567

THE LANCET.

LONDON, SATURDAY, NOVEMBER 21, 1846.

PLANS OF "THE LANCET" FOR DEFEATING QUACKERY.

IT is impossible for us to notice individually, and with thecourtesy and attention we could wish, all the approving letterswhich we are constantly receiving on the subject of the effortsof THE LANCET in the cause of legitimate medicine. One and

all of our correspondents we thank most cordially, and weassure them that no effort of ours shall be wanting to furtherand secure the true and noble objects of our profession asopposed to pretence and empiricism. Nothing shall be toohigh or too low to escape our observation. The eye of the

profession shall be placed upon the true intent and meaningof quackery and its supporters, whether it be found in the

scepticism of physicians in high practice and high places, orin hysterical ladies and gentlemen; in the bland-lookingQuarterly, or the obscene handbill: and we shall show, thatwhen court physicians say there is little or nothing in physic, Iit is a natural corollary that the druggist should think himselfable to prescribe; that when professional authors cannot

keep themselves free from medical unbelief, the non-medicalliterary dilettanti may well be expected to sit in judgmentupon medicine. From the Royal Society, which must andshall for the future dispense its rewards with unmistakeable

justice and impartiality, so far as its medical section is concerned,to the lowest parochial or union board,-the last though notleast in Importance,—we will endeavour to set forth the honour,rewards, rights, and duties, of every member of the medicalrepublic, attempting to diminish cliquism and toadyism amongthe heads of the profession, and striving to defend and

strengthen those who occupy the humbler, but equally honour-able, posts in the borders and less wealthy walks of medicalpractice.As regards quackery, and the ethical condition of medicine ’,

at the present time, we are not merely working from week toweek, and from hand to mouth, trusting to the events of one dayfor material to comment upon in the next. From the first

our plan of operation was marked out. But the suggestionswe are constantly receiving, the development of the subjectby constant discussion, and the approaching it from differentpoints of view, has enlarged and cleared the field of our opera-

s tions. Although the response of the profession has strengthenedus much, and rendered our progress more effective, we maybe paradoxical enough to say that it has rendered it slower; butonly in the same way that new bodies of troops, and the acces-sion of artillery, albeit they slacken a military march, render itsultimate victory more certain. We feel ourselves yet only onthe threshold of the subject. Our first aim was to destroythe system of testimonial-giving, which had grown so rifeamong physicians and surgeons of otherwise sound repute,and which was an important support to quackery, and ascandal to the profession. Already we have, by the mereforce of argument and exposure, nearly destroyed this per-nicious system. The advertisement of old testimonials will

still go on; but in time these must become stale and effete,and there will be none to succeed them; for we do not believethat now, or for the future, any professional man of respect-ability, in London, would risk the opinion of his brethren b

giving a testimonial for public advertisement in favour ofany medical or semi-medical article. In the provinces thesame state of things must speedily follow, a vigilant eye beingkept meanwhile upon those who may venture to offend afterthis manner. Having fought the battle with the testimonial-mongers, we must now direct the attention of the professionto HYDROPATHY, MESMERISM, and HoM(EOPATHY, and we do notdespair of ultimately leaving those idols without a rag tocover them. After this, there is a reserve of other subjects,from the evils of which legitimate medicine must be cleansed.No terms must be kept with quacks and quackery; they arenot even to be fought with, excepting as pirates who must beput down with the strong hand. No one can say that this

assault is uncalled for, when it is considered that the presentyear has witnessed the spectacle of a professor of medicine inone of the chief medical Universities of this country or the

world, openly teaching homoeopathy; of a mesmeric professorscandalously appointed to the HARVEiAN Oratorship in theCollege of Physicians of London; and of a Quarterly MedicalReview openly advocating the claims of hydropathy as a

system of medicine quite as good as the Hippocratic.When these things-the spawn of PsMSSNiTZ, HAHEBiAN,.

