83

THE LANCET.

LONDON: SATURDAY, JULY 28, 1855.

THE THAMES AS A SOURCE OF DISEASE.

IN reply to questions put to us by numerous correspondents,we have to state that Mr. WAKLEY was the sole author of the

ANALYTICAL SANITARY COMMISSION. That all parties em-

ployed on the Commission, Analysts, Microscopists, Artists,and Printers, were paid by him. That all articles purchasedfor analysis and the use of the Commission were obtained athis expense. That he alone discharged all law costs, and

incurred all risks of libel. It was Mr. WAKLEY who first

converted the press into an instrument of police for pre-

venting the adulteration of food and other articles of consump-tion, by establishing the precedent in THE LANCET of publish-ing the names and addresses of the parties from whom the

analyzed articles had been purchased. With respect to whom

the greatest debt of gratitude is due from the public for the

origin, labours, risk, and expense of the Commission, we are

quite willing to leave the public and our brethren of the pressto determine. The benefits which have already resulted fromthe ANALYTICAL COMMISSION are acknowledged by us as

gratifying rewards for our humble services.

WE sincerely trust that at length the public mind is fairlyawakened to a proper sense of the urgency of instituting effec-tive measures for the purification of the Thames. Never was

there a question of more vast and vital importance to thehealth of the inhabitants and the prosperity of the great centreof the national business. It is a matter of observation, admit-

ting of no dispute, that year by year, and day by day, thestream which bears upon its surface alone an enormous popula-tion-upon whose banks dwell two millions of souls-becomesmore and more polluted and poisonous. Deterioration of

health and actual disease are traced directly to the drinking ofits waters, and to the breathing of air corrupted by its exhala-tions. It is a matter quite within the scope of science to pre-dict, that the actual state of pollution of the Thames cannotcontinue, much less that progressive pollution shall go on,

without entailing the constant danger of wide-spread and fatalepidemics.But great as is the need of exertion, urgent as is the call for

some mitigation, if we cannot have all at once a completearrest of the evil, it is not the less important to examine de-liberately into the feasibility and value of the different schemesthat may be proposed, with the view of accomplishing theseends. Let us beware lest, after the sacrifice of much valuabletime, and vast sums of money, we find a foul tide still ebbingand flowing through the town. The scheme at present beforethe public is to collect the sewage of the town into giganticdrains, one on either side of the river, to carry these drainsdown to Barking, on the north, and to Plumstead marshes onthe south side, there to discharge their contents into the river;that is, simply to prevent the Thames from being polluted at

one spot, in order to pollute it a little further down. It was

anticipated, no doubt, by the projectors of this scheme, that ifthe sewage were thrown into the river at the point described,it would then be carried away by the ebb-tide. But some

considerations urged by the Examine1’ subject this anticipationto considerable doubt. It is urged that if the sewage be dis-charged at Barking at high-water, (the most favourable

moment,) at twelve o’clock, and assuming what cannot be thecase, that the discharge is completed simultaneously, it will

meet the flood somewhere about Gravesend at five, certainlynot later, and will then come back with the flood, which will

carry it far above the metropolitan bridges till about twelve orone. Thus it will have had at least seven hours and a half offlood against five hours of ebb. If this calculation be correct,we should therefore not have succeeded in purifying the Thameseven at London, whilst we should have succeeded completelyin befouling it as far as Gravesend. Now, we will ask whether,admitting for a moment that we could by this scheme answerour own purpose here in London, it would be just or wise to

poison our neighbours lower down the stream? What will the

inhabitants of the numerous places on either bank of the riverbetween Barking and Gravesend say to it ? What will be the

condition of that enormous floating population that daily andhourly must pass the very spot where the concentrated sewageof this huge metropolis is being constantly disgorged ? The

records of the Registrar-General exhibit the fact, that nowherewas cholera more rife and more deadly than on the river. It

is certain that this fact is intimately associated with the foul*ness of its waters. It is therefore as clearly our duty, as it is

our interest, to consider well whether some effectual meansmay not be found of preserving the Thames piire along thewhole of its course to the sea, instead of resting content withthe conclusion that we have no other choice but that of poison-ing it at one point or at another.The question is one of such urgent, great, and national im-

portance, that we conceive it cannot be satisfactorily solved,or an efficient remedy carried out, by a purely local body, withlimited powers, and with such funds as can be raised from a

limited locality. It is not Londoners alone who are imme-

diately and vitally interested in the condition of the Thames -.above and below London, on its banks and upon its bosom,there dwell thousands upon thousands, who cannot remainunaffected. The health of the metropolis, where the Govern-ment of the nation and an immense portion of its com-

merce are carried on, is not simply an affair of its permanentinhabitants. It is an affair of deep national concern.The question is at once so great in importance, and so diffi-

cult of solution, as to call for the highest skill in the country.We would earnestly suggest that a Commission, comprisingsuch men as STEPHENSON, BRUNEL, FARADAY, and Sir JOHN

M’NEIL, be forthwith appointed, with instructions to take thewhole bearings of the case into consideration, and to reportupon a definite scheme, that shall not be a mere postpone-ment or mitigation of the difficulty, but a real and permanentrelief from an enormous and rapidly-growing evil.

