?f)c Entrtait ittctucal (Snjcttc. MAY 1, 1875.
AN The
writing
deed,
we
INQUIRY
INTO LEPROSY.
of these words has almost caused us a qualm ; inexperience of the sensation
must confess to the full
acceptation, though it has fortunately fallen short physical effect implied by the term. A new sanitary " inquiry ! These inquiries" are so rapidly treading ou the heels of each other that, before discussing the matter and manner of iu its moral
of the
this one, it may be well to pause and consider how
its prede-
THE INDIAN MEDICAL GAZETTE.
130 have fared.
cessors
pretend
We cannot
within the last half dozen years
or
to
give
a
complete
that have been initiated
special inquiries
account of all the
so, in addition to volumes of which have been
occasionally circulated. Here are some of them :?cholera, tropical skin diseases medical meteorology, subsoil water level, famine fever, typhoid fever, Burdwan fever, cattle plague, snake poisoning. Now what has come of these inquiries? We shall endeavour We to give as brief a reply to this question as possible. certainly, thanks to Drs. Lewis and Cunningham, have gained some very valuable information on the subject of cholera, and some cognate topics ; but how imperfect our knowledge and chaotic and contradictory our views still are ! and how much remains to be done in order to render the former complete and the latter sound and stable! Some interesting facts questions
on
all kinds of
undoubtedly
were
subjects
contributed
by
civil surgeons on the sub-
ject of tropical skin diseases, which Drs. Fox and Farquhar notion probably in time publish ; but we have a shrewd has fallen aggregate amount of information collected far short of the expectations originally entertained, and of what the extent of the field of inquiry might reasonably be presumed to furnish. As regards medical meteorology, it is obvious that the cultivation of general meteorology must prewill
that the
cede the
special application of
the science to the elucidation of We would fain believe that
the laws of health and disease.
during recent
recent years some progress has been made, and that the appointment of so able a meteorologist as Mr. Blandford
general direction and supervision of observatories and throughout India will lead to further progress ; but we are fully aware that very much of the work which has been done and recorded in recent years is utterly unsound, and it is open to question whether the agitation which lias been so persistently made on this subject has not, for want of really reliable arrangements for observation and record, done more harm than good. The development of medical meteorology is still in the distant future ; and we doubt much whether clear and correct views exist as regards the manner and aim of its cultivation. A crude comparison of meteorological tables with what we are pleased to call vital statistics is certainly not the way to do it, and the attempts which have already been made in the way of medical meteorology, e.g., Bryden's monsoon theory of cholera, are not such as to command our respect. The inquiry regarding the
to
the
observations
sub-soil water level
trumpets, i;ear
and
was
and led to no
no
introduced with a great flourish of little expenditure of money for well
small expenditure of
directions, and returns, but that the whole
thing
has
Into
have
the causes
foolscap
believe
proved
all the fuss and expense
importance.
we
paper for
we are
conveving stating
correct in
lamentable failure, and that produced any one fact of of this failure we are not
a
not
prepared with sufficient confidence to enter; but a study of them would doubtless be very instructive. Famine fever never
made
its
appearance; but it was, we understand, contemplation, in the event of its breaking out, to
in
deflect Drs. Lewis and
they
to
from the work for which
were
specially selected and appointed, in which they special training, and have acquired much skill experience, and which ia still so very far from complete,
received and
Cunningham
the
a
investigation
of
a
subject regarding which their iuforma*
tion must
service,
from the circumstances of their
necessarily,
be
1875.
