conference on medical organisation at manchester

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1389 CONFERENCE ON MEDICAL ORGANISA- TION AT MANCHESTER. (Contiuued from p. 1308.) PUBLIC VACCINATORS. AT the Conference in the afternoon session on May 2nd Dr. Ratcliff.Gaylard’s motion (printed in THE LAXCET, May 5th, p. 1306)- That it is desirable that those who have the carry ing out of the pro- visions of the Vaccination Act should perform their duties in such a way as not to trench upon the interests of general practitioners, and that instructions to this effect be issued to public vaccinators- led to some debate. Dr. Ratcliff-Gaylard said that public vaccinators gave their patients to understand that they used a superior kind of lymph. That had occurred in his practice more than once. Mr. WOLSTENHOLME, in seconding the motion, said that he knew of two public vaccinators who had used blandishments and almost compulsion to get the opportunity of vaccinating children at public expense. They said that their lymph was Government lymph, that the vaccination would cost the patient nothing, and on one occasion that general practitioners had ceased to vaccinate. Dr. MAJOR GREENWOOD said that a serious charge had been made against a respectable body of men few of whom could be so mean and dishonest. He saw no necessity for thus fouling their own nest. Dr. S. WOODCOCK said that it was almost impossible under the terms of the Act for anything to be done as Dr. Ratcliff- Gaylard suggested. Why did not medical men look after the children and vaccinate them before they were four months old ? 7 The public vaccinator was compelled to call and vaccinate such children as the parents were agreeable to submit to him. 50 per cent. of the children in Manchester were not vaccinated properly. In a large union that he was acquainted with he had never heard of a complaint of any undue pressure being put on anybody by a public vaccinator. For them in that Conference to pass such a resolution as was proposed would be to assume that it was a common practice for public vaccinators to abuse their position under the Act under which they were obliged to discharge their disagreeable duties. He considered that it would not only be unjust, but it would be ungenerous, for the Conference to pass such a motion. Dr. F. REES said that the resolution was inadequate because it did not sufficiently call attention to the grievances of the general practitioner with regard to the Vaccination Act. Dr. BRASSEY BRIERLEY said that it was a reckless charge and that no evidence had been brought forward. The accusa- tion ought to have been supported by the most direct and complete proof. The motion on being put to the vote was lost by 19 votes to 17. THE MIDWIVES BILL. On the third day of the Conference, Thursday, May 3rd, Mr. G. A. WRIGHT (Manchester) took the chair. Dr. GLOVER read a paper on . Some Debated Points in Medical Politics" which will be found reported verbatim in THE LANCET of May 5th, 1900, p. 1306, at which point our report of the proceedings stopped. Mr. G. H. BROADBENT (the Incorporated Medical Practi- tioners’ Association) said that the title of Dr. Glover’s paper was a misnomer. It was useless to talk of a Bill for the control of midwives and for remedying the difficulties which existed, because the Bill was simply for the furtherance and promotion of midwives, and as to their control and super- vision it was worth nothing at all and was altogether mythical. The object of the present legislation was to make the midwife an independent medical practitioner. He con- sidered that Dr. Glover ought to have given notice that his address was to be for the promotion of the Midwives Bill. Mr. R. H. WOLSTENHOLME (Salford) said that though the midwives existed as a fact they were not recognised as a legal class. The profession would not oppose the creation of midwifery nurses, but the Bill formed a new inferior class of medical practitioners from ignorant women who were one day to be at the washtub and the next were to be acting as legalised medical practitioners. Dr. MAJOR GREENWOOD (the Poor-law Medical Officers’ Association) said that the great objection to the Bill was that these women would be made legal practitioners of midwifery. The Local Government Board did not recognise midwives acting independently of medical men. If the Bill were passed the Local Government Board would be compelled to recognise the midwife to be a practitioner in midwifery. If the Bill were passed would the present happy agreement continue by which medical men saw cases with midwives ? 1 It might create a sort of conflict between the medical pro- fession and this new class of practitioner which would result in a deadlock and render the Bill unworkable. Dr. A. G. C. IRVINE (Birmingham and District General Medical Practitioners’ Union) said that many medical men held a view quite different to that expressed by many at that conference. Legislation on the subject of midwives was a certainty and could not be avoided. They were blind and foolish who tried to avert proper legislation, but the medical profession could not approve of the present Bill before Parliament. Dr. F. REES (Wigan and District Medical Guild) cordially agreed with every word that had fallen from Dr. Glover. It had been stated at that conference by some of the gentlemen present that whilst recognising the serious evils which existed they were not willing to have any legislation on the matter of registration of midwives. How was the Government to get rid of the evils which these gentlemen acknowledge to exist except by some sort of legislation ? 7 Some gentlemen said that they would not object to the Bill before Parliament if the midwives were called midwifery nurses, but the Govern- ment were simply defining a state of things that was really in existence. The midwives in practice now were women who were engaged to attend confinements and if anything went wrong a medical man was called in to help. There were members of that conference who would be perfectly willing to see all women removed from attendance on mid- wifery cases (cries of "Certainly") and their places taken by medical men who would strive to make a living, if that were possible, from the low fees paid to midwives. He had a higher opinion of the conduct of the medical profession than to desire such a state of things. Dr. GLOVER said that Mr. Broadbent considered the title of his (Dr. Glover’s) paper to be a misnomer and expressed the opinion that the proposed supervision of the midwives was nothing at all-in fact, merely mythical. That was, to say the least, scarcely complimentary to the Midwives Board. It would be to the ultimate advantage of the profession if gentlemen would treat governing bodies with more respect, and he must deny that Mr. Broadbent’s remark was either correct or proper, because the supervision of the midwives would be very real. If the midwife disobeyed the orders and regulations of the Midwives Board she would be taken off the list and prevented from following her work, which would be a greater punishment than merely fining her 10s. Mr. Broadbent objected to the definition of midwife and he (the speaker) personally could not understand the definition ; he did not know any member of the General Medical Council who was satisfied with it; it was therefore to be the subject of discussion with the Government. Mr. BROADBENT said it was not a Government measure, and was proceeding to refer to a letter which he had received from the Leader of the House of Commons when the chairman directed Dr. Glover to proceed. Dr. GLOVER, continuing, said that in regard to its being a Government measure it must be remembered that the Lord President of the Council was in communication with the Government on the subject. It had practically become a Government measure either actually or potentially. It certainly was not correct to say that it was not a Govern- ment measure. The Government had said to the promoters of the Bill, " You satisfy the General Medical Council and then we will consider the matter." The Government had assumed that on the main points the General Medical Council had been satisfied, and on any points in which the Council should fail to be satisfied the support of the Government would be withdrawn. Mr. Broadbent with a sweeping style which did not commend itself to accuracy, said that all the safeguards in the Bill were mythical, but he (Dr. Glover) must deny that there was any justification for such a remark. The difference of opinion between them and the Government was that they wanted inserted in the Bill literally that when a midwife got into a difficulty she was to send for a medical man, and to that the Government replied, " You have the whole matter in your own hands already, you are to make the regulations." (Cries of .. No, no.") Replying to this interruption Dr. Glover said that they must allow him to know about the matter, for he had spent half

