medical annotations

3
76 sets forth some additional illustration of unrestrained sensu- ality. The conclusion forces itself on our minds, that much cause for grave reflection exists, so far as the question of public morals extends. We have already directed attention to this subject. We again do so in a spirit of practical earnestness, and call on those whose duties lead them to interfere on occasions when complaints of so grave a nature are preferred, to take such steps as will at least secure the fullest official in- vestigation, and, in the event of conviction, the amplest punishment. It may be argued that this is a social, not a medical ,question. It partakes of a twofold character, and both it inseparably unites. Public morals and personal sanity are more intimately associated than the casual observer may sup- pose. The force of example, and the knowledge that certain offences may be perpetrated with comparative impunity, act most injuriously on weak minds. There are abroad on society. many who are merely restrained from the commission of crime by the apprehension of discovery, and the conviction that punishment will follow on detection. To all such every in- stance of a miscarriage of justice acts as a strong inducement to the commission of wrong, partly from the special attraction which crime presents to weak minds, but principally from the fact that amongst those so predisposed there exists an imi- tative propensity for the perpetration of similar acts, which exercise fascination in proportion to their abstract depravity. Medical practitioners know well that erotic excitements, unless kept in the strongest check, exert the most pernicious in- fluence. On this ground, as well as for the equally impor- tant reason that publicity without punishment is a declaration of the weakness of our legislation, and so far an argument that a certain impunity attaches to such offences, we venture to affirm that when outrages on public morality are submitted to the decision of public justice, no precaution should be omitted which may secure full inquiry with prompt and com. mensurate retribution. . NOTWITHSTANXDING the measures which have been taken of recent years to carry out more effectually than before the vae- cination of our soldiers and sailors, there is still, it must be confessed, no inconsiderable amount of small-pox from year to year both in the army and the navy, and the annual number of deaths from this disease is greater than is supposed. It is not only on the home stations and in this country, it is to be remembered, that such casualties occur: there is not a colony to which our troops are sent, or a foreign land which our ships visit, where losses to the service are not sustained from this destructive scourge. Perhaps no epidemic disease is so widely spread over the face of the globe as small-pox. The annual reports on the health of the army and navy alone may serve to show how universally it prevails. This feature formed one of the most striking points in an able and elaborate paper on the results of revaccination in the British army as compared with the results in continental armies, by Dr. BOWEN, formerly of the Coldstream Guards, read at the Epidemiological Society on the 4th inst. No portion of the world seems to be exempt. From Canada to the Mediterranean, from the West Indies to Sierra Leone, and from the Cape of Good Hope to India and China, the same tale is to be heard of small-pox prevailing amongst the civil population, and of the troops suffering more or less severely in consequence. No stronger argument can be adduced for the utmost vigilance and perseverance in maintain- ing at all times and in all places a thorough and efficient vac. cination in the army and navy, exposed as the men must neces- sarily be to frequent sources of infection abroad as well as at home. Mr. MARSON expressed his opinion strongly that, judging from the amount of small-pox in both public ser- vices, a large proportion of our troops and of the crews of our ships are at this moment imperfectly protected. His experience from year to year only strengthens his conviction that if vaccination and revaccination were uniformly practised as effectively as they ought invariably to be, the disease would be almost unknown in the army and navy, notwithstanding the exposure of the men in foreign countries and in colonies where it is so frequently prevalent. During the last twenty- eight years not a single nurse or servant in the Small-pox Hos- pital has caught the malady ! This signal immunity has been due to the precaution of revaccinating thoroughly-that is, so as to ensure a considerable degree of local irritation, if not dis. tinct vesicles, around the punctures- everyone immediately upon their admission into the establishment. There is too much reason to believe that a large proportion of so-called re- vaccination which, under the influence of the recent epidemic of small-pox, has been performed during the last year or two in the metropolis and many parts of the country, has been not much better than a sham-nominal rather than actual. In reference to the far greater exemption of the continental armies as compared with the British army, Mr. MARSON drew attention to the circumstance that revaccination has been re- peated at intervals of a few years only, and not merely per- formed once, as has been usually done with us. This point well deserves the attention of our military and naval officers. Medical Annotations. 11 Ne quid nimis." PRISON DIETARY. A SPECfAL meeting of the Health Section of the Society for the Promotion of Social Science was held on Thursday, the 7th inst., when Dr. Edward Smith, F.R.S., read a paper on " Gaol Dietary : the Operations of the Committee of the House of Lords, and of Sir George Grey’s Committee respecting it ; and the present state of the question." Sir Eardley Wilmot, Bart., in the chair. The author, after a short reference to the con- clusions of the Royal Commission on Penal Servitude in refer- ence to the dietary of convicts, described the system of dietary pursued in county and borough prisons, and showed that although the Government had prepared a scheme in 1843, which was recommended to the visiting justices of gaols, it was so little based upon scientific proof that one-half of all the gaols in the kingdom had declined to adopt it. The Committee of the House of Lords on County and Borough Prisons, after the prolonged inquiry of last year, arrived at the conclusion that the scheme of dietary was not sufficiently based upon scientific principles to be a safe guide, that its details were anomalous, and that its low dietaries were defective, whilst the high dietaries were excessive in nutriment. Also that much additional information was required before a scheme of prison diet could be finally settled ; and they recommended that a commission should he issued with authority to determine by scientific experiment the various questions which had been discussed by them. The inspectors of prisons subsequently

