Modern Medicine

Source: The British Medical Journal, Vol. 2, No. 294 (Aug. 18, 1866), pp. 197-199
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25205857
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-IGilw

Ittgult,18,4866.

Aitmq.
~

-Me&b3a.T,xtviar

I have now endewvroumded

to eonvey to you, I fear
trtnilations, 'unless promptly brought to us and
tolerably full, are of comparatively littbe value. Nor At too great length,, my generad imptessions on this
ca*oour weekly and quarterly journals, ccnducted as head, I hope without offence to any one and with
they are with constantly increasing ability, and all sincerity, certainly very inadequately. I have long
of them, I think, comprising a foreign section, do looked upon this Association as the element in outr
much to satisfy this particular waxit.
profession out of which stronger bonds of ttnion
Our New Sydenham Society isworlthy of all praise, between hll tanks, classes, and degrees, might be
bqVtits sphere is too limited and its publications are expected to grow, than out of any other-at least, at
-restricted to its oVn subscribers; and these only present; for it is framed on the most comprehensive
2500? too small a number out of so great a pro basis, and is organised so that all interests in all
fession. The original memoirs and works in medi parts of our cominmon country may find their plae
cine and the allied sciences bear a considera'ble pro and voice in it.
portion to the whole of the cientific productions of May it be more and mcote every yoatr an arena
thb World; land some 'idea niay be lformed of -the where the wisely expressed objects of its Founders
numlber of these, from the fact that the separate may be temperately, but steadily and earnestly pur
scientific memoirs and works of all countries, of sued-.above all, in a spirit of union! and may the
which the distinct titles could be ascertained as leading minds of ouir profession, whose cooperation
having appeared between the yeaks 1800 and 1863 we somuch require, and so highly appreciate, cothe
inclusive, brought together under the authority ot more and more amongst us, to help fotward that
the President ahd Cotuncil 'of the Royal Society, great and noble Art of Healing, to which, in one or
reachXthe astonishing total of -120,000, while every other of its departments, the lives of all of us are
.year's,produee is becoming greater than the last.
devoted!
Tlhe medical literature of Germany, France, Hol
land, and other continental countries, abounds in
materials of great value to us, both as scientific men We are requested to remind members of theAsso'
ciation that the Anual
'and as practitioners (as ours, tno doutbt, does to
Sbsc'it'ions
becrne
due on the 1st of January.
Thley can be paid,
'them). But unle 'wbare kept fully aware, in each
department, of the additions;as they acerue, we are
either to the Secretaries of theBranches;
or to
in danger of ;lagging in the raoa of improvement,
the General Secretaryj, T. Watkin Williarn,
and can hardly hope to do. justie to our patients or
Esq., 13, Newhall Street, Birminigham.
to ourselves.
But, Gentlemen, I must coliclude. I Would wil
'lingly 'have resigned into abler 'ands the task
unexpectedly insposed upon me -by youri Council.
Cibumstances 'andmy tastes have eaused me for
-some time 'past to desire to play my humble part
noiselessly in the world; and I have been less able
SATURDAY,
AUGUST
18TH;r 1866.
than I could have sometimes wished to share even in
the pleasure and the profit of professional gather
ings. I have, therefore (more perhaps than some
MO]YERN MEDICINE.
men), looked somewhat asaa spectator, fromnthe out
"WHAT
is
the
pradtice of medicine coming to?" asks
side, on many of the more public doings of our pro
"1
are gone
Where
the ancient
tra,.
fession, whose well-being, prosperity, and honour, a correspondent.
I yet esteem above aUlprice, and am constrained by ditions of our art? Where are to be found the
eveetymotive to desire to promrte. I must say that modern principles to guide the hand of the practi
I have witnessed with delight every suaccessive sign tioner to his work ?" These questions are put apropos
of a bpixit of coniciliation and approaohment between
the old, venerable, and most justly lhonoured, but, of the teachiDgs which have issued in recent dayhs
from our schools, and especially from the veneratble
still independent and detached, rather never-yet
united, corporate institutions, to which so many of walls of 'Guy's Hospital. The leading physicias
us. owe an allegiance undertaken formally by a and professors of one of the largest and most
solemn act. It has seemed to me that we have been respected schools of medicine in the metropolis tetich
weaker
for -good than we
and
been;
'might have
especially for the furtherance of those beneficent lessonswhich surpass the understanding of our ques
objects, which no clamswill .pursue if not our own, tioner. He has beenbrought up in a belief aid a con
so well
as, our own;
and none
it fidence in the power of his art to cure diseases; and
which,
therefore,
'would seem to be incumbent on us to prosecute by now, at the end of a long life of earnest zeal and
all the means
in our power;
and which
have appa
conscientious labours, he is -told that all he has done
renitly been less thought of because of our divisions.
in this wise has been not only useless but worse than
Not real divisions of feeling, nor any wide or deep
divergence of interests, but only a want of united useless. SfIe has been busy and anxious in the skilful
action; through the continued existence, in too much application, as he thought, of his remedies, and full
of their traditional shape, of isolated Institutions, of trust that his anxiety
was
in benefits
repaid
wvhich, -intheir present form, we have somewhat ouit thereby beetowed on his patients. But all this on
grown, and which seem to need some considerable
is no*
taken
from him.
His
con
3olution
rudely
reQarrangement if not consolidation, if they are to
a
for
and
is
fidence
exchanged
pitiless
scepticism;
repreent the altered state of the whole profession,