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1389

CONFERENCE ON MEDICAL ORGANISA-TION AT MANCHESTER.

(Contiuued from p. 1308.)

PUBLIC VACCINATORS.

AT the Conference in the afternoon session on May 2ndDr. Ratcliff.Gaylard’s motion (printed in THE LAXCET,

May 5th, p. 1306)-That it is desirable that those who have the carry ing out of the pro-

visions of the Vaccination Act should perform their duties in such away as not to trench upon the interests of general practitioners, andthat instructions to this effect be issued to public vaccinators-

led to some debate. Dr. Ratcliff-Gaylard said that publicvaccinators gave their patients to understand that they useda superior kind of lymph. That had occurred in his practicemore than once.

Mr. WOLSTENHOLME, in seconding the motion, saidthat he knew of two public vaccinators who had usedblandishments and almost compulsion to get the opportunityof vaccinating children at public expense. They said thattheir lymph was Government lymph, that the vaccinationwould cost the patient nothing, and on one occasion thatgeneral practitioners had ceased to vaccinate.

Dr. MAJOR GREENWOOD said that a serious charge hadbeen made against a respectable body of men few of whomcould be so mean and dishonest. He saw no necessity forthus fouling their own nest.

Dr. S. WOODCOCK said that it was almost impossible underthe terms of the Act for anything to be done as Dr. Ratcliff-Gaylard suggested. Why did not medical men look afterthe children and vaccinate them before they were fourmonths old ? 7 The public vaccinator was compelled to calland vaccinate such children as the parents were agreeable tosubmit to him. 50 per cent. of the children in Manchesterwere not vaccinated properly. In a large union that he wasacquainted with he had never heard of a complaint of anyundue pressure being put on anybody by a public vaccinator.For them in that Conference to pass such a resolution aswas proposed would be to assume that it was a commonpractice for public vaccinators to abuse their position underthe Act under which they were obliged to discharge theirdisagreeable duties. He considered that it would not onlybe unjust, but it would be ungenerous, for the Conference topass such a motion.