Sin BENJAMIN HALL, before retiring from the Board ofHealth, informed a deputation from the inhabitants of Wal-worth that he should immediately after the 31st of Augusturge the Secretary of State for the Home Department to

84

THE UNIVERSITY OF LONDON.

appoint a Commission to investigate the course pursued byeach of the Water Companies in reference to the Act of 1852,and to ascertain how far they had complied with the chargelaid upon them, of taking their supply from the river aboveThames Ditton. The Companies have enjoyed a period ofthree years for the completion of the works rendered necessaryto carry out this measure. We earnestly trust that the

Government will tolerate no evasion, no delay in the perform-ance of this contract.

THE University of London is essentially the offspring of thePeople in this country. Contrary to the expectation, not tosay wishes, of a large and influential party, it has become, inthe course of a very few years, a great fact, and that becauseit was called into existence to supply a great want. The

insignia of a high education, the honours conferred uponscholastic achievements were, but one quarter of a centuryback, within the reach only of a few. Not that we were

wanting in rich and ancient seats of learning worthy of a greatcountry; nor in a race of illustrious scholars who should, bythe glory of their own labours, extend the renown and enhancethe reputation of their alma mater. But the very constitution of

our universities disqualified them almost entirely for offeringany educational advantages to the people. Of many causes,that which is most to the present purpose, was the existence of a

theological shibboleth which barred an entrance to a large sec-tion of the fairly educated middle classes; a confession of faithwas required of the young student who, thirsting after classicallearning, wished only to take his fill at the highest source, butcared not in doing so to ignore and forsake the earliest, thenoblest, and the brightest aspirations in which his soul had beentaught to indulge. No matter what-of the varied formularies

by which the many families of man acknowledge and worshipthe Supreme and the Infinite-no matter what had become,through the force of education or other circumstances, the ruleof faith to him, every worshipper at these shrines of learningwas bound solemnly to record his full assent to that one which,for the time being, was in the ascendant, or received politicalrecognition in these realms. But one road existed to univer-

sity distinctions and privileges; it lay through " The Thirty-nine Articles." The majority took it complacently, undoubt-ing ; a few faltered, hesitated, but were carried through bythe crowd, and thenceforward gave no thought to theologyand " The Articles;" fewer still, sincere in thought and action,failed in bringing themselves to regard the religious oath asan unmeaning form, viewed " the narrow way," and found itimpassable for themselves. Men these were of sterner mould

than most-men who believed in life’s work, its duties, and

responsibilities, and did not shun its trials-men not to be

lightly refused admission, and whose presence within the time-hallowed walls of the universities might have contributed toneand vigour to the society within-men of faith as well as

action, for is there any proof of faith so certain as that whicha vigorous doubt supplies ? Men of this temper and in likecircumstances laid the foundations of the Western world. Such

men have ever furnished the sinews of society, and have ad-vanced the age in which they live; and such have often in-herited a martyrdom as the reward of their faith, their energy,and their enterprise. Out of the loins of such men sprang the

University of London.

No profession of religious faith is the price of admission here.An institution most religious, but guiltless of theology. Amplein its aids to the study of all that is true and honourable, and of

good report, it imposes no man-made rites; it interferes in nomatters of conscience. Science alone is its end ; the unfoldingof the Infinite to man. Not a debased image of that Infinite,marred and shorn of its fair proportions to bring it within the

range of man’s little vision-a contemptible sensual caricatureof that transcending greatness and goodness which the studyof life reveals. An institution most religious, because, mostreverently jealous for the purity of natural truth, it adjuresall admixture of man’s uncertain, erring, and mischievous pol.lutions. Leaving to the influences of the parent and of home,their choicest source, the development of faith in revealedfutures, it seeks mainly to enlighten and elevate the intel-lectual man, and thence to cultivate his moral powers and