[Mat 1,
comparatively limited,
previous experience scanty. studied mainly from an and
Typhoid fever has hitherto been arithmetical point of view. We believe that the British Medical Department has lately commenced a detailed clinical, pathological, and etiological study of it, and if the work is conducted with sufficient elaboration and care, valuable results will, no doubt, be forthcoming in time; but time is requisite for solid results in such investigations. The inquiry into the Burdwan fever has hitherto borne no fruit. Dr. Wilkie, who was appointed about a year ago to study the subject under the control and direction of the local Sanitary Commissioner, has not, as far as we know, done any thing, and has now joined another appointment. Dr. C. J. Jackson, the late Sanitary Commissioner of Bengal, has submitted a report representing an amount of laborious
enormous
that his conclusions are
work ; but
we
are
informed
to be
challenged by a competent likely critic, and we defer offering any opinion regarding them for the present. The latest arrangement for the study of this fever is, we understand, to depute Drs. Lewis and Cunningham to the fever tracts, in the event of the disease again breaking out. To this arrangement the objection above stated equally applies. The subject of cattle plague was investigated by a commission, and the information thus obtained
very exhaustive.
was
subject has also been practically and usefully dealt with by competent men specially deputed to investigate it. The ?' general facts" obtained by circulars and questions were for the most part very vague and of very doubtful value. Snake poisoning has been investigated by men specially interested, and by
The
a
committee of selected
medical
officers.
The
thus obtained has been sound and valuable,
of
"general inquiry"
a
which
was
information
but the results
simultaneously
made were
almost nil.
Generally, it may be accepted as a broad truth that no scientific facta of any value have ever been obtained anywhere except by men specially interested and qualified for the work, " General or by competont men specially appointed to it. facts" in scientific questious are useless, and "general inquiries" as a rule lead to nothing or worse than nothing. We are not aware of any exception to this law. Such being the fate of previous inquiries, what guarantee have we that the now proposed investigation of leprosy will be more successful ? Our information on the subject is derived from the is
of the 14th ultimo. The article resolution of the Government of
Englishman
apparently based
on
India in the Home
a
Department, dated
1875 ; but it seems to
embody
this
the
12th
document
February
fully, and is?
It appears then, that Dr. Carter, of Bombay Medical Service, proposed tho appointment of a special leprosy commission. This is objected to on tho score of one officer being unable to prosecute so largo a research we
dare say, correct.
the
over
so
wide
a
field
as
the whole continent of India.
depends on the time which the tho objection is undoubtedly valid.
If, however, subject why appoint only one man?why not
worth
investigating,
appoint
several ? In matters of this kind universal
has,
as
we
have already remarked, taught
agencies, interested are
indispensable.
This
research it to occupy ; bnt is tho
in the
subject
and
us
competent
experience
that
special
for tho work,
To commit work of this kind to
general
AN
Mat I, 1875.]
INQUIRY
INTO LEPROSY.
131
tary and insanitary conditions under which the people live," agoncies otherwise occupied, and fully so, is wittingly to invite the field is simply immense. Then, leprosy may be (most pro* failure; and yet this is precisely what is about to happen. a "
Ihe
inquiry
must
sanitary inquiry, requiring the combined action of the whole sanitary department in India." If there were such a in the department, ordinary sense of the term, much might be urged in favor of this view, though we should still cling to the superiority of a special machinery for the inquiry. I3ut what does the "sanitary department" consist of ? One administrative head with three special assistants and eight executive officers for the whole of India, three of whom have very important additional duties?a staff quite unequal to the accomplishment of the ordinary sanitary work of so immense an area and population ; nor does the sphere of their duties embrace the whole of India. The "general facts" are to be dealt with by the Sanitary Commissioners aided by the Civil Surgeons in their capacity as Health Officers. Civil Surgeons have, however, several other capacities in which they are responsible for a great deal of work to several other departments, and the fraction of their sanitary capacity, which they can devote to leprosy investigations, we have no hesitation whatever in pronouncing inadequate to the task. Drs. Lewis and Cunningham are, it appears, available to take up the microscopic and scientific portion of the inquiry. This looks
to
us
necessarily
be
a
the very worst feature of the whole matter.