Dr. F. REES said that the resolution was inadequate becauseit did not sufficiently call attention to the grievances of thegeneral practitioner with regard to the Vaccination Act.

Dr. BRASSEY BRIERLEY said that it was a reckless chargeand that no evidence had been brought forward. The accusa-tion ought to have been supported by the most direct andcomplete proof.The motion on being put to the vote was lost by 19 votes

to 17.THE MIDWIVES BILL.

On the third day of the Conference, Thursday, May 3rd,Mr. G. A. WRIGHT (Manchester) took the chair.

Dr. GLOVER read a paper on . Some Debated Points in

Medical Politics" which will be found reported verbatimin THE LANCET of May 5th, 1900, p. 1306, at which pointour report of the proceedings stopped.Mr. G. H. BROADBENT (the Incorporated Medical Practi-

tioners’ Association) said that the title of Dr. Glover’s paperwas a misnomer. It was useless to talk of a Bill for thecontrol of midwives and for remedying the difficulties whichexisted, because the Bill was simply for the furtherance andpromotion of midwives, and as to their control and super-vision it was worth nothing at all and was altogethermythical. The object of the present legislation was to makethe midwife an independent medical practitioner. He con-sidered that Dr. Glover ought to have given notice that hisaddress was to be for the promotion of the Midwives Bill.

Mr. R. H. WOLSTENHOLME (Salford) said that though themidwives existed as a fact they were not recognised as alegal class. The profession would not oppose the creationof midwifery nurses, but the Bill formed a new inferior classof medical practitioners from ignorant women who were oneday to be at the washtub and the next were to be acting aslegalised medical practitioners.

Dr. MAJOR GREENWOOD (the Poor-law Medical Officers’Association) said that the great objection to the Bill was thatthese women would be made legal practitioners of midwifery.

The Local Government Board did not recognise midwivesacting independently of medical men. If the Bill were

passed the Local Government Board would be compelled torecognise the midwife to be a practitioner in midwifery. Ifthe Bill were passed would the present happy agreementcontinue by which medical men saw cases with midwives ? 1It might create a sort of conflict between the medical pro-fession and this new class of practitioner which would resultin a deadlock and render the Bill unworkable.

Dr. A. G. C. IRVINE (Birmingham and District GeneralMedical Practitioners’ Union) said that many medical menheld a view quite different to that expressed by many at thatconference. Legislation on the subject of midwives was acertainty and could not be avoided. They were blind andfoolish who tried to avert proper legislation, but the medicalprofession could not approve of the present Bill beforeParliament.

Dr. F. REES (Wigan and District Medical Guild) cordiallyagreed with every word that had fallen from Dr. Glover. Ithad been stated at that conference by some of the gentlemenpresent that whilst recognising the serious evils which existedthey were not willing to have any legislation on the matterof registration of midwives. How was the Government toget rid of the evils which these gentlemen acknowledge toexist except by some sort of legislation ? 7 Some gentlemensaid that they would not object to the Bill before Parliament ifthe midwives were called midwifery nurses, but the Govern-ment were simply defining a state of things that was reallyin existence. The midwives in practice now were womenwho were engaged to attend confinements and if anythingwent wrong a medical man was called in to help. Therewere members of that conference who would be perfectlywilling to see all women removed from attendance on mid-wifery cases (cries of "Certainly") and their places takenby medical men who would strive to make a living, if thatwere possible, from the low fees paid to midwives. He had ahigher opinion of the conduct of the medical profession thanto desire such a state of things.

Dr. GLOVER said that Mr. Broadbent considered the title

of his (Dr. Glover’s) paper to be a misnomer and expressedthe opinion that the proposed supervision of the midwives

was nothing at all-in fact, merely mythical. That was, to

say the least, scarcely complimentary to the Midwives Board.It would be to the ultimate advantage of the professionif gentlemen would treat governing bodies with more

respect, and he must deny that Mr. Broadbent’s remark waseither correct or proper, because the supervision of themidwives would be very real. If the midwife disobeyedthe orders and regulations of the Midwives Board she wouldbe taken off the list and prevented from following her work,which would be a greater punishment than merely finingher 10s. Mr. Broadbent objected to the definition of midwifeand he (the speaker) personally could not understand thedefinition ; he did not know any member of the GeneralMedical Council who was satisfied with it; it was thereforeto be the subject of discussion with the Government.Mr. BROADBENT said it was not a Government measure,

and was proceeding to refer to a letter which he had receivedfrom the Leader of the House of Commons when thechairman directed Dr. Glover to proceed.

