BLACKWELL FAMILY ELIZABETH BLACKWELL Printed MatterTHE MORAL AND PHYSICAL EVILS LIKELY TO FOLLOW IF PRACTICES INTENDED TO ACT AS CHECKS TO POPULATION BE NOT STRONGLY DISCOURAGED AND CONDEMNED. BY C.H.F. ROUTH, M.D., M.R.C.P. LOND., FELLOW OF UNIVERSITY COLLEGE, LONDON; SENIOR PHYSICIAN TO THE SAMARITAN HOSPITAL FOR WOMEN AND CHILDREN; CONSULTING PHYSICIAN FOR DISEASES OF WOMEN TO THE NORTH LONDON CUNSUMPTIVE HOSPITAL, ETC. Reprinted from THE MEDICAL PRESS AND CIRCULAR, Oct. 1878. LONDON: BAILLIERE, TINDALL, & COX, KING WILLIAM ST., STRAND. (PARIS AND MADRID.) 1879. 10 Undercliff, St Leonards on Sea -Dr. Elizth Blackwell with the authors kind regard THE MORAL AND PHYSICAL EVILS LIKELY TO FOLLOW IF PRACTICES INTENDED TO ACT AS CHECKS TO POPULATION BUT NOT STRONGLY DISCOURAGED AND CONDEMNED. BY C.H.F. ROUH, M.D., M.R.C.P. LOND., FELLOW OF UNIVERSITY COLLEGE, LONDON; SENIOR PHYSICIAN TO THE SAMARITAN HOSPITAL FOR WOMEN AND CHILDREN; CONSULTING PHYSICIAN FOR DISEASES OF WOMEN TO THE NORTH LONDON CONSUMPTIVE HOSPITAL, ETC. Reprinted from THE MEDICAL PRESS AND CIRCULAR, Oct., 1878. LONDON: BAILLIERE, TINDALL, & COX, KING WILLIAM ST., STRAND. (PARIS AND MADRID.) 1879.LONDON: BAILLIERE, TINDALL, AND COX, STEAM PRINTERS, KING WILLIAM STREET, STRAND. PREFACE. IN putting forward the full text of the Address delivered before the Obstetrical Section of the British Medical Association last August, together with the opinions of those who spoke in the discussion which followed, I am anxious to give a short prefatory explanation. The Address was given at no special request of mine. I was desired by some distinguished members of the profession to open the discussion so as to afford them a public opportunity of condemning, and with no uncertain sound, baneful practices which they knew were making their way into this country. A disreputable work had been largely circulated, and was producing a curse upon the land. It was felt by several in our profession that it was unwise to remain silent when vice, clothes in a misnamed Malthusian garb, and so transformed as to deceive any, was put forward as a new virtue to be practised. I confess I felt somewhat diffident in taking the duty upon myself, not that I ever doubted that the evil prevailed and should be put down, but because there were not wanting some good men who thought it was impolitic to speak openly, and especially before a meeting of the Association, on so indecorous a subject. But others, more qualified than A2iv I was to form an opinion, and to whom I was accustomed to look up, thought otherwise. They believed it was cowardly to remain passive, and that the time was come to hold up such customs to condemnation; and the public good would be more likely to follow, if it was first done before a meeting of medical men whose province it was to treat the diseases consequent on such customs. I saw the force of this argument, nor was I disposed to show a white feather when so urged. I felt the responsibility of having one's motives misconstrued, but was ready to fulfil a manly and generous part. I may have done it less perfectly, perhaps, than another might, but in any case the large numbers who honoured me with their presence, the high moral tone which pervaded the assembly, the universal reprobation with which such customs met, proved to me, and that incontestably, that the noblest of the profession were on our side, and entirely approved the course we had taken. I gratefully acknowledge the courtesy of the members of the section in passing upon me a vote of thanks my acclamation for imperfect endeavors. I trust their manly and Christian deportment and their bold example, will destroy this many-headed monster from the realm, and bring a blessing upon it from Him who overruleth all things for our good. C.H.F. ROUTH, M.D. 52 MONTAGUE SQUARE, LONDON, W. December, 1878 CHECKS TO POPULATION* IT has been reserved for the present day to adopt a system of philosophy, falsely so-called, whereby checks to population not only be advised, but, what is worse, fully carried out. Some economists would have us believe that they are, after all, only more advanced Malthusians. Such a profession, however, is founded on error. The disciplines of Malthus, and his immediate followers, repudiated immorality, and based their doctrines mainly on the following grounds:- 1. The productions for the maintenance of humanity, i.e., the means attainable for the support of life, exist in the arithmetical proportion of 1, 2, 3, 4, &c., while generation, i.e. the actual power of increase of the human species, exists in the geometrical proportion of 1, 2, 4, 8. Indeed, it is asserted without fear of contradiction, that a quarter of a century will, under favourable circumstances, such as were those of *Being an address spoken before the Obstetrical Section, at Bath, of the British Medical Association, August, 1878.6 America at its discovery, suffice to double the popu- lation of a country. But even under more unfavour- able circumstances, the increase of population far exceeds the means of support, and hence it is - 2. That excessive population leads to poverty, distress, and crime, and more especially criminal abortion and infanticide. 3. That over productiveness is injurious to a woman. To these three recognised influences, which the school of Malthus adopted, the more modern economists have added two more: (4) That poverty and increased fecundity always go together in women; (5) Whereas wealth increases the sexual passion of men. And so it happens that while Malthus taught we should - 1. Discourage improvident marriages; 2. Ameliorate the condition of women; 3. Do all we can to increase the productions for maintenance of mankind; The so-styled modern Malthusians have been obliged to add a fourth desideratum:- To provide channels for the increasing sexual passion which shall have other results than those of procreation. The consideration of each of these points, of them- selves, would occupy hours of debate. In regard to the first, I must remark that the increase of marriages always indicates the greater prosperity of a nation. This fact is incontestably proved by the returns of the Registrar-General. To arrest these, is therefore to arrest the prosperity of a nation. 2. To ameliorate the condition of women. Upon 7 this point I wholly concur, not indeed with a wish to diminish her fecundity, but because it is one of the noblest attributes of man to help the weaker vessel. 3. As to the wisdom of the third proposition, all must concur. But this, commerce, science, and in- creased enterprise, must effect. But it is quite a different thing when we come to consider the two additional dogmas propounded. 4. It is doubtless true, that among the very poor, more children are born than among the rich. But then this comes from other causes - less luxury, less sexual vice, less conjugal frauds ; but, unfortunately, as through privation, want, and ignorance of proper sanitary measures, the children of the indigent are generally less long lived, they cannot be said to increase population. This is, I consider a great misfortune. Still, infant mortality is less rife among us than in France. Education and better style of living are also ex- tending among the working classes themselves. Both these circumstances will tend to bring out, by-and-bye, not only a larger, but also a healthier and wiser generation, which much prove a great cause of prosperity to the country ; and this may be certainly looked for if we carry out, also effectually, the second proposition. 5. I do not believe it to be true that increased pros- perity necessarily increases sexual passion in the male. Is man, because more civilised, more at ease, and better educated, necessarily more carnal in his appetites? Is increased moral and religious knowledge and deportment, which progress pari passu with civilisation, rather in restrain of all excesses in this 8 direction? I deny, therefore, the fifth proposition in toto. But supposing it true - is the remedy proposed either correct or philosophical? Let us see. We are told we must provide for the increased sexual passions, specially of males, channels which shall have other results than those of procreation. Gentlemen, - It is upon the last point (and then only upon one side of the question) that I wish to direct your attention to-day. For this proposition has two sides to it, and both have been advised and attempted to be supported by argument. The first side of the question, is that for these classes among whom you discountenance marriage, you shall provide by a system of license and sanitary inspection, clean prostitutes of their use. Hence, those odious Contagious Diseases Acts, about which I shall not further speak to-day. 2. You shall recommend artificial means, whereby ab initio you will prevent fructification; in other words, advise sexual fraudulency, conjugal onanism; and the mischief is that such measures are advised under the garb of humanity, medical science, philosophy, and the like. I look upon the whole transaction as a base and moral crime, against which the whole body of a medical profession should protest with abhorrence and disgust. The first mention we have of the crime occurs in Gen. xxxviii., 8, 9, 10: "And Judah said unto Onan, go in unto thy brother's wife and marry her, and raise up seed unto thy brother. And Onan knew that the seed should not be his; and it came to pass when he went in unto his brother's wife that he split it on the ground lest that she should give seed to his brother. 9 And the things which he did displeased the Lord, wherefore he slew him also." Our French medical contemporaries, who see so much more of this system than we do, are very condemnatory of this vile habit. Thus, Bourgeois, in his work on the Passions, says: "Conjugal onanism is a real social pest. Every fraud is a choked germ rendered unproductive - an indirect infanticide! Indeed, for the full development of this crime we must look mainly to France. Great and noble as that nation has been, and I know yet will be, it has tasted deeply of the pleasures of immorality. It can scarcely be otherwise when wholesale crime is licensed and encouraged by the State. Onan was a criminal, and was sorely punished in consequence. But now-a-days science has devised other fraudulent aids. Nor will I dwell upon them; suffice it to say, that Onan's crime is imitated; coverings are used by males, plugs and injections by females, to complete their shame. It is almost defilement even thus cursorily to allude to these vile practices. It has been reserved, however, for some of our own people to discover a fifth method. In a debate before the Medical Society of London last session on the use of intra-uterine stems, devised originally for uterine diseases, we were credibly informed that they were also used by some ladies of high position, and continually worn by them, with a view to prevent conception. Thus often it happens that malicious art perverts good intentions. An instrument calculated, if worn for a time, a to dilate a constricted os uteri and the uterine canal, and when removed to place a woman in those conditions most favourable for conception, is thus used10 for the opposite result. For it is manifest that concep- tion during the time these stems are retained in utero is well nigh impossible. I do not say it always prevents impregnation, because I have known of two cases where conception did occur while the stem was in utero, and pregnancy went on to the full period. But, under ordinary circumstances, such a result would prove, I imagine, of very rare occurrence. Still, there is the fact. To find them placed in proper position, and with this intent, implies the assistance of a person of some skill, and shows to what a degree of degradation some men have fallen. The question naturally then presents itself, "Who put them there?" There is yet a sixth and baser method practised, of which I have met a few examples ; but it is too gross to refer to before you, not would it serve any useful purpose. First, let me state that I look upon conjugal onanism as a great moral crime. It is perverting a noble attri- bute to vicious propensities. It is feeding a lustful impulse, and in the most degrading manner lowering the status of a woman. It is even doing that which an animal actuated solely by instinct would never do. It is destroying in the beginning what, under God's blessing, might have matured with a living soul, and proved a blessing to humanity. Masturbation is mean and bad enough, and must to be reprehended, because it is fostered by a filthy spirit which can no longer control the sexual impulses. But here, at least, there is no partner in the sin, and no pure woman is degraded thereby. Conjugal onanism places both the man and the woman below the instincts of the brute creation. 11 But, secondly, like all crimes, it cannot be, and it is not, practised with impunity. The effect on the health of both men and women is very injurious. The sub- ject has been fully treated in a very philosophical work written by Bergeret on Sexual Fraud. It was to be expected that true science and moral worth could not stand by and see a practice almost universally carried out in any country without remonstrance. Written in a true philosophical and inquiring spirit, and among those who are so little ashamed of their vile habits that they freely confess them, Bergeret had a vast field before him upon which to ground his conclu- sions He shows that sexual frauds produce acute metritis in the woman, of which disease he details nine cases and two deaths. 2. The conjugal onanism is a frequent cause of chronic metritis, of which he also narrates several cases. 3. Leucorrhoea, as would be primarily suspected, is frequently a result of it. 4. Also menorrhagia and haematocele, of which he in- stances five cases. 5. Eleven cases of hysteralgia and hyperaesthesia of the generative organs are also given. 6. Cancer in an aggravated form, assuming in such examples of galloping character, so rapid is it in its course, of which nine cases are given, is another form of disease which this baneful practice induces. 7. Ovarian dropsy and ovaritis are also commonly produced by the habit. 8. In cases where severe results are not ob- served, the generative organs become so changed and chronically diseased that absolute sterility results. Lastly, mania, leading to suicide and the most repul- sive nymphomania are induced thereby in many cases, of which several examples are given. Among men, general nervous prostration, mental12 decay, loss of memory, intense cardiac palpitations, mania, conditions which also lead to suicide, are given as the results of conjugal onanism. I may say that these opinions are not singular. They are confirmed by several French authors.* Dr. Meyer, in his work on "Conjugal Relations Considered in Relation to Population, Health, and Morality ;" Dr. Bourgeois, in his work "On the Passions ;" Richard, in his work "On Generation ;" all confirm these views. Let me guard myself, however, while yet confirming these opinions. I do not say all and every one of these diseases may not often be produced by other causes, but when they occur in persons who, before they adopted such habits were free from any such complications ; when they are met more frequently among conjugal onanists; when they assume a peculiarly severe type in such persons ; when the sufferers themselves tell you that they can trace occurrence of their troubles soon after the adoption of such baneful habits ; and, finally, when, in some of these cases, the very moment the habit is abandoned and a pregnancy occurs, all the bad symptom disappear and health of body and mind results, then, and then certainly, I think it would be unphilosophical to deny that the several diseases were produced by these habits. Let it also be borne in mind that in England we have not yet reached that shameless mental perversion which leads men to take credit for their filthy habits, as I have often heard Frenchmen do, and say that they are not so silly as Englishmen in having large families *"Des Fraudes dans l'Accomplissement des Functions Genetrices." Par L. F. G. Bergeret, Médècin-en-Chef de l'Hôpital d'Ardois Imas. Baillière & Fils. 1877. 13 and bringing them up in poverty, but that they understand these things better in France than we do in England ; also, that as conjugal onanism is at present practised very rarely, I believe, in this country, we are not, as professional men, open to receive the confessions of the unfortunate victimised women as the doctors are in France. But if we are raised in our tone of conjugal morality above some of our neighbours, it behoves us, as medical men and moral men, to protest strongly against the ingress among ourselves of habits that can only add to our national shame and must increase the category of our national diseases. I will, however, go further. These habits are injurious in other ways. 1st. They lead to a diminution of population. 2nd. They produce a deterioration in the physical strength of a race, and they bring about great demoralisation. 1st. They lead to a diminution of the populations. In a paper read by Broca before the Academy of Sciences, in 1867, he proved that the marriages in France were becoming less productive, and that the women were more diseased. Thus he states that the proportion of births to the number of inhabitants for the following countries was :— Russia 1 in 18 or 19. Venetian States " " 22. Bohemia " " 24. Prussia " " 25. England and Switzerland " " 28. France " " 33. The same fact is enforced in another way by Bergeret (op. cit.), p. 214.14 At the end of the last century the number of chil- dren to a marriage in France was 4 to 5. At the beginning of the present century it was 4.3 ; to-day it is only 2.9. The following is a more particular return. 