and MESMER—have been dealt with to the best of our humble

zeal and ability, we shall turn to that enormous abuse, thesystem of QuAcK MEDICINES ; and having faith in the ulti-

mate triumph of truth and justice, and knowing this formof quackery to be based preeminently in lying, vice,and crime, to an extent which pollutes the whole com-muuity, we do not doubt that its destruction may be

effected. Quack medicines, and the trade in them, con-stitute Qne of the great social vices of the age, and as

such must be made to topple down. This last may appear a

visionary scheme. We have already said that it is the justiceof the cause, the ease with which it can be shown that the

struggle is required for the defence of the social moralities, thatmakes us deem it to be not Utopian. In a free country, withan independent press, no great iniquity has ever stood-canever stand - against continued and searching exposure.What we shall chiefly ask from the profession in thismatter is the support and pressure of their opinion as an aidto our labours. The cause is their own. We shall be pre-

pared to give edge and temper to the weapon, and the

hands to use it; but the blade and the haft must be suppliedby the profession. In the present state of medical feeling,every man must frequently have had thoughts arise in his mind

respecting the evils and vices of quackery; and every man musthave had under his observation the disastrous results of

quackery. Let him digest those thoughts, and fix such observa-tions, by writing them down, and making them public. A

thought passing through a single mind, a fact known onlyto a small circle, may thus be made to speak to thousands,and to produce fruit a thousandfold. Our own pages are

always open to receive the record; but the general press of, this country might, we are sure, be used with great success, inglaring cases, by professional men. We do not mean in an- ostentatious manner, or for the vanity of individuals; but for1 the good of the profession. There must, indeed, be few

medical men without influence of some kind with the press.They should never suffer an opportunity of vindicating the- profession, or of attacking quackery, to pass unimproved.twenty thousand educated men, or a moiety, or even a small

568 THE ROYAL SOCIETY.-CONTROLMENT OF SYPHILIS.

proportion, of that number, acting in this manner, would soonleaven the public mind.Then, again, besides the foregoing, there is the legal sepa-

ration of the profession from uneducated pretenders-a justand noble object, and one which can only be attained by asystem of REGISTRATION; and the defence of the public healthand safety by an adequate and summary punishment of igno-rant and unqualified persons venturing to undertake the

treatment of disease. This may be executed by a rigorousand active enforcement of the present laws, and by obtainingnew ones of a more explicit character than those we possess.Two of our zealous correspondents, under the signatures of"Exterminator" and "Recruit," have proposed a society forthe execution of the present laws. That the regeneration ofthe administrative portion of the profession is called for, andwill come, in the due and proper time, we have no doubt.The present movement will not end in mere words. Every-thing points to the establishment of an Anti-QuackerySociety, which should deal effectively with the pestilentempiricisms besetting the profession on all sides.We have been charged with orthodoxy. We accept the ac-

cusation ; it is consistent with the soundest professional politics,the truest devotion to the Res-publica Medica, as HARVEY lovedto say. We have been accused, too, of having become aristo-cratic : this may be so, according to the etymological signifi-cation of the word; but we can promise that it shall be aftera democratic fashion. We have been complained of by somefor having fixed the stain of indirect support of quackeryupon some eminent names, as that of Dr. BRIGHT, for instance.This has, however, been from no vulgar desire to abuse andpull down those in high station, but simply because we shouldhave thought it cowardly to attack the faults of beginners? i

and of the poorer members of the profession, while the dero- Igatory practices of the rich and advanced were allowed to go ’’

unwhipped.In a series of future articles, we shall call the attention of

the profession, for some short time, to that triple" Brood of folly without father bred"-

Hydropathy, Mesmerism, and Homoeopathy. May the goodcause of medical orthodoxy prosper!

THE balloting-list prepared by the present Council of theRoyal Society for the election of the new Council on the 30thof November, has just been issued to the Fellows. Accordingto the statutes, eleven members of the existing Council, andten Fellows, not members of the existing Council, are chosenby ballot, to be recommended to the Society for election intothe Council. That this has been a matter of hesitation and

deliberation is evident from the list appearing this year a

fortnight later than usual. The Secretaries remain as before,but not a single name connected in any way with the proceed-ings of the late Council and the Physiological Committee hasbeen introduced among the ten new members proposed, norhave any of the anatomical or physiological members of theCouncil now hastening to its close, been suffered to remain.This is so far well. But the new members proposed are notexactly fitted to further the interests of anatomy and physio-logy, those branches of medical science which come under thecognizance of the Royal Society. The only medical memberof the old Council remaining on the list is Dr. DAUBENY.The new ones proposed are, Mr. SAMUEL COOPER, Dr. PARIS,