Dr. GLOVER, continuing, said that in regard to its beinga Government measure it must be remembered that theLord President of the Council was in communication withthe Government on the subject. It had practically becomea Government measure either actually or potentially. Itcertainly was not correct to say that it was not a Govern-ment measure. The Government had said to the promoters ofthe Bill, " You satisfy the General Medical Council and thenwe will consider the matter." The Government had assumedthat on the main points the General Medical Council had beensatisfied, and on any points in which the Council shouldfail to be satisfied the support of the Government would bewithdrawn. Mr. Broadbent with a sweeping style which didnot commend itself to accuracy, said that all the safeguardsin the Bill were mythical, but he (Dr. Glover) must deny thatthere was any justification for such a remark. The differenceof opinion between them and the Government was that theywanted inserted in the Bill literally that when a midwifegot into a difficulty she was to send for a medical man,and to that the Government replied, " You have thewhole matter in your own hands already, you are tomake the regulations." (Cries of .. No, no.") Replyingto this interruption Dr. Glover said that they must allowhim to know about the matter, for he had spent half

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an hour in consultation with the Solicitor-General and wasspeaking from actual personal experience. The Govern-ment said, when told what they wanted in the Bill, that themedical profession were empowered by the Bill to make allthe rules in regard to the matter and that it was entirely inthe hands of the General Medical Council ; therefore Mr.Broadbent and his friends might go on denying the fact tillthe end of time, but it would not alter matters. Mr.Wolstenholme had said that the midwives did not exist as alegal class, but was there any gentleman present there whowould take a midwife into a court of law and say that shewas using an illegal title ? 7 Was there any gentleman therewho would deny that a midwife had been able to recoverher fee in a court of law ? 7

Mr. R. B. ANDERSON (the Corporate and Medical ReformAssociation, Limited) said that he was surprised at the

question: a midwife could not recover her fee in a court oflaw.Dr. BRASSEY BRIERLEY (Manchester Medico-Ethical Asso-

ciation) said that in that district a midwife had thusrecovered her fees.

Dr. GLOVER, continuing, said that he challenged Mr.Anderson to prove the correctness of his contradiction. He

(the speaker) had taken legal advice on the matter and hadbeen informed that the services of a midwife had been reco-gnised in a divisional court as quasi-medical or surgical.[Dr. GLOVER was here subjected to considerable interruptionwhich did not subside till Mr. R. B. ANDERSON had repliedin the affirmative to the question, Did he consider that amidwife was liable to prosecution under Section XL. of theMedical Acts ? 7 Dr. GLOVER having been called upon by theaudience to "Go on " and " Never mind Mr. Anderson," con-tinued his reply.] What was the use, he said, of the GeneralMedical Council trying to raise the profession if Parliamentwas to be told that medical men in large numbers wereto be found willing to attend midwifery cases at 5s. 6d.?(A voice : 11 It was not true.") He agreed with thegentleman, though perhaps the point had been made in asomewhat monosyllabic manner, and he put it to the

meeting whether he was not supporting the dignity of theprofession in that matter. It was not until the Bill cameforward that it became a crime to recognise a midwife. Hehimself thought that the best term to use was I midwiferynurses," but it was impracticable to urge that ; it was noteven within the power of Parliament to obliterate the word11 midwife from their language, and that was a commcn-senseview of the matter. His friend and neighbour (Dr. MajorGreenwood) objected to the midwife being raised to the

position of a medical practitioner, but the Bill said

specifically that she was not to be placed in that position.In answer to Dr. GREENWOOD Dr. GLOVER said that heconsidered that the Obstetrical Society in labeling theirdocuments as diplomas did very wrong and he voted forthat to be stopped. Last year he voted that the GeneralMedical Council should withdraw their recognition of thepresent document issued by the Obstetrical Society, but hewould not be a party to accusing men like Sir John Williams,Dr. C. J. Cullingworth, and Dr. F. H. Champneys of beingguilty of infamous conduct in a professional respect. Sucha charge would only bring the General Medical Council intoridicule.

Mr. BROADBENT asked if poorer men were wanted.The CHAIRMAN interposed with the remark that Mr.

Broadbent should not have said such a thing and consideredthat it was an improper remark.

Dr. GLOVER, continuing, said that Dr. Major Greenwoodfeared that if Parliament passed the Bill the friendlyassistance granted to the midwife by medical men would bewithheld, but he, Dr. Glover, did not believe that. Perhapsone or two might consider it their duty to act in thatmanner; he did not think that that would be the generalaction of the medical profession.

MEDICAL ORGANISATION.Dr. E. JEPSON (Durham) read a paper on Medical Organisa-

tion in which he advocated the organisation of the medicalprofession into a number of unions or guilds throughout thecountry from which provincial councils could be chosen onthe same lines as the National Union of Teachers. Thesecouncils would then work through the Council of the BritishMedical Association. He suggested that members shouldattend in force the Ipswich meeting of the British MedicalAssociation and demand a handsome annual grant for threeyears towards the complete organisation of the profession.

