1
53 food, digestibility is one factor in the sum ; now the digestibi- lity of alcohol (so to speak) surpasses that of any other aliment ; it requires less elaboration to fit it for its ultimate purpose, namely, the translation into nervous force ; and, con- sequently, for the special end desired, alcohol is the very best food. Moleschott, in his " Kreislauf des Lebens," says, " wine saves the tissues from being burnt by offering itself as fuel, and that is why wine enables us to dispense with an equivalent of pudding; we eat less, because we spend less." Of course, if wine replaces pudding, pudding will replace wine ; the temperance advocates have been copious in proving the latter, but have ignored the other truth. Their reciprocity is an Irish reciprocity-" all on one side." Had they not ignored it, they could not have declared alcohol to be a poison, for poisons have not the property of replacing wholesome food. It has been said, that alcohol is a great generator of force ; it is no answer to this, to say the force is temporary. All force is temporary. Only a temporary exaltation of the organic process is needed ; if it were prolonged, it would be pernicious. The effects of alcohol are very analogous to those of a brisk mountain-walk, which, if moderate, is attended with agreeable excitement, followed by moderate depression ; if excessive, by too great fatigue. Life is only possible under incessant sti- mulus. Organic processes depend on incessant change, and this change is dependent on stimuli. The stimulus of food, the stimulus of fresh air, the stimulus of exercise, are called natural, beneficial ; the stimulus of tea and coffee is called agreeable, refreshing, and so forth; the stimulus of alcohol seems selected for special reprobation, without cause being shown, except that people choose to say it is not natural. Of two things, one ; either we must condemn all stimulus and alcohol, because it is a stimulus ; or, we must prove that there is something peculiar in the alcoholic stimulus, which demar- cates it from all others. Every stimulus is temporary in its effects ; this is no argument against its virtue ; if the effects of alcohol are temporary, why, so are the effects of beef, or a mountain-walk. Indeed, this question of time is idle. So long as the stimulus is kept within certain limits, the bent spring rebounds to its original position, the elastic web recovers its original length, the organic disturbance is temporary, and does not produce a change of structure ; but exceed those limits, you break the spring, tear the web, and deteriorate the tissue. I abstain from any further extracts, lest they should occupy too much of your space ; and for the rest, refer your readers to the original article. Yours trulv. D. HOOPER, B.A., M.B., M.R.C.P. ‘* Mr. Hooper’s letter has been unavoidably delayed. HINTS ON MEDICAL EDUCATION. To the Editor of THE LANCET. SiR,—Your correspondent, who writes upon medical educa- tion in your last number, proposes that the degree of B.A. shall be made a necessary preliminary to the medical degrees of the University of London. Before such a measure can be carried out, it will be necessary that those who have the framing of the University regulations shall give up the idea that a knowledge of classics, mathematics, and logic, is worth having only when it has been acquired by two years’ study within the walls of one of two institutions; situated, the one in Gower-street, the other in the Strand. So long as University and King’s Colleges retain their present exclusive privileges, few students from other hospitals will take degrees in Arts. Let it be the part of the press to see that this evil is rectified in any new charter which may be framed for the University. I am, Sir, yours truly, January, 1856. X. PAYMENT OF MEDICAL OFFICERS OF HOSPITALS. To the Editor of THE LANCET. SIR,—Allow me to correct a slight inaccuracy which ap- peared in your remarks in reference to the Consumption Hos- pital at Brompton, (THE LANCET, Jan. 5th.) It is there stated that the medical officers of the kindred institution at the Victoria Park are paid for their services. This is a mistake; they never have, from the commencement of the institution, received any remuneration whatsoever. But this, I believe I am warranted in saying, has not proceeded from a want of appreciation of the value of their services by the committee, or of the sound policy of paying the medical officers, but simply from. the financial difficulties of the institution. For my own part, after extensive observation and experience in the management of medical charities, I have been led en- tirely to adopt the sentiments which you have so well ex- pressed. I feel assured that it is in every way unwise to require medical men to give their best energies to the service of the public in this way without remuneration. In the case of institutions like the Brompton and Victoria Park Hospitals, the medical men necessarily reside at a great distance, and can only do justice to the patients under their care by a great ex- penditure of time and by considerable actual outlay of money. To require, however, as at Brompton, that the medical officers should not only give their gratuitous attention, but should hold no other hospital appointment, is yet more unjust and impolitic. To secure a good staff, and the best exertions of its members, their services should be paid; and to prevent a special hospital falling behind the actual state of science, its medical officers should have appointments to general hospitals, dispensaries, or other institutions, in which they would keep up their knowledge of the practice of all departments of the profession. I am, Sir, yours, &c., ONE OF THE MEDICAL OFFICERS OF THE HOSPITAL FOR DISEASES OF THE CHEST, VICTORIA PARK. January, 1856. LARVÆ OF THE FLY, SUPPOSED TO BE VOIDED FROM THE BLADDER. To the Editor of THE LANCET. SIR,—Allow me to explain the case related by Dr. Gibb, in page 607 of THE LANCET, of December 22nd, thus :-‘ He referred to the case of a child who voided large quantities of the larvse of the common fly from the bladder ; how they got into that viscus was a puzzle." About twenty years ago I was requested to attend a little girl who was in very good health ; but the parents were in great anxiety about her, she was supposed to pass large quantities of maggots from the bladder, and they were shown to me in some clear healthy-looking urine. I was at first as much puzzled as Dr. Gibb, but I soon came to the conclusion that it was impossible they could have come from the bladder. I went into the nursery and saw the small chaise percée on which she sat over the chamber-utensil ; there was a flannel cushion stuffed with feathers on it ; these feathers, from fre- quent moisture, had acquired the flavour which tempted the common house-fly to deposit its larvae there. I ripped open the cushion, found great numbers of lively maggots, and told the parents that was the source from which they had come. The cushion was burnt, and no more maggots appeared in the urine. I remain, Sir, your obedient servant, SAMUEL SMITH. SCOTLAND. (FROM OUR OWN CORRESPONDENT.) THE ROYAL INFIRMARY, EDINBURGH.—The contributors to this Institution assembled on Jan. 7th, in order to hear the Report of the Managers for the year ending October lst. Peter Bell, Esq., read the Report, which was of a satisfactory nature. Upwards of 3990 people were admitted inmates during the past year, and of these 2212 were completely cured. The average number of inmates daily was 435, and the length of time they were under treatment, also averaged, was 38 z days. It is a matter of regret such an excellent institution should still be involved in pecuniary difficulties. As a medical school it ranks as one of the highest in the kingdom, and the extensive benefits which are derived from it by all classes of sufferers, render its prosperity of the highest importance. Various modes have been suggested to assist at the present juncture, but the surest and most successful seems to be an appeal to the public. During the last year the debt has been considerably lessened, and it is to be hoped the endeavours of the managers and contributors generally will this year be as warmly seconded again by all classes of society. A grant from the Government, even, if obtained, would change the character of the Institution and materially alter the position it now maintains. It is hoped that the present aDDeal will

