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THE PROSPECTS OF MEDICAL REFORM.
19 mortality. Those, however, whom it spares are thrown, subsequently, on the industrious for support. They leave the hospital, to enter the workhouse or gaol. Such is the miserable shortsightedness of our legislation. We consider it better to support these blighted specimens of mankind, when unable to maintain themselves, than, by wise government and timely care, to save them from the miserable necessity of either supplicating our charity or outraging our laws. Yet, alas! these are their gloomy alternatives. Here we stop. But one bright page in the history of our
profession is connected with these dark records of human suffering. To their honour be it spoken, the medical men of England, Ireland, and Scotland, have ever been at their post; and although barely labourers’ wages have been allowed them in some cases, and in others no recompence has been accorded, they have never shrunk from vindicating their character for the loftiest and purest heroism. They have not regarded the rags and filth of the sufferers, but have acknowledged their humanity, at the risk, and too often at the loss, of life itself. Would that their conduct could receive more substantial reward than the humble, but fervent approbation of us and our contemporaries. With that, and the comfort of having done their duty, we fear they must for the present rest satisfied.
common
___________
for the signal failure, in so many cases, of all medicines as yet tried, and the two together would seem to indicate the intro. duction of medicines which can restore the natural secretion from the skin, by some other channel, into the system, and as. it is evident from many causes, that absorption from all parts of the body, except the intestines, is going on actively, thf application of medicines endermically appears to me to be the best mode of proceeding, and accordingly I should apply morphia so as to produce its sudorific effects, which Pereira states
are
exceedingly powerful. (" Materia Medica," z.
vol. ii. p. 1755.) In the two cases to which I have before alluded this treatment was successful. M. Malgaigne, of Paris, and Dr. Thomas, of New Orleans, both employed it, and the mere mention of their names will suffice to show that it is a rational method of treatment. As to the cause of cholera, I see no need of the theory (however elegant and scientific it may be) of Mr. Freeke, whose letter also appeared in your last volume; indeed, were I asked the cause of the disease, I should rather be inclined to say, that owing to some unknown atmospherical influence, the secretion from the skin is entirely checked, and accordingly Nature endeavours to counteract this violence offered to her laws through the medium of the intestines, which become deranged, and by an excessive reaction drain off from the system all the fluids which are so necessary for its existThat a check offered to the secretion from the skin isence. no unusual cause of more or less diarrhoea is a fact dwelt on considerably by Dr. Williams, in his work on the " Principles and Practice of Medicine;" and post-mortem appearances in the intestinal canal of those who have died of cholera seem to me to favour this view of the case. Other treatment, as external warmth, &c., is of course to be employed. I should, in conclusion, observe, that so far as I am concerned, the above is based entirely on theory, as I have not been in a position to submit the treatment to the test of ex-
Undercliff" of the Isle of Wight; its Climate, History, and Natural Productions. By GEO]ETGE A. MARTIN,1LD. London: Churchill. 1849. pp. 366. EVERYTHING connected with this celebrated locality is here described most fully, and with great care. The situation-the scenery-the history and antiquities-the climate, and all connected with it-its influence on the health of residents perience. If you are of opinion that these observations may in any and visitors-the natural history, including the zoology, tend to awaken a rational consideration of the cause degree and of the district-the botany geology, hydrology, cottages, and treatment of this important and fearfullv fatal disease; receive full notice, in- their insertion in villages, Ventnor, the town &c.,-all your valuable journal will oblige, cluding the most particular directions as to the localit,ies obedient servant, most suitable as residences for invalids of different classes,— A STUDENT. June, 1849. even the rides, walks, and drives which they are likely to find most useful and agreeable, are indicated. The tables of THE PROSPECTS OF MEDICAL REFORM. To the Editor of THE LANCET. meteorology, extending over a period of ten years, afford an opportunity to the medical practitioner of judging how far in the past week’s LANCET, of theannouncement Sitt,—The the climate is likely to suit his patient; whilst the descrip- abandonment of medical legislation by the ministry, will tions of the scenery, and the full account of the