1782

presented us with an exhaustive description of the gloriousmedievalism of nine of our English catbedrals-viz., Durham,Ely, Lincoln, Salisbury, Worcester, Hereford, Chichester,Chester, and Bristol. In a book dealing with Englishcathedrals the author rightly claims for ancient English artthe highest possible place; indeed, he does not hesitate toaffirm with regard to sculpture that in the thirteenth centurythe English school was superior to the Italian; while withregard to architecture he proves that the architect of thatsuperb structure, Lincoln Cathedral, was an Englishmanwhose descendants exist in that county to the present day.The sister art of music also finds full place in this volumeand amongst other interesting facts relative thereto we aretold that the first four-manual organ in England was built asearly as 1710 by Renatus Harris for Salisbury Cathedral. In

the introductory sketch the author gives one of the mostcomplete histories that we have read of the Gothic Revival inEngland. The book is enriched with many beautiful illus-

trations, and the busy professional man with a taste for artand with but little time to fare far in search of it will findit a delightful as well as an instructive companion during thescant moments of his leisure.A Beggar’s Wallet. Edited by ARCHIBALD STODART

WALKER. Pp. 291.-This handsome volume is described on

the title-page as a collection of Contributions in ProseVeree, and Pictorial Illustration sent by upwards of 50authors and artists in response to the editor’s invitation.The "Beggar" is, in fact, the editor himself and hisI wallet," which is resplendent externally with scarlet andgold and is embellished within by many full-page illustra.tions, was on sale at a bazaar held at Edinburgh in

November for the benefit of the Royal Victoria Hospital forConsumption in that city. Among such a multiplicityof work by so many hands detailed criticism wouldbe impossible, but it may be mentioned that the first six

pieces are as follows :-" The Seasons," a poem by Mr. EdenPhillpotts ; "Literature and History," by Mr. G. W.

Prothero, editor of the Quarterly Review; ; "Silence," a

French poem, by Lady Margaret Sackville ; "Dogs of Cele.brated Edinburgh Men," by Eve Blantyre Simpson ; "Helio-dora," a poem by Mr. Justin Huntley McCarthy; and " Tide-marks of Battle," by Mr. Douglas Story, lately war corre-spondent with the Russian forces in Manchuria. The title-

page instead of giving the name of the publisher mentionsthat the printers are Messrs. Dobson, Molle, and Co., Limited,of Edinburgh and London.

JOURNALS AND MAGAZINES.The Dublin Journal of Medical Science (November).-Dr.

Charles G. Cumston deals at length with the subject ofExtra-articular Tuberculosis of Bones and lays stress uponthe importance of early diagnosis of what otherwise developsinto a most serious affection. By way of treatment ofadvanced cases he speaks highly of Lannelongue’s "sclero-genous" treatment by injections of chloride of zinc intothe neighbourhood of the lesions. He admits, however,that the method is so painful that patients often refuse tocontinue it. In view of the curative powers which have

been attributed to violet leaves, especially in cases of

cancer, Mr. H. Wippell Gadd has examined their chemicalproperties. He found present a glucoside, previouslyidentified by Mandelin with quercitrin, and also obtained

from the dried leaves an oily material, but throws no freshlight upon the therapeutic properties of either substance.

The Edinburgh Medieal Journal.-The original communi-cations contained in the December number of this journalare of more than average interest. Mr. A. W. Mayo Robsondeals with Chronic Pancreatitis, a subject upon which he hasmade himself perhaps the leading authority, and points outthe symptoms which may enable a diagnosis of this condi-tion to be made during life. We are glad to see that heallows a period of medical treatment in pancreatic cases

before operation is resorted to. Professor J. Arthur Thomsonwrites on Heredity, his article being practically a review ofDr. G. Archdall Reid’s book, " The Principles of Heredity."He recommends the study of this subject as of importance toall medical men, but we fear that his paper, seeing that itdeals rather with the subtleties of the subject than with itsbroad outlines, will hardly prove an inviting introduction.Dr. R. W. Philip contributes a valuable summary of the pro-ceedings of the recent Tuberculosis Congress, which shouldbe read by all who have not otherwise followed the labours ofthis assembly. Dr. David Fraser Harris writes on Psycho-chromassthesia, or Sensation of Colour accompanying MentalConcepts, and Dr. J. Wright Mason describes the InjuriesInflicted by the Russian Cannonade upon the Victims

belonging to the Gamecock Fishing Fleet.