perceptions.Manifestly, also, in relation to the profession of medicine

was the want urgent of a metropolitan university in England.Oxford and Cambridge had well-nigh ceased to rear physicians,because they possessed but slender means for the purpose.Here, in the great city of London were unrivalled clinical faci-lities, and not a few men who were well qualified to fill pro-fessional chairs. Edinburgh was almost the only place fromwhence a diploma of high order and unimpeachable charactercould be obtained. The leaders of the present age in medicinearose from its university; amongst them was MATTHEW BAILLIE,the founder of pathological anatomy in this country; there,also were educated CHRISTISON, BRIGHT, MARSHALL HALL,PROUT, ADDISON, CARPENTER, and a host of other

illustrious worthies. Hence our aspiring students flocked tothat renowned and flourishing seat of learning. This was an

anomalous state of things which could not be permitted by theEnglish physicians to endure with honour to themselves, or totheir nation. Although not entering very largely into theoriginal idea, inasmuch, as above indicated, to impart a soundlay education, and to confer degrees in Arts, and, perhaps, inLaws, were the main objects of the new university, the Facultyof Medicine soon became the prosperous and predominant one.The members of our own profession were the first to identifythemselves with it, and the first to be invested with its

honours, extended as was the curriculum, and stringent aswere the examinations required-beyond all precedent in thiscountry. The medical element is still greatly in the ascen-dant. The degrees granted in medicine are very numerouscompared with those either in arts or law. And it is now

acknowledged, that the possession of the M.B. of London is

the most certain guarantee of a first-rate medical educationwhich can be produced in the United Kingdom. A result

of nearly twenty years of active existence on the part ofthe University of London, is the formation of a body ofmen possessing great talent and energy, whose claim to

special political privileges has already been recognised byGovernment, and who bid fair to exercise a large and im-

portant influence upon the progress of science and Free

Education in this country. Already are its members acquiringthose posts of honour and responsibility, in the filling of whichmerit is regarded as the sole qualification. Few men of the

coming generation will be appointed to the higher publicoffices in our hospitals, and other important services, whether

85

THE NEW CIRCULAR RELATIVE TO NAVAL ASSISTANT-SURGEONS.

n the practice of medicine or surgery, who do not possess theUniversity diploma; and, consequently, all the better educatedand’aspiring students are seeking it as the highest distinctionwhich examining bodies have it in their power to bestow.

AT length the contest regarding the assistant-surgeons of thenavy is brought to a close. An order was made by the Boardof Admiralty last week that "henceforth the naval assistant-’’ surgeons shall have separate cabins, with all the privileges"of the ward-room. " It is deeply to be regretted that thisjust concession was not long ago made to the highly-respectableand useful class of officers to which it refers. The Admiraltyhave given way entirely from the force that has been broughtto bear upon them. Let us take a short review of the circum-

stances attendant on this memorable struggle-a strugglewhich shows, in a remarkable manner, not only the powerwhich the profession united possesses, but also that the interestsof the profession are essentially those of the public.

It is many years since THE LANCET entered the field as the

advocate of the assistant-surgeons of the navy. For a longtime this journal stood alone in the fight, and we well remem-ber how hopeless the position we had taken was regarded evenby the best friends of our ill-used brethren. We were told

that the system which had existed for upwards of a century-that was sanctioned by every lay official at home or " afloat"-was too strongly entrenched behind custom and prejudice everto be successfully carried by assault. Firmly impressed, how-ever, with the justice of the cause in which we had embarked,we determined to persevere, and the besieged have at lengthsuccumbed to that which we foretold must be the inevitable con-

sequences of their obstinacy-" the cutting off of the supplies."During the progress of the siege we were joined by severalallies of no ordinary importance-by men, in fact, who havingfelt the tyranny of the commanders of the old garrison,with a noble and disinterested spirit, entered into the

struggle, at a sacrifice and loss to themselves, to aid those oftheir brethren who were still suffering under tyrannical laws.Of these, three must in justice be particularly mentioned, Dr.F. J. BROWN, Dr. MICHAEL HEALEY, and Dr. M’WILLIAM.

