190

THE LANCET.

LONDON: SATURDAY, AUGUST 20, 1859.

THE MARCH OF MIND.

AMIDST all the marchings and counter-marchings which havebeen going on in modern times, the most forced and rapidmovement has assuredly been that which has been quaintlytermed the "march of intellect." But, like other forced marches,it has been attended by some heavy drawbacks ; for all forcedmarches, it is well known, will, if frequently repeated, wearout the finest troops that were ever urged to them. And so

has it been with modern intellectual advancement, the rapidprogress of which has been attended with those many phasesof the " overworked mind," of "wear and tear," "nervous

exhaustion," " premature old age," &c., that start up before us

at every step. It has been affirmed, that although the averageduration of life appears to be greater now than formerly, therecan be no doubt that the power of vital resistance has sensiblydiminished, and that not only the brain, but other importantorgans, more readily yield to the influence of disease. It maybe true, indeed, that the duration of human life is greaternow than it was a century back. If so, it is mainly due to thecorrection of some of those terrible anti-hygienic physical in-fluences which environed our ancestors, and cut short their

lives. If, together with the improvements which we havegradually made in this respect, we had not-to use a commonexpression-burnt the candle so much the faster at the otherend, a yet greater amount of health and happiness would, we

firmly believe, have been our lot. But our mental excitement

cannot be very easily checked. We have put down the manof muscle from his throne, and elevated the man of thought tohis place. It is not in these days the hewer of wood anddrawer of water whom we honour; it is the ingenious inventor,the teacher in our broadways, the speculator in our market-place. From the senate to the mechanic’s reading-room, all are

pervaded by the same aspiring and restless spirit; from the mostrefined to the most plebeian, from noble to roturier, we witnessthe same effort to work the brain whenever it is possible, inpreference to working with hands or feet. And at such a forced

march as this, we have, for the last thirty years, been progress-ing, and at so rapid a rate that at length we have become nearlybreathless in our speed-a speed like that to which our bodilylocomotion has attained, in which, steam-projected throughthe air, we are thrown at the rate of fifty miles an hour from

place to place. Thus, as CARLYLE forcibly tells us, " the

" race of life has become intense; the runners are treading upon" each other’s heels; woe be to him that stops to tie his shoe-" strings." Even in those walks of human industry in whichmere physical strength still continues to bear a high value-asmachinery has not yet displaced it-we find that competition,surplus labour, &c., are ever at work, goading on the exhaustedbodily powers to work against time, at over hours, or undersome such disadvantageous circumstances, as render the labourto be performed little less than a slave-like task of endurance.If there is unceasing competition in art, science, and literature,so is it to be found struggling amongst mere human machinery.Take Dr. JAMES JOHNSON’S familiar illustration-the coal-

heaver upon the banks of the Thames, straining daily, like anATLAS, under the loads of " Northumbria’s entrails," which he

bears upon his back. Through his stomach and veins passsome three or four gallons of porter six days of the week.Compare him with the barrister, straining his brain duringtwelve hours of the day from the beginning to the end of termtime, with scarcely any exercise of his muscles or physical

strength. Nothing can be more striking than the contrast between

these two classes of operatives as far as complexion is concerned.But wait awhile; let us strip them of their habiliments; washoff the charcoal and hair-powder, and examine their constitu-tions. We shall find that the "wear and tear" of body and ofmind have forwarded each of them a step or two in advance

along the pathway of human existence. But it is clear that it

is not the amount in itself either of mental or of bodily exertionthat in these modern days proves so deleterious. As the late

Dr. ARNOLD, of Rugby, said, " It is not work that injures aman; it is vexation that does it." Our modern labour is

attended with a fearful amount and intensity of enzotional ex.citement. Restless thought, hazardous speculations, and momen-tous undertakings, bring with them sleepless hours of anxiety.These latter it is which have been the cause of that questionbeing lately raised, and which is still sub juc7ice-viz,, insanity:does it or does it not increase in these latter times? The fol-

lowing observations from the evidence given by the Earl ofSHAFTESBURY (Chairman of the Commissioners of Lunacy) be-fore the Select Committee of the House of Commons will well

illustrate some of our preceding remarks :--" I dare say many will differ from me, that if there is not

an actual increase of insanity, there is developed a very consi.derable tendency towards it; and I think it arises from the

