« AnteriorContinuar »
Vaccine Stations at Hospitals. THE ‘Annual Report of the National Vaccine Board, issued in the month of March of the present year, concludes with a suggestion which we think cannot too soon be adopted; and as it would be difficult to discover any reasonable objection, we trust that by giving it further publicity we may secure its speedy realization. The Board are of opinion that it would be “very advisable that all the metropolitan hospitals should institute the plan of having one of their house-surgeons specially appointed to the duty of vaccination." It is obvious that, by the introduction of this feature, students would have an opportunity of becoming properly acquainted with the course of the vaccine disease, no less than with the proper mode of performing the operation. At present the young practitioner acquires this knowledge in a fortuitous way, and at the commencement of his practice feels less confidence in this matter than in more serious proceedings. And yet it is important that every practitioner should be well informed in regard to the theory and practice of vacci. nation. Moreover, if this subject is properly carried out at hospitals, we shall acquire a further field of study, which will not fail to yield fruit. Thus the question of the influence of vaccination in the production of other diseases, which has a strong hold upon the public mind, has never been properly investigated, and, with others of a similar bearing, would be more readily solved if subjected to a general and careful scrutiny.
We may take this opportunity of reassuring the profession of the real value of vaccination. The Report gives us statistics which amply confirm the protective power of the vaccine lymph, while, per contra, unmodified small-pox is shown still to offer all its former terrors. We quote the following remarks from the document, in evidence :-“Mr. Marson, surgeon to the Small-Pox Hospital, states to the Vaccine Board, that in five years, from 1852 to 1856, 2253 patients have been admitted into the hospital with small-pox after vaccination. Of these, 355 had each four or more vaccine cicatrices. Three of these patients have died, one from small-pox, and two from superadded disease, wholly independent of small-pox; so that it may be fairly said, deducting two cases, that of 353 patients having four or more cicatrices, only one died. This number added to the cases already published, makes 620 cases followed by three deaths, or rather less than half per cent.
“For sixteen years, in the published accounts, the unvaccinated cases die at the rate of 35 per cent.; and the patients badly vaccinated, having only one indifferent cicatrix, or none at all, but believing themselves vaccinated, died at the rate of 15 per cent. This statement shows, 1. The great loss of life from natural small-pox; 2. The great protective power of vaccination.
" The Board therefore feel fully justified in unhesitatingly reiterating, that vaccination properly performed is al but a complete protection.”
Middle-Class Education. Fact is indeed stranger than fiction. What many of us have yearned for, but what none could have expected to see realized, is come to pass : Oxford and Cambridge have spontaneously, and with all the gracefulness of ancient lineage, offered to become the patrons and promoters of the education of the middle classes of this great country. The silent working of the spirit of intellectual development, the germination of the seeds of mental growth, scattered with no sparing hand by the best of their generation through the land, have been observed and acknowledged by those whom we all would wish to regard as the watchers over the mind of the nation, no less than the tutors of the few. Oxford has taken the lead in an undertaking which the promoters themselves may scarcely compass in its promise of rich and never failing fruit, which will develope the intellectual energies of the people of England, and fertilize the fields of mental culture now unproductive from mere want of seed, while it will redound to the honour of the Universities, and secure to them a power which will find no rival in ancient or modera story.
We should be loth to withhold our sympathies from any great movement affecting the highest weal of our compatriots; but the proposal to which we advert has a special bearing upon the medical profession, to whose attention we therefore warmly commend it. The Rev. F. Temple-to whom be all honour as the immediate originator of the scheme in question !-proposes that Oxford and Cambridge should undertake the task of guiding and testing the instruction given in the schools of the middle classes. Their education, he observes, in a letter addressed to the Master of Pembroke College, Oxford, suffers at present from the want of any definite aim to guide the work of the school. masters, and from the want of any trustworthy test to distinguish between good and bad. Mr. Temple dwells upon the unsatisfactory results generally obtained in the private schools of the middle classes, where the masters rarely sufficiently understand their duties, or know the precise object they are to aim at: and where they thoroughly understand their duties, they have no means of convincing the parents of their pupils that they are doing so.
