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THE INDIAN MEDICAL SERVICE.
320 of Chester, is almost the only one of the ex-officio members of the Committee of Council who, on questions between the corporations and the profession, wisely and generously takes part with the latter. His colleagues, as in the memorable session of the General Medical - Council in 1867, sit opposite. I am. Sir, vour obedient serva,nt. SAMPSON GAMGEE, F.R.S. (Edin)., Surgeon to the Queen’s Hospital, Birmingham. August, 1869.
profession. Dr. Waters,
THE LONDON WATER-SUPPLY. To the Editor of THE LANCET. SIR,-The complaints made by the St. Olave’s district, Southwark, of the water supplied by the Southwark and
Vauxhall Company have at length received attention. On the 17th inst. a deputation had a lengthened interview with Captain Tyler, of the Board of T-uacle, at which Mr. Quick, jun., engineer to the Company, was present, when the causes of complaint-viz., the turbidity of the water, and MR. NUNNELEY AND THE ANTISEPTIC the possibility of its being taken from the Thames at BatTREATMENT. tersea, were investigated. The cause of the turbidity of the To the Editor of THE LANCET. water during so many months was acknowledged to arise SiB,—Mr. Nunneley’s recent attack (see THE LANCET of from the subsidence reservoirs and the filtering beds not August 14th) seems to me little calculated to impede the being of sufficient capacity to properly purify the water before delivering it for consumption. This is now in course progress of the antiseptic treatment; nor do I feel called of being remedied by the Company constructing additional upon to point out in how many respects he has misappre- reservoirs and filtering beds, so as to allow in future of all hended my published views. That he should dogmatically the water undergoing proper subsidence and filtration ; but oppose a treatment which he so little understands, and as it will be the close of the presentyear before these which by his own admission he has never tried, is a matterworks are in operation, the district may again, until then, of small moment. But I was grieved to find him statingbe supplied with turbid water, especially after heavy rains. that his colleagues who had once adopted the system were With regard to the culvert from the river at Battersea to now abandoning it as untrustworthy. It was therefore withthe reservoirs, Captain Tyler considered its existence so much pleasure that I received a very different account of’ evidently calculated to be dangerous, that he should at the matter from Mr. Teale, in a letter which, with his per- once order it to be stopped in such a manner as will prevent mission, I now request you to publish. even a suspicion of any water being ever again taken T a-m qir vmiT r)1ifr!iM!t servant. from that source. JOSEPH LISTER. T a.m. Sir your obedient servant Glasgow, Aug. 24th, 1869. J. NORTHCOTE VINEN, M.D., 1869. 20, Park-row, Leeds, Aug. lith, Medical Officer of Health, St. Olave’s District, Southwark. M? DEAR Sin,— May I call your attention to the attack August 25th, 1869 upon "antiseptic treatment" in 21r. Nunneley’s surgical address in which he quotes the experience of his colleagues EFFECTS OF VACCINATION. as unfavourable to it. I think it due to yourself to inform you that Mr. Nunneley To the Editor of THE LANCET. was in no sense justified in making such a statement; that SIR,-As we are clearly in for a, flood of exaggerated nonwe still use, and have as much confidence as ever in, antisense and prejudice on the subject of the consequences of and that we in or some septic treatment; hope shortly, way vaccination, let me inform you of a case in point-that of a other, to have Mr. Nunneley’s misstatement corrected. child from whose face I removed two sebaceous cysts the in want of success our be attripractice may fairly Any other day, which its mother remarked came on after vaccibuted to imDerf action in ca.rrvino’ out vour rules. I am. Sir. vour obedient servant. nation ! Yours truly-V JAMES GREY GLOVER, M.D. Prof. Lister. T. PRIDGIN TEALE. Compton-terrace, N., August 20th, 1869. To the Editor of THE LANCET. ’
-
THE INDIAN MEDICAL SERVICE.
