162

THE LANCET.

LONDON: SATURDAY, FEBRUARY 1, 1879.

LAW v. COMMON SENSE.

AN important issue has been raised and, for a time imust be assumed, determined, by the recent proceedings o:

the Medical Officer of Health of the City of London in thEmatter of what was alleged to be flour adulterated witlplaster-of-Paris. Finding a parcel of flour in the market;apparently containing a large proportion of sulphate oj

lime, and hearing that it was to be sold as food, Dr,

SEDGWICK SAUNDERS deemed it officially incumbent uponhim to analyse a sample. The tests proved it to be

adulterated to a considerable extent. He therefore took

legal advice and applied to the Lord Mayor-not, be

it observed, to order its destruction, but to condemn it

as unfit for food; the legal presumption being that theonus of showing it was intended for use in some other

way would rest on the owners. The Lord Mayor, takinghis stand upon the strict letter of the law, and seem-

ingly more intent on displaying his acumen as a justice thanhis sagacity as a magistrate, rejected the application. The

Commissioners of Sewers-that strange body to which isdelegated the care of the health of the City-at first appeareddisposed to support their medical officer; but, having sub-mitted a case for counsel’s opinion, they find that in theabsence of distinct proof of actual, or contemplated, sale ofthis flour or plaster-of-Paris-whichever it be-as food, itmust be regarded as an article not designed to be eaten ; inshort, adulterated plaster-of-Paris, and not flour-and there-fore one which cannot be legally " condemned." It is not forus to traverse the opinion of counsel, although, were we todo so, we could argue that it would be difficult to provethat anything found in the public market was intended forfood, and the office of medical officer of health might, forall the service it is likely to render, be abolished forthwith.Meanwhile we will select a more practical line of argument,and ask how, unless the medical officer is to be a lawyer aswell as an analyst, and so combine the functions of bothcrafts in his public person, he is to discharge his duty to thecommunity ?Dr. SEDGWICK SAUNDERS acted with prudence in not asking

the Lord Mayor to condemn the dead pony recently foundskinned and in a basket at a sausage-maker’s shop in theMeat Market. There was no proof that it was intended forhuman food, and if there had been, horseflesh may be as

good here as across " the silver streak," which spares us somany worse inflictions. This particular pony was, it seems,destined for the knacker’s-at least it was sent there after

the medical officer moved in the matter. The owner had

skinned the animal for the sake of the hide or to save the

knacker trouble. When next a few baskets of half-putridfish are found, who shall say that the article is not intendedfor use as manure or for some manufacturing purpose ? It

may be contended that the presence of decomposition mustbe taken as evidence of an evil destiny. Not at all; de-

composition is a very good thing in its proper place, and

answers a useful purpose in certain processes of manufac-

ture. If decomposed fish is to be regarded as an unmis.takably bad commodity, why not flour adulterated with

plaster-of-Paris ? f It so happens, although counsel may notbe aware of the fact, that sulphate of lime or plaster-of-Paris is one of the extraneous substances with which flour

used to be commonly adulterated until the labours of thevery class of officials upon whom it is thought desirable to

, heap contempt put an end to the practice. Now, whenthere seems reason to believe that there is a growingtendency to take advantage of the laxity of the law againstadulteration, and of those very numerous modes of evadingit which judicial wisdom has suggested, medical officers andanalysts are to be hampered in the discharge of their duty,first, by the figment that if the purchaser is not prejudiced,the sale of an adulterated article is not an offence, and then

by the requirement that not only shall the medical officer showthat a commodity is unfit for food, but he must furtherprove that it was intended for use as food ! Surely this isthrowing obstacles in the path of duty and digging pitfallsto the peril of public health. Nothing can be easier thanto throw the onus of showing that any commodity whichresembles an adulterated article is not intended for food on

the owner. The exposure of such mixtures in a publicmarket, or their open sale, except in packages which couldnot be mistaken for parcels of eatables, might be inter-

dicted. It would be no great hardship, for example, t&

enact that plaster-of-Paris should not be sent out preciselyas flour.