Mr. Temple proposes no complicated scheme in order to place middle-class education on a proper basis. He asks that “the University should conser some such title as Associate in Arts on every person who passed an examination before examiners appointed either by the hebdomadal Council, or by a delegacy, as might be thought best." This examination should pretty nearly follow the precedent set by the present final schools. “It should be held annually in Oxford. But if the gentry or local authorities of any place asked for an examination to be held in their neighbourhood, and would undertake to bear the expense of the necessary arrangements, an examiner should be sent down to them.”
That the country will be glad to avail itself of a test such as the one proposed, can scarcely be doubted. There may be sluggards and dullards who would rather lag behind, or avoid entering into a new and an unknown course; but the vis à tergo will be too powerful for them, and the current once having set in, will sweep along with it all recusants.
The desire of the public for an independent standard has been manifested on various occasions. One of the best known schemes of examination of an analogous character is that commenced already by the Society of Arts; and the best evidence of the value in which it is held, is afforded by the number of persons who subject themselves to the ordeal, and the interest taken by their friends in the success or failure of the denizens of distant towns and counties, as recorded in the daily papers. But important and demonstrative as these individual instances of spontaneous action may be, they will fail of the universal influence that must be acquired, uniess a general organization is secured. It is this that is held out by the proposed scheme of Mr. Temple.
The importance of the certificate to be obtained will be a sufficient security that the examinees will not be wanting. The security that the examiners will do their duty, will lie in their independent position,-independent as far as peity and local or nepotic influences are concerned, dependent only upon the controlling influence of enlightened public opinion.
The medical profession cannot, we are assured, but hail the prospects of a high standard of testing preliminary education-the education that must precede professional studies, if those studies are to bring fruit commensurate with their importance. Our medical corporations have striven nobly to secure this preliminary education in all their candidates, but it is manifestly not the
proper sphere of a licensing body to do more than to ascertain the fact that the candidates have gone through a suitable curriculum. It will therefore necessarily be their interest to promote such a scheme as the one proposed, by requiring all their candidates not possessed of a University degree, to pass the examination before the Oxford or Cambridge Board. We would suggest that they at once put themselves in communication with the Board, as soon as constituted, so as to arrange about the character of the examination which they would wish to regard as a minimum qualification.
With these few remarks, and with a special request to our readers to study a pamphlet by Mr. Acland, * on Middle-Class Education,' in which these questions are amply discussed, though without reference to individual classes, we introduce the subject to our readers, fervently hoping that they may, as far as in them lies, give their full aid in realizing a scheme fraught with immeasurable benefit to our children and children's children. .
Since the preceding observations on Middle-Class Education have been in type, we have received the following Report, which we have much pleasure in introducing to our readers :
“Report of the Committee on Middle-Class Examinations.-(Dr. Williams, Vice-Chancellor; Dr. Cotton, Provost of Worcester; Dr. Jeune, Master of Pembroke; Dr. Scott, Master of Balliol; Dr. Cradock, Principal of Brasenose; Professor Macbride, Principal of Magdalen Hall; Professor Daubeny; Professor Pusey; Mr. Michell; Mr. Gordon; Mr. Mansell.) Your Committee, having taken into consideration, in connexion with the subject referred to them, two letters addressed by the Rev. F. Temple to the Master of Pembroke, a pamphlet on Middle-Class Education published by T. D. Acland, Esq., and numerous memorials to the Hebdomadai Council (which are appended to this Report),—and having had the advantage of a conference with the Rev, F. Temple and the Rev. H. W. Bellairs, two of her Majesty's Inspectors of Schools who attended by permission of their superiors, and with Mr. Acland, -report as follows:
“1. It appears a duty that the University should answer to the call made upon it, and endeavour to extend its beneficial influence to the education of classes now for the most part beyond its reach.
“2. For the instruction of the children of the poor, Parliament makes large provision. The Universities exercise a great influence, directly or indirectly, on the training of a considerable portion of the young in the upper classes.
"3. As to those, however, whose parents occupy an intermediate position, nothing is done, perhaps nothing could be done beneficially, by the State; and there is little connexion between them and the Universities.
