396

THE LANCET.

LONDON: SATURDAY, OCTOBER 17, 1857.

PESTILENTIAL STATE OF THE SERPENTINE

IN such a vast metropolis as this, where so many and suchpotent causes of physical degeneration are at work over whichwe have comparatively little control, it becomes a paramountduty to remove all those causes of disease which are undercontrol. To pretend that money is an object when such avitally important measure as the cleansing of the Serpentine isconcerned, is an excuse so frivolous as to be an insult to thecommon sense of our citizens. If we can assign our royalfamily a dotation of something like half a million a year, andgive splendid dowries to each daughter of England as she be-comes marriageable-if we spend all this money without a

murmur to secure the permanent luxury of a few individuals, itis the grossest folly in anyone to say that even £100,000 would bean expenditure calculated to excite the animadversions of tax-

payers, when the health and life of hundreds of thousands of

persons are involved- a consideration we would humbly ventureto represent as of infinitely greater account than the lining ofroyal purses. The money which the Ministers of the Crown

expend with so niggardly a hand is always that which thenation wishes to pay away at the first opportunity of gettingthe work done, and that which is profusely expended is in-variably on account of objects which only interest a parcel ofdilettanti Downing-street officials. After all, if the self-con-stituted auditors of the public accounts-the systematicgrumblers and opposers of estimates of all kinds-are so veryformidable, there is plenty of money somewhere. It is not

very long since the Grand Duke of TUSCANY spent £500,000of his private fortune in a work of a cognate nature-viz., in

draining and otherwise remedying the condition of an extensivemalarious district in his dominions. We are not of a temperhere to be pensioners on royal bounty, but we should like tosee money expended with a little more regard to the lives of themasses. Existence is hard enough to them under any circum-stances ; but to be poisoned by the miasmas of a filthy pond,which might be easily made as clear as crystal, is downrightslaughter and cold-blooded cruelty.

There is no excuse for indifference or incredulity as to theeffects of such exhalations as the Serpentine gives off. It is

folly to ask for individual instances of disease clearly traceableto the influence of its miasmas. The shifting nature of thepopulation, the obscure and adynamic form of the disorderswhich derive from such a cause, the difficulty of eliminating in

particular cases the numerous other possible causes of disease,and the fact that a great part of the effect of deleterious

miasmas is expended in lending a type and character to thediseases of a district or a neighbourhood, are sufficient reasons

why it may be difficult to produce those individual and per-sonal facts which alone seem to influence the lay mind. But

if there is any reliance to be placed upon the ordinary processesof reasoning which we employ-if like causes produce likeeffects-if agencies at work and producing disease at one placewill act in the same way in another, making allowance onlyfor differences of degree-we are fully justified in speaking ofthe mortal nature of the effluvia of the Serpentine. Sulphuretted

hydrogen and carburetted hydrogen, and the nameless butsubtle emanations which produce intermittent fevers and hostsof other disorders in the Campagna of Rome, the territoryadjacent to Rochefort, the Sologne, the delta of the Ganges, Orthe fens of Lincolnshire, are the same, identically the same, aswe have here in London. The only real difference is one of

degree. We have a smaller extent of surface from which such

emanations arise, and a less ardent sun than in some of th9localities mentioned, but every element of disease and deathwhich is at work there is at work here.

Now setting aside cases of disease, let us simply ask howsuch emanations act upon a population, in circumstances wherethere is an absolute certainty as to their direct causative con.nexion with the observed conditions of the people.As far as the personal aspect of the inhabitants of such dis.

tricts is concerned, we are told upon the very best authority,that they are from birth characterized by every appearance ofa deep-rooted cachexia, that they are small in stature as theyadvance to adolescence, with bloated countenances, waterybodies, impoverished blood, pot-bellies, engorged livers, feeblemuscles, heavy wits, and general sluggishness of the nervoussystem. Here is a faithful picture of those London childrenwho from birth oscillate between the cradle and the dispell’sary or hospital, and find their way to the cemetery before fiveyears of age-children never seen by the upper ten thousand,but constituting just o:1e-half of all the children born in themetropolis. But the full extent of such an evil is only visiblewhen its effect upon the duration of life, and per-centage ofmortality, is taken into account. In the malarious district ad.

jacent to Rochefort, the mean duration of life was formerly onlyabout twenty years, and, indeed, according to CONDORCET, onlyeighteen years. BECQUEREL tells us that one-half the youth ofthis district are usually unfit for military purposes. It has, in-deed, sometimes happened that every man called out by theConscription has been found useless. And to crown the whole,M. LETERME, a person well acquainted with the subject frompersonal contact, avers that in some particular parts there is nota soul to be found more than twenty years of age. The deaths

in some districts are one-fourth, and even one-third, morenumerous than the births, and the number of deaths to the

population as one to thirteen(!) per annum. That is, aboutthree times the proportion of deaths throughout France. In

order to remedy, as it were, this frightful mortality, the birthsin these malarious districts are considerably more numerousthan elsewhere; but this does not suffice to keep up the popu.lation, which undergoes a regular diminution, even though sub-ject to constant immigration.Now these facts are the results of causes identical in their

nature with what we have detailed as pertaining to the effluvia.of the Serpentine. The only difference is one of degree. Addedto all our necessary causes of physical degeneration, we have inLondon fifty acres of malaria-generating surface as an unnece8-say cause of disease. A plaything converted into a lake ofpoison.We find that Dr. SANDERSON recommends the adoption of

the same measures with regard to the Serpentine as have beentaken with regard to the water in St. James’s-park; but withthe caution that the mud should not be exposed to the airmore than possible. The mud should be removed during theapproaching winter, if possible in successive portions. The

bottom of the lake should be laid with rubble and conerete, and

397

INTERNECINE WAR AT ISLINGTON.

the water-supply should be derived entirely from springs. Thecost of such an undertaking has been estimated at about

£50,000; for such an object it would be well spent. In the

- event of there not being funds available for the purpose, it.would be easy to procure a special vote when Parliament meets.A popular Government would find no difficulty in proouringsuch a grant. Part of the expense might be defrayed by thesale of the slime, which must be valuable manure.

If this winter passes over without the cleansing of the

Serpentine, the Commissioners of Woods and Forests will beresponsible for many thousands of deaths between now andthis day twelvemonths.

WE are sorry to have to call attention to a fierce controversywhich has been going on of late in the pages of the Islington I

,

Gazette, an hebdomadal periodical, if we mistake not, latelyestablished. We are sorry to find professional men quarrelling.at all, and, still more, carrying on their disputes in a laypaper. We shall have the motto "perfervidum ingeniumscotorum" changed into "perfervidum ingenium medicorum"if we do not take heed. Surely we ought to roar as gently asany sucking dove, and when accumulated wrongs at lengthmake us blatant, we should inveigh against each other in ourown organs. Modesty is a maiden, and we know

’"The chariest maid is prodigal enoughIf she unmask li Pr beauty to the moon-" ’*

It surely savours somewhat of boldness then to flaunt ourselvesin the Islington Gazette, to be made the jibe and jest of un-discerning people, and the mark for arrows aimed at failings,foolishly supposed to pertain to ourselves as a body, instead ofto our common humanity.The history of this suburban émeute is as follows :-A certain

Mr. GILSON, now dead, was in his lifetime the district medicalofficer for the south-east division of Islington. For twentymonths prior to his decease, illness incapacitated Mr. GILSONfrom discharging his duties, and Dr. BRADFORD, his partner,undertook them by and with the approval, it appears, of theboard of trustees. But upon Mr. GtLSON’s death it became

necessary to elect a successor, and thereupon ensued occur-rences " horrescimus referentes," to wit these.Dr. BRADFORD, the partner of the late Mr. Gn,sox, who for

twenty months had discharged the duties of district officer to’the entire satisfaction of all parties concerned, became a candi-date for the vacant office. Dr. BRADFORD is a graduate inArts and Medicine of Trinity College, Dublin, a member of the.Irish College of Surgeons, and a possessor of the obstetricdiploma of the Rotunda Lying-in Hospital. But at a meetingof the general purposes committee, a Mr. HERVEY, a vestry-man, who is in practice as a surgeon, states that Dr. BRADFORDhas no English diploma, no professional status, and ought notto be elected. This statement finds its way into the IslingtonGazette amongst the local reports, and then Dr. BRADFORD,

"Obstupuit, steteruntqne comae, vox faucibus haesit,"

but only for a time; for Dr. BRADFORD soon gathers togetherhis forces, and attacks Mr. HERVEY and others, who crop upas time rolls on, with great vigour, and with a wit and pun-gency which might well have been expended on a better cause,and against worthier adversaries.

It appears that Mr. HERVEY practises on the strength ofhaving done so before 1815, and Dr. B. retorts the charge .of

no professional status upon Mr. HERVEY. Then an anonymous

correspondent takes up arms; but as he simply goes upon thetheory that the " Hall" is a necessary qualification for thevacant office in question--a theory amply accounted for by thefact of his being himself an apothecary his remarks onlyobscure the real quarrel.Now, for anyone to say Dr. BRADFORD has no professional

status is simply ridiculous. He is a graduate in medicine of aschool that stands high, a member of a college of surgeons, thediploma of which confers all the privileges of an English sur-gical diploma, he is a certified man-midwife, and a graduate inarts. But because he did not take one diploma in Lincoln’s.inn-fields, whose value our readers may infer from our obser.vations a few weeks ago, and because, moreover, he did nottake the Blackfriars’ licence, he has no professional status (!)and ought not to be elected. The retort against Mr. H. waswell-deserved, though we do not endorse it, because he is aqualified practitioner by prescription-just as a right of wayobtains by so many years of unobstructed traffic, or as it be.comes unlawful to block up a neighbour’s window after hisfamily have been quietly investigating one’s domestic arrange.ments through it for another certain number of years, or as adebt become statute run.

The question really is this : Does the law require the officerto be an apothecary ? If it does, then Dr. B. is not eligible inthe event of a surgeon- apothecary presenting himself as,a

candidate; but if no such doubly-qualified person comes for-ward, then Dr. B. is eligible. Any question of his profes-sional status is at once untrue and puerile.

This, then, is the great Islington war :Thus all through merry IslingtonThese gambols they did play."

We are sorry to find such a disagreement at all, and especiallyin a lay periodical The fault, however, lies with the presentanomalous state of the law, which makes a distinction be.

tween virtual and legal qualification in the teeth of degreesand diplomas.

WE can hardly believe some statements which have appearedregarding the management of the surgical duties at St. Tho.tnas’sHospital. At an inquest lately held, evidence was given tothe effect that a man who had been knocked down by a vehiclewas taken to the hospital, and thence summarily dismissed.Further, the man in question was subsequently seen by Mr.KNAGGS, of Westminster, who discovered that the poor fellowhad sustained a fracture of eight ribs on one side, and nine onthe other. And this man is gone where Polonius went-that

is to say, to a certain supper; and St. Thomas’s Hospitalis charged, or, rather, is not entirely acquitted of beingconcerned in the result.

Now it most probably has really happened, that some juniorstudents officiating for the house-surgeon have made this

blunder-for blunder it was to omit to examine the chest of one

knocked down in a, crowded thoroughfare by a dray or omnibus.The dozen medical students were not out of place, but exactlywhere they ought to have been; but it does appear strangethat some one more responsible than anyone proven to havebeen on the spot was not there. Mr. WHITFIELD did not,explain the circumstance satisfactorily; and we, like many

other parties, would like to know if the facts spoken of asf facts in the daily nress are reallv facts: and if not. what is

398

MEDICAL ANNOTATIONS.

the truth. There is a very practical point connected with sudoccurrences which we are anxious to see settled.

It is evident, at a glance, that such an occurrence as the on(referred to could not take place if there had been a responsiblEsurgeon resident at the hospital. It is absurd to expect th<

very young men who are the " dressers" at our metropolitan

hospitals to be equal to every emergency. What is wanted its a

resisident surgical officer-a man of attainments and professionaposition, remunerated in a manner worthy of his services, wh<

may be responisible in the absence of the senior, and in whonthe seniors, the governors, and the public can repose confidence,In all our large hospitals there ought to be such an officerUntil this measure is taken, cases will arise from time to timcalculated to shake the confidence of the public in institution:which are deserving of every support and commendation. I

is but a short-sighted economy which calculates the salary oan experienced resident-surgeon. The mere existence of sucl

an officer would be the making of the minor hospitals, and th<

staff of the larger institutions is discreditably incomplete without one.

ANATOMY is the foundation of medical science. A thorouglknowledge of the structure of the human body is essential tc

every man who practises the healing art. Whatever, then. interferes with the practical study of anatomy must be regardedas an injury inflicted upon the profession and the communityat large. Up to the time of the passing of the Anatomy Act,subjects for dissection were difficult to obtain, and the studenihad to pay very largely for the " parts" allotted to him. Wherthat measure became law, there was a much greater facility iEobtaining bodies for the dissecting-room, the charge for whiotwas made simply for the purpose of after-interment. Occasion.ally, however, there has been great dissatisfaction expressed,both as to the supply and to the mode of distribution. Com

plaints have reached us of late of the manner in which thebusiness of the office of Inspector of Anatomy is conducted.We need not at the present moment enter further into this

part of the subject than to condemn a system which places, in

reality, the proper supply of subjects, both as regards thenumber and the price paid for them, in the hands of the under-takers. The price at present charged to a student for eachpart varies from eight to ten shillings, an exorbitant sum whencompared with that paid in Paris and other Continental cities.But the undertakers now propose, nay, actually insist on, rais-

ing their price for a subject by ten shillings, making theircharge for the interment of the body exactly &pound;3 2s. This

surely must be an extortion. If, however, medical students areto be subjected to the caprices of officials, and the extravagantcharges of undertakers, some change in the mode of supplymust be made. The matter should be urged upon the Govern-ment, and it would be well for a deputation from the differentschools to wait on the Home Secretary, and lay their com-plaints fully before him.

Medical Annotations." Ne quid nimis."

WHEN Jacques related his ambition to don the motley, andthus attained a license to " cleanse the foul body of the infectedworld," he displayed consummate knowledge of the most assail-

able point of the wicked and vicious, whose presence is a pollu.tion to the fair earth. Using his baton with the same goodpurpose, we believe that the sparkling articles of our contem.porary, Punch, are frequently far more potent against wrong.doing than ponderous and solemn leading articles stuffed withdreary truisms.

"Ridiculum acriFortius ae molius magnaa plerumque secat res."

It is fitting that we should acknowledge the shrewd blow reocently dealt to the quacks in the columns of Piancle, Leapinginto the midst of the hawk-billed tribe who prey upon the hot.blooded vices of our youths, and exchanging his bauble for asharp and many-tongued scourge, he has spread more terrorand dismay in their ranks than did Wamba with his hamamongst the Jews of York. He has converted the luxuriantfruits of their rascalities into nauseous Dead Sea slime; he hastransformed those gaudy equipages in which they are wont toinsult our parks into tumbrils of infamy. Their gorgeous man.sions he has made gilded prison-houses of convicted shame;their painted and bedecked female companions the just mark ofscorn; their splendour, emptiness; and their gold, guilt. Asthese men are a common nuisance and a public hurt, it is theduty of honest citizens to pelt them with whatsoever is mostunsavoury to their nostrils, or most cutting to their skin. Butwe should regret if the whipping-post were cheated of any ofits lawful prey; for there are certain less-known quacks whoserascality is not less mischievous. Rogues who prey upon theblamelessly infirm-who trifle with the blind, and abuse thedeaf-who heighten the fears of the "nervous," deepen thegloom of the " melancholy," and increase the ills they promiseto assuage. They make a market of disease, and produce suf.fering for their own vile ends. Their puffing advertisementsare patent in the broadsheets of the press, and are framed withthe most ingenious mendacity. To one a secret remedy hasbeen revealed by a sheikh, to another by a doctor of divinity.One brings his roguish art from the Crimea, and another visitsus from the United States. For, since the adventure of Dr. Fell,several American quacks have arrived in England, evidently im.pressed with a belief in our extreme gullibility. We cannot

deny that one ’cute Yankee has made a good harvest amongstour simple ones, but do not think the process will be soon reopeated.

-

" Pudet hoc opprobria nobisEt dici potuisse et non potuisse reFELLI."

One of these newly-arrived men styles hims3lf Dr. Watson,of the " Reformed Medical College," United States, and is now

distributing a pamphlet, entitled " Remarks on the RationalTreatment of Spermatorrhoea, and its Concomitant Complaints,by means of the American Curative Instrument," price .63 38.in silver. This precious production is the very type of un.blusliing impudence, ignorance, and qua‘kery. Persons arecautioned against " applying to country practitioners, who toooften not only protract the cure to a longer period than neces-sary, but not uufrequently permanently damage the consti.tution of the patient by improper treatment." Such assuranceis almost sublime: the wolf cautioning the sheep against theirshepherd. All the artifices which the vulpine nature of quackerycan suggest are brought into play: garbled extracts falselyapplied; the deceptive use of phrases apparently applied to thegreat and good Dr. Watson; the lie concealed, the lie suggested,and the lie declared. The system is completed by the institutionof a " Philanthropic Society of Grateful Patients" of Dr. Wat.son, cured of "great nervousness, debility, exhaustion of thesystem, groundless fears, thoughts of melancholy, and directedby Providence (sic) to that gentleman." A" Reverend" H.

Williams, in pursuance of the resolutions of the committee,transmits a copy, gratis, to thousands of people through thepost-and so the sham is completed. As this abominablequack courts publicity, we accord it to him. He seeks a re-

cognition of his services, and will receive it in the indignationof our reader?.’