SIR,-I have read with pleasure the very able protest
lately laid
before the profession by Mr. Nunneley, against To the Editor of THE LANCET. the fallacious inferences which have been drawn regarding SIR,-I beg you will kindly afford the aid of your powerful the effects or carbolic acid in surgical cases; inferences in the interests of justice to the Indian Medical in are calculated to and which journal mislead, which, my opinion, ought to be withstood by those who have given this remedy Service, which is fast being deprived, not only of its anything like a trial. It has been said to succeed in Glas- privileges, but its rights. gow, and to fail in London and elsewhere; but after a comOur staff allowances, guaranteed by Mr. Henley’sclause parative trial, most impartially conducted, in the wards of in the Act of Parliament transferring India,to the Queen, the Glasgow Royal Infirmary, I am in a position to state that it does not succeed in Glasgow any better than in Lon- have been taken from us. The majority of our appointdon ; or, to take the same ground as Mr. Nunneley, that as ments, civil and military, are paid at a lower rate than the great-or greater-success, in severe surgical cases, is at- pay of our rank, laid down in the Secretary of State’s detained in those cases treated without carbolic, as in those spatch of May, 1864. More than one-third of our adminitreated with it. strative appointments have been abolished. But having Every surgeon knows that very much depends upon skill and care in dressing, and this has lately been most forcibly suffered these, and other injustice with almost assinine illustrated by the unrivalled success of Dr. Thomas Keith patience, the last straw is now applied to our bending backs; in ovariotomy; and it appears to be a grievous error not to the last kick administered to our metaphorical dog. And in attribute success to this, but rather to a dilution in oil or this wise. The benefits permitted by the Furlough Rules water of an odorous antiseptic. Young medical men, and of 1868 are withdrawn from medical officers thus :the public generally, are being taught to regard this acid Paragraph 2 of the new Furlough Rules states that as a panacea. At present I will not say anything of the theory upon "leave taken under the new rules will not involve forfeiture which it has been attempted to found this practice. My of appointment." Paragraph5 states, "An officer proceeding on furlough object now is to give what support I can to Mr. Nunneley’s will be allowed pay at the rate of 50 per cent. of thesalary position; and at an early date some cases may be given of his substantive office." which have a bearing on this very important subject. Paragraph 13 reads, "Officers of the Indian military and Those who mount a hobby generally allow it to carry them medical service will be required to notify their intention to too far. accept these rules on the first occasion of taking furlough." With every wish to arrive at the truth, Thus it is evident the rules were intended to apply to both I am, Sir, your obedient servant. military and medical officers. JAMES MORTON, M.D., Now mark the action of the Government six months after: Lately Surgeon to the Glasgowt Athole-place, Bath-street, Glasgow, " Under a recent decision of the Government of India, it 1869. Royal 23rd, Infirmary. August .
’
321 spring quarter returns with other localities differently circumstanced. Had I taken as the basis ofmy computation the deaths in Torquay registered between January Ist, referred to], and consequently medical officers holding such 1868, and January 1st, 1869, the result would show still charges have no claim to any portion of the allowance more favourably. The deaths during the above period attached thereto when absent on furlough in Europe, nor amounted to 345, or to about 16.50 per 1000, including all any lien on the appointment after departure from India."- imported cases, and this, let me remark, during a period ! when reports were industriously spread as to our bad saniExtract from Govemment Gazette, Feb. 4th, 1868. condition. And in another six months medical officers in civil employ I nm. Sir. vonr obedient servant. are treated in a similar manner. Resolution of Government I SPENCER THOMSON, M.D. No. 660 of 1869, dated 17th of June, states-" The GovernorAshton, Torquay, August 24th, 1869, General in Council is of opinion that a medical officer in charge of a civil station should, when proceeding on furlough’, retain a lien on some similar appointment. He THE LONDON DIALECTICAL SOCIETY. should not as a general rule have any claim to re-appointment to the same station." To the Editor of THE LANCET. Now this practically places civil medical officers in the SIR,--With reference to the allegations concerning the same position as those in military employ. They have no claim to their appointment ; and hence, as the Financial London Dialectical Society, contained in your report of Dr. Department rule, no lien on the 50 per cent. of pay. The Beatty’s address at Leeds, I am directed by the Council of transparent manner in which the harshness and injustice of that Society to state that the whole of those allegations are this last order is sought to be veiled, by saying the medical officer may retain a lien on some similar appointment, only The Society does not advocate Malthusianism or antirenders the treatment more disgraceful. A medical officer or any other view or theory of any kind; Malthusianism, not permitted to return to his appointment after