TrIfisb tebira1 '4}ournatl1

such

as'it

has

ing progress.

oome

to be

in our

own

age of astonish

his consolation-of
verted

into

life of well

'an a-atrance

that

applied

it -would

197
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labour

con

have

been

LEADJ1Gi

British Med4ioal;Jourtal.)

ARTI?fJES.

better for humanity if his labours, his anxieties, and

his skill, had never been thus employed. "What
am I to think and say ?" he asks. "Dr. Gull assures
me, and gives the proofs of his assurance in a lonig
list of cases, that dill-water is the best of remedies in
thie cure of acute rheumatism. Through a long life
of practice," he adds, " I have for this disease
largely bled my patients, mereurialised, purged,
cupped, blistered, antirmonialised' salined, alkalised
now

and

them;
to have

done

it comes

this,

I am

taught

that

things

would

have

been

ta

these

of

Hone

to do that which is best for acute rheumatic suffer

ing humanity; that to have done these things was
to have had in hand a very unsatisfactory business.
I must put up with the wretched consolation that I
did my best, according to my lights, whilst doing
was

what

bad.

very

Dr. Wilks,

has given

again,

me

some bitter draughts to swallow." Our correspon

dent here refers to some of those bold and admirable
discourses of Dr. Wilks, wherein he has what may
be called " spoken his mind" about the uses, or
rather abuses, of drugs, etc., in diseases.
But what most of all astonishes our country
brother is the teachings of Dr. Owen Rees (lately
referred to in our pages) concerning the treatment
diabetes.

of

seems

He

in

to have

some

degree

re

conciled himself to many of the modern inventions,

which so contradict his traditionary knowledge and
his past experience; bit this las blow at medical
practice has quite thrown him off his balance. We
must omit his indignant remonstrance, as given in
his own words; for they would be thought rather
too strong for the occasion.
Now; to tell the truth, we are really not surprised
that he should take exception to Dr. Owen Rees's
statements. Certainly the profession has a, right to
require a further development of them from their
author. It is only fair, we must candidly say, that
they who flatly contradict an accepted method of
a method

treatment,
has

which

stood

almost

universally
of many

test

the

adopted,

and

of

even

years

modern criticism, should give some proofs or suffi

cient grounds to show the reasonableness of their
contradiction. Dr. Gull eays dill-water is the best
cure

acute

of

and

rheumatism;

by

reference

to some

read and

comment

on

ment

he

backs

cases,

forty

his

which

state

we

can

for ourselves.

But Dr. Owen Rees does nothing of this sort.

Ie

says

that

his

large

and

long

experience

as a phy

sician of Guy's Hospital has brought him to the be

lief

that

do

on

matter.
disee
medical

do better

" diabetics
a restricted

on a natural
and

diet;"

there

he

than
leaves

they
the

He flatly contradicts the treatment of this

as carried
man

in

out
the

by,

we

country;

may

say,

but

gives

every

other

u4 no data

upon which to comment, and whereby to test the

correctness of his conclusions. True, he gives two
cases in his lecture; but these, as our correspondent
198

