In these cases, I think, we have every reason to be hopeful for improvement; it comes slowly, but it will come. Let us recollect that, in his last minute, Lord Dalhousie declared that, should his proposals for the improvement of our service be carried into effect, it ’’ will then be second to none in the world."’’ Once in England, on furlough, I paid a Christmas visit to
that of Warwick-street, Pimlico, are to be expected. If the excreta sewers" are to be ventilated, the ventilating orifices will be new, and greater sources of danger, as the risk from poisonous gases and miasms depends rather upon their concenas "
tration than their quantity. But it will be replied, that it is not intended to ventilate them but by careful adjustment of their size and fall to secure such uniform onward flow and rapid transit of the contained matters as to do away with the necessity for ventilation. 1st. Experience shows that it is not possible in such pipes to prevent obstruction. Amongst the contents are such things as human hair, the daily combings of two millions of heads, paper, rags, and even large and heavy substances, which are daily thrown down waterclosets. The pipes become choked, the gases evolved force their way into the houses, fluids refuse to flow, the streets must be opened, and filth of new and yet tincommon stenches be placed under the public nose. Similar sewers in Croydon, a place not naturally unhealthy, injured the general health so much that typhoid fever, accidentally introduced, gave rise to a serious epidemic; and the same occurred with cholera at Sandgate. 2ndly. The traps of house drains are only of use on the sup. position that pressure is prevented by free communication of the air in the drain with the external air. So well is this known to practical men, that where the drains of a house are trapped with several inches of water near their entrance to the sewer, they are in the habit of making a communication with the rain-water pipes to give air, or otherwise every rush of water into the drain, or even a fall of the barometer-i. e., diminished atmospheric pressure-would cause the gas to bubble through the traps into the house. From this, it necessarily follows that only ventilated sewers can be trapped. I recapitulate the argument briefly thus :If the "excreta sewers" be small and unventilated, they will be constantly obstructed, and cannot be trapped; if they be large and ventilated, the orifices will be tenfold worse than the existing gully-holes. These difficulties I have no wish to represent as insuperable, but the real friends of progress will not slur them over, but fairly grapple with them. I am, Sir, your obeeient servant, J. MORRIS, F. R. C. S. MORRIS, M.D., Park-street, Grosvenor-square, M. D., F.R.C.S. December, 1856.
my former college chum, then in fair country practice. He fell ill during my visit. For a day or two I looked after a few of his patients (and the medical day there includes the whole twenty-four hours). Let those who complain of our service take up the practice of their friend—the country doctor-at home, for a few winter days, and they may, like me, learn to appreciate the East India Company’s service more correctly. Campaigns are light and pleasant compared to country practice. Expertus dico. One cause of such complainings is, that many look upon home under the aspect it presented to us in the heyday of our free youth, when we had a certain command of the paternal money, with every disposition to spend it. I myself had a longer enjoyment of untrammelled life, in many lands and cities, and with more indulgence accorded to my caprice, than may fall to the lot of the majority; but that Europe is not the one I must look to as having been my possible alternative fate, had I not come to India. I should more truly look for it in the home of the jaded practitioner, with ceaseless toil and many humiliations earning a scanty livelihood amongst numerous rivals. No doubt there are at home some-a very fewinvestigators of science as the handmaid of medicine, or direct practitioners of the art, who early win a merited fame or fortune, or both, by force of their genius and diligence-their love of knowledge, and sympathy with suffering humanity; and such a career I hold to be the most truly noble that man To such men as Marshall Hall, Simpson, Syme, can aspire to. and Dieffenbach, mankind will ever be indebted. But how few may win such laurels! The proportion is so small as to be equivalent practically to none. It may appear strange to have undertaken, at such length, the defence of a service, whose advantages may be considered so well known as to render it a matter of little moment whether it be defended or not; but a dislike of what I conceive to be misrepresentation, (though, I haveno doubt, made in good faith,) and perhaps some esprit de co ps have induced me thus to advert to attacks which, I am sorry to see, have been made by some of our own number. I am Sir, your obedient servant, " A WEARY EXILE, BUT NOT "ONE ONE India, extra Gangem,
September, 1856.
OF THE
DELUDED."
THE TOBACCO QUESTION.—IS SMOKING INJURIOUS? To the Editor
.
of THE LANCET-.
from the note-book or diary of eminent physician in the north of England, will interest your readers:"In 1848 I met with one of the very worst forms of typhus fever, accompanied with a cleft and ulcerated tongue, together with black and bloody urine, which was clearly traceable to my patient indulging (?) in a couple of cigars (he not being an habitual smoker) given him by a captain of a foreign vessel." This tobacco controversy may-I sincerely trust it willlead to directors of Insurance Companies taking the precaution of inq uiring from the party proposing an insurance, or through his agents and medical referees, -if he is an habitual or inveterate smoker ? Mr. Solly distinctly states that he can always tell such characters by their complexion and their fauces !! With such evidence, there can be no doubt of its effects. I am. am, Sir, your obedient servant, J. J. B. NEIL. January, 1857.