furlough and utmost freedom of debate is the fundathe wait falls have to months before another vacant. Also although may his prospects are altogether injuriously affected by this mental principle of its constitution, no member or visitor withdrawal of the right of return. When he now goes has ever mentioned, except to reprobate, the odious prachome, he must sell his house, furniture, and everything at tices for the carrying out of which it has been stated that an "alarming sacrifice," and purchase again at a fresh the has Society sought the co-operation of the medical prostation when he returns-a necessity not thrust upon any Neither has any book whatever, at any time, been fession. other officer in the Indian services. All but surgeons retain their appointments when home published under the auspices of the Society. Medical on furlough, and draw 50 per cent. of their pay. of the Society (a copy of I enclose a prospectus, &c., officers are not permitted to do so-a piece of injustice which I shall be happy to forward to any of your readers without parallel. making application for the same), from which it will be seen I arm, Sir, your obedient servant, that the following propositions are the basis of its constiAN INDIAN OFFICER. tution. July, 1869. That Truth is of all things the most to be desired, and is best elicited by the conflict of opposing opinions. HEALTH OF THE TORQUAY. That the Society should afford a field for the philoTo the Editor of THE LANCET. sophical oonsideration of all questions without reserve, but of those comprised in the domain of ethics, SIR,-In the Pall Mall Gazette for July 31st, 1869, there especially and theology. metaphysics, a in table of the death-rate is published, with remarks, That it should be unsectarian in the widest possible various "English watering-places." In that table Torquay sense, and allow the most absolute freedom of debate, no is put down as having a death-rate of 19’49 per 1000 for the subject whatever being excluded from consideration except the ground of its triviality. spring quarter of the present year, in contra-distinction to onThe following remarks by Professor Bain may be con16’98 per 1000, the average for the ten years 1851-60. As sidered to embody the leading principle of the Society, and these figures would seem to indicate a decrease in the health show the origin of the title :and life averages of this place, and also to contrast unThe essence of the dialectic method is to place side by favourably with those of some other health resorts, I think side, with every doctrine and its reasons, all opposing docit right to point out one or two sources of fallacy. One of trines and their reasons, allowing these to be stated in full these is, as remarked in the Pall Mall Gazette, that whereas by the persons holding them. No doctrine is to be held as far less proved, unless it stands in parallel array in some places the figures are taken solely from town dis- expounded, to every other counter theory, with all that can be said for tricts, in others they include a considerable extent of ham- each. For a short time this system was actually maintained let and village area, as in the case of Llandudno, and of and but the execution of Socrates gave it its the Isle of Wight. In Torquay the returns are taken from first practised; check, and the natural intolerance of mankind rendered the parish of Tormohun, almost solely a town area. Of this its continuance impossible. Since the Reformation struggles parish the population, which has very rapidly increased have been made to regain for the discussion of questions since last census, is, at the lowest computation, 21,000.* I generally-philosophical, political, moral, and religious-the have been furnished with a copy of the local registrar’s two-sided procedure of the law courts, and perhaps never return, not only of the number of deaths, but of the causes morestrenuously than now." of death in the above parish, from March 24th, 1868, to T a.m. Sir your obedient servant. March 24th, 1869. The number is 373, giving a death-rate D. H. DYTE, Hon. Sec. of not quite 18 per 1000. But of these 373deaths, 48 are George-street, Hanover-square, Aug. 23rd, 1869. registered as due to pulmonary consumption, the average With few exceptions, age at death being thirty years. THE DEATH-RATE OF WORTHING. these deaths from phthisis are due to invalids who have come to Torquay in the hopeless stage of the disease, and To the Editor of THE LANCET. the number may be taken as superadded to the ordinary SIR,—As the table issued by the Registrar-General in his death-rate of the town; but if some few be indigenous, as people are sent to Torquay for other diseases besides con- last Quarterly Report might lead one to consider the deathsumption, and die of other diseases, we shall not go far rate of 20 per 1000 living to apply to Worthing alone... wrong in deducting 48 deaths as superadded, which would, might I ask of you to place the following facts before the as nearly as possible, give a rate of 16 per 1000. Moreover, public. as a large proportion of the deaths from phthisis occur in The "district of Worthing" comprises the towns of the spring months, another element of fallacy is introduced when the death-rate of Torquay is compared as to the Worthing, Littlehampton, and Arundel, together with the has been ruled that regimental medical charges are not considered appointments in the sense of Clauses 2-10 of G.G.O., No. 1064 of 1868 [the new Furlough Rules above
tary
entirely untrue.