exaggerated state of society-the new state of society in anotheraspect upon which we are entering. It is impossible not tosee the effect that is produced by the immense speculation thattakes place amongst all the various small-trading classes andpeople keeping costermongers’ shops, and everyone who has£5 that he can invest; they are carrying it on to a very greatextent, and the number of disappointments and the great ruinthat have come upon so many people, and the horrible distressto which they have been subjected, have had a very consider-able effect upon their minds; and society is living in a state ofperpetual agitation. It does not signify whether it be politicallife or literary life. Everyone must see, now, that life is in-finitely more active and stirring than it used to be; the verypower of locomotion keeps persons in a state of great nervousexcitement, and it is worthy of attention to what an extentthis excitement prevails. I have ascertained that many per-sons who have been in the habit of travelling by railway havebeen obliged to give it up, in consequence of the effect uponthe nervous system. I was speaking to one of our commis-sioners the other day, who had just come off a journey, and hesaid that his whole nerves were in a state of simmer; and hewas not able, without some period of rest, to enter upon busi-ness. I think all these things indicate a very strong tendencyto nervous excitement, and in what it may issue I do not

know; but I am quite sure, with regard to persons in thatclass of life entering into trade, and living in, and very con-stantly under, the influence of this stir and agitation, thatthe nervous systems of these persons are in a much more irri-table state than they were twenty years ago....... The predo-minant cause amongst the richer classes of lunatics appears tobe a disordered imagination, the pursuit of money, disappointedambition, or great losses in trade, and sometimes you will findit from over-work."

, The prolonged and reflective mental labours of the philo-

191

RECOVERY OF PENALTIES UNDER THE MEDICAL ACT.

sophers and lawyers are far less permanently detrimental tothe frame than are the intense and highly nervous efforts of thepoets and musicians. The great temporary excitement of theyoung and passionate phantasist is followed by a depressionand renewed by a reactional emotional pyrexia much moreexhausting to the vital powers than is the more equable andcontinuous exertion of the ratiocinative faculties of the philo-logist, the man of science, and the divine. Of the last ten

Chancellors-e. g., from Lord TnunLOW downwards-the

youngest is Lord CEAKWOHTB:, who is about seventy years old.The average age of the ten is something higher than seventy-six years. If, for the purpose of comparison, we take a likenumber of our more distinguished poets from SPENSER to BYRON,we shall find the average age of them to be fifty-two, everyone being more than twenty-four years younger than each ofthe last ten Chancellors. Thus is borne out the generalopinion, that musicians and poets usually die young, and that

philosophers and lawyers do not.*In the windows of some of our sporting print-shops, we have

seen the "Mail Driver" of 1825 represented in contrast withthe " Express Driver" of 1855. They are admirably opposed,and form types of the different characters of the respectivetimes, now separated by more than a quarter of a century.The one, a jolly rubicund" JOHN BULL," loaded with capes,top-boots, and " Belcher" handkerchief, and strong enough tobear an ox upon his back, is prepared to go soberly and steadilyalong the road at about ten miles the hour. There is a look of

contented, self-satisfied, though good-humoured complacencyabout him, which seems to say—What possible state of matterscan be better than the present?

He whistles as he goes, light-hearted wretch,Co!d and yet cheerful-messenger of grief,Perhaps, to thousands, and of joy to some-To him indifferent whether grief or joy."

The other is a pallid, rather meagre and sharp-visaged man,clad in short blue jacket, and devoid of all superfluous cloth-ing or impedimenta, but with a restless look that seems toshow his active and anxious mind is accustomed to proceed ata rate of progress analogous to that at which he is soon aboutto guide hundreds through the air, and that, instead of beingsatisfied with repose, it would for ever " keep moving."

" The grand debate,The popular harangue, the tart reply,The logic and the wisdom, and the witAnd the loud langh-he longs to tell them all,And burns to set th’ imprison’d wranglers free,And give them voice and utt’rance once again."

This acute, pallid, meagre man, then, who directs the rail-road engine while rushing on at its appalling speed by a slighthandle that could be moved by a child, is a type of the strangechange which has taken place-the ascendancy of mind overmatter. But, as we before observed, this forced march of in-tellectual civilization has its drawbacks, and yet we still urgeit further ! " My brain is burning, I can bear life no longer,"said the author of the " Old Red Sandstone," and shortly ceasedto exist. " Fits !’’ says BERNARD LINTOT, in Pope’s pasquinadeagainst DENNIS, " a man may well have fits and swollen legswho sits writing fourteen hours a day." The battle of life and

death is often fought as really in chambers or in an office as itis on the field. If we were to select a model for the artist

which should portray in allegory the spirit of our times, it

Westminster Review, Xo. xxvi., July, 1859. Article, The Influenee ofT.nnal Causes D’n Natinnnl Character p. 85

would be some such unfortunate as KIRKE WHITE at nocturnal

study, with wet towels round his heated head, pale, faint, andtrembling lest his sand should run out ere his insatiablemappe-tite for acquisition and desire for praise should come to begratified, if not appeased.

