193

THE LANCET.

London, Saturday, May 1, 1841.

THE POOR-LAW AMENDMENT ACT.

IN one of the earliest books of sacred lite-

rature there is a simple apologue, which

might well make those pause who contendthat, to carry out the new Poor-law, the livesof even the virtuous poor of England shouldbe sacrificed in workhouses. Three men

sent to destroy a city, were entertained byABRAHAM,’ who had no sooner learnt their

’

mission than he addressed the LORD, andinquired if he would not spare the placefor the sake of fifty righteous persons, ifthat number were found within it ? « That

be far from thee," said he, 11 to slay the" righteous with the wicked. Shall not the

"Judge of all the earth do right?" The

LORD promised to spare the place for thesake of fifty righteous ; but the Patriarch,persevering, said, 61 Feradventure there shall

lack five of the fifty, wilt thou destroy all the city for the lack of five ?" And the i

numbers were reduced, by successive appli-cations, to forty, and thirty, and twenty, and,finally, to ten; for whose sakes the LORD

promised to save the city. The workhouse-

test could not be brought into universal use,as proposed by the Poor-law Commissioners,at less than an annual sacrifice of 25,000lives, according to our previous calculations.The Government and the House of Commons

will, of course, be told that the numbers are

exaggerated in this calculation. But will

the Legislature support a measure that de-

stroys one thousand of our fellow-creaturesannually ? Will Parliament consent to the

illicit destruction of a hundred innocent

labourers every year in workhouses ? Nay,if it should be proved that one poor, indus-

trious, virtuous man is destroyed by the

workhouse system, should it be sustained

by a Minister of unquestionable humanity,like Lord JoHN RUssELL ? We trow not.

We know of no fact in statistical science

so firmly established as that of the excessive

mortality in the present workhouses. The

Poor-law Commissioners themselves will

admit that a prima-facie case has been madeout. According to the returns of their own offi-cers, it appears that out of 12,313 poor peoplein workhouses, two thousand five hundred andfifty-two perished in one year! 98,000 paupershave already been dragged from their homes,and driven into the workhouses. The Com-

missioners propose to apply the test to the

580,000 who still receive relief out of thehouse. If the 678,000 enter these places,and the mortality should be the same as in

the hundred and ten workhouses referred

to, it will be seen instantly, by the rule of

three, that 145,000 poor men, women, andchildren, would perish annually under thePoor-law Amendment Act.

We shall immediately discuss the causesto which the mortality in workhouses maybe ascribed; and shall show that no small

proportion of the deaths must be directly as-

, cribed to the workhouse-test. It is not,! however, our duty, or the duty of those who

support the system of out-door relief, to provethat the workhouses increase the mortalityof the poor. The onus probandi lies with theapostles of the new system. They are boundto prove that the workhouses do not increase

the mortality and sufferings of the destitute.But this they have never attempted. The

Commissioners have, on the contrary, eircijm-spectly withheld the most decisive information,and have kept the Government, the House ofCommons, and the public, in the dark. Theyhave never even stated in their Reports thenumber of deaths in the workhouses under

their administration.

That the workhouse-test is, in many cases,a virtual denial of relief, cannot be disputed ;and innumerable facts prove that many of the

most deserving poor prefer death by starva-

tion, to the doom which awaits them withinthe gloomy prisons prepared for them by thePoor-law Amendment Act. But we have

now to inquire, whether the mortality is in-creased by collecting the poor in workhouses.The question is simply this: If the feelingsof the poor were consulted, and they re-

194

ceived an equal amount of relief at their own

homes, would as many die as now perish inthe workhouses? Do 2552 in 12,313 pau-pers perish annually out of doors? The

Poor-law Commissioners might have fur-nished data for a direct answer to the ques-tion. They are fond of experiments. Whydid they not give out-door relief exclusivelyin a certain number of unions, and countthe number of deaths, among the recipients ?There would have been nothing inhumane orrevolting in this experiment. In the absence

of the direct observations which should have

been furnished to the Secretary of State andto Parliament, we submit the following factsto public attention :-

In the year 1837-

2552 paupers died out of 12,313 in work-houses.

382 persons died out of 12,313 persons, inthe district of St. Giles’s, London.How is the enormous difference to be ac-

counted for ? The age of the inmates of

workhouses will account for a part of thedifference. The proportion of old person/! is

greater in the workhouses than in the un-

healthy district of the metropolis. But the

mortality of persons in England above theage of 60 is 7l per cent., according to Mr.