1819-32 in France there were 3.73 births to every marriage ; 1832-46, only 3.28. Between 1847-60 only 3.25. But in Paris and some other places it was much less. In 1865 it was for all France 3.10 ; for the Department of the Seine, 2.65. And so the population of France diminishes; and but that the mean duration of life has increased from the ages 36 to 38, owing to better sanitary measures and more ease of the population. that popu- lation to-day would be rapidly diminishing. And a diminution of population now-a-days cannot be taken as an indication of prosperity. England and America are far more prosperous now than they were. The prosperity of a nation depends on plenty population and plenty of work for that population. The Anglo- Saxon race is fortunately pre-eminent in these respects throughout the world. 2nd. They produce a deterioration in the physique of a race. Common sense will lead one to suspect such an influence. Those who expend by excesses their virile power must engender a weakened offspring. The beauty the stature, the strength, and necessarily the courage and powers of endurance, must diminish. When we read that out of 1,000 births in France, in 1770, 583 were alive at 5 years old, and 502 at 20 years ; between 1817-30, 720 were alive at 5 years, and 638 at 20 years ; 1840-59, 723 were alive at 5 years, and 640 at 20 years ; it is a terrible mortality. Meter believes it due to the excess of births, whereas 15 if less numerous, the children would be better cared for. This may be true in measure. But is not something due to hereditary weakness, weakness engendered by pa- rents debilitated by sexual excesses. One of the papers on Infant Mortality, by Dr. Drysdale, proves how pre- carious the life of the little children in France has be- come. Note also, the French armies conquered the world under the first Napoleon. The very Prussians were overcome. Under the third Napoleon how was the position changed ! If the generals proved less com- petent, the men, accustomed to waste their strength in unholy debauches, were, like the luxurious nations of old, less able to cope with the sturdy sons of the North, and in their turn they were conquered : and the Commune proved that brutality had taken the place of courage, and Socialism of manliness. But, lastly, such habits tends to demoralise a nation. Here, again, common sense will foresee what result must inevitably follow. A man who is accustomed to gratify without restraint his lustful desires, is not likely to improve in moral tone. It is a passion, and like drunkenness will know no bounds. His conver- sation, his habits, his business, will become tainted by the moral perversion, and he will seek in baser debauches for new channels wherewith to gratify his baser desires. The very woman will become contami- nated. Thus it is that while the number of registered prostitutes in Paris, because of the surveillance of the police, diminishes, that of the unregistered has greatly increased, so much so that syphilis is more rampant than ever. In 1865 there were 3,313 registered prostitutes, which, in 1869, had diminished to 2,782; while the16 clandestine prostitutes were estimated at 40,000 ; and M. Lefort lately advised that a body of police should be provided to arrest 50,000, the present increased number, of these clandestine prostitutes, and keep them in brothels. But it does not stop here. Apart from the filthy exhibitions of nude persons which France allows, apart from the frightfully immoral theatrical performances which are acted in most of the theatres, so that no unmarried modest woman can frequent them, houses for the commission of unnatural crime exist, and one practitioner alone, Tardieu, could collect 302 such cases, and, by the careful examination of the pathological changes in them, was enabled to lay down accurate rules for medico-legal inquiries. Could the whole British profession, if called upon in a Court of Law, cite half-a-dozen similar cases? Assuredly not. Thank God, we have not yet as a nation attained to such depravity. No, gentlemen ; if checks to population are ever desirable, if men have not the means to marry and bring up a family, let us not become the slaves to habits of infamy. There is such a thing a moral restraint. "Greater is a man that ruleth his spirit than he conquereth a city." The man who habitually keeps down evil thoughts, and who allows integrity and a Christian sense of honour to rule him, is a noble creature. He is free to do everything which is grand and glorious, and we have a right to expect great things from such a character. The habit of doing well necessarily entails distinction. Let the passions be kept down by athletics, hard mental work, and industrial occupations ; and if we cannot afford to keep a wife, let us not seek to gratify sexual lust by unholy and debasing practices. Let us not lower the character 17 of a woman by making her the lewd plaything for our vices. Let us remember she must hereafter bring up our children. If the married cannot continue to increase their families, let them do as St. Paul advises, "Defraud ye not one the other, except it be with consent for a time that ye may give yourselves to fasting and to prayer, and come together again, that Satan tempt you not for your incontinency." (1 Cor. vii. 5.) Let the mothers do their duty by their children, and suckle them as they are bound to do, and so they shall not procreate more frequently than is consistent with health. Ameliorate, improve, raise her moral position. Use her as a help-mate worthy of an honourable man, not as a vessel for unbridled lust. Be pure in your conjugal relations ; so regulate and nobly practise moral restraint. Such a course of conduct will produce elevation of character in both sexes, and ensure happy domestic homes. There only remains that small minority of cases where the life of either party is likely to suffer, or perhaps to be sacrificed by procreation, and this objection is especially relevant in persons who have married in ignorance of their infirmities. I allude, for instance, in the female to those examples of pelvic deformity, or other serious local organic disease which would render a labour extremity hazardous - if, indeed, possible at all ; or in the case of the male, where consumption, insanity, cretinism, or other great disease render procreation dangerous both for parent and future offspring. The late Sir James Simpson judged that in such cases to permit sexual relations was to pander to hurtful propensities. I cannot speak so severely. For where a pure affection has guided a married originally, and B18 where mutual love gilds the life of both, I should hesitate to put asunder those whom God had joined together. I should rather say with St. Paul, "Brethren, let every man wherein he is called so abide with God." (1 Cor. vii. 24.) "Art thou bound to a wife, seek not to be loosed. (27.) I should also hope great things from the unselfishness and forbearance of a true and sincere affection. But "all men have not this gift." To such married couples (as also to a woman who procreates too rapidly for health) I would say, methodise your conjugal relations. It has been shown by Mayer (Rapports Conjugaux, p. 240) that conception cannot occur after the twelfth day which follows the end of the period, and up to the recurrence of the catamenia, during which interval connection is not likely to lea to impregnation. Within these physiological limits it may be wise to regulate restraint, if not imperative wholly to practise it. But let it not be made an excuse or a cloak for fraudulency. For conjugal onanism is not only criminal in men, it must tend to demoralise women. If you teach them vicious habits, and a way to sin without detection, how can you assure yourself of their fidelity when assailed by a fascinating seducer? And why may not even the unmarried woman taste the forbidden pleasures also, so that your future wife shall have been defiled ere you know her? Mr. President and Gentlemen, - As medical men we are often the guardians of female virtue. We admitted into the closest confidence of our patients. We know the secrets of many a household. We are trusted, respected, nay loved, for our considerate kindness to the sorrowful and the sick. Shall we now remain 19 silent when attempts are made to introduce into our happy homes, habits of immorality, which are so vile in their character, so dishonourable in their development, so degrading in their practice! Let us protest as medical men, as moral men, as Christian men, against recommendations, by whomsoever made, so filthy, so base, and so abominable. B2DISCUSSION. THE PRESIDENT (DR. MCCLINTOCK, of Dublin) was so fully satisfied of the downright immorality of the practises referred to, that he did not think there was much occasion for the con- sideration of the physical evils resulting from them. It was, nevertheless, satisfactory to have it demonstrated in a conclusive manner, that the methods employed to frustrate the great phy- siological object of sexual intercourse were capable of giving rise to various evils, social and physical, of a serious kind, so that in this, no more than in any other instance, can the physiological laws of our bodies be violated with impunity. For a married woman to try and evade the natural consequences of connubial relations, he believed, was an offence against the laws of God ; and whilst he hoped no member of our profession would ever be found to sanction such a species of immorality, still it was well that we should know, and be able to recognise, the morbid sym- ptoms resulting from the practice in question. He trusted that the subject brought under their notice in the able paper of DR. ROUTH would recieve full and impartial discussion at their hands. Dr. HENRY BENNET (Mentone) considered that the amount of diseases during pregnancy, and in the first month after parturition, was due to the uterus being in a diseased condition at the time of conception. He believed that there was a very much larger amount of disease of the womb than was supposed. Thus he constantly found uterine disease two months after parturition. His youth 22 had been spent in France, and so he could speak from immediate observation. He stated positively that the system of withdrawal was the one almost universally practised in France. That of coverings was only selected where either party is diseased. It was partly the result of the law by which property was subdivided; and hence the desire of not multiplying children. A man who, for instance, had an only son, to whom he could leave at his death two or three acres of land, would himself seek for him a wife among ladies similarly circumstanced, and an integral part of the agreement made was that there should not be a large family, so as to compel a considerable subdivision of the property. There were in France six millions of landed proprietors, and the population of France was diminishing. The Roman Church opposed this state of things, and this was one reason why the men, who would be obliged to confess their errors, ceased to attend its services, and so soon to disregard all religion. This criminal condition of things led to promiscuous intercourse. Many students had their grisettes, and the women as well as the men were taught from a very early period how to evade impregnation. That during such unions sexual frauds were practised was proved by the fact that when either party got married later in life children were born, though their number was still limited according to the will of the parents. On the whole, he agreed with Dr. Routh, but thought he had attributed too much disease to this cause. Dr, MARION SIMS (New York) said that the doctrines of Malthus were based on a false philosophy. They were not true at the day and time in which they were first promulgated.; and now they were simply absurd. For the while world was not girdled with a band of civilisation, with rapid inter-communication, and with speedy interchange of products, by which no nation and no people need fear the increased ratio of population over production. if the England of to-day were wholly cut off from the rest of the world, the agricultural products of the country would barely support its teeming population. But as it is now with her multiplied industries and her marine ploughing every ocean, all the world paid tribute to her in everything necessary to feed her busy millions. Her colonies and dependencies, even my own immense 23 country, are but great farms, whose superfluous productions are absorbed by the mother country and other exigent nations. England never lived more sumptuously than she does to-day. And the doctrines of Malthus are not now applicable to her or to any other civilised country. In New York there exists a society for the suppression of obscene literature, and such articles or artifices as may contaminate the morals of the young and inexperienced. I regret that I cannot give you the statistics of its workings. But I have been amazed at the variety and number of devises of immorality with which vicious and unprincipled men at one time flooded the country, in some instances pervading even the sanctity of school. And I am happy to say that our Government has willingly lent its aid to break up this nefarious business. It has authorised the detention and examination of suspicious publications, and of their confiscation and destruction when of immoral character. Many tons of such matter have been seized and destroyed, and now the mail is purified and innocence is protected. The Government has also authorised the search of premises suspected of manufacturing articles for immoral purposes, and in many instances these dens of evil have been broken up and their authors held amenable to the penalties of the law. All means taken to prevent conception may be and often are followed by injury to both sexes guilty of it. I have seen one woman who was married thirteen years to a strong man who indulged his passions to an unlimited degree, but in such a way as never to deposit semen in her vagina, for fear she would conceive/ Her nervous system was completely shattered, and she ended her days in a lunatic asylum. I have seen any number of women whose health was ruined by this conjugal onanism. And I have seen several whose health was promptly restored by persuading the husband and wife to live together as husband and wife should not live. We cannot rudely violate any of the great laws of Nature with impunity. And the nervous system of the strong man will as certainly break down under these abuses as will that of his delicate and refined wife. This device of trying to prevent conception is one of the great evils of the day. And I becomes us as medical men and philanthropists to set our faces against it. I am glad that we have one man amongst us who is not afraid to grapple with this delicate question; a man who exalted posi-24 tion in his profession and in the community commands the respect of every one, and whose earnest manner and eloquent discourse to-day must carry conviction to the mind of all thinking men. Dr HEYWOOD SMITH, London (one of the Secretaries), on rising, said that some statement was due to the Section from him as to the reason why this subject had been brought before them. With him rested the sole responsibility of its introduction, and he was extremely obliged to Dr. Routh for so kindly undertaking to open the discussion, and he congratulated him upon the temperate yet forcible language with which he had clothed the subject matter. He was led to select Dr. Routh for so delicate a task from his position in the profession, and especially in this department of medicine, and because he believed him to be a God-fearing and right-minded man. He had written to Dr. Drysdale, telling him his intention of getting up a discussion against the doctrines he had lately been publicly enunciating, as he considered their tendency in the highest degree immoral, and he regretted that Dr. Drysdale being in Paris, where he was ventilating the subject of checking population before the Social Science Congress, he was prevented from being present. If any justification were needed for the step which had been taken, the large number present (upwards of 90) gave ample proof of the interest in the subject, and he (Dr. Heywood Smith) was desirous that a decided expression of opinion should go forth from so influential a body in the profession against practices which tended by their immorality to lower the self-respect both of men and women, and which were, besides, so contrary to the direct commands of God. Dr. MACNAUGHTON JONES (Cork) said that to his mind this subject, in so far as related to its moral and physical aspect, was like the Siamese Twins - it was utterly impossible to do as had been suggested, and disassociate the physical from the moral bearing of the encouragement of such practices as those recommended in the two papers read before Dr. Routh's. It was just because medical men were, in a sense, as suggested in one of the papers, responsible for the wellbeing of their patients in matters involving the higher psychical nature of man, that physicians should be jealous of any 25 approach to a breach of that trust which had ever been reposed in the rectitude and honour of the medical profession. The