Sir,—The following extract,
an
LONDON
DRAINAGE.
To the Editor of THE LANCET. Sir.,-The subject of metropolitan drainage is, I think, very properly discussed by the medical press, and it is pleasing to find that it is occupying the attention of so powerful a mind as that of Dr. Marshall Hall. No one who is at all conversant with animal and vegetable chemistry and physiology can refuse to admit that it is most desirable that "all the rainfall should go to the river, and all the sewage to the soil;" but in striving to attain this, we must be careful that no elements of prime importance are omitted from our reasonings, or the most disheartening failure may be the result. I fear that such omissions enter into the basis of Dr. Marshall Hall’s plan-namely, the formation of " excreta sewers" as distinct from the rain conduits. The irresistible force of gases evolved from decomposing matters is not sufficiently recognised, even in quarters where we should most expect it to be so. Only last summer, the remains of a young relative of a distinguished London physician were carried a long distance by railway, and safely deposited with his friends, to await the funeral. The undertakers had not perforated the coffin, as they usually do. In the night, it exploded with a considerable report and an overpowering stench. This lead-coffin fallacy, which you, Mr. Editor, have often powerfully exposed in your journal, enters into the plan of the " excreta sewers," as I trust, with your permission, to show. The contents of the present sewers are of course far more diluted than those of the contemplated " excreta sewers" could possibly be, and "flushing" in dry weather is a further means of purification ; yet the necessity of ventilation is constantly felt; hence, not many years ago, gratings were inserted in large numhers, by which the air enters, and the noxious gases escape; and where these precautions are not taken, such catastrophes
50
injurious ’
POOR-LAW MEDICAL REFORM. To the Editor of THE LANCET.
SIR,—It is a customary saying, as well in the profession as it, that the salaries of the Union Surgeons will not bg
out of
long as men can be found willing to take the appointprice. My object in writing this letter is to furnish an answer that may be promptly returned to this remark. It is this,-that if the Government were to advertise the appointments in the civil service, and were to fix the salaries at a trifling amount, there would be, nevertheless, raised
so
ments at any
candidates. If the various classes of Society were placed in similar cirone class would be found cumstances, it is probable that only to advocate the principle of the " strike," and this would be the class of artisans; but even this class is discovering that numerous
*" strikes" are essentially injurious to a community. A strike, in its full meaning, includes refusal to commence work, as well as cessation of labour. The -medical profession abjures the ’’ principle of the " strike." There is little doubt but that be would Union supplied with medical officers even if every the appointments were absolutely unsalaried; yet educated men expect proper treatment and fair salaries from the public bodies that require their services. The Government employées receive remuneration, whilst the Poor-law medical officers are treated with injustice and indignity. There is but one remedy applicable to the case. This consists in an appeal to Parliament by the whole profession. Let Let us do for the Poor-law us all come forward as one man, medical officers that which was done for the naval assistantsurgeons. All the colleges petitioned Parliament, and the civil practitioners throughout the United Kingdom did the The medical students associated themselves for the pursame.
good policy to publish those grievances again rupture a wound that had almost or
LONDON STUDENTS AND THE SCOTCH UNIVERSITIES.
SCOTLAND. (FROM
OUR EDINBURGH
CORRESPONDENT.)
A YOUXG man once said to Dr. Johnson, "Sir, I intend to set up for a critic." " Then," said the doctor, " I advise you to set down again." This Johnsonian advice, short, quaint, but emphatic, is unhappily appropriate to several Edinburgh médicates of the present day. Not satisfied with quietly abiding by a rejection received at the hands of their fellowbrethren, some impelled by an insatiate desire would rush yet deeper into a mire, formed by themselves. This is unfortunate, as it is ill-timed. Edinburgh is already famous for its medical cabals, for the combativeness displayed in scientific controversies to a greater or less extent. If at the hand of an overwhelming majority any rejected candidates from the late election for the Council of the College of Physicians should feel aggrieved, it is certainly neither in accordance with good taste
world, and "
Every
author,’’ says Goethe, " pourtrays himself in his writings," and precisely the same maxim applies to men in their actions. Those who cannot calmly and complacently bear a check to their own wishes, but must needlessly endeavour to resent it, are more apt to hurt their position and lower their status than those whose better sense enables them to take warning at the result, and to quietly deliberate upon a better means for obtaining a successful issue at a future time. Whatever indiscretion may be said or committed at an election should be regarded not as an error, but as a mere lapsus linguce engendered by a contest. To attempt a retaliation upon a large body, by retorting and aiming resentment at one or more individuals only, is not only malicious, but extremely little. That any such result may accrue from the late election for the Council of the Royal College of Physicians is unlikely, if cooler judgment is allowed to intervene, and the "vexed subject" quietly and impartially to