EDMONDS; and if none of the 12,313 inmatesof workhouses had been under 60 years of

age, the deaths should not have exceeded

93G ! It is, however, erroneous to supposethat the workhouses are peopled exclusivelyby old men and women. The following state-ment shows the number of adults and chil-

dren in the workhouses at Midsummer, 1838:

The proportion of children under 16 yearsof age is greater in the workhouses than inthe general population of the country ; for 44in 100 are under 16 years old in the worh

houses; and not more than 41 in 100 in the

general population. The proportion of veryyoung children is small: only 4090 of the

42,767 children are under 2 years of age. The

great majority are 2, and under 16, years of

age. Medical men are well aware that, fromthe age of 5 to 16, is the healthiest period oflife. The mortality in England at the age of10-20, is 5 in 1000; the mortality in Lon-don at the age of 5-10, is 11 in 1000. At

ages corresponding with the ages of childrenin the workhouses, the mortality in St. Giles’scannot exceed 2 per cent. annually.Are the paupers sick at the time of their

admission into the destructive workhouses?A certain number are admitted in a state of

sickness, but the proportion is not much

greater than in the general population. About6 in 100 are constantly sick in St. Giles’s dis-trict ; and we have deduced the following re-sults from a table published by the Poor-lawCommissioners in their last Report (p. 10),professing to show the number of paupersrelieved in 178 unions during the quartersending Christmas, 1838, and Christmas, 1839.According to this table, of 67,497 personswho received in-door relief, 4117 personswere relieved on account of sickness or acci.dent." Only 6 in 100 received into the work-houses were relieved " on account of sick.

ness or accident." The diseases which proveso fatal, therefore, assail the poor after theirentrance into these ANTE-CHAMBERS or THE

GRAVE.

The number constantly sick in the 110 work-

houses, was 1407 in 12,713, or nearly 11 percent. ; the number stated to be infirm, was36 per cent. ; but this evidently included theinfirm from age, as well as the infirm from

lameness, blindness, and chronic diseases ofvarious kinds. The mortality among the in-firm pensioners on the list of the East-India

Company’s labourers in London, was 16 percent. annually; it is at least as high amonginfirm out-door paupers in the metropolis.But the mortality of the young, able-bodied

‘ Maculloch’s Statistics of the BritishEmpire, art. Vital Statistics.

195

adults, and the aged or infirm, taken toge- wife is separated from her husband, and thether, was 29 per cent. in the ten metropolitan child is separated from its parent, and diesworkhouses ! ! in the hands of strangers ? The very air of

We agree with those who ascribe a con- an union workhouse has death in it, or makessiderable share of the mortality in work- the heart sigh for death as a haven wherehouses to the wretched gruel dietaries. The human wretchedness may hide itself in

experience of the old prisons, and the elabo- " cold obscurity;" where sensation, and

rate evidence in the Milbank-Penitentiary the frail tenements of flesh, may perish; oraffair, demonstrated the destructive effects of where the emancipated children may rest

a low, unvaried diet, in conjunction with im- from their sufferings in the arms of the

prisonment. Father of All, and the GoD of the oppressed.The principal cause of the high mortality in It is a fact which cannot be too frequently

the Poor-law workhouses is, however, the im- repeated, that where the diet is the same,

prisonment itself; for if we are to believe the the mortality and sickness are much less

Reports of the Commissioners, the food alone among a hundred families, for instance -

costs more than the whole wages of the agri- lodged in a hundred detached houses -

cultural labourer come to, out of which he than in a hundred families collected under

has to pay his rent, and to find firing and the roof of one large establishment. The

clothing for his family. The felons in the ventilation is better ; for it is exceedinglyhulks have, we believe, one pound of meat difficult to ventilate a large establishment,a-day, or a diet at least three times as sub- particularly where many of the inmates arestantial as the workhouse regulations allow confined to their beds. When any infectious

the poor inmates. The diet, we may add, disease attacks two or three persons in a

was originally bad enough at the hulks ; but workhouse, it vitiates the whole atmosphere :the health of the prisoners was found to all the inmates suffer more or less ; the housesuffer so much from the combined effects of in an epidemic,-is like a city on fire, whereinnutritive food and confinement, that it be- the houses have no party-walls. The malig-came necessary, after a painful and destruc- nant diarrhoea and dysentery produced bytive experience, to raise it to the present the Poor-law in the Bridgewater workhousestandard. How deeply is it to be regretted spread to the neighbouring districts; and

that the Poor-law Commissioners did not subsequently destroyed persons of all ranks

profit by that experience ! and ages in Taunton. Several epidemicsMankind was created to live in Families; appear to originate in the workhouses, as

