416

THE LANCET.

LONDON: SATURDAY, APRIL 24, 1858.

DEFICIENCIES OF THE VACCINATION ACT.

THE facts developed in the petition of the EpidemiologicalSociety, with reference to vaccination, at page 425, demonstratethe absolute necessity of some further legislative measure inthis most important matter. We have always contended thatunder the present system vaccination must be, to a certain

extent, inoperative in carrying out the legitimate and wholesomepurposes of that truly grand discovery. It was evident that the

machinery of the Act at present in operation must fail in effect-ing the objects of its promoters. The measure is not onlydefective in regard to the stringency of its clauses, but dealswith the medical profession in a niggardly and obstructivespirit. Within the last three or four years the number of

children vaccinated has fallen off to the extent of eleven per

cent., and the deaths from small-pox have increased in

the same ratio. This is very alarming, and calls loudly forthe interference of the Legislature. The petition to whichwe refer is a most convincing document, and ought not to

fail in arousing those in authority to devise some more efficientmeans of protecting the public from the ravages of one of themost deadly and loathsome diseases to which the human raceis liable.

IF any efficient Medical Bill is to be carried through Par-liament this session, the friends of Medical Reform must exertthemselves promptly in the matter. The time has gone by formerely expressing opinions; and the period for action has come.The Corporations have met, and a deputation from them haswaited on the Home Secretary professedly to object to

Mr. CowrER’s measure. Their objections are not, indeed,very weighty-scarcely grave enough to merit any serious con-sideration ; but they may still not be destitute of influence onthe Government. It is now necessary that the Medical Re-

formers-those who have fought the battle over and over again,as well as others who have more recently joined the ranks ofthe veterans in the cause-should unite and make one more

grand effort. Individually, the members of the professionwould greatly promote the success of Mr. COWPER’S Bill byaddressing those senators with whom they may happen to bepersonally acquainted, and soliciting their support for the mea-sure. Petitions or letters, or both, might be productive of thebest results.

In all previous attempts to obtain an Act of Parliament for

the profession, the cause has been injured and obstructed bydisagreements on details amongst medical practitioners them-selves. Let us hope that it will not be so on the present occa-sion ; but, since a perfect enactment for the re-organization ofthe medical body cannot at the present time be looked for, letus accept the best that is offered. Mr. COWPER’S proposedmeasure, with the introduction of a penal clause against illegalpractice, might be so modified as to meet the wishes of allparties-of all such, at least, as have the benefit of the pro-fession at heart, and are not actuated by narrow corporateviews.

There is a story told of a little vulgar boy, addicted to thatvariety of the gambols of youth known as " pitch and toss,"who desired his playmateto "Throwup a penny." "Haverit

got a penny," was the reply. "Pitch up a ha’penny."" Haven’t got a ha’penny." "Chuck up something." "Haven’t

got nothing." It would be very irreverent to attempt anyparallel between the impotent conclusion of these gamins anithe decision of the corporate medical bodies we last weeimentioned as holding counsel together about the Bills novbefore the House of Commons. The deputation from that cor.clave waited upon the Home Secretary for the purpose of statingthe upshot of their deliberations. But when we read that the.r

only proposition was the re-introduction of a third Bill, andtheir only objection to Mr. CowpER’s Bill consisted in a generaland unproven assertion as to its " lowering the dignity of theprofession," we fear many suggestions must have been givenup in despair before thus presenting themselves at the Home.office, in a condition o nearly resembling that of the little boywho " hadn’t got nothing."The Home Secretary evidently understood the drift of the

proposition that Mr. HFADLAM’S Bill should be again broughtforward. The introduction of a third Bill, under Governmentauspices, would at once crush out all hope of legislation on thesubject during this session. It would thus prolong the term ofour wrongs, and would also preserve intact the dearly-prizedprivileges of the corporate bodies ;-which are the heads of theprofession it is true, but no more express its general opinionsthan the remote and narrow head of a river represents itsmouth. It would have been far more satisfactory and lessopen to reasonable suspicions, had the deputation been contentto suggest how the Bill of Mr. C OWPER might be improved, in-stead of denouncing it as tending to " lower the dignity of theprofession." For such assertions are comparative; and whathave the corporations done that entitles them to throw stones?We advocate the interests of the profession as a whole; ofthe 15,000 who form the body-medical. That there is much

in the intrinsic constitution and the ancient and noble endow-

ments of the corporate bodies which is deserving of highrespect, we willingly admit. But even to this consideration

the welfare of the toiling thousands of medical men may notbe sacrificed. Whilst we acknowledge, with ULYSSES, thatLotos-eaters may be a harmless and good sort of people, webelieve it our duty to protest, like the grand old Greek, againstany attempt to lull our comrades into a similar condition of

apathy; and one almost as harmful as direct injury fromwithout.

Oú&dgr;’ apa &Dgr;&ohgr;To&phgr;á&Ugr;oL µ&eegr;&dgr;ov&thgr;’ ∈Tá&rgr;oL&sgr;L&ngr; o&lgr;∈&thgr;&rgr;o&ngr;.Hµ∈TÉ&rgr;oLs á&lgr;&lgr;á &sgr;&phgr;L &dgr;óoa&ngr; awroio &pgr;á&sgr;a&sgr;&thgr;aL.

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THE subject of Special Hospitals has been again brought be-fore the public. We have yet a few remarks to proffer.The object of an hospital is by no means simply to relieve

the sufferers actually within its walls. The legitimate rangeof action of an hospital is twofold : first, to harbour and givemedical and surgical succour to a certain number of patients;and, secondly, to promote the interests of science, and train upa constant succession of medical practitioners for the com-munity at large.