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Page 1: Medical Annotations

76

sets forth some additional illustration of unrestrained sensu-

ality. The conclusion forces itself on our minds, that muchcause for grave reflection exists, so far as the question of publicmorals extends. We have already directed attention to thissubject. We again do so in a spirit of practical earnestness,and call on those whose duties lead them to interfere on

occasions when complaints of so grave a nature are preferred,to take such steps as will at least secure the fullest official in-

vestigation, and, in the event of conviction, the amplestpunishment.

It may be argued that this is a social, not a medical

,question. It partakes of a twofold character, and both it

inseparably unites. Public morals and personal sanity aremore intimately associated than the casual observer may sup-pose. The force of example, and the knowledge that certainoffences may be perpetrated with comparative impunity, actmost injuriously on weak minds. There are abroad on society.many who are merely restrained from the commission of crimeby the apprehension of discovery, and the conviction that

punishment will follow on detection. To all such every in-

stance of a miscarriage of justice acts as a strong inducementto the commission of wrong, partly from the special attractionwhich crime presents to weak minds, but principally from thefact that amongst those so predisposed there exists an imi-tative propensity for the perpetration of similar acts, whichexercise fascination in proportion to their abstract depravity.Medical practitioners know well that erotic excitements, unless

kept in the strongest check, exert the most pernicious in-fluence. On this ground, as well as for the equally impor-tant reason that publicity without punishment is a declarationof the weakness of our legislation, and so far an argumentthat a certain impunity attaches to such offences, we ventureto affirm that when outrages on public morality are submittedto the decision of public justice, no precaution should beomitted which may secure full inquiry with prompt and com.mensurate retribution.

.

NOTWITHSTANXDING the measures which have been taken of

recent years to carry out more effectually than before the vae-cination of our soldiers and sailors, there is still, it must be

confessed, no inconsiderable amount of small-pox from year toyear both in the army and the navy, and the annual number

of deaths from this disease is greater than is supposed. It is

not only on the home stations and in this country, it is to be

remembered, that such casualties occur: there is not a colonyto which our troops are sent, or a foreign land which our shipsvisit, where losses to the service are not sustained from thisdestructive scourge. Perhaps no epidemic disease is so widelyspread over the face of the globe as small-pox. The annual

reports on the health of the army and navy alone may serve toshow how universally it prevails. This feature formed one of

the most striking points in an able and elaborate paper on theresults of revaccination in the British army as compared withthe results in continental armies, by Dr. BOWEN, formerly ofthe Coldstream Guards, read at the Epidemiological Society onthe 4th inst. No portion of the world seems to be exempt.From Canada to the Mediterranean, from the West Indies toSierra Leone, and from the Cape of Good Hope to India andChina, the same tale is to be heard of small-pox prevailingamongst the civil population, and of the troops suffering more

