33

the questions-four in each paper and no choice-proves thelast straw to many a deserving and hard-working student,and practitioner. Snrely such an education in "cram" isthe worst that could be devised for our future surgeons,and would cause the surgeons of the past generation to4 turn in their graves " if they could only know what hadbecome of their excellently practical scheme. The examina-

tion is at the present time only a field for intellectual

gladiators in competitive examinations to exhibit their

.abilities, and is absolutely devoid of consideration as a

training ground for practical surgeons. It is now quite ananachronism, and the examination has still more glaringdefects than those which we pointed out some twenty yearsago. Collegiate privileges should be divorced from a pure.examination test, and the surgical appointments at our

hospitals should not be restricted within such narrow limitsas those which seemed expedient to our predecessors in the<earlier days of the century.

Annotations.

THE DIAMOND JUBILEE COMMEMORATION.

11 Ne quid nimis."

THE rejoicings and spectacular displays commemorativeof Her Majesty’s reign of sixty years have ended, and thenation may look back upon the occasion with sincere satis-

faction. Such a spontaneous demonstration of affectionateloyalty and of unity has probably never taken place beforein the world’s history. Responsibility and power must gohand-in-hand, and it would ill-become the people of this

country to recognise the power and forget the responsibilityof the British Empire. What have been the most strikingxeflections to which this Jubilee has given rise? 1 In thefirst place, we owe it to the peoples and Governments ofthe rest of the world to state that the most gratifying andbrightest fact in the history of this commemoration hasbeen the sympathetic magnanimity which they have dis-

played towards the Queen and this country. On all sidesthe expressions have been most generous and cordial on thepart of other powers and peoples, and the fact has left behindit a peculiar sense of grateful appreciation; and, in truth,there was nothing aggressive or of menace in all the

.display that has been exhibited. This is a free country, andits inhabitants are a law-abiding people with a keen love forfreedom and good government everywhere. It is not a mere

phrase, it is a fact, that the British Empire is peace. The

admirable organisation and excellent arrangements by whicheverything has passed off so well, and the splendid conductof the people-their enthusiasm, cheerfulness, good temper,and forbearance-must have struck everyone. The Qlleenis a wise sovereign and a good woman, and her peoplewere determined, so far as their conduct was concerned,that nothing should frustrate or mar the effect of the

expression of their loyalty and trust, and Her Majestymanifestly must have felt in full force the pride andpathos of her position as the vast crowd spontaneously burstforth in singing the National Anthem and compelled thebands to adopt and follow their lead. The people feltthat the Queen had never for dynastic or selfish

purposes, deceived or distrusted them, and the throne ofEngland, supported on the shoulders of a democracy, isnot only the most stable throne in the world, but the

occupants of all the others really owe it a debt of gratitudein this respect for the strengthening influence of the fact.-Then, again, there was a unity of sentiment, spirit, and

purpose running through all classes, from the costermongerto the peer, as they recognised the emblems and tokens ofthe vast Empire in the streets of London-the roots

extending from Great to Greater Britain-of which the

Qaeen was the representative and symbolised embodiment.That the President and people of the United States shouldhave been foremost in their expressions of kindly sympathywas to be expected and could be counted upon, but thatFrance, our nearest neighbour, should indulge in no word ofenvy, jealousy, or cynical coolness towards this country, but,in the spirit of that old chivalric generosity which has alwayscbaracterised her, should have "let herself go" in kindlyexpressions of friendly admiration was most gratifying. The

easy, pleasant manner in which the crowd obeyed the police,protected women, and showed their kindly disposition tochildren ; the way in which they abstained from smoking inorder to diminish danger and annoyance ; the fact thatthe number of cases at the London police courts followingthe Jubilee procession did not exceed those of an

ordinary Monday morning; and the absence of crime,and of all panic and serious accidents, may well makeus proud of the conduct of those present in the streets ofLondon on that occasion. The police, the navy, the military,the London County Council, and the people have, one

and all, played and performed their allotted parts most

creditably ; nor do we believe that the effect of all thathas taken place during the acute stage of jubilation feverthrough which we have just been passing will be loston those from abroad who have honoured us with their

presence in this country. --

THE ATTITUDE OF THE MEDICAL PROFESSION

TOWARDS THE PROVIDENT PRINCIPLE.

A THOUGHTFUL and fair paper on Provident Dispensariesand the Medical Profession, by Mr. Charles H. Warren,secretary of the Metropolitan Provident Medical Association,is published in the Oharity Organisation Review of February,1897 (Longmans, Green, and Co.), and should be read

by all medical men. It deals with the subject of providentdispensaries and the principles on which they should bemanaged and governed, as well as with the causes whichhave hindered their success, which may be said to be prin-cipally two-first, the competition of free hospitals, and,secondly, lack of support from the medical profession. The

first cause of the slow progress of provident dispensaries, thecompetition of hospitals, is obvious. Such dispensaries arefound not to thrive in the neighbourhood of free

hospitals, though, by way of proving the rule, there

is one exception just opposite the London Hospital. Mr.

Warren gives a striking fact in illustration of the unfitnessof a large proportion of hospital patients. It is the result ofan experiment for which the Hospital Saturday Fund and theMetropolitan Provident Medical Association must have thecredit. The Hospital Saturday Fund found the applicationsfor letters for chest hospital treatment so numerous thatadditional letters had to be purchased. They agreed withthe hundred medical officers of the Provident MedicalAssociation to examine cases applying for such letters andto certify fitness for such relief. Each applicant wasrequired to produce a certificate before getting a chest letter.The result was that only 226 returned with the necessarycertificate. No less.than 238 did not see fit to submit them-selves to examination. Of the total numberapplying for chestletters only 152, or 32 per cent., were considered proper casesfor hospital treatment; the remaining 68 per cent. were keptaway from hospitals because of their unsuitability, and forthose treated at the dispensaries the medical men havereceived such remuneration as the rules of the dispensariesprovide. Mr. Warren is quite right in believing that there hasbeen a coldness of late years on the part of medical men