It has never yet been shown that these two principal ideasare incompatible. Wherever a great charity has done much

417

MEDICAL ANNOTATIONS.

work, it has been by combining the nosocomial and educa-tional ideas. Our great hospitals owe their reputation, theiracceptability to society, their efficient and scientific working,to the conjunction of the two lofty aims of curing and teachinghow to cure. Separate these aims, and our receptacles for thesick lose half their dignity, nine-tenths of their usefulness;they dwindle down from magnificent national institutions tomere local caravanseries, in which to harbour the accidents anddisease of a particular neighbourhood.Experience has shown that, even as regards the efficient

administration of medical and surgical relief, no system worksso well as that which combines a school and an hospital. Phy-sicians and surgeons notoriously work under a powerful influ-ence when they discharge their duties in the eyes of a numberof critical and inquiring youths. House-surgeons are neces-sarily kept close up to the efficient discharge of their functions;clinical clerks and dressers are similarly influenced; and

students are, in short, an impelling power in the working ofan hospital, which forces everything and everybody into a faith-ful and diligent course of action.But the second intention of an hospital always claims atten-

tion. Secondary in importance it can hardly be called; it is

only secondary as regards the fact that patients may be housedand cured without a single student appearing within an hos-pital’s walls, or a single idea making its way out into the ex-ternal world-a coincidence more in the nature of things thanmay at first sight appear.We are desirous of laying particular stress upon the educa-

tional offices of our hospitals. Every year these noble institu-tions send forth a number of men, who within their walls have

acquired the knowledge which is to save or protect the lives ofall through the length and breadth of the land. Here within

these hospitals you shall see earnest students educating theirsenses, and learning an art; and not less earnest teachers de-veloping a science, and utilising for the student the boundlessmultitude of facts which are offered through the senses to hisreason. It is not enough merely to learn anatomy per se.

Disordered anatomy is to be studied at the same time : frac-

tures, dislocations, and every variety of alteration from thenatural in the relations of parts, make up that wider anatomywhich the practical surgeon must know. The general doctrinesof pathology, moreover, alone, will instruct very little unlessillustrated and proved at every turn by the numerous varietiesof disease, out of whose facts those doctrines have themselvesarisen. Therapeutical teachings require a similar universalityof illustration, and must be subjected to the provings of expe-rience ere they can benefit the future practitioner in the

slightest degree.In order to illustrate by cases that which is taught as a

matter of theory, or dogmatically asserted as the result of ex-perience, an hospital must be general. It will be of little use

to lecture to students respecting a disease which is never seenwithin the walls of the institution; the differential diagnosisof diseases nearly allied in signs and symptoms may not belearned at a prelection, unless verified at the bedside. He

will, indeed, be a sorry practitioner who cannot verify in thehospital what he learns in the school, and recognise in its

wards the elementary facts of all kinds which go to constructthe art and science of the schools

Special hospitals may be, and no doubt are, very useful

establishments under proper regulations. But our greatnational hospitals ought to be so conducted, in all their depart-ments, as to reduce as much as possible the demand for specialinstitutions.

Medical Annotations." V quid iiimis."

’

A CORNISH PILL-MONGER.

THE great claims of the medical profession for public pro-tection are ordinarily met with a careless neglect that formsbut poor return for their gratuitous public services. If theyprotest against the encroachments of lying quacks, they arereminded that numbers of their own body are as unblushingcharlatans as any ignorant nostrum-venders. If they appealto those who sit in the high places of the profession, and whoalone possess the power over qualified men that disgrace them-selves to the level of quacks, they are met with cold indiffe-rence and a pusillanimous shrinking from the responsibility ofdenouncing such procedures.We have always thought it our duty to expose in good set

terms the proceedings of any members who fail in their alle-giance, and to let the public know that their doings are re-pudiated by all honourable men. Floods of letters appealingto THE LANCET as the professional " censor morum," andacknowledging our exertions, prove that the heart of the pro-fession is whole and sound, and that the general body lookswith indignation on any proceedings that tend to lower ourdignity as a scientific body. Any glaring case of such mis-conduct rarely passes without due notice; and from four sepa-rate quarters we have received information concerning thefollowing reprehensible conduct on the part of a qualified manresident at Redruth, in Cornwall :-A surgeon of the name ofBoase, who recently died at the above place, had some com-pound, which he dignified by the name of renovating pills, andthe ingredient of which he kept secret. There was a female

engaged in their manufacture, and a pupil, who was also in thesecret. This pupil is now practising as a surgeon at Redruth,his name is Henry Harris, he is a member of the College andHall, and holds several appointments in the neighbourhood.The original pill-maker having gone to his last account, it

seems that the woman above referred to considered that she

might turn a penny by preparing these pills, and advertised inthe local papers that not only did she know the process, butactually possessed the identical machine which had been usedfor their manufacture. Thereupon Mr. Harris has written aletter, also inserted as an advertisement, wherein he begs toinform the public, that he vends the only genuine articles,which may be obtained at his surgery, and that " having faith-fully adhered to Mr. Boase’s mode in the treatment and cureof diseases, I shall continue the same course with regard to allpatients who may place themselves under my care." The wholeletter is, in the same sickening, self-laudatory strain. If in-

dependently published, it would be sufficiently reprehensible;but it is the effusion of a qualified practitioner, who volun-tarily squabbles with an old woman for the right to vend aquack nostrum. The editor, with true discrimination, insertsthe woman’s advertisement first; and we can assure him thatthis implied opinion of the merits of the candidates for cus-

I tomers is fully shared by the profession.

AN EYE TO BUSINESS.WE may suppose, from the numerous imitators, that greatsuccess attended the ingenuity of that tradesman who first

recklessly trampled down the bounds between the real and the

ideal, harnessed Pegasus to his advertising-van, and " kept a