579

THE LANCET.

LONDON: SATURDAY, MAY 27, 1854.

THE POOR-LAW MEDICAL RELIEF COMMITTEE.

ON Monday last, the select committee on Poor-Law Medicalelief, was appointed in the House of Commons. The names

the gentlemen composing the committee are as follows :---Mr. Pigott, Mr. Miles, Mr. Grey, Mr. Seymour Fitzgerald,

Mr. Bramston, Sir John Trollope, Lord Henry Cholmondeley,iscount Goderich, Mr. Barrow, Mr. Deedes, Mr. Water, Mr.

Grenville Berkeley, Mr. Robert Palmer, Mr. Rice, and Mr.Henry Berkeley.On making a careful examination of this list, we cannot dis-

cover the names of more than four or five gentlemen who arefavourable to making changes in the present system, whichwill improve the present condition of Poor-law medical officers.Contrary to the usual practice, we find that the office of chair-man of the committee is to be occupied by Sir JOHN TROL-LOPE, the late President of the Poor-law Commission, instead ofMr. PIGOTT, on whose motion the committee was appointed.We regard this selection as a step hostile to the just and com-mendable objects which Mr. PIGOTT holds in view, and as hisbenevolent intentions are known, it appears quite evident to usthat a majority of the committee are opposed to the viewswhich he entertains. That Sir JOHN TROLLOPE will act im-

partially in the chair we firmly believe, but the indicationsarising from what has taken place, induce us more than everto point out to the union medical officers and to the professiongenerally, that if all the requisite and possible means be nottaken to present before the committee the facts of the case in

evidence, as they really exist, the condition of the aggrievedparties, will, at the termination of the inquiry, be even worsethan it is at the present moment. If there is to be a change,we should look with apprehension on the one that would beeffected under the auspices of a majority of the select com-mittee. We ask, then, will the profession act or sleepwhilst there is such a threatening prospect before them ?

THE testimony borne by HovrEx to the pre-eminent import-ance of medicine as an arm of military science is as true at the ilpresent moment as when the Greeks of olden time had tocontend against sickness and pestilence under the walls ofTroy. After the revolution of centuries, vast armies are againencamped in hostile array upon classic ground. Admittingthe general advance of civilization,-and this, perhaps, asregards a large portion of the belligerents, is not very con-

spicuous,-can it be maintained that the Turkish or Russianforces now assembled on the banks of the Danube, or even the

better-equipped legions of England or of France now gatheringon the shores of the Bosphorus, are very much better off asregards protection against epidemic disease than were thosearmies whose deeds and disasters are recorded in immortal

verse? Is it not still true, true as in days of old, that

pestilence is the most terrible of enemies, the most destructiveof foes ? Is it not also true that pestilence rages under certainconditions, some of which are known, and may be avoided ?Is it a hopeless or an unattainable object to discover all theaws of epidemic disease, and to shield masses- of men from

wholesale destruction, from dying like sheep of the rot ? It

may be confidently asserted that the science of medicine, asfar as it can be studied in communities living under theordinary hygienic conditions of modern civilization, has beencarried to a pitch of eminence at least on a level with thatobtained in any other science, if we except, perhaps, that ofmathematics. But the truths of medicine can only be partiallypursued and imperfectly determined by study in this circum-scribed field. In ordinary civil life we are exempted frommany of the conditions which favour the development andspread of zymotic diseases. The study of medicine is prin-cipally confined to the observation of those diseases which

attack individuals, the whole history of which begins and endswith the phenomena that single individuals exhibit. This

kind of medicine we have ventured to designate as minutemedicine, as contrasted with that larger view of the scope ofmedicine which embraces the study of the influence of external

agents upon the physical and moral health of aggregations ofmen. Is it not obvious that there is a wide difference between

the kind of skill required to treat a particular case of disease-a pleurisy, for example-where our concern is directed exclu-sively to the individual sufferer, and the skill required tocombat an epidemic disease that has laid low its hundreds orthousands of victims, and where our efforts are imperativelycalled for, not only to heal the sick, but to preserve the sound ? ?We again assert that medicine in this larger sense has never

yet been studied as it ought to be. Nor is the blame of this to

be attributed to those who follow medicine as a profession.Our great civil hospitals do not supply the means of advancingfar beyond the bounds of minute medicine. Our young men