principles at issue in this matter could not be decided by mere statistics, no matter how voluminous or elaborate. Statistics could never prove wrong right. He would be sorry to take as his guide in medical ethics, and to construct a scheme of moral responsibility from, the visionary utterances from John Stuart Mill. He was not prepared to accept him as his prophet in these things. He could say for Ireland, and the President would endorse the statement, that such habits and guilty contrivances were not generally, if at all, practised. Bearing out what Dr. Marion Sims had said, he could refer to the peasantry of Ireland as a proof of what the results of abstinence from all these debilitating habits are in contributing to the physique and morale of the race. In Ireland he had often been struck with the singular immunity of the women from ovarian disease. Considering the population, ovarian disease was, comparatively speaking, a rare disease, as contrasted with its occurrence in England. In speaking over this with Dr. Heywood Smith, he had attributed it to the fact that the Irish women were proverbially more moral and less subjected to irregular ovarian excitation. In conclusion, Dr. Jones said, in dealing with such a question it was impossible to ignore the action of higher causes in the propagation of the species than the mere caprice or passion of man, unless indeed we were prepared to ignore altogether our moral responsibility and relationships. For his part, inscrutable as might be the ways of higher Power, and incomprehensible as such might be to our human faculties, he should prefer to believe with Schiller, "that a God, too, there is, with a purpose sublime, though frail may be reason's dominions;" and acting on that belief, he would never sanction the faintest approach to the toleration of such scientific aids to immorality as those now under discussion. Dr. DONOVAN (Whitwick) said, having practised in Ireland for some years, I can add my testimony to that of my friend, Dr. Macnaughton Jones. In Ireland I scarcely ever had a case of uterine or ovarian disease under my care. On purchasing a practice in England I found so many of my patients labouring under some form of disease of those organs, that I felt compelled26 to make myself an adept in diseases of the uterus and its appendages. To my mind the proverbial virtue of the Irish women accounts for their freedom from these distressing complaints. Mr. GEORGE BROWN, M.R.C.S. (Islington), said the thanks of the members of the Association were due to Dr. Routh for affording them an opportunity of discussing this important question. The practises referred to were, he believed, much more common than was generally supposed, and he was satisfied that in many cases the use of so-called checks to conception, was the direct although often unsuspected cause of disease. Since the publication of the cheap edition of the notorious work "The Fruits of Philosophy," many cases had come under his notice, in which he had reason to believe that the morbid conditions resulted from following the instructions given in that book. When these practises are adopted by married persons the temptation to excessive sexual indulgence is very strong, and many of the cases of nervous exhaustion and extreme debility in young married females which come under our notice are due to this cause. Not only are general and constitutional disorders induced by the adoption of "checks," but some cases of local diseases of the genital organs take their origin from the same cause. Two cases of this kind had come under Mr. Brown's notice. In the first case he was asked to prescribe for a patient whom he had attended in her confinement only a month previously, who was suffering from extreme irritability of bladder and profuse yellowish discharge. On examination, the vagina and external organs were found to be very red and swollen, and the inflammation extended up the urethra and bladder. There was a copious puriform discharge both from the urethra and vagina. At first no cause for this condition could be discovered; the husband stoutly denied having had gonorrhea, and on examination no evidence could be found to indicate that he had recently suffered from that disease. On being closely questioned as to the possible cause of the condition of his wife, he stated that with a view to prevent conception he had adopted the method recommended in the "Fruits of Philosophy" of injecting a solution of sulphate of zinc into his wife's vagina immediately after copulation. Unfortunately for his wife, he made the solution at least 27 four times stronger than should be used as a vaginal injection. Its use caused great pain, and undoubtedly was the cause of all the mischief. In the second case the cause was even more obvious, and the results more serious. Mr. Brown was called one evening to see a patient whom he had attended in her confinement some few months previously. She was a very delicate woman, and of a highly nervous temperament. He found her pacing her bedroom in a great state of excitement, and evidently suffering much pain. She stated that two nights before, on going to bed, she had, at her husband's suggestion, introduced a piece of sponge into her vagina, by which he assured her would avoid any further increase to her family. Next morning she endeavoured to remove the sponge, but to her alarm found that it had been pushed beyond her reach. She refused to have a doctor fetched, hoping that she would be able to get the sponge away. All her attempts, however, failed, and at the end of the second day the symptoms became so alarming that the husband insisted on calling in Mr. Brown. On digital examination the sponge could be felt very high up in the posterior cul-de-sac of the vagina. Its removal was effected with some difficulty, and caused great pain, owing to the intensely inflamed condition of the vaginal canal. When removed, the surface of the sponge was found to be covered with an extremely foetid mucous discharge. On further examination it was found that the cervix of the womb had been pushed upwards and backwards, the os pointing towards the sacrum, and that the fundus was ante-flexed. The womb was also larger than natural, but it is probable that a condition of sub-involution existed previous to the introduction of the sponge. Metritis and severe constitutional disturbance followed, and for several weeks the patient was unable to leave her bed. The uterine displacement still exists, necessitating the occasional use of a pessary. This case raises the question whether flexions of the womb may not be frequently due to a similar cause. That the presence of a piece of sponge in the vagina during sexual intercourse would have in many instances such an effect can be readily understood. Had the patient in this case been able to remove the sponge before a medical man had been called in the cause of the uterine mischief would have been carefully concealed, and perhaps never suspected. Mr. Brown concluded by saying that he was glad to28 have had an opportunity of mentioning these cases, as it was important the profession should recognise the fact that the "Fruits of Philosophy" were worthy of consideration as a factor in the etiology of diseases of the generative organs. Dr. NORMAN KERR (London) was convinced that, so far from objecting to the discussion of this delicate subject by the Asso- ciation, the members of the Section and the profession generally would feel under a deep obligation for the opportunity afforded them of indicating what he believed to be the conviction of nearly the whole profession. Dr. Routh had opened up the subject so moderately and chastely as to prevent any possible misconstruc- tion of the part of any person of ordinary intelligence. It was high time that the voice of the medical profession should be raised with no uncertain sound to reprobate and condemn the immoral and indecent manner in which what were called checks to popu- lation were unblushingly expounded to missed audiences of males and females. Some of the evil physical and mental effects of these interferences with the operation of natural laws had been clearly and felicitously set forth, and it was the duty of all honest and honourable practitioners to point out to the advocates of such unnatural practises the disease and death that they all knew might result therefrom. He hopes it was in the power of the Section to pass a resolution condemnatory of the practice of medical men promulgating at meetings attended by men and women such doctrines as had been brought forward. Dr. Norman Kerr said he had been asked to propose such a reso- lution as he had hinted at, and had accordingly drafted the following:- "That in the opinion of this Section the advocacy of physical checks to population by medical men in promiscuous gatherings of both sexes is an offence against public order, decency, and morals." He (Dr. Kerr) was of opinion, and so were several around him, that such a resolution was urgently called for, but in deference to the mature judgment of their esteemed President, who thought that the very general expression of the feeling of most of those present would prove as effectual, he contented himself with simply proposing a cordial vote of thanks to Dr. Routh for his able, comprehensive, impressive, and chaste treatment of the subject. That physical, mental, and 29 moral mischief frequently followed the employment of unnatural preventive checks was undeniable, and much good must result from its clear and unflinching exposure that day. But over and above the general question, as members of the great profession of medicine, it was their duty to protest most strongly against any of their number discussing such subjects in ordinary public meet- ings attended by numbers of excited men and women, many of whom were young persons. Dr. MARION SIMS said England had proposed a vote of thanks to Dr. Routh. It was but right that America, whom he repre- sented, should support that vote. He had very great pleasure and gratification, therefore, in seconding the resolution of Dr. N. Kerr. The Motion was carried by acclamation.A FEW RECENT PUBLICATIONS OF BAILLIERE, TINDALL, & COX ----------------o------------- In 2 Vols., with 1,000 Illustrations, chiefly original, Second Edit., £1 11s, 6d. The SCIENCE and PRACTICE of SURGERY. A text-book for Practitioners and Students, By FREDERICK J. GANT, F.R.C.S., Senior Surgeon to the Royal Free Hospital. With Chapters on Special Subjects by WM. ADAMS, F.R.C.S.; ROBERT BARNES, M.D., F.R.C.P.; MORELL MACKENZIE, M.D., M.R.C.P.; F.A. MAHOMED, M.D.; HY. POWER, F.R.C.S.; LAIDLAW PURVES, M.D.; CHAS. T. TOMES, B.A. Oxon; Professor ERASMUS WILSON, F.R.S., F.R.C.S. "In concluding our notice of Mr. Gant's able and laborious work, we cannot forbear to refer again to the very numerous woodcuts which are profusely distributed through both volumes, and more especially do we we wish to draw attention to those figures which illustrate practical subjects . . . The reader has the advantage of mature experience in treating of 'special subjects,' that are either omitted or very lightly referred to in ordinary works on surgery." -- The Lancet. Containing 88 full page Steel Plates; price, plain, 25s,; coloured, 50s. The TEXT-BOOK of OPERATIVE SURGERY. By Professor CLAUDE BERNARD. Translated and edited (by permission) from the French by ARTHUR TREHERN NORTON, F.R.C.S. Surgeon to, and Lecturer on Surgery at, St. Mary's Hospital. 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The following works are specially designed to assist Students in committing to memory, and grouping the subjects upon which they are about to be examined. They are published in a convenient and uniform size for the pocket. Price 1s. each, paper wrapper ; 1s. 6d. in cloth. AIDS TO ANATOMY. A multum in parvo Guide for Students going up for EXAMINATION. By GEORGE BROWN, M.R.C.S., Gold Medallist, Charing- Cross Hospital. Fourth Thousand. "The little book is well done." -- The Lancet. "With this little work, Students need have no dread of College Examiners." -- Medical Press. AIDS TO BOTANY. Consisting of Brief Outlines of the Elementary Facts of the Science, in which is included a Description of some of the most important Natural Orders. By C.E. ARMAND SEMPLE, B.A., M.B. Cantab., M.R.C.P. Lond.; Examiner in Arts at the Apothecaries' Hall ; late Clinical Assistant and Surgical Registrar at the London Hospital. "The Student who can commit this to memory will doubtless be proof against pluck." Medical Journal. AIDS TO CHEMISTRY. Part I. -- Inorganic: Oxygen to the Metalloids Inclusive. Part II. -- Inorganic : The Metals. By the same Author. Third Thousand. "Students preparing for Matriculation at the London University, and other Examinations, will find it simply invaluable." -- Students' Journal. AIDS TO EXAMINATIONS. Being Questions and Answers on Materia Medica, Medicine, Midwifery, Pathology, and Forensic Medicine. By W. DOUGLAS HEMMING, M.R.C.S. :We have no fault to find with the Answers -- indeed they are models of succinctness and accuracy." -- Medical Times and Gazette. AIDS TO FORENSIC MEDICINE AND TOXICOLOGY. By the same Author. "We have no hesitation in recommending Mr. Hemming's book." -- The Lancet. AIDS TO THERAPEUTICS AND MATERIA MEDICA. Part I. The Non-Metallic and Metallic Elements, Alcoholic and Ethereal Preparations, &c. By. C.E.A. SEMPLE, B.A., M.B. Cantab.; Examiner in Arts at the Apothecaries' Hall. Seventh Thousand, Price 1s. THE VEST-POCKET GRAY ; or, ANATOMIST'S VADE-MECUM. Compiled specially for Students. By C.H. LEONARD, M.D. Contents : -- Each Bone, Muscle, Artery, Vein, Nerve, &c.: their Types, Development, Origin, Course, Structure, &c., &c. Second Edition, Enlarged, 1s. THE STUDENTS' CASE-BOOK. Containing Practical Instructions, and all the Necessary Information for Clinical Work and Systematic Case-Taking, with a number of Ruled Sheets, for Recording Particulars of Cases as seen. By GEORGE BROWN, M.R.C.S.; Late Demonstrator of Anatomy, Westminster Hospital; Gold Medallist, Charing-Cross Hospital. LONDON : BAILLIERE, TINDALL, & COX. [PARIS & MADRID.] BY THE SAME AUTHOR. ON the PUERPERAL FEVER of VIENNA. Med. Chir. Trans., Vol. xxxii. ON TRANSFUSION OF BLOOD. Medical Times, Vol. xx. ON PROCREATIVE POWER PHYSIOLOGICALLY and MATHEMATICALLY CONSIDERED. London Journal of Medicine, 1850. FELLOWS' PRIZE ESSAYS for 1845. Medical Gazette, 1849-50. FALLACIES of HOMEOPATHY. 1852. NATURE of FOOD. 1852. CHEAPEST and MOST NUTRITIOUS FOOD for CHARITABLE INSTITUTIONS. 1854. ON PNEUMONIA : CAUSES AND TREATMENT. 1855. ON MORTALITY of INFANTS. 1858. LETTSOMIAN ORATION before MEDICAL SOCIETY of LONDON. 1859. INFLAMMATORY AFFECTIONS in CHILDREN, ETC. 1862. TWO LECTURES delivered at the SAMARITAN HOSPITAL ON ENDOMETRITIS. 1862. USE of HYSTEROTOME, ETC. 1864. ON HYPERTROPHY of the MAMMAE, as the RESULT of UTERINE DISEASE. Medical Mirror. ON the SIGNS of VERY EARLY PREGNANCY. 1864. CASE of FIBRO-CYSTIC DISEASE of UTERUS. 1867. TREATMENT of EPITHELIAL UTERINE CANCER. No. 1, 1867. ON the TREATMENT of CERTAIN FORMS of UTERINE CANCER, No. 2. 186 FURTHER REMARKS on the TREATMENT of UTERINE CANCER specially by GASTRIC JUICE, No. 3. 1873. CAUSES of UNPRODUCTIVE MARRIAGES CONSIDERED in A NATIONAL POINT of VIEW. 1869. ON UTERINE DEVIATIONS. 1869. SCARLET FEVER : ITS ETIOLOGY AND TREATMENT. 1870. CASE of ABSENCE of VAGINA. 1871. ON FUNDAL ENDOMETRITIS. 1871. ON VARIOUS PREPARATIONS of PHOSPHORUS to be used THERAPUETICALLY. 1874. ON an EPIDEMIC of CONTAGIOUS SORE THROAT. 1875. ON HYPERPYREXIA. 1876. ON a CASE of EXTRA-UTERINE FIBROID SUCCESSFULLY REMOVED by GASTROTOMY. 1877. AN ADDRESS on the FAILURE of the CONTAGIOUS DISEASES (WOMEN) ACTS, both as a SANITARY and MORAL MEASURE. OVERWORK as a CAUSE of PREMATURE DECAY. INFANT FEEDING. 3rd Edition. 1877. ON FIBROID TUMOURS of the THROAT. OF FAECAL FERMENTATIONS as a CAUSE of DISEASE. Brit. Med. Jour. Guild of S. Matthew, THE CHURCH AND SECULARISM: BEING SOME ACCOUNT OF AN ATTEMPT TO "JUSTIFY GOD TO THE PEOPLE." Printed for the G.S.M. by the WOMEN'S PRINTING SOCIETY, LIMITED, 21B, GREAT COLLEGE STREET, WESTMINSTER, S.W. PRICE TWOPENCE.GUILD OF S. MATTHEW. [Founded S. Peters' Day, 1877. Admitted to Church Guilds Union, 1879.] Warden: -- REV. STEWART D. HEADLAM, B.A., S. Michael's Clergy House, Mark St., Finsbury, E.C/ Hon. Sec:-- MR. FREDERICK VERINDER, 5, Goldsmith Square, Stoke Newington, London,N. OBJECTS. 1. -- To promote frequent and reverent Worship in the Holy Communion and a better observance of the teaching of the Church of England as set forth in the Book of Common Prayer. 2. -- To get rid, by every possible means, of the existing prejudices against the Church -- her Sacraments and Doctrines : and to endeavour "to justify GOD to the People." 