Dr. Jepson concluded by pointing out that a small annualregistration free from medical men would produce sufficientto secure that two representatives should be sent to theHouse of Commons to support the interests of the medicalprofession.

Dr. S. CRAWSHAW (Ashton-under-Lyne), honorary secretaryto the conference, moved the following :-That in the opinion of this conference no scheme of medieal organi

sation can be considered satisfactory unless it provides the followingmachinery ;-

1. Local or district associations formed wholly or partly for thediscussion of medico-ethical or medico-political topics, to which allpractitioners in the locality shall have the right to belong, suchassociations to be formed for this purpose where not already existing.

2. An annual conference of delegates from these associations, at whichconference only medico-ethical and medico-political topics shall bediscussed.

3. A central executive committee which shall be nominated andelected by the local associations, every member to retire annually, butto be eligible for re-election.

Dr. T. W. HIME (Bradford and West Riding MedicalUnion) suggested that instead of "all practitioners" thewords should read, "all registered medical practitioners ofgood repute," otherwise the wording was so general that theuntidy, dirty, and drunken women of whom they had beenspeaking would have the right to belong.

Mr. J. S. WHITAKER (the Incorporated Medical Practi-tioners’ Association of Great Yarmouth) said that everyregistered practitioner prepared to conform to the rules of anassociation should have the right to belong, otherwise theydrifted into local jealousies and dislikes.

Dr. S. WALKER (North of England Branch of the BritishMedical Association) said that the object should be to bringthe black sheep into the fold. If these small societies wereformed in every town and district so that the local intelli.gence of the practitioners was best able to be brought intoforce they would have a better organisation of the pro-fession. He considered that the real work would be doneby the little local associations.

Mr. R. B. ANDERSON suggested an addition to the resolu-tions of a paragraph dealing with a well-considered platformof common objects and methods.

Mr. WHITAKER opposed this addition. The mass of thepractitioners must say what they want and let the centralorganisation carry out their dictates.

Dr. A. B. RITCHIE (Lancashire and Cheshire Branch ofthe British Medical Association) said that the organisationshould be grafted on to the British Medical Association.

Dr. MAJOR GREENWOOD said that smallness of size insocieties in regard to ethical questions was not satisfactory,because the ethical conduct of members was not a subjectfor decision by small associations.

After further discussion Dr. CRAWSHAW’S motion wascarried in the following form :-That in the opinion of this conference no scheme of medical organisa-

tion can be considered satisfactory unless it provides the followingmachinery:-

1. Local or district associations formed wholly or partly for the dis-cussion of medico-ethical or medico-political topics, to which allregistered medical practitioners in the locality who agree to conformto the rules of such associations shall have the right to belong, suchassociations to be formed for this purpose where not already existing.

2. An annual conference of delegates from these associations, atwhich conference only medico-ethical and medico-political topics shallbe discussed and voted on.

3. A central executive committee which shall be nominated andelected by the local associations for a period of three years, one-thirdof such committee to retire annually and be ineligible for re-electionfor one year.

Dr. ALFRED Cox (Gateshead) brought forward the follow-ing motion :-That this conference is of opinion (1) that the pressing need in

medical organisation is concentration; (2) that the multiplication ofassociations other than those purely local is to be deprecated; (3) thatthe size, position, and wealth of the British Medical Association makeit the most suitable national medical organisation; and (4) that theefforts of all medico-ethical and similar associations and of the confer-ence should be directed to the conversion of the British MedicalAssociation into an energetic body really representative of the nro-fession.

-

He said that the British Medical Association was a played-outbody as far as medico-ethical matters were concerned. Theyfelt strongly that in the past their energies had been dissi-pated by forming many associations all with practicallysimilar objects, and it seemed to him foolish not to use theaccumulated funds of the British Medical Association.The British Medical Association had lasted 60 odd yearsand it had attained a position of importance whichenabled it to go to Parliament and the Govern-ment with more or less responsibility, chiefly less. Most

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practitioners making a comfortable living did not care

a straw about these things, but every man should join hisbranch of the British Medical Association ; the constitutionof that body should be altered and the funds secured bycollaring " the British Medical Association.Dr. BRASSEY BRIERLEY said that on the council of the

British Medical Association he had received support not fromthe general practitioners there but from the consultants.The branches should pay the men they sent up to the counciland could then demand that they did the work they weredeputed to perform. He deprecated the "highfalutin’"

"

fashion of talking adopted by Dr. Cox.Dr. HIME saidthat he could not ask his society to accept

the view that their whole duty was the conversion of theBritish Medical Association.

