42

was ’accordingly to sanitary improvements that he lookedwith’the most confidence to protect India against the plague.

Professor W. J. SIMPSON said that he had much pleasure in.accepting the invitation of the President to join in this dis-cussion because it afforded him an opportunity of expressing’his high admiration for Mr. Haffkine and his work. He hadthe honour of being associated with Mr. Haffkine in a

secondary position in the cholera inoculations and that asso-ciation had revealed to him the untiring energy and perse-verance of Mr. Haflkine. It had also shown to him thecaution and unbiased character of the man. In fact, heoften thought that Mr. Haffkine was the strongest antagonistto the inoculations, viewing every fact in the most adverse’light. He mentioned this because he could personallytestify to the solidity of the basis on which the"facts connected with the cholera inoculations rested and- from his experience in 1897 at Kirkee, near Poona,’he was satisfied that the same careful investigation and-verification of facts were carried on with reference to the’inoculations in plague as had been done in the case of the- cholera inoculations. To his mind there was no question asto the solid foundation on which the results of the cholera- and plague inoculations were based. He would also saythat facts and results were more attractive to him thantheoretical considerations such as those raised by ProfessorWright. The one fact of importance was that wherever theinoculations of cholera and plague had been performed and- cholera and plague prevailed the incidence on the inoculated’Was always less than among the uninoculated. That was<the major fact. Other considerations were of minor import-ance and would no doubt in time be attended to. He knewthat Mr. Haffkine was most anxious to introduce improve-,ments into his system of inoculation.The PRESIDENT (Lord Lister) said that from the informa-

tion which he had been able to collect some time ago he had- satisfied himself as to the success of the inoculations. Thosewho had previously to the meeting been somewhat sceptical- of the results of the inoculations would, he felt sure, afterlistening to Mr. Haffkine and the other speakers, be con-’vinced of the benefits to be derived from the system. No-doubt progress would be made in the direction indicated byProfessor Wright. Seldom was any system introduced whichdid not later admit of improvement, and if progress inthis respect was to be made he did not know of anyoneIDetter qualified for that purpose than Mr. Haffkine him-self. He was glad to learn from Professor Wright thatMr. Haffkine’s work in India had facilitated the introduction-of the typhoid inoculations. He was also particularly struckby the facts that 80,000 inoculations had been performed and-that when the benefits of the inoculations had been explainedto them the inhabitants had come forward in such large’numbers and paid for the inoculations. It appeared to himthat Mr. Haffkine’s work in India was doing good not only’by saving thousands of lives but by producing an excellentpolitical effect, in that it showed the natives of India that the’Government and Europeans were doing their best at a time.of great distress and in this way they were breaking downthe barriers which existed between the natives of India andEuropeans.

Mr. HAFFKINE said that he was very sensible of the kindwords which had fallen from the President and others withTegard to his work and he thanked them most cordially. As

’regarded the questions raised by Professor Wright he had;answers for some of them but not for all. The latter wouldno doubt provide material for Professor Wright and others towork out. He had done his best under the conditions andfue hoped that they would excuse him for what he had not’been able to do. All work was limited by the extent of their.abilities and the conditions under which the work had to be.carried out.

MARGATE HOSPITAL.-An interesting ceremonywas performed at the above hospital on the afternoon of.June 21st. Dr. Church, President of the Royal College ofPhysicians of London, in the presence of the treasurer of the’hospital, Mr. Michael Biddulph, M.P., Member of the Court ofDirectors, the Mayor of Margate, and many other distin-guished visitors, named the wards which have been recentlyreopened, the first being called after the founder of the hos-pital, Dr. Lettsom. A garden party added to the interest ofthe occasion. The highly efficient sanitary arrangements forthe patients and the admirable accommodation for the nursesand servants drew forth many complimentary and justremarks such as they richly deserve.

ANNUAL DINNER OF THE EPIDEMIO-LOGICAL SOCIETY OF LONDON.

SPEECH BY MR. HAFFKINE.

THE annual dinner of this society was held at the GrandHotel, Trafalgar-square, on June 23rd, the President,Dr. FRANKLIN PARSONS, occupying the chair. The guestsof the society were Dr. Church, President of the RoyalCollege of Physicians, Mr. W. M. Haffkine, C.LE., Mr.

Lithiby, Assistant Secretary of the Local Government Board,and Mr. Thomas Wakley, jun.The toast of ’’ The Queen and Royal Family" was proposed

by the CHAIRMAN and that of " The Navy and Army," whichwas coupled with the names of Fleet Surgeon TheodorePreston, R.N., and Colonel Lane Notter, by Mr. SHIRLEYMURPHY.The toast of The Visitors," which was proposed by

Dr. J. F. PAYNE, was associated with the names of Mr.Haffkii2e and Mr. Lithiby. Dr. Payne extolled the servicesrendered to public health by the Local GovernmentBoard and stated in the course of a very appreciativespeech that the perusal of Mr. Haffkine’s discourse atthe Royal Society left in his mind no doubt as to theefficacy of the inoculation system and the great benefitderived therefrom in combating the plague.

