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THE LANCET.

LONDON: SATURDAY, FEBRUARY 18, 1905.

The Hunterian Oration.THE name of JOHN HUNTER can never be forgotten. His

services to surgery were so great that we need no HunterianOration to remind us of all that he has done and of all that

he was. Yet the delivery of such an oration as that of

last Tuesday cannot but help us to appreciate more fully, toestimate more highly, the character of the man and the workwhich he accomplished. We have listened to many HunterianOrations and we have valued the eloquence of the orators,but we have never been privileged to listen to a HunterianOration which contained a more just appreciation of its

subject. To devote an hour to mere eulogies of JOHN

HUNTER is futile ; indeed, no one would have disliked themmore than JOHN HUX’TER himself. But to occupy the timein pointing out the way in which HUNTER accomplishedall he did, to show how he spent his time, his money, andeven his life itself in the advancement of knowledgeand the attainment of progress, is quite another and a muchmore appropriate method, and this was the method adoptedby the most recent orator, Mr. JOHN TWEEDY, President ofthe Royal College of Surgeons of England.To understand JOHN HUNTER’s life three things are

necessary. We must first realise the parlous state of the

study of anatomy in England in the middle of the

eighteenth century. In 1746 WILLIAM HUNTER, JOHN’S

elder brother, had commenced the systematic instruction of

anatomy, with dissections, for a society of naval surgeonsand this was indeed the starting point of the true study of

anatomy in this country. The successful practice of medicineand surgery is unattainable without an exact knowledge ofthe structure of the human body and for this dissection

is essential. While the prejudice against dissection was

strong, as in the Middle Ages, it was impossible for teachersof anatomy to obtain the material which they neededfor dissection: this prejudice had in some degree abatedwhen WILLIAM HUNTER established his school of anatomyand surgery but to a certain extent this unreasonable

prejudice against dissection exists even now, for many boardsof guardians decline to permit the unclaimed bodies of

paupers dying in their infirmaries to be used for anatomicalpurposes. JOHN HUNTER profited greatly by being intro-duced early into the progressive school of his brother and

this doubtless had much to do in training and fitting himfor his future work. But Mr. TWEEDY shows that there was

a second cause for JOHN HUNTER’S extensive contributions

to surgery. Most of the work of his predecessors was

empirical ; it was based chiefly on the precedent of previouscases, while of pathology, as affording working theories,there was almost none. HUNTER saw that disease could

not be treated satisfactorily without a knowledge of the

morbid processes and to obtain that knowledge he strove

persistently. He recognised that for the attainment of thisknowledge of pathology careful observation was needed ofthe products of disease and for that reason lie set about

the formation of a museum. From the first he saw the

need of not limiting the study of anatomy and pathologyto the human body. He felt that man was so near

akin to the lower animals that the study of the vital andthe morbid processes of the one must assist in the inves-

tigation of the life processes and the diseases of the other ; -,therefore his museum included numerous dissections and

examples of the organs of birds, beasts, and fishes. The

museum of the Royal College of Surgeons of England, asthe present representative of HUNTER’S museum, contains

one of the most elaborate collections in the world in illus-

tration of the physiology of animals and plants.There was a third factor which assisted JOHN HUNTER

greatly in the prosecution of his task. All the time duringwhich he was carrying on his extensive and numerous

investigations he was in the active practice of his pro-fession. This always suggested to him the applicationof the facts which he elicited in his researches and thus he

possessed a touchstone on which he could try the theories

suggested by his facts, which explains the splendidlypractical nature of his work. There may have been

greater surgeons, better pathologists, and more erudite

anatomists than HUNTER but it may safely be said that

never in the whole history of medicine has there been a

man who devoted himself more thoroughly and more

intensely to the advancement of the medical sciences.