whose cholera work is still
officers, are having
so
These
very far from
complete, all kinds of miscellaneous work imposed on them, and it is not hard to see that the cholera inquiry, in which they have already worked so well, will be simply stifled thereby. !Now, what is the scope of the inquiry which is to be conducted by Sanitary Commissioners and Civil Surgeons in their capacity as
Health Officers? "Nor would such
smallest
value,"
we
an
inquiry
be of the
told, " which did not embraco a full principal diseases under which the people
are
consideration of the
labour, especially in those parts of the country in which leprosy is most common, and of the
sanitary
and
insanitary
conditions
tinder which
they live." To this we most willingly subscribe, but the work here indicated means nothing more nor less than
detailed hygienic eyclopa;dia or gazeteer for India, the collection of materials for the preparation of which would occupy a
the whole medical service of
India, adequately aided,
a
very
"
nothing else to do. Yet long reports are concise summary will suffice." A concise sumThe extent mary of what ? Let the article (? resolution) reply?" long time, if required ;
not
it had a
leprosy exists among the people in each district." This necessarily demands a correct census of the whole district and its several ports, and a correct leprosy census corresponding.
to which
To be of any use such
a
census
must descend to individual
"
communities?villages. If localized, the locality in which it, is of this locality, if there chiefly found, the special peculiarities are
special
any, and the
which the
people
in this
conditions in other respects live." In the first
locality
under
place,
it
would be necessary to determine whether the localization were duo to circumstances causing an aggregation of lepers in the
locality
or
to circumstances
causing
the
people
of the
locality
to
become leprous?an inquiry of very great labour and difficulty. do the terms, " special Then, what an immensity of research
peculiarities" and special conditions" suggest! To determine their speciality the conditions must, of course, be studied " elsewhere as wellj and us these conditions embrace the saui-
pably is) result, not of present conditions, but of the cumulative effect of past conditions, geological, climatic, racial, dietetic, &c., &c., and the inquiry must necessarily take a historical form also.
But this is not all:
"
opportunity will,
doubt, also regard to individual cases and the circumstances under which they seem to have arisen, whether by contagion or hereditary taint, or any other offer for
collecting
no
valuable information in
cause."
Contagion and heredity are subjects which demand the most inquiry and the nicest balancing of extensive data, and cases bearing on these points must be studied, recorded, and published with the greatest accuracy and detail. All this leaves out of sight the vitally important matters of the hygiene and therapeutics of the disease. How an inquiry of this description concise summary" we are utterly can be compressed into a unable to conceive. Scientists of the present day will not remain content with mere categorical conclusions. They must have the detailed data on which conclusions rest, and calling for concise summaries" in a question of this sort is simply courting vague, perfunctory, and utterly useless work. Government does not seem to be aware that a very similar inquiry to that now ordered was made in 1863. A set of questions on Leprosy, drawn up the London College of Physicians, was circulated through the medical department, and numerous replies to them were obtained. These were, very properly, printed in extenso in a blue book. What was valuable in them was summarised by Dr. C. Macnamara in the 1st Volume of this journal. The replies contained a good deal of " general" information ; but of so vague a kind that they left the causation, contagion, heredity, and treatment of the malady elaborate
"
"
much where
very
it
was.
It does
seem
waste
a
of labor to
repeat in 1875 what lias already been done in 1863, and with less promise of success ; for the " concise summaries" which will be
in response to the vague, indefinite, and diffuse resolution cannot possibly equal in value the
forthcoming
terms of this
detailed information obtained in
telligently
framed questions of
a
auswer
to
carefully
and in-
definite kind.
