Oct.
PROFESSOR OGSTON'S ADDRESS.
1899.]
371
come to pass that few men^ inferior qualifications, aspire to Senior men, he said, how" enter the service. their lips, show them ever much loyalty seals selves and discouraged with the
it,
enter
and it has
and those of
THE
Jiulian JjfUdipl ?azqtti;.
disappointed
OCTOBER, 1899.
they have to lead. Attendance ailments, trifling complaints, and the life
diseases and
THE BRITISH MEDICAL ASSOCIATION"
men
MEETING AT PORTSMOUTH.
on
minor
few serious
among bodies of of life constitute the whole
injuries occurring
in the
prime
majority of the in the Army. ving They and Navy had no reason to feel themselves afford to the Army or Navy Surgeon, it is British the of neglected at the recent meeting no exaggeration to say, scarcely any chance of Medical Association at Portsmouth. It was acquiring the knowledge and skill that would be natural that they should figure conspicuously Under the existing demanded of him in war." The Medical Services of Her
Army
Majesty's
ordinary
work of the immense
medical officers
"
ser
"
sreat naval station like Portsmouth, and within easy reach of the Army Medical School at Netley. We cau only at present refer to a few of the subjects of interest
at a
meeting held
at
o
a
o
discussed at the Annual Meeting. The visual tests regulating the admission of all ranks to the services, the vital question of the prevention and efficient treatment of syphilis
which
were
in the army were fully discussed, and we hope with advantage. It is not, however, our present intention to refer to these matters now. We propose to confine ourselves to a brief consideration of what may be called the two controversial addresses of the Meeting viz., that O7 '
in the surgery section and that of Dr. G. Thin in the section for tropical of Professor
Ogston
diseases. remarks on the new day in surgery, and the effects of Lister's disto consider coveries, Professor After
a
few
preliminary
Ogston proceeded
Medical Services of the British and Army Navy were in a condition to keep themselves abreast with the highest develophow far tbe
" ments of surgery. It is moderate and reasonable to expect," he said, " that the Medical
Departments
Army and Navy shall commanding the respect and
of the
be
apthe and medical of the public, proval profession that the officers shall be at least as favourably placed in regard to their work as their civil brethren, and that both afloat and ashore they shall be able to efficiently perform their funcm a
condition
tions in time of peace and be fully prepared for the eventualities of war." Professor Ogston went on to say that of recent years the Army Medical Service had fallen in the estimation of graduates of the medical schools; the most
talented graduates
have ceased to
aspire
to
sj'stem," the critical "no junior officer of has any
Corps
surgery; even by restrictions
Professor goes on to say, the Royal Army Medical
practising modern if occasion offer, he is tied down and impediments enforced by his
opportunity
of
seniors, and his natural desire for the So
highest
work is
to prepare himself
disregarded and repressed.
the conditions of the service entail an intellectual sterility, so long will our best graduates recoil from such a life."
long
as
Professor
then proceeded to point out apply to the Indian
Ogston
that these remarks do not Medical Service, where the
of proand where twoabundant, of civil the conthirds its officers are in employ, ditions of service thereby approximating those
fessional work
of the Continental
Ogston
held out
natural result
opportunities
are
as
is,"
armies,
which
Professor
models for imitation. said Professor Ogston,
"
The
"
that
the Indian Medical Service continues to attract the best graduates of the Medical Schools." There is strain of
no
doubt
pessimism
that, apart from a certain exaggeration, there is a
and
strong substratum of truth in the above remarks of Professor
Ogston, but as Surgeon-General proposing the vote of thanks, pointed out, things are not quite so bad in the Royal Army Medical Corps as Professor Ogston mainHarvey,
in
tained.
