The Reluctant Dean

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By John Atherton Young

Contents

The Original Act of Incorporation

THE ORIGINAL Act of Incorporation of the University of Sydney included provision for the Senate to examine candidates for admission to the degrees of Bachelor and Doctor of Medicine and to advise the Government concerning what institutions or schools in Sydney would be able to provide suitable training, not only for physicians and surgeons, but also for male midwives and pharmacists. Although it had long been the practice in Scotland for the Universities to provide medical training as well as to examine for admission to medical degrees, this was not the case in England where, until well into the 19th century, the normal practice was for a trainee, who would commonly have apprenticed himself to a practitioner for some years, to study at a private or hospital-associated medical school and to be examined and licensed to practice by one or other of the professional colleges such as the Royal College of Surgeons or the Society of Apothecaries. Indeed, it was only by the middle of the century that the University of London (founded as a medical training institution in 1827, but denied powers of examining for some years) began to emerge as a major medical examining body in England, and it was not until later still, that it gained even partial control of the training offered by the various London hospitals. The framers of the Sydney Act of Incorporation were much influenced by the way the University of London had been constituted, and they evidently envisaged a similar role for the colonial University. Under the influence of Nicholson and Wentworth, however, the Senate decided to open a Medical School and moved rapidly: as it happened, too rapidly.

In 1855, by-laws were framed by Senate making provision for a Board of Medical Examiners and defining the matriculation and examination requirements. These were adopted by Senate on 3 December 1855 and received the assent of the Executive Council in time to be promulgated in the 1856 Calendar. On 13 June 1856, Senate proceeded to create a Faculty of Medicine, with Professor John Smith as Dean presiding over a Board of eight other practitioners (see Table 2.2), and published the details in the Sydney Morning Herald on 23 and 24 July 1856, inviting candidates to come forward to be examined. It also made provision for ‘a Professor’ to give lectures in Chemistry, and indicated in the by-laws that the Board of Examiners would continue to function only ‘until other professorships in the Faculty of Medicine be constituted in the University’.

Unfortunately, no one thought to consult Smith who, it transpired, was opposed to the establishment of a Medical School (see Chapter 1). The Board of Examiners, officially constituting the Faculty of Medicine, remained in existence however, and Smith remained its Dean until Anderson Stuart arrived.


The original medical by-laws of 1856

The original medical by-laws (1856 Calendar) provided for examination for award of both the Bachelor’s and Doctor’s degrees in Medicine (MB and MD). Candidates for examination for the MB degree, who had to be at least twenty-one years of age, had first to prove that they held a BA or other equivalent degree from Sydney University or another institution or, lacking such qualifications, had first to sit for and pass an examination equivalent to that for the Sydney BA degree. In addition, candidates had to furnish evidence of having studied all the traditional medical subjects (including Chemistry, practical Chemistry, Botany, Physiology and practical Physiology) at a recognized medical school for a period of at least four years, as well as of having had at least eighteen months’ experience in a hospital of eighty or more beds and at least six months’ dispensing experience. Only when these preliminaries had been satisfied could the examination for the MB degree take place. If successful, a candidate obtained the MB degree and, after the elapse of a further two years, became eligible to submit himself for the MD examination. To do this he had to prepare and defend a thesis in some medical subject, to be selected by himself; the thesis could be ‘in the Latin or English language, and if approved by the board of examiners’ might be published (in fact, none ever was).


The medical by-laws are amended in 1861

In 1861 the by-laws were amended to permit persons holding the BA and MB degrees from other Universities, including specifically the University of Melbourne (which had yet to confer medical degrees by examination, but did so in 1862), to present for the Sydney MD examination. This relaxation of the original by-laws seemed necessary since it had become apparent that the original MB rules were so restrictive that no candidate had been accepted for examination and consequently neither the MB nor the MD degree had been awarded. Notwithstanding this slight relaxation, no acceptable candidates were forthcoming so, in 1866, a relaxation of the MB by-laws was also adopted. This permitted the BA prerequisite to be waived at the discretion of the Senate in the case of candidates who had been in bona fide medical or surgical practice for not less than ten years. These changes followed on an earlier decision of Senate’s to relax the matriculation standard and the BA requisites and can be viewed as part of a general move on the part of the Senate at that time to increase the University enrolment.