It is high time the whole subject of adulteration cameagain under legislative consideration. The last year has

been prolific of difficulties and embarrassments, created, ytwould almost appear, for the benefit of unscrupulous trades-men. Trade is undoubtedly in a bad plight, but not in s&

desperate an extremity that the ingenuity of judges,counsel, and magistrates, needs to be taxed for the discoveryof new ways of escaping the penalty of practices injuriousto the public health. There can be no reasonable questionas to the effect of recent proceedings in this matter. It has

been demonstrated, for the benefit of all who may be dis-

posed to take advantage of the discovery, that the selling ofan adulterated article is no offence in law unless some one-

is cheated; so that on the whole a trade in adulterated

goods, if judiciously conducted, is not perilous. Any riskwhich the tradesman may run by having adulterated goodson his premises can be avoided by simply leaving the in-spector to prove that they were intended for sale. After then

experience gained by the medical officer of the City ofLondon, we venture to think gentlemen holding similarpositions will not be eager to draw an inference prejudicialto the interests of the salesman, from the mere fact of

obviously impure goods being found on his premises. It

will always be remembered that flour, largely adulteratedwith plaster-of-Paris, may be intended for use as plaster,and we are not aware of any law to prevent a baker from

selling the last-mentioned article side by side with his

bread, after the manner of the huckster of former days. If

a general revival of the practices which THE LANCET Com-mission of 1852 did so much to extinguish is to be prevented,.the rights and interests of common sense will need to bedefended against the encroachments of legal fiction and

163THE PLAGUE AND ITS PREVENTION.

forensic casuistry. This is a matter in which the medical Government Board for 1877, is of peculiar interest withprofession must take a very lively interest. It is one of reference to this reappearance of plague in Europe. In thisthe first conditions of health that the food of the people memorandum and previous memoranda the history of theshould be pure. Turning to an old volume of PEREIRA, modern development of plague is so given that we areeven now no mean authority on the subject of adulteration, enabled to follow the progress of the disease from year to

and the text-book of practitioners twenty years ago, we year and from place to place to the frontier of Transcaucasiafind at the top of the list of articles " which have been used and to the inlet to Russia, by way of the Caspian Sea,to adulterate wheat-flour, chiefly chalk and sulphate of lime at Astrakhan. Throughout the year 1877 and part af

(plaster-of-Paris)." The object of adulterating plaster-of- 1878 plague was rife in the parts of Persia on the

Paris with flour is not so obvious ! That would be like de- southern shores of the Caspian; and Mr. RADCLIFFE

preciating the value of the silver coinage by gold. It must makes a significant reference to probable plague on thehenceforth be clearly understood by medical officers of Caspian shore of Transcaucasia, at Baku, in 1877. It

health and analysts that the mere presence of a foreign sub- is with reference rather to the mode of spread and deve-stance in any article usually employed for food, particularly lopment of recent appearances of plague, and to the sym-if the adulterating agent be found in large proportion, is ptoms of the disease as observed in them, that the

not evidence that the commodity should be condemned, but memoranda have especial value at the present moment ; yrather that it is intended for some purpose other than use and they furnish abundant data on these subjects. Con-

as food. For example, butter much adulterated may be trasting the accounts given of recent outbreaks of plaguelooked upon as intended as grease for cart wheels ; milk in Mesopotamia and Persia with the account now given of

containing a quantity of extraneous matter will be destined the outbreak in Astrakhan, we observe at once the close

for cleaning kid gloves ; while flour mixed with considerable similarity of the phenomena, while at the same time we

quantities of sulphate of lime is to be used as plaster ; and notice several differences. The similarity is marked as to.if loaves are found actually baked with foreign ingredients, the comparatively slight diffusiveness of the disease, exceptthese will probably be specially prepared and on sale for the to persons in very intimate communication with the sick g

cleansing of wall-papers, or some equally useful and inno- but in the pulmonary complication and excessive mortalitycent purpose. In short, it is idle to seek to apply the law the Astrakhan outbreak seems to be exceptional. Thera-

as it stands to practical sanitary purposes. The only rational peutically, it is to be feared that Dr. DoPPNER’s experienceaim will henceforth be to procure a revision of the Statute- is not singular;. but, hygienically, the several outbreaks ofbook in the interests of public safety and, as we have said, plague which have occurred since 1873 yield precious in-common sense. To this end, we venture to think, medical struction.

officers of health should straightway address themselves ; First of all they confirm, as it seems to us, in the clearestand if public opinion is really alive to the importance of the way, the conclusion, usually accepted in this country, of

question raised by this strange difference between Dr. the utter inutility of quarantine, land or sea, as ordinarilySEDGWICK SAUNDERS and the Lord Mayor, the movement understood and practised, against the spread of plague; and,will not be without suceess. next, they furnish the strongest grounds for the belief that

the measures which are found efficacious in the suppression.