and Sir Joarr RICHARDSO:f. Thus, if the present list be adopted,there will not be a single anatomist or physiologist upon theCouncil of the Royal Society for the ensuing year, if we exceptDr. ROGET. We suppose the other members of the Council,in balloting the list, intended to show that they were sick ofthe late proceedings in anatomy and physiology, and werehappy, as far as possible, to get quit of these troublesome de-partments. It may be expected that we should storm at theproposed reappointment of Dr. ROGET. We do nothing of thekind. We do not feign, but feel the most perfect indifferenceabout that point. We are quite satisfied that so much of

irregularity and partiality has been proved against him, thatno proceedings in which he is suffered to take part will haveany scientific weight. It will be an agreeable task for thenew Council to watch his proeeeedings, as they doubtless will

do, in the continual fear that he will involve them also in actssuch as those which have so greatly disturbed the composureof the retiring Council throughout the current year.

IN a late number of this journal, we alluded to the apathyshown by the public authorities in allowing a disease likesyphilis, which affects one-half of the surgical out-patients inour London hospitals,to continue unchecked, when, by adoptingthe precautions taken by the Belgian government, this plaguemight be nearly exterminated. Our remarks were principallyfounded on the numbers so affected in the army and navy, and

large bodies of otherwise healthy adults. We likewise tookoccasion to allude to the loss of labour which our public ser-

vices suffered in consequence of this neglect, and furtherpointed out the absurdity of supposing that vice would decreaseif its effects were thus neglected. To-day we shall continuethe subject, and describe some more of the consequences ofsyphilis.An individual in one of our public services contracts syphilis;

he is examined by the surgeon of his corps, and is sent to the

hospital, where he remains until cured. The worst that can

happen in such a case is, that the country defrays the expenseof maintaining him for a period, during which he is a non-

productive individual. This, on board ship, is, however, of thegreatest inconvenience, when the complement of men is per-haps only sufficient to navigate the vessel. Who suffers in

such a case? Not the individual so much as the service. But

supposing we inflict punishment by enjoining confinement, orloss of rations; the sailor will then not report himself sick,or he will attempt by every means to evade the detection

II

of his complaint. The result is, that the disease goes onunchecked for some time; and that, ultimately, the manis laid up for a longer period, and the efficiency of theservice is further impaired. To punish men who have

contracted syphilis, fails in its object; indeed, we have heardmany surgeons say that they advise and enjoin their men toapply on the appearance of the earliest symptoms after

infection. If this be true of the public service, it is

equally applicable to our hospitals. Within the last few

years, it was contrary to the regulations of the MiddlesexHospital to treat a patient labouring under syphilis; and wehave heard that, even at the present day, the surgeons at theBloomsbury Dispensary are forbidden to prescribe for avenereal case unless the patient pays a fine of five shillings.

Society has, however, paid dearly for the experience bywhich it is now becoming convinced that these puerile regu-

569THE "PRINCIPLES" OF MR. WHITLAW.

lations have completely failed in deterring men from con-tracting the disease, as it has invariably been found that suchsupposed precautions only react upon society itself. We

should recollect that physical contagion is very different frommoral contamination. However well the " silent system" maybe found to answer in preventing moral contamination, itcompletely fails in preventing this physical contagion. Take

a prostitute,who, having contracted syphilis, is unable to pay foradvice, or to lay up at her own rooms until she has recovered.She has been refused attendance or medicines at the institu-

tions above alluded to; is it to be believed that she will starverather than run the risk of infecting a drunken mechanic whohas a few shillings in his pocket ? What is the consequence 1Her own complaint becomes aggravated; she applies to theparish, which is BOUND to relieve her, take her into the house,or send her to the hospital. It is society that suffers, as sheprobably now will be maintained for three months at thepublic expense, instead of at first receiving a little adviceand medicine. But the " harlot’s progress" does not end here;she has infected a drunken married man; he communicates

syphilis to his wife, and the mother to the child. The father

is afraid to confide to his wife" the nature of his complaint;the woman is ignorant of the consequences, until the diseasehas made considerable progress; and then we find an entirefamily converted into non-productive individuals for the space