While not exactly opening a floodgate, this enabled candidates from among the medical practitioners of the Colony to come forward. Unfortunately, no systematic record of the proceedings of the Board of Examiners has survived, but from the Senate minutes and the roll of graduates we learn of eleven successful candidates who presented for the MB examination between 1866 and 1874 (Table 2.3). Of these, all but two availed themselves of the ten-year clause, presenting evidence of the possession of appropriate medical diplomas and licences and of at least ten years’ practice in New South Wales or elsewhere. The remaining two had Arts degrees (Rev. W. F. Clay MA Cantab. MRCS and Patrick Smith MA Aberdeen) and so could be accepted more readily, but, in fact, both of these would also have satisfied the ten-year rule.


Table 2.1 Registered Medical Practitioners in Australasian Colonies (1883)

N.S.W. Other Colonies Total

No listed qualification 041 (4%)41 (3%)

Licences only 229 (63%)682 (58%)911 (59%)

University Degree137 (37%)443 (38%)580 (38%)

Totala 366 1116 1532


Origin of University Qualification

N.S.W. Other Colonies Total

Scotlandb 66 (48%) 218 (49%) 284 (49%)

Irelandc 25 (18%) 56 (13%) 81 (14%)

Englandd 5 (4%) 15 (3%) 19 (3%)

Continental Europe 20 (15%) 41 (9%) 61 (11%) North America 12 (9%) 27 (6%) 39 (7%)

Melbourne University e 7 (5%) 73 (17%) 81 (14%)

Sydney University 2 (1%) 4 (1%) 6 (1%)

Unassigned 0 9 (2%) 9 (2%)


a 24% of all registered practitioners were working in N.S.W.

b Edinburgh, Glasgow, St Andrews and Aberdeen Universities.

c Trinity College Dublin and Queen’s University of Ireland.

d Over 80% from London University.

e Of the eighty-one practitioners with Melbourne degrees, sixty-six were working in Victoria.


In due course all eleven candidates presented for, and passed the MD examination as well, most after the minimum two-year period, but several after three years and one after four years. In addition to these candidates, there was one further MD graduate, James Houison, admitted to the MD examination on the basis of an Edinburgh MB. He actually presented for the MD examination in 1868 but was denied his degree until 1870 because Senate required all MD candidates to have been MBs of at least two years’ standing. He also was one of Sydney’s early Arts graduates, having been an undergraduate at Sydney University in 1859–1863 and having received his BA in 1863.

Table 2.2 Examiners of the Faculty of Medicine 1856–1882

Appointed Initially in 1856

1856–1885 The Hon. John Smith MA MD HonLLD Aberd. (Dean 1856–1883)

1856–1863 The Hon. Arthur Martin a’Beckett FRCS LSA FRGS

1856–1893 George Bennett MD Glas. FRCS FLS

1856–1866 Richard Greenup MD Cantab.

1856–1870 The Hon. John Macfarlane MD Glas. MD Melb.

1856–1859 Donald Macintosh McEwan MD Edin. LRCPEd

1856–1870 Charles Nathana MRCS HonFRCS LSA

1856–1862 James Robertson MB Lond. MD StAnd. FRCS LSA

1856–1866 George West? MD Dublin LRCSIrel


Lecturers Appointed Subsequently

1863–1883 Sprott Boyd MD Edin. LRCSEd MRCS LSA HonFRCS

1863–1868 John Foulis MD Edin.

1863–1898 Sir Alfred Roberts Kt MRCS LSA

1864–1900 James Charles Cox MD Edin. FRCSEd FLS

1866–1875 Edward Samuel Pickard Bedford FRCS

1867–1882 Haynes Gibbes Alleyne MD Edin. LRCSEd

1873–1903 Frederick Norton Manning MD StAnd. MRCS LSA

1874–1918 Sir Philip Sydney Jones Kt MD Lond. FRCS LSA

1874–1908 The Hon. Sir Arthur Renwick Kt MD Edin. BA FRCSEd

1876–1914 The Hon. Sir Normand MacLaurin Kt MA LLD StAnd. MD LLD Edin.

1884–1889 Frederick Harrison Quaife MD ChM Glas. MA FRCSEd


aIn the University Calendar and in the 1860 Medical Directory, Nathan is credited with an MD degree but with no specified University of origin. However, there is no record that Nathan held such a degree. It was not uncommon for licensed, non-graduate practitioners to assume the style MD although it seems unusual for the spurious MD to be listed in such official documents as the University Calendar or the Medical Directory.