or less severely in consequence. No stronger argument can beadduced for the utmost vigilance and perseverance in maintain-

ing at all times and in all places a thorough and efficient vac.cination in the army and navy, exposed as the men must neces-

sarily be to frequent sources of infection abroad as well as athome. Mr. MARSON expressed his opinion strongly that,judging from the amount of small-pox in both public ser-

vices, a large proportion of our troops and of the crews

of our ships are at this moment imperfectly protected. His

experience from year to year only strengthens his convictionthat if vaccination and revaccination were uniformly practisedas effectively as they ought invariably to be, the disease wouldbe almost unknown in the army and navy, notwithstandingthe exposure of the men in foreign countries and in colonieswhere it is so frequently prevalent. During the last twenty-

eight years not a single nurse or servant in the Small-pox Hos-pital has caught the malady ! This signal immunity has beendue to the precaution of revaccinating thoroughly-that is, soas to ensure a considerable degree of local irritation, if not dis.tinct vesicles, around the punctures- everyone immediatelyupon their admission into the establishment. There is too

much reason to believe that a large proportion of so-called re-vaccination which, under the influence of the recent epidemicof small-pox, has been performed during the last year or twoin the metropolis and many parts of the country, has been notmuch better than a sham-nominal rather than actual. In

reference to the far greater exemption of the continental

armies as compared with the British army, Mr. MARSON drewattention to the circumstance that revaccination has been re-

peated at intervals of a few years only, and not merely per-formed once, as has been usually done with us. This pointwell deserves the attention of our military and naval officers.

Medical Annotations.11 Ne quid nimis."

PRISON DIETARY.

A SPECfAL meeting of the Health Section of the Society forthe Promotion of Social Science was held on Thursday, the 7thinst., when Dr. Edward Smith, F.R.S., read a paper on " GaolDietary : the Operations of the Committee of the House ofLords, and of Sir George Grey’s Committee respecting it ; andthe present state of the question." Sir Eardley Wilmot, Bart.,in the chair. The author, after a short reference to the con-clusions of the Royal Commission on Penal Servitude in refer-ence to the dietary of convicts, described the system of dietarypursued in county and borough prisons, and showed that

although the Government had prepared a scheme in 1843,which was recommended to the visiting justices of gaols, itwas so little based upon scientific proof that one-half of all thegaols in the kingdom had declined to adopt it. The Committeeof the House of Lords on County and Borough Prisons, afterthe prolonged inquiry of last year, arrived at the conclusionthat the scheme of dietary was not sufficiently based upon

scientific principles to be a safe guide, that its details were

anomalous, and that its low dietaries were defective, whilst thehigh dietaries were excessive in nutriment. Also that muchadditional information was required before a scheme of prisondiet could be finally settled ; and they recommended that acommission should he issued with authority to determine

by scientific experiment the various questions which had beendiscussed by them. The inspectors of prisons subsequently

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reported that experimental inquiries were not necessary ; andthe Home Secretary appointed three medical officers of convictprisons to examine and report upon the dietary in countyprisons. Dr. Smith then proceeded to examine the reportwhich those gentlemen had presented, and the new scheme ofdietary which they had recommended for adoption. He

showed that the report was based entirely upon the replies ofvisiting justices to queries which had been forwarded to themthrough the Home Office, and not in any part whatever uponexperimental researches, as was recommended by the House ofLords’ Committee; and stated that the Committee had adoptedthe existing scheme without further inquiry, so far as relatedto the arrangement into classes according to duration of thesentence and to the supply of a much smaller quantity of foodwith the short than with the long sentences. They statedtheir inability to determine by experiment what is the effect ofconfinement both absolutely and in its duration as proving whethera man in confinement needs more or less food than in freedom;also what is the ordinary diet of free labourers in different partsof the country as a guide to the construction of gaol dietaries.They had not ascertained the ordinary diet in workhouseewith a view to prove that gaol dietaries are not more abundantand luxurious. They had introduced the new plan of "progressive dietaries," by which all prisoners would begin upon sdietary containing scarcely more than one-half of the food othe worst-fed farm labourers- and had thrown unon the surgeon!