*
This upon
authority.
intermediate
villages, extending
over a
space of 42,457
profession. Dr. Waters,
THE LONDON WATER-SUPPLY. To the Editor of THE LANCET. SIR,-The complaints made by the St. Olave’s district, Southwark, of the water supplied by the Southwark and
Vauxhall Company have at length received attention. On the 17th inst. a deputation had a lengthened interview with Captain Tyler, of the Board of T-uacle, at which Mr. Quick, jun., engineer to the Company, was present, when the causes of complaint-viz., the turbidity of the water, and MR. NUNNELEY AND THE ANTISEPTIC the possibility of its being taken from the Thames at BatTREATMENT. tersea, were investigated. The cause of the turbidity of the To the Editor of THE LANCET. water during so many months was acknowledged to arise SiB,—Mr. Nunneley’s recent attack (see THE LANCET of from the subsidence reservoirs and the filtering beds not August 14th) seems to me little calculated to impede the being of sufficient capacity to properly purify the water before delivering it for consumption. This is now in course progress of the antiseptic treatment; nor do I feel called of being remedied by the Company constructing additional upon to point out in how many respects he has misappre- reservoirs and filtering beds, so as to allow in future of all hended my published views. That he should dogmatically the water undergoing proper subsidence and filtration ; but oppose a treatment which he so little understands, and as it will be the close of the presentyear before these which by his own admission he has never tried, is a matterworks are in operation, the district may again, until then, of small moment. But I was grieved to find him statingbe supplied with turbid water, especially after heavy rains. that his colleagues who had once adopted the system were With regard to the culvert from the river at Battersea to now abandoning it as untrustworthy. It was therefore withthe reservoirs, Captain Tyler considered its existence so much pleasure that I received a very different account of’ evidently calculated to be dangerous, that he should at the matter from Mr. Teale, in a letter which, with his per- once order it to be stopped in such a manner as will prevent mission, I now request you to publish. even a suspicion of any water being ever again taken T a-m qir vmiT r)1ifr!iM!t servant. from that source. JOSEPH LISTER. T a.m. Sir your obedient servant Glasgow, Aug. 24th, 1869. J. NORTHCOTE VINEN, M.D., 1869. 20, Park-row, Leeds, Aug. lith, Medical Officer of Health, St. Olave’s District, Southwark. M? DEAR Sin,— May I call your attention to the attack August 25th, 1869 upon "antiseptic treatment" in 21r. Nunneley’s surgical address in which he quotes the experience of his colleagues EFFECTS OF VACCINATION. as unfavourable to it. I think it due to yourself to inform you that Mr. Nunneley To the Editor of THE LANCET. was in no sense justified in making such a statement; that SIR,-As we are clearly in for a, flood of exaggerated nonwe still use, and have as much confidence as ever in, antisense and prejudice on the subject of the consequences of and that we in or some septic treatment; hope shortly, way vaccination, let me inform you of a case in point-that of a other, to have Mr. Nunneley’s misstatement corrected. child from whose face I removed two sebaceous cysts the in want of success our be attripractice may fairly Any other day, which its mother remarked came on after vaccibuted to imDerf action in ca.rrvino’ out vour rules. I am. Sir. vour obedient servant. nation ! Yours truly-V JAMES GREY GLOVER, M.D. Prof. Lister. T. PRIDGIN TEALE. Compton-terrace, N., August 20th, 1869. To the Editor of THE LANCET. ’
-
THE INDIAN MEDICAL SERVICE.