Mr. HAFFKINE, in thanking the speaker and the societyfor their hospitality and their kind appreciation, saidthat it afforded him great pleasure to see the epi-demiologists of London collected into an organised bodyof scientific investigators. It so happened now that inwhatever part of the world an epidemic of any magni-tude broke out - except when epidemics broke outon the Continent of Europe-it was sure to affect a

British possession. In this case, as in others, honourand burden and obligation remained inseparable; and ifit has come to be that among nations that of GreatBritain is the first in trade, expansion of dominion,rule over civilised and uncivilised races, the wbrldmust expect that that country will be the first as far as

knowledge of and provision for the health and safety of man-kind are concerned. The advent of the plague in China,India, and Egypt has directed as much attention towardsthe epidemiologists of this country and their labours as someseven years ago the cholera on the continent did towardsthe studies and efforts made at that time in France,Germany, and Russia. An enormous amount of new know-ledge was then created by numberless investigators-byRoux, Metchnikoff, Sanarelli, Renan, Mendoza, Pfeiffer andKolle, Fraenkel, Lomer, Neisser, Pfuhl, Sobemheim, MaxBleisch, Gunter, Foker, Weibel, Heider, Kutscher, Bonhoff,Russell, Dunbar, Fischer, Dahmen, Sprong, Orloff, Bujwid,Wiltschur, Sawtchenko, Blackstein, and very many otherstoo numerous for him to mention. It seemed to him, how-ever, that one very important teaching was to be extractedfrom all those past efforts. While they themselves (the com-pany at the dinner) were rightly proud of the acquisitionsmade by their craft during those memorable years it wassad to see that the practical statesman, the man concernedin the welfare of nations, was scarcely aware of those acquisi-tions and remained conscious of one fact, which was that if

’ cholera were to break out to-day again in Europe or in anyother part of the world the sanitarian and the administratorand the ordinary citizen would find not a single weaponadded by those innumerable continental investigations to

their arsenal of defence as it existed before 1892. Wouldthey be justified in quarrelling with the statesman becauseof his want of appreciation ? He (Mr. Haffkine) presumedthat the majority of the company present, including himself

r in that majority, belonged to the category of thinkersE who believed that brains and powers of observation and off study were given to man for the purpose of bettering

the conditions of life whether those conditions affectedf himself or his fellow creatures or the animal or vege-- table or the inanimate world around him. And if that

was true the investigator might well feel his re-- sponsibility before the sceptical statesman who remainedf unsatisfied and before the ordinary everyday man whor looked up to the scientist for instruction as to how to resists evil and attain good and who got no response to his appeal.t If they were to be questioned as to how it was thatso much valuable knowledge contained no teaching, no

43

guidance in actual life and was taking so long to leadto any palpable benefit, he for one would answer thatwhatever experience he possessed in the matter pointedfor him to one circumstance-to the want of organisation inthe studies and laboratories of Europe. Was it not true thatfor knowledge to be useful it must not only comprise a largenumber of facts, but that all those facts must be such as tofind themselves connected in one particular central pointwhich then appears as a real, concrete lever whereby tomove and to direct the course of events in nature ? ? Notonly in such a vast complex of phenomena as that repre-sented by an epidemic, but upon one square yard of gardensoil, every one of them would be able to point out quite adefinite set of associated or dissociated objects of investi-gation such as might keep occupied all the institutions of theworld for physical, chemical, mineralogical, zoological,botanical, even sociological, and many other researches duringa period of time-if they wished only to limit it there-of a century to come. It was clear that the good applicationwhich man could make of his intellectual gifts consisted notin taking in all the infinity of facts and phenomena whichhappened to pass around him, but in discerning and selectingamong them such as were combined by an intimate, concrete,palpable relation of cause and effect, or of common causeor of combined effect or of any other clearly conceived rela-tion and of which at the existing stage of his power andknowledge the best use for the benefit of the livinggenerations could be made. There was hardly any need forhim to qualify that conclusion by adding that the recognitionof that kind of facts was not always easy or possible ; that,secondly, if they were to systematically neglect th 1 cord-ing of information which they came across, but forwhich there happened to be no recognised demand in theforum of science, great losses for that science would

ultimately result; and that, lastly, the natural develop-ment of thought necessitated the investigation of subjectswhich found themselves in logical sequence with alreadyexisting information, whether those subjects be or benot of a character leading to benefit to man. Thosemaxims were irrefutable and should be accepted as such.But when setting out upon an investigation immense import-ance belonged to the general plan, to a judicious selectionof problems, to the recognition of essential and unessential,important and secondary, points; and it remained truethat the secret of obtaining useful knowledge lay in that

necessity of collecting in a short space of time and while thestudy is guided by one leading and discriminating purposeof a large amount of correlative facts. In experimentalscience, however, every bit of knowledge is to be gatheredby direct exploration, by seeing, feeling, analysing, inter-