HINTS ON MEDICAL EDUCATION

  • Upload
    duongtu

  • View
    217

  • Download
    2

Embed Size (px)

Citation preview

Page 1: HINTS ON MEDICAL EDUCATION

53

food, digestibility is one factor in the sum ; now the digestibi-lity of alcohol (so to speak) surpasses that of any otheraliment ; it requires less elaboration to fit it for its ultimatepurpose, namely, the translation into nervous force ; and, con-sequently, for the special end desired, alcohol is the very bestfood. Moleschott, in his " Kreislauf des Lebens," says, " winesaves the tissues from being burnt by offering itself as fuel,and that is why wine enables us to dispense with an equivalentof pudding; we eat less, because we spend less." Of course,if wine replaces pudding, pudding will replace wine ; thetemperance advocates have been copious in proving the latter,but have ignored the other truth. Their reciprocity is anIrish reciprocity-" all on one side." Had they not ignoredit, they could not have declared alcohol to be a poison, forpoisons have not the property of replacing wholesome food.It has been said, that alcohol is a great generator of force ;it is no answer to this, to say the force is temporary. Allforce is temporary. Only a temporary exaltation of the organicprocess is needed ; if it were prolonged, it would be pernicious.The effects of alcohol are very analogous to those of a briskmountain-walk, which, if moderate, is attended with agreeableexcitement, followed by moderate depression ; if excessive, bytoo great fatigue. Life is only possible under incessant sti-mulus. Organic processes depend on incessant change, andthis change is dependent on stimuli. The stimulus of food,the stimulus of fresh air, the stimulus of exercise, are callednatural, beneficial ; the stimulus of tea and coffee is calledagreeable, refreshing, and so forth; the stimulus of alcoholseems selected for special reprobation, without cause beingshown, except that people choose to say it is not natural. Oftwo things, one ; either we must condemn all stimulus andalcohol, because it is a stimulus ; or, we must prove that thereis something peculiar in the alcoholic stimulus, which demar-cates it from all others. Every stimulus is temporary in itseffects ; this is no argument against its virtue ; if the effects ofalcohol are temporary, why, so are the effects of beef, or amountain-walk. Indeed, this question of time is idle. Solong as the stimulus is kept within certain limits, the bentspring rebounds to its original position, the elastic web recoversits original length, the organic disturbance is temporary, anddoes not produce a change of structure ; but exceed thoselimits, you break the spring, tear the web, and deteriorate thetissue.

I abstain from any further extracts, lest they should occupytoo much of your space ; and for the rest, refer your readersto the original article.

Yours trulv.D. HOOPER, B.A., M.B., M.R.C.P.

‘* Mr. Hooper’s letter has been unavoidably delayed.