Prestige and professional status

It is interesting to speculate about the motives of the twelve candidates. All of them, except Houison and Clay, were well established medical practitioners who, with the exception of Charles Taylor, a full-time Government employee, could not really expect to increase their earning capacity by obtaining extra qualifications. Without a doubt the principal, if not the only motive, had to do with questions of prestige and professional status. In England in 1850, only about 12% of all the registered practitioners had University degrees (Robb-Smith, 1966), the rest holding diplomas or licences from corporations such as the Royal College of Surgeons. Of those who did have University degrees, an incredible proportion of 74% held them from one or another of the four Scottish medical schools (only 12% from the University of London and 4% and 5% from Oxford and Cambridge, respectively). Nevertheless bodies such as the Royal College of Physicians admitted only graduates to the superior rank of Fellow so that the need of a University degree was keenly felt by the ambitious, particularly the ambitious physicians. Indeed, until 1835, the Royal College restricted its Fellowships not merely to graduates but specifically to Doctors of Medicine from Oxford or Cambridge. Furthermore, the prevailing social attitude in England at that time was that medical practitioners, or rather, those who lacked University degrees, mainly the apothecaries and surgeons, belonged to the tradesman class (McMenemy, 1966). The preponderance of Scottish University degrees among the graduate practitioners (a phenomenon that can be discerned well back into the 18th century) stemmed, in part, from the superior and better organized training system in that country, in which the medical and surgical Colleges had long taught and examined in collaboration with the University (Tait, 1966). In addition, Oxford and Cambridge also required a preliminary BA, often necessitating five or more additional years of study (Robb-Smith, 1966). The prevailing attitude to teaching was that a good general education was the best background for a physician to possess and that he would have no difficulty in learning his art if he were properly educated. Physicians, or at least the Candidates and Fellows of the Royal College of Physicians, were considered to be gentlemen, and the Royal College was in consequence most anxious to preserve the status of its Fellows by maintaining clear distinctions between Physicians, Surgeons and Apothecaries (general practitioners).


Graduates receiving the MD Degree by Examination (1856–1903)

Before 1886 Name MB MD Other Qualifications

Charles Field Goldsbro’ 1866 1868 FRCPEd LSA MRCS

Patrick Smith 1867 1870 MA Aberd.

James Houisona — 1870 BA Syd. MB ChM Edin.

Frederick Lloyd 1870 1872 LRCSIrel

Cornelius Stewart 1870 1872 LFPSGlas

George Moore 1870 1872 MRCS

Richard Theophilus Jones 1870 1874 LFPSGlas LRCPEd LMidRCPEd

James Barrett 1871 1873 LSA MRCS LMidRCS

Rev. William French Clay 1871 1874 MA Cantab. MRCS

Charles Taylor 1873 1875 LSA MRCS LMidRCS

John Blair 1874 1877 FRCSEd

Selby Mars Morton 1874 1877 MRCS LSA

Thomas Rowan — 1882 MB Melb. LRCP FRCSEd LMidRCPEd

Craig Dixson — 1882 MB ChM Edin. MRCS FRCSEd

Chisholm Ross — 1886 MD ChM Edin.

After 1888

Grafton Elliot Smith 1893 1895 MB ChM Syd.

Cyril Ernest Corlette 1892 1895 MB ChM Syd.

Aeneas John McDonnell 1889 1896 MB ChM Syd.

James Froude Flashman 1894 1897 BA BSc MB ChM Syd.

Harold Skipton Stacy 1898 1901 MB ChM Syd.

John Burton Cleland 1900 1902 MB ChM Syd.

C. B. Blackburn 1899 1903 BA Adel. MB ChM Syd.

Frank W. A. Magarey 1899 1903 MB ChM Syd.

Francis Percival Sandes 1899 1903 BSc MB ChM Syd.


aPresented for examination in 1868 but prevented from taking the degree until 1870 because of a restriction in the Sydney by-laws requiring holders of the Bachelors degree to wait at least two years before presenting for examination for the MD degree.


MB MD Other Qualifications

Arthur Todd Holroyd — 1881 MD Edin. MB Cantab.