and extinction of typhus will be found equally efficacious inON another page we give a translation of the first detailed the suppression and extinction of plague. Even admitting

official medical report on the fatal disease in the province of that certain measures of restriction, after the manner of

Astrakhan which appears to have been made public by the quarantine, may be admissible in districts where a semi-Russian Government. The reporter, Dr. DÖPPNER, the barbarism still exists, and where local sanitary organisation)principal medical officer of the Cossack troops in the pro- and administration is rudimentary, it is not without shamevince referred to, is the sole survivor of the medical staff- that we contemplate the official representatives of the

eight in number-which endeavoured to combat the disease medical profession of Russia, of Germany, and of Austro-in question at the outset. His report explains much of the Hungary, concurring in the adoption of measures of land anddoubt which has hitherto rested upon the nature of the sea quarantine, for which nothing can be advanced in

malady; but although he hesitates to express a positive support except tradition. We cannot suppose that the

opinion as to its special character, his description leaves official information as to the recent plague, of which Mr.little doubt that the disease which has scared Russia and NETTEN RADCLIFFE has become the reporter in this country,Central Europe is true plague. We learn from the report can be restricted to the British Government; yet, on the-how the earlier manifestations of pestilence were masked, other hand, it is difficult to understand, in face of recentso to speak, by a prevalence of local malarious fevers ; and experiences of the disease, under what circumstances thewe can understand how Dr. DÖPPNER, when confronted, Governments of Russia, Germany, and Austro-Hungary candoubtless for the first time in his life, with the pestilence have committed themselves to the quarantine follies repodedwhich had so long vanished from Europe, hesitated to admit during the past three or four days. Let us hope that our-the fact, and to take the responsibility of the conclusion own Government will escape similar follies. Should plaguewhich must inevitably have been forced upon his atten- extend westwards, and reach these shores, we may ex-tion. pect some local panics, unless the Government has the‘

The publication at this moment of Mr. NETTEN RAD- foresight to anticipate them by taking such measures asCLIFFE’S third memorandum on the recent progress of will give the public confidence in our present sanitaryplague, in the Report of the Medical Officer of the Local organisation and mode of administration, which we believe-

164 THE ARMY MEDICAL DEPARTMENT.

will, if duly exercised, prove amply sufficient for our pro- examination," but insist upon the importance of it beingtection against any serious invasion of the disease. really competitive, which, they maintain, it is not at

. present. We have always held that, however useful it mayTo the " Statement by Members of the Board of Ex- be for the selection of candidates when the number exceeds

aminers of Candidates for the Army Medical Department," the vacancies, it ought not to be required when that is notwhich has been laid before Parliament on the motion of the case. The double qualification should be a sufficientDr. LYON PLAYFAIR, Colonel STANLEY has added "Re- guarantee of fitness for admission, and the medical schoolmarks by the War Office Committee " on the statement. at Netley should be utilised for testing the qualities of theAs we have already discussed at some length the letter of men so admitted. The opportunities of judging the menthe examiners, it appears unnecessary again to go over all during their four months’ course, and the high qualities ofthe ground, and we shall therefore content ourselves with the professors under whom they work at Netley, ought to bebriefly noticing the chief points in the reply of the Com- a sufficient guarantee that any of them who are physically,mittee. The Committee object to the inference drawn by educationally, or morally unfitted for the service, would bethe examiners from the comparison of the average pro- found out and relegated to civil life. We observe that the

portion of candidates to vacancies during the five years Committee express the intention of still adhering to thepreceding 1873, and the five years following. This mode of system of competitive examination for one-half of the

statement makes it appear as if a sudden decrease had taken vacancies ; we presume they mean only when the can-

place at that date, while the Committee state " that the didates are sufficiently numerous to require it for the pur.fall was progressive, and that it becomes year by year more pose of selection. One-half of the vacancies are to be filleddifficult to obtain candidates." There can be no doubt that up on the recommendation of the various medical schools,the popularity of the Department had been gradually but we are still without any information of the way in

diminishing from the period when the provisions of Lord which this double-portal system is to be worked. We foreseeHERBERT’S Warrant began to be modified and contracted many difficulties in it; but there is always one way of gettingby confidential memoranda from the Horse Guards, and out of them-by throwing open the service to all men pos.War Office Circulars, until the beginning of 1873, when the sessing the double qualification and producing satisfactorynumber of candidates did not equal that of the vacancies. testimonials of character, subject to the condition of theirThe inference of the examiners, however, that this falling final appointment being dependent upon the report of theoff was the result of the Warrant of 1873, can scarcely be Netley professors. But whether the entrant examination is