3. -- To promote the Friendly Intercourse, Recreation, and Education of its Members. Rules, Forms of Nomination, Programmes and all other information will be gladly supplied on application to the Hon. Sec. as above. I. "GOD JUSTIFIED TO THE PEOPLE." The "Guild of S. Matthew, Bethnal Green," originated three years ago among a few of the communicants of the church from which it took its name, who felt the need of some organization for promoting good churchmanship in themselves and their neighbours. The objects of the Guild, as relating to the members themselves, were something like these: -- To promote frequent and reverent worship in the Holy Communion, and a better observance of the teaching of the Church of England as laid down in the "Book of Common Prayer," and "to promote the friendly intercourse, recreation and education of its members." As regarded objects external to ourselves as a Guild we added -- anyone who knows anything about the Communicants' roll of an ordinary East-end parish will readily understand why -- "To do all in our power, individually and collectively, to remove the prejudices so common in the neighbourhood against Confirmation and Holy Communion." Members to communicate on "all the great Festivals," at least to be present at Holy Communion on red-letter Days and Sundays, to meet for united worship on S. Matthew's Day : and so on. The other Rules provided in the ordinary way for Social and Devotional Meetings, classes for Theological and other Studies, Papers and Discussions, etc. A flourishing Sunday School was established and worked by members of the Guild. With considerable success the Guild worked on these humble but useful parochial lines, till circumstances, into which I need not enter here, to our great sorrow made it impossible for the Guild any longer to carry on its work in the parish. It then became a question as to whether we should dissolve or find some fresh field of work. We resolved to wait When our Warden was appointed to the curacy of S. Thomas,' Charterhouse, we began to look about for a raison d'- etre. Our numbers 4 were small, and the members confined to no particular parish. For these and many other reasons parochial work was out of the question. But our Bethnal Green experiences had taught us that we were surrounded by a multitude of non-churchmen -- many of them non- Christians -- among whom was a splendid field of work, at present almost unoccupied. After much deliberation we resolved to make an experiment in this new direction. Our rule for ourselves remained unchanged ; we simply altered one of our "Objects," thus : -- "To endeavour by every possible means to remove the existing prejudices against the Church, her Sacraments and doctrines : and to endeavour to "justify God to the People." The last phrase sums up, I think, better than anything else, the work we had before us. The methods by which such an object could best be carried out were our first matter of enquiry. The classes which we wanted to reach were of course entirely beyond the influence of the Pulpit. They openly refuse to go to church to listen to public statements which they are not allowed to publicly challenge. On the other hand we found many earnest clergymen who felt that if the People would not go to the Parson, the Parson must go to the People. We were asked to give them an opportunity of coming out of "Coward's Castle," and of meeting the People on their own ground in fair and open discussion. We resolved to undertake, as an experiment, the task of providing in the East End of London Popular Lectures by Priests and Laymen, on church questions, followed by open discussions, in which difficulties and doubts might be freely stated and answered on the spot. A short course of three lectures* in Shoreditch (January-February), 1879) gave us some little encouragement and led to a much more ambitious course of ten fortnightly lectures, beginning September, 1879. The broadest invitations to "Men and Women of any Religion --------------------------------------------------------------------- *These were: -- "Equality" by REV. A.H. STANTON, M.A.; "Socrates." bu REV. J.E. SYMES M.A.; "S. Clement of Alexandria," by REV. S.D. HEADLAM, B.A. 5 or no Religion" were issued. The discussion after each lecture was as "full and free as possible." The first lecture gave the key-note to the course : -- (1) :God Justified to the People," by REV. S.D. HEADLAM. (2) "Is Life Worth Living?" REV. H.C. SHUTTLEWORTH; (3) "The causes of and excuses for Dissent," by REV. J. W. HORSLEY. (4) "The Incarnation: Its Social and Political Meaning." by REV. W.H. LEEDS. (5) "Buddha," by RE. J.E. SYMES. (6) "Church and State," by REV. T. HANCOCK. (7) "Joshua Davidson, Christian and Communist,: by REV. S.D. HEADLAM. (8) "Mr. Brighton Nonconformity," by REV. T. HANCOCK. (9) "Church Reform," by THOS. LAYMAN, ESQ. The most interesting and probably the most original feature of these meetings was the discussions. These were entirely successful. In them, Churchmen of all shades of opinion, Atheists, Secularists, Positivists, Quakers and representatives of several other phases of belief and un-belief, took part with perfect good humour. We had all varieties of political opinion (some of them would be considered positively dangerous in certain circles) from Tories to Communists. Our room held about 120 at a pinch ; we never succeeded in crowding it, but it was often moderately filled. The Discussions certainly solved any doubt we might have entertained as to the possibility of reaching "them that are without" with such lectures. As before hinted these Lectures were more or less experimental. We had no more than a rough, general idea of the kind of subjects we should have to deal with, or of the material at our command. When any important point was raised incidentally in a discussion, we usually endeavoured to devote a lecture to it later on. Feeling our way in this fashion, and carefully noticing the chief objections as they were brought forward, we were enabled to form a more accurate idea of the proximate causes of the widespread revolt of the "working classes" in our large towns from christianity.6 There can hardly be a surer means of learning the "causes of unbelief" than a careful study of the freely- expressed thoughts of the unbelievers themselves. A bare hint only can be given here of the line of thought and action which we have been led to take by con- sidering the many phases of Secularism and Atheism with which our work has brought us into contact. It is perfectly certain in the first place, that nothing but evil can possibly come of accepting the frequent challenge of the least intellectual adherents of Secularism to enter upon a perpetual wrangle about "texts." The question must, above all things, be fought out, as between Secular- ism and Christianity on broad principles, to which all details may subsequently be referred. Isolated texts may, as we all know, be made to prove almost anything : it is not so with a great doctrine. We find, then, that the most pertinaciously asserted objections to the Christian Faith range themselves chiefly under two heads which for brevity's sake we may call (a) Theological and (b) Political. (a) Theological. There seems to be but one method--- and that a simple one---of dealing with this class of objections. That is, an uncompromising return to, and insistence upon, the first principles of Christianity, Primitive Catholicity. There must be no truce with any merely modern accretions, whether Roman or Protestant, to "the Faith once delivered." For the Christian the final standard of appeal must necessarily be the teaching of Christ, His Apostles and the Primitive Church. But the attacks of Secularists are directed almost exclusively against modern doctrines---doctrines either never heard of at all by the Early Church, or now re-stated in such a form as to render them almost irrecognisable when compared with the teachings of Christ. The lamentable fact which we, members of the English Branch of the Holy Catholic Church, have to face is the identification of the teaching of Christ and His Church, in the minds of these men with the Calvinistic teaching from which they have revolted. The doctrines from which they have recoiled in horror 7 and disgust are such doctrines as that of the "predestina- tion to damnation" of an overwhelming majority of GOD'S children ; of Salvation from punishment by the Moody-and-Sankey-and-Salvation-Army "Scheme" of "Substitution" ; of Salvation by "only believe" when "doing is a deadly thing, doing ends in death"; and so on.* The fact is, the Secularists, like some of ourselves, have probably in most instances, been brought up under the dark shadow of Calvinistic Sectarianism: we have by God's Providence been led to see how far this de- parts from the teaching of Christ and His Church : they have known no other form of Christianity. A passionate rejection of such a religion is the natural consequence. (b) Political. "This world," says the Secularist motto "demands and will repay our utmost care and attention." The noblest aim of a man's life is to leave the world better than he found it," "to promote the greatest good of the greatest number" and so on. But, by an extraordinary misapprehension of Christianity they suppose there is something in all this utterly opposed to its Spirit. Christianity they tell us has been throughout its whole career the steady and persistent foe of human progress. The teaching of Christ, say * Proofs cannot be given here. But see the following typical instances. Austin Holyoake, who died an Atheist, said on his death bed : "I was born of religious parents, my mother being especially pious, belonging to that most terrible of all sects of the Christian body---the Calvinistic Methodists. From my early childhood, I remember being taught to dread the wrath of an avenging God, and to avoid the torments of a brimstone hell." (National Reformer, April 19th, 1874.) The italics are our own. Again, "Jesus is there painted (in the current Roman teaching) as the Father is painted (by orthodox Protestants) in stern majesty, hard, implacable, exacting the uttermost farthing; and Mary is represented as standing between Him and the sinners for whom she pleads." (Mrs. Besant's Path to Atheism, p. 53.) "Jesus Christ is the Saviour of men (according to the Christian teaching which Mrs. Besant seems to have received) not because he delivers men from sin, but because he saves them from hell, and from the fiery wrath of God"! (p. 56.) Compare, too, the revolting extracts from Father Furniss' description of Hell on page 64 of the same work, with the above, and all of them with the New Testament, and it will at once be seen what sort of Christianity the Secularist has thrown over with indignation and disgust.8 some, is concerned almost entirely with another world, with the means of avoiding a hell of physical torment and of attaining a heaven of dreamy enjoyment. Hardly a single unbeliever with whom we have come into contact seems ever to have heard of the elementary fact that "The Kingdom of Heaven" of the Gospels is a righteous Society here on earth, a Society or Church which all men are invited to enter---a Society whose objects embrace in the highest sense of the words the principles of "Liberty, Equality, and Fraternity," and the promotion of the highest good---bodily, mental, and spiritual---of the totality of mankind. But some of them are perfectly willing to concede that much of the teaching of Christ is noble and true---they assert, however, that the Society which calls itself by His name has never or seldom acted up to that teaching. "The Church has steadily resisted the freedom of the people, opposed the spread of truth, and upheld tyranny and the divine right of kings." Again, the remedy for this misconception is an appeal to the teaching of Christ Himself, to show that when the Church has done, or has seemed to have been doing, these things, she was manifestly falling away from the standard set up by Her Divine Founder. The advantage which the English Church possesses over the sects in dealing with these questions must be obvious to every churchman. We are able to stand before the world as Democrats (in the highest sense of the word) by logical necessity. The firm hold which our Church has ever maintained on the great doctrines---or rather the great facts---of the Fatherhood of God and the Incarnation of Christ enables us to rest our belief in the Brotherhood of Man on an impregnable foundation of fact. Moreover the restoration within late years of the Holy Communion to its rightful position as the central act of Christian worship enables us to appeal to the most * For some hints as to the way in which the ranks of Atheism are recruited by men who first began with doubting as to the bearing of Christianity on political and social questions, see Rev. G. Sarson's pamphlet mentioned on page 9 solemn and dramatic witness to Equality and Fraternity which the world has ever seen. What greater protest in favour of the true "Rights of Man" could be made than that which our creed makes in the assertion that He whom we worship as "Very God of Very God was made man." We are thus able to appeal from any of the accidental instances in which the Church or any side of oppression and tyranny to the authorative teachings and Sacraments of the Church itself. This method we find may most readily be combined with studies of typical Churchmen or typical periods of Church History treated in such a way as to allow of the general question as between Christianity and Democracy being raised. But it cannot be too much insisted upon that every one of these many subjects must be distinctly and avowedly based upon a reassertion of the first principles of Christianity. In noticing the extraordinary variety of the titles of our Lectures, it must be borne in mind that the attempt to do this underlies them all. There are many other lines along which it is necessary to strengthen the defences of Christianity. Next in importance to the two groups already mentioned, are the questions raised by the recent extensions of Physical Science. We have been able to do but little in this direction at present, but have at any rate made a beginning by treating during the past winter of the very pressing question of "Darwinism," and of the bearing of Christianity on Sanitary questions. The same thing was done incidentally in Rev. H. Shuttleworth's Lecture on "Kingsley." The Ancient Religions of the world are favourite subjects with Secularist Lecturers, and therefore require to be carefully treated from a Christian point of view. We have dealt with one or two of them: not without urgent necessity as the discussions proved.10 II. A HALF YEAR'S WORK, Sept. 1st, 1880---Feb. 28th, 1881. The following detailed account of our work during the past winter will serve to show how the objects of our Guild are sought to be carried out: --- "The Secretary has great pleasure in submitting his Seventh Half-yearly Report to the consideration of the Members of the Guild. The Half-Yearly Meeting of the Guild was held in the Guild Rooms on Sept. 13th last. No changes in the Objects and Rules were proposed or made. The Half- Yearly Report was adopted unanimously and without discussion, the remainder of an unusually long meeting being entirely occupied with the discussion of arrangements for the coming winter. The Annual Festival of the Guild was duly observed in the usual manner. There was a special celebration of the Holy Communion (for London Members) at S. Thomas' Charterhouse on the morning of S. Matthew's Day. On the Sunday within the Octave special Sermons were delivered: that in the morning by the Rev. Warden: in the evening, a telling and eloquent address was delivered, as on previous similar occasions, by our good friend, REV. A. H. STANTON, of S. Alban's, Holborn. The Octave of S. Matthew was also marked by two important gatherings, On the Evening of the Day itself, a Social Meeting of Members and Friends took place. About sixty Church-people were present, and passed a very enjoyable evening, seeming greatly to appreciate the opportunity thus pleasantly afforded to those interested in our special branch of Church work of becoming personally acquainted with each other. On the following Monday a meeting of communicants interested in the work of the Guild was held at Bridgewater Square. The Secretary explained the aims and method of the G.S.M.; and after an interesting discussion, several of those present filled up Nomination Papers. 11 During the past Half-year, twenty-five Members have joined the Guild, and four have left us. The number of Members is now forty-seven. Five "Ordinary Meetings" have been held during the Half-Year in accordance with the published Programme. The attendance of members has been small: but this fact is largely to be accounted for by the small number of members within easy reach of any one place, and the pressure of other Guild work. At the Meeting of October 11th a paper by the Rev. Warden was read on "Holy Communion and Its relation to our work:" on November 8 (Octave Day of All SS.) a paper by REV. W. H. LEEDS on "The Communion of Saints." These were followed by discussions. On December 13th, MISS PRINGLE kindly read some selections from the "Dagonet Ballads." The arrangements for the January and February meetings had to be set aside owing to the pressure of more important business. On S. Thomas' Day the members were asked to unite in Special Intercession for the work of the G.S.M. at the Holy Sacrifice, each in his own Church; our members being scattered over the whole of Southern England, "united worship" in any other sense is at present impossible. The Special work for which we exist as a Guild has been carefully developed during the past Half-year. The means chiefly adopted for carrying out "Object II." have been (1) "Lectures and Discussions" (2) Classes. (I.) A. The "Lectures for the People" have been delivered during the greater part of the winter in the Lecture Theatre of S. Thomas' Charterhouse Boys' School, generously placed at our disposal by the late REV. J. RODGERS, the permissions to use them being kindly continued to us after the sudden and lamented death of Mr. Rodgers by his successor, REV. H. SWANN. The following is a list of the Lectures given during the Half-year: --- 1880. (1) Oct. 5, "Political Morality," } REV. J. W. HORSLEY, (2) Oct. 12, "Liberty," }M.A., Chaplain of the House of Detention, Clerkenwell.12 (3) Oct. 19, "St. Francis Xavier,--Jesuit, Missionary and Martyr," by REV. W. E. MOLL,* of Plaistow. (4) Oct. 26, "Altruism," by BROTHER GEORGE, G.S.A., Master of S. Dunstan's House, Plaistow. (5) Nov. 2, "A Churchman's View of Disestablishment," by THOS. LAYMAN, ESQ. (6) Nov. 9, "Charles Kingsley," by REV. H. C. SHUTTLEWORTH,* of S. Paul's Cathedral (7) Nov. 16, "Fraternity," by BR. A. W. Crickmay, G.S.A. (8) Nov. 23, "The Church and Democracy," by Rev. T. HANCOCK, M.A. of Harrow. (9) Nov. 30, "The Religion of the Ancient Egyptians." by REV. J. N. HOARE of S. Luke's, Chelsea. (10) Dec. 7, "Religious Aspects of Darwinism," by MR. F. VERINDER.