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in 1878, I proposed to take advantage of the invitation issued in its Report to all practitioners who were specially interested in the cases for which the hospital is reserved. Sometimes this jealousy takes a sufficiently comic form. For instance, I received for two successive years a lithographed circular inviting me by name to send to the Lancet the reports of interesting cases that might occur in my dispensary practice; but when I wrote in response to this supposed offer of professional fellowship, I received by next post a hurried assurance from the editor that it was all a mistake, and that in fact the Lancet could not stoop to record medical experiences, however interesting, if they occurred in the practice of the inferior sex! Probably it will not require many more years to make this sort of thing ridiculous even in the eyes of those who are now capable of such puerilities.

2. The second obstacle lies in the continued exclusion of women from the majority of our universities, and from the English Colleges of Physicians and Surgeons. Here also the matter may be left to the growth of public opinion as regards those existing bodies which do not depend upon the public purse; but it is time that Parliament should refuse supplies to those bodies whose sense of justice cannot be otherwise awakened, and it is certainly the duty of Government to see that no new charter is granted without absolute security for equal justice to students of both sexes.

3. The third difficulty is that of finance. If women are to be excluded from public schools, and obliged, with great additional labour and expense, to make their own arrangements, it certainly seems not unreasonable that some modest share of public money should be assigned to them, and that a helping hand should be given, at least during the earliest years of probation. I quite agree that in the long run all medical schools should be self-supporting, and if the fees and the expenditure are properly balanced they are sure to become so eventually; but even then some kindly help will be always needed for individual students whose means are too slender to meet the full expenses of medical education. The number of scholarships and exhibitions founded for the benefit of young men cannot be easily told, and surely the claims of young women are not less valid or less pressing. The average wealth of women is less than that of men, and few fathers are as ready to spend money on professions for their daughters as for their sons. Less money is available for women students, and their need of it is greater; for, while almost all endowments are reserved for men, more than average expense has to be incurred in making separate arrangements for women. Surely public money should not be altogether denied to them, nor should private generosity lose sight of the very considerable number of struggling women students, whose merits and whose energies are sadly in excess of their available means.

4. But to my mind by far the most formidable danger, and the only one that need really alarm us, arises not from without but from within-from the professed, and probably sincere, friends of the movement itself. I refer to the threatened discredit of medical women by the introduction into their ranks of those who, refusing to go through the door into the sheepfold, are encouraged by well-meaning but ill-judging persons to climb up some other way, and who, therefore, cannot complain if they find themselves held as thieves and robbers. Not long after the foundation of the London School, it was found necessary to prevent the admission to it of foolish persons, who fancied that after taking a few classes' they might consider themselves competent to practise as medical missionaries or otherwise; and in order to do this a regulation was passed that every medical student must sign a declaration stating her intention to go through the whole course of study, with a view to admission to the National Register. The same rule is in force in Edinburgh, and therefore neither of the special schools for women can be held in any degree responsible if ill-educated women creep surreptitiously into the profession. Unfortunately, provision has been made elsewhere for two years' courses' of instruction, and women are being sent out under the name of medical missionaries, who cannot possibly be duly qualified for the very serious responsibilities of practice. Every doctor who has gone through the ordinary four years' course will testify that it has been all too short, and that not a day could be spared from it if even the most essential knowledge is to be secured; and if this is so in this country, where opportunities of consultation with senior practitioners abound, how much more is it the case in the East, where each medical women is probably isolated in a faraway station, and must meet emergencies of life and death with no outside aid whatever? Let those who think differently ask themselves if they would be willing to trust the lives of their nearest and dearest in the hands of an average second year's student of either sex; and, if they would not do so, whether they can be justified in foisting such deceptive assistance on dying natives, and making it their excuse that they desire the spread of the Christian religion? Is it not rather a case of

Assist us to accomplish all our ends,

And sanctify the means we take to get 'em?

Let me quote on this subject the indignant protest uttered by Dr. Edith Pechey in her Inaugural Address delivered at the London School in 1878.

I confess that I have been somewhat horrified to hear occasionally remarks from the supporters of medical missions, to the effect that a diploma is not necessary, that a full curriculum is superfluous-in fact, that a mere smattering is sufficient for such students. I cannot believe that such sentiments are held by the students themselves, and if there are any here to-day, I beg of you not for one moment to

give way to this idea. Is human life worth less in other lands, amongst people of another faith-or do such persons imagine that disease there is of a simpler nature, and that the heathen, like the wicked, are not in trouble as other men'? . . . 'Christian England' is renowned in every land for her adulterated goods; let it not be said that, under the very guise of Christianity, the medical help she sends out is also an inferior article. Let it not be said of you hereafter, as was said of some medical missionaries more than one hundred years ago, 'The usual introduction and security of these missionaries is the pretence to the practice of physic, that in destroying bodies they may save souls,'" but let your practice prove you a worthy member of the profession by saving life, or, where that is impossible, by lessening pain and smoothing the passage to the grave.