Richard Ryther S. Bowker — 1881 MD StAnd. HonFRCS MRCP LSA

Arthur Oakes 1881 — MB ChM Edin.

Lachlan H. J. Macleana — 1882 MD Heidelberg MRCS MRCP

Walter William J. O’Reilly — 1882 MD QUIrel. MRCSEd

Thomas Bowerman Belgrave — 1882 MD Edin. MRCS LSA

Samuel Thomas Knaggs — 1882 MD ChM Edin. FRCS Dublin

Frederick Milford — 1882 MD Heidelberg LRCP MRCS LMidRCS

Arthur Murray Oram — 1882 MD ChM Edin.

William Edward Warren — 1882 BA MD MCh QUIrel.

W. Odillo Maher — 1884 MD ChM QUIrel. MRCS

David Collingwood — 1886 MD ChB Lond. FRCS

Edward Johnstone Jenkins — 1886 MD Oxon. FRCP MRCS FRACP LSA

James Graham 1886 — MA MB ChM Edin. (MD Edin. 1888)

William Chisholm — 1886 MD Lond. BA Syd. MRCS

Henry Augustus Ellis 1887 — MB ChB Dublin

William Andrews 1887 — MB ChB Melb.

Alexander MacCormick — 1888 MD ChM Edin. MRCS

Ralph Worrall — 1888 MD MS Lond.

Francis Antill Pockley 1888 — MB ChM Edin.

Robert Scot Skirving 1888 — MB ChM Edin.

T. P. Anderson Stuart — 1889 MD ChM Edin.

George Lane Mullins — 1890 MD Dublin

Michael John Lyden — 1892 MD QUIrel.

Wahab McMurray — 1892 MD QUIrel.

Francis Alexander Bennet — 1896 MD Aberd.

William Thomas Chenhall 1897 — MB BS Melb.


aListed in Graduate Register but not in the University Calendars.


Colonial practitioners

Not surprisingly, therefore, the majority of the Colonial practitioners had no University degrees at all. Thus, even as late as 1883, when Sydney had a population of around 270,000, only 37% of the registered practitioners of New South Wales were graduates and the position in the other Australasian colonies was similar (Table 2.1). In New South Wales, as in England, the bulk of the graduates had Scottish (48%) or Irish (18%) degrees but the number from continental Europe (15%) and North America (9%) was much higher than in England. In Victoria, of course, the proportion of Melbourne graduates (circa 20%) was high but in New South Wales it was only 5%. Those who were graduates of English or foreign Universities therefore felt no need to submit to an examination at Sydney University, which might well have led to a humiliating failure. For those practitioners who lacked degrees, however, the University of Sydney provided a means for improvement of their standing in the eyes of both the profession and the community, although clearly those having a Scottish MD, with its enviable reputation, would have been rather more highly respected than those possessing merely a Colonial degree1. Sydney degrees did, however, confer somewhat more status than those of many other Colonial Universities since Sydney University, thanks to Nicholson, had been granted a Royal Charter which ensured that its degrees would be recognized and given due precedence throughout the British Empire.

It is interesting to note that of the twelve candidates who obtained degrees under these by-laws, six practised in the colony of Victoria (although one later moved to Queensland), and one in Auckland, New Zealand. The New Zealand case is easy to account for: the Medical School at Dunedin did not confer its first medical degree until 1887. An explanation for the large number of Victorian applicants is to be found in the way in which the University of Melbourne established its Medical School (Russell, 1977). Although Melbourne’s University was founded three years later than Sydney’s, the Melbourne University Council included a forceful group that was determined to open a medical school along Scottish lines, the most notable being Sir Anthony Colling Brownless MD StAnd. MRCS, a Member of Council from 1855 until his death in 1897, Vice-Chancellor from 1867 and Chancellor from 1887. Melbourne University, furthermore, did not have a reluctant Dean.