The recent experiences on the NorthWest Frontier showed that the Corps contained
large number of skilled surgeons possessed surgical qualities, which any civil hospital might be proud of, and, we may add that the still more recent experience on the battle-
a
of
field
of Omdurman
showed
exactly
similar
results, and results as regards the aseptic treatment of wounds which could not be surpassed
372
THE INDIAN" MEDICAL GAZETTE.
by an}7 band of surgeons imported from the best metropolitan hospitals. Nevertheless, no one will gainsay the general application of Professor Ogston's remarks, more especially with regard to men in the Army Medical Service at home stations. It is different in India. The want of variety in professional work, the purely military system of seniority, the want of independence, the restriction of all practice to the ills of men in
prime of life and chosen for their health strength, undoubtedly are real entities, which do not make for professional skill and knowledge. It is beyond a doubt that it is the infinite variety, the early independence, the early granting of great responsibilities and the vast opportunities for medical and surgical work, which (as Professor Ogston says) make the Indian Medical Service popular, and attract to it the best men the
and
That it does continue to from the schools. so attract, and that the Indian Medical Service "
(as Surgeon-General Harvey said) as good as ever it was" can be proved by anyone who cares to look at the qualifications, and previous is
experiences
who have entered that within the past dozen years, the
of the
Service?say of Army
period a
Medical
service attracts
Royal Colleges house surgeons
men
men
who
long
as
Fellows of the
are
of
Surgeons, who have been and house physicians?as the
Medical Service
Indian
As
agitation.
now
attracts them?
fear of its decadence need be entertained. The most striking feature however in Professor Ogston's address is that the very training which he pleads for as necessaiy to the efficiency of the Royal Army Medical Corps and the
no
Medical Department of the Ro3'al
ivhat is
'provided by
Medical
Service.
forms the best is of
Navy is exactly
the civil side The
reserve
to
the Indian
branch in fact
civil
of
of
imagine. possible men placed often at an early point
career
in medical and to
districts, accustomed and every emergency
we
have
sanitary charge rely
on
several ovariotomies, compound fracof the skull, operations for cerebellar abscess, for liver abscess, gunshot wounds of the
gestation, tures
cures for hernia and for for intestinal obstruction,
head, radical
operation
comminuted
hydrocele, compound
fractures, enterectomy,enterorapliy,
and Ccesarean section. are only the few cases
These be it remembered
in our columns. If any one wants to learn the real surgical strength of the Indian Medical Service reserve, and what for surgery the civil branch of the a field Service provides, he has only to consult any of the Provincial Annual Hospital Reports. We pick up the last Punjab Report, which lies
reported
What do
we find (page 7) ? One officer heads the list with 547 major operations in one year, these include 25 tumours, 35 opera-
before
tions and
us.
bone,
on
G5 11
crushing),
operations for stone (cutting amputations and no less than
cataract extractions. Another officer has 370 operations to his credit. These are figures which any London Surgeon might be justly proud of, and they are by no means exceptional 406
among Civil Surgeons in India. In the face of all this it is hear
talk
some
many
as
extraordinary
if there
persons in civil employ. speech is the best
men
Ogston's present system that lias
ever
practical and
to
too
Professor
Why
defence of the
in the Indian Medical Service made. Here we have in
been
successful
working
scheme which Professor
Ogston
professional redemption
for the
were
order the very lias advocated of the
Royal
Army Medical Corp3. We feel convinced that the Government of India recognises this and will never do anything to disturb such a satisfactory state of affairs?never as long as it may be necessary to keep the Army of India in a state of preparedness to meet a European enemy
of their of
ing
that it
a
body large
themselves in
(what Professor Ogston
wants) daily accustomed to every variety of surgical work, emergency or otherwise. Proof of this statement is scarcely needed; if it is we commend the doubter to consult the pages of this Gazette. Even in the past few months what will be found? Numerous cases of abdominal
1899.
the field. Moreover, the members of this of surgeons in civil employ have all passed through the necessary preliminary train-
Army Surgeons Here
[Oct.
section, hysterectomies, ruptured
tubal
in
reserve
in
military methods,
of which medical civil life, are more has been mistakes
abundantly of
the
a
knowledge
from useless?a fact which proved by the troubles and
men, or
without
newly imported
less
hastily
collected
volunteer
surgeons in the recent Spanish-American War. We commend these facts and Professor Ogston's recommendations to those superficial reformers
who, for
reasons
advocate the
not
separation
difficult
to
understand, Military
of the Civil and
Oct.
INSANITY IN INDIA.