His influence was great in his own day and from

that time to this can be traced in the work of his

immediate pupils-ABERNETHY, CLINE, ASTLEY COOPER,and JENNER. At the present time his work is still

bearing fruit and his museum, enlarged and extended, is

of the greatest value in the advancement of medicine

and surgery. So will it be in the future. To few is it

given to accomplish so much work while living and toleave behind so vital an effect on the science of succeedingages ; and the reasons why HuNTER will receive the lastingregard of the world are well revealed in Mr. TwEEDY’s

eloquent oration, which we publish this week.

The Claims of Sociology.UNDER the modest title of "Sociological Papers," the

recently constituted Sociological Society has just issued

what might perhaps be better described as a first volumeof "Transactions," containing presumably only a selectionfrom the essays read at its meetings, with reports of thedebates, and with written contributions to those debates

from absent members to whom advance proofs of the

essays had been furnished. At one of the meetings thechair was taken by Professor KARL PEARSON who openeda discussion by declaring that he was not a member of the

society and that he was sceptical of its power to do

effective work ; a declaration which ultimately called fortha reply several pages in length from the secretary, Mr.

BRANFORD, but with which, nevertheless, we are disposedto think that most readers of the volume will be likelyto agree. It may be admitted that the course of social

organisation must be subject to laws which would be

440

ascertainable if they were rightly sought for ; but the effortshitherto made in this direction have not been conspicuouslysuccessful. In 1357 a body called the National Associationfor the Promotion of Social Science was founded under the

auspices of the first Lord BROUGHAM who was said to havebeen greatly pleased at the "wide and indefinite area " overwhich its labours were designed to extend. This area was,

indeed, so indefinite that the first volume of the Transac-

tions contained a paper by a member of the House of

Commons, in which, as a remedy for most of the domesticevils afflicting the lower classes of the labouring population,he gravely proposed that pleasant modulation of the voiceshould be systematically taught in elementary schools forgirls, in order that their future husbands, returning tired fromwork, should be soothed by the gentle tones of their help-mates and should no longer be subjected to the shrill accentsof the scold. For several years the annual meeting of thisassociation was held to be an event of some importance ; butits useful work was gradually smothered under a weightof superincumbent trivialities and, after a vain effort to

obtain new blood by amalgamation with a society for

amendment of the law, it perished from an atrophy mainlydependent upon the unfitness of its nutriment to sustain thevastness of its aims. The new society must to some extentbe regarded as its successor and we doubt whether its

history is likely to be more fortunate. The general character of the contributions contained in

the volume before us is one of vagueness, arising partly froman absence of sufficiently definite ideas, and partly from an

incapacity for expressing them, the latter perhaps some-

times arising from the circumstance that several of the con-tributors have foreign names, with a consequent probabilityeither that they have written in what was to them a foreignlanguage or that their compositions have been but imper-fectly translated. Whatever may be the explanation, we finda general clumsiness of the sentences, a frequent employ-ment of common words in strained or unnatural meanings,and an obscurity of construction which a few well-employedprepositions and conjunctions would have done much to

obviate. It is none the less noteworthy that the gentlemenreading papers, and the gentlemen (or ladies) sustaining thediscussions, appear to have been profoundly convinced of theimportance of their several contributions to the stock of

human knowledge ; moreover their politeness to one ar.othercan only be described as exemplary. It would be difficult to

read the reports without some recollection of the historical

society described by the poet :-" Where, ladling butter from alternate tubs,Stubbs butters Freeman, Freeman butters Stubbs."