* (11) Dec. 14, "The Democracy of Ritualism," by THOS. LAYMAN, ESQ. (12) Dec. 21, "Modern Fashions--Their Physical and Moral Effects," by JOHN J. PILLEY, EQS.* 1881 (13) Jan. 11, "Materialism," by REV. J. E. SYMES, M.A. (Cambridge University Extension Lecturer. Jan. 18--(Lecture postponed to March 15 on account of the great snowstorm.) (14) Jan. 25, "Labour's Prayer," by REV. C. E. ESCREET, M.A.,* of S. Mary's, Battersea. (15) Feb. 1, "Luxury," by REV. J. W. HORSLEY, M.A. (16) Feb. 8, "Gregoire--Bishop and Democrat (of the French Revolution,") by REV. W. H. LEEDS, B.A.,* of Christ Church, Clapham. (17) Feb. 15, "The Priesthood and Popular Progress," by REV. H. C. SHUTTLEWORTH, M.A.* (18) Feb. 22, "Priestcraft in the Church of England," by THOMAS LAYMAN, ESQ. They will be continued into the next Half-year as follows :-- (19) March 1, "The Democratic Teaching of the Bible," by MR. F. VERINDER.* (20) March 8, "Sir Thomas More's Utopia," by REV. A. SINCLAIR BROOKE. 13 (21) March 15, "The Republic of Plato and the Republic of Christ," by REV. BROOKE LAMBERT, M.A., Vicar of Greenwich. (22) March 22, "Equality," by BROTHER GEORGE, G.S.A. (23) March 29, "Thomas Carlyle," by REV. G. SARSON, M.A., Rector of Orlestone. (24) April 5. "The injustice of the English Law as to the Expression of Religious Opinion," by Rev. W. E. MOLL, B.A.,* of Christ Church, Clapham. The arrangements for the concluding lectures of the course (Easter to Whitsuntide) are not yet complete. On February 22nd, the Lectures were transferred to St. Michael's Boys' School, Leonard Street, Shoreditch, where they will be continued will further notice. It would be premature to say anything as to their prospect of success in our new quarters at this early stage : as experience shows that considerable pains and some little time are necessary before a new neighbourhood can be successfully worked. The Lectures have been on the whole much better attended than those of a year ago. There was a perceptible falling off in the attendance during several weeks before Christmas, many of our friends having to work "overtime." The discussions have been in many cases exceedingly interesting and have always been well maintained on the "Christian" side by Members and Visitors. The extraordinary persistence with which some well-worn arguments are "trotted out: week by week by some of "our friends the enemy" bears witness to the strong hold which certain false conceptions about GOD and His Church have taken on the minds of many, and to the continued necessity of re-asserting with all our might, but with as much good-humor and patience as possible, the Revelation of GOD in CHRIST as against the dark narrow "Calvinistic" Theologies from which there is so widespread a revolt. The God whom these men have rejected is unknown to the Gospels and the Catholic Church ! The value of open discussion in which the *Lecturers whose names are marked thus are Members of the G.S.M.14 objections to Christianity---so often founded on an utter confusion of Christ's teaching with that of modern Calvinistic bodies---can be freely stated and fully answered, becomes more and more evidence as our work goes on. (B) The REV. C. E. ESCREET, M.A.,* curate of S. Mary's, Battersea, has nobly volunteered to carry on a similar course of Lectures on "The difficulties of the Christian Faith" at his own cost. The Lectures are delivered on Sundays (after Evening Service) in the Vicarage Room, Battersea Square. Lectures followed by discussions have been delivered during the greater part of the winter on such subjects as "The Miracles of Christ," "His Church," "His Parables," "His Resurrection," "The Creation," "The Fall," "Eternal Punishment," etc., etc. "The attendance," says a correspondent, "was at first very poor, but is improving; on the whole the discussions have been very satisfactory . . . Those of opposite views have the greatest possible respect for Mr. Escreet, and admit that he treats them in a fair and manly spirit." It is greatly to be regretted that as yet "the church people do not seem to take much interest in the Meetings." (C) Two other courses of Lectures, not our own, are however so closely connected with our work that they must be mentioned here. The REV. S. D. HEADLAM, warden of the Guild, has delivered, as usual, his Sunday Evening Lectures as curate first of S. Thomas,' now of S. Micheal's. Our friend BROTHER GEORGE, borrowing a title from our "Object II" has also delivered an extended course of Sunday Afternoon Addresses to Working Men ("GOD justified to the People") at S. Gabriel's, Canning Town, E. We hope to be able shortly to announce some further and important extensions of this kind of Church Work. (II) Classes. As a supplement to the work of the Lecture Room a class for the careful detailed study of the Parables as illustrating the teaching of Christ was held during the latter part of the old year by the Warden. A class for the study of Shakespeare had to be ultimately abandoned, as had also some other proposed classes, 15 partly owing to the enforced absence of Rev. Warden from England during the early part of the Half-Year. There are not wanting signs that the importance of such work as ours is beginning to be felt by Churchmen at large. Many letters of sympathy with our aims and methods have been received. "I am heartily glad," says one of our correspondents, a clergymen in the West of England "to find a Society, however small at present, doing a needed work among people who (very many doubtless) are not believers in GOD because GOD has been caricatured to them. To justify GOD to the people is a noble if arduous task." The Council of the Church Guilds Union have again referred to our work in their Annual Report in the following terms--- "The Guild of S. Matthew continues its peculiar and valuable work of providing lectures and discussions on religious and social topics for the working classes, more particularly, and with a special view to meeting the difficulties of some, and the sceptical attacks of others." The Hon. Sec. attended the Conference of the Union in January last as the Delegate of the G.S.M. A paper on the "Democratic Basis of the Church" was read by Br. the Rev. Thos. Hancock, in which the Rev. Lecturer maintained the same position which he so eloquently defended in a Lecture given for the Guild last November. An incidental mention of our work in the Discussion on Paper was well received by the Delegates present. As will be seen by the appended Financial Statement, the Guild has not yet solved the problem of carrying on a greatly extended work with a very disproportionate increase of Income. The two points which naturally suggest themselves to our consideration are (1) How can we without narrowing our operations curtail our expenditure? and (2) How can we so arouse the practical interest of Churchmen in our Missionary enterprise as to induce a much larger number of them to contribute to our Funds either as Members or as Subscribers?16 In looking back over the work of the last Half-year, we can indeed see many things for which we many "thank GOD and take courage." Our work is difficult to carry out owing to the vast number of points on which it is necessary to "justify GOD" and the Catholic Church "to the People" of our great cities : and our aims are as yet but half understood by a large number of our fellow- churchmen. Yet in spite of these and many unexpected difficulties and changes during the past half-year we have been enabled to enlarge the area of our operations to a very considerable extent. The Priests and Laymen who had helped us in the past with Lectures on their own special subjects have again made eloquent and cogent appeals on behalf of the Christian Faith from our platform; to them, and to the large number of Churchmen who have helped us in the Discussions and in other ways our heartiest thanks are due, and are hereby tendered, coupled with a strong hope that they will not only be able to continue their generous help, but will also be able by their example to induce many others to do similar work, here or elsewhere. "It is good for us, Christians," a well-known London Priest said at one of our meetings "to feel the rough breeze of a free expression of opinion --it only serves to root our Faith more deeply." We need not fear an open discussion of our opinions so long as we really believe what we often say "Magna est veritas et prevalebit." 17 The Hon. Treasurer in Account with the Guild of S. Matthew, (Sept. 1st, 1880 to Feb 28, 1881.) Dr. Cr. £ s. d. To Members' Sub - - - scriptions - - - - 5 1 0 To Offertories - - - 2 16 8 To Donations - - - 1880. Rev. V. H. Stanton - £1 0 0 Miss Simpson 5 0 "L. J. H." - 5 0 MissHarrington 2 0 Rev. S. Barnett 5 0 Rev. C. Hankey 1 0 0 Miss Saunders - 2 6 Mrs. Croydon - 5 0 Miss Grimshaw 1 0 Miss Wade - - 1 0 1881 Rev. W.Osbore Allen - - 5 0 A.Kinnaird Esq. 10 0 ------4 1 6 To Rev. S. D. Headlam's contribution toward Rent of Guild Rooms - 10 0 0 To Music Fees - - - 4 9 To Hire of Guild Rooms 13 6 To Sale of Pamphlets presented by Rev. G. Saron - - - - - 8 2 To Balance due to Treasurer - - - - - 24 10 5 £47 16 0 £ s. d. By Balance due to Treasurer - - - - - 3 13 8 By Postage - - - - 3 4 1 By Payment on Acc. to Women's Printing Society - - - - - 5 0 0 By Guild Rooms:-- Rent - - £20 0 0 Gas Fittings&e. 5 0 0 Furniture - - 4 7 1 1/2 Cleaning- - 8 6 -------29 16 11 1/2 By 'Social Evening' Sep. 27, 1880. General Expenditure - - - £2 3 8 Less amount received for Tickets - - 16 0 -------1 7 8 By Advert. of Special Sermon (in Church Times) 2 6 By Hire of Piano - 4 10 0 Sundries - - - - 1 1 1/2 £47 16 0 Liabilities: To Women's Printing Society for Printing to end of Half-year- 3 10 6 Bal, duetoTreasurer 24 10 5 Total £28 0 1118 III. "COME OVER AND HELP US." We feel sure that all earnest Churchmen will sympathize with us in our effort to "reach the masses with the Gospel," and that many will feel the value of our special method of dealing with a very special problem. To such we earnestly appeal for help. There are many ways in which so varied a work may be helped on: some of them may be suggested here. (1) It is hardly necessary to point out that a considerable expenditure is entailed by our Lectures, Classes, etc. For good and sufficient reasons our nominal Subscription is kept very low, and a small subscription from a small number of members does not go so far. The work to which we pledged ourselves last September has proved somewhat more expensive than we anticipated, while the help which we seemed likely to receive has by no means answered to our expectations. The result is a considerable deficit which seriously hampers our movements. The removal of our lectures to new quarters will entail additional printing and advertising. May we hope that the many friends fo the movement in London and elsewhere will help us to get rid of the monetary difficulties which beset the path of a small and little-known Society which is touching the fringe of a great work? (2) We hope, however, that our hands will be permanently strengthened by an accession of new members Only by showing a united front will churchmen be able to make any progress in Home Mission work. Individual effort is too often put down as individual eccentricity. The greater the numerical strength of the Guild the greater weight will its message carry. "Any communicant of the Church of England" who can heartily subscribe to our Objects and submit to our few simple Rules "may become a member of the Guild." (3) We shall be glad to acknowledge and, if possible, to act upon any suggestions which may be sent by those who have had experience in dealing with Secularists in our large towns. Suggestions on the following subjects 19 are particularly valuable:---Useful Subjects for Lectures, Tracts, Pamphlets etc. useful for distribution; quarters in which it would be desirable to advertize the Lectures etc. Names of those who could or would lecture for us, names of churchmen who would be likely to take an interest in our work, and offers to distribute hand- bills etc., will receive immediate attention. (4) Gifts of Books for our Library will be welcome. It is in contemplation to form a Library of Reference on the questions with which we have principally to deal. It is hoped that in course of time local branches of the Guild, or independent Guilds with similar objects, may be formed in some other large towns. In London new centres for Lectures are now being arranged for. IV. PAMPHLETS The following Pamphlets have been found useful. They are distributed or sold, under the direction of the Guild, at the Lectures: --- "Ought Secularists to wish Christianity to be True?" An Address delivered before the East London Branch of the National Secular Society, by Rev. G. Sarson, M.A., Rector of Orlestone. 2d. (F. Davis, 1, Chapter House Court, E.C.) "The Secular Work of Jesus Christ, His Apostles, and the Church of England." An Address delivered to a Society of Secularists by Rev. S. D. Headlam, (Warden G.S.M.) 1d. "The Church's Mission to the Upper Classes." 1d. or 2s. 6d. per 100. "Forgiveness after Death." The testimony of the Church and of Scripture as to the possibility of Pardon in the Future State: by Rev. J. Ll. Davies. 2d.20 "Papers by Clergymen of the Church of England." In Four Parts. Price of each Part, One Penny. Part I. The Religious Condition of the Nation. The Church in Relation to Poverty. The Church and the Organization of Labour. Part II. The Three Schools of Thought. The Church and Dissent. The Church and Drunkenness. Penitentiaries. Part III. Church Preferment. Forms of Unbelief. Moral Dangers of Factory and Workshop Life. Part IV. Church and Stage. The Communion of Saints. An Address to Working Men. (Women's Printing Society, 21B. Great College Street, Westminster, S.W.) "Christian Socialism" by a Radical Parson, 1d., and also: "Priestcraft and Progress." Sermons and Lectures (on 'Popular and Progress, ''The Glorious Gospel,' "Popular Mistakes about the Church's Teaching,' 'Secular Value of the Church's Catechism,' 'Science and Art' etc. etc.) 2s. 6d. (Post-free from Hon. Sec. G.S.M for 1s. 1d.) (John Hodges, King Williams Street, Strand.) April, 1881 [*Dorcas Society*] "A Cup of Water in My Name." It is now nearly thirty years since, having recovered from an attack of typhus, I went, at the request of a friend, to enquire for her servant, who had been taken in typhus to Parliamentary Road Fever Hospital - a dismal-looking place not far from the St. Rollox Works and smoke, where not a blade of grass was to be seen, only black wooden wards standing each apart within a large enclosedpiece of ground. While being conducted over the place by the Resident Physician (Dr. T.), a Roman Catholic priest appeared on the scene. "What is that man doing here?" I asked. "He is the only Christian visitor who ever comes," was the reply, "and the Protestants are much aggrieved by the neglect of them." I had to see this woman several times, and very soon such an urgent desire for regular visits was expressed that the matter was forced upon me. Clearly, if it was work that ought to be taken up, it was as clear that it should be done by some one who had been prepared for it as I had been. While little more than a child I had been brought through smallpox, and now, but a year past, through typhus. There seemed nothing to speak of [*nor*] to fear. So, too, 4 thought our family doctor. He said if I kept a dress at the hospital (and let it be silk) I would neither take any harm myself nor carry any away. Without further delay I began, and soon found that I was being eagerly watched for. Nurses were on the outlook to get me into their ward first: one young nurse - a Roman Catholic, I remember - intercepting me in this way :- She was feeling very much about a young girl of 14 who she said was dying of typhus. Following her into the ward I found a priest standing near the door; she introduced us, and he speedily taunted me with the fact that no Protestant visitor ventured within the gates, that he and his brother priests only had the courage to enter in. "Well," I replied, "I have come now to see this young girl," and 5 moved up to the head of the ward where she lay. He came too, and as we both stood at the bedside it felt awkward. At last, looking him straight in the face, I said, "Perhaps, sir, you will pray." This took him rather aback; he declined, mumbling something about having no desire to interfere with those who did not belong to him. "O!" I said, "I should think it no interference for a Christian minister to pray for any one;" but he went away, leaving me alone, and this was really what I wanted. I always went supplied with large type texts, and as I went from bed to bed they served to introduce myself and the subject of the text, and very seldom was I repulsed. It may be asked, what use is there in speaking to fever patients? None, certainly, to those who 6 are delirious, or too ill even to think. But, in a large ward containing about 20 people, there are those who are newly brought in, very much alive to the gravity and solemnity of their position; they are face to face with death— perhaps for the first time in their life—and they want, more than they want anything else, to hear the words of life repeated to them. And those who have passed the crisis and are recovering are mostly in a peculiarly sensitive and receptive state of mind. Some of these, with their quickened, vivid realisation of eternal things, having lived without God and without hope, are almost in despair. This was the case with one woman coming out of typhus. The doctors said she was dying of despair, they could do nothing more for her. Could I think of any- 7thing to rouse her? I thought I would try the effect of a few grapes and anything else she might like, and, by-and-by, it did seem that, by means of these little human kindnesses which she could understand, she was able to take in some idea of God's goodwill to her, and of His purpose to save and bless. Attached to each acute ward is the convalescent, and there I was next expected to go. There the convalescents were all gathered in, and a seat placed for me in their midst that I might sit down and read something aloud to them. On one such occasion, just as I was done reading, a nurse from the acute ward came and told me that a man there had asked her who I was. "The missionary lady," she said. I had passed him by as being too ill to be disturbed. 