"4. But it is desirable that the efforts of good teachers in the schools freqaented by this class of pupils should be guided, encouraged, and pointed out to public approbation; and, on the other hand, that parents should be put on their guard against incapacity and false pretences. .
“5. It is desirable that the industry and talent of the boys should be stimulated by the prospect of attaining distinction of a higher character than can be gained in a small school; that promising youths should be pointed out to etaployers; and that all the talent of the country should be directed into the course in which it can be most effectively employed.
"6. A well-digested and well-administered system of voluntary periodical examinations and distinctions is calculated to effect these objects.
“7. Administered by the Universities, whose motives are above suspicion,
• Middle-Class Education. Scheme of the West of England Examination and Prizes for Jane, 1857. With Introductory Remarks addressed to Members of the Universities. By T. D. Acland, Esq. London: Ridgway. 1857. Price 1s.
1857. With Introductory Re
and whose command of men of ability is very great, such a system would, it may be hoped, obtain the confidence of the country, and would produce all the fruits which may be fairly expected from it.
“8. It appears to your Committee, that there should be two Examinations annually, one for boys under the age of fifteen, the other for boys under the age of eighteen; the former to secure soundness in the elementary training, without which more advanced education cannot be satisfactorily carried on; the latter to prove that the candidates are well fitted for the situations in life into which young men usually enter about that age, or for continuing their studies with advantage.
"9. The examination would probably be holden in the Long Vacation.
“10. Oxford itself would offer many advantages for the purpose; but it might be desirable that the examination should be conducted simultaneously in other considerable places, by an examiner or examiners deputed for the purpose. The papers should be everywhere the same.
“11. There should be an examination in the rudiments of religion, suited to the character of the University and to the age of the candidates : but not in cases where objections are signified by parents or guardians.
“12. The distinctions given at the first examination (beyond the certificate of the examiners) need not be numerous or great. At the second there should be a distribution of the candidates into classes according to merit; and some certificate, attested by the Vice-Chancellor, given to all who pass; showing their position in the award of the examiners, and conferring some title marking the connexion of the possessor with the University of Oxford.
“13. It is difficult to find a title of this kind wholly free from objection. Perhaps that of Associate in Arts (A.A.) of the University of Oxford, sug. gested by Mr. Temple, would be as good as any.
“14. It is impossible to foresee the number of candidates who may be expected annually to come forward : and therefore it appears inexpedient to propose any definite arrangements. Nor does it seem advisable to fix by legislation the system of examination in any detail, or the precise classification of the successful candidates.
“15. Your Committee is of opinion, that the best course for the University to pursue, is to appoint a delegacy of persons entitled to its confidence, with power to nominate such a number of examiners as may be from time to time required, to prescribe the subjects of examination, to frame a system of honours, to fix upon the times and places of examination, and to determine the salaries of the examiners and other officers who may be required. The experience of the delegates would probably enable the University at no distant period to frame a more definite statute.
“16. The delegacy should consist of the Vice-Chancellor, the Proctors, and eighteen other members; six chosen by the Hebdomadal Council from its own body; six by Congregation; and six added by the Vice-Chancellor and Proctors. The first delegacy to last for three years.
“17. The delegacy should be bound to make an annual report to the University.
"18. The system ought, in the opinion of your Committee, to be selfsupporting; but should not be permitted to yield any profit. There is reason to believe that a fee of 58. from every candidate for the first examination, and of 11. from every candidate for the second examination, would be sufficient. The delegates ought, however, to be entrusted with the power of varying these sums.
“19. The Committee has reason to believe that the proposed scheme of examination has been favourably received by distinguished persons in the University of Cambridge. Should both Universities arrive at the conclusion that it is their duty to adopt it, the country will be well served by their har
are geographicant, actior
monious, but independent, action. Your Committee would not in such a case propose any geographical division of labour, or any system of combined exami. nation. The choice should be left to the convenience or inclination of the candidates or their parents.
"20. Your Committee recommend that a statute, in accordance with these suggestions, should be presented to Congregation and Convocation.” *
Appended to this Report are numerous memorials from all parts of the kingdom in favour of the scheme, not the least important of which is one signed by a large number of lecturers attached to the London schools of medicine.