of gaols the responsibility of deciding whether the prisonerscan be safely placed upon this low dietary or not. They hadnot ascertained the effect of the various kinds of labour (variedas the kind is), but had arbitrarily made certain substitutionsof food with labour, and recommended that if the food shouldbe insufficient to maintain health the labour should be broughtdown to the dietary ! The author then showed that the schemeof dietary which they had proposed was, both in its frameworkof classes and in the variation in nutriment, constructed with-out any scientific proof ; that the chemical composition of foodhad been entirely ignored and subordinated to its mere weight ;and that the results were so erroneous that the low diets hadbeen made lower, and the high diets higher in nutriment,whilst the Committee believed that they had made the lowdiets higher, and the high diets lower ! 1

In the discussion which followed, the Chairman, Mr. Alfred_

Hill, formerly Inspector of Prisons, Dr. Lankester, Mr. Graham,of Holloway Prison, and other officers of gaols took part.There was an almost universal concurrence of opinion on thepoints raised in the paper, and as to the utter failure of theinquiry undertaken by Dr. Guy and the other officers of con.vict prisons, and the necessity for new inquiries before thequestion of diet could be properly settled. They also agreedthat the recommendation of the Lords’ Committee should bEcarried out, and a commission of scientific men accustomed t(such inquiries should be issued. The paper will be publishecin extenso either by the Society or otherwise.

THE BRITISH PHARMACOPCEtA.

MANY inquiries are made in all quarters as to the probabledate of the appearance of the new Pharmacopoeia; and ominousconclusions are drawn from the profound silence of the Phar-macopoeia Committee of the Medical Council on the subject.It has been feared that this committee are disposed to proceedwith the same sham secrecy and real exclusiveness which didso much to spoil the present volume, by cutting off all thesources of contemporaneous information which might havebeen most usefully employed. We anticipate, however, anopposite course; for we believe the Executive Committee tobe sensible of these defects, and only anxious to remedy them.At the present moment they are without materials for progress;for the book and all the criticisms upon it are still in the handsof Mr. Warrington, the chemical operator of the Apothecaries

Company, who has undertakes the task of reporting generallyupon defects, criticisms, and suggestions. Such a report is-necessarily laborious, and must be produced carefully andleisurely. Mr. Warrington has been employed on it almostever since the termination of the session of the Medical Council,and his report will probably not long be delayed. When it isin the hands of the Pharmacopoeia Committee, we hope thatthey will not hesitate to furnish it to the press, and otherwisetake the most able opinions upon the matter submitted.

In reply to the question, When will the new Pharmacopoeiabe ready ? we may say that it is stated authoritatively that itwill not be ready in less than two years. We protest earnestlyagainst so preposterous a delay; and feel perfectly sure thatthe profession will not go on buying the present edition, how-ever long the new may be in forthcoming. Physiciansare, meantime, prescribing from the old London Pharma-

copoeia. We trust that the committee will not compromisethe dignity of the Council, or lower its position, by descendingto book-jobbing operations, and dawdle over the new editionin the unfair attempt to put off the surplus copies of the old.

: This is a matter of science, not of bookselling; and the; Council represents a profession, not a trade. We advise aU

prescribers to abstain from troubling themselves about the-4 British Pharmacopoeia until the changes are finally made andf revised for the new improved edition.

HONOURS TO ENGLISH SURGERY.

THE King of the Belgians, having now passed thirteen monthsin ease and comfort, has been pleased to confer upon Mr. HenryThompson, of London, to whom he owes his cure, and whonthe has rewarded by the munificent fee of .64000, the furtherdistinction of nominating him Officier of the Order of Leopold,and Surgeon-Extraordinary to his Majesty. This is a just andwell-earned honour. The King is in excellent health, can takeall sorts of exercise freely, all symptoms of the former maladyhaving disappeared. The case, as is well known, was one ofgreat difficulty and responsibility; and it was also knowm

throughout Europe that M. Civiale, of Paris, and the distin-guished German surgeon Langenbeck, had each been speciallysummoned previously, and, after patient endeavours, had beenbased in their labours, and had failed to effect a cure. Thus,when the skill of Mr. Henry Thompson succeeded in relievingthe King from his suffering, and removing its immediate cause,the honours which he won were reflected in some degree uponthe English school of surgery which he represented ; andMr. Thompson will assuredly receive cordial and general con-gratulation upon the marks of esteem which King Leopold

now publicly bestows upon him.EASTBOURNE REDIVIVUS.