HINTS ON MEDICAL EDUCATION.To the Editor of THE LANCET.

SiR,—Your correspondent, who writes upon medical educa-tion in your last number, proposes that the degree of B.A.shall be made a necessary preliminary to the medical degreesof the University of London. Before such a measure can becarried out, it will be necessary that those who have theframing of the University regulations shall give up the ideathat a knowledge of classics, mathematics, and logic, is worthhaving only when it has been acquired by two years’ studywithin the walls of one of two institutions; situated, the one inGower-street, the other in the Strand. So long as Universityand King’s Colleges retain their present exclusive privileges,few students from other hospitals will take degrees in Arts.

Let it be the part of the press to see that this evil is rectifiedin any new charter which may be framed for the University.

I am, Sir, yours truly,January, 1856. X.

PAYMENT OF MEDICAL OFFICERS OFHOSPITALS.

To the Editor of THE LANCET.SIR,—Allow me to correct a slight inaccuracy which ap-

peared in your remarks in reference to the Consumption Hos-pital at Brompton, (THE LANCET, Jan. 5th.) It is there statedthat the medical officers of the kindred institution at theVictoria Park are paid for their services. This is a mistake;they never have, from the commencement of the institution,received any remuneration whatsoever. But this, I believe I

am warranted in saying, has not proceeded from a want ofappreciation of the value of their services by the committee, orof the sound policy of paying the medical officers, but simplyfrom. the financial difficulties of the institution.

For my own part, after extensive observation and experiencein the management of medical charities, I have been led en-tirely to adopt the sentiments which you have so well ex-pressed. I feel assured that it is in every way unwise torequire medical men to give their best energies to the serviceof the public in this way without remuneration. In the caseof institutions like the Brompton and Victoria Park Hospitals,the medical men necessarily reside at a great distance, and canonly do justice to the patients under their care by a great ex-penditure of time and by considerable actual outlay of money.To require, however, as at Brompton, that the medical officersshould not only give their gratuitous attention, but shouldhold no other hospital appointment, is yet more unjust andimpolitic. To secure a good staff, and the best exertions of itsmembers, their services should be paid; and to prevent aspecial hospital falling behind the actual state of science, itsmedical officers should have appointments to general hospitals,dispensaries, or other institutions, in which they would keepup their knowledge of the practice of all departments of theprofession.

I am, Sir, yours, &c.,ONE OF THE MEDICAL OFFICERS OF THE HOSPITAL FOR

DISEASES OF THE CHEST, VICTORIA PARK.January, 1856.

LARVÆ OF THE FLY, SUPPOSED TO BEVOIDED FROM THE BLADDER.To the Editor of THE LANCET.

SIR,—Allow me to explain the case related by Dr. Gibb, inpage 607 of THE LANCET, of December 22nd, thus :-‘ Hereferred to the case of a child who voided large quantities ofthe larvse of the common fly from the bladder ; how they gotinto that viscus was a puzzle."About twenty years ago I was requested to attend a little

girl who was in very good health ; but the parents were ingreat anxiety about her, she was supposed to pass largequantities of maggots from the bladder, and they were shownto me in some clear healthy-looking urine. I was at first asmuch puzzled as Dr. Gibb, but I soon came to the conclusionthat it was impossible they could have come from the bladder.I went into the nursery and saw the small chaise percée onwhich she sat over the chamber-utensil ; there was a flannelcushion stuffed with feathers on it ; these feathers, from fre-quent moisture, had acquired the flavour which tempted thecommon house-fly to deposit its larvae there. I ripped open thecushion, found great numbers of lively maggots, and told theparents that was the source from which they had come. Thecushion was burnt, and no more maggots appeared in theurine.

I remain, Sir, your obedient servant,SAMUEL SMITH.

SCOTLAND.

(FROM OUR OWN CORRESPONDENT.)

THE ROYAL INFIRMARY, EDINBURGH.—The contributors tothis Institution assembled on Jan. 7th, in order to hear theReport of the Managers for the year ending October lst.Peter Bell, Esq., read the Report, which was of a satisfactorynature. Upwards of 3990 people were admitted inmatesduring the past year, and of these 2212 were completely cured.The average number of inmates daily was 435, and the lengthof time they were under treatment, also averaged, was 38 zdays. It is a matter of regret such an excellent institutionshould still be involved in pecuniary difficulties. As a medicalschool it ranks as one of the highest in the kingdom, and theextensive benefits which are derived from it by all classes ofsufferers, render its prosperity of the highest importance.Various modes have been suggested to assist at the presentjuncture, but the surest and most successful seems to be anappeal to the public. During the last year the debt has beenconsiderably lessened, and it is to be hoped the endeavours ofthe managers and contributors generally will this year be aswarmly seconded again by all classes of society. A grantfrom the Government, even, if obtained, would change thecharacter of the Institution and materially alter the positionit now maintains. It is hoped that the present aDDeal will