learn much it is true. We do not fear contradiction when we

say, that in no other profession do young men pass from theranks of students, to enter upon the more responsible duties of

practice, better prepared for the step. Looking simply to the

sphere of action to which the majority of young physicians andsurgeons are destined, it may be contended that their educationis carried to a very high point. But if we extend our view

beyond civil practice, to the medical care of our fleets andarmies, we do not hesitate to say, that the education of thoseto whom this important charge is confided, is defective in a

very essential particular. The proper field for the completionof the education of our army and navy surgeons, is actual service

with armies and fleets. There is always much that is specialin the practice and duties of the military or naval surgeon.If this view be correct,-and we may safely appeal for confir.mation to what is actually passing under the observation, andwe may add, the animadversion of the country,-of the medicalservice of the navy, we speak with an indignation we cannot

suppress. The official neglect and contumely manifestedtowards that service would have been disgraceful in the days ofCHARLES the SECOND. That reckless monarch exposed theBritish fieet, under every privation, to the assaults and insultsof the enemy. TV now behold in the Baltic and in the Black

Sea two of the most splendid fleets England ever equipped,carrying many thousands of our finest seamen, exposed undernew circumstances, to be assailed by an enemy no valourcan resist. The personnel of the British navy-we say it

without any wish to detract from the well-deserved characterof many able men-is lamentably deficient, both in quality andin numbers. It is a fact too notorious in the profession to begainsaid or discredited by official quibbling and perversion,

580 DISQUALIFYING CAUSES FOR ADMISSION INTO THE ARMY.that none but those hopeless of earning for themselves anhonourable position ashore, or in any other service, can beinduced to enter the navy.The army is indeed better supplied. In this service the

medical officer is placed upon a footing more consonant to theposition he is entitled to hold in society. It is therefore less

unpopular; a better class of young surgeons accordingly seekadmission. But it may be fairly questioned whether even inthe army there is a sufficient number of medical officers com-

petent to meet the numerous emergencies arising in an active e

campaign. The medical organization is barely adequate tothe ordinary requirements of the service in times of peace. In

the havoc of battle the surgical staff must be literally over-whelmed with the extent of their duties.

In organizing the medical services of the Army and Navy,regard should undoubtedly be had to providing a school for

training the junior officers in the experimental and scientific

knowledge of the higher departments of medicine. For this

purpose it is necessary that the staff should be largely in-reased,-that every proper encouragement should be held ontto induce young men who have shown the greatest promise offuture excellence in their profession to seek for further

instruction and honour in the public service. Not only shouldthe regular staff be enlarged, but liberal facility should beiven to medical practitioners, actuated by a desire to extendtheir sphere of observation, to attach themselves for a periodto certain ships or regiments as supernumeraries. There are

many men, animated by the love of enterprise, or impelled bythe thirst of knowledge, who would gladly give their services ’,,in this latter capacity. It is a duty, no less than the interest,of the Government not to disregard assistance of this kind.The want of a Professorship of Military Surgery in this metro-polis is now strikingly obvious. If the practice of militarysurgery can only be studied in actual service, the foundationof the profitable pursuit of practice-the theory-can at leastbe laid in London.

The leading public journal has lately, in the course of someremarks, dictated by the best spirit towards our profession, ex-pressed an opinion with reference to the relation of medicine tothe state and to the public service, which we cannot but thinkerroneous. The Times would appear to think that every strugglemade by the profession, either with a view to improve its politicalstatus, to advance the science of medicine, or to make it more

extensively useful to the public, must be treated as a questionpurely interesting to the profession, and as one with whichthe public have no concern. Shall we ask whether the pre-servation of the health of our armies and of our marine

is a professional or a national question ? Is there no in-

stance of a campaign being lost, of our army being defeated,of our national flag being stained, because the right arm ofthe soldier was paralyzed by sickness, because the aid of medi-cine was slighted ? The error which led to the disaster of

Walcheren, is one that reflects even less discredit upon our

military strategy, than upon our unwise neglect of the counselsthat medicine could have given.