be examined before being involved in the broils and meshes of a court of law. It is only justice to the public as well as the profession that any difficulty, when it arises in connexion with science, should be thoroughly sifted and explained; the more openly the better: but when merely private pique and personal feelings are involved, then it is better taste, and more in unison with proper feeling, to avoid publicity in the matter. But this is only assuming a causa belli really to exist, a real practical pretext to be found. If, on the other hand, there is nothing of the kind, and the merest and most trivial occurrence should be found the alleged cause of grievance, then the result is not only probable to be ludicrous, but also mortifying to the aggrieved ones. Some juries. (even Scotch ones) have a stubborn sense of justice; and when they find no substantial cause to exist for them to determine the merits, but in its place the flimsiest pretext on which a. charge is based, not only is the " case" generally dismissed, but an expression of feeling made calculated to wound the tender natures of those who may have cherished the littlebantling. It is indeed seriously to be hoped that nothing may arise calculated to promote disunion and disruption amongst the medical circles of Edinburgh; a spark will kindle a flame, and one skirmish may lead to more ; and gratifying, doubtless, as this display would be to the gentlemen of the legal profession, and those generally who regard it as an accurate maxim, that "doctors never agree,"yet to the great number those who sympathise with truth, justice, and unanimity of opinion, any such a display at this present time cannot only be regarded as unworthy, but also as uncalled for and irreverent. The second conversazione of the Royal College of Surgeons for this season took place on the 9th inst, when Prof. George Wilson delivered a lecture on " Phosphorus and Nitrogen as Elements of Plants and Animals."
pose of seeing justice done to the junior members of the profession serving in the Royal Navy. All this was done for the direct interest of a few hundreds of assistant-surgeons (omitting the consideration of the importance of the subject to the profession and the public at large.) Shall 3000 surgeons be permitted to groan under a burden that is intolerable, whilst we stand by and join the crowd in saying, "Let them alone : why do they take the Union appointments ?" I am, Sir, your obedient servant, FRED. FRED. J. J. BROWN, M.D. 1VI.D. Chatham, Dec. 1856.
To the Editor of THE LANCET. THE LANCET of the 3rd instant, there is a letter SIR,—In signed "R. Macleod." He says there are but few London students who take the degree of M.D. at Edinburgh or Glasgow, but most go to St. Andrew’s. He does not state the reason, which, perhaps, I can best illustrate by stating my own case. I was a student in the University of Edinburgh during the session 1843 and 1844, and desired to be admitted to examination for the degree of M.D., but was informed by the Dean of the Faculty that my London lectures would count for only one session, and that if I desired to graduate in Edinburgh, I must complete three years in that, or some other university. Having already passed the London College of Surgeons and Apothecaries’ Hall, I did not desire to continue two years more as a student, and desiring the degree of M.D., took it at St. Andrew’s. I can assure Mr. Macleod that many London students, who would not disgrace the University of Edinburgh, are prevented presenting themselves for examination there solely by the length of residence required in the University. And it seems somewhat absurd that the students of King’s College and University College, in London, should be admitted for examination with one year’s residence in Edinburgh, whilst those from the large schools of St. Bartholomew’s and Guy’s should be required to reside three years. I happen to know something of the Guy’s men who have taken the St. Andrew’s degree, and I also knew many Edinburgh graduates during my residence there, and I must say the Guy’s men were the most practical, and in every other respect equal to the graduates with whom I was acquainted. I am, Sir, your obedient servant, ANDREW’S. M. D., ST. ANDREW’S. M.D., January, 1857.
to the
healed.
I
Obituary. DR. ANDREW URE, F.R.S. Tms distinguished chemical philosopher was born at Glasgow,. in the year 1778. He studied at the University there,* and subsequently at that of Edinburgh; and took his degree of doctor of medicine, in 1801, at Glasgow. In the following year he was appointed Andersonian professor of chemistry and natural philosophy in the university of that name in Glasgow, and there he also gave systematic courses of lectures on materia medica. In the year 1809, he went on a mission to London preparatory to establishing the Observatory in his native city. He there met and acquired the friendship of Maskelyne, Pond, Groombridge, and other astronomers, as well as of Davy, Wollaston, Henry, and the other distinguished chemists of that period. He resided for some years in the Observatory, then second only to that of Greenwich, devoting part of his time to astronomical science, and was there visited on friendly terms by the celebrated Sir W. Herschel. In the year 1813, he published " A Systematic Table of the Materia Medica,’’ with In a preliminary dissertation on the Operation of Medicines. 1818 appeared an interesting memoir, entitled "New Experimental Researches on some of the leading Doctrines of Caloric, particularly on the Relation between the Elasticitv, Temperature, and Latent Heat of different Vapours, and on Thermometric Admeasurement and Capacity." The conclusions offered ’
*
While a student in the anatomy on Hernia.
class,
Essay
51
he carried off the
prize for
an