Consequently, plans to open a medical school went ahead. Appropriate regulations were enacted in 1861 and the first students were accepted in 1863. In the interim period, special regulations empowered the Medical School Committee chaired by Brownless (the Committee was not called a Faculty and Brownless was never appointed Dean) to admit practitioners to examination for the MB degree, with the MD following by cumulation. For the years 1862 and 1863, such candidates were to be admitted without taking a matriculation examination provided they had been in bona fide medical practice for at least five years, but thereafter, a matriculation examination was to be imposed. Having been accepted for examination, all candidates had to pass regular medical examinations as well as examinations in Latin or Greek, and in Botany and Chemistry. A number of Victorian practitioners came forward only to be failed, the list of failures containing several prominent members of the Medical Society of Victoria including its President. In all, only six practitioners were admitted to the MB degree under these special regulations but some twenty nine others, who held degrees from the United Kingdom, were admitted ad eundem gradum. It was abundantly clear to the practitioners of Victoria not holding degrees, that this avenue to increased status would be closed to most of them, particularly after 1863, when they had first to pass a matriculation examination before taking the MB examination. Consequently, they turned to Sydney University which was more accommodating.


The medical by-laws change 1873-1878

Whether the shame of appearing to provide an easier pathway to a degree than Melbourne University provoked the Sydney Senate or not is unclear, but it is a fact that the by-laws were suddenly toughened up again after the initial burst of examining activity2. Thus in 1873, the conditions for the MD candidacy were extended to include attendance at a Public Lunatic Asylum for at least three months, and, in 1876, the ten-year rule as an alternative prerequisite to possession of a BA degree was dropped. Finally, in 1878, we find that examination for award of the MD degree by thesis (evidently not a very rigorous test since Charles Field Goldsbro’, the first successful MD candidate (1868), submitted a thesis of just sixteen hand-written pages) was replaced by an extensive series of written and oral examinations in clinical subjects3. Perhaps not surprisingly, few further candidates succeeded. Only three are recorded, and the award to one of these, Chisholm Ross MD (1866), may have been somewhat of a formality since Ross obtained an MD from Edinburgh in the same year, although the Senate minutes are quite specific that he was examined for the MD degree having been admitted MB ad eundem gradum on the basis of his Edinburgh MB. Both the other two, Craig Dixson MB Edin. and Thomas Rowan MB Melb., held bachelor’s degrees from other institutions. It is noteworthy that one of these three was a Melbourne graduate—perhaps the Sydney Doctorate had become more respectable than the Melbourne counterpart, but it may just be that Rowan had moved to Sydney to live. These three were the last of Sydney’s early graduates to obtain the MD degree by examination under the provisions of the by-laws enacted before the opening of the Medical School.

The Electoral Act of 1858, in analogy to the practice in England with respect to Oxford and Cambridge, recognized the University of Sydney as a Body Politic and made provision for Convocation, limited at that time to those holding higher degrees from the University, to return a member of parliament to the Legislative Assembly as soon as the roll should number one hundred persons. The required number was reached in 1876 and William Charles Windeyer, Sydney University’s first graduate, was duly elected. When, in 1879, he resigned his seat, Edmund Barton was elected in his stead but a change in the Electoral Act, which deprived the University of its privilege, unseated him a few months later. Perhaps, with this privilege abolished, parliament was more receptive to University moves to enlarge the roll of Convocation, for in 1881 an Act was passed allowing for the award by the University of degrees without examination to graduates of other institutions ad eundem gradum. The same Act, and a subsequent one of 1884, extended the roll of Convocation to include all holders of Bachelor’s degrees of at least three years’ standing. These changes had the effect, as was intended, of making election to the Senate a less exclusive privilege.


Ad eundem gradum by-laws are enacted by 1881

Once the ad eundem gradum by-laws were enacted, many practitioners with Scottish degrees and a few with German, English and Irish degrees sought and obtained degrees of equivalent standing but the many practitioners holding only licences or diplomas who remained in practice in the colony stayed away from the University examiners. The list of ad eundem gradum degrees conferred between 1881 and 1900 comprised twenty MDs and seven MBs (Table 2.4) and the recipients included many who had been or were to become teachers at the newly opened Medical School—Alexander (later Sir Alexander) MacCormick, Edward Jenkins, Arthur Murray Oram, Frederick Milford, Samuel Knaggs, Robert Scot Skirving, Francis Antill Pockley and James (later Sir James) Graham. Others, such as Arthur Todd Holroyd, a well known jurist and politician, were active in other spheres and did not practise medicine, so they may have hoped for the restoration of the University’s electoral privilege. Holroyd, who was a Foundation Fellow of St Paul’s College, may have hoped to become a Fellow of Senate or at least to play a role in its election.