foregoing it is not difficult to gather that we enterstrong opinion that the terms and manner in which the prosecution of this inquiry has been ordered do not contain in them the elements or promise of success; and we have no hesitation in predicting that an investigation so conducted will not contribute materially to the solution of the very intricate problems above indicated. We desire to treat a resolution emanating from the GovernFrom the
tain
a
very
ment of India with the respect which is due to it; but, with and the great the failure of so many past inquiries in view, the with utterly inadequate difficulty of this one, coupled for its prosecution, we can arrive at no other 0gency proposed We know not, and care not to than the conclusion stated. for having advised Government who is
responsible
speculate,
did so must have known very in this matter; but whoever or of the civil medical service. little either of leprosy nibbling at great and weighty questions of sanitary
Inept
science
can
"
and
we
unless
a
only end
in
bringing sanitary science into contempt;
scientific inquiry should be initiated reasonable prospect of its successful prosecution exists, hold that
no
the INDIAN MEDICAL GAZETTE.
!32 ?which is not the
case
service consists of
a
in this instance.
The Indian medical
number of medical officers selected for
certain professional duties ; its members possess good average general and professional abilities, and are quite equal to the duties, medical and sanitary, which they are ordinarily required to perform. But inquiries such as this demand a much higher class of mind and attainments than suffice for the performance of these duties, and many civil surgeons belonging to the apothecary and assistant surgeon class, though quite equal to the performance of the work ordinarily required of them, are not able to grapple with questions such as contagion and heredity in leprosy, than which no more difficult and delicate exist in the whole range of medical science. composed of Budds, Jenners, and
Were the civil medical service
Murchisons, with nothing else to do,
exist some hope might but, as matters now stand, there is very little; besides, the policy of splitting up officers into a lot of capacities," with a divided allegiance in respect of these to several " departments," is destructive of economy and unity of effort, general or special. Wo consider, moreover, that it would be well that Sanitary Commissioners themselves should perfect one branch of labour, say mortuary registration, before commencing another. Though we have stated our opinion thus freely regarding the method arid probable success of this new inquiry, we, nevertheless, trust that medical officers will loyally and heartily do their best to meet the views of Government; and if the result is otherwise than we anticipate, we shall be but too glad to own ourselves wrong ; for the subject is, undoubtedly, one of immense scientific interest and of greatp ractical importance. of
success;
"
[Mat 1,
1875.
AN The
writing
deed,
we
INQUIRY
INTO LEPROSY.
of these words has almost caused us a qualm ; inexperience of the sensation
must confess to the full
acceptation, though it has fortunately fallen short physical effect implied by the term. A new sanitary " inquiry ! These inquiries" are so rapidly treading ou the heels of each other that, before discussing the matter and manner of iu its moral
of the
this one, it may be well to pause and consider how
its prede-
THE INDIAN MEDICAL GAZETTE.
130 have fared.
cessors
pretend
We cannot
within the last half dozen years
or
to
give
a
complete
that have been initiated
special inquiries
account of all the
so, in addition to volumes of which have been
occasionally circulated. Here are some of them :?cholera, tropical skin diseases medical meteorology, subsoil water level, famine fever, typhoid fever, Burdwan fever, cattle plague, snake poisoning. Now what has come of these inquiries? We shall endeavour We to give as brief a reply to this question as possible. certainly, thanks to Drs. Lewis and Cunningham, have gained some very valuable information on the subject of cholera, and some cognate topics ; but how imperfect our knowledge and chaotic and contradictory our views still are ! and how much remains to be done in order to render the former complete and the latter sound and stable! Some interesting facts questions
on
all kinds of
undoubtedly
were
subjects
contributed
by
civil surgeons on the sub-
ject of tropical skin diseases, which Drs. Fox and Farquhar notion probably in time publish ; but we have a shrewd has fallen aggregate amount of information collected far short of the expectations originally entertained, and of what the extent of the field of inquiry might reasonably be presumed to furnish. As regards medical meteorology, it is obvious that the cultivation of general meteorology must prewill
that the
cede the
special application of
the science to the elucidation of We would fain believe that
the laws of health and disease.