WisE men and prudent communities always do their best twoconvert seeming misfortunes into real benefits. This is often

exemplified in localities visited by any epidemic. We are

glad to find it the case with that favourite watering-placeEastbourne, which last year suffered from scarlatina. Everyeffort has since been made to raise the town above even itsformer high rank as a place of health-resort. In the winter,the local Board of Health appointed a committee of medical mento examine into the condition of every house in which illnesshad been present. Under their control, such houses were

fumigated, papered, painted, and whitewashed throughout. Avery perfect plan of sewerage is in course of construction, bywhich, in a little time, all the seweis will empty themselves intoPevensey Bay, at a considerable distance from the town. The

expense which the townspeople have sanctioned for this pur-pose is enormous, considering the size of the place; amounting,in fact, to nearly 10,000. This shows the determination ofthe inhabitants to maintain the reputation of their locality.On the recommendation of Dr. Hayman, a very perfect system

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of flushing the present sewers weekly by many thousand gallomof water has been adopted; and the medical profession will bi

glad to learn that at no other time has Eastbourne been morlfree from illness of every kind than it is at present.

HONOURS TO MEDICAL MEN.

THE University of Dublin has conferred the honorary degreeof M.D. upon Sir William Wilde, the eminent surgeon andoculist of that city. This is a graceful tribute to the mostdistinguished of living Irishmen. It is scarcely necessary tcenumerate the claims of Sir William Wilde to the highest lite-rary and scientific rank. A traveller, whose writings are un-surpassed for power and fidelity of description ; a biographer,whose portraitures bear comparison with the best masters of

the English school; an antiquarian, whose researches haverendered him familiarly known to the savans throughoutEurope; an expositor of practical science, whose works on thetreatment of the abstruse classes of disease-those of the earand eye-are universal text-books; a medical philosopher of thevery highest genius, who has eliminated from the dry statisticsof Census details practical conclusions of incalculable value,-Sir William Wilde more than reflects the honour he receives.While congratulating him on his merited distinction, we atthe same time are glad to perceive that the University hasbeen so mindful of its own interests as to avail itself of the

opportunity of thus recording its appreciation.

MEDICAL CORONER FOR INDIA.

INDIA is progressing most satisfactorily, not only in materialprosperity, but in the sciences and in the arts. It is gratifyingto announce that on the retirement of a legal coroner forBombay, the vacancy thus caused has been filled by Dr. Thos.Diver, a gentleman qualified in every possible way to fill the

important office. The Bombay Times commends the choicewhich has been made by the authorities, and remarks that" the post is rightly filled by a gentleman of the medical pro-fession ; and with a man of Dr. Diver’s energy, the public mayexpect to see the functions of coroner discharged in a mannertheir great importance demands."

MR. FERGUSSON’S LECTURES AT THEROYAL COLLEGE OF SURGEONS.

WE publish this week the last of the course of lectures justdelivered by Mr. Fergusson at the Royal College of Surgeonsas Hunterian Professor of Surgery and Anatomy. Theselectures were anticipated with warm interest, which has beenamply justified by their value and importance. They havegone beyond the groove of technical and surgical discussion,and have dealt with the greatest questions in the art andscience of surgery -broadly, eloquently, and with a largenessof view and fulness of illustration which mark them as the

productions of a ripe and skilful surgeon, whose immense expe-rience is ordered and analysed by commanding mental powers.We have felt it desirable not to allow anything to break theircontinuity, and have to apologize to some distinguished con-tributors, whose communications we have been reluctantlycompelled to displace for the moment. We have supplied alsoto these lectures ample graphic illustration, which gives them aspeaking interest, and vitalizes the words of the lecturer bypresenting to the eye the results which he described. Howvaluable was this richness of illustration has been made espe-cially evident by the contrast of the pages of a half-starvedcontemporary, which has thought it desirable to publish abare reporter’s version of the lectures without a single illustra-tion-an act of great injustice to the lecturer, albeit a veryobvious compliment to him and to ourselves. These lectureshave been widely read and abstracted, and constitute an im-portant record of some of the greatest triumphs of the Britishschool of surgery.