natural his- doubtless create quite a panic among an immense majority of For many years medical reform has been contory, which the author gives, cannot fail to prove of great the profession. before this session was declared. brought stantly interest, and the pursuit, thus encouraged, a source of healthful in THE LANCET " to be parliament,and the one for medical reform," when the amusement to the invalid resident or tourist. A great variety long-agitated question would be finally settled. The matter of information, collected with much labour, and so agreeably then seems to have fallen into atrophy and decay! How unplaced before the general and professional reader, speak highly satisfactory and disheartening such a result must be !1 No medical bill !-no reform ! How these declarations continue for the zeal and ability of the author. to vibrate on the ear! No wonder inactivity prevails, when every year each attempt at medical change proves unsuccessful and abortive! Our energies are prostrated by long-conENDERMIC TREATMENT OF CHOLERA. tinued blighted hopes. We may have defeated the cunning To the Editor QfTRE LANCET. and devising schemes for the specious head and home quarters; SiR,—Ihave for some time held an opinion on the treat- but all has now mouldered to the dust. We are to live on in, ment of cholera greatly differing from those commonly enter- strife. Rancorous jealousies are still to be rampant, and we. tained on the subject, and with which I would not now trouble are still to drag on an unhappy and miserable medical existyou, were it not that in perusing your journal of last week, I ence. If the College of Surgeons were now opportunely to come forfound, two cases reported, in which it had been successfully employed, and which will, I therefore hope, in some measure, ward, (after so prolonged and obdurate an opposition,) and exjustify an attempt to make the treatment more generally tend the olive branch,and confer honour on its members,taking the whole management of medical affairs and education withinknown. Dr. Skiers, in his pamphlet on cholera, states that when its walls, the rejoicingin the profession would be universal;, medicines, as calomel, &c., have been given internally, it has scarcely a dissentient voice would be found. May I ask, Sir, been fully ascertained that they may after death be found still when is the full justice to be done to that portion of the proin the alimentary canal, unchanged in quantity and quality, fession, promised so many months back, at the end of last. session ? Are restrictions to continue in full force ? Are such having been quite inert. More recently also, Dr. Garrod, in deducing conclusions a useful and intelligent class of men to be placed in such a from his remarks on the analyses of the blood in cholera, pub- position, and is such palpable wrong to be suffered ? I allude to, lished in the London Journal of Medicine, observes that medi- i the members of the various colleges of the United Kingdom cines given internally are almost useless. I fear our cause has been much injured, and well nigh deAgain, it is generally acknowledged by all practitioners, stroyed, by your indisposition and long absence from parliathat one great indication in the treatment of cholera is the ment, and such must be a source of much sorrow to the profesrestoration of the action of the skin, and this always accom- sion at large.-I have the honour to be, Sir, your most obedient servant, panies the first signs of the patient’s recovery. COLLEGIAN. The former of these observations will sufficiently accoun June, 1848. The "
Your
-
.
profession is connected with these dark records of human suffering. To their honour be it spoken, the medical men of England, Ireland, and Scotland, have ever been at their post; and although barely labourers’ wages have been allowed them in some cases, and in others no recompence has been accorded, they have never shrunk from vindicating their character for the loftiest and purest heroism. They have not regarded the rags and filth of the sufferers, but have acknowledged their humanity, at the risk, and too often at the loss, of life itself. Would that their conduct could receive more substantial reward than the humble, but fervent approbation of us and our contemporaries. With that, and the comfort of having done their duty, we fear they must for the present rest satisfied.
common
___________
for the signal failure, in so many cases, of all medicines as yet tried, and the two together would seem to indicate the intro. duction of medicines which can restore the natural secretion from the skin, by some other channel, into the system, and as. it is evident from many causes, that absorption from all parts of the body, except the intestines, is going on actively, thf application of medicines endermically appears to me to be the best mode of proceeding, and accordingly I should apply morphia so as to produce its sudorific effects, which Pereira states
are
exceedingly powerful. (" Materia Medica," z.
