PUBLIC REVACCINATION AND THE PANIC.
1
200 THE TURKISH BATH IN THE TREATMENT OF INSANITY. which preceded the adoption of this resolution, some extra- ordinary statements were made respecting the wonderful percentage of cures alleged to have been effected by the bath; but we miss in the arguments used, as well as in the medical superintendent’s report which was the occasion of the discussion, any exact statement of the real scientific value of the Turkish bath in the treatment of insanity. Some of the Visitors appear to have desired such a state- ment before sanctioning the required outlay, but to have obtained only, in place of it, an assurance that the bath is found to be the cheapest mode that can be adopted as a means of cleansing. The report of an asylum in which it was stated that 74 per cent. of insane cases were cured by the use of the Turkish bath seemed, as it well might, to occasion some scepticism. 11 Was he an Irishman," one gentleman asked, " who made the statement?" 11 Yes," replied another; 11 and he must be an Irishman who can believe it." We certainly think that he who believes such a statement, whether Irishman or not, must be a man of not little faith. Perhaps the asylum referred to was the same which was visited on one occasion by a gentleman much interested in the question of the therapeutical use of the Turkish bath in asylums. He had gone there to ex- ’, amine the arrangements which were alleged to produce so large a percentage of recoveries, in order that he might imitate them; but when he got there he discovered, to his dismay, that the Turkish bath was used regularly as a drying closet, and had not been used as a bath for months ! It can admit of no question that the real value of the Turkish bath in the treatment of the insane remains to be determined, no exact discrimination having yet been made of the cases in which it is useful. There has been an abun- dance of vague laudation; but there is yet an entire absence of precise scientific details. The consequence has been that no little distrust has been excited in many minds, which the extraordinary percentage of cures spoken of, giving to its advocacy an air of quackery, has not tended to diminish. It is much to be desired that a thorough trial of its thera- peutical effects should be made in accordance with a proper scientific method. There is ample opportunity for such trial in the county asylums which have Turkish baths. But when we think of the scientific work which is not done, but which ought to be done, in our numerous county asylums, we are almost in despair. With a few, a very few, honour- able exceptions, medical superintendents seem ambitious only to be good clerks, stewards, or farrn-bailiffs, dreaming the while that they are engaged in some marvellous moral treatment of the insane; so that it would be no exaggera- tion to say that there is not a hospital in London, however small, in which more scientific work is not done in a year than is done in all our county asylums in ten years. Per- haps the Visitors of the North Wales Asylum will, after opportunity given for adequate trial, call for a precise report from their superintendent of the results of the use of the bath. DR. ACLAND, the Regius Professor of Medicine at the Dxford University,,proposes to form a class for the prac- tical study of the requisites for personal and public health. In connexion with the class, instruction will be given at the museum by Dr. C. C. Poole, of Exeter College. Medical Annotations. PUBLIC REVACCINATION AND THE PANIC. "Ne quid nimis:’ IT is gratifying to us to see that at last Mr. Simon has directed public attention to the necessity for the revaccina- tion of all persons at or over the age of puberty. We do not doubt that Mr. Simon has good reasons for not having done this sooner. But it is still to us a matter of regret that it was not done a month or two months ago. Many lives would have been saved, and the proportions of the epi- demic would doubtless by this time have been decidedly re- duced. We have urged the matter from the beginning of the high mortality from small-pox, and expressed our sur- prise that it was not more prominently noticed in the various letters and memoranda of the Privy Council. Now the notice of it comes only in the rear of public opinion, or rather public panic. We can only say, "better late than never." It remains to be seen whether the authorities of the Privy Council will follow up the memoranda setting forth the import- ance and gratuitousness of revaccination with any modifica- tion or enlargement of the machinery for public vaccination. We are entitled from much observation to speak strongly on this point. The vaccination stations are in a state of panic, and the public vaccinators are unable to overtake the pri. mary duty of vaccinating all the children that present themselves. It is impossible to breathe freely, much less to move freely, in most of the stations, which are simply a promiscuous crowd of women and children, with a copious sprinkling of gentlemen, who are evidently general prac- titioners wanting any amount of vaccine lymph they can get to take away with them. There are two secondary duties which will now press more and more severely on the public vac- cinators, and which they will be quite unable to discharge satisfactorily without assistance. One is to utilise all the lymph of accomplished vaccinations, greedily storing in tubes that which is not given to medical applicants or used by the public vaccinator. The other is the revaccination of grown-up people, who come in shoals to the stations, and who will now come still more freely. Unless special assist- ance and more method are imported into the working of the stations, precious lymph will be wasted, as to our know- ledge it is already, and women and children will be elbowed out of the way by men and boys. The collection of lymph in tubes is a duty that might well be entrusted to one per- son at each of the stations, otherwise revaccination will be done with points, and brought into discredit. Whether the small number of public vaccinators is best for ordinary work is doubtful, but certainly for the present crisis it is insufficient. ____ IMPORTANT ALTERATION IN THE FIRST M.B. LOND. REGULATIONS. THE Senate of the University have decided to improve the practical portion of the examination in Physiology at the First M.B., and have instructed the Registrar to give notice to the various medical schools in connexion with the Uni- versity that at the First M.B. examination of 1872 and subsequent years, candidates will be required to show a practical acquaintance with histology. This step has been taken in consequence of certain representations lately made by the examiners in physiology, Mr. Power and Dr. Michael Foster, to the Senate. These gentlemen, peculiarly fitted to form an opinion on the subject, reported that, as the simple vivâ voce examination, as at present conducted, is of little use beyond the opportunity it affords of clearing up uncer-
Transcript of PUBLIC REVACCINATION AND THE PANIC.