during recent
recent years some progress has been made, and that the appointment of so able a meteorologist as Mr. Blandford
general direction and supervision of observatories and throughout India will lead to further progress ; but we are fully aware that very much of the work which has been done and recorded in recent years is utterly unsound, and it is open to question whether the agitation which lias been so persistently made on this subject has not, for want of really reliable arrangements for observation and record, done more harm than good. The development of medical meteorology is still in the distant future ; and we doubt much whether clear and correct views exist as regards the manner and aim of its cultivation. A crude comparison of meteorological tables with what we are pleased to call vital statistics is certainly not the way to do it, and the attempts which have already been made in the way of medical meteorology, e.g., Bryden's monsoon theory of cholera, are not such as to command our respect. The inquiry regarding the
to
the
observations
sub-soil water level
trumpets, i;ear
and
was
and led to no
no
introduced with a great flourish of little expenditure of money for well
small expenditure of
directions, and returns, but that the whole
thing
has
Into
have
the causes
foolscap
believe
proved
all the fuss and expense
importance.
we
paper for
we are
conveving stating
correct in
lamentable failure, and that produced any one fact of of this failure we are not
a
not
prepared with sufficient confidence to enter; but a study of them would doubtless be very instructive. Famine fever never
made
its
appearance; but it was, we understand, contemplation, in the event of its breaking out, to
in
deflect Drs. Lewis and
they
to
from the work for which
were
specially selected and appointed, in which they special training, and have acquired much skill experience, and which ia still so very far from complete,
received and
Cunningham
the
a
investigation
of
a
subject regarding which their iuforma*
tion must
service,
from the circumstances of their
necessarily,
be
1875.
[Mat 1,
comparatively limited,
previous experience scanty. studied mainly from an and
Typhoid fever has hitherto been arithmetical point of view. We believe that the British Medical Department has lately commenced a detailed clinical, pathological, and etiological study of it, and if the work is conducted with sufficient elaboration and care, valuable results will, no doubt, be forthcoming in time; but time is requisite for solid results in such investigations. The inquiry into the Burdwan fever has hitherto borne no fruit. Dr. Wilkie, who was appointed about a year ago to study the subject under the control and direction of the local Sanitary Commissioner, has not, as far as we know, done any thing, and has now joined another appointment. Dr. C. J. Jackson, the late Sanitary Commissioner of Bengal, has submitted a report representing an amount of laborious
enormous
that his conclusions are
work ; but
we
are
informed
to be
challenged by a competent likely critic, and we defer offering any opinion regarding them for the present. The latest arrangement for the study of this fever is, we understand, to depute Drs. Lewis and Cunningham to the fever tracts, in the event of the disease again breaking out. To this arrangement the objection above stated equally applies. The subject of cattle plague was investigated by a commission, and the information thus obtained
very exhaustive.
was
subject has also been practically and usefully dealt with by competent men specially deputed to investigate it. The ?' general facts" obtained by circulars and questions were for the most part very vague and of very doubtful value. Snake poisoning has been investigated by men specially interested, and by
The
a
committee of selected
medical
officers.
The
thus obtained has been sound and valuable,
of
"general inquiry"
a
which
was
information
but the results
simultaneously
made were
almost nil.
Generally, it may be accepted as a broad truth that no scientific facta of any value have ever been obtained anywhere except by men specially interested and qualified for the work, " General or by competont men specially appointed to it. facts" in scientific questious are useless, and "general inquiries" as a rule lead to nothing or worse than nothing. We are not aware of any exception to this law. Such being the fate of previous inquiries, what guarantee have we that the now proposed investigation of leprosy will be more successful ? Our information on the subject is derived from the is
of the 14th ultimo. The article resolution of the Government of
Englishman
apparently based
on
India in the Home
a
Department, dated
1875 ; but it seems to
embody
this
the
12th
document
February
fully, and is?
It appears then, that Dr. Carter, of Bombay Medical Service, proposed tho appointment of a special leprosy commission. This is objected to on tho score of one officer being unable to prosecute so largo a research we
dare say, correct.
the
over
so
wide
a
field
as
the whole continent of India.
depends on the time which the tho objection is undoubtedly valid.