Dr. R. E. HOWELL (Middlesbrough and District MedicalSociety) said that the plan would necessitate every memberof the medical profession becoming a member of the BritishMedical Association, which was an excellent idea, but theremight be men who objected to that.

Dr. Cox’s motion was put to the vote and declaredcarried.

___

The final session of the conference was held on the after-noon of May 3rd, when Mr. GEORGE JACKSON (Plymouth)occupied the chair.Mr. T. GARRETT HORDER (Cardiff) read a paper on the

British Medical Association from a General Practitioner’sPoint of View, in which he urged that the association inquestion did not possess that power which it ought to andthat it had failed to support the interests of the profession.Its financial condition was in a most satisfactory position,but it failed to support and defend the rights of the generalpractitioner. Mr. Horder then proceeded to discuss - indetail the constitution of the council of the British MedicalAssociation. In his opinion no reform would ever be broughtabout in the council unless the branches themselves electedmen who were in favour of such reforms. He considered thatthe term of office of councillors should be limited. He advo-cated the redistribution of branches, limitation of office to acertain period of all officials, and an alteration in the modeof voting. Before Mr. Horder resumed his seat after havingread his paper he said that they had felt disappointed, not tosay hurt, that some further definite action had ,not beenproposed by Dr. Glover, the chairman of the Medical AidAssociation Committee for the General Medical Council,after having passed the resolution with regard to medicalaid associations disapproving of those bodies touting for

patients. Ten months had passed since that resolution hadbeen declared to be otherwise than a pious opinion, but theywere at the present time just in the same position as theywere then.

Dr. MAJOR GREENWOOD discussed the question of thesize of the branches of the British Medical Association anddeclared that general practitioners were not so systemati-cally kept down as described, and there was no attemptmade to put hospital men with appointments before practi-tioners, though undoubtedly practitioners had a tendency tobow the knee before consultants.

Dr. Cox said that the voting in the branches should bethrough the post and it was ridiculous to propose importantresolutions at annual meetings attended as they were at thepresent time and they must have proxy voting. Men mustbe sent to vote in a certain way and must give an accountof their stewardship.Mr. WHITAKER said that as to the size of the branches

each part of the country must work out its own salvation.To attempt to reform the whole constitution of the BritishMedical Association was a business that it was useless toundertake.

Dr. RITCHIE said that he could see no insurmountabledifficulty in transforming the British Medical Association.

Dr. GLOVER said that he thought the General MedicalCouncil had passed a resolution which had met with thegeneral support and approval of the profession withregard to touting by medical aid associations, and hebelieved that he spoke the mind of his colleagues whenhe said that the Council was quite prepared to givepractical effect to the resolution they had passed lastyear as soon as they had an actual case before them.Did Mr. Garrett Horder or any other member presentthere really expect that the Council should act withoutan actual and concrete case before them? The law ofthe land was that if a man committed a murder he was to

be hanged, but surely Mr. Horder would agree that. the manmust commit the murder first and then the case must be

proved before the man was hanged. There was no one butwould admit that these two preliminary steps were at leastnecessary, and if Mr. Horder would present a case he wouldpromise him the attention of the Council in accordance withits resolution that was passed last year.

Dr. HIME declared that Dr. Glover had made a perfectlycharming answer and nobody was disappointed in the least.In the British Medical Association there was a system ofelection of the same set from generation to generation andthe government was too much from headquarters.

Dr. BRASSEY BRIERLEY said that the funds of theassociation were their own money and they must use them.It had been decided that the council of the associationwas bound to carry out the resolutions of the annual generalmeeting. The association was a limited liability companyand the council was an illegally constituted body. If theannual meeting chose to elect the council it could do so asthe directors of the company.Mr. GARRETT HORDER said the time had come for the

redistribution of the branches of the association. In regardto the General Medical Council it had given warning that itdisapproved of touting by medical associations, and it wasnot reasonable of Dr. Glover to say, "Send up a concretecase," because he (Mr. Horder) was certainly not going tosend up the names of medical men in Cardiff who wereconnected with medical aid associations and render himselfliable to action for libel.The CHAIRMAN suggested that this might be done by some

association and the discussion closed.

THE CONCILIATION BOARD.

Dr. A. Cox said that he asked the conference to approve ofthe general principle of a conciliation board chiefly on thegrounds that such a board could not do any harm. He hadheard ’no reason adduced why they should not have thisboard. They had not been told of any other method bywhich they would get better terms from the friendlysocieties. In regard to the appointment of the representativesit was suggested that the British Medical Association shouldappoint a committee to confer with the friendly societies,and if the council of the British Medical Association couldnot do it he asked who could ? 1

Mr. BROADBENT suggested the conference they wereattending.