200 THE TURKISH BATH IN THE TREATMENT OF INSANITY.
which preceded the adoption of this resolution, some extra-ordinary statements were made respecting the wonderfulpercentage of cures alleged to have been effected by thebath; but we miss in the arguments used, as well as in themedical superintendent’s report which was the occasion ofthe discussion, any exact statement of the real scientificvalue of the Turkish bath in the treatment of insanity.Some of the Visitors appear to have desired such a state-
ment before sanctioning the required outlay, but to haveobtained only, in place of it, an assurance that the bath isfound to be the cheapest mode that can be adopted as ameans of cleansing. The report of an asylum in which itwas stated that 74 per cent. of insane cases were cured bythe use of the Turkish bath seemed, as it well might, tooccasion some scepticism. 11 Was he an Irishman," one
gentleman asked, " who made the statement?" 11 Yes,"
replied another; 11 and he must be an Irishman who canbelieve it." We certainly think that he who believes sucha statement, whether Irishman or not, must be a man ofnot little faith. Perhaps the asylum referred to was thesame which was visited on one occasion by a gentlemanmuch interested in the question of the therapeutical use of the Turkish bath in asylums. He had gone there to ex- ’,amine the arrangements which were alleged to produce so
large a percentage of recoveries, in order that he mightimitate them; but when he got there he discovered, to his
dismay, that the Turkish bath was used regularly as adrying closet, and had not been used as a bath for months !It can admit of no question that the real value of theTurkish bath in the treatment of the insane remains to be
determined, no exact discrimination having yet been madeof the cases in which it is useful. There has been an abun-
dance of vague laudation; but there is yet an entire absenceof precise scientific details. The consequence has been that
no little distrust has been excited in many minds, which the
extraordinary percentage of cures spoken of, giving to itsadvocacy an air of quackery, has not tended to diminish.It is much to be desired that a thorough trial of its thera-peutical effects should be made in accordance with a properscientific method. There is ample opportunity for such trialin the county asylums which have Turkish baths. But
when we think of the scientific work which is not done, but
which ought to be done, in our numerous county asylums,we are almost in despair. With a few, a very few, honour-able exceptions, medical superintendents seem ambitious
only to be good clerks, stewards, or farrn-bailiffs, dreamingthe while that they are engaged in some marvellous moraltreatment of the insane; so that it would be no exaggera-tion to say that there is not a hospital in London, howeversmall, in which more scientific work is not done in a yearthan is done in all our county asylums in ten years. Per-
haps the Visitors of the North Wales Asylum will, after
opportunity given for adequate trial, call for a precisereport from their superintendent of the results of the useof the bath.
DR. ACLAND, the Regius Professor of Medicine at the
Dxford University,,proposes to form a class for the prac-tical study of the requisites for personal and public health.In connexion with the class, instruction will be given atthe museum by Dr. C. C. Poole, of Exeter College.
Medical Annotations.
PUBLIC REVACCINATION AND THE PANIC.
"Ne quid nimis:’
IT is gratifying to us to see that at last Mr. Simon hasdirected public attention to the necessity for the revaccina-tion of all persons at or over the age of puberty. We do
not doubt that Mr. Simon has good reasons for not havingdone this sooner. But it is still to us a matter of regretthat it was not done a month or two months ago. Manylives would have been saved, and the proportions of the epi-demic would doubtless by this time have been decidedly re-duced. We have urged the matter from the beginning ofthe high mortality from small-pox, and expressed our sur-prise that it was not more prominently noticed in thevarious letters and memoranda of the Privy Council. Nowthe notice of it comes only in the rear of public opinion, orrather public panic. We can only say, "better late thannever."
It remains to be seen whether the authorities of the PrivyCouncil will follow up the memoranda setting forth the import-ance and gratuitousness of revaccination with any modifica-tion or enlargement of the machinery for public vaccination.We are entitled from much observation to speak strongly onthis point. The vaccination stations are in a state of panic,and the public vaccinators are unable to overtake the pri.mary duty of vaccinating all the children that presentthemselves. It is impossible to breathe freely, much lessto move freely, in most of the stations, which are simply apromiscuous crowd of women and children, with a copioussprinkling of gentlemen, who are evidently general prac-titioners wanting any amount of vaccine lymph they canget to take away with them. There are two secondary dutieswhich will now press more and more severely on the public vac-cinators, and which they will be quite unable to dischargesatisfactorily without assistance. One is to utilise all the
lymph of accomplished vaccinations, greedily storing intubes that which is not given to medical applicants or usedby the public vaccinator. The other is the revaccinationof grown-up people, who come in shoals to the stations, andwho will now come still more freely. Unless special assist-ance and more method are imported into the working of thestations, precious lymph will be wasted, as to our know-ledge it is already, and women and children will be elbowedout of the way by men and boys. The collection of lymphin tubes is a duty that might well be entrusted to one per-son at each of the stations, otherwise revaccination will bedone with points, and brought into discredit. Whether thesmall number of public vaccinators is best for ordinarywork is doubtful, but certainly for the present crisis it is
insufficient. ____
IMPORTANT ALTERATION IN THE FIRSTM.B. LOND. REGULATIONS.
THE Senate of the University have decided to improve thepractical portion of the examination in Physiology at theFirst M.B., and have instructed the Registrar to give noticeto the various medical schools in connexion with the Uni-
versity that at the First M.B. examination of 1872 and
subsequent years, candidates will be required to show apractical acquaintance with histology. This step has beentaken in consequence of certain representations lately madeby the examiners in physiology, Mr. Power and Dr. MichaelFoster, to the Senate. These gentlemen, peculiarly fitted toform an opinion on the subject, reported that, as the simplevivâ voce examination, as at present conducted, is of little
use beyond the opportunity it affords of clearing up uncer-
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