Once the Medical School opened, the old regulations for examination were repealed, although the composition of the Board of Examiners, chaired by the new Dean, continued to be promulgated in the Calendar. The Examiners, together with the Professors and Lecturers of the Medical School, the Chancellor and Vice-Chancellor, and the medically qualified Fellows of Senate, were constituted into a new Faculty of Medicine in 1884. The extra-mural examiners thus became, de facto, the distinguished representatives of the profession who ought always to form part of any professional Faculty. In addition, of course, they acted as examiners for the clinical examinations.

In 1882, by-laws had been enacted in anticipation of the new Dean’s appointment, to enable the degrees of Bachelor of Medicine (MB) and Bachelor of Surgery (ChB) to be conferred on the graduates of the newly opened School (first anticipated for the end of 1887, although none actually graduated until 1888, see Table 3.1). In fact, however, the by-laws were again altered in 1884, after Anderson Stuart’s arrival, to allow for award of the MB degree, not with a Bachelor’s but rather a Master’s degree in Surgery (ChM), the latter to be conferred only on those MBs who elected to receive it. The first degree in surgery was again made a Bachelor’s degree (BS) in 1922 but it remained as an optional award to be conferred only on those MBs who so elected until 1974, although, naturally enough, throughout this period, most graduates elected to take both degrees4. After 1884, award of the MD degree still required an extensive series of clinical examinations but, in addition, submission of a thesis was reinstated as a requirement. By 1903 nine additional candidates, including the future Sir Charles Blackburn and Professors F. P. Sandes and Sir Grafton Elliot Smith had obtained the MD degree by examination (Table 2.3), and six others, including Anderson Stuart, had been admitted ad eundem gradum (Table 2.4). Slowly the ad eundem gradum provisions came to be used as a substitute for award of honorary degrees, but, since 1952, when the right to confer honorary degrees was finally granted to the University by Parliament, the ad eundem provisions have ceased to be employed although they still remain in force and are listed in the Calendar. Honorary Doctorates of Medicine have been awarded only to five persons: Sir John Thomson Gunther (1973), Sir Ian Douglas Miller (1979), Sir Brian Wellingham Windeyer (1979), The Rev. Francis Stanislaus Flynn AO (1981) and Emeritus Professor Peter Orlebar Bishop FAA FRS (1983).


References

Bruck, Ludwig (1883). The Australasian Medical Directory and Hand-Book. Australasian Medical Gazette, Sydney. Clark, George and Cook, A. M. (1964–1972). A History of the Royal College of Physicians, 3 Vols. Oxford University Press, Oxford. McMenemy, W. H. (1966). Education and the medical reform movement. In: The Evolution of Medical Education in Britain, pp. 135–154, edited by F. N. L. Poynter. Pitman, London. Robb-Smith, A. H. T. (1966). Medical education at Oxford and Cambridge prior to 1850. In: The Evolution of Medical Education in Britain, pp. 19–52, edited by F. N. L. Poynter. Pitman, London. Russell, K. F. (1977). The Melbourne Medical School 1862–1962. Melbourne University Press, Melbourne. Tait, H. P. (1966). Medical education at the Scottish universities to the close of the eighteenth century. In: The Evolution of Medical Education in Britain, pp. 53–68, edited by F. N. L. Poynter. Pitman, London. University of Sydney (1855–1883). Senate Minutes. Manuscript Volumes, University of Sydney Archives. University of Sydney (1855–1883). Calendars. Published privately for the University of Sydney. University of Sydney Archives.

1In 1883, there were no Fellows of the Royal College of Physicians registered in Australia. 2Like the earlier relaxation of the MB prerequisites in 1866, the tightening up of medical admission standards in 1873 and 1876 forms part of a general change in University standards adopted by Senate at this time, largely at Badham’s urging. 3The requirement to present evidence of having worked for three months in a public Lunatic Asylum was dropped in 1882 in order to accommodate a request from Craig Dixson (q.v.), a member of a rather influential family. 4Since, originally, a separate fee was levied for the award of each degree, it may be that those who opted only to receive the MB degree did so to minimize costs. This point has not been investigated but the author knows of at least one case where a Glasgow graduate deferred acceptance of the ChM degree on these grounds. H. K. Ward, the second Bosch Professor of Bacteriology, never received his ChM although he graduated MB in 1910.

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