vol. ii. p. 1755.) In the two cases to which I have before alluded this treatment was successful. M. Malgaigne, of Paris, and Dr. Thomas, of New Orleans, both employed it, and the mere mention of their names will suffice to show that it is a rational method of treatment. As to the cause of cholera, I see no need of the theory (however elegant and scientific it may be) of Mr. Freeke, whose letter also appeared in your last volume; indeed, were I asked the cause of the disease, I should rather be inclined to say, that owing to some unknown atmospherical influence, the secretion from the skin is entirely checked, and accordingly Nature endeavours to counteract this violence offered to her laws through the medium of the intestines, which become deranged, and by an excessive reaction drain off from the system all the fluids which are so necessary for its existThat a check offered to the secretion from the skin isence. no unusual cause of more or less diarrhoea is a fact dwelt on considerably by Dr. Williams, in his work on the " Principles and Practice of Medicine;" and post-mortem appearances in the intestinal canal of those who have died of cholera seem to me to favour this view of the case. Other treatment, as external warmth, &c., is of course to be employed. I should, in conclusion, observe, that so far as I am concerned, the above is based entirely on theory, as I have not been in a position to submit the treatment to the test of ex-
Undercliff" of the Isle of Wight; its Climate, History, and Natural Productions. By GEO]ETGE A. MARTIN,1LD. London: Churchill. 1849. pp. 366. EVERYTHING connected with this celebrated locality is here described most fully, and with great care. The situation-the scenery-the history and antiquities-the climate, and all connected with it-its influence on the health of residents perience. If you are of opinion that these observations may in any and visitors-the natural history, including the zoology, tend to awaken a rational consideration of the cause degree and of the district-the botany geology, hydrology, cottages, and treatment of this important and fearfullv fatal disease; receive full notice, in- their insertion in villages, Ventnor, the town &c.,-all your valuable journal will oblige, cluding the most particular directions as to the localit,ies obedient servant, most suitable as residences for invalids of different classes,— A STUDENT. June, 1849. even the rides, walks, and drives which they are likely to find most useful and agreeable, are indicated. The tables of THE PROSPECTS OF MEDICAL REFORM. To the Editor of THE LANCET. meteorology, extending over a period of ten years, afford an opportunity to the medical practitioner of judging how far in the past week’s LANCET, of theannouncement Sitt,—The the climate is likely to suit his patient; whilst the descrip- abandonment of medical legislation by the ministry, will tions of the scenery, and the full account of the natural his- doubtless create quite a panic among an immense majority of For many years medical reform has been contory, which the author gives, cannot fail to prove of great the profession. before this session was declared. brought stantly interest, and the pursuit, thus encouraged, a source of healthful in THE LANCET " to be parliament,and the one for medical reform," when the amusement to the invalid resident or tourist. A great variety long-agitated question would be finally settled. The matter of information, collected with much labour, and so agreeably then seems to have fallen into atrophy and decay! How unplaced before the general and professional reader, speak highly satisfactory and disheartening such a result must be !1 No medical bill !-no reform ! How these declarations continue for the zeal and ability of the author. to vibrate on the ear! No wonder inactivity prevails, when every year each attempt at medical change proves unsuccessful and abortive! Our energies are prostrated by long-conENDERMIC TREATMENT OF CHOLERA. tinued blighted hopes. We may have defeated the cunning To the Editor QfTRE LANCET. and devising schemes for the specious head and home quarters; SiR,—Ihave for some time held an opinion on the treat- but all has now mouldered to the dust. We are to live on in, ment of cholera greatly differing from those commonly enter- strife. Rancorous jealousies are still to be rampant, and we. tained on the subject, and with which I would not now trouble are still to drag on an unhappy and miserable medical existyou, were it not that in perusing your journal of last week, I ence. If the College of Surgeons were now opportunely to come forfound, two cases reported, in which it had been successfully employed, and which will, I therefore hope, in some measure, ward, (after so prolonged and obdurate an opposition,) and exjustify an attempt to make the treatment more generally tend the olive branch,and confer honour on its members,taking the whole management of medical affairs and education withinknown. Dr. Skiers, in his pamphlet on cholera, states that when its walls, the rejoicingin the profession would be universal;, medicines, as calomel, &c., have been given internally, it has scarcely a dissentient voice would be found. May I ask, Sir, been fully ascertained that they may after death be found still when is the full justice to be done to that portion of the proin the alimentary canal, unchanged in quantity and quality, fession, promised so many months back, at the end of last. session ? Are restrictions to continue in full force ? Are such having been quite inert. More recently also, Dr. Garrod, in deducing conclusions a useful and intelligent class of men to be placed in such a from his remarks on the analyses of the blood in cholera, pub- position, and is such palpable wrong to be suffered ? I allude to, lished in the London Journal of Medicine, observes that medi- i the members of the various colleges of the United Kingdom cines given internally are almost useless. I fear our cause has been much injured, and well nigh deAgain, it is generally acknowledged by all practitioners, stroyed, by your indisposition and long absence from parliathat one great indication in the treatment of cholera is the ment, and such must be a source of much sorrow to the profesrestoration of the action of the skin, and this always accom- sion at large.-I have the honour to be, Sir, your most obedient servant, panies the first signs of the patient’s recovery. COLLEGIAN. The former of these observations will sufficiently accoun June, 1848. The "
Your
-
.