I

of two months. Death overtakes a large proportion of thechildren thus affected, (as shown in Mr. Acmorr’s paper,) thehealth of the parents is permanently damaged, and the

pharisee who turned the afflicted prostitute away from thehospital door, with the expression, "Get thee hence, Satan!"has now the pleasing satisfaction of learning that HE sentabroad "the pestilence which walketh by night" to afflict theinnocent mother and the child yet unborn.Now we appeal to the profession, if this be not the conse-

quence of allowing this " do-nothing treatment" for syphilis,on the nearly exploded doctrine of preventing vice? and, aswe observed in a former article, has it effected its purpose, ifsuch be its object? No, surely that cannot be, when one halfof the surgical out-patients in London labour under syphilis;one man out of five in the army, and one in seven in the navy.In these articles we are dealing with facts; and will any

one deny that they are not the consequences of allowingdisease to go on unchecked in the metropolis. Is the Christian

community aware of these matters? We say, the Christian; forwe are not addressing ourselves to the canting hypocrites ofthe day, but the philanthropic individual who thinks for him-self. We reply, the public are not aware of the mischiefthey do in not providing relief for the sick prostitute. Sooner

or later the public authorities must investigate her conditionwith as much care as they are about to do the cesspools, ancthe other collections of refuse left in the slums of our largtcities. The period cannot be far distant, when all engaged iithe sanatory condition of our population must become awarEof the physical contamination arising from the neglect in whiclprostitutes are at present allowed to remain; and then it ithat we may look for amendment.

It is not our present purpose to allude to what precautionor regulations should be used; it is sufficient for us first t

point out the condition of syphilis, and to call public attentioto its effects on society,-not in the narrow spirit of the corventicle, but treatingit on the broad and honourable basis whic

should guide all practicable sanatory regulations, fully con-vinced, as we are, that hitherto the philanthropist in thiscountry has not been- made aware of the true effects of this

disease, or he would have paid greater attention to it than isshown in the formation of our Magdalens, or Penitentiaries,-institutions which, as we may hereafter show, have very insuffi-ciently answered the purpose for which they were intended ;for although the promoters of those societies have been guidedby truly catholic notions, yet they have been carried out ina spirit that is thoroughly inconsistent with the nineteenthcentury. But we must reserve the further consideration of

this subject to another occasion, when we purpose further

developing our ideas on these important matters.DoES any one know anything of Mr. WHITLAW, or " Mr.

WHITLAW’S principle," or the " Medical Principles of

Mr. ’WniTLAW," as it is respectively put in a Prospectus of a" Medicated Vapour-bath Establishment," which has beenforwarded for our inspection 1 We should like to learn some-

thing of the "medical principles" of this non-medical person,and whether his non-medical "principles" in private prac-tice are of the same value as those which he advertises to

the public in the Prospectus in question.His " principles," and the institution for their diffusion in

the form of vapour, we are told, have been " countenanced"by the QuEEN DOWAGER, the DUKE OF YORK, Lord BEXLEY,and other noblemen, and although their " sphere of action hasbeen arrested, from the want of funds," our non-medical

empiric asserts that;"For restoring the functions of the skin, removing the

effects of mercury from the system; for dropsical, rheumatic,scrofulous, and inflammatory complaints; there is no remedywhich can be applied with an equal chance of success, and solittle demand upon the constitution."

Besides the" little demand upon the constitution," there is a littledemand upon the pocket. The committee, of course, make anearnest appeal to that most respectable gull, " the benevolent

public who may be anxious to provide their own conscienceswith pillows of down, and to " relieve the sickness of the poor,and give them permanent relief, at a comparatively small cost:’Besides this little demand" upon the public, there is anotherlittle demand upon such poor persons as may not be so fortu-

nate as to get a letter of recommendation from some memberof the benevolent public who has been caught by the

unprincipled assertion of "medical principles." They arekindly promised that they

" Shall, upon the payment of two guineas, be entitled to theuse of baths, medicines, medical attendance of the institution,of the same number and quantity as stated in the third rule,(i. e., sixteen baths,) to be taken by them during the ensuingthree months from the time of payment. The charge for asingle bath, without medicine and medical attendance, to be2s. 6d."

