics. Like other

upholders of this system, he has met with many difficultiesand much opposition. He has persevered, and been success-ful. Many will echo the sentiments which fell from Mr.

HARVEY, the seconder of his nomination.