8 When I went back to him I found a fine-looking man, in the prime of life, from Inverness, and suffering from the very worst kind of smallpox. At his desire I sat down and read to him passage after passage out of the Bible - many of them over and over again. For the next few days I was at home with cold, and the first thing I did when I got out again was to go to see this man. His funeral met me at the gate of the hospital. Many very sad things happened during this great outbreak of smallpox; there were so many fatal cases of strong, young men who had either never been vaccinated at all, or not revaccinated. On going into a male ward one day there were four such men all hopelessly ill lying near each 9other. The nurses and many of the patients were deeply affected. I had to stand in the middle of the floor where the dying men could hear, and, as I slowly repeated text after text, I could hear "that again" from the poor swollen lips. They all died in a few hours after. In another ward lay dying a young Roman Catholic woman, entreating me to speak to her - not of Mary, nor of any of the Saints, but of Jesus. And once, but once only, it was an au revoir from a young mother passing away in an ecstasy of joy. She was going to glory! She would see her little lamb! "No," correcting herself, and with hand clasping mine, "My Saviour first." Scenes like these made me feel that there should be some one there always, every day; 10 some one whose sole duty it would be to attend to the spiritual needs of the people. But for a good while there were always difficulties and objections - the chief being that public money could not be used to pay any Protestant because of the Roman Catholics. At length, however, the Directors of the City Mission were induced to look for an agent, and they appointed a medical student from Aberdeen who had recovered from smallpox. For 20 months this excellent young man laboured with great success, and at the end of that time he went away to Central Africa, capped and ordained as the Rev. Dr. Laws, Medical Missionary of the Pioneer Band to Livingstonia. His successor, the Rev. Mr. Hall, has, for the last 20 years and more, been a great blessing 11 to many souls. Very soon he proposed to accompany me to the wards. I had a small, portable, musical instrument, and he had a fine voice, and so began a series of bright little services which go on to this day, and very seldom do we leave a ward without being warmly thanked and begged not to be long of returning. In other parts of the work, too, I soon experienced the comfort of Mr. Hall's assistance, as in the case of two sisters from the West of Ireland. They had run away from home- first helping themselves to GBP3 belonging to their father. Poor things! they had enough of low life in the heart of the Calton, and of teasing hair from morning to night in a factory. It was home they wanted. But the GBP3 was gone. How could they ever face their father? 12 I wrote to propitiate him, and, under Mr. Hall's kindly escort, got them safely on board the Irish steamer. Next came to me such a gush of Irish gratitude, with the most fervent invitation to visit them in their cabin. I should explain that two years after I began to visit at Parliamentary Road Hospital the estate of Belvidere was acquired, and temporary wards rushed up to meet an emergency arising out of greatly increased epidemic. Parliamentary Road was then reserved for smallpox entirely, and my time had to be divided between the two places. Not infrequently I found members of the same family in both places, between whom I was sometimes the medium of communication. In one instance, where the father died of smallpox and the mother of fever, I promised to each 13 that I would look after their boy, which I did by taking him to Mr. Quarrier. Another man told me that he had married a second wife only two months before, and, knowing that the care of his little boy of 8 years would be only a burden to her, he asked me to do what I could for him when he was gone. As soon as this man was buried, I took the boy and the stepmother to Mr. Quarrier, who, after trying in vain to discover any special aptitude in the boy, asked at last, "What would you like to be?" "Jist a lawddie," was the instant reply. Mr. Quarrier was not long of deciding that Canada was the proper destination for this poor little waif, and gave us directions to take him at once to his reception home in the city. But as soon as we got to the pavement - "I'm no gawin. 14 No; I'll no gang," began the little fellow. "Oh! very well," I said, "Mother is coming with me to get some breakfast, and you can go where you like - wherever you please." The effect was just as I expected. He followed us, had breakfast, made no more objections, only asked, "And will I win up here again to see you?" "O yes," I replied, "if you are a good boy; and I will always be glad to see you." With this assurance he willingly set out again, walking in front of us until we got to the thoroughfare of Sauchiehall Street, when I thought he was rather far ahead, and probably meant to disappear up some close, or to give us the slip somehow. So I signalled across the street to a policeman, who at once joined us, and the little man, quick to understand, walked 15 along the rest of the way the very picture of sobriety and propriety. It has not been always easy to find homes for all the orphans and others, for, it must be remembered, there is no convalescent home for fever patients, nor well can be. I was soon confronted with this difficulty. About one old woman who had recovered (and very few old people do pull through) the nurses said, "Oh! Miss T., you will surely never let this old woman go to the poorhouse?" Here was a problem - she had no home and no friends - how was she to be housed, if not in the poorhouse? Who could I expect to take her in just out of typhus? At last I remembered another old woman up about Port-Dundas, whose husband had recently died; she was lonely and cold, especially at 16 night, and her piteous complaint - "I aye think I fin' 'im at my back" - suggested the bringing them together. I got the old woman at Belvidere properly rigged out, and, to the great satisfaction of the nurses, drove her off in a cab to her new home, and, wonderful to tell, these two people hit it off together pretty tolerably for the rest of their days. This same difficulty met me when a girl from the Lock Hospital had to be helped. She was a fresh, innocent-looking girl of 19. The child of parents who had never been married, she ran away from them, and landed herself on the streets of Glasgow friendless and penniless. For four months she had lived this terrible life, and as she lay on her bed of fever she was horrified to think of it, and begged me to help her, saying 17 she would do anything or go anywhere I liked. I asked Dr. R. if he would have her isolated for a fortnight, for unless he could promise this it would be useless for me to think of doing anything. A most troublesome request - there was no provision for anything of the kind. However, it was done, and I then took the girl to the Shelter in Hill Street, which she left at the end of a year, with a new character, to begin a new life in a new situation. But a more difficult case came next. Dr. R. stopped me one day on the grounds to say that an orphan boy of twelve years, whose father had died of typhus, was to be dismissed next day. Could I find some place for him; he must go next day. "O," I replied, "this can't be managed in a day; you must keep him 18 where he is until I'm ready." On the way home that night I called on two kind old women who had brought up a family of orphan nephews, one of whom only now lived with them; he was a lad of eighteen or so, called Ritchie. On the first mention of the thing they said, "Ritchie'll no alloo't." I saw the tables were turned. Ritchie, the wage-earner, was now the master of the house. It was clear I must find what I wanted elsewhere, and a weary, fruitless search it was for some days, till at last a motherly woman, who had one little boy of her own, was moved by my story to say that she would take my boy if I would supply bedding and blankets. This I gladly did, but when I took him to this places, prepared as I thought, it was to learn that the man of the house had 19 changed his mind, had made his wife take back to our house all my things, and refused to admit to his house anyone straight from the Fever Hospital. So here was I, late in the evening, with this boy on my hands. What could I do but go back to the two old women. I told them to tell Ritchie from me that he had been an orphan boy once himself, that neither he nor they would have had a roof over their heads many a time but for me and my sisters, and they must take my boy. This, with the poor little boy sitting there rejected by everybody, won the day. Yet another. On entering an enteric ward one day I was surprised to see a young man back to bed whom I had seen up and going about repeatedly. That morning he had a letter from his landlady refusing to take him in 20 straight from Belvidere, and he did not know what to do. He was an engineer, and had t take care of a younger brother, who was still in his apprenticeship. Just a few days before he was taken to the hospital he had spent all his money in paying up for himself and his brother all that was due to this landlady, and now, when he felt unable to begin work without a fortnight's rest in the country, he had not a penny. I said, "You must not lose heart like this. I can lend you money. How much will you need?" "£4 or £5," he said. He got it, along with my address, but when weeks and months passed I thought I would never more see my man nor my money either, when one day he appeared, and, with great pride and pleasure, repaid every sixpence he owed me. 21And now, if I am not to omit altogether an important part of the work, I must go back to the spring of the first year. It was about this time Dr. R. told me that there must be clothing got somehow for the patients when they left the hospital. Many of them came in with nothing more than the blanket of the van wrapped about them, and when they had to return to their miserable homes it was in the van again nude as when they came. He showed me a room which he had got shelved all round for the reception of Dorcas garments which Miss Clugston had at one time kindly sent, but these supplies had ceased, and the shelves were empty, and it was not legal to give away clothes out of the rates. Very averse was I to move in this. It could 22 not to be done without much speaking, and it felt as if the sweetness of my quiet work would escape in the telling of it; but, when I could no longer bear what was going on, I did set forth to tell what was wanted, and in the winter of 1870 was formed a Dorcas Society for the Fever and Smallpox Hospitals. We had gone on for about 7 years, when, by the requirement of the Health Act, another hospital arose for the Burghs of Partick, Maryhill, and Hillhead. Up to that time the patients of this burghs had all been treated in the City Hospitals, and we saw no reason why they should not continue to participate in the benefits of our Society, and, two years later, when the Govan Combination Hospital was built for the various burghs over there, we included them also, so preventing need 23 less multiplication of societies, with its attendant waste of money. It may be thought rather outside the legitimate work of a Dorcas Society to supply Scripture texts for the wards. But as I first saw the great, dark, bare walls at Parliamentary Road, they looked so utterly desolate that I lost little time in getting large-type, cheap-paper texts pasted up. These were well enough for the temporary place, but when the beautiful wards of the permanent hospital were ready, I asked and obtained permission to have all the principal spaces reserved for me to use in this way, and, without stint by the ladies of the Dorcas Society, carte blanche was given to procure the best that could be got. So, on both sides of each ward, in clear, large 24 type, are always to be seen the words of truth and love and life, and we have had many testimonies from both men and women as to the unspeakable comfort these have been to them. It would seem, too, as if their voice at times is heard by those who in delirium are heedless of all other sounds. Interesting and touching was it to watch a woman when, not long laid on her enteric bed, her eye feel on "He that heareth My word, and believeth on Him that sent me, hath everlasting life, and shall not come into condemnation, but is passed from death unto life." The words "whispered low and sweet" to her disordered mind, and she sang them away to herself all through her illness, until her spirit was caught hence -leaving the ward as if filled with the 25 echo of the "new song" she had apparently gone to take up. The walls of the Burgh Hospitals are also hung with these texts. It is rather a slight connection we have with these distant hospitals, but as far as possible, by correspondence and occasional visits, we keep in friendly, sympathetic touch with the various matrons, not forgetful of their peculiarly isolated position. As a Dorcas Society we have now been in existence for 27 years - 27 years of happy, harmonious work - and while it is true that no other lady goes to the hospitals but myself, it is also true that never has any one been more heartily, more kindly backed up than I have been. The work has been full of compensations in the warm friendships it has brought me with 26 Dr. E. Blackwell No. 1 JUNE 1902. THE WOMEN STUDENTS' MEDICAL MAGAZINE EDITORS. G.HAXTON GIFFEN, F.R.C.S.I., D.P.H., Camb. VIOLET A. PENROSE COGHILL, M.B. Edin. Published thrice Yearly, in the beginning of June, November, and February. Annual Subscription - TWO SHILLINGS, Post Free. Published by WILLIAM BRUCE, 54 and 54A Lothian Street EDINBURGH.H. HILLIARD & SON, Surgical Instrument Makers, 7 Nicholson Street, EDINBURGH. (ESTABLISHED 1824.) STUDENTS purchasing their Requisites for the various Practical Classes from us may rely upon getting them of correct Pattern and Best Quality, and at Moderate Prices. PRICE LISTS ON APPLICATION. MEDICAL PRELIMINARY AND OTHER UNIVERSITY EXAMINATIONS. Miss ETHELWYN LEMON, M. A. Hon, Classics, Edin. and Oxon. Mods., Coaches for above Examinations Privately and in Classes during Winter and Summer Sessions and Long Vacation. Class-Room - The HALLS, 4 MARSHALL STREET. Address - c/o HALLKEEPER. TYPEWRITING. MEDICAL and General Offices - 56 Lothian St., EDINBURGH. Miss WEMYSS has made a Specialty of Medical Work in all its branches during the past five years, and Writers can depend on accurate and intelligent treatment of their MSS.CONTENTS. Introductory Letter from ELIZABETH BLACKWELL, M.D. … PAGE 1 An Account of Hospital Work in Ludhiana, by M. ROSE GREENFIELD … 2 A Case of Purpura Haemorrhagica, reported by A. SUTCLIFFE … 5 A Case of Bright's Disease, reported by MARION MACKENZIE … 8 Some Observations on the Urea Treatment of Tuberculosis, by FLORENCE PRICE … 10 Notes of Leprosy and its Treatment, by CAROLINE TWIGGE … 11 Development of Mammalian Heart as an Illustration of Theory of Recapitulation, by O'Nera A. Merritt … 13 Medical Study in the University of Calcutta, by ELIZABETH M. CARDOZO … 17 The Ceylon Medical College, by CLARIBEL F. VAN DORT … 19 On the Recording of Anatomical Abnormalities, by V.A.P. COGHILL, M.B. … 23 Chloroform Narcosis … 25 Editorial Notes and News … 28 DIPLOMA IN PUBLIC HEALTH. A Complete Course of Instruction, qualifying for Edinburgh, Cambridge, Glasgow, or Dublin, is given at Messrs R.R. TATLOCK & READMAN'S LABORATORIES, 4 LINDSAY PLACE, EDINBURGH. CHEMICAL LABORATORY WORK, By G.H. GEMMELL, F..C, F.C.S. PRACTICAL BACTERIOLOGY, Specially designed for Public Health Students, By J. TAYLOR GRANT, M.D., B.Sc. (Public Health), M.R.C.P.E PRACTICAL SANITATION, SANITARY LAW, & VITAL STATISTICS