ASSISTANT SURGEONS IN THE NAVY.

ASSISTANT SURGEONS IN THE NAVY.

313 questions such as infant feeding and milk-supply ; the was opened in the Polytechnic and delivered a most degeneration of the people must be arre...

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313

questions such as infant feeding and milk-supply ; the was opened in the Polytechnic and delivered a most degeneration of the people must be arrested by giving them interesting address on decent houses and promoting their physical development by The Drainage of London affording them facilities for exercise. which was both historical and practical as regards modern Diet and Disease.

conditions. A paper was read

on the Destruction of Town Refuse by Councillor ATKINSON (Hull), and at King’s College, Strand, Mr. C. G. MooRE discussed Problems in Practical disinfection. He dwelt on the ineffective character of many of-the routine methods of disinfection and called atten’ ion to the variable and often valueless character of the o-called disinfectant fluid4 of commerce. Although the disinfection of clothes and other fabrics was practised by some sanitary authorities it was neglected very largely in districts which had failed to understand the importance of providing that means against, the spread of infection. Dr. DAVID WALSH read a paper on Hom to nterilise London, Drinking Water. Referring to the contamination of the Thames by sewage,. he said that hitherto it had not been possible tosterilise sewage on a very large scale but now it could be done by the Salvator apparatus which had been tested and found torender water absolutelv sterile. By its aid water could be rapidly sterilised and delivered cool, sparUing, and palatable. The same machine could be used to sterilise all’ sewage tifiuents discharged into the upper Thames.

Dr. J. HADDON read a paper on this subject, remarking that he lived on one meal a day and ate no animal product except butter. The PRESIDENT of the section said the reader of the paper often wa" enthusiastic but pointed out that enthusiasm degenerated into faddism. It ought to be remembered that concurrently with the decrease in the death-iate there had been an increase in the consumption of meat. Nature was against one meal per day. Dr. S. G. MooRE (Huddersfield) read a paper on

Infantile mortality. He said that in the worst parts of some of the great cities only three out of four children born lived for 12 months. With regard to supplying milk for infants he advocated the formation of children’s dispensaries, such as existed in France. Misleading statements relating to food should be stopped. Some of the foods ndvertii-ed for infants caused many deaths. He knew of one article freely ad veJ tised as a special food for infants which upon analysis proved to be nothing but baked flour, not only imulliciently nutritive but even injurious to children. Dr. T. N. KELYNACK opened a discussion on

Smoke Abatement.

Sanatoriitmsfor Consumptives. He said that one-third of all the deaths from consumption in London took place in Poor-law institutions. There were now some 70 sanatoriums in the United Kingdom, with accommodation for about 2760 patients, but the beds available for the working classes and destitute were very few, and even in the be.,,t of our paying insti utions for the poor beds had to be kept vacant owing to lack of funds. In regard to the poor public effort was merely touching the fringe of the difficulty. It was well to remember that we were still in the experimental stage of our research. He advocated a direct controlling body which could deal with all cases of pulmonary tuberculosis throughout the country. The time was ripe for a Government inquiry into the methods of treatment of the consumptive poor. SECTION OF MUNICIPAL ADMINISTRATION OF THE EDUCATION ACTS. This section also met at the Polytechnic, where the President, Mr. J. H. YoxALL, M.P., gave an address on

Secondary What were

A paper on this subject was read by the Hon. ROLLO RUSSELL. lIe expressed the opinion that kitchen and ordinary The domestic fires were the main cause of London fogs. remedies he suggested were improved methods of heating but the best of all remedies, he said, would be the removal of the people of London to the country.

Tlte Air Supply of London. Dr. T. GLOVER LYON read a paper dealing with the q1’1estion of supply ifg fresh air to London and said that "tube "’ railways could be arranged to supply pure air to the central part of the city and to remove vitiated ’air from it. There to be a department of public health presided over by a sitting in the Cabinet.

ought Minister

Looking Back.

Education.

FROM

wanted, he said, for the bulk of children who transferred from elementary schools to places of was

THE

education was a continuative education which would fit them for the higher posts of service in the world of industry and commerce and not the kind of education which would lead up to the learned professions. Ventilation of Public Buildings. Mr. J. H. BLIZZARD, after remarking that properly ve’ntilated and sanitary school buildings were the foundation upon which the medical profession should start to prevent the spread of infectious disease, referred to churches which he i-aid were the best places for the spread of pulmonary tuberculosis and the dissemination of the germs of infectious diseases. Medical -inspection of Sohools. Sir GEORGE KEKEWICH advocated the appointment by the Board of Education of a medical officer whose duty sliould be to see that local authorities appointed a medical officer to inspect every school in the country and to report on its sanitary condition and the health of the children. He was also of opinion that there should be a thorough inquiry into the sanitary condition of all schools and that those found to be seriously defective should be eliminated. SECTION OF CHILD STUDY AND SCHOOL HYGIENE. - Training (If Teachers. Lord STANLEY of ALDERLEY presided over this section which was held at the Poly technio and in his address dwelt upon the necessity of teachers possessing some preliminary

secondary

I

LANCET, SATURDAY, July 28, ASSISTANT SURGEONS IN THE

1827.