Dr. Cox said that the ’conference could not do it becauseit had not enough influence. Dr. Cox concluded with thefollowing motion :-That this conference approves of the general principle of a concilia-

tion board on the understanding that the findings of such a board arenot necessarily binding on the profession and request the council ofthe British Medical Association to appoint a small committee to conferwith the representatives of the friendly societies for the purpose ofdrawing up a scheme for the formation of such a board.

Mr. WHITAKER seconded the motion and, in reply toMr. Broadbent’s suggestion that that conference should

appoint the committee, said that the conference representednobody but a small number of societies scattered throughoutthe country. He did not consider that they ought to adoptan impracticable non possumus attitude on all - publicquestions.

Dr. W. GRAHAM moved as an amendmentThat this conference deems it undesirable to encourage contract

practice and furthermore declares that if any proposed representativeconciliation board re club practice be constituted it should be electedfrom general practitioners.Mr. BROADBENT seconded this amendment.Dr. RATCLiFF-GAYLARD objected to a conciliation board.

No one had a right to ask medical men to go and try toconciliate the friendly societies. Club practices existed forthe good of friendly societies, not for the benefit of themedical men. Medical men were not averse to having a con-ference, but they were averse to anything like a conciliationboard.

Dr. F. REES pointed out that the General Medical Councilwas independent of the practitioners and ought not to

legislate on this matter. They did not object to a con-

ference between real &OK&6 representatives of the generalpractitioners and the friendly societies.Mr. WOLSTENHOLME said that the friendly societies con-

tended that it would be a semi-legal board to settle finallythe questions between the societies and the medical men, withthe acceptance on the part of medical men that they gave uptheir contention for a wage limit.

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Dr. A. B RITCHIE said that the easiest way to find outwhat the friendly societies proposals were was to ask theBritish Medical Association to get the information for them.Gentlemen at that conference had spoken in ignorance ofthe efforts that had been made to get these details, of thelong correspondence that had taken place to find out whatthis conciliation board really meant. The practical outcomewas that it had been found that the only way to influencethe friendly societies was to go to the men at the head ofaffairs. These societies must be worked from the top and notfrom the bottom.

Dr. HIME said that to talk of their going to consult thefriendly societies in the vague way proposed was to bringthat conference into contempt. He asked what was meantby a conciliation board. Whom were they to conciliate andwhat or about what was the conciliation to be ? 7The CHAIRMAN then put Dr. W. Graham’s amendment to

the meeting and declared it carried.Dr. A. Cox explained to the conference that it was per-

fectly well understood that any conciliation board or what-ever they cared to call it would not have the power to bindthe profession.Mr. WOLSTENHOLME said that he had seen it stated in

the medical papers that the board was to be a quasi-legalconference.Mr. GARRETT HORDER said that the men to meet the

friendly societies were those who had clubs. He consideredthat the members of the General Medical Council who hadmet the members of the friendly societies had given thewhole case of the profession away. The members of thefriendly societies laid it down distinctly and the membersof the General Medical Council agreed that a wage-limitshould never be discussed at the conciliation board.

Dr. RATCLIFF-GAYLARD proposed the following amend-ment :-

That whilst in the opinion of this conference the proposed concilia-tion board is unnecessary it will welcome a conference for the purposeof finding some means of agreement. The members of such confer-ence shall be general medical practitioners in actual practice.

This was put to the meeting by the CHAIRMAN and carriedas was also the following addition proposed by Mr.WHITAKER :-

And that it be referred to the Provisional Committee of this con-ference to consider how this resolution can be carried into effect.

Mr. WOLSTENHOLME made the following propositionswhich were carried :-

That the conference appoint a Provisional Committee to carry outits decisions.

That this Provisional Committee be instructed as follows :-1. To laythe resolution on medical organisation before the Council of the BritishMedical Association and request them to organise a permanent medico-political and medico-ethical department on the lines therein described.2. Failing success, to formulate rules for the formation of an entirelynew organisation on the lines described in that resolution and tosubmit the same next year to a conference similar to the present onefor consideration and adoption.

The following were appointed members of the ProvisionalCommittee with power to add to their number: R. H.Wolstenholme, S. Orawshaw, A. Cox, G. H. Broadbent, T.Garrett Horder, A. B. Ritchie, J. S. Whitaker, T. W. Hime,G. A. Wright, G. Jackson, L. Browne, M. Greenwood, J. A. ’,Macdonald, A. G. C. Irvine, H. E. Dixey, W. A. Carline, E. iJepson, F. Rees, R. R. Rentoul, T. M. Dolan, J. Ratcliff-Gaylard, and W. M. Smith. !