’IN concluding our observations on the subject of recruiting,and the circumstances acting as the least disqualifying causesfor admission into the ranks of the army, we may first remark,that the small proportion of men coming under the second

degree of least disqualifying causes* (viz., the being markedwith the letter D) is a subject for congratulation. Brandingfor desertion appears to be a punishment peculiar to the British

army, though formerly the recruits of the Romans and theslaves of Eastern masters underwent marking to prevent de-sertion and establish identity; and we presume we should bedoing no more than injustice to the slaveholders of the UnitedStates, if we regarded in the same light the various markingsso minutely alluded to in the advertisements respecting fugi.tives from their much-abused power. Nothing of any forcecan be said in favour of this punishment, but very much againstit. It may be true that, if marking deserters be consideredindispensable there are no possible means by which it can beaccomplished with less pain and greater certainty than arenow adopted, t

Nevertheless, there is a gno2-al pain attending the practice,and one which endures a lifetime, be the physical suffering notvery great; and moreover, if the branded sign cannot beeradicated as to entirely escape detection, its previous exist’ence may at least be rendered very doubtful. This is evident

from what Dr. MASSY states in his Comments on the 18th

Article of the Official Instructions :-" Traces of the letter D

" should always be looked for, as it is sometimes erased.

’’ Instances have occurred where men have been approved" bearing unequivocal evidences of erasure of this mark. The

"letter D can rarely be removed without leaving some

4 evidence. Any mark on the left side of the chest, in the" usual situation of this stigma, ought to be viewed with great" suspicion." (Op. cit. ) We believe that the circular issued

from the Horse Guards directs that the punishment of brandingis only to be inflicted in the presence of the surgeon; but ac-cording to a good authority the special duty assigned to themedical officer is neither of a medical nor surgical character, but"merely to instruct the drum-major how to apply the instru-ment." A very different duty fell to the lot of the great chief§of all army surgeons, Baron LARREY, as the following anecdotewill prove :-In the course of the year 1830, happening to be upon a jury

when a well-educated young man was tried and convicted of

forgery, and thereupon condemned to be branded and sent tothe hulks, the Baron was so affected at the barbarity of thesentence-of the shoulder being burnt with a hot iron by thepublic executioner-that he made an appeal to the royalclemency to have it remitted in the present instance. The

favour was granted, and, says the Baron, " before many months" were over I had the satisfaction of finding that this article of" our criminal code was expunged on the establishment of the

"present dynasty in France." p The excuse offered for the

* These causes, it may be remembered, stood thus :-1. Weak intellect ......... 158 rejections out of 50,436.2. Marked with the letter D... 238 " "

3. Impediment of speech...... 254 " "

See our previous remarks also, page 520.t See upon this and related points " Military and Naval Discipline," in the

20th number of the "Topic;" also Mr. Deputy-Inspector Marshal’s observe- .tions on " Punishments in the Army and Navy."

1+ The instrument employed is made of brass, shaped at the end into theform of the letter D, from the outline of which is protruded, by means of aspring, a series of needle-points. By these means the left side is punctured,and the punctures thus made are rubbed over with a marking compositionformed of pulverised indigo and Indian ink.

§ Speaking of his visit to England, Larrey says, "On leaving the garrison,(Chatham,) military honours were paid to me as a general officer."

Relation Medicale de Campagnes et Voyages de 1815 a 1840, &c. ParM. le Baron Larrey.

581THE ANALYTICAL SANITARY COMMISSION.

infliction of the ignominy of branding is the necessity of pre-venting men discharged from the army as incorrigible fromagain attempting to enlist; but it is plain that even this argu-ment will only apply to men discharged within that period oflife when enlistment is possible. When some men are branded

after they have attained twenty-six years of age, and othersare marked twice over, it is clear that the argument in questionis valueless, and the act of branding then assumes the cha-racter of vindictive malice, or appears like a relic of the daysof ear-cropping and nose-slitting, or of the times of the Star-chamber and pillory, when the ignorant barbarism of the timespermitted that a fellow-creature might be made an object ofscorn for his whole lifetime.

Strange views still exist, however, as to the value and pro-priety of certain kinds of military and naval punishments, asreference to an article on " Our National Defences" in the last

October number of the Eclinbicr9h Review will sufficientlyprove.* According to its intelligent ( !) and humane(!) author,the sailors, both of this country and of America, rather like

flogging as a punishment; the majority of the former preferringit to six months’ hard labour in the common gaol, and the latterabsolutely refusing to enter again the service, now flogging hasbeen therein abolished, " until," as they ask, " they shall havesome assurance that a better system of discipline may be re-stored. " " Thus it appears," says the writer of the article in

question, " that where the trial has been made, the abolition,not the retention of corporal punishment has produced un-popularity." Sentences to 500, 800, 1000 lashes were common

things in the army thirty years ago, (Topic, loco cit.;) and whenColonel PERRONET THOMPSON tried to bring down a man’spunishment to one hundred and fifty, at a regimental court-martial, he was told " you must not make a joke of the ser-vice." The best answer to all such perverse views as the above

will be found in the following extract from the late statistical

reports we have before often referred to-viz., that regarding" the more frequent occurrence of offences of the highest grade," and a consequent increase in the number of general and dis-" trict courts-martial, nothing of this kind has been apparent"in the course of our investigation. On the contrary, the ex-

"perience of the ten years (1838-1847) included in this

"report affords undoubted evidence that the rarity and dimi-" nished severity of corporal punishment in the army have"been attended with the happiest effect." (p. 25.)Upon the third but least frequent cause of rejection-impe-

diment of speech-we have nothing to remark, except that, inorder to exist as such, it must be present in that degree aswould incapacitate a soldier challenging a sentry or repeatingthe orders delivered to him on his post.

WE congratulate the Governors of St. Bartholomew’s

Hospital, and those who wish well to the cause of medicaleducation, upon the result of the late election to that ancientinstitution. On Wednesday last Dr. BALY was unanimouslyelected Assistant-Physician in the place of Dr. FAERE, whohas been promoted to the rank of full physician. On the same

occasion Mr. McWHINNIE was also elected assistant-surgeon in

* See also Staff-Surgeon Roberts, who says (op. cit.), "The frequency ofoffences is precisely the same under the institution of the lash, shot drill,olitary confinement, and low diet."

the room of Mr. SKEY, who at length, after many years of

servitude in the subordinate office, rises to the rank of surgeon.Let us remind the Governors that they will not be held

justified by the measure of justice they have thus given in notpursuing the same course with consistency. Another appoint-ment remains to be made. The same principle, the same ruleof justice, of propriety, of decency, must govern their choice.We earnestly trust that we shall soon have to record the

appointment of Dr. KIRKES.

THE

ANALYTICAL SANITARYCOMMISSION.

RECORDS OF THE RESULTS OF

MICROSCOPICAL AND CHEMICAL ANALYSESOF THE

SOLIDS AND FLUIDS

CONSUMED BY ALL CLASSES OF THE PUBLIC.

POISONOUS COLOURED CONFECTIONERY.(Concluded from p. 526.)

POTATO.

82oad Sample.Purchased-of W. J. Odell, 28, Brick-lane, Spitalfields.

This is also of a yellow colour, and is slightly tinted at oneend with a little of the usual non-metallic red pigment, theyellow consists of CHROMATE OF LEAD.

83rd Sample.Purchased-of T. Holloway, 102, Drury-lane.

This potato resembled the previous sample in form and ap-pearance, but was coloured with a thinnish coating of GAM-BOGE.

SWAN.

84th Sample.Purchased-of T. Holloway, 102, Drury-lane.The colours in this are yellow for the beak, brown for the top

of the head, and a border of dull green rouud the base orstand. The yellow pigment consists of a thick coat ofCHROMATE OF LEAD, the brown of M?H&e)’, and the green ofMIDDLE BRUNSWICK GREEN, containing CHROMATE OF -

LEAD.

PIGEON.

85th S’ample.Purchased-of T. Holloway, 102, Drury-lane.The pigments employed for colouring the pigeon, are light

yellow for the beak, red for the eyes, and orange yellow forthe base or stand. The yellow colour consists of the lightkind of CHROMATE OF LEAD or PALE CHROME; for the eyes,BISULPHURET OF MERCURY or VERMILION, and for thestand, the deeper variety of CHROMATE OF LEAD or ORANGECHROME.

COCK.

86th ;Sample.Purchased -of T. Holloway, 102, Drury-lane.The beak of this bird is coloured bright yellow; the comb

brillzant red; the wings and tail are variegated -with black,two different reds, and yellow, while the stand, as in mostof these sugar ornaments, is painted green. The yellow ofthe beak consists of CHROMATE OF LEAD, the comb andpart of the red colour on the wings, of VERMILION, whilethe second red colour on the wings and tail is the usualpink non-metallic colouring matter, and the stripes ofyellow consist of GAMBOGE; lastly, the green of the standis MIDDLE BRUNSWiCK GREEN, and therefore containsCHROMATE OY LEAD. In the colouring of this article