This is the exemplary mode adopted for" Affording gratuitous relief to operative mechanics, do-

mestic and other servants, and indigent persons, upon themedical (?) principles of Mr. Whitlaw."

The " principles" are supposed to be " countenanced," as wehave said, by royalty, by a bevy of lady patronesses and lordlypatrons, noble encouragers of quacks. There is a committee,with, of course, a due sprinkling of reverend abettors of

. medical scepticism, and, to their shame be it spoken, a braceof medical men, in the persons of " Dr. D. B. REID, IS, Duke-

L street, Westminster," and "B. HoRSBUnGa, Esq., Surgeon,

570 MR. ERASMUS WILSON ON THE MINUTE STRUCTURE OF MUSCLE.

Homerton." The Prospectus is further supported by thename of a " Dr. PARSONS" as " physician;" but where the saidDr. PARSONS acquired his insight into " Mr. WHITLAW’S prin-ciples," and his right to the title of Doctor, the " LondonMedical Directory" sayeth not. There is some comfort in the

fact, that the abettors of such nonsense are obliged to whineout, that "its sphere of action has hitherto been limited," andthat there is a sad "want of funds." That lords and ladies who

dabble in quackery as a set-off against their labours for im-proving the sanatory condition of the poor, and that clergymenshould ease their sceptical bosoms in physic instead of divinity,is, perhaps, natural. At all events the thing is too common toattract much attention; but the profession must judge of thepropriety and decency of medical men lending their names tothe promotion of these and similar "principles."

PUNISHMENT BY FLOGGING.

ON THE MINUTE STRUCTURE OF THE ULTIMATE FIBRIL OF THEMUSCLE OF ANIMAL LIFE.

BY ERASMUS WILSON, F.R.S.To the Editor of THE LANCET.

SIR,—As I shall have occasion, in a future communicationon the pathology of flogging, as illustrated in the case ofPrivate Frederick John White, of the 7th Hussars, who diedfrom the effects of corporal punishment at Hounslow, on thellth of July, to refer to the minute structure of muscle, willyou do me the favour to give insertion to the following shortpaper, which was communicated to the Royal Society in June,1844. The paper is in the form of a letter, addressed to thesecretary of the Royal Society, and its principal facts werepublished in the third edition of my work on anatomy, the"Anatomist’s Vade Mecum."

I have the honour to be, Sir, your obedient servant,Nov. 16th, 1846. ERASMUS WILSON.

SIR,—If I needed any apology for addressing you on thesubject of the structure of the ultimate muscular fibril ofanimal life, I should seek it in the fact of the deficiency ofour information with regard to that structure, and in the im-portance of its knowledge to a just understanding of the iproximate phenomena of muscular action. Our iinpel-fectacquaintance with this essential element of the animal organi-zation appears to me to be due to three principal causes:-First, the extreme minuteness of the object; secondly, theobstacles to procuring it in a perfectly normal state ; andthirdly, the great difficulty of isolating the fibril, and preparingit for observation. I might add to these impediments, thewant, until within the last few years, of optical instruments forits examination; for with any power inferior to one capable ofmagnifying five hundred diameters, the structure which I amnow about to describe would be totally invisible.Among the impediments attendant upon the microscopic

examination of the ultimate muscular fibril, I have alluded tothe difficulty of making the requisite dissection; and I maynow remark, that an unusual degree of delicacy of manipula-tion is necessary for this purpose. I have made many attempts,and have failed altogether, and unless I had been aided in thisrespect by a gentleman* whose daily avocations are essentiallymicroscopical, I should have been unable to have determinedthe presence of a structure of exceeding simplicity, but notthe less positive in its existence. The muscle used in the ob-servations which I am now about to detail, was procured fromthe arm of a strong, healthy, man, amputated immediately afterhaving received a very serious injury. Mr. Lealand was fur-nished with the muscle a few hours after the operation, andthe dissection was made by him at once. Here, then, wereconditions the best calculated to ensure a successful observa-tion-the muscle of a man in sound health, and prepared asspeedily as possible by an experienced manipulator, so thatonly a few hours elapsed between the life of the muscle andits preservation as a microscopic object.The ultimate muscular fibril of animal life possesses a mag-

nitude of 200"0 of an inch in diameter. It is cylindrical infigure, uniform, and composed of minute cells. The cells are