and all the parallelogram, panoptican, or they did in the prisons of old; and in someother systems, which break up the family, are cases they decimate the community. Choleraas incompatible with health, as they are in- was only epidemic in one place in the yearjurious to the moral, intellectual, and social 1838: it destroyed fifty-five persons, in onefaculties. Man is not a solitary animal; month, in the Coventry wo)-khou.5e, which, itneither is he a thing to be ticketed, labelled, is right to add, is not under the administra-and lodged in cribs, rows, rooms, or bare, tion of the Poor-law Commissioners. We

barn-like workhouses. What sight is more cite the case to show the danger of the work-

delightful on earth, than to see the decrepit, holtse system to the Ilealtii of the community.

old, sinking labourer attended by his natural We have stated enough to explain the mor-

nurse, his daughter; or defended from harm tality which induced the Commissioners to

by his son ? And what is more distressing or ask Parliament to pass a clause for the con-

more deplorable than to traverse an union secration of special burial-grounds in connec-workhouse, where the old women lie in tion with the union workhouses. The neigh-rows, and the old men crawl about wards bouring churchyards are rapidly filling up,into which the sun never shines ; where the and the parishes in which the workhouses

196

are situate complain of the encumbrance. The clause was struck out of the new Bill at the

suggestion of Sir ROBERT PEEL, who, as hehas refused the Commissioners accommoda- I

tion for the victims of the law, on grounds of humanity, will, we trust, on the same,

grounds, join us in refusing them the work-houses, which must henceforward be consi-dered insidious instruments for terrifying,entrapping, and destroying the aged, help-less, unfortunate poor of England. Before

Sir ROBERT PEEL wastes his sensibility onthe modes of burying paupers, let us hope thathe will inquire whether it be necessary to killso many ?We earnestly entreat the Medical Profes-

sion throughout the country to exert them-

selves to the uttermost at the present crisis.

They may put a stop to the atrocities of thenew Poor-law system. We address the Me-

dical Profession on this subject, as a bodyof the most intelligent and benevolent men inthe country; they know the poor; they havewitnessed their sufferings. Let them, then,in the name of GoD, and of our common hu-manity, with one voice, call upon the Legisla.ture for deliverance from the fatal work-

house system: it is their office to stand be-

tween the destroyed and the destroyer. All

relief should, if practicable, be administeredto the families of the poor at their own homes.

THE last Number of the 11 WestminsterReview" contains a valuable article on theMedical Corporations, which well merits theattention of our readers, although it is ad-dressed to the public rather than to the

profession. The writer’s principles are sound,and are expressed with a vigour, conviction,and raciness, which contrast with the smoothphrases of the article in the " QuarterlyReview " on the same subject. We shallextract a few passages." The perusal of the facts which we have

detailed must lead to the inevitable conclu-sion, that the College of Physicians, insteadof preventing illegal practice, such as thetreatment of disease by empirics, which wascertainly the original object of its institution,has degenerated into a secret, inquisitorialcourt, where jealousy can bear full swaywithout being subject to any responsibility

whatever. The president of the college pos=sesses power in some measure analogous toa bishop. He is supposed ex officio to pos·sess more wisdom and discrimination thanhis brethren. He has the power of patro-nising such licentiates as he pleases, and ofraising them to the fellowship ; the fellowsonly collectively have the power of nomi.nating, but the president has a veto."

« The College of Surgeons is a self electedboard of twenty-one persons, who transacttheir business without any regard to theopinions of the profession. They exact ex-aminations and fees, but give no publicstatement of the mode in which they expendthe latter. This conduct has always been

productive of the greatest dissatisfaction tothe profession, and has, upon more than oneoccasion, led to conflicts between the mem-bers of the college and the council ; it hascontributed also, in no small degree, to theexistence of illegal practitioners.

" APOTHECARIES.—The origin of this classof practitioners is, perhaps, one of the moststriking proofs extant of the total incapacityof the two other licensing boards as now

constituted, and of the danger of entrustingirresponsible power to any class of meawhatever. An individual acquainted withthe practice of surgery and of medicinewoulfl constitute, one would expect, a gene-ral medical practitioner: an examination,therefore, both by the College of Physiciansand the College of Surgeons, would be suf.ficient security to the public of the abilityof a professional man to practise all thebranches of the healing art, provided theexaminers gave satisfactory evidence to thepublic and to the profession that they werequalified to perform their functions with

efficiency. Instead of superintending, how-ever, the interests of the profession, andproviding for the benefit of the public, thesociety of druggists or of apothecaries, in1815, were allowed to seize upon the pro-vince which the existing corporation couldnot or did not choose to adjust, and to con-stitute themselves into a distinct order,who, strange to say, not only granted licencesfor persons to act as physicians and sur-geons, but in the third capacity of drug-gists, or dispensers of medicine. Now,what were at first, under the corporations,two distinct branches of the profession, reoquiring distinct individuals to practise each,were conjoined together in the persons ofdruggists. It has been asserted that thisnew body have done much to improve thequalifications of the general practitioner.But we aslc, could any corporation, entrustedwith such powers as have been granted tothe Apothecaries’ Company, have done lessthan has been effected through their instru.mentality ? The Apothecaries’ Companyhave imitated the College of Physicians,but on a larger scale. Instead of prosecut-ing illegal and ignorant practitioners, they,

197

on many occasions, carried on a crusade

against highly-edlicated and competent men,who happened to be members of Scotch orIrish colleges, and merely sinned by not

being members of the Apothecaries’ Com-pany. Instead of excluding from practicethe impudent quack, they prosecuted, insome instances, the qualified surgeon, thehighly-educated doctor of medicine, and thusgave a loose rein to that envy and jealousyin the profession which are always too aptto spring up wherever competition exists."The puerile objections to the representa-

tive system are disposed of in a single para-graph." The whole of the members of the pro-

fession might be enrolled in a general list,either by the voluntary or coercive system ;and a representative council might be electedby the suffrages of the whole profession.While we recommend the representativeprinciple, we are influenced by the consi-deration that it is the only just system of choosing rulers with which mankind are ]acquainted. Objections can be urged againstsuch a system, only because the highest perfec- 1tion of man is but imperfection. We have no i

hesitation in giving it as our firm belief, that tthe best men in the present corporations would be returned as councillors. It is ]true that the present objectionable mem- (

bers, and there are many, would be sufferers by the change; all those who are sensible iof the unworthiness of their present honours fwill, therefore, be opponents of every scheme tfor uniting the exising corporations." c

The system of public competition for public offices is ably advocated." Cornplaints are continually made by

candidates for public medicat offices, thatmerit has no part in the recommendation tosuch situations. One reason we believe tobe that, under the present system, the mem-bers of the profession are pulling differentways ! If they competed upon a fair field,their exertions would tend to strengtheneach other’s interests. Ou the contrary, ina majority of instances, candidates are de-pendent upon the votes of uneducated per-sons, who are unacquainted with the propermode of testing their qualifications. Thegreat question at issue in the appointmentto responsible employment is, after all, theproper mode of testing the qualifications ofa candidate. It has been affirmed that En-glishmen are so peculiarly constructed, thatmen of talent and of established reputationwould not, as in other countries, presentthemselves at a public competition. It maybe true that the older men would not engagein a contest with younger spirits ; but thelatter, who are to stamp the character of thecoming age, would enter npon public com-petition with zeal and alacrity. It is agrievous mistake to say that the system ofcompetition is foreign to our nature. The i

schoolboy exists, we might say, byemula-tion, and the college student contends forhis prizes. It is only when he has reachedmanhood that the nature of an Englishmanalters. It is a libel upon the laws of natureto say that their study admits of no compe-tition, and that Latin and Greek are the onlybaubles worth contending for. As wellmight we proclaim those the best physiciansqui savent en Grec les noms de tous vos rhu-

matismes.’ The advantage of our positionhas been well illustrated by Professor Clark,of Aberdeen (Commissioners’ Report, 1838),who states that, in the year 1717, severalprofessorships in King’s College were madevacant by royal commission on account ofthe political offences of the professors ; ;among others, the chair of mathematics.The vacancy on that occasion was filled upby competition, and the person appointedwas Colin M’Laurin. Ten years afterwardsa vacancy occurred in the same chair; itwas not filled up by competition, and theson of a former provost was elected, un-known to possess any other qualification.The next vacancy took place in 1766, andthe appointment was made by competition.On that occasion no less than six candidates

presented themselves; the most distinguish-ed of these were William Trail, late Dean ofRaphoe, who proved to be the successfulcandidate; Robert Hamilton subsequentlyprofessor, and known to the world by hiswork on the national debt; and John Play-fair, late professor of natural philosophy inthe University of Edinburgh. One of thecandidates was a son of one of the profes-sors, who was a son of a provost; there islittle doubt that he would have been ap-pointed had there been no competition, andthe other candidates would not have ap-peared."The article is said to be written by Dr.

R. D. Thomson, and is as creditable to thecharacter as the talents of that young and

rising physician. At another time we willendeavour to make room for a sensible noteon medical reform by the editor of the

" Westminster Review," which, we mayadd, is now conducted with’a talent that

places it on the very foremost rank of thequarterly periodicals.

A Treatise on the Nervous Di&*ases of Wo-men; comprising an Inquiry into the Na-ture, Causes, and Treatment of Spinal andHysterical Disorders. By THOMAS LAY-cocK, M.D. Longman and Co.

IN introducing the above work to the noticeof our readers, we cannot but re-echo thesentiments which have induced the authorto devote his attention to the subject. He

regrets that works on the practice of medi

198

cine are usually dry recapitulations of certainphenomena, symptoms and modes of cure,which, although, probably, quite applicableto the disease in its most independent andcharacteristic form, yet fail to supply anydata by which unexpected secondary, anddistant effects are produced. There can beno question that such works may be founduseful and invaluable records for occasional

reference ; but as they conjoin in their de-lineations of disease, none of the physiolo-gical characters by which morbid affectionsof certain parts are accompanied, they ceaseto interest the mind, and to supply it withsubject for thought and reflection. More-

over, from their very nature, works of merepractical detail must necessarily be dry anduninteresting, well stored with facts, excel-lent dictionaries of disease, but still avail-able only in the majority of cases as worksof occasional reference : nor, indeed, is it

possible in any disease, however simple initself, to follow out the endless chain of

sympathetic phenomena, without a deeperacquaintance with the laws of vital action

and vital sympathies than such works af-ford.With this view, Dr. Laycock has aimed at

producing a fire-side companion, a treatisewhich shall interest in its reasoning, as wellas instruct in its more practical materiel; ;and for the purpose of aiding in the fulfil.ment of his wishes, he has had recourse tothe noble and rich fiold which physiologyunfolds to the scientific cultivator of medi-cine. Nothing can be more dignified andennobling than the science and practice of

medicine combined ; and we conceive thatthe author of this work is entitled to the

approbation of his fellow-members of ourprofession, for striving to introduce a moreelevated consideration of the science ofdisease and human suffering than has

hitherto been the habit, and for endeavour-ing to lead the practitioner to reflect uponthe causes involved in the daily routine ofhis duties.

Scientific medicine, observes the author,has a much wider range of immediate prac-tical usefulness and prospective benefit thanthis mere practical medicine: its rules areless applicable to individual diseases thanto the infinite variety of individual cases.It gladly makes use of empiricism; hut itstudies symptoms to demonstrate their causes,and relieves the former by removing the

latter; or counteracting their effects) and

when science fails to guide, it is still ableto apply empirical knowledge with preci-sion and effect.

Dr. Laycock’s work will he perused withmuch interest; and we doubt not that itwill fan into life the spark of philosophicalreasoning present in the minds of manyof our professional brethren, but wantingsuch a stimulus as the treatise before us to

develop its presence.

Popular Cyclolrccdia of Natural Science:Vegetable Physiology. Published by theSociety for the Promotion of Popular In.struction. Tanner, Brothers.

THE treatise before us, on Vegetable Physi-ology, is the first of a series proposed to bepublished by a Society for the Promotion ofPopular Instruction. If we may judge bythe present number, we should augur wellof the undertaking; the treatise is well

written, and is stored with useful and valu-able information. It is intended that the

subjects shall be treated upon the same

general plan, to be executed by the samewriter, so that the necessary connection andharmony may be maintained between them.The list of subjects for future essays are,

mechanics, astronomy, hydrostatics, hydrau-tics, pneumatics. Sound, heat, light, elec-tricity, magnetism. Chemistry, and its ap’plication to the arts. Mineralogy and geo-logy. Vegetable physiology, botany, zoo-logy, animal physiology, the habits andinstincts of animals ; and the series will beconcluded with a volume on natural theology.

DR. ZECCHINELLI. *

* We are indebted to one of Dr. Z.’s dis-tinguished countrymen, now in London, forthis brief notice, which we give in his ownexcellent English.—ED. L.

ON the 18th of February, 184!, died, atPadua, one of the most learned and cele-brated physicians of Italy, Dr. G. M. Zec-chinelli. He was born in Grantorro, a littlevillage in the vicinity of Padua, in the yeer1776. At the age of 15 he became a studentof the university of that city, and took hisdegree in medicine in the year 1795, havingthen completed his 19th year. Throughoutthe course of his studies he always evincedreat talent ; a rare perspicacity and a re-markable firmness of purpose. Aloof fromthe dissipations by which, at his age, so

many are led away, he spent his life amonghooks, furnishing his mind with a store of