ANNUAL DINNER OF THE FELLOWS OF THEROYAL COLLEGE OF SURGEONS.

ON Thursday, the 7th’inst., this dinner took place as usualafter the election to the Council, at the Albion Tavern,Aldersgate-street. Mr. Arnott, F.R.S., in the chair. Onehundred and thirty Fellows assembled, an attendance morenumerous than during the last few years.On removal of the cloth, the Chairman gave the health of

"the Queen." The toast was drunk with all the honours.In proposing the health of the "Prince and Princess of

Wales, and the rest of the Royal Family," Mr. Arnott spokeof the deep interest manifested by the heir apparent in theadvancement of national education in our hospitals and otherpublic charities, and of the patronage he extends to our sportsand amusements.

The "Army, Navy, and Volunteers," gave occasion to a

graceful allusion to the professional efficiency and militarymerits of the medical officers. A large proportionate numberof these gentlemen were distinguished by having the VictoriaCross, and medical literature had long since been largely repre-sented by such men as Sir John Pringle, Sir Gilbert Blane,Rose and Guthrie, not to select others of more recent date.Mr. JUDD, for the army, returned thanks, and was under.

stood to denounce the conduct of the Government towards themedical officers in that department of the service.Mr. Ds LA GARDE, Jun., replied in courteous terms for the

volunteers.

The " General Medical Council" was proposed by the Chair-man, with a prefatory apology for the defects of the BritishPharmacopoeia,, which had recently been "completed." Thedefects alluded to were, he contended, almost inseparablyconnected with the extent and complication of an undertakingwhich involved the differences of three national Pharma-copoeias ; yet, nevertheless, they would be remedied in thenext edition. (Hear, hear.) Then, again, the Medical Councilis empowered to control the medical corporations in matters ofeducation and examination. Therefore it became necessary togive them a standard up to which they would be expected tocome. Hence a scheme of education was now under the calmconsideration of the Council, and they relied with confidenceon the profession to support them in their deliberations.(Cheers.) It had been proposed that more compulsory powersshould be granted, by which the disfranchisement of any cor.poration could be summarily accomplished by a vote of thenew Council. Can it, however, be doubted, that the medicalcorporations demand anything less from those who seek tobecome members and Fellows than competency to practise,and that they should have a good preliminary education ?Therefore he (the Chairman) disapproved of any such com-pulsory power, but trusted, under the able presidency of Dr.Burrows, that their deliberations on the matter in question. would be brought to a successful issue.

Dr. BURROWS, on the part of the General Council, returnedthanks for the favourable manner in which the toast had beenreceived by the distinguished and influential body there assem-bled. The Fellowship of the Royal College of Surgeons wasone of those institutions destined to uphold the true nobility ofour profession. Honours from the Crown were bestowed onbut few, and were far between; they, therefore, could scarcelybe said to elevate the whole profession. Scientific culture andmoral worth are its internal sustaining power. And if he (Dr.Burrows) could again begin life, he certainly would seek thehonour of the Fellowship of that College. He sincerely trustedthat the Medical Council, putting aside hll-he was going tosay-"idle talk," would propound a scheme of educationworthy of the entire profession.

In proposing the "Medical Corporations," the Chairmanobserved that they recommend themselves by virtue of thatprinciple of local self-government which distinguishes many ofthe institutions of this free country ; they form bonds of union,and accomplish many things which Government could not door appreciate. Witness the scientific growth of the College ofSurgeons, without any assistance from the State, and theformation of their unrivalled museum, originally by the pur-chase of John Hunter’s famous collection, when actuallyrejected by the Government. The scientific eminence of the