If, however, subject why appoint only one man?why not
worth
investigating,
appoint
several ? In matters of this kind universal
has,
as
we
have already remarked, taught
agencies, interested are
indispensable.
This
research it to occupy ; bnt is tho
in the
subject
and
us
competent
experience
that
special
for tho work,
To commit work of this kind to
general
AN
Mat I, 1875.]
INQUIRY
INTO LEPROSY.
131
tary and insanitary conditions under which the people live," agoncies otherwise occupied, and fully so, is wittingly to invite the field is simply immense. Then, leprosy may be (most pro* failure; and yet this is precisely what is about to happen. a "
Ihe
inquiry
must
sanitary inquiry, requiring the combined action of the whole sanitary department in India." If there were such a in the department, ordinary sense of the term, much might be urged in favor of this view, though we should still cling to the superiority of a special machinery for the inquiry. I3ut what does the "sanitary department" consist of ? One administrative head with three special assistants and eight executive officers for the whole of India, three of whom have very important additional duties?a staff quite unequal to the accomplishment of the ordinary sanitary work of so immense an area and population ; nor does the sphere of their duties embrace the whole of India. The "general facts" are to be dealt with by the Sanitary Commissioners aided by the Civil Surgeons in their capacity as Health Officers. Civil Surgeons have, however, several other capacities in which they are responsible for a great deal of work to several other departments, and the fraction of their sanitary capacity, which they can devote to leprosy investigations, we have no hesitation whatever in pronouncing inadequate to the task. Drs. Lewis and Cunningham are, it appears, available to take up the microscopic and scientific portion of the inquiry. This looks
to
us
necessarily
be
a
the very worst feature of the whole matter.
whose cholera work is still
officers, are having
so
These
very far from
complete, all kinds of miscellaneous work imposed on them, and it is not hard to see that the cholera inquiry, in which they have already worked so well, will be simply stifled thereby. !Now, what is the scope of the inquiry which is to be conducted by Sanitary Commissioners and Civil Surgeons in their capacity as
Health Officers? "Nor would such
smallest
value,"
we
an
inquiry
be of the
told, " which did not embraco a full principal diseases under which the people
are
consideration of the
labour, especially in those parts of the country in which leprosy is most common, and of the
sanitary
and
insanitary
conditions
tinder which
they live." To this we most willingly subscribe, but the work here indicated means nothing more nor less than
detailed hygienic eyclopa;dia or gazeteer for India, the collection of materials for the preparation of which would occupy a
the whole medical service of
India, adequately aided,
a
very
"
nothing else to do. Yet long reports are concise summary will suffice." A concise sumThe extent mary of what ? Let the article (? resolution) reply?" long time, if required ;
not
it had a
leprosy exists among the people in each district." This necessarily demands a correct census of the whole district and its several ports, and a correct leprosy census corresponding.
to which
To be of any use such
a
census
must descend to individual
"
communities?villages. If localized, the locality in which it, is of this locality, if there chiefly found, the special peculiarities are
special
any, and the
which the
people
in this
conditions in other respects live." In the first
locality
under
place,
it
would be necessary to determine whether the localization were duo to circumstances causing an aggregation of lepers in the
locality
or
to circumstances
causing
the
people
of the
locality
to
become leprous?an inquiry of very great labour and difficulty. do the terms, " special Then, what an immensity of research
peculiarities" and special conditions" suggest! To determine their speciality the conditions must, of course, be studied " elsewhere as wellj and us these conditions embrace the saui-
pably is) result, not of present conditions, but of the cumulative effect of past conditions, geological, climatic, racial, dietetic, &c., &c., and the inquiry must necessarily take a historical form also.
But this is not all:
"
opportunity will,
doubt, also regard to individual cases and the circumstances under which they seem to have arisen, whether by contagion or hereditary taint, or any other offer for
collecting
no
valuable information in
cause."