SIR,-I have read with pleasure the very able protest
lately laid
before the profession by Mr. Nunneley, against To the Editor of THE LANCET. the fallacious inferences which have been drawn regarding SIR,-I beg you will kindly afford the aid of your powerful the effects or carbolic acid in surgical cases; inferences in the interests of justice to the Indian Medical in are calculated to and which journal mislead, which, my opinion, ought to be withstood by those who have given this remedy Service, which is fast being deprived, not only of its anything like a trial. It has been said to succeed in Glas- privileges, but its rights. gow, and to fail in London and elsewhere; but after a comOur staff allowances, guaranteed by Mr. Henley’sclause parative trial, most impartially conducted, in the wards of in the Act of Parliament transferring India,to the Queen, the Glasgow Royal Infirmary, I am in a position to state that it does not succeed in Glasgow any better than in Lon- have been taken from us. The majority of our appointdon ; or, to take the same ground as Mr. Nunneley, that as ments, civil and military, are paid at a lower rate than the great-or greater-success, in severe surgical cases, is at- pay of our rank, laid down in the Secretary of State’s detained in those cases treated without carbolic, as in those spatch of May, 1864. More than one-third of our adminitreated with it. strative appointments have been abolished. But having Every surgeon knows that very much depends upon skill and care in dressing, and this has lately been most forcibly suffered these, and other injustice with almost assinine illustrated by the unrivalled success of Dr. Thomas Keith patience, the last straw is now applied to our bending backs; in ovariotomy; and it appears to be a grievous error not to the last kick administered to our metaphorical dog. And in attribute success to this, but rather to a dilution in oil or this wise. The benefits permitted by the Furlough Rules water of an odorous antiseptic. Young medical men, and of 1868 are withdrawn from medical officers thus :the public generally, are being taught to regard this acid Paragraph 2 of the new Furlough Rules states that as a panacea. At present I will not say anything of the theory upon "leave taken under the new rules will not involve forfeiture which it has been attempted to found this practice. My of appointment." Paragraph5 states, "An officer proceeding on furlough object now is to give what support I can to Mr. Nunneley’s will be allowed pay at the rate of 50 per cent. of thesalary position; and at an early date some cases may be given of his substantive office." which have a bearing on this very important subject. Paragraph 13 reads, "Officers of the Indian military and Those who mount a hobby generally allow it to carry them medical service will be required to notify their intention to too far. accept these rules on the first occasion of taking furlough." With every wish to arrive at the truth, Thus it is evident the rules were intended to apply to both I am, Sir, your obedient servant. military and medical officers. JAMES MORTON, M.D., Now mark the action of the Government six months after: Lately Surgeon to the Glasgowt Athole-place, Bath-street, Glasgow, " Under a recent decision of the Government of India, it 1869. Royal 23rd, Infirmary. August .
’
321 spring quarter returns with other localities differently circumstanced. Had I taken as the basis ofmy computation the deaths in Torquay registered between January Ist, referred to], and consequently medical officers holding such 1868, and January 1st, 1869, the result would show still charges have no claim to any portion of the allowance more favourably. The deaths during the above period attached thereto when absent on furlough in Europe, nor amounted to 345, or to about 16.50 per 1000, including all any lien on the appointment after departure from India."- imported cases, and this, let me remark, during a period ! when reports were industriously spread as to our bad saniExtract from Govemment Gazette, Feb. 4th, 1868. condition. And in another six months medical officers in civil employ I nm. Sir. vonr obedient servant. are treated in a similar manner. Resolution of Government I SPENCER THOMSON, M.D. No. 660 of 1869, dated 17th of June, states-" The GovernorAshton, Torquay, August 24th, 1869, General in Council is of opinion that a medical officer in charge of a civil station should, when proceeding on furlough’, retain a lien on some similar appointment. He THE LONDON DIALECTICAL SOCIETY. should not as a general rule have any claim to re-appointment to the same station." To the Editor of THE LANCET. Now this practically places civil medical officers in the SIR,--With reference to the allegations concerning the same position as those in military employ. They have no claim to their appointment ; and hence, as the Financial London Dialectical Society, contained in your report of Dr. Department rule, no lien on the 50 per cent. of pay. The Beatty’s address at Leeds, I am directed by the Council of transparent manner in which the harshness and injustice of that Society to state that the whole of those allegations are this last order is sought to be veiled, by saying the medical officer may retain a lien on some similar appointment, only The Society does not advocate Malthusianism or antirenders the treatment more disgraceful. A medical officer or any other view or theory of any kind; Malthusianism, not permitted to return to his appointment after furlough and utmost freedom of debate