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de Paris et de Londres." " Does this mean city of Paris andLondon, or city of Paris and city of London ? The authoritiesof St. Bartholomew’s Hospital are naturally disposed to put thelatter interpretation on it; and as the Hospital of St. Bartho-lomew is the only hospital within the city of London, the wholeof the London share of the legacy would fall to that hospital.This would, at least, simplify the matter. For, otherwise, afterall these knotty points are decided, it remains to settle the ques-tion of proportions; and we are altogether unable to see how thiscan be done satisfactorily, or what principle can be invoked. Ifthe extent and size of the large and rich hospitals govern theamount, then an obvious injustice will be done to smaller insti-tutions which are wholly unendowed. We think, however,that it is not very difficult to see to whom will fall the oyster,and to whom the shell.

KING’S COLLEGE HOSPITAL.(FROM A CORRESPONDENT.)

THE present state of, and proposed alterations in, the staffof King’s College Hospital, have been forcibly brought underthe notice of the profession by your correspondents during thelast fortnight. Being of modern foundation, King’s CollegeHospital differs from kindred institutions in not being in anyway under the control of the subscribers or governors; for, byits Act of Incorporation, all power of government is vestedin the Council of King’s College-a body consisting of sometwenty members. There is, of course, a Committee of Manage-ment at the hospital; but this has to do merely with theeconomics of the institution.

It has been certainly not for want of advertizing if the pro-fession does not know that the staff of the hospital, for the lastthree years, has consisted of three physicians and three sur-geons (with care of in-patients); one physician and two assis-tant-physicians, together with one surgeon and two assistant-surgeons (with care of out-patients); besides a physician-accoucheur, with care of both. These out-patient appoint-ments attracted some little attention at the time they weremade from the fact that equal rank was not accorded to all theofficers; but it was generally understood that the senior rankwas a species of brevet, and would not entail further promotion.Another novelty was, that the assistant officers were to be onduty for only six months at a time; but this, again, was ex-plained by the fact, that one at least of these gentlemen alsoheld an office in the College which fully occupied his time inthe winter months.Things appear to have worked smoothly enough up to

Christmas last, when the assistant-physicians and surgeonswere astounded at receiving a formal notice from the Councilof the College that it proposed to re-elect them for a period ofthree years from May next, at the expiration of which periodthey would be ineligible for re-election. To this the assistant-

physicians and surgeons reply in their memorial, that since atthe time of their appointment they were told that they weresubject to re-election for other three years, and not a syllablewas said as to non-eligibility for further appointment, they hadalways considered that re-election would take place every threeyears as a matter of course, provided they gave satisfaction inthe performance of their duties. I can bear witness as tothis having been the general impression throughout the profes-sion, which was confirmed by the fact that two members of thein-patient staff (Dr. Todd and Mr. Bowman) were appointed onsimilar terms-re-election every five years. It seems probablethat this new resolve of the Council would have remainedlonger in abeyance but for the sudden resignation of Dr. Todd,owing to his increasing duties in private practice. Within afew days of that event, and at a period of the year when mostof the members were out of town, a meeting of the Council wascalled, Dr. Beale’s brevet was converted into substantive rank,-without any public notice of a vacancy amongst the in-patientphysicians, or any invitation to candidates to come forward,-and the junior officers served with notice to quit.

I would ask whether it is fair to the public, or just to theprofession, that important appointments at a public charitableinstitution should be made in this manner ? It is with no wishto engage in personalities that I ask, has the officer who ha,been promoted so gained the confidence of his colleagues and

pupils; or, on the other hand, have the officers who are to becashiered so disgraced themselves, as to merit the severalawards of the Council ? It is understood that the plea of theCouncil for the arrangement regarding the juniors is, that itwill give them a large number of men from whom to choosewhen any vacancy shall occur amongst the seniors; and, more-over, that the appointments will serve as prizes to the mostdiligent students, who will be able hereafter to tack on totheir names " late assistant physician (or surgeon) to King’sCollege Hospital." Now, King’s College has long been noto-rious for its devotion to the prize system. Scholarships, medals,and prize-books abound, and no doubt form an attraction forstudents entering the profession, though what effect they mayhave upon their after-welfare is quite another question. Per-chance these appointments may attract a few extra students,but what will the public, and the subscribers to the hospitalespecially, say to the poor being entrusted, without any super-vision, to the care of inexperienced young men ? As it is, theimmense number of out-patients at the hospital obliges themedical officers to entrust a large proportion of them to thecare of students, but there is always an experienced medicalman to fall back upon in cases of urgency or danger. Soon,however, even this safeguard will be swept away.But let us take a broader view of the whole question, and

look at the effect such arrangements will have upon the pro-fession. Such a proceeding at one hospital will be reflectedupon the others. If it becomes known that the assistant phy-sicians and surgeons at one are merely students, the public willnaturally conclude that the officers at other hospitals are ofthe same standing, and thus irreparable damage will be doneto able and learned men. Again, it is in the out-patient roomsthat the student must learn to treat the diseases of every-daylife, common enough it is true, but which form the staple ofprivate practice. From whom will he gain instruction, or bywhom will his attention be called to points of diagnosis, if themedical officers be men of little experience, and but slightlysenior to himself?

It has hitherto been always supposed that hospital physiciansand surgeons were men who have been content to devote yearsto the study and examination of cases of disease, and hence thevalue of their opinion in cases of difficulty. If we inquire atwhat period they had these opportunities for study, we findinvariably that it was while filling the junior offices of an hos-pital during several, perhaps many, years. Should the plan ofchanging office every two years be carried out, we must saygood-bye to all extended experience in years to come.

There is another point which must not be lost sight of asrespects these appointments. It is to the juniors generallyand naturally that we look, both from their time of life andtheir greater leisure, for original work and research, more par-ticularly in pathology and morbid anatomy. Let the autho-rities of King’s College look at the work done in the post-mortem rooms and museums at Guy’s, St. Thomas’s, the London,or St. George’s, by the junior officers, and compare it with theirown uncatalogued museum and imperfect post-mortem arrange-ments. Would it not be better to encourage able and intel-

ligent men to devote some of their time to improving thesematters, than to cast them adrift in the way proposed ? The

plan can only bring down dishonour and damage upon the ,

institution in which it is carried out; and it is doubtful whetherany honourable man can come forward to fill the vacancies thuscaused.

QUALIFICATIONS OF POOR-LAW MEDICALOFFICERS.

Poor-law Board, Whitehall, Jan. 3rd, 1880.

SiR,--I am directed by the Poor-law Board to transmit tothe guardians a copy of a General Order which they haveissued, relative to the qualification of medical officers to behereafter appointed by the guardians.The full qualification which has hitherto been required by

this Board for such officers has consisted of a competent know-ledge of medicine and surgery, and the legal capacity to exer-cise both those branches of medical science in England.The then existing law did not enable any person to practise

medicine in England who did not possess a diploma or licenceconferred upon him by some public constituted authority ofthat country, and consequently the qualification for medicalofficers was specially limited in the General Consolidated Order,in regard to Medicine, in the manner prescribed in that order.But the alteration in the law effected bv the Mfdica.1 Act of