Looking Back.FROM

THE LANCET, SATURDAY, Dec. 15th, 1827

A pure surgeon is one who holds out to the public, that heis ready to prescribe, but not to dispense, medicine to hispatients, and that he expects the sum of twenty-one shillingsfor every prescription or visit his patients receive from him,saving, moreover, the right which the law gives him, ofbringing his action in cases of non-remuneration, or what hemay deem inadequate remuneration for any operation he mayperform. It is evident that there is no limitation as to thetime at which a member of the College may call himself apure surgeon ; a veteran retailer of drugs, who may happenalso to be a member of the College, may, at any time, shut uphis shop, and declare his purity, or purity may be professedimmediately after a student’s examination and admission.The ratio of the soi-disant Pures, to the great body ofEnglish surgeons, is about one to three hundred; supposing,therefore, that this class is, to a man, hostile to the causeof medical reform, its hostility will not be of the smallestpractical importance.We of course restrict these observations to the soi-disant

Pures of the surgical profession. We admit that men whohave attained great eminence in their profession have aright, in effect, to make their own terms with the public;and that superior ability in tLe medical, as in all other pro-fessions and pursuits, is entitled to superior remuneration.But the fact is, that, in the surgical profession, the superiorremuneration is claimed by men who are not entitled to iton the score of ability, but whose pretensions are founded onthe holding of offices, for which they are indebted, not totheir professional merits, but to the influence of corruption.Let the public look, for instance, at the manner inwhichhos-pital surgeons, for the most part, obtain their situations, anddecide whether it is possible that fair play can be given tothe development of the average amount of talent that might,under a different system, be fostered in those institutions.SIR ASTLEY COOPER on one occasion publicly declared, thatthere was not a hospital surgeon at ST. THOMAS’S and atGuv’s, who was not either his nephew, or his niece’s husband,or connected with him more or less closely by ties pecuniaryor domestic. What are the consequences of a system whichis thus unblushingly admitted to be founded in corruption?Our hospital surgeons are not only inferior to men holdingsimilar situations in other countries, but they are below par,in point of professional information, as compared with prac-titioners at home. Some of them are the laughing-stocks oftheir assembled pupils ; some few of them acquire consider-able dexterity in the performance of particular operations;but we repeat, that as a body, they are below par in point ofprofessional information, and know less of pathology, less ofthe nature and treatment of disease, than the mass ofgeneral practitioners. Yet these hospital surgeons are Purespar excellence. If there be one English surgeon more

entitled than another to any distinction that may be due tosuperior professional attainments, it is Mr. LAWRENCE; butthis eminent individual scouted, it will be recollected, at thegeneral meeting of practitioners, the designation of puresurgeon, and identified himself with the great body of theSURGEONS OF ENGLAND.1

1 Excerpt from leading article headed "The Bats and the Pures."

1783THE ROYAL COMMISSION ON THE POOR-LAWS.

THE LANCET.

LONDON: SATURDAY, DECEMBER 16, 1905.

The Royal Commission on thePoor-laws.

WHILE the appointment of the Royal Commission on thePoor-laws and the scope and terms of its reference appear to

be generally acceptable to the public, indications of dis-

satisfaction with its composition have found expression inmany quarters, and have been mainly based, so far as theyhave fallen under our notice, upon the absence of persons, orof classes of persons, whose various forms of knowledgewould be likely to afford useful guidance in relation to

particular aspects of the questions which will have to beconsidered. We published last week a letter from Mr. F. R.HUMPHREYS, complaining of the absence of any inde-

pendent medical expert," and pointing out that this

deficiency is not supplied by the presence of Dr. A. H.