1899.]
Branches
of
the
Indian
Medical
Service,
a
would teach him
37; more
twice as long a school in England, no
separation which we firmly believe would lead course at any tropical matter how well endowed to the deterioration of both branches.* So much for this part of our subject. We staff may be.
have left too little space to deal properly with Dr. Thins extremely interesting address. We must, therefore, for the present pass over his valuable
resume
of the
present and
state of the
mosquito-malarial theory, portion of his address. little difficulty in demonstrating great advantages which the large controversial
and
medical
other
school at
possible
Netley
institution
in
to
come
has
Europe
the
He had the
very
hospital over
for
any the
tropical diseases. With the single of beriberi every important tropical disease is to be seen in far greater numbers the at Netley than in any other hospital in is United Kingdom. This we may add exactly what more than a year ago we advocated in these columns. But though the facts do not admit of the discussion could have teaching
of
exception
dispute yet
little more than an academic interest. -The London School of Tropical Medicine is an accom-
plished fact,and will be in working order by the time these words are in print. For reasons obvious to all who have followed the subject in the medical press, it was clear from the veiy | of the commencement that the supporters
consent to anyIhis we of their own.
London Scheme would
thing
but
a
school
never
think is to be regretted, and we can only hope that the London School, in the hands of the able staff now in charge of it, will fulfil all tlie
hopes of its supporters. The Liverpool School of Tropical Medicine has also started undei good auspices, and will be able to command a supply of tropical cases inferior only to Netley. For the investigation of diseases peculiar to Africa the Liverpool School has unique oppoitunities.
have, however, always maintained that even after a course of teaching at Netley, Liveipool or London, the young practitioner newly We
tropics will still have much to learn, and a few months' experience at one of the big hospitals at any of the Presidency Towns
arrived in the
in
India
*
or
any other Colonial
capital town,
[We
propose in a future issue to consider a scheme for medical men in military employ to ? share in the surgical and medical practice of the large civil hospitals which exist in many stations in India.?Ed.,
admitting
l.M,G.~\
than or
how brilliant the
PROFESSOR OGSTON'S ADDRESS.
1899.]
371
come to pass that few men^ inferior qualifications, aspire to Senior men, he said, how" enter the service. their lips, show them ever much loyalty seals selves and discouraged with the
it,
enter
and it has
and those of
THE
Jiulian JjfUdipl ?azqtti;.
disappointed
OCTOBER, 1899.
they have to lead. Attendance ailments, trifling complaints, and the life
diseases and
THE BRITISH MEDICAL ASSOCIATION"
men
MEETING AT PORTSMOUTH.
on
minor
few serious
among bodies of of life constitute the whole
injuries occurring
in the
prime
majority of the in the Army. ving They and Navy had no reason to feel themselves afford to the Army or Navy Surgeon, it is British the of neglected at the recent meeting no exaggeration to say, scarcely any chance of Medical Association at Portsmouth. It was acquiring the knowledge and skill that would be natural that they should figure conspicuously Under the existing demanded of him in war." The Medical Services of Her
Army
Majesty's
ordinary
work of the immense
medical officers
"
ser
"
sreat naval station like Portsmouth, and within easy reach of the Army Medical School at Netley. We cau only at present refer to a few of the subjects of interest
at a
meeting held
at
o
a
o
discussed at the Annual Meeting. The visual tests regulating the admission of all ranks to the services, the vital question of the prevention and efficient treatment of syphilis
which
were
in the army were fully discussed, and we hope with advantage. It is not, however, our present intention to refer to these matters now. We propose to confine ourselves to a brief consideration of what may be called the two controversial addresses of the Meeting viz., that O7 '
in the surgery section and that of Dr. G. Thin in the section for tropical of Professor
Ogston
diseases. remarks on the new day in surgery, and the effects of Lister's disto consider coveries, Professor After
a
few
preliminary
Ogston proceeded
Medical Services of the British and Army Navy were in a condition to keep themselves abreast with the highest develophow far tbe
" ments of surgery. It is moderate and reasonable to expect," he said, " that the Medical
Departments
Army and Navy shall commanding the respect and
of the
be
apthe and medical of the public, proval profession that the officers shall be at least as favourably placed in regard to their work as their civil brethren, and that both afloat and ashore they shall be able to efficiently perform their funcm a
condition
tions in time of peace and be fully prepared for the eventualities of war." Professor Ogston went on to say that of recent years the Army Medical Service had fallen in the estimation of graduates of the medical schools; the most
talented graduates
have ceased to
aspire
to
sj'stem," the critical "no junior officer of has any
Corps
surgery; even by restrictions
Professor goes on to say, the Royal Army Medical
practising modern if occasion offer, he is tied down and impediments enforced by his
opportunity
of
seniors, and his natural desire for the So
highest
work is
to prepare himself
disregarded and repressed.