accepted, because the entrant examination for that year had to be continued or not, without reference to its competitivetaken place before the promulgation of the Warrant. That character, we trust the Secretary of State will no longerthe Warrant tended to increase the unpopularity of the delay bringing out the Warrant to regulate the new con-service we are quite prepared to admit, but it was only one ditions of service, but will enable intending candidates to-of many causes, and we fail to see that its existence has any come forward in time to join the next course at Netley,bearing on the question of the deterrent effects of the which, we believe, will commence in the beginning of April.entrant examination. The Committee admit the greater —————-——————

popularity of the Indian Medical Service, and the consequent THE last Report on the Health of the Navy (a brief sum-adequate supply of candidates for it, but as they despair of mary of which has already appeared in THE LANCET) con-being able to "level up " to its attractions, they have tains some important statistics on the working of the Con-proposed such measures as in their opinion may induce a tagious Diseases Acts. A short Parliamentary papersufficient number of candidates to come forward for the Army has also appeared which attempts to controvert a state-

Medical Department. ment made in writing by the Rev. Mr. GRANT, Vicar of

The next point to which the Committee object is the de- Portsmouth, who has recently, in an official form, avowc d

preciation by the examiners of the value of the evidence his belief that these Acts have greatly benefited the sanitaryadduced to prove that the half-yearly examination acts as a status of his own town. Again, "Seven Reasons for the Repealdeterrent. This evidence consisted of the opinions expressed of the Contagious Diseases (Women) Acts (1866-69) " haveby two universities, the Catholic University of Dublin and been lately issued in the form of a pamphlet by the Citythe Edinburgh University; by three London hospitals, of London Committee for obtaining the repeal of these Acts.St. Bartholomew’s, St. Thomas’s, and Westminster; and by (This last-named pamphlet may be bought for 2d., and isfour members of the profession. The reasons, if they can prefaced by an extensive quotation from Archdeacon PALEY’Sbe justly so called, advanced by the examiners to set aside Moral Philosophy," which appears to us to plead as muchthese opinions amount to nothing more than that they were against the argument of the repealers as in its favour).mere expressions of opinion, and, being opposed to those of Meanwhile we recur to this unsavoury subject once againthe four examiners, ought not to be regarded ! But surely the for the purpose of pointing out to our readers and the publicopinion of the teachers of five important medical schools as that, as Canon MILLER remarked the other day at a meetingto the influence upon their pupils of certain examinations of the Hospital Sunday Fund Council, if anything couldought to carry considerable weight; and as the four gentle- be more fallacious than figures it was facts; and so the so-men have at least this in their favour, that they can have e called facts as to the amount of disease at ports under theno personal interest in the retention or abolition of the Acts are shown in the Health of the Navy Reports,examination, we see no reason why their opinion should compiled by Dr. SLOGGETT, to be altogether incorrect andnot be set against that of the four examiners. The Com- untrustworthy. In these Reports appears a careful analysismittee admit the advantage of a "competitive entrance of statistics which, e4"ordi-ng to, Dr. LpGCT, show that

165THE CONTAGIOUS DISEASES ACTS.-HAMPSTEAD HOSPITAL.

more than half the cases of primary syphilis at the home the Health of the Navy Reports as a step in the right direc-stations were (during the period comprehended in the tion, and e.ntertain a hope that it will be repeated until theReport) contracted at places ’J’wt under the Acts, as well object indicated is fully realised.as more than a third of the cases of gonorrhoea. These 0cases came into the protected ports, and are, of course, THE litigation in the Hampstead Hospital case has reachedscored up to them, and, as far as the enemies of the Acts are a further stage, though, no doubt, not a final one, by the judg-concerned, against them. The facts are (and in this case we ment of Mr. Baron POLLOCK. It will be remembered that in

do not think them fallacious) that seamen come from all the trial of Sir ROWLAND HILL and Others v. the Metropoparts of the United Kingdom to the principal protected litan Asylums Board, the jury found for the plaintiffs, on theports, and men paid off get leave for at least six or eight several questions left to them by the learned Judge, whoweeks, which is spent at various places in which the disease took time to consider his judgment. The jury found thatis contracted. Short terms of leave, varying from forty-eight the hospital was a nuisance per se, and by the comingto ninety-six hours, are also given to well-conducted men on to and going from the hospital of the patients ; that the

full-pay, and these men have, of course, abundant opportuni- defendants had not erected and carried on the hospital withties of going to London, or to many places out of the pro- proper care, and with due reference to the plaintiffs’ rights;. ;.