may be taken in the City or District. Full particulars and advice on application to Mr G.H. GEMMELL, Public Health Laboratory, School of Medicine, 4 Lindsay Place.CONTENTS. PAGE Introductory Letter from ELIZABETH BLACKWELL, M.D......................................................1 An Account of Hospital Work in Ludhiana, by M. ROSE GREENFIELD...........................2 A Case of Purpura Haemorrhagica, reported by A. STUCLIFFE.........................................5 A Case of Bright's Disease, reported by MARION MACKENZIE........................................8 Some Observations on the Urea Treatment of Tuberculosis, by FLORENCE PRICE..10 Notes on Leprosy and its Treatment, by CAROLINE TWIGGE............................................11 Development of Mammalian Heart as an Illustration of Theory of Recapitulation, by O'Nera A. Merritt..........................................................................................................................13 Medical Study in the University of Calcutta, by ELIZABETH M. CARDOZO..................17 The Ceylon Medical College, by CLARIBEL F. VAN DORT...................................................19 On the Recording of Anatomical Abnormalities, by V. A. P. COGHILL, M.B.................23 Chloroform Narcosis..........................................................................................................................25 Editorial Notes and News.................................................................................................................28 DIPLOMA IN PUBLIC HEALTH. A Complete Course of Instruction, qualifying for Edinburgh, Cambridge, Glasgow or Dublin, is given at Messrs. R. R. TATLOCK & READMAN'S LABORATORIES, 4 LINDSAY PLACE, EDINBURGH. CHEMICAL LABORATORY WORK, By G. H. GEMMELL, F.I.C., F.C.S. PRACTICAL BACTERIOLOGY, Specially designed for Public Health Students, By J. TAYLOR GRANT, M.D., B.Sc. (Public Health), M.R.C.P.E PRACTICAL SANITATION, SANITARY LAW, & VITAL STATISTICS may be taken in the City or District. Full particulars and advice on application to Mr. G. H. GEMMELL, Public Health Laboratory, School of Medicine, 4 Lindsay Place. ADVERTISEMENTS. BAILLIERE, TINDALL, & COX'S NEW MANUALS. ROSE AND CARLESS'S SURGERY. Fourth Edition. With new up-to-date material. New Illustrations, new Plates, &c. Price 21s. net. "It is the best Manual of Surgery for all students." - Lancet. STEWART'S PHYSIOLOGY. Fourth Edition. Corrected and Revised. New Illustrations, Coloured Plates. Price 15s. net. "It is one of the very best English text-books." - Lancet. "We do not know of one that comes up to the ideal text-book as does Professor Stewart's volume." - British Medical Journal. MACNAUGHTON - JONES'S DISEASES OF WOMEN. Eighth Edition, Revised and brought up to date. With 28 new Plates and 640 Illustrations. Price 18s. net. MENSTRUATION AND ITS DISORDERS. By ARTHUR E. GILES, M.D., B.Sc., F.R.C.S., Surgeon, Chelsea Hospital for Women, Just out. Price 2s, 6d. net. ROBSON AND MOYNIHAN'S DISEASES OF THE STOMACH AND THEIR SURGICAL TREATMENT. Just out. Profusely Illustrated. Price 15s. net. LESSONS ON MASSAGE, By Mrs Margaret D. Palmer, Manager of the Massage Department and Instructor of Massage to the Nursing Staff of the London Hospital. 258 Pages, with 106 Illustrations, mostly original. Price 7s. 6d. net. MAY'S DISEASES OF THE EYE. Second Edition. 13 Coloured Plates, 275 Cuts. Price 8s. 6d. net. This book will be found to have covered all that is essential to Students and Practitioners in this branch. It is the cheapest, best illustrated, and most modern work on the subject. PEDDIE'S PHYSICS. Designed for University and Medical Students. New Edition for Elementary and Advanced Students, Price 7s. 6d. CAMPBELL CLARK'S CLINICAL MANUAL OF MENTAL DISEASES. Profusely Illustrated. Price 10s. 6d. THE POCKET GRAY, OR THE ANATOMIST'S VADE MECUM. 20th thousand. New Edition, Revised by C. H. Fagge, M. B., M.S., F.R.C.S. Price 3s. 6d. net. ANCIENT GYNAECOLOGY, Its History and Progress from the Earliest Times. By W. J. Stewart Mackay, M.B., M. Ch., B.Sc. Price 7s. 6d. net. GEMMELL'S CHEMICAL NOTES AND EQUATIONS, INORGNIC AND ORGANIC, FOR STUDENTS. Price 5s. ''Will save the student much time and purely mechanical labour.''-Pharmaceutical Journal. VEST-POCKET MEDICAL DICTIONARY. The handiest and best of the smaller Dictionaries. Including Pronunciation of all the Ordinary Terms used in Medicine and Collateral Sciences. By Albert H. Buck, M.D. 529 pp., bound roan. Price 3s. net. LONDON: BAILLIERE, TINDALL, & COX, 8 HENRIETTA STREET, STRAND. The Women Students' MEDICAL MAGAZINE. Vol. 1. June 1902. No. 1. Rock House, Hastings, Sussex, April 1902. My Dear Miss Coghill, -- In answer to your friendly request for a few words of greeting from me in the first number of the Women Students' Medical Magazine I gladly respond, and wish ''God speed'' to my young consœurs of the medical profession. I heartily wish for them in the future that satisfaction with a medical career which I myself feel at the end of a long and active medical life. During the many years that have elapsed since I graduated as a physician in 1849, I have fully realised the important work that a well-educated and intelligent woman physician can render to society. As human beings are composed of mind and body, the true physician always takes this double aspect of a patient into account, and especially as a family physician, this moral as well as physical aspect of our profession comes into play, and it is as a family physician rather than as a specialist (guiding the children as well as the adults) that the medical profession has seemed to me of special importance to women and to the ''State''. I trust, therefore, that whilst our women doctors are, as you say, ''carefully recording observations on cases or other material and recording them in a scientific manner,'' that this double aspect of all rational life may be remembered, and no research carried on which violates that moral kinship which links together all ranks of living creatures. As that enlightened physician (John Garth Wilkinson) said long ago in writing of the true physician:- ''There is scarcely a case in which he (the physician) should not do something actual, besides the administration of drugs, for2 THE WOMEN STUDENTS' MEDICAL MAGAZINE. the sick organism expects to be handled. It proclaims to us what an artistry should be cultivated by those who practise Medicine; what tact should electrify their fingers; what resolve should vertebrate their words; what cordials should drop from their mouths; what airs of assurance should surround them, and how ease and cheerfulness should radiate from their presence as they move from bed to bed. They must verily believe that Medicine is the daughter of Heaven, and that they live to be inspired and to inspire. What the physician should be I dare not attempt to sketch. But I see that already he is called out of the ranks as the most humane man of his time. I see that he wants the largest faith with the largest science; gentleness and sternness also moulded together, as the lion with the lamb. Nor can heroism, using all the rest as a resource, be dispensed with, to the very brink of death, for while there is life there is hope. Perhaps without attempting more, we may sum him up in saying that he should be the model of the health of the age." May these noble words, written long ago, inspire you, my brave young friends, as you enter upon your medical career, so that you may regard your life work, not as a trade, but as the noblest calling of life. This is the earnest hope of your sincere well wisher, ELIZABETH BLACKWELL, M.D. CHARLOTTE HOSPITAL, LUDHIANA, PUNJAB, 17th February 1902. DEAR DR GIFFEN, ---You ask me to write a short article on the hospital work I and my colleagues did here before ever any medical woman had been in Ludhiana. That carries me a long way back. It was in 1875 that I arrived here, and the sufferings of the women appealed to me at once. Though not in any sense "qualified", I had to use common-sense and my little medicine chest to the best of my ability, for there was no Zenana Hospital in the whole of the Punjab, and the women were being maltreated by their own people to a terrible extent. It was May 1881 that we opened our first Dispensary for Women and Children, "for Jesus' sake," and it was then almost a new thought even in missionary circles that women needed separate treatment or would come to a place set apart for them. I wanted to use this as a means of telling them the Gospel, and a fixed time and place facilitated this. Not having a medical education, I had to feel my way along by the help of books, and experience taught. I knew the Punjabi names for many illnesses long before THE WOMEN STUDENTS' MEDICAL MAGAZINE. 3 I knew the Latin ones, and was more or less successful in treating them too! By 1883 our register showed over 8,000 attendances, and our tiny courtyard was often full to overflowing. The noisy crowd could hardly be kept in order by the Biblewoman who sat and read to them. One of the great difficulties in healing them was in getting our orders carried out, and one has to resort to stratagems to get directions obeyed. Something they did believe in was used to lead up to what they did not understand. A leaf of a pepal tree over a fomentation fell in with their love for the sacred tree, and made a cheap and effectual waterproof covering. Strict injunctions that the medicine must not be given on an empty stomach secured that the patient should be fed at least twice a day, and an assurance that milk would agree with our drugs reconciled them to give it a trial at least. At that time the use of water as a mean of cleansing sores was almost unknown, and the most abominably filthy messes were plastered over foul ulcers to keep the pus in. To offer to wash a wound was enough to drive some of the patients away---their one fear was that the water should get into the sore with fatal results! But when you advised their boiling a handful of nim leaves and washing with the decoction, they nodded their heads approvingly and thought you a wise woman. Village woman fled from the stethoscope as if it were a lancet; to offer to syringe your patient's ear was to ensure a headlong flight downstairs! Twenty-one years have changed all that as far as the city women are concerned. Not a few families always come to us for even trifling ailments, and bring their little ones to have abscesses opened or ears syringed as a matter of course. Many mothers have learned the value of a "polsit" (poultice), and not infrequently a girl with a tendency to phthisis is brought with a request that we would "dúrbin lagáo," "apply the telescope" (their name for a stethoscope), and see what is wrong with her lungs. It is only now and then that a village woman shows fear at being examined and has to be reassured by the other patients. Several small children come bravely for their own medicine and tell all their little ailments in childlike confidence which is very sweet. I opened the Charlotte Hospital in 1889, really for the sake of the village women. It was so hard to let them go away with only a little medicine when they needed feeding and nursing. Our aim has been not to make them conform to our idea of what a hospital should be, but to make the hospital suitable to their needs, so that in matters of food, clothing, and arrangements we have as far as possible studied their habits and likings, and everything has been done to give them confidence.4 THE WOMEN STUDENTS' MEDICAL MAGAZINE Such funny little ways they have! One can only drink from a brass vessel, another must not wear blue cloth, while nearly all strongly dislike the wire wove mattresses and prefer the native string woven beds. "Let every one of use please his neighbor for his good unto edification" is, I think, a good motto for a medical missionary, for she will surely find many things not at all like an Edinburgh Hospital, and may fret her own soul and sorely worry her patients in trying to have things just so. As an old missionary I might sum up my experience in these words of advice to my young sisters just starting hospital work. First, get your patients in-- often a difficult task. The proverbial slip between the cup and the lip is nothing to the chances of slips between the dispensary and the hospital door. A crying child inside may be sufficient to determine your patient that to-morrow will be a much more suitable day to begin treatment, and that to-morrow, alas, may never come. Careful angling in the dispensary, keeping the patient under outside treatment for a time till she gains confidence, may at last bring her in for that more complete treatment you are longing to give her. Second, keep your patients, and to do this will need tact. Make them happy, if you can. Change the form of a disagreeable medicine rather than force it down against their will--your resources should be equal to this. Listen to the long stories of bygone illnesses even if you think the present condition does not depend on them. But if they want to go, let them depart. An hospital that gets a name for keeping people against their will is likely to have empty beds. It is of course very trying to have an epidemic of taking leave in the ward--to go round one morning and hear from one after another woeful tales of sick children at home, or granny's sudden death, of a still more sudden wedding just arranged which makes it imperative that the speaker should go home to-day ; but any attempt at pressure is bad for the others--they may be speaking the truth, they may only by trying to see what you will do, but anyhow "urgent private affairs" has to be allowed as a sufficient plea. Third, treat you patients--this would seem obviously what the medical missionary is here for ; and yet sometimes I think we are tempted to treat the disease rather than the patient, and not to realise how much the mental, moral, and spiritual condition needs attention, and what may be done towards transforming their lives during even a brief stay in hospital. Sunshine treatment--the full light of the glorious Gospel--the healing leaves of the Sun of Righteousness--the kindly atmosphere of a Christian home--try for that, and you will see marvellous things wrought, healing for both body and soul. --Yours truly, M. ROSE GREENFIELD. THE WOMEN STUDENTS' MEDICAL MAGAZINE 5 A Case of Purpura Haemorrhagica Reported by permission of Dr ALEX. BRUCE. Clinical Clerk, A. SUTCLIFFE. E. W., aet. 27, was admitted to Ward 27 on 23rd January with the following history. On the morning of that day, during the process of dressing, the patient suddenly noticed the saltish taste of blood in her mouth, and on expectorating found the sputum tinged with bright red blood. She then noticed small red marks resembling flea-bites on her arms, whilst the legs were covered with very small pin-pricks. On the upper arms and elbows patient also noticed several marks of a faint bluish colour resembling bruises. The patient felt in robust health and was able to perform her ordinary work. The bladder and rectum were emptied during the day ; in neither case was there any sign of haemorrhage. The bleeding from the mouth still continuing, the patient was sent to the Infirmary the same evening. State on Admission.--There was a conjunctival haemorrahage of the right eye, whilst scattered irregularly over the forehead and face were spots varying in size from a pin-head to about 1/8 of an inch. Most of these were of a bright red colour, although several were duller, and a few were almost black. On the left temple was a bluish-black mark resembling a bruise. On everting the lips, small crusted spots were seen. The tongue presented a somewhat rugged appearance, showing small areas of a purple colour, whilst anteriorly on the dorsum was a small patch from which blood was then escaping. Towards the back of the tongue there were two smaller areas of haemorrhage. The roof of the mouth showed small spots dotted irregularly over its surface. These were also present on the inner side of the cheeks and in small numbers on the soft palate. There was no haemorrhage from the gums. Over the neck, thorax, and abdomen, spots of various sizes were irregularly scattered, those on the abdomen being fewer and smaller than in the other regions. The nature of the spots was in all cases the same. They did not project beyond the surface of the skin, did not disappear on pressure, nor were they surrounded by any zone of hyperaemia. The blood was of a very bright red colour when drawn. Haemorrhage was profuse from a prick of the ear, and did not case for fully half an hour. On microscopical examination the red blood corpuscles were found to be normal in6 THE WOMEN STUDENTS' MEDICAL MAGAZINE. number, size and shape. The leucocytes numbered 18,000 to the cmm., and on staining showed an increase in the polymorpho- nuclear variety. There was a total absence of blood platelets. The haemoglobin was 80 per cent. Bacteriological examination of the blood revealed a few colonies of staphylococci, most probably of the staphylococcus epidermidis albus; there was no other apparent growth. No drug was administered immediately on admission, but from the first the patient was kept as quiet as possible, being put on cold milk diet and ice being given to suck. Next day the suggestion of the use of adrenalin chloride was made, but this drug was not prescribed owing to its power of raising blood pressure, which would tend to increase the haemorrhages. The styptic turpentin was therefore given in capsules of 5 minims every four hours. Owing to the diminished coagulability of the blood (shown by the difficulty experienced in stopping bleeding from a prick of the ear), calcium chloride in 15 grain doses was given every four hours in a mixture of simple syrup and water. On the second day after admission there was marked haematuria, and an enema caused a considerable amount of fresh blood to be returned with the rectal contents. During the first few days the haemorrhages increased in severity, invading the surrounding tissues of the eyes, and occurring from the nose and posterior pharyngeal wall. The patient was now much paler in appearance. On 29th January the respiration began to be of a sighing character, giving rise to great anxiety as to the possibility of internal haemorrhage. The patient was somewhat collapsed with a pulse rate of 112, and as no ordinary stimulants in the shape of alcohol or ammonia could be given. musk in pills containing 4 grains each was administered three times a day. For one day the patient suffered from a most severe vertex headache, which was relieved by the application of iced cloths, and did not again recur. The administration of the musk was followed by most satisfactory results. The sighing character of the respirations gradually passed away, and by 2nd February was entirely absent. The patient herself felt stronger, whilst from this time the amount of blood passed in the excreta became gradually less. There were still a few new cutaneous haemorrhages appearing every day, but on 6th February no fresh spots could be discovered. Eight days after admission menstruation occurred at the usual period. It lasted three days, the amount lost not being any greater than at the customary periods. On 7th February the urine was only slightly smoky, and the musk pills were stopped. A microscopical examination of the THE WOMEN STUDENTS' MEDICAL MAGAZINE. 