WHATEVER may be thought of the powers or obligations ofthe Medical Council to prosecute offenders who are practisingillegally or have committed frauds on the Register, it is quiteclear, that in one respect the profession, acting through theLondon Medical Registration Association, have be en doing theCouncil’s own work. The Association have been constitutingthemselves the fiscal advocates for the Council. As is well

known, our Legislature, in almost every public measure, is sureto manufacture an article having some flaw. By a strangeoversight, the new Medical Act, in which so many holes hadalready been discovered, is now found to be, in one of its

clauses, (Clause XLII.,) in direct contravention of the Police

Act, Clause XLVII. In fact, until the matter be fairly set atrest by the Secretary of State, or by a decision of the Court ofQueen’s Bench, it is doubtful whether the Medical Council can

recover, for the benefit of its exchequer, the proceeds of anypenalties at all from illegal practitioners.The history of this notable discovery is simply as follows. A

person, named NUNN, was lately prosecuted by the LondonMedical Registration Association at the Lambeth Police Court,for assuming the title of "surgeon," he being possessed of no

legal qualification. The charge was proved, and a penalty offorty shillings, with costs, was inflicted. Dr. LADD, the Hono-rary Secretary of the Association, went there a few days after-wards to receive the costs which had been incurred. These

were paid; but on his inquiring whether the penalty would behanded over to the Medical Council, he was answered, " Oh," no ! According to the Police Act it remains with the Receiver" of Police ;" and his attention was directed to Clause XLVII.of the Police Act, (2 and 3 VICT., cap. 71,) which runs asfollows :-

"And be it enacted, that where, by any act or acts, anypenalties or forfeitures, or shares of penalties or forfeitures, areor shall hereafter be made recoverable, in a summary manner,before any justice or justices of the peace, and by such act oracts respectively, the same are, or shall be limited, and madepayable to her Majesty, or to any body corporate, or to anyperson or persons whomsoever, save the informer who shall suefor the same, or any party aggrieved, in every such case, thesame, if recovered or adjudged before any of the said magis-trates, shall be recovered for, and adjudged to be paid to thesaid receiver for the time being, and not to any other person."

" But (said Dr. LADD) here is Clause XLII. of the new

Medical Act. Read it."

Any sum or sums of money arising from conviction and re-covery of penalties as aforesaid shall be paid to the treasurer ofthe General Council."

However, the astute functionaries of the transpontine tribunalkept, and still keep, a firm possession of the money.

This transaction, together with some other matters, formeda, staple ground for an appeal made to the Secretary of Statea few days since, to put right, if possible, some dislocationsthat had occurred in the working of the new Medical Act, towatch over which was one of the main objects proposed by the

London Medical Registration Association at its establishment.An account of the interview between a deputation of this body

192

THE NEW BYE-LAWS OF THE ROYAL COLLEGE OF PHYSICIANS, LONDON.

and Mr. CLIVE, Under-Secretary of State, will be found in ourcolumns, at p. 193. We have great reason to hope, from theattention which was paid to the representations of the deputa-tion by Mr. CLIVE, the opinions which he was said to have

expressed, and the promise which he is stated to have made,that he will cause directions from the Home Office to be con-

veyed to the different police-courts, so that in future there maybe no mistake as to who the Legislature intended shouldreceive the penalties imposed for illegal medical practice. Wetrust, that in consequence of the appeal already made, theright of the Medical Council to receive the same for the benefitof the profession, will be henceforth clearly and decisivelyestablished beyond all contradiction.