the conditions of the service entail an intellectual sterility, so long will our best graduates recoil from such a life."
long
as
Professor
then proceeded to point out apply to the Indian
Ogston
that these remarks do not Medical Service, where the
of proand where twoabundant, of civil the conthirds its officers are in employ, ditions of service thereby approximating those
fessional work
of the Continental
Ogston
held out
natural result
opportunities
are
as
is,"
armies,
which
Professor
models for imitation. said Professor Ogston,
"
The
"
that
the Indian Medical Service continues to attract the best graduates of the Medical Schools." There is strain of
no
doubt
pessimism
that, apart from a certain exaggeration, there is a
and
strong substratum of truth in the above remarks of Professor
Ogston, but as Surgeon-General proposing the vote of thanks, pointed out, things are not quite so bad in the Royal Army Medical Corps as Professor Ogston mainHarvey,
in
tained.
The recent experiences on the NorthWest Frontier showed that the Corps contained
large number of skilled surgeons possessed surgical qualities, which any civil hospital might be proud of, and, we may add that the still more recent experience on the battle-
a
of
field
of Omdurman
showed
exactly
similar
results, and results as regards the aseptic treatment of wounds which could not be surpassed
372
THE INDIAN" MEDICAL GAZETTE.
by an}7 band of surgeons imported from the best metropolitan hospitals. Nevertheless, no one will gainsay the general application of Professor Ogston's remarks, more especially with regard to men in the Army Medical Service at home stations. It is different in India. The want of variety in professional work, the purely military system of seniority, the want of independence, the restriction of all practice to the ills of men in
prime of life and chosen for their health strength, undoubtedly are real entities, which do not make for professional skill and knowledge. It is beyond a doubt that it is the infinite variety, the early independence, the early granting of great responsibilities and the vast opportunities for medical and surgical work, which (as Professor Ogston says) make the Indian Medical Service popular, and attract to it the best men the
and
That it does continue to from the schools. so attract, and that the Indian Medical Service "
(as Surgeon-General Harvey said) as good as ever it was" can be proved by anyone who cares to look at the qualifications, and previous is
experiences
who have entered that within the past dozen years, the
of the
Service?say of Army
period a
Medical
service attracts
Royal Colleges house surgeons
men
men
who
long
as
Fellows of the
are
of
Surgeons, who have been and house physicians?as the
Medical Service
Indian
As
agitation.
now
attracts them?
fear of its decadence need be entertained. The most striking feature however in Professor Ogston's address is that the very training which he pleads for as necessaiy to the efficiency of the Royal Army Medical Corps and the
no
Medical Department of the Ro3'al
ivhat is
'provided by
Medical
Service.
forms the best is of
Navy is exactly
the civil side The
reserve
to
the Indian
branch in fact
civil
of
of
imagine. possible men placed often at an early point
career
in medical and to
districts, accustomed and every emergency
we
have
sanitary charge rely
on
several ovariotomies, compound fracof the skull, operations for cerebellar abscess, for liver abscess, gunshot wounds of the
gestation, tures
cures for hernia and for for intestinal obstruction,
head, radical
operation
comminuted
hydrocele, compound
fractures, enterectomy,enterorapliy,
and Ccesarean section. are only the few cases
These be it remembered
in our columns. If any one wants to learn the real surgical strength of the Indian Medical Service reserve, and what for surgery the civil branch of the a field Service provides, he has only to consult any of the Provincial Annual Hospital Reports. We pick up the last Punjab Report, which lies
reported
What do
we find (page 7) ? One officer heads the list with 547 major operations in one year, these include 25 tumours, 35 opera-
before
tions and
us.