NAVY. 1

To the Editor nf THE LANCET. SIR,-I surprised that you should have inserted in a former number of THE LANCET, the fastidious arid unfounded complaints of "An Assistant Surgeon in the Navy." He talks about being degraded to mess in tne midshipman’s berth, "with unruly boys." What! is it a degradation for a medical school-boy (for such, in point of practical experience is a young assistant surgeon,) is it ’a I ask, to mess with a young Rodr,ey, a Howe, a Duncan, a Nelson ! Doubtless, if this assistant had bel n so degraded, he would have gloried in his shame, and stood "a tip toe " when their names were mentioned. " Surely," says this Assistant Surgeon, "his education, and respectability as a medical man, entitle him to rank with any lieutenant, master, purser, or marine officer in the Navy." Now, Sir, neither respectability nor education entitle any officer to rank; and no such degree of them, as thirteen experience have enabled me to observe in assistant surgeons in the navy, will render them superior in general information to the junior officers, whose society this gentleman deems so unruly. I do not hesitate to say, that in any midshipman’s berth he ever entered, there was as much respectability, and as much education, before his entrance as after it. Non omnia poaumus oronnes ; even’tle am

degradation,

l.Iyears’

training in biology and physiology.

ENCIiEERIRTG AND BUILDING CONSTRUCTION. Sir ALEXANDER BINNIE presided over this section which

1 See letter from " An Assistant Surgeon in the Navy"reproduced under the heading of "Looking Back"in THE LANCET of June 24th,

1905, p. 1730.

314 is not groicnd in all knowledge. education but what is anatomical ? Is there no respectability but what is medicinal ? Are the sciences exclusively medical? Is plane trigonometry concentrated in the carving of lozenges, or spherical in the rolling of pills ? Surely, Sir, there is no less absurdity in comparing the "airy apartments of a house on shore, to the necessary confinement of a ship ; and. in complaining of his want of accommodation, there is no less injustice in the statement of the Assistant Snrgeon. When the junior officer-the messmate of this respectable and unruly boy-the offensive educated assistant, is ‘biding the pelting of the pitiless storm," he, "good easy man," is snugly housed between decks, reading books, learning, or most probably picking bones. When the "degraded" midshipman is on the high and giddy mast, watching the out-hauling of a weather earing, the scientific "idler," as he is not inaptly called at sea, is either elaborating an extract, or rotating a pill ; and instead of being recommended by the wet or cold, his manipulations are aided latprally by the rolling of the ship, and anteriorly by her pitching ; in short, Sir, he is at perfect liberty to take every advantage of the wind and

medical Is there

gentleman himself

VITAL STATISTICS.

no

HEALTH OF ENGLISH TOWNS.