preting every single act and object at work in the factory ofnature. And the scientist, be he as greatly gifted as hemay, has no more than one set of eyes, ears, hands, one

brain to work with, and it is not more possible for him todivine knowledge or to effect many things at one time thanit is for any other worker in any other field of activity.An organisation of studies is evidently necessary. Itmust be rendered universally known and understoodthat problems of scientific inquiry necessitate the main- tenance of not less strict and combined a serviceof trained workers than even a military organisation, or

a mill or factory, or an enterprise of any kind wherecomplicated work is to be done and divided amongst anumber of coordinate agencies. The scientist from whomuseful teaching is expected must be able to know well everycollaborator with whom he is sharing a given part of hisprogramme of work; must be well aware of the extent ofhis abilities, of his fitness for special tasks ; must understandand be able to rightly appreciate the meaning of his reports,the value of his observations; must be able, so to say, tolook through the instruments and eyes of his staff of co-workers, to listen through their ears, as well as to reckon atevery given moment on their loyal cooperation in the commontask of research. It is only by introducing a whole service ofstudents into a coordinate machinery of inquiry, by trans-forming a scientific school into one collective investigator,animated with trust in their teacher and guided by one ideathat important knowledge as to the things in nature-usefultruth-can be gathered, and that the study of calamitousphenomena such as are represented by epidemics can yieldeffective information for the benefit of a country and ofmankind as a whole.

Mr. LITHIBY, in the course of an interesting speech,insisted that the epidemiologist must not Icse heart because

his work is not at once taken advantage of by the legis-lature. An Act of Parliament was, as it were, the resultantof many complex and often antagonistic forces, of whichscience was not at present as powerful an one as it shouldbe. There was, however, this consolation to the epidemio-logist : that what he thought to-day the Local GovernmentBoard would not improbably think to-morrow.The toast of " The Epidemiological Society " was proposed

by Dr. CHURCH, President of the Royal College of Physicians,and the CHAIRMAN in returning thanks for the society pointedout that the Epidemiological Society was the oldest of thesocieties dealing with questions of public health, having beenin existence for nearly half a century. Its formation wasfirst mooted by Mr. Tucker, afterwards one of its honorarysecretaries, and it was inaugurated at a meeting held onJuly 30th, 1850, under the chairmanship of Lord Ashley,then a member of the first General Board of Health,and afterwards, as the Earl of Shaftesbury, so wellknown for his labours of practical philanthropy in manydifferent fields. The first President was Dr. Benjamin GuyBabington who held that office for 14 years and who wasfollowed by a line of distinguished successors. It was atfirst expected that the society would be largely supported bythe general public as well as by medical men, but this hopewas not realised although the membership of the societyhad never been limited to the medical profession andvaluable papers had occasionally been contributed bylaymen. Owing to want of funds in its earlier years the

society was unable to carry out one of its original objects-viz, the instituting of investigation on its own behalf intolocal epidemics and the need for such work was latersuperseded by the appointment of a Government medicalstaff and of local medical officers of health. For a similarreason the society was unable at first to publish Transactions,being dependent on the medical press for the insertion ofabstracts of its proceedings, but since 1859 it had publishedTransactions, at first occasionally and now annually. Theearlier labours of the society dealt with small-pox and vac-cination. On this subject it presented in 1853 a report whichwas ordered by the House of Commons to be printed andwhich largely contributed to the passing in that year of thefirst compulsory Vaccination Act. In 1859 it carried out aninvestigation by a committee on the subject of diphtheria.Among the other subjects which had frequently occupied itsattention might be mentioned cholera, plague, fevers, leprosyand tropical diseases, naval and military diseases, and generalquestions relating to epidemics. In 1897 it had founded incommemoration of the centenary of vaccination a Jennermedal which had appropriately been first bestowed on Mr.W. H. Power, F.R.S., whose demonstration that the aggrega-tion of small-pox patients in hospitals in populous placescaused the disease to spread around them had led to theremoval of small-pox hospitals out of towns and thus haddone more, at any rate as regards London, to diminishsmall-pox than anything since the introduction of vaccina-tion. The society differed from other similar societiesin its cosmopolitan character, having correspondents andcontributors not only in British colonies and dependenciesbut also in foreign countries in all quarters of the world, andalso in its dealing with the behaviour of diseases amongcommunities of men rather than with clinical and patho-logical studies on the one hand or with administrativequestions on the other hand. Whatever progress might bemade in bacteriology the need for checking the results oflaboratory experiments by epidemiological observation wouldstill remain.Mr. MALCOLM MORRIS proposed " The Health of the

Chairman," and the reply of Dr. PARSONS concluded aninteresting series of speeches.

THE PROPOSED CONSULTING INSTITU-TION OF THE HOSPITAL SATURDAY

FUND AT BIRMINGHAM.

A MEETING of the medical profession convened byDr. Saundby to consider this matter (to which full referencehas been already made in THE LANCET’) was held at theBirmingham Medical Institute on the afternoon of Friday,

1 THE LANCET, May 13th and 20th, 1899.