bone,
on
G5 11
crushing),
operations for stone (cutting amputations and no less than
cataract extractions. Another officer has 370 operations to his credit. These are figures which any London Surgeon might be justly proud of, and they are by no means exceptional 406
among Civil Surgeons in India. In the face of all this it is hear
talk
some
many
as
extraordinary
if there
persons in civil employ. speech is the best
men
Ogston's present system that lias
ever
practical and
to
too
Professor
Why
defence of the
in the Indian Medical Service made. Here we have in
been
successful
working
scheme which Professor
Ogston
professional redemption
for the
were
order the very lias advocated of the
Royal
Army Medical Corp3. We feel convinced that the Government of India recognises this and will never do anything to disturb such a satisfactory state of affairs?never as long as it may be necessary to keep the Army of India in a state of preparedness to meet a European enemy
of their of
ing
that it
a
body large
themselves in
(what Professor Ogston
wants) daily accustomed to every variety of surgical work, emergency or otherwise. Proof of this statement is scarcely needed; if it is we commend the doubter to consult the pages of this Gazette. Even in the past few months what will be found? Numerous cases of abdominal
1899.
the field. Moreover, the members of this of surgeons in civil employ have all passed through the necessary preliminary train-
Army Surgeons Here
[Oct.
section, hysterectomies, ruptured
tubal
in
reserve
in
military methods,
of which medical civil life, are more has been mistakes
abundantly of
the
a
knowledge
from useless?a fact which proved by the troubles and
men, or
without
newly imported
less
hastily
collected
volunteer
surgeons in the recent Spanish-American War. We commend these facts and Professor Ogston's recommendations to those superficial reformers
who, for
reasons
advocate the
not
separation
difficult
to
understand, Military
of the Civil and
Oct.
INSANITY IN INDIA.
1899.]
Branches
of
the
Indian
Medical
Service,
a
would teach him
37; more
twice as long a school in England, no
separation which we firmly believe would lead course at any tropical matter how well endowed to the deterioration of both branches.* So much for this part of our subject. We staff may be.
have left too little space to deal properly with Dr. Thins extremely interesting address. We must, therefore, for the present pass over his valuable
resume
of the
present and
state of the
mosquito-malarial theory, portion of his address. little difficulty in demonstrating great advantages which the large controversial
and
medical
other
school at
possible
Netley
institution
in
to
come
has
Europe
the
He had the
very
hospital over
for
any the
tropical diseases. With the single of beriberi every important tropical disease is to be seen in far greater numbers the at Netley than in any other hospital in is United Kingdom. This we may add exactly what more than a year ago we advocated in these columns. But though the facts do not admit of the discussion could have teaching
of
exception
dispute yet
little more than an academic interest. -The London School of Tropical Medicine is an accom-
plished fact,and will be in working order by the time these words are in print. For reasons obvious to all who have followed the subject in the medical press, it was clear from the veiy | of the commencement that the supporters
consent to anyIhis we of their own.
London Scheme would
thing
but
a
school
never
think is to be regretted, and we can only hope that the London School, in the hands of the able staff now in charge of it, will fulfil all tlie
hopes of its supporters. The Liverpool School of Tropical Medicine has also started undei good auspices, and will be able to command a supply of tropical cases inferior only to Netley. For the investigation of diseases peculiar to Africa the Liverpool School has unique oppoitunities.
have, however, always maintained that even after a course of teaching at Netley, Liveipool or London, the young practitioner newly We
tropics will still have much to learn, and a few months' experience at one of the big hospitals at any of the Presidency Towns
arrived in the
in
India
*
or
any other Colonial
capital town,
[We
propose in a future issue to consider a scheme for medical men in military employ to ? share in the surgical and medical practice of the large civil hospitals which exist in many stations in India.?Ed.,
admitting
l.M,G.~\
than or
how brilliant the