[AtUgiat' 18tal

says, are unsatisfactory camesas proofs of his conclu

sion. One of them certainly backs the view that,
under ordinary diet, a diabetic may live very-mauy
years; annd that, under the change from a resticted
to a common diet, a patient may rapidly improve.
But then this case occurred many: years .ago, and
clearly has not got all that clinical detail required in
the settlement of such an important question. More
over, it is quite neutralised by Dr. Rees' other,, a
recent hospital case- the case of "a young womaM
ret. 20, of ruddy comple ion and stout figure, strong
and healthy, and showing Ao outward signs of dis
ease. She was passing ll pin's of urine per day,
of specific gravity 1040. She had suffered from th;e
disease for three'years." She had been under'treat
ment be'fore admission into 'Guy's, and du;ring tv
time strictly dieted. Dr. Rees gave her chloride of
arsenic, and ordered 'an unrestricted diet. ,'On
leaving her" he says, "I spoke to those around me,
and predicted the ideath of this apparently, healthy
person withih a' very short' time; adPing, that my
only reason for the opinion was, that I had seen
more than one such case in' young girls of healthy
appearance terminate fatally, in spite of every' care!"
She went on pretty well for about three weeks, but
then fell suddenly ill,- 6snited, and was sleepy, add
soon tfiereupon died.
"Post mortem appeatides
showed nothing remarkable." This case, as our it4*
respondent says, surely does iaotdo much credit, as -gi
illustration, to Dr. Rees' non-Testrieted diet methld.
We may also add, that no details lar'egiven 'toshd-*
what the state of 'the urine was'duritg the patiet-ts
residence in hospital.
We trust Dr. Owen Rees will produce clinica'l
illustrations of his remarkable averment that di
betics do best on' a non-restricted diet.' In thete
fluctuating days of pr'actice',we are prepared- to! ri
ceive and welcQine any the most astounding innovaa-'
tion, provided only it come backed with a good bpsis
of proof; but we quite agree with'our respected cor
respondent, that all comers with novel 'teachings,
even the very highest authorities, must be prepared
to show just cause, if they expect us to listen to
them. Of all modern innovations in this way, we
surely have met with none which has more;'surprised
us than this one now issued by Dr. 'Rees. lf thexe
was one point in the practice of medicine 'whichWe
had thought to be sure of, it was, that restriitinl
the diet of diabetics was of service to them; we"haa
fancied to have seen patients get better and -become
worse, grow stronger and grow weaker, in accord
ancewith the kind of diet they took. We nevertheless
willinglyadmit the fallacies which attach to experiet6e
in medicine; and are ready to welcome anythin,
however strange, if it be but well proved. But ;tAhs
new doctrine of Dr. Rees we cannot accept, because
it is wanting in the sort of proof required. We
must,

therefore,

for

the

present,

adhere'

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fo

the'ol

Aagust 18, 18]IO

method; asking Dr. Rees either to supply the chi
nicel details requisite in such a case, or else not to
disturb our faith by the high authority of his per
sonal assertions.
"dSi quid novisti rectius illis,
Candidus

si non,

iniperti;

his utere

mecum."

[BriItie MklUca1 JotrW.

that the decrease

in the deaths
singular
coincidence,
from all causes
is exaetly
362.
the 4apme, namely,
The daily return
for Sunday
and Monday
last shows
that 139 died of cholera
and 46 of diarrhcea,
giving
as the average
of each day 694 and 36, as against
94
31
on
saturday,
showing
a, considerable
decrease
an4l
in the former,
and a slight
in the latter.
increase
on Sunday
The deaths
and Monday
from cho
were,
lera-west,
1; north, 2; eentral,
3; east, 123; south,
11:
from diarrhcea-west,
6; central,
8; north,
5;
east, 14; south,
13.
The Registrar-General
adds a
" No greater
warning
word:
mistake
could be made
than to relax the efforts
for combating
the disease,
or for relieving
the distress
it ha
which
already

MR. KARKFEK, House-surgeon to the Chester In

firmary, inform us (August 13th) that both the
patients upon whom Mr. Spencer Wells performed wrought."
ovariotomnyat Ctiester last week, are doing Iaswell
A large hospital
for the treatment
of infectious
as could be desired. The youing one is perfectly diseases
to be erected
is about
in Liverpool;
?8,000
and
the Town
Council
old one had been troubled by has been subscribed,
have
comfortable. Te
a grant
of ?5,000
made
towards
the eost.
cough, but itwas relieved by simple treatment.
TWENTY-FOUR-gentlemen were sixece ful candi
d4,te of, Her Majesty's B3ritish Medical Service, at
thep competitive examination in March last, and
have

passed.t*hrough

w40oo1.

