MANCHESTER

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pratice under au assumed is

matter of special interest for foreign medical men who dmatter of special interest for foreign medical men who dwould like to practise under their foreign qualification. If i:

they do so they must understand that they are regarded as t

unqualified and that when their foreign title is similar to aGerman one they are liable to be punished. Foreignersdesiring to become duly qualified in Germany have to passall the examinations even if they have already studiedmedicine and taken diplomas at home. This subject wasdealt with in THE LANCET of Sept. 5th, 1896, p. 666(Students’ Number). Exemption from the examination is

only allowed by law in cases when the Government desiresto appoint foreign medical men of scientific renown as

iuniversity professors, hospital physicians, &c. ; but this pro- vision has come into force only in a few caes of professors jof foreign nationality-Austrians, Swiss, Dutch, &c.-whoobtained their qualifications by a special order of the Federal Council.Altogether apart from and independent of the State

examination the universities have preserved their old-established right of conferring on medical men the degreeof M.D. (Doctor of Medicine), but this is a mere academictitle and not a legal qualification to practise medicine. Theexamination for M.D. differs greatly in the variousuniversities according to their respective statutes and by-laws. As a rule a four years’ course of study, an oralexamination, and a written thesis are required ; at someuniversities a certain number of printed copies of the thesismust be provided at the expense of the candidate. Afterthe examination has been passed a formal, old-fashioned"disputation" is held between the candidate and the" opponents," whom he may choose among his friends, andafter the disputation the dean, in full academical costume,hands the diploma to the candidate. This examination isin several universities made so easy that it is little morethan a formality. It is a common joke of German studentsto say that at some universities the degree may be takenwhile the train is waiting at the railway station. Gradua-tion expenses also vary very much and the poorer studentsnaturally prefer to take their degrees where there is least topay, for there is no objection to studying at one universityand graduating at another. Although the title of M.D. isnot necessary for practice the great majority of medical mennevertheless take it and it is indispensable for those whodesire to become privat doeenten at a university. Thedegree, being quite independent of the State examina-tion, could hitherto be taken either before or after the"approbation," but as was explained in THE LANCET ofApril 16th this state of things will now come to an end, forthe degree will only be given to those who have previouslypassed the State examination. This reform originated in thefact that in a few instances candidates who had passed theuniversity examination were rejected at the State examina-tion and when they engaged in practice it was very difficultto make out a case for prosecution because they had legallytaken their degree and avoided calling themselves prak-tischer Arzt. The public call every medical man a " doctor"even if he has only passed the State examination.Although it is almost impossible for foreigners to pass the

State examination every facility is afforded them for takingthe degree of M.D. They are put at an advantage in com-parison with Germans as they may begin to study at a

university without the certificate of a German gymnasium.They are only bound to prove that they are qualified for medical study according to the laws of their respectivecountries. They can present themselves for the M.D.examination after a much shorter time of study than isrequired of Germans who intend to pass the State examina-tion and the time spent at foreign universities is countedin a liberal manner. A great number of foreignmedical men, especially Americans, take the GermanM.D. under this condition, a system which is notwithout drawbacks. For instance, Germans of deficientgeneral education have gone to America and after becomingAmerican citizens have returned to Germany for the purposeof taking the M.D. degree as foreigners and have thenentered on practice in America as German medical men. Asthe public abroad know little about German qualificationsthis fact has undoubtedly lowered the credit of the Germanmedical profession. The above described reform, however,will not refer to foreigners, as they will in future be entitledto take the degree without having previously passed theState examination. The whole question of practice and ofqualification is a rather complicated one. It would certainly

be the best plan to confer the title of Doctor eo ipso on everyduly qualified man, as in Austria, but this reform is not yetin sight, as it would interfere with the ancient privileges ofthe universities.

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MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

The Training of Feeble-minded Children.! THE best mode of educating and training feeble-mindedchildren, of enabling them-generally, perhaps, with a littlekindly help-to earn their own living, and of saving themfrom pauperism and crime, is a problem which has long beenforcing itself on the attention of the Manchester SchoolBoard. So far the board has been collecting informationonly, but there is some hope of action being takenbefore long. Miss Dendy, a lady who was previouslyto the last election a member of the school board,.has voluntarily undertaken an enormous amount of labourin order to ascertain the mental condition of suchchildren and the proportion they bear to the wholenumber. On May 19th she gave an address on thesubject of Dull and Defective Children in ElementarySchools and their Treatment, in which she acknow-

ledged the aid she had received from Dr. Ashby andDr. Shuttleworth. Her inquiries showed that some 5001children in Manchester board schools were unequal, as Dr.. Woodcock said, ’’ to the ordinary strain of school life andhad not the capacity to be benefited by the ordinary teach-ing which obtained in the elementary schools." He con-sidered that there were 1000 children who had claims for-special help. They are not imbeciles, or idiots, or lunatics,but are more or less feeble in mind, over whom the guardians.have no jurisdiction unless they are paupers, and even thenthey cannot be sent to asylums unless certified as lunatics.If a working-man has a child mentally below the normalstandard he cannot get instruction for the same while-at home, and the few institutions for such childrenare far beyond his means. At present Manchester has.no provision for such children. As Miss Dendy statedthe school boards in London, Leicester, Birmingham, Brad-ford, Bristol, and Brighton have already provided specialclasses for such children and it is strange to find that Man-chester, which sometimes thinks itself advanced, should lagso far behind. It must not be forgotten that the factsascertained as to board school children will obtain equallyin all probability with those attending voluntary schools, andit will be equally incumbent on those responsible for theirmanagement to provide for the training, of their feeble--minded children.