is the fundathe wait falls have to months before another vacant. Also although may his prospects are altogether injuriously affected by this mental principle of its constitution, no member or visitor withdrawal of the right of return. When he now goes has ever mentioned, except to reprobate, the odious prachome, he must sell his house, furniture, and everything at tices for the carrying out of which it has been stated that an "alarming sacrifice," and purchase again at a fresh the has Society sought the co-operation of the medical prostation when he returns-a necessity not thrust upon any Neither has any book whatever, at any time, been fession. other officer in the Indian services. All but surgeons retain their appointments when home published under the auspices of the Society. Medical on furlough, and draw 50 per cent. of their pay. of the Society (a copy of I enclose a prospectus, &c., officers are not permitted to do so-a piece of injustice which I shall be happy to forward to any of your readers without parallel. making application for the same), from which it will be seen I arm, Sir, your obedient servant, that the following propositions are the basis of its constiAN INDIAN OFFICER. tution. July, 1869. That Truth is of all things the most to be desired, and is best elicited by the conflict of opposing opinions. HEALTH OF THE TORQUAY. That the Society should afford a field for the philoTo the Editor of THE LANCET. sophical oonsideration of all questions without reserve, but of those comprised in the domain of ethics, SIR,-In the Pall Mall Gazette for July 31st, 1869, there especially and theology. metaphysics, a in table of the death-rate is published, with remarks, That it should be unsectarian in the widest possible various "English watering-places." In that table Torquay sense, and allow the most absolute freedom of debate, no is put down as having a death-rate of 19’49 per 1000 for the subject whatever being excluded from consideration except the ground of its triviality. spring quarter of the present year, in contra-distinction to onThe following remarks by Professor Bain may be con16’98 per 1000, the average for the ten years 1851-60. As sidered to embody the leading principle of the Society, and these figures would seem to indicate a decrease in the health show the origin of the title :and life averages of this place, and also to contrast unThe essence of the dialectic method is to place side by favourably with those of some other health resorts, I think side, with every doctrine and its reasons, all opposing docit right to point out one or two sources of fallacy. One of trines and their reasons, allowing these to be stated in full these is, as remarked in the Pall Mall Gazette, that whereas by the persons holding them. No doctrine is to be held as far less proved, unless it stands in parallel array in some places the figures are taken solely from town dis- expounded, to every other counter theory, with all that can be said for tricts, in others they include a considerable extent of ham- each. For a short time this system was actually maintained let and village area, as in the case of Llandudno, and of and but the execution of Socrates gave it its the Isle of Wight. In Torquay the returns are taken from first practised; check, and the natural intolerance of mankind rendered the parish of Tormohun, almost solely a town area. Of this its continuance impossible. Since the Reformation struggles parish the population, which has very rapidly increased have been made to regain for the discussion of questions since last census, is, at the lowest computation, 21,000.* I generally-philosophical, political, moral, and religious-the have been furnished with a copy of the local registrar’s two-sided procedure of the law courts, and perhaps never return, not only of the number of deaths, but of the causes morestrenuously than now." of death in the above parish, from March 24th, 1868, to T a.m. Sir your obedient servant. March 24th, 1869. The number is 373, giving a death-rate D. H. DYTE, Hon. Sec. of not quite 18 per 1000. But of these 373deaths, 48 are George-street, Hanover-square, Aug. 23rd, 1869. registered as due to pulmonary consumption, the average With few exceptions, age at death being thirty years. THE DEATH-RATE OF WORTHING. these deaths from phthisis are due to invalids who have come to Torquay in the hopeless stage of the disease, and To the Editor of THE LANCET. the number may be taken as superadded to the ordinary SIR,—As the table issued by the Registrar-General in his death-rate of the town; but if some few be indigenous, as people are sent to Torquay for other diseases besides con- last Quarterly Report might lead one to consider the deathsumption, and die of other diseases, we shall not go far rate of 20 per 1000 living to apply to Worthing alone... wrong in deducting 48 deaths as superadded, which would, might I ask of you to place the following facts before the as nearly as possible, give a rate of 16 per 1000. Moreover, public. as a large proportion of the deaths from phthisis occur in The "district of Worthing" comprises the towns of the spring months, another element of fallacy is introduced when the death-rate of Torquay is compared as to the Worthing, Littlehampton, and Arundel, together with the has been ruled that regimental medical charges are not considered appointments in the sense of Clauses 2-10 of G.G.O., No. 1064 of 1868 [the new Furlough Rules above
tary
entirely untrue.
*
This upon
authority.
intermediate
villages, extending
over a
space of 42,457