The proceedings of the conference then terminated. ,

THE ROYAL SOCIETY’S CONVERSAZIONE.

IF the exhibition held annually in the rooms of the RoyalSociety at Burlington House may be taken as in a measurean index of a year’s scientific work then the record of thepast year must be of the dullest possible description. At

any rate, it has admitted of no very striking demonstrationjudging from the very meagre and almost colourless characterof the exhibits brought before the visitors on the occasionof the conversazione held on Wednesday last. Most of

the subjects illustrated in experiments or otherwise, had

indeed been demonstrated on previous occasions, whileothers were quite familiar.Mr. SHENSTONE’s demonstration of the "workability" "

of silica in the oxy-hydrogen blowpipe attracted, perhaps,most interest. He showed several forms of apparatus con-structed of vitreous silica, including a long tube for use witha platinum thermometer, a mercury thermometer, bulbsand stems for thermometers, a Geissler tube, a small

distilling tube and rods, and tubes of various sizes forvarious purposes. The fused silica presents exactly theappearance of blown glass, but of course its meltingpoint is infinitely higher. Mr. H. B. HARTMT, withwhom was Mr. H. L. BOWMAN, M.A., gave a veryinteresting demonstration of the properties of crystalsyielding doubly-refracting liquids on fusion. Hencethe term ° liquid crystals." Certain crystalline organiccompounds have been found to give, on melting, liquidspossessing the properties of double refraction and dichroismeven under conditions wherein a state of strain is impossible.When these an-isotropic liquids are further heated theychange at definite temperatures of transition into ordinaryisotropic liquids. The intermediate bodies have beencalled "liquid crystals" because while the evidenceof their elasticity, viscosity, and dielectric capacityshows them to be undoubtedly liquids, yet like crystalsthey possess both double refraction and dichroism.A very successful demonstration was given in which thephysical changes indicated as taking place on a microscopeslide were projected by means of the electric lantern andmicroscope upon a screen. In the next room a clock wasshown under control at some distance by wireless tele-graphy or Hertzian waves. The exhibit is the inventionof Mr. Isaac H. Storey, and it consists of a receiving instru-ment with a coherer attached to the clock. A transmittinginstrument in another part of the room sets up the waveswhich actuate the movement of the hands of the clockwhich are under complete control. Of course there are nowires or tubes intervening and the demonstration wasvery instructive in showing how movement could beexcited without any visible means of communication.The exhibitor, Mr. RICHARD KERR, F.G.S., suggestsa system of synchronising clocks in this way from acentral clock keeping standard time and also the guiding ofboats or torpedoes. Mr. WIMSHURST, F.R.S., showed apowerful influence machine constructed with 12 plates ofvulcanite which is suitable in size, durability, and efficiencyfor either screen or photographic work in the hospital or onthe battle-field.A beautiful collection of examples of leadless glazed ware

was shown by Professor T. E. THORPE. We may point outthat more than a year ago we invited the medical professionto inspect in THE LANCET Laboratory similar examplesof lead less glazed ware which had been carefully testedby our Commissioners with results which, as regardslead, were quite negative. Despite the hostile criticismwhich our inquiry provoked we now find all theleading pottery manufacturers sending specimens ofleadless glaze to the Royal Society Conversazione as

examples of what can be done without the use of lead atall. Amongst the prettiest experiments, though not con-ducted on a very large or striking scale, were those byProfessor MINCHIN in which he showed the flashes inducedin a helion tube by Hertzian waves.Some amusing experiments were shown by Professo1

SILVANUS P. THOMPSON, in which he reversed the De I&Rue’s experiment, employing a floating magnet instead of afloating battery. A complete outfit of instruments for theuse of travellers desirous of making anthropometric obser-vations on native races or on the inhabitants of any speciallocality whether at home or abroad formed the interestingexhibit of Dr. J. G. GARSON. By taking impressionsof the lines on the thumb the identity of a personcould be established and thus an interesting system couldbe set up by means of which the identification of criminalcould be established. Dr. PATRICK MANSON showed anexcellent series of microscopical mounts of longitudinalsections of filariated mosquitoes, showing that filariaM’’<M7’M, like the malaria parasite, leaves its mosquitohost vid the proboscis. The insects were killed about threeweeks after feeding on a girl in whose blood embryo filariaeabounded. In insects similarly fed and subsequently killedat serial intervals and " aectioned" the passage of the filariafrom the stomach to the thoracic muscles and their develop-

! m’nt there could readily be followed. The sections under the