DOWNES who, although an eminent medical official of thePoor-law side of the Local Government Board, cannot make

up for the lack of independent medical men, ’’ free from thehabitual trammels of red tape and of tradition founded uponthe prevention of idleness and not upon the treatment ofdisease." Dr. A. SHADWELL in the Times has called atten-

tion to the absence of representatives of agricultural andof manufacturing districts, a complaint supported, so faras the former are concerned, by Mr. H. G. FORDHAM ;and Dr. F. E. FREMANTLE, the medical officer of health

of the county of Herts, asks for representation of the

county council system, especially on the ground of

the probable transference to these councils of the duty of

superintending vaccination and on that of the manifest

propriety of rendering the medical department of the Poor-law a branch of the general sanitary system of the country.There seems to be much weight in the whole of these

representations; and even although there might be prac-tical objections to an undue increase in the mere numerical

strength of the Commission, it cannot be denied that

deficiencies calculated to diminish its usefulness should be

supplied before it is too late. It may be urged, of course,that the present members may obtain full information fromwitnesses upon points as to which their own knowledge maybe incomplete, but this argument can only be accepted to avery limited extent. A certain amount of special knowledgeis sometimes necessary to the mere comprehension of

evidence and, still more frequently, to the power of formingan adequate estimate of its value. We greatly doubt, forinstance, whether the physiological bearings of the case,

the relations of poverty to the intellectual decadence and

physical degeneration of large classes of people and oftheir offspring, would be likely to make an impression

’’

adequate to their gravity upon the intelligence of the

average economist; or whether the real national importance

of the permitted prevalence of disease would be any morecorrectly estimated by a practically non-medical Commissionthan it has been by the successive Parliaments under whichthe systems of administration now flourishing have beencreated and maintained. We entertain no doubt that the

addition of one or two medical members to the Commission,even if they were compelled to prepare a minority report,would be of great value to the public and would at least

pave the way for an adequate consideration of the vast

interests which it would be the duty of such members torepresent and to maintain.

By the terms of their reference the Commissioners are

instructed to inquire: (1) into the working of the laws

relating to the relief of poor persons in the United Kingdom;(2) into the various means which have been adopted outsideof the Poor-laws for meeting distress arising from want of

employment, particularly during periods of severe industrial

depression, and to consider and report whether any, and ifso what, modifications of the Poor-laws or changes in theiradministration or fresh legislation for dealing with distressare advisable. This is all; and it will probably be main-tained by official persons that the consequent inquiry willnot be sufficiently extended in its scope to call for the

assistance of medical Commissioners in conducting it. The

argument would sufficiently refute itself if it were appliedto cover either the absence of representatives of agri-culture and of manufacture, or the generally metropolitancharacter of the Commission as a whole, and we do notsee that it can be sustained even against the objections raisedby Mr. HUMPHREYS. "The working of the laws relating tothe relief of poor persons in the United Kingdom" is a

description which certainly includes the whole subject ofmedical relief ; and the subject of medical relief is

intimately associated with that of national sanitation. It is

perfectly well known in rural districts that one of the chieffactors in local epidemics is the tramp and it is not too muchto say that the suppression of vagrancy would be followed bya material diminution in the prevalence of many infectiousdiseases and by the saving of many lives. The tramp as heis ordinarily met with, filthy, ragged, verminous, a hotbedfor the growth and propagation of everything to which theterm " saprophytic can be applied, a systematic pilfererwhen he is not a professional thief, and with a female of hisown class following in his wake, is at present, so long as hedoes not commit any special outrage, practically at liberty tofollow his own devices and to carry infections about with

him at his own sweet will. Our national tenderness

for the liberty of the subject has hitherto extended

to him an amount of toleration which those who

know him best are the first to regret, and it is clearlyneedful that other arguments for the restraint of his

activities and of his power to reproduce his kind should

be reinforced by driving home the facts which elucidate

his importance as a carrier of disease. Apart from him,it may fairly be questioned whether the sums expendedin medical relief are so directed as to afford the largestattainable amount of benefit either to the individuals

concerned or to the community. It is certain that manymedical officers under the Poor-law are very inadequatelypaid for their services and that a greal deal of the attend-ance given to the sick poor is given under conditions