But, a word or two to the Medical Council in respect of the

application of these penalties. The Association cannot-and

we suppose do not-say, in paraphrase of some memorablewords of the great Duke of WELLINGTON, " We are not the" guardians of the interests of the profession, nor do we collect"the Medical Council’s debts." By very prompt and judiciousaction on the part of the Association, we trust that the MedicalCouncil will have been spared the trouble and expense of

arguing their right to penalties before a police magistrate onone or successive occasions, or of an appeal to the Court ofQueen’s Bench. They have been saved that labour, as we verysincerely hope, by the interview of the deputation of the Asso-ciation with the Under-Secretary of State on Thursday week.In our report relative thereto, it will be seen that it was statedthat the London Medical Registration Association had prose-cuted JOHN BURTON at a charge of £56—a prosecution whichwas refused by the Medical Council, although the offence

oharged was a fraud upon their own Register. in the case of

NUNX, also, the Committee of the Association has taken painsto secure the penalty for the coffers of the Council. Circum-

stances render the Association, in spite of the disregard andrebuffs which they formerly experienced, the natural allies of

the Council, and the active means by which the latter can maketheir authority acknowledged, if they do not feel that theyhave the power to prosecute conferred upon them. We think

it would be only gracious-not to say due-to the London

Medical Registration Association, that the Medical Council

should hand over to the treasurer of that body the penalty inthe case of NuNN, if received in consequence of the interferenceof the Home Secretary, and that in all cases in which the Councilrefuses to prosecute, the penalty recovered should be similarlywaived by the Council on behalf of the prosecutor, or prose-cuting body which incurs the risk of the action. If we are

rightly informed, there is a feeling on the part of the Councilthat such a line of conduct would be just and considerate. We,therefore, entertain the expectation, both that the Governmentwill aid the Medical Council, and the latter the RegistrationAssociations, by handing over to the proper recipients the fineslevied from offenders against the new Medical Act, and thusinsure a proper premium to those who undertake to carry outthe provisions of the law, and render it of real service to the

profession.

THE new Bye-laws of the Royal College of Physicians,England, published in the last LANCET, embrace some importantchanges. A candidate is now eligible to receive a licence topractise as a physician at twenty-five years of age, and anycandidate who has already obtained the degree of Doctor or I ’

Bachelor in Medicine, at any University in the United King-dom, after a course of study and an examination satisfactory tothe Censors’ Board, will be exempt from all parts of the

examination, except such as relate to pathology and thera-

peutics. The College has also rendered an act of tardy justiceto its Members; it actually permits them to use the Collegelibrary and museum, and to attend lectures given at the

College; nay more, the Members may enjoy any further pri-vileges which from time to time may be defined by new bye-laws. It seems almost incredible that the Licentiates of a

learned body should have been so long excluded from whatmust appear to every right-minded person their just rights andprivileges. The recent bye-laws are another indication of themarch of improvement-of the breaking up, indeed, of thoseabsurd and dangerous distinctions which have never served

any useful purpose; but, on the contrary, have given rise to

heart-burnings and jealousies-have detracted from the dignityof the institution, and have identified it with the bigotedtimes in which it was founded. Reform has come late, and hasbeen the result, not of a love of freedom upon the part of thosein office, but, in reality, of a necessity for some means to savethe College from impending ruin. Had these alterations been

effected before the passing of the Medical Act, the Collegewould have been entitled to just commendation; but at the

present time they can only be looked upon as a prudent re-treat from a position which had been stormed and carried bythe enemy.The Fellows of the College are now also to be elected without

regard to the particular school in which they were educated,and the monopoly which pertained to the graduates of Oxfordand Cambridge is broken down. Shades of ARMSTRONG and

CLUTTERBUCK, what a change !’ The College officials, following in the steps of the MedicalAct, have also passed the following bye-law :-

" If any Member has obtained admission by fraud, false state-ment, or imposition, or been guilty of any great crime or publicimmorality, or acted in any respect in a dishonourable or un-professional manner, or violated any bye-law, rule, or regula-tion of the College, the President and Censors may call theparty so offending before the Censors’ Board, and having inves-tigated the case, may admonish, or reprimand, or inflict a finenot exceeding £10, or if they deem the case of sufficient im-portance, may report it to the College, and, thereupon, amajority of two-thirds of the Fellows present may declare thatthe accused shall forfeit all the rights and privileges which hedoes or may enjoy, and his name be expunged from the list ofFellows or Members accordingly."Had this regulation been carried a few years since, how much

might the dignity and usefulness of the College have been en-hanced ! Now the Medical Act renders the most importantpart of it superfluous and unnecessary.On the whole, however, it is due to the College authorities

to state that they have set a good example to more than oneother of the antiquated medical institutions of the kingdom." It is never too late to mend." Freedom obtained from the

fears and jealousies of corporate tyranny is not that which

Englishmen should experience; they should be enfranchisedby the influence which they bring to bear upon their oppressorsby their virtue, their talents, and their acquirements; moreespecially is this the fact, when the circumstances pertain to alearned and noble profession, filled with men acutely sensitive eto unmerited neglect.