Eventually the public, to some extent, also joined in the con-test, and the result was, that remonstrances and petitions, andeven a vote in Parliament, were brought to bear on the autho-rities of the Admiralty. Unfortunately, however, the fortressof corruption and injustice still refused to capitulate. Then

came the preparations for a "coup de main;" the besiegedwere hemmed in on all sides; the profession to a man wereagainst them; the army and the public joined in the attack;the supplies were cut off; and, fairly vanquished, the Admiraltyat length finally surrendered, under the apprehension of theeffects of a motion threatened in the House of Commons by Mr.BRADY, to whom great praise is due for his exertions in this

movement. The Board have not even the satisfaction of retiringfrom the contest with the " honours of war;" for now they are

compelled to appeal to the besieging forces for assistance againstan enemy from another quarter. If we have been honest and

consistent enemies, we have also the magnanimity to treat afallen foe with every consideration. We desire to give themthe support they require; we desire to show them that wehave fought not for triumph, but for justice, and, having

accomplished our end, we will render them every assistance inour power. We ask, then, for volunteers for the navy-nay,we entreat educated and efficient members of our profession toenter the service as assistant-surgeons. We would implorethese gentlemen to wipe away the foul blot that at this

moment disfigures our national character; we call upon them,in the name of our country and humanity, to join our fleets inthe Baltic and Black Seas. Let it never be said on any future

occasion that the lives and limbs of our gallant sailors ar&

subjected to the treatment of unqualified and incompetent"surgeons" under the name "of dressers. Let bygones be by-gones ;

"Let the dead past bury its dead ;"

and let the members of the medical profession, true to theinstincts which have ever animated them, now that they areto be treated as gentlemen, and placed in a position in whichthey can properly perform the important duties which will beconfided to them, enter the service.The result of this memorable contest should inspire us with

hope for the future, and teach us a lesson which it is our ownfault if we forget. Let us urge our just demands on the powersthat be with the perseverance and energy which we have exhi-

bited in this struggle, and success is certain.To the gentlemen composing the Naval Medical Reform

Association this remark is peculiarly applicable : that Associa-tion has been organized and carried out by the men who aresoon to exercise a great influence upon the welfare of the bodyto which they so honourably belong. Let them on any future

occasion act with the same energy and disinterestedness, and

they must succeed; for ours and theirs "is not the cause offaction or of party, but the common interest of every man inBritain."

THE letters of Dr. ANDREW SMITH, relating to the sanitarycare of our Army in the East will be read with interest by theprofession. They constitute the complete vindication of theMedical Director-General, and demonstrate the fact, that ifour soldiers were dimidiated by disease, exhaustion, and ex-

posure, it was not for lack of foresight, of zeal, or of timelycounsels on the part of the Medical Department. The evidenceof these letters, replete as they are with wise suggestions, con-trasted with the neglect with which they were treated bythose superior and conflicting authorities which had the powerand the indiscretion to override the Medical Director-General

in his own department, constitutes about as striking a case ascan be advanced of the necessity of Administrative Reform.With these letters, with the testimony of Lord HARDINGE,

who, being in the best position to judge, declared before theCommittee his unqualified opinion of the great zeal and abilityof Dr. ANDREW SMITH, and with the deliberate decision of theCommittee itself, which completely exonerates him, it will

henceforth be impossible to shift upon him any portion of thatheavy guilt that must be apportioned exclusively amongstthose who, enjoying trust and power, have been found unequalto, or remiss in, the discharge of what they undertook.

These documents will be referred to hereafter by those whomay be called upon to administer to the sanitary wants ofarmies in the field.

86

PRESIDENCY OF THE BOARD OF HEALTH.

WHATEVER mistakes the Royal College of Physicians of

England have fallen into in days past, it has been evident, oflate, that it has been their desire to pursue a course more con-sistent with the position they occupy, and the interests of theprofession they represent. They have shown, on some recentoccasions, symptoms of a policy which will make amends formany errors. We have heard, then, with deep regret, that amotion is about to be submitted to them, the effect of which

will be to exclude from examination all those gentlemen whohave possessed themselves of the honorary degree of M.D. The

framer of this motion is no other* than the "reforming" SirJOHN FORBES! However just such a motion may primâ facieappear, it is evidently, on close inquiry, most illiberal and im-politic. It is well known that many highly qualified men,holding diplomas from Colleges of Surgeons and other authorizedbodies, have received the Doctor’s degree on the strength ofthese documents. Now, many of these gentlemen, even in theabsence of that degree, would have been entitled by the by-laws of the College to present themselves as candidates for theobtainment of a licence to practise as physicians. Upon whatground, then, are their claims to be ignored? But, we mayfurther ask, is the examination at the College a mere matter ofform, or is it to be regarded as a legitimate test of the capa-bility of the person who undergoes it, for the honour he seeks?We put these questions to the Fellows of the College for theirconsideration. It will be curious to see what answers can be

given to these interrogatories.__

AFTER a successful and honourable career of eleven months,Sir BENJAMIN HALL resigns, for higher, but not more useful,political office, the Presidency of the Board of Health. He

assumed this office at a time when the Board of Health had

fallen into such disrepute that its recommendations were

derided, and all its efficiency was lost. Under the vigorousand judicious management of Sir B. HALL, popularity wasregained and useful action restored. In a very short time he

has been able to make signal progress towards developing, con-solidating, and simplifying the powers of the Board. He has

carried through the House of Commons two most excellentmeasures-the Metropolitan Local Government Bill, and theDiseases Prevention Bill-two Bills that will hereafter be

looked upon as marking an era in sanitary legislation. With

such evidence of zeal and administrative vigour, we cannotbut regard it as a misfortune that Sir BENJAMIN HALL shouldbe removed from his office at a time when it was growing intoaction and gave promise of great public usefulness. We firmlybelieve that more solid and lasting honour is to be achieved inthe office he has left than in that to which he is promoted.