Of course, unless the whole principle of medical legislation is wrong, the practice of medicine by imperfectly educated persons is always to be most earnestly deprecated; but in the present case the special sting of the injury depends on this, that when disastrous results follow, as they are sure to do from such reckless intrusion into posts of the deepest responsibility, the blame of the consequent fatalities will be laid, not on the shameful imperfection of education in individual cases, which probably will not be known or realised by the public, but on the sex of the persons who are thus justly blamed; and it will be said that the victims fell a sacrifice not to the exceptional and criminal ignorance of the individual, but to the mistaken idea of the practice of medicine by women; and it is therefore in the name of all my sisters in the profession that I desire most emphatically to record the above protest.


"Discourse on Inoculation, by La Condamine.

Preface by translator (Maty)



TRY, my reader, to imagine yourself in the position of some weary African explorer, who is travelling through some little known part of the dark continent. You may be just quitting the slightly civilised coast-belt for the unknown and savage interior, and you may have sickened with the first touch of fever, and with all your enthusiasm for exploration you feel depressed and saddened at the snapping of all ties which bind you to the world of culture and comfort: your new tent is leaky and lets in the rain, or it fails to mitigate the blazing heat of noontide: your untried cook cannot at once acquire the art of producing a decent cuisine amid the exigencies of campcooking: the bread you are eating is perhaps four days old, a piteous relic of the pleasant sojourn spent at the house of your consul, or of some merchant compatriot in the coast-town whence you started.

Or it may be that the circumstances under which you are travelling are somewhat different. You are at the end of some great journey, some expedition which has had its moments of exhilarating success, of wonderful discovery; but now the excitement is over, and is succeeded by a dull apathy that is almost despair: you no longer anticipate, with a joy that can scarcely be outwardly repressed, the pleasures which are about to reward your months of toil, privation, and danger-the first night's sleep in clean sheets, the first juicy steak and floury potatoes, the first visit to a theatre: you are weary of scanning in your mind's eye the distinguished audience that is to listen in rapt attention while you describe your own exclusively discovered mountain, lake, river, tribe of cannibals, or new zoological species: you merely confine yourself to reflecting dully on the probabilities of reaching your destination alive, and to doubting whether, under any circumstances and especially the present ones, life is worth living.

In either case, whether your work lies behind you, finished, or before you, to be accomplished, you jog along the narrow winding path, tired, ailing, heartsick, homesick; your sore and weary feet tripping over stocks and stones, your aching eyes bent on the ground but seeing nothing, your face scorched by the hot wind, your hands scratched by the grass blades that have to be continually

pushed aside in your dogged progress. Perhaps, even, you may be enduring worse discomfort; you may be drenched to the skinmacintosh notwithstanding-in some torrential downpour, and overweighted with your heavy, streaming rain-coat, you stagger along half-blindly through slushy mud and soaked vegetation. Then you hear your guide saying to some one, that he recognises the districtthat the white man's house is near at hand. "What white man?' you apathetically ask, too weary to show an interest in anything. 'He be mission-man, them white man,' the guide replies, and then if you only know this modern type of evangelist by tradition you will smile bitterly and say to yourself, 'Oh! a missionary? H'm, I don't feel much in a mood to pray or sing hymns just now.' Then you continue plodding on in stupid resignation to whatever fate awaits you.

We will suppose, to make this picture more effective, that it is now late afternoon. The sun-if it is the sun that has chiefly troubled you during the day's march-is at last sinking behind an imposing clump of forest trees, and the fierce heat of noon is beginning to be tempered by the rising breeze. Or the murky rain clouds are drifting away in ragged, piled-up masses to the east, leaving a large space of the western heavens clear; and this expanse of open sky has become a pale lemon-yellow through the diffused misty glory of the declining sun. The surrounding country has a more pleasing appearance. Here and there in the distance are bright green and yellow patches diversifying the grey scrub and sombre forest, and these clearly indicate the existence of plantations, while the vicinity of man is proved by occasional puffs and spirals of blue smoke where the natives are burning weeds. The path, too, is wider, clearer, and better cared for. The obtrusive wayside vegetation has been checked and no longer impedes your progress. Then you begin. to meet occasional inhabitants of the distant unseen settlementwomen with babies slung on their backs and earthen pitchers poised on their heads, on their way to the spring to obtain their evening's supply of water; or men returning from the chase armed with long-barrelled, ancient-looking guns, spears, assegais, or clubs, and accompanied by several snarling curs, whose collars are hung with little bells. To your surprise, instead of plunging terror-stricken into the bush or assuming a defiant and hostile attitude, each native greets you politely with "Morning! Goo' morning!' for they have learnt from the missionaries our matutinal salutation, which they indifferently make use of at all hours of the day and night. On each side of the widened road a straggling row of young plantain trees begins to make its appearance, evidently planted with the view of its forming ultimately a shady avenue; then, behind a wooden fence, appear thriving plantations of vegetables and hedges of pineapples; and, at last, a turn in the road brings into view a garden of

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