, The Present Stage of the Sewage Question.

On May llth the adjourned summons at the instances. of the Mersey and Irwell Joint Committee against the Cor-,

poration of Manchester for pollution of the River Irwell anc’the Manchester Ship Canal came on for hearing at the;county police-court before Mr. J. M. Yates, Q.C., the

stipendiary, and other magistrates. The Corporation applied. for an extension of time. The decision was given on the- 14th and the application was dismissed with costs. Mr. Yates,reviewed the history of Manchester, dealing with its sewage,r its unwillingness to purchase the 200 acres of land required by the Local Government Board, and its inability to persuade. the Board to alter their views. He concluded by saying 9 " The bare facts are that the sewage of an ever-increasing. population, now amounting to 600,000, is being turned into-1 an almost stationary body of water unpurified ; that thi&i haa been going on to a greater or lesser degree for at leastifive years; and that the corporation are no nearer a finalt settlement of the question than they were in 1893. If thet court were still to prolong this period it would, we think...Dy be stultifying itself and the order made by it by consente of the parties in 1896. We therefore unanimously andn unhesitatingly refuse the application." On the 17th thes stipendiary granted an application for summonses whichs were made returnable for June 8th. The Rivers Committee"11 on the 16th resolved to recommend the City Council to., appeal at the Salford Hundred Quarter Sessions against thisd decixion, and further recommended the Council to call ine three experts to give evidence as to the condition of affairs’of at the Davyhulme Sewage Works-viz., a civil engineer tospeak as to the fitness of the land for the construction

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thereon of bacterial filters; a chemist to speak as to themature and quality of Manchester sewage ; and a biologistto state his views as to whether the bacteria can live andperform their functions in the city sewage.

Salford and its Sewage.On May 23rd the Salford Corporation were brought before

Judge Parry at the Salford county court for failing to carryout an order of the court made in Jaly last. The corporationthen promised to get rid of the accumulation of sludge whichhad taken place; to borrow 50. 000, the estimated cost of thesewage works ; and to let all the contracts and to completethe same, none of which things had been done. On July 22ndlast his honour gave the corporation eight months in whichto let their contracts and that time expired on March 22nd,since which date the corporation had been liable to a fine of£50 per day. The judge made some severe remarks and gavethe corporation to understand that though he would thenonly impose a penalty of two days’ fine of £50 each day, if’any further laxity were shown he would impose the maximumpenalty of £50 each day.

Manchester Volunteer Medical Staff Corps.A fund is being started on behalf of the Manchester

Volunteer Medical Staff Corps to provide a suitable head-quarters and drill-hall, which they have now a chance ofbuilding in Chester-road. So far they have been dependent.on the generosity of chief officers of various regiments, who<have where possible kindly provided them with accommoda-tion. It will, however, be a great advantage to have head-quarters of their own. It is to be hoped that the servicesof the corps will never be required in actual war, tut whilethe civilised quite as much as the uncivilised nationsof the world are in an ominous condition of unrest it is acensible thing to be prepared for contingencies, and even intimes of peace, reviews and manoeuvres generally afford- opportunities of showing the importance of promptlyobtaining medical aid. The sum required is about R5000,a large amount, but the district is wealthy, so a generousresponse to Surgeon-Captain Coates’ appeal may be expected.So far about 116 have been promised, and among the(subscribers are the Lord Mayor of Manchester and Sir W. H.Mouldswortb, M.P., while seven members of the VolunteerMedical Staff Corps are giving the sum of &pound;77 12s.May 24th.

SCOTLAND

(FROM OUR OWN CORRESPONDENT.)

Medical Appointnbents.MR. JOHN KNIGHT, M.B., C.M. Glasg., has been appointed

Assistant to the Professor of Forensic Medicine in the

University of Glasgow. The position of Additional Examinerin Physics for degrees in Medicine and Science in the

University is vacant. The directors of the Glasgow CentralDispensary have elected Mr. J. Lindley Carstairs, M.A.,M.B., C.M. Glasg , Physician for Diseases of Women, viceDr. Archibald Sloan, resigned; they have also agreed toappoint an extra dispensary physician as well as surgeon.