.3 in England,

Igeju,

at

cous

Of- these gentlemen,

the Arpay

Medical

18 were educated in

in Scotland,

and

1 at

rJF. nursing of the "sisters" during this cholera

epidemic is pronounced as invaluable. In, one large
Infirmary (we have it from the best authority), the
presence of two of these ladies allayed, a positive
"Their services were invaJuable. Every
paic.
ting that human beings could do, was done by
One of thewe ladies thirough. the fearful
thm."
onslaught of the epidemic remained day and night
at h4erpost,, inFpiring confidence, until,she was forced
to give in through 4ieer exhaustion. The other
sier had to retire, being seized with diarrhcea.
But they had done the work; and left things in
perfect order.
Dr. Ferrand, in a work on Rhetumatic Exanthe
mata, endeavours to show-1. The coincidence of
acute exanthematous eruptions with acute rheu
matism; 2. The inflammatory character of these
epuptions, as shown by an exacerbation of the special
rheumatic fever; 3. The frequency of these exan
themata in a serous form; and 4. Their close relAtion
to the disease, of which they are, in fact, only a
pianifestation; the rheumatism, therefore, being the
immediate cause of their production.
CHOLERA.

return
by the Registrar-General
issued
THE weekly
the week
in London
during
ending August
of deaths
the numbers
a
considerable
decrease;
11th shows
respec
for the last five weeks
being
-frm cholera
and 781;
and from diax
1053,
32, 346, 904,
tively,
Of both
forms of
rfrwa, 150, 221, 349, 354, and 264.

4isease, therefore, 1045 persons died last week, which

ts'leo

than'ii

Sir FowelU Buxton

has placed
a large house
in the
at the disposal
of Miss Marsh,
country
of Beeken.
ham,
for convalescent
cholera
children.
Miss
Bur
is establishing
dett Coutts
a small cholera
hospital

in Bethnal Green.

Toronto.

THE

- A grant
of money
has been made
by the Treasury
to the Department
of Health,
for the purpose
of
conducting
a, special
series
of experimenuts
and re
in connexion
searches
with
the present
of
outbreak
cholera.
Mr. Simon will conduct
the inquiry.

-the *evidius

'Oedk by 362;

and

In the eastern
of Prussia,
provinces
the cholera
is
from day to day. Among
spreading
the larger towns,
and Dantzic
have of late been severely
Konigsberg
visited.
the news
from the seat of
Unfoztunately,
in Bohemia
is likewise very alarming.
Now
that
w,r
of battle
is over, the forced marches,
the excitemenat
and the maany and long continued
begin
privations,
t6 tell in favour of the development
of epidemie
dis
in various
eases, whilst.
the marshy
localities,
condi
tion of the groLud
at the same
time exerts
its un
It is to be hoped
toWard influence.
that the armi.
stice will facilitate
as well
as the provisioi
transfers,'
-of good. and strengthening
Where
aliment.
these
from
are deficient,
we know,
sad experience,
that
d:isease becodmes a far worse
of armies
than
destroyer
the most
battles.
to the
sanguinary
If, in regard
have been complained
commissariat,
shortcomings
of,
not be forgotten
it should
how unexpectedly
rapid
was
of our armies,
the advance
and
the fabulous
number
of wounded
and captured
enemies
should be
for whom
taken into account,
the care has devolved
commanders.
In this campaign,
upon the Prussian
have had to be dealt with,
fcgtors
which must
be
the most
donsidered
extraordinary
throughout
the
of war.
history
In Berlin,
the couree
of the epidemic
his,
since
been more
the end of last week,
favourable
from 4py
to the 24th
to day.
Up
July, the total of sqizure*
had been 3701.
From noon of that day to the 31st
at noon,
the number
of fresh cases
and of deatht
were
59;
respectively-186,
203, 68;
172, 139;
84,
The grand
total up to July 31st was as
35; 131, 50.
2528 deaths,
follows-4616
590 recoveries,
seizures,
under
1498 cases
treatment.
At
the four cholera..
each of which
is attended
hospitals,
by a physician
two or three assistant-physicians,
with
there were up
tq the 26tb July
received
1159 patients;
of whom
300 were
614 died,
and 245 re
discharged
cured,
under
treatment.
The spread of the diseae
msined
of the town, if the propor
over the various
districts
to the number
of inhabitants
is taken
tion of seizures
in consideration,
appears
uniform.
pretty
(Deutsche
A'inik,
No. 31, Aug. 4th, 1866.)

i is a

199
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