7 blood at this date revealed 9,800 leucocytes to the cmm., the differential count giving the following result :- Polymorphonuclear - - 85 per cent. Lymphocytes - - - - - - - 10 " Eosinophiles - - - - - - - - 2 " Mononuclear - - - - - - - 3 " The red blood corpuscles numbered 2,200,000, whilst the haemoglobin was 46 per cent. On 11th February, thirteen days after admission, no trace of haematuria could be found. The haemorrhage from the mouth had entirely ceased, and most of the cutaneous spots had altogether disappeared. Around the eyes, however, and in some of the larger spots there was still a faint bluish-black discoloration. The turpentin and calcium chloride was now discontinued, and a tonic containing iron and arsenic was prescribed, the patient now being allowed a more stimulating diet. The last examination of the blood on 10th March showed an increase in the number of red blood corpuscles to 3,800,000, and in the haemoglobin to 70 per cent. After remaining six weeks in hospital the patient was dismissed on 12th March, having entirely recovered.8 THE WOMEN STUDENTS' MEDICAL MAGAZINE. A Case of Bright's Disease. Reported by permission of Dr BRUCE. Clinical Clerk, MARION MACKENZIE. ELIZABETH G., aged 27. Occupation.---A compositoress. Date of Admission to Royal Infirmary, Edinburgh, 4th November 1901, under care of Dr Bruce, Ward 27. Complaint.---"Dimness of vision, headache, sickness, and swelling of face, legs, and ankles." Family History.---Nothing important. Previous Illnesses.---Measles as a child. Smallpox seven years ago. Hæmorrhoids five years ago, operated on and cured. Present Illness.---For the last two years the patient has suffered very severely from headaches. About six months ago the patient found that she became very thirsty, and was never able to satisfy her thirst. This was particularly distressing for about six weeks, at the end of which time she noticed that her ankles and legs were swollen. She states that she did not notice that she passed more water than usual. She was also unable to retain her food, and vomited even after taking a drink of water or soda-water. She consulted a doctor, who told her she must give up work and go to bed and be on milk diet. She remained in bed eight weeks, but the vomiting still continued. She went in to the country for a month, where she improved and felt stronger, and the vomiting was less persistent, but on coming home her condition became much as it was before. She managed, however, to go back to her work for a few hours a day for a short time, but had to give it up and spend most of her time in bed till about three weeks ago, when she noticed that she was going blind, so she came up to the Eye Ward, where they recommended that she should come in. General Facts: Present Condition.---The patient is emaciated and anæmic-looking, with a slight yellow tinge about the face, and large dark rings under the eyes. Her eyelids are puffy, but there is no œdema of the feet. She is easily breathless. She suffers from severe headaches and palpitation. She vomits constantly. The vomit is greenish, and contains a good deal of blood-tinged mucus. Her stomach is dilated. Discomfort always after eating. She complains of a sharp shooting pain in the back on a level with the highest part of the iliac crests. She has frequency of micturition, and has to get up in the night to pass water. Her tongue is furred, and breath very fœtid. She has dimness of vision, and THE WOMEN STUDENTS' MEDICAL MAGAZINE 9 on ophthalmoscopic examination there is albuminuric retinitis of both eyes. Pulse.---Rate 96. Rhythm.---Regular in time and force. High tension and thickened artery wall can be felt. Heart.---In the mitral area, first sound is reduplicated, a blowing systolic murmur accompanying the second half; a curious chirping sound is heard, distinctly superficial and exocardial; cardio-pulmonary murmur. The second sound is accentuated markedly in all areas. Urine contains albumen (.4 per cent.). Sp. grav., 1010. Reaction acid. A trace of blood Granular and epithelial casts. Urea.---3 3/4 grs. per oz. Diagnosis.---(1) Arterio-sclerosis, which is purely a secondary condition following the renal mischief; also hypertrophy of left heart. (2) Chronic interstitial Bright's disease, with some parenchymatous change, and uræmia. (3) Mitral incompetence? Dr Bruce distinctly told the clinique that the valves would be found quite competent, notwithstanding the presence of a soft systolic murmur. Further Notes.---The patient gradually became worse. The sickness continued. On 20th November she developed symptoms of pericarditis, and had a severe unbearable pain in the left infra-clavicular region, where friction could be heard. Hot fomentations were applied, and amyl nitrite seemed to relieve slightly. On 23rd November she became very restless, throwing herself about in bed. She said her head felt queer, and that she had been "sailing all day." On 26th November she was drowsy and much quieter, and slept under the influence of morphia. On 25th November she became delirious, and tossed about the bed all night. At 2 A.M. she was given 1/100 gr. hyoscine, and later 1/6 gr. of morphia, which appeared to quiet her. On 29th November she had convulsions about 2 A.M., and died without recovering consciousness. Post-Mortem.---Valves of heart competent. Both kidneys showed marked interstitial change, also fatty degeneration. Capsules were adherent. Pericardium covered with fibrinous lymph and contained an ounce of blood-stained fluid. Stomach.---Dilated with catarrhal and hæmorrhagic patches. Large Intestine congested and hæmorrhagic.10 THE WOMEN STUDENTS' MEDICAL MAGAZINE. Some Observations on the Urea Treatment of Tuberculosis. BY FLORENCE PRICE. THE treatment of tuberculosis with urea was first brought to the notice of the medical profession by Dr Harper of Nottingham in the Lancet of 9th March 1901. Since then I have had frequent opportunities of watching the progress of the disease under the above treatment. The following are notes taken on a few of the cases in which urea has undoubtedly proved of great benefit. Case 1.---W. W., æt. 56. Has had pleurisy with effusion three times; cough and marked wasting, with the usual temperature of 101°, and physical signs of advanced pulmonary tuberculosis. Patient was put on urea six months ago, and a gradual improvement has taken place up to the present time. The disease is now apparently arrested, the temperature being normal and cough gone; the patient has increased 10 lbs. in weight. Case 2.---Girl, æt. 14. Has had pleurisy with effusion. Suffered from cough, increasing weakness, night sweats, and had evening temperature; well-marked physical signs of phthisis at left apex. Patient was treated with urea, and her condition rapidly improved; she has now been in good health for eight months. Case 3.---E. B., æt. 3. Noticed to be lame about a fortnight before medical advice was sought. When patient was examined, marked symptoms of hip joint disease were discovered. A consultation on the case left no doubt as to diagnosis. The parents were strongly advised to bring the child into hospital, but they refused to do so. Patient was then treated at home with urea, and a complete recovery ensued. The usual dose to commence with is 20 grs. thrice a day, This is gradually increased up to 1 drachm or more thrice daily. I regret that I do not know whether the excretion of urea in the urine was increased or not in the cases I have mentioned above, but Dr Harper found on examining the urine of two of his patients an increase in one and no increase in the other. It is found that patients take the drug well, the digestion being in no way interfered with. THE WOMEN STUDENTS' MEDICAL MAGAZINE. 11 Notes on Leprosy and its Treatment. BY CAROLINE TWIGGE. THE tubercular or nodular form of leprosy is comparatively rare, and it presents characters so various from the usual form of the disease that it merits, in the opinion of some writers, a different name altogether. In these notes, therefore, the remedy mentioned corresponds only to the anæsthetic form---the maculo-anæthetic leprosy of Hansen and Looft---and the term leprosy is restricted to this disease. Secale cornutum, the poisonous fungus of ergot, possesses in its pathogenesis all possible elements of similarity to leprosy. Whether this similarity renders ergot the curative remedy it is not necessary to argue. It is a matter for practical demonstration. Compare the "formication" stage of leprosy with the crawling sensation under the skin in ergot poisoning, variously described by Wagner, Schamm, Dreyssig, and others. Trophic changes may appear very early in leprosy,* frequently articular changes corresponding to those seen in Tabes dorsalis † Tuczek on the other hand finds in spasmodic ergotism sclerosis of the posterior columns of the cord implicating the root zones as in tabes. ‡ The mutilating of leprosy runs a parallel if somewhat more protracted course to the ulceration, gangrene, and loss of parts in the symptoms of ergot poisoning. § Noel in Histoire de l' Acad. des Sciences, Ann. 1710, p. 80, records a case where "no blood followed the separation of the limb by gangrene." It is impossible to go further into details here. These remarks serve merely to draw the parallel roughly. The following are records of cases sent home by C. S. Daraund, M.D., in 1896, which were treated by him during the previous two years in Hardu, Central Provinces:--- I. April 19, 1894.---Krishn, Brahmin, æt. about 30. Has had leprosy five years. Nose and lips swollen. Hands and feet affected. Disease well advanced into the second stage. One toe much ulcerated, looks almost ready to drop off. May 17.---Ulcers entirely gone. The toe that looked ready to drop off is well. February 1, 1896.---The patient remains here, and since May 17, 1894, has no return of leprosy. Has taken no ergot since 1894. * Osler. † Hansen and Looft. ‡ Arch. f. Posychiat, 1882. § Read, Hensinger, Perrault. 12 THE WOMEN STUDENTS' MEDICAL MAGAZINE. II. February 21, 1894.—Babu, Rajput, æt. 28. Leprosy seven years. Right hand—Thumb drawn out of shape. Two joins off each first and second fingers. One each off ring and little fingers. Third and fourth fingers at middle joint stiff. Left hand—Thumb twisted similar to right. Fingers all flexed at second joins, but intact except forefinger, which has lost the first phalanx by absorption. Feet also affected; great toe of either foot partially absorbed. Ulcers about the joints of several toes. April 2.—Both feet well. Ulcers on hands where he has burnt them. June 20.—Well to all appearances. This man has not been seen since the last report, June 1894, so it is impossible to say whether the disease has become active again or not. III. October 24, 1895.—Dariyas, æt. 40. Toes nearly all gone from both feet. The surfaces are ulcerated, bleeding slightly where irritated with the shoe, and suppurating. Very weak, can scarcely walk. Fingers much swollen and black—some phalanges off. Ulcers on various parts of the body. December 20, 1895.—Feet entirely well, fingers much better, ulcers all healed. Still under observation. These were among the first cases treated with ergot. Space does not allow others to be quoted, but in every one where treatment was continued fifteen days, marked improvement followed. The treatment in all cases was the same. No special attention was paid to diet or hygienic surroundings, nor was their massage or any other adjuvant. ℞. Extract. Ergot. Liq. . . . . . 3i. Spir. Rectificatus . . . . . . 3ii. Aquæ . . . . . . . . . . 3iii. M. For internal use 30m. of the mixture to be given once daily. The same applied to ulcers on lint. This course of treatment should be continued six weeks to two months. Dr Daraund, writing from Missourie, N.W.P., March 1902, further confirms the efficiency of his treatment. "Further experiments are necessary," I quote from his letter, "to determine the best dilution in which to administer ergot. Complete and permanent cures may be expected when the disease has not passed beyond the first stage, and often, too, when anæthesia has taken place." THE WOMEN STUDENTS' MEDICAL MAGAZINE. 13 Development of Mammalian Heart as an Illustration of Theory of Recapitulation. BY O'NERA A. MERRITT. THE mammalian heart during its development passes through a number of anatomical conditions which admirable illustrate the theory of recapitulation. This is the tendency every organism (and every organ) has of passing in its ontogeny (or individual development) through some or all of the stages in which it existed in its phylogeny, or type evolution. The facts of development given apply to all mammals, the times to the human embryo. At the thirteenth day of fœtal development there appears in the cervical region two straight pulsatile tubes, which on the fourteenth day unite in median line to form one pulsatile tube. This tube develops into the adult heart after acquiring a connection with blood-vessels anteriorly and posteriorly. This potential heart is single from the first in amphibians and elasmobranchs, but originates by the union of two lateral tubes in mammals, sauropsida (birds and reptiles), and teleosts. This early heart consists of two layers, an inner of endothelium and an outer of muscle. The heart is situated in a pericardium to which it is attached anteriorly and posteriorly, but the remainder is free. At first the heart is connected with aorta in front and with omphalo-mesenteric veins (from yolk sac) behind. Hence the blood flows forwards in this ventral vessel, which is a union of three parts—aorta, heart, and yolk vein. It is obvious that at present the heart is part of a ventral vessel, but a part differentiated by its superior contractile power and by its enclosure in a pericardium. That the heart is only a part of a blood-vessel is a fact to be borne in mind when considering not only the development but also the physiology of heart. At this stage the heart plus aorta and omphalo-mesenteric vein is comparable to the ventral vessel of amphioxus, in which the blood flows forwards by contractions of the whole vessel or only an anterior part. If there is a localised pulsatile portion in this lowest of vertebrates, the resemblance to fourteenth day human heart is very striking. Some have thought that this early condition of vascular system bore a marked resemblance to that of an annelid in the presence of a longitudinal ventral vessel and a lacunar rather than a capillary circulation. The pericardium grows in all directions, but especially transversely, but it does not increase in length as rapidly as the heart.14 THE WOMEN STUDENTS' MEDICAL MAGAZINE. Hence the latter, in order to find room for itself, bends to the right and becomes S-shaped (fifteenth day). About this time the heart is divided by constrictions into four chambers, named thus from before backwards—sinus venosus, auricle, ventricle, and truncus. Towards the end of the third week the auricle has much increased in size, and is placed transversely to length of heart. In connection with the truncus there are now five aortic arches This S-shaped heart of four chambers is very like that of the lowest fish— a dog-fish or a lamprey. The lamprey has undoubtedly a less compact heart than the dog-fish, hence appears the more primitive; but as the lamprey is undoubtedly degenerate as well as a primitive fish, it is safer to consider the relation of fœtal heart to that of the dog-fish (an elasmobranch). The resemblance to the elasmobranch heart is striking; in both a median sinus venosus opens into a transversely enlarged auricle, the auricle into a ventricle, and that into the truncus, from which pass outwards five pairs of aortