324

THE LANCET.

LONDON: SATURDAY, MARCH 28, 1857.

DOES SMOKING INJURE THE CONSTITUTION t

CALM and unbiassed observers may always draw from thennumerable disputes and controversies of the passing hour, ’,additional confirmation of the wise maxim- ’

" Medio tutissimus ibis."

If the three paramount excelleaces of oratory are-first, ’,action; second, action; and third, action: it is no less certainthat the three first essentials of the philosophy of living are- ifret, moderation; second, moderation; and third, moderation. IMan, in his triple aspect of moral, intellectual, and physical,still requires for the purposes of life, and for the pleasures of ex-istence, a just conservation of the middle course. Frantic enthu-siasm is as far removed from moral health as dull apathy. The

meteoric glare of a CHATTERTON is as unhealthy and profit-less as the Boeotian stupidity of a clodpole. And the reli.

gious abstainer from every species of physical enjoyment hasno more claim to be considered a model for the imitation of

humanity, than the systematic wallower in every manner ofsensual gratification. If we were to become, in turn, the con-verts of every species of abstinence recommended to us fromtime to time, we must land ourselves eventually in some veryextraordinary doctrines. Let us forswear meat with the vege-

tarians; salt with someone else; alcoholic drinks with the

disciples of Father MATTHEW; sugar, spices, and cotton ve4li-ments, with the ultra-emancipators; and TOBACCO with an-

other section of mankind. Where is the prohibitory list tostop ? In what article of consumption is there not hidden a"lurking devil ?" Are we fed and clothed with destruction?

Do we drink and inhale daily perdition? Are we to become

Manicheans, and settle down into the lugubrious convictionthat whatever is material is the creation of the Author of Evil ? 1

Are we to wage a war of utter extermination upon whatever

gratifies the senses? Are poetry, painting, port wine, andpipes,-all that is sweet, and all that is sapid; all that is exhila-rating, and all that is soothing, to be run down by a moral razzia,and humanity, with all its innumerable cravings and capacitiesfor enjoyment, reduced to the condition of an intellectual vege.table? !

If all were true that has been urged against each of the goodthings a bountiful Providence has given us, the human racewould have been exterminated long ago. It. needed not the

additional horrors of tobacco to put the extinguisher upon theflickering light of human vitality. Inflamed and degraded byfeeding upon animals, struck down by the leprosy of salt, andsubdued in soul and body by the filthy enchanter, alcohol,-we were silently and surely (so said the vaticinators) progressingtowards our own final abolition as a race. But the prophetshave prophesied falsely; and we can still point with triumphto modern instances of moral excellence, vast intellect, and

high physical development. Moreover, we worship more ar-dently than did our fathers fifty years ago; there is ten timesthe active benevolence; and morals have wonderfully im-proved. We can pour a continuous stream of voluntarywarriors upon the inhospitable shores of a hostile power three

thousand miles distant from our ports. We still continue te

absorb whole empires whose early history is lost in the dimtwilight of antiquity. We press into our service agencies ofgigantic powers, whose properties were sealed to the vision ofmen fifty years ago; and we coerce the very elements to

do our bidding. Yet we are confidently informed, about twicein each decade, that the tocsin of our national destruction hassounded; that glory has departed from us; that nothingis left us now but to " weep o’er days more blest," or sing anepithalamium over the tomb of English pre-eminence.The weekly strife which has found an arena in our pages

since the first number of the present year, is full of instructionfor those who will take the trouble to analyse it carefully forthemselves. It has been a strife of many words, many facts,many deductions, and, above all, of many general impressions.Now the denouncers of tobacco have appeared to be in theascendant; now the advocates for its moderate use, under

special circumstances and conditions: the tide of victory ha*rolled hither and thither,

Non tam prsecipites bijugo certamine campumCorripuere, ruuntque, effusi carcere currus;Nee sic immissis aurigse undantia loraConcussere jugis, pronique in verbera pendent.***** x

.... Pulsati colles clamore resultant."

And truly the clamour has been very great.Now we are not going to give a verdict in favour of

the abolition party, neither can we defend tobacco-smokingas it is now practised by the majority of the middle

class; for it is, in our opinion, the middle class who are

principally concerned. The abundantly wealthy, whose socialposition is not dependent upon the daily expenditure of brainby which the middle class live, nor upon the diurnal wasteof muscle by which the masses exist, may live pretty nearlyas they like. Exhaustion does not dog them in a thousanddifferent shapes as it does the brain-workers and muscle.

workers; they may exceed now in one item or mode of ex-haustion, and now in another; but the general result, howeverthey may for the time incur voluntary self-degradation, is un-important both as regards the class and as regards the nation.The general conditions under which the aristocracy live are sonotoriously adapted to and productive of a longevity unknownin other ranks of life, that, except as an aesthetic question,they have no concern with the matter.But as a question of taste and expediency, we imagine that

the scions of aristocracy are mistaken in their indulgence. If

smoking has any advantages, they have to be purchased-thatis to say, something must be sacrificed for them. Cleanliness

of person is one thing to be in a measure subordinated to the

pleasure. Personal appearance is another. And any protestagainst excess of any kind, which might be made by the higherranks is materially diminished in effect so long as theythemselves retain a practice which is confessedly abused bygreat numbers, and never necessary except under exceptional cir-cumstances and conditions. The habitual exceeder in any in.

dulgence is more powerfully appealed to by a total abstainer,as far as the non-necessity of his habit is concerned, than byeven the moderate user of the habit. We do not mean to pushthe total abstinence doctrine so far as to imply that the totalabstainer has every argumentative circumstance in his favour,that he can hang every objection to the practice from which heabstains upon his own abjuration, or every denial of its utility

325

WOOLWMR AND ],ÓRT.ÞiT HOSPITALS.

ttpon his own freedom from the necessity of using it; but as far in the East, argal she is a competent judge of the requirements1115 the absolute ison-necessitv of the habit amongst persons of of a general hospital at home. Miss NIGHTINGALE is a most

similar constitutions, living under somewhat similar conditions excellent organiser of nursing arrangements and the mannerto the total abstainer, is concerned, great force is acquired by of distributing medical comforts, argal she is an architect, anexample from ths mere circumstance of the totality of the ab- engineer, a pathologist, a thermometer, an hygrometer-instmence. short, an ultimate referee upon all matters which have tht

We may again take another view of the question, and ask in slightest relation to medico-military establishments, from th.what manner can we best control the excessive smoking of the details of diet and daily routine, to the generalities of site,present day! How can we most effectually deter beardless structure, and adaptation to the multifarious requirements ofyouths and besotted nicotia-maniacs from continuing to indulge 500 inmates. If anyone’s mouth has to be stopped, Miswin habits which are undermining their mental and bodily NIGHTINGALE is forthwith quoted, and the Dogberry of thehealth! Is it our best plan to initiate a furious crusade against occasion thinks to himself,8moking, to stigmatize it as beastly, sensual, vulgar, and de- Yea, marry! that’s the eftest way." "

moralizing, and to attribute to it every possible form of ex-istent disease, whether of the body, the mind, or the body- We repeat it, Miss NIGHTINGALE is very badly used.

politic! Shall we exclaim against the thing as a practice di<t As far as Woolwich is concerned, our remarks apply chieflyoountenanced by every scientific, moral, and religious teaching? to the Artillery Hospital. Both this latter and Fort Pitt are

Or 8hall we adopt a more temperate opinion, shall we exclaim most carefully placed in the bleakest and most exposed situa-

against excess, point out when and how the habit may be tions anywhere within a radius of some miles from their re-

jastifiable but useful, when and how it is absolutely use- spective sites. The view from Fort Pitt is very commanding,ea, or detrimental to health, or positively immoral ! Shall and as a picturesque, cool, breezy residence during July andwe endeavour to gain credit with the thinking part of the August, the place is admirable. In fact, the P.M.O. has ;ttnoking community by a calm and temperate statement of very fine time of it at this season of the year; but in winter,established medical facts as regards excess ? Or shall we sacri- And especially when the wind shows that perverse tendency t.fice our permanent hold upon the minds of the public, and blow from anywhere between north and east which characterizes

destroy our continuous influence over the opinions of reflecting an English winter, the breeziness and coolness alluded t.

men, by overstating the case? Will it not be the more politic, become developed into howling blasts of wind, which blowthe more useful, and, above all, the more trulliful plan, to lift through and through the wretched old fabric, shaking ite

up our protest against excess in smoking as against all other ricketty casements, and whistling along its passages, to the

excesses; but still to allow its very moderate use under particular great delectation and hygienic advantage of all and sundrycircumstances? In so doing we may fail to terrify some half- patients-and more especially of such as may be suffering fromdozen persons into total abstinence, but we shall produce pneumonia or acute rheumatism. The Artillery Hospital atthousands of moderate smokers in place of the same host of ex- Woolwich is at a considerable elevation; if it had been built

ceeders; and we may fail in securing that sudden access of sooner, it would have doubtless been on the very summit of the

popularity, which pretty nearly always accrues to violent hill; but as that could not be, the next best (or worst) thingasserters of violent opinions-for a short time ;-but we shall that could be done, was done, and the frontage of the buildingretain our permanent influence, the respect we have always en- was judiciously placed nearly north-east, the hospital itself

joyed as promoters of calm and philosophical views, and, above being high up on the north side of the hill on which it is

all, we shall be remembered as the consistent advocates of situated. As a means of intercepting what little sun mighttruth when the fervour of dispute has subsided, and the Great creep into the windows of the south aspect, the medical officere

Tobacco Controversy has become matter of history. quarters are placed there as a kind of screen, for fear the sun.In our next article upon this question we shall point out the shine should prove too exhilarating if allowed to fall upon the

fearful effects of the excessive use of tobacco upon the system of whole of the frontage illumined by the sun. The Cadet HOI-

tkose who are slaves to the practice, pital, though of course more comfortable in its general arrange-

_______ ments, is perched upon the very top of the hill, and is a notablemonument of the perverse ingenuity of Government engineers.

IN redemption of our promise of last week, we purpose to- The temperature of the Artillery Hospital at Woolwich isday to put the public in possession of some descriptions relating frightfully low in cold weather. This is the result, in part, ofto those wonderful receptacles for sick warriors which are the situation; in part, of the interminable galleries dotted withgenerally known as the Military Hospitals at Woolwich; and innumerable windows, which rattle in the casements like peaswe shall also refer to that misapplied parallelopipedon of dingy in a bladder; in part, of the insufficient fire-places; and instone situate at Chatham, and called Fort Pitt. part, of the stupid system of ventilation, which resolves itselfWe might possibly have allowed our particularly unfavour- into nothing more or less than a series of holes in the walla&mdash;a.

able impressions concerning these institutions to remain seething show of carefulness being given to them by their being occu-in our own mind somewhat longer, had not a member of the pied with perforated metallic plates. We have shivered throughLegislature dragged them forth from their deserved obscurity, the wards of this wretched place, and have been shocked to seeand paraded them before Parliament and public as models of cases of capillary bronchitis and pericarditis in an atmospherewhat hospitals should be. It is a very bad requital of Miss certainly not above 40&deg; Fahr. The wards, besides being in-NIGHTINGALE’S services to produce her on every possible occa- tensely cold, are for the most part absurdly small, so thatsion, to bolster up the failing credit of Government medical there is the disadvantage of a quick draught through eacftaffairs. Miss NIGHTINGALE has been amongst military hospitals from the door to the fire-place.

326

OUR POLITICS.

The utensils of all kinds are of the meanest and most dis- electoral dignities there have lately been conferred on two medi.reputable kind. Spitting-pots, drinking-cans, and all other cal men. Dr. PALMER, whose edition of HUNTER’s Works is so

vessels, are made of tinned iron; the paint rubbed off some, widely known, has been chosen President of the Elective Council

nearly all rusted where the tin is worn off, and every one of of the Colony of Victoria ; and another medical man has alsothem of such a disgusting appearance that any gentleman been selected as Speaker of the Legislative Assembly. But in

woud kick them out of his stable into the kennel. But they England, where it is just now of vital importance to the futureare good enough for the soldiers, forsooth. prospects of the profession that its claims be adequately repre-The diets are cut up at such a distance from the wards that sented, there is a sad want of activity in bringing to bear on

they are miserably cold by the time the patients get them, the respective candidates the great influence directly and indi.instead of their being sent to each ward in bulk. rectly possessed by the profession. This influence ought, inThe Itch-wards are huge rooms with bare brick walls, less every available way, to be exercised, for the common benefit

comfortable than the tramp-rooms of most workhouses. of the profession, and hence for the good of the country. The

The nursing is carried on in the worst manner imaginable at higher the standing of the medical profession in any country,the Artillery Hospital. It is divided between the orderlies the more prosperous and civilized is the state of the people.and a herd of useless old women. The orderlies are invari- What pregnant illustration of this is afforded by the presentably chosen from amongst the most idle men in the dep6t; condition of Greece, of Italy, and of Spain, and the degradedand lest they should acquire any facility in the discharge condition of the profession in these lands, from which, in theirof their duties, they are changed every four-and-twenty palmy days, emanated the works of GALEN, of CELSUS, and ofhours ! The duty is looked upon as a bore and a punishment; VESALIUS.

the orderlies feel no interest in the cases, and have no time At a meeting lately held in Southwark, to receive the con-

allowed them in which their sympathies may be enlisted in fession of faith of one of the candidates, a most energetic andthe sufferings of the unfortunate inmates. The few women laudable course was adopted by Dr. LADD, a resident medicalwho are employed as nurses are, for the most part, not allowed practitioner. He explained to the meeting how much it cou-to remain through the night, so that if perchance their feminine cerned them all that the men on whose skill any moment mightinstinct had overridden their ignorance and decrepitude, the make their lives dependant should be protected and cared-for.sick men are deprived at night even of that slender comfort. Having thus spoken, he demanded the opinion of the candidate

So that the arrangements upon which Parliament is congra- in reference to those measures of medical reform to be broughttulated, and which FLORENCE NIGHTINGALE is, perforce, made forward next session. Now in every county and boroughto testify favourably of, are: a cold, bleak site; egregiously bad throughout the land there is one or more medical men who,internal arrangement of wards and passages; loose, ricketty from social position, would command the ready attention of thecasements and rattling windows ;.thrice as many draughts as most turbulent gathering of the many-headed; and whose in-necessary; insufficient firing; reckless and inefficient ventila- fluence might be thus beneficially exercised, to ascertain the

tion; a perilously low temperature of the wards; disgustingly opinions of the respective candidates. Few would refuse tomean utensils; cold diets; and diurnal change of almost use- give a favourable reply; knowing the direct influence that itless orderlies and nurses. lies in the power of medical men to exercise for their weal orWe never in the whole course of our experience saw worse woe. Hence representatives, when returned, would stand

specimens of hospitals than Woolwich Artillery Hospital and pledged to support our interests, and would not-because asFort Pitt. If the former is to be commended as military hos- honest men they dare not-listen to the voice of any homceo-pitals go, what must the confessedly-defective be ! Truly, this pathic supporter or quack-pill proprietor (Pa1’1’ nobiles fratres),is putting bitter for sweet and sweet for bitter, should such men again form part of the House of Commons.

. Moreover, we should be glad to learn that each member whoenters the House brings with him a petition in favour of the

THE measures of professional importance that will be brought great professional reformation which the coming session will,before the Parliament to be forthwith fashioned from the dis- we trust, inaugurate.jectra niembi-a now scattered far and wide by the dissolution,might well excuse a more than usual interference on the part few men have deserved better of the profession than Mr.of the profession in the present elections. Ordinarily a medi- ;yAM, of Farnham. We are gratified to observe that itcal man has a far higher vocation than that of politician or is intended to present him with a testimonial for his serviceselectoral partisan. He holds himself aloof from discussions in the cause of charity to his poorer professional brethren.that are prone to arouse bitter enmities, and only produce The Medical Benevolent Fund owes its present position to Mr.auspicious or undesirable friendships. NEWNHAM’S unwearied but unrewarded exertions. All honour

The party-curse is with the canvass past, to such a man !But party friendship, for your grief, will last." _

.

If we ever adopt and use political terms we gild them in the TnB PuBLic HEALTH.-By an order in Council, issuedd I". I .ld h .

h this week, and dated March 20th, it is directed that the Public

use. Our political economy is the economy of health. Our con- Health Act should be enforced in the township of Denton,servatism goes no further than conservative surgery; and our Manchester, the order having been passed owing to a reportradicalism rests satisfied with the performance r radical cured.

from the Board of Health on the defective drainage of the dis-radicahsm rests satisfied with the performance of radical cures. trict in question. Several fresh orders in Council have like-Our duty is to care for the health of nations, jeopardized by the wise been issued for the closing of certain graveyards, and,legacy of the first ADAM, instead of studying the " Wealth of amongst others, those of St. James’s, Ratcliffe, Hornsey, Croy-Nations" left us by ADAM .

land, (Lincolnshire,) Husbands Bosworth, Kimbolton, Sutton-Nations left us by ADAM SMITH. in-Ashfield, Selston, (Notts,) St. Mark’s, Shelton, and Smen-We learn by the last accounts from Australia that the highest ton, (Notts); which orders are to be final after the 4th of May.