* Mr. Lealand, partner of the eminent optician, Mr. Powell.t When isolated, these fibrils are distinctly cylindrical; but being com-

pressible, it is more than probable that they are polyhedral when collectedinto a fasciculus.

disposed in a linear series; they are flattened upon their sur-faces of apposition, and are so compressed in a longitudinaldirection as to leave no indentation upon the cylinder corre-sponding with the point of adhesion. They constitute, indeed,an uniform cylinder, divided into minute subdivisions bytransverse septa, the septa being the adherent surfaces of con-tiguous cells. The contents of the cells are a transparent sub-stance, which, in imitation of the term applied to the contentsof the tubuli of nervous filaments, may be called myoline.The myoline is evidently of different density in different cells,and is the seat of the colouring principle peculiar to muscle.On the density of the myoline are dependent the differencesof refraction of transmitted light, and, consequently, the pecu-liar transverse markings which are characteristic of this kindof muscular fibre.The cells of the ultimate fibril of animal life are arranged

according to a principle of alternation which is coarsely ex-hibited in the alternation of dark and light striae upon theultimate fibre or fasciculus. This alternation, moreover, hasan interesting physiological illustration in the successive ac-tions which are known to be taking place at different pointsof a muscular fibre. It is not, however, my intention tospeculate upon the action of the cells in producing muscularaction; I will therefore at once proceed to record the obser-vations which appear to me to be certain.When the ultimate muscular fibril is examined with refer-

ence to its general characters, a succession of dark oblongbodies, separated by light interspaces, will be observed. Oncloser and more careful examination, these oblong bodies willbe found to be a pair of cells, containing the densest form ofmyoline, and hence, from their highly refractive power, ap-pearing at different focal distances as opaque bodies, or highlyrefractive globules. The density of the myoline of these cellspresents, occasionally, some degree of variety; thus, for ex-ample, I have observed fibrils in which these cells werescarcely to be distinguished from adjacent cells, while inothers they formed prominences on the surface of the fibril-cylinder.Having now fixed the attention upon an alternating series

of highly refractive cells, arranged in pairs, I shall in the nextplace describe the muscular fibril as it appeared in threedifferent states-viz., of contraction, relaxation, and tension.In the contracted state (A), the pair of highly refractive cellspossessed the ordinary size, having the appearance, when outof focus, of a dark oblong body; and the transparent spacebetween the pairs of dark cells was equal in length to one ofthose cells. Moreover, the transparent space was crossed bya well-marked transverse line, indicating the presence of aseptum.The fibril in the state of relaxation (B), measured 2000 of £

an inch in diameter; the dark oblong bodies were the samein appearance as in the preceding fibril, but the transparentspace was equal in length to that of the dark. The transverseline was distinct, and the fibril seemed to be composed ofalternate pairs of transparent and dark cells, all the cellsbeing of the same size.The third fibril (C) was very much stretched, and measured,

according to Mr. Lealand’s estimation, 50600 of an inch indiameter. In this fibril a streak of light could be perceivedbetween the dark cells, and the dark cells themselves appearedto be double. The transparent interspace was somewhat greaterthan the dark; it was crossed, as before, by a strongly markedtransverse line, indicating the situation of the septum, andbetween this transverse line and the adjacent dark cell therewas a faint but very distinct line, marking the existence ofanother septum.From the above analysis of the muscular fibril, made by

stretching, I infer, that the dark and the transparent portionsof the fibril are each composed of four cells, and the seriesconsequently of eight cells ; four containing a more fluidmyoline, and transmitting the light with little refraction, andfour containing a more solid myoline, and transmitting thelight with a higher degree of refraction.

I have, in the next place, to point out the evidence of thestructure now described existing in the ultimate muscularfibre or fasciculus. The fibrils, as is well known, are collected,in considerable numbers, into a bundle, in order to constitutean ultimate fasciculus. It is known, also, that they are soarranged, that similar parts are disposed on the same parallelplane. In consequence of this plan of arrangement, the fourhighly refractive cells will lie side by side throughout thewhole bundle, and the four less refractive cells the same.But as we generally examine the ultimate muscular fasciculusin the state corresponding with the second-described fibril-

viz., that in the state of relaxation, I may simplify the appear-