ON Thursday, the 19th instant, the first election of Founda-tion Scholars and of Pensioners to the Royal Medical Benevo-lent College took place. Twenty of each were elected. The

balloting-paper, which gave an epitome of the claims of each ofthe candidates to support, was indeed a painful document,illustrating as it did the immense amount of destitution whichprevails amongst members of the profession, who have beendisabled by sickness or otherwise, and the widows and orphansof medical men. The College will do much to alleviate thisdistress.

LETTERS ADDRESSED BY DR. A. SMITH,MEDICAL DIRECTOR-GENERAL,

TO THE AUTHORITIES AT THE WAR-OFFICE, RELATING TO THESANITARY CARE OF THE TROOPS AT THE COMMENCEMENT OF

THE WAR.

(From the Appendix to the Second Report of the Committee onthe State of the Army before Sebastopol.)

CIRCULAR TO MEDICAL OFFICERS.

Army and Ordnance Medical Department,March 3, 1854.

SIR,—Your regiment being one of those about to proceed onservice, you will of course take with you the regimental medi-cine chest complete, the apparatus for reducing dislocations,your own and your assistant-surgeon’s surgical instruments,and such other surgical appliances as may be necessary forservice in the field.

It will not be requisite to take the detachment chest, unlessyour regiment should proceed in two different vessels. In theevent of this chest being left behind, you will report to me howit has been disposed of.You will forthwith forward to me a return, showing the con-

dition of all these implements, and state whether the supply ofmedicines &c. in your charge (not contained in the chests) isconsiderable.A pair of panniers, one of which contains medicines and

surgical materials suitable for emergencies, will be provided foreach corps serving with Lord Raglan’s army, and will be issuedto you by the purveyor, upon your application through theprincipal medical officer with the force, previous to taking thefield.The other pannier, being at present nearly empty, is to con-

tain your own surgical instruments, and such other materialsas may be wanted in the field, or when separated from yourheavy baggage.In conclusion, I have to inform you that a valuable work,

entitled, " Commentaries in Surgery," has been lately pub-lished by Mr. Guthrie, and I strongly advise that all medicalofficers proceeding on service should provide themselves with acopy of it, if they are not already in possession of one.You will be pleased to communicate the last paragraph to

your assistants. I have, &c.,The Surgeon in charge, (Signed,) A. SMITH, D.G.- Regiment.

P. S. -You will be pleased to state whether the pocket in-struments belonging to yourself and the assistants are full orsmall sets.

ABOUT WAGGONS.

Army and Ordnance Medical Department,March 3, 854.

SIR,—Adverting to my letter of the 17th ultimo, transmit-ting a return of hospital stores, &c., necessary for the use ofthe expeditionary force proceeding to the Mediterranean, andin which waggons for the removal of wounded from the fieldwere stated to be required, I beg now to submit two models oftwo different kinds of waggons planned by myself, whichwaggons, if properly constructed, will, I think, answer wellthe purpose for which they are wanted.

In the event of the Master-general and Honourable Boardapproving the forms proposed, I beg to recommend that onefull-sized waggon of each description be built, and that I maybe put in communication with the builder, so that I may ex-plain in detail much that is not evident in the models.

I have, &c.,(Signed,) A. SMITH, Director-general.

Sir Thos. Hastings, &c. &c., Office of Ordnance.

RECOMMENDING MEDICAL OFFICERS TO GO TO EXAMINECLIMATE, &c., OT TURKEY.

(Immediate.) Army and Ordnance Medical Department,March 21,1854.

SIR,—As I have reason to suspect that disease of a veryserious and fatal nature prevails in Turkey during a considerablepart of each year, that is between July and March, and that itproves particularly malignant in persons not natives of thecountry, as was evinced during the Russo-Turkish campaign of1828 and 1829, I am therefore of opinion measures ought to beadopted, without delay, to ascertain the character of the com-plaints which prevail, the localities in which they prove the