Contagion and heredity are subjects which demand the most inquiry and the nicest balancing of extensive data, and cases bearing on these points must be studied, recorded, and published with the greatest accuracy and detail. All this leaves out of sight the vitally important matters of the hygiene and therapeutics of the disease. How an inquiry of this description concise summary" we are utterly can be compressed into a unable to conceive. Scientists of the present day will not remain content with mere categorical conclusions. They must have the detailed data on which conclusions rest, and calling for concise summaries" in a question of this sort is simply courting vague, perfunctory, and utterly useless work. Government does not seem to be aware that a very similar inquiry to that now ordered was made in 1863. A set of questions on Leprosy, drawn up the London College of Physicians, was circulated through the medical department, and numerous replies to them were obtained. These were, very properly, printed in extenso in a blue book. What was valuable in them was summarised by Dr. C. Macnamara in the 1st Volume of this journal. The replies contained a good deal of " general" information ; but of so vague a kind that they left the causation, contagion, heredity, and treatment of the malady elaborate
"
"
much where
very
it
was.
It does
seem
waste
a
of labor to
repeat in 1875 what lias already been done in 1863, and with less promise of success ; for the " concise summaries" which will be
in response to the vague, indefinite, and diffuse resolution cannot possibly equal in value the
forthcoming
terms of this
detailed information obtained in
telligently
framed questions of
a
auswer
to
carefully
and in-
definite kind.
foregoing it is not difficult to gather that we enterstrong opinion that the terms and manner in which the prosecution of this inquiry has been ordered do not contain in them the elements or promise of success; and we have no hesitation in predicting that an investigation so conducted will not contribute materially to the solution of the very intricate problems above indicated. We desire to treat a resolution emanating from the GovernFrom the
tain
a
very
ment of India with the respect which is due to it; but, with and the great the failure of so many past inquiries in view, the with utterly inadequate difficulty of this one, coupled for its prosecution, we can arrive at no other 0gency proposed We know not, and care not to than the conclusion stated. for having advised Government who is
responsible
speculate,
did so must have known very in this matter; but whoever or of the civil medical service. little either of leprosy nibbling at great and weighty questions of sanitary
Inept
science
can
"
and
we
unless
a
only end
in
bringing sanitary science into contempt;
scientific inquiry should be initiated reasonable prospect of its successful prosecution exists, hold that
no
the INDIAN MEDICAL GAZETTE.
!32 ?which is not the
case
service consists of
a
in this instance.
The Indian medical
number of medical officers selected for
certain professional duties ; its members possess good average general and professional abilities, and are quite equal to the duties, medical and sanitary, which they are ordinarily required to perform. But inquiries such as this demand a much higher class of mind and attainments than suffice for the performance of these duties, and many civil surgeons belonging to the apothecary and assistant surgeon class, though quite equal to the performance of the work ordinarily required of them, are not able to grapple with questions such as contagion and heredity in leprosy, than which no more difficult and delicate exist in the whole range of medical science. composed of Budds, Jenners, and
Were the civil medical service
Murchisons, with nothing else to do,
exist some hope might but, as matters now stand, there is very little; besides, the policy of splitting up officers into a lot of capacities," with a divided allegiance in respect of these to several " departments," is destructive of economy and unity of effort, general or special. Wo consider, moreover, that it would be well that Sanitary Commissioners themselves should perfect one branch of labour, say mortuary registration, before commencing another. Though we have stated our opinion thus freely regarding the method arid probable success of this new inquiry, we, nevertheless, trust that medical officers will loyally and heartily do their best to meet the views of Government; and if the result is otherwise than we anticipate, we shall be but too glad to own ourselves wrong ; for the subject is, undoubtedly, one of immense scientific interest and of greatp ractical importance. of
success;
"
[Mat 1,
1875.