IN 76 of the largest English towns 8900 births and 4002 deaths were registered during the week ending July 22nd. ! The annual rate of mortality in these towns, which had been 12 - 7, 11 6, and 12’9 per 1000 in the three preceding weeks, ! further rose to 13 4 per 1000 last week. In London the ’ death-rate was 12-7 per 1000, while it averaged 13’7 in the 75 other large towns. The lowest death-rates in these towns were 31 in Hornsey, 5’5 in Bournemouth, 5’8 in Smethwick. 60 in Burton-on-Trent, 6-2 in Hastings, 7’6 in Handsworth (Staffs.), 7’7 in Derby, and 7-8in while the highest rates were 18’ 4 in Sunderlan and in Merthyr Tydfil, 18-9in Great Yarmouth, 19-1in Stockport, 19-9in Barrow-in-Furness, 20’5 in Oldbam, 22’11 in Liverpool, and 24-1in Bootle. The 4002 deaths in these towns last week included 612 which were referred to the principal infectious diseases, against 371, 388, and 486 in the three preceding weeks ; of these 612 deaths 431 resulted from diarrhoea, 64 from measles, 45 from weather. whooping-cough, 32 from diphtheria, 24 from scarlet fever, In battle too, when the " unruly boys"" are lifting their and 16 from " fever " (principally enteric), but not any voices amidst the roar of cannon, and surrounded by "the from small-pox. No death from any of these diseases was pride, pomp, and circumstance of glorious war," the respect- registered last week in Hornsey, Bournemouth, Great able medical assistant is doing his duty, deeply sunk in a Yarmouth, Burton-on-Trent, King’s Norton, Derby, Tynebomb proof element. and Newport (Mon.), while they caused the highest The education of this respectable assistant has taught him, mouth, death-rates in Aston Manor, Stockport, Birkenhead, Liver. it seems, that it is very warm in hot climates, so much pool, Bootle, Leeds, Sheffield, and Sunderland. The greatest so, indeed, as to render it agreeable to dine with the coat from measles occurred in Birkenbead, off. Forsooth this hot weather and close apartments, are proportional mortality and Sunderland ; from whooping-cough Barrowin-F iirnesp, insufferable to our gallant assistant ; it is by no means in Aston Manor ; and from diarrhoea in Hanley, Aston salubrious "Look," says he. at the army medical man Manor, Stockport, Birkenhead, Liverpool, Bootle, Wigan, in a and all the comfortable dining airy apartment, enjoying Sheffield, and Merthyr Tydfil. The mortality from luxuries of the shore." It is certainly natural for the human Leeds, scarlet fever, from diphtheria, and from "fever" showed members to take care of the human belly, and especially for nc markecl excess in any 01 me large towns, ana no medical members to consider a medical belly ; but there is death from was registered during the week. small-pox somewhat too much of this, even in a respectable assistant The Asylums Hospitals contained three Metropolitan surgeon, who has been so many years in the naval service. small-pox cases at the end of last week, against four, five, what his the He appears to me, messmates, unruly" boys, and four at the end of the three preceding weeks ; no new Look cases were admitted would certainly call him, a shore-going doctor. during the week, against one, two, and again," says he, "at the army medical man, who has his two in the three preceding weeks. The number of scarlet him with can be quarters allotted to every convenience that fever patients in these hospitals and in the London Fever procured on shore." I suppose such an assistant would have Hospital, which had been 2473, 2499, and 2520 on the three the ship herself on shore. had declined again to 2485 on Saturday The Assistant Surgeon invidiously notices, "That the preceding Saturdays, 304 new cases were admitted during the 22nd ; last, July gunner, boatswain, and carpenter, are each entitled to a week, against 334, 354, and 356 in the three preceding cabin." Now, Sir, had his superior education only lifted weeks. The deaths in London referred to pneumonia his mind from the mortar, to contemplate the reason of and diseases of the respiratory system, which had been the circumstances which stood around him, and had his and 104 in the three preceding weeks, further 140, 90, respectability permitted him, he might have perceived rose to 117 last week, but were three below the that these warrant officers are each of them at the head number in the corresponding period of last year. The of their respective professions, and can attain no higher causes of or 1-2 per cent., of the deaths in the 47, station, and should therefore justly be allowed as many 76 towns last week were not certified either by a registered as render their a situation desirable one, medical privileges may practitioner or by a coroner. All the causes of to excite the emulation of such as may seek it. He death were duly certified in West Ham, Portsmouth, Bristol, would not thus have complained, that such privileges were and in 46 other smaller towns ; the highest withheld from an assistant surgeon, to whom are open Salford, Leeds, of uncertified deaths were registered in Liverpool, proportions the superior ranks of surgeon and physician, with their Sunderland, South Shields, and Gateshead. respective profits and accommodations. The Assistant Sur- Warrington, that he to in is a hammock geon complains obliged sleep HEALTH OF SCOTCH TOWNS. "like one of the lowest rank ; " why, Sir, all his messmates The annual rate of mortality in eight of the principal sleep in hammocks, the lieutenants, the captain, and even the admiral himself sleep in 11 cots," a species of hammock, Scotch towns, which had been 16 - 5,14’ 7, and 14 -3per 1000 and sometimes prefer the hammock itself ! What, in the in the three preceding weeks, further rose to 15’2 per name of Æsculapius, would the assistant sleep in? "Airy 1000 during the week ending July 22nd, but was 1’8per 1000 in excess of the mean rate during the same period apartments, quarters allotted to him, dressing tables, &c." Why, Sir, even the Lord High Admiral himself dispenses in the 76 large English towns. The rates in the eight with these things. With respect to his comparison between Scotch towns ranged from 90in Leith and 13’0in Dundee, the pay of the medical men in the army and navy, it least of to 16’5in Paisley and 198 in Perth. The 510 deaths in all becomes one of his class to make the complaint. It is these towns included 22 which were referred to diarrhoea, true that the navy generally is paid far inferior to the army. 21 to measles, 12 to whooping-cough, three to diphtheria, But both in pay and convenience the naval assistant two to "fever," and one to scarlet fever. In all 61 deaths surgeon is better accommodated than any of his rate on resulted from these principal infectious diseases last week, board, and the full surgeon than his rate ; the assistant against 65, 57, and 55 in the three preceding weeks. These surgeon’s pay is far greater than a midshipman’s who has 61 deaths were equal to an annual rate of 1’ 8 per 1000, served ten or twelve years ; he has no watch to keep, and which was 0 -2 per 1000 below the mean rate last week from is never exposed to the inclemency of the weather. By the same diseases in the 76 large English towns. The inserting this letter, you will do but justice to the govern- fatal cases of diarrhoea, which had been 14, 13, and seven in the three preceding weeks, rose again last week ment of the navy, as it respects assistant surgeons. to 22, of which 16 occurred in Glasgow, two in Edinburgh. I am, Sir, and two in Dundee. The deaths from measles, which had Your obedient humble servant, CT. H. H.I 17, 14, and 19 in the three preceding weeks, further rose Dublin, June 29,1827. --

Gateshead ; ’

been