1866
MODERN MEDICAL EDUCATION. THE CHICAGO STOCKYARDS. 10 the Editors of THE LANCET. ENERGETIC ACTION OF THE LOCAL AUTHORITIES.—GREAT SEIZURES OF DISEASED MEAT. SIRS,-May I call attention to a very serious blot on our (FROM OUR SPECIAL SANITARY COMMISSIONER.) present system of medical education?‘! For the last nine years I have spent a large part of my professional income in educating my son for our profession : first for five years at a at Chicago in regard to THERE has been a university, then f r two and a half years at one of our largest the abominations great awakening at the notorious union stockperpetrated London medical schools, and then for a year (without salary) In columns these At the end of it all I find yards. on the junior staff of Ms hospital. energetic protests have been that he is totally unfi for the daily routine work of private made against the fact that the United States meat practice. inspectors have to examine for trichinae all the hogs’ flesh. After 30 years’ experience of such work myself, I see that that is exported from Chicago to Austria, Germany, my patients take but little interest in bacteriology and blood Denmark, but that the hogs’ flesh and France, counts, but they cling with perverse superstition to the oldto Great Britain or consumed in the United fashioned desire to have
They
want
a
some
cough mixture,
medicine to make them better. or
a
tonic,
or a
gargle,
exported
or an
aperient, and so forth. This is precisely what the new "physician and surgeoni unable to give them, owing to his profound ignorance and contempt for materia medica and therapeutics. In my son’s case the comparative e-ise and credit with which he passed all his 10 or 12 examinations forbid me to attribute this want of knowledge to stupidity or indolence on his part ; it is simply due to lack of teaching. I
am aware
that at all
our
medical schools
a cour-e
of
given on materia medica, but as no practical knowledge of pharmacy is demanded either by the colleges or the universities, it is, of coure, not acquired by the student. A distingui-hed F.R.C.S. once told me that the Society of Apothecaries had done more for medical education than either of the colleges ; and I quite agree with him. I only wish that the foolishly and snobbishly despised L.S A. was compulsory instead of optional. An old-fashioned Hall question, such as " Mention six of the official preparations of opium, stating the quantity of opium in each, and give their therapeutics and doses,"would make our young physicians and surgeons," break out in a cold perspiration of horror and amazement. Verily, " Cucullus non facit monachum, and M.A., B.M., B Ch., L.R.C.P., M.R.C.S. do
lectures is
not
speii I I general practitioner."
I recall with complacency and satisfaction the two whole sessions I spent in the early " seventies " in grinding up my "Garrod," until I knew that most excellent book well-nigh by heart. I believe that the apothecaries of the seventeenth and eighteenth centuries, with theirherbs and simples," and even the Egyptian physicians of 5000 years ago, had more practical knowledge of pharmacy than our young graduates and conjoint men have at the present day. Who is to treat the common " ills which flesh is heir to"when the therapeutical old fogies like myself have passed away ? Will not this practice of necessity pass moie and more into the hands of chemists who alone will have the knowledge required by the public for giving them something to make them better, which after all, they not unreasonably prefer to a mere scientific diagnosis of their complaints ?? I rejoice. Sirs, that I can subscribe myself not only a mere Your obedient servant, M.R.C.S., but also, Sirs, L.S. A. Dec.l8th.l905.
OF
POONA.-The Mission to
to$10,793,710
were
and
respectively.
But at uhicago,
paid in salaries, only$46,901 were paid to the health department. As the commissioner of health of Chicago points out, upwards of 14 per cent. of the total salaries are appropriated for the health department of New York and Philadelphia and more than 9 per cent. I t Boston. But at Chicago the expenditure devoted to this all important and lite-saving service only amounts to 3. 1 per cent. of the whole. Though with this small sum very excellent work has been done, it is not surprising that many important maters have been neglected. Why the stockyards should have been numbered among the latter must be left for local economi-ts and politicians to explain. For ihe moment it must suffice to congratulate the city sanitary authorities on the recent appointment of six new meat inspectors and the far more energ. tic measures that arewere
summer
THE LEPERS
States is not so examined and guaranteed. As it is found among the hogs examined that, on an average, 1½ per cent. are infected with trichinas the ques ion naturally arose why the Americans and the British consent to consume this dangerous parasite. It would appear that now, however, the inhabitants of the city of Chicago haveawakened to some sense of the risks and dangers created by the staple industry established in their midst. Of course, each city has the right to take what measures it deems necessary to inspect and to control its own food-supply. At the stockyards there always have been some meat inspectors. appointed by the city of Chicago but little was heard of them. They were obviously utterly unable to. cope with the task before them and when it is impossible to do a thing properly there is a strong temptation to leave it alone altogether. In any case, the sanitary services of the city of Chicago have always been starved. The following few figures e oquently set forth this fact. Thus the city of New York paid its municipal employé,salaries amounting in 1903 to$52,364,272, and of this sum$751,533 went to the health department. Duringthe same year the municipal salaries at Philadelphia amounted and at Boston to$10,095,639. The amounts that in each city went to the health departments.
Lepers
has secured in gifts and promises £825 towards the f.lOOO required for its new asylum for the lepers of Poona (Bombay Presidency). A further sum of .EL75 would enable it to claim the grant promised by the authorities and to make proper provision for the many homeless outcasts of the district. It is specially desirable that this sum should be raised by the end of the year. Contributions should be sent to Mr. John Jackson, F.R.G.S., the Mission to Lepers,
now
enforced. Also, there h
s
been issued
an
official statement
to the health of the inhabitants of Packing Town, as the stockyards district is called. Of course, this should be
as
exceptionally good. Here dwell the workers who have the good fortune to be employed in the staple, the everincreasing, and most prospetous industry of the country. They do not live in an old town with narrow streets, antique houses, reeking with filth and standing on soil infected with
foulness accumulated during centuries. Yet this description would apply very well to the slaughterers employed at, for instance, the Villette abattoir at Paris. A century ago Chicago did not exist. The stockyard workers are living on virgin soil that has never been inhabited before they came. ’Ihey have cottages surrounded by large gardens and open spaces. Practically they are living in the country and it is claimed that they earn ample wages. Consequently, Exeter Hall, London, W.C. and if the work they do in the stockyards is performed DEATH OF A CENTENARIAN.-The Times of u r wholesome sanitary conditions, the sick- and death-rate Dec. llth states that Mrs. Annie Vickers of Waddington, among them should be exceptionally and extraordinarily Lincolnshire, has just died at the age of 101 years. She was low. Nevertheless, the bulletin of the Chicago health bern at Bardney and at the age of 16 years married Mr. department issued on Sept. 16th authoritatively states that Mrs. the death-rate of the stockyards district of Chicago averages. William Vickers of Sudbrooke, who died in 1887. Vickers was very active and enjoyed good sight up to 1903 about 6’ 4 per cent. higher than the general death rate of Of course, in the poverty and slum when she was seized with paralysis and was deprived of the whole city. speech. Four of her 17 children are living and there are quarters of the city a much worse state of affairs is Thus the death-rate of the stockyards district also 41 grand children, 85 great-grandchildren, and two found. averages between 12 and 13 per cent. lower than the average great-great-grandchildren.
1867 of ten other districts or wards where there are no stockyards. In 1900, the last year of the old ward boundaries, the deathrate for the entire city of Chicago was 14’ E8 per 1000. That of the twenty-ninth ward-the stockyards district-was 15-62 per 1000, or 6-4 per cent. higher. But the deathrate in the twenty-first ward was 15 95 ; in the sixth, it was 16 50 ; in the fifth, 16-71; in the first, 16 80 ; in the second, 17-05; in the nineteenth, 17-40; in the sixteenth, 18 21 ; in the seventeenth, 18 63 ; in the twenty-third, 18 69 and in the eighteenth, 23-06. The average deathrate of these ten wards was 17 90 per 1000, or 12 7 per cent. higher than the stockyards ward. Perhaps it is because this comparison was interpreted as being favourable to the stockyards district that the necessity for action was not so keenly felt. Nevertheless, it is obvious that the statistics are not to be judged only on their numerical appearIt is necessary to consider not merely what the .ance. mortality of the stockyards district is but what it ought to be. It is obvicus that living right away from the centre of the city and in what is practically a country district, with ample air space, regular employment, and with what the master packers, in any case, maintain is a very high rate of wages, the 50,000 to 60,000 employed in the stockyards should have a death-rate not merely below that of the bad, slum, and poverty stricken parts of the city, but the death-rate of so favoured a district and population should fall below that of the city as a whole. If the Beef Trust is the beneficent institution that it represents itself to be, then its employes should constitute the most fortunate, the most healthy, section of the population of Chicago, whereas they have a death-rate 6’4 per cent. higher than that of the average of the entire city. But the conditions under which they work and which have been so fully described explain -
this disparity.
-
limits of legitimate criticism. The meat was condemned because the animals were suffering from tuberculosis, pneumonia, " lumpy jaw," Texas fever, jaundice, necrosis, cholera,pleurisy, uræmia and anaemia, emaciation, asphyxiaIt would seem as if tion, bruisec, killed by trampling, &c. the two city meat inspectors, in their newly awakened zeal, had shown more perspicacity than the Government inspectors who are appointed by the central authorities at Washington and whose special mission it is to protect those foreign and European Governments which have legislated against the importation of trichinae from Chicago. In any case, the report says, speaking of the condemntd meat :-
Among these animals viere six cattle that had been passed by the Two cattle were found last week by the Government inspectors. Department inspectors that had been passed by the Government inspectors after the evidences of tuberculosis had been trimmed out. The city inspectors destroyed these cattle The Government inspectors refused to allow the city meat inspectors to remove glands and other organs suspected of being diseased, for the purpose of microscopic examination by the laboratory bacteriologists. Then comes this startling statement that, while during the week ending Sept. 23rd, 1905, the city inspectors condemned at the Chicago stockyards no less than 173,769 pounds of meat, they had condtmned during the corresponding week of the previous year only 2002 pounds. This indicates in what a perfunctory manner the work of inspection was done but a short time ago. Dr. Whalen, alluding to these statistics, says: "The above figures show the quality of the food supplies generally to be not only discreditable but
positively dangerous." By Oct. 14th we hear of four meat inspectors being at work and in cne week they condemned 131,954 pounds of meat, including 115 cattle and 428 hogs, together with 5576 pounds of dressed meats, sour hams, bacon, &c. This was 53 per cent. more than three inspectors had been able to discover and condemn the week previously. -
-
-
-
At the end of June last Dr. Arthur R. Reynolds, who was first appointed as commissioner of health of the city of Seven diseased carcasses of tuberculous cattle were disChicago in 1893, retired from office. On more than one covered, with evidences of the disease cut away, in the occasion Dr. Reynolds has been congratulated for the remark- "coolers" after having been passed by Government inable reduction of the death-rate of the city during his tenure spectors. By Oct. 28th six new meat inspectors had of office. It was 21.6 per 1000 in 1893 and by 1900 it had been appointed by the city authorities and they defallen 25 per cent., being 16’2per 1000, while last year it stroyed in the one week 496 animals weighing 145,343 was only 13-62 per 1000. Dr. Charles J. Whalen is the pounds. Again five cattle were found in the ’’coolers" present medical officer of health, as the post would be with the evidences of tuberculosis cut away from them. defined in England, and it is under his guidance that the By the month of November it was found that since new measures against the stockyards have been taken. At August 7th, when the present service had been established, the stockyards, where more than 15,000,000 animals of the average weekly condemnation of meat as unfit for food different sorts, from poultry to bulls, are killed during the was equal to 137,300 pounds. If this average is maintained course of the year, the interests of the meat consumers of it will make an aggregate of 7,141,316 pounds in a year. As Chicago were only represented by two inspectors. These a result circulars have now been sent out calling upon farmers two individuals were supposed to look after such portion and cattle-breeders to be more careful as to the conditions of the meat prepared at the :stockyards as was in- of the animals which they send and hopes are entertained that tended for consumption within the boundaries of the city " Chicago has ceased to be a dumping ground for unfit food." of Chicago. Evidently, as mentioned above, this duty has By Dec. lst it had been estimated that since August 7th been grossly neglected. Whether it be that the Government the Chicago city inspectors had seized and destroyed of the United States, having commenced a series of 2,391,719 pounds of meat and fish and 389,478 pounds of actions against the Beef Trust, has caused the local fruits and vegetables. The authorities conclude that this authority of Chicago to pluck up its courage, in any case. means that the housewives of Chicago have been prevented and apparently for the first time, the two city meat in- from cpending .647,722 in the purchase of food ’’the conspectors have been unmuzzled and let loose into the sumption of which would have injured health and spread stockyards. As a result the following naive admission tuberculosis, trichiniasis, and other diseases." On Nov. 4th appears in the health department’s bulletin of Sept. 23rd last. a report states that the principal causes of the condemnation "More recently the union stockyards and neighbouring of meat was in 85 per cent. for tuberculosis, in 12 per cent. slaughter- and packing-houses have received attention." for actinomycosis or "lumpy jaw," and in 4 per cent. for hog The "more recently" is a beautifully guileless expression cholera. The report adds: " Many nuisances which, owing to use in the face of the bitter and fierce struggles that have to the inadequate force, could not heretofore be abated, taken place in regard to these stockyards. In view of their will now receive prompt attention." This, so far as it goes, dramatic history the following continuation of the report will is highly satisfactory and it is something to know that a ’be read with the deepest interest and amazement: ’’During check has been exercised over the reckless proceeding that the last two weeks the two inspectors at the stockyards-the prevailed in the stockyards. Nevertheless, there remains entire available force for this work-have condemned the fundamental fact that the entire system of slaughtering and destroyed 242 cattle, 503 hogs, 31 sheep, and nine is defective from beginning to end. It is grossly inhuman, calves, being a total of 202,901 pounds of meat unfit because no effort is made to mitigate the apprehension and for human food, but ready to be offered for sale to torture of the animals It is absolutely insanitary and the citizens of Chicago." Here it must be noted that dangerous, because there are no slaughter-houses or abattoirs but for this newly found energy on the part of only in the technical sense of the term and therefore the wholetwo inspectors, the inhabitants of Chicago would un- some meats are exposed to the risk of contamination throughdoubtedly have eaten in the course of a fortnight some out the whole process of their preparation. This risk will be It that somewhat reduced by the fact that that seems 200,000 pounds of diseased meat. portion of the meat when I ventured to denounce the condition of the stock- which diseased is intended to be sold to the inhabitthough yards and the industry there carried on as a public ants of Chicago is now more likely lobe seized and danger and a disgrace to civilisation I did not exceed the de-troyed. But what about the rest’’ There is but one remedy that will be really effective throughout-the build1 THE LANCET, Jan. 7th (p. 49), 14th (p. 120), 21st (p. 183), 28th ing of a public abattoir and the compulsory closure of all (p. 258) and July 15th (p. 186), 1905. ptivnte slaughter-Louse.