BOOKS RECEIVED FOR REVIEW.
Is Ovariotomy justifiable or not? By J. On Pepsin. By M. Boudault. TransMatthews Duncan, M.D. Edinburgh, 1857. lated by M. S. Squire, P.D. London, 1857.
The North-American Medico-Chirurgical On the Diseases of Women, including Review. A Bi-monthly Journal. No. I. those of Pregnancy and Childbed. By Jan. 1857.
Fleetwood Churchill. Fourth Edition. First Report of the Home and School for Dublin, 1857. (Two copies ) Invalid and Iinbecile Children, Gayfield Vocal Gymnastics ; or, a Guide for StamSquare. Edinburgh, 1857.
merers. By G. F. Urling. London, 1857. The Report of the Committee of Visitors pp. 89. and Medical Superintendent of the Devon Practical Hints on the Management of County Lunatic Asylum. Exeter, 1857. the Sick Room. By R. Hall Bakewell,
Surgical Cases communicated to the M.D. London, 1857. Pp. 47. Boston Society for Medical Improvement, Statistics of Insanity. Being a DecenOct. 27th, 1856. By G. H. Gay, M.D. nial Report of the Bethlehem Hospital, Boston, 1856. pp. 24. (Reprint.)
from 1846 to 1855. By W.C. Hood, M.D., The History, Diagnosis, and Treatment &c. London, of the Fevers of the United States. By On the Diseases, Injuries, and MalforElisha Bartlett. M.D. Fourth Edition, re mations of the Rectum and Anus. By F." vised by A. Clark, M.D., &c. Philadelphia, J. Ashton. Second Edition. London, 1857. 1856. pp. 610.
pp. 296. On the Function of the Thyroid Body. On Diseases of the Liver. By George By 0. Martyn, M.D., R.N. Proceedings of Budd, M.D., F.RS. Third Edition. Lonthe Royal Society, Jan. 8, 1857.
don, 1857. pp. 496. Des Anévrysmes et de leur Traitement. A few Words on Homeopathy and HoPar Paul Broca, Chirurgien des Hôpitaux, moeopathic Hospitals. By W. T. Gairdner, &c. Paris, 1856. pp. 931.
M.D. Edinburgh, 1857. pp. 14. The Structures, Functions, and Diseases ctions, and Diseases Medical Examinations and Physicians'
Medical Ex of the Lungs. By Thomas Williams, M.D. Requirements considered. By Thomas Part I. Water and Air Lungs of Inverte Mayo, M.D. London, 1857. pp. 21. brate Animals, and Aquatic Respiration. The Hygienic Treatment of Pulmonary London, 1857. pp. 201.
Consumption. By B. W. Richardson, M.D. The Functions and Disorders of the Re- London, 1857. pp. 115. productive Organs in Youth, in Adult Age, On Stricture of the Urethra. By Henry and Advanced Life. By William Acton, Smith, F.R.C.S. London, 1857. pp. 280. late Surgeon to the Islington Dispensary, Report on the Sanitary Condition of the &c. London, 1857.
City of London. For the Quarter ending The Quarterly Journal of Dental Science. March 28th, 1857. By H. Letheby, M.B. No. 1, April, 1957. London.
The Climate of the Crimea, and its Die Tod und Schwefelhaltigen doppelt Effects on Health. By W. R. E. Smart, kohlensauren Natronquellen zu Kranken M.D. London, 1857. heil bei Tölz in Oberbayern. Von Dr. The Wonders of the Abendberg. By L. Gustav Höfler. Freiburg, 1856. pp. 28. Gaussen. A New Edition. Berne, 1857.
Contributions to the Pathology of Cardiac pp. 35. Disease. By W. 0. Markham, M.D., Notes on Belgian Lunatic Asylums. By F.R.C.P. 1857. pp. 8. (Reprint.) Jobn Webster, M.D., F.R.S.
On June 19th, 1857, the Statute on Middle-Class Education was submitted to Convo. cation, in two classes, each of which was carried.