The Medico- Chirurgical Society of Glasgow.The following gentlemen were elected at the annual

general meeting of the society to be the office-bearers for thesession 1898-99: -President: Dr. Geo. S. Middleton. Sectionof Medicine: vice-president, Dr. W. G. Dun ; councillors, Dr.John Love and Dr. Barclay Ness; secretary, Dr. Hinshel-wood. Section of Surgery : vice-president, Dr. J. Barlow;councillors. Dr. Robert Kennedy and Dr. Henry Rutherford;secretary, Dr. J. H. Nicoll. Section of Pathology : vice-president, Dr. Walker Downie; councillors, Dr. W. R. Jackand Dr. Workman ; secretary, Dr. R. M. Buchanan.Section of Obstetrics: vice-president, Dr. George Halket;councillors, Dr. Munro Kerr and Dr. J. K. Kelly; secre.

tary, Dr. Balfour Marshall ; treasurer, Mr. Henry E Clark ;general secretary, Dr. Walker K. Hunter.

Glasgow Eastern Medical Society.The following gentlemen were elected office bearers at the

annual general meeting of the society for the session 1898-99 :&mdash;President: Dr. Malcolm Black. Vice-president : Mr.W. L. Muir. Secretary: Dr. John McDonald, Dennistoun.Treasurer: Dr. William Buchanan. Reporting Secretary: Dr.John Patrick. Seal-keeper : Dr. James Danlop. Council:Mr. J. R. Buchanan, Dr. Robert Wilson, Dr. David Young,Dr. A. Munro, Dr. John Knight, and Dr. Daniel McNicol.May 24th.

IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

The Public Health Congress in Dubltn.THE Executive Committee met on May 16th at the

Offices of Pablic Health, Dublin, Dr. Grimshaw, C.B., theRegistrar-General, being in the chair. Numerous subscriptionswere announced, including &pound;50 from the Royal Academy ofMedicine and &pound;20 from Messrs. Guinness, Son, and Co. Itwas stated that Sir H. Cochrane and Sir Christopher Nixonproposed to give garden parties in connexion with theCongress.

Viceregal Entertainment to the Hospital Nurses of Dublin.Their Excellencies the Lord-Lieutenant and Countess

Cadogan gave an entertainment at the Viceregal Lodge onthe afternoon of May 19th to the staff nurses of the Dublinhospitals. The lady superintendents and the resident medicalofficers of the various hospitals were also invited, and hadthe honour of being specially presented to her Excellency bySir William Thomson, the President of the Royal Collegeof Surgeons in Ireland, who was one of the guests. The

, weather was favourable and the garden party and hospitableentertainment by their Excellencies were most thoroughlyenjoyed.

The Royal College of Surgeons in Ireland.The half-yearly examination for the Fellowship came to a

conclusion by a conference on May 21st. The number ofcandidates was unusually large and included a lady graduatein medicine of the University of Calcutta Miss Cohen

. passed and was entered on the roll as a Fellow of theL College, she being the third lady who has received such

honour., The Belfast Royal Hospital.

From the report presented at the quarterly meeting onMay 23rd I find that from Feb. 1st until April 30th of this

. year there were 567 intern and 5907 extern patients,Special reference was made to the loss which the charity has

. sustained by the death of the Countess of Shaftesbury. To: the end of April there was an increase of &pound;113 15s. in general

subscriptions and &pound;103 Os 8d. in contributions from theworking classes. There is also a slight increase in churchcollections. The entire receipts for the eight months endingApril 30th amounted to &5125 13s. lld. and the expenditureto R6321 ICs. lld which is a deficiency of &pound;1195 17s., and ifthe deficit of &pound;349 ls. lld. carried forward from the previousyear’s accounts are added to this it will be seen thaton April 30th the hospital was in debt to the extent of&pound;1544 18s. Ild. The general condition as well as theworking of the hospital continue satisfactory. Saturday,May 28th, is fixed for the street collections, when it is

hoped that there will be a liberal response.l The Summer Medical Session., The number of students attending the Belfast Royal

Hospital this summer session shows an increase of twelveover that of last year. The feeling is growing among theteachers that more work should be done in the summer soas to prevent the present tendency to overload the studentswith classes during the winter.

Nursing Arrangements in Larne Workhouse.At a specially summoned meeting of guardians held on

.

May 15th a correspondence was read from the Local Govern-: ment Board to the effect that they were satisfied that the arrangements made for the nursing of the sick poor in the, workhouse were inadequate and unsatisfactory, and they’

trusted that the guardians of Larne Union would not bringr discredit upon their administration by allowing the standard. of comfort and treatment in their workhouse to be behind; that of other workhouses. A resolution was passed, declin-: ing at the present juncture, when Irish local government, is under consideration in the British House of Commons, to

make any radical changes respecting night nursing arrange-ments in Larne Workhouse, and more especially as the

9 medical officer had expressed his approval of existing- arrangements, and as no guardian or ratepayer has taken. exception thereto..

Belfast Branch of the Royal Medical Benevolent Fund.; At the annual meeting held in Belfast on May 19th,,

when the President, Dr. Whitaker, took the chair, it was,

reported that of the 175 members of the medical professionin Belfast only 57 were subscribers, to the extent of