tected districts. This is specially the case as regards Sheer- and that in some other particulars they had failed of theirness and Chatham, from which ports men can without any duty. The learned Judge concurred in the view, that

difficulty come to the metropolis, if only for one night, although the defendants might have acted under the powersand return to the ship in the Medway infected with a life- conferred upon them, those powers would not absolve them

long foul disease. Dr. NEVINS accuses the official returns from the obligation of so erecting and conducting the

of wilful inaccuracies and misstatements, and instances the hospital as not to interfere with the legal rights of thecase of A.M.S. Caledonia, which ship in 1870 spent two days plaintiff. "If," he said, "the defendants could at any

at Naples and 180 days at Malta. But, curiously enough, place, and in any manner, carry out the requirements ofwe are asked to take this as an example of the futility of the Act without creating a nuisance, it cannot be supposedprotection under such circumstances ; Malta, as we all that the Legislature armed them with an option so to performknow, being a stringently protected port, and Naples sub- their duty as to create or not to create a nuisance respectingjected to no sanitary jurisdiction whatever. Is it possible the rights of others, as it might seem to the defendants or toto rely upon the facts stated when such as these are pro- the Local Government Board fitting and proper with referduced to support the arguments and theories ? en-ce to the internal advantage or economy of the asylum."

It is much to be regretted that the Army Medical Depart- In other words, they would not be allowed to ignore all

ment do not publish a vigorous and exhaustive statement existing rights, especially as no compensation for possibleyear by year as to their official experiences in connexion injury was provided for by the statute. Judgment waswith the Contagious Diseases Acts. A table similar to that therefore given for the plaintiffs, with costs; and an in June-published in the Navy Reports could be easily compiled tion granted to restrain the defend’ants from carrying on theby them, as they have all the necessary data at Whitehall, asylum so as to be a nuisance to the plaintiffs, the issue of’and most careful deductions could with very little trouble the injunction being suspended for three months with

be drawn therefrom. But even up to the present time, liberty to either side to apply. There can be no doubt

whpn the quarterly returns are compiled, all cases admitted that the Board will resist the injunction by all the meansin the list are included, as if contracted in the place from in their power. Whether they will ultimately succeedwhich the report is dated. A correspondent of this journal depends upon a variety of contingencies which it is im-

recollects, on a certain occasion, that of thirteen cases of possible to foresee. The effect of the injunction would be

primary syphilis that occurred in a regiment at Sheerness, most serious if there should be any considerable spreadeleven had actually come into barracks infected with the of small-pox or other epidemic disease. Yet we cannot

disease, which had been contracted in London. It is also but hold that the judgment is sound, and it is very

perfectly well known to the Windsor police force that the greatly to be regretted that the Board did not by timelysoldiers of the Household Brigade quartered there go to concession prevent so serious an issue. There is amplethe metropolis very frequently, contract the disease there, evidence that they might at one time have done so, and

and as a result swell the returns of a protected district, thus not only have prevented the lawsuit, but, what is

and so give it, as with many others, a glaringly unfair of even greater importance, checked an agitation which is

aspect. in the main groundless, and, as it affects other hospitals,It is considered advisable again to refer to this subject may lead to great embarrassment of a most important

thus early in the year, because, whether legislative action work.

be undertaken on the question or not, it is but rightthat the public should know how far figures and facts A MEDICAL PRACTITIONER in the vicinity of Leeds hasinfluence this very important question. The medical pro- been fined for neglecting to give to a private patient a cer-fession, as a body, with a minute minority of exceptions, tificate of successful vaccination as the law directs. The-

thinks that it has just and good grounds for believing in omission, no doubt, happened from the gentleman being im-the success of these Acts, and hence for insisting, reason- perfectly acquainted with the law ; but the local vaccinationthe success 0 these Acts, and hence for insisting, reason- authority thought proper to prosecute, as their officer hadably, but very emphatically, on their continuance, and, if had trouble on several previous occasions in obtaining cer.possible and practicable, on their extension. Such being tificates from medical men. The stipendiary magistratethe case, we oannot but look upon this special appendix to inflicted a fine of five shillings, with costs.