If proceedings thus conducted are not likely to lead to dis-coveries of importance, it is at least tolerably certain that

they will be sources of harmless pleasure to the great majorityof the learned or unlearned persons concerned in them. An

important discussion as to which an exception must bemade, and which, moreover, was calculated to be of greatinterest to the medical profession, arose out of the readingof Mr. FRANCIS GALTON’S paper on Eugenics. This paperwas so fully referred to when first issued as a "proof underrevision," in a leading article in THE LANCET of May 14th,1904, and has since been so often reproduced in entire

or in abbreviated form, that it can hardly be other than

familiar to our readers. We need only remind them thatits object was to advocate such a system of controlling the-

reproduction of the human species that the useful classes.of the community should contribute more than their pro-portion to the next generation. The results anticipated bythe author are that it might be possible to raise the averagequality of our nation to that of its better moiety at the.

present day. If this could be done, he thinks that "the.

general tone of domestic, social, and political life would be

higher. The race as a whole would be less foolish, less-

frivolous, less excitable and politically more providentthan now. Its demagogues who played to the gallery,would play to a more sensible gallery than at present.Men of an order of ability which is now very rare would become more frequent, because the level out of which theyrose would itself have risen."

These be brave words and Mr. GALTON’d belief in the

possibility of realising what they imply depends upon his-.

corresponding belief in an habitual inheritance by children-of the good qualities of their parents. In the very short;

speech with which he closed the discussion, he said that" much which had been urged against this view might havebeen appropriately said 40 years ago, before accurate-

measurement of the statistical effects of heredity had beencommenced, but that it was quite obsolete now." As-

evidence in support oE his view he gives, in the volume.

under consideration, an " Index to the Achievements of nearKinsfolk of some of the Fellows of the Royal Society," thesome" including but eight persons, of whom only one, orat most two, could be described as of the highest eminence.It is scarcely invidious to point out that, even in the RoyaSociety, there are Fellows and Fellows ; but it is more-

practically important to scrutinise the achievements in,

question, the great majority of which appear to us to

resolve themselves into the capable discharge of dutyin positions certainly responsible, but for the attainment

of which the persons referred to have enjoyed exceptional,facilities dependent upon the social or financial position&of their respective families. We do not regard the existingknowledge of the operation of hereditary influences a&

being sufficient either to justify the enunciation of generallaws or to afford any adequate guidance for the regula-tion of marriages; and we believe it would be as easy to.

compile an imposing list of the achievements of persons who.are not related to Fellows of the Royal Society as of those-who are. What is commonly called an inheritance of geniusmight often be more correctly expressed as an inheritance:

of advantages by which a very moderate amount of genius-was afforded exceptional opportunities for displaying itself-We expressed last May our doubt whether any science-

of Eugenics was really in existence, and this doubt

has not yet been dispelled. So far as we know,. attempts in the indicated direction have not been con-

spicuously successful in practice. Among the queer so-

called " religious sects now or formerly existing in.

America, and which were so graphically described by the- laterMr. HEPWORTH Dixox, there was at least one in which.

intended parents were specially selected for pairing by theelders, with a definite view to the production of offspringcapable of guiding the affairs of the community to a

successful issue. We do not know whether the community

441

iin question still exists as an organised body but we haveheard that it never produced a single individual of con-

-spicuous ability.

The Indian Medical Service.WE have received, from time to time communications from

officers of the Indian Medical Service, and from some,members of the subordinate medical service who are findingemployment in civil hospitals all over India, in regard to’various points in the existing medical system of the

Empire in which they are severally or mutually interested.The present and the future standing of both services and the

- relationship of the officers one to another are now much

under discussion, and the aspirations entertained by manyof the more able and ambitious members of the subordinate

medical department will certainly serve to keep these topicsfrom neglect. Not so long ago the difficulties were only in

prospect and could not be said to be of an urgent kind, sothat it seemed to us more expedient to leave the wholesituation to mature, when in process of time it mightpresent features which could be more opportunely and

usefully discussed. This has now happened and comment- seems to us to be called for. Great changes have been

taking place in matters of Indian administration generallyand in the growth, spread, and development of Indian

medical education. Proof of this has been manifested in

our columns but some of the correspondence upon these and

.cognate matters which has reached us has been dictated byfeelings that are of a personal or a purely controversial

nature and therefore lacking in sympathy with the best

interests of both the public medical services and the medical- requirements of India. And so the points thus raised may,. u.,.....u as, N., u at present ,

if only that a most difficult matter may be removed fromthe sphere of personalities to that of general policy.

Commissioned medical officers of the Indian Medical

Service, as everybody knows, are employed extensively as

professors at the large medical colleges of the Empire and

give instruction at the great hospitals-those of Madras,Calcutta, and Bombay for example. This for a long time

past has always been the case. The consequence is that thereare now in India large and increasing numbers of really goodmedical men belonging to Eurasian and native classes whohave been thoroughly educated up to European standards. Areference to some of the papers set for the degree examina-tions of Calcutta, Bombay, and Madras will remove any

doubt that may exist as to the rigour of the qualifying tests.These graduates are, as we have said, chiefly employed assubordinates in the civil hospitals all over India and

surgical operations of every kind, major as well as minor,are continually being successfully performed by them.Officers of the Indian Medical Service are not alone in

their appreciation of the professional value of the work

so done, for it is recognised also by Collectors and

magistrates of dis.ricts and all classes of the native

population. The result is that the Government of India is

now, or is fast becoming, fairly well supplied with a highlytrained body of servants who, so far as professional qualifications are concerned, aie e capable of undertaking at les1

expensive rates of pay most of the duties of the com

missioned offi rs of the Indian Medical Service. Indeed

one of our correspondents goes so far as to forecast what,in his opinion, is likely to be in store for the latter service.He expresses his belief that the policy of the rulers of

India towards the Indian Medical Service is based uponthe principle of utilising the Service mainly in creatingfor the Government a sufficiently large and efficient

number of subordinate medical servants, recruited from

the Eurasian and native classes of India. And in supportof this view he adds that such a movement while

opening an outlet to the present clamour of the intelligentnative who desires Government employment for his

educated intelligence might at the same time ease the

country of a portion of its expensive administration.

The Indian Government, he points out, does, moreover, now

occasionally employ such medical subordinates to look afterthe whole medical and sanitary business of large districts

containing no inconsiderable European population whenthere happens to be no commissioned medical officer avail-able for the purpose. Such a letter as that from which

we are quoting expresses the spirit of toleration and

generosity which all medical men of a right understand-

ing must feel towards their professional brethren. It is not

logical-to say nothing stronger-that we should spare no

pains to educate the Indian and, at the same time, shouldrefuse him for ever the opportunities of a free exercise of thetalents that we have enabled him to cultivate. But the time

when a more liberal scheme can be adopted by the IndianGovernment is delicate to fix-those who know least the

difficulties are clearest as to the absolute necessity for

, immediate reform and most unable to see how valuable it is

for future peaceful developments that bhe change shouldcome so gradually as to appear a merely inevitable process ofsocial evolution. Ana in considering tne question or tne

increased employment, and the employment in more

responsible and highly placed duties, of the native medicalgraduates we must not ignore the influence which the

difference of race introduces into it-not merely those ofa physical nature but racial distinctions of character,religion, education, and methods of thought which, how-ever much we may regret their existence, neverthelesstend to keep the European and the native races of Indiamore or less apart. Nor is it the case that the natives of

India do not themselves fully recognise these distinctions.It is a topic upon which we would prefer not to enter butso long as human nature is what it is it cannot be ignored.That in respect of trustworthiness of character there are

among the members of the subordinate medical service

quite a number of unimpeachable servants will be

admitted but that the ethical standards of the native and

the European are identical cannot be maintained. The

native of India, notwithstanding all his confidence in

the British character, has profound confidence in himselfand is firmly convinced that either he or one of his

compatriots is eminently fitted to administer the businessof any official post in India. Ask the same native, how-

ever, when he is very ill whether he would prefer treat-ment at the hands of a compatriot or of an officer of theIndian Medical Service and his preference will be immediateand flattering to our race.

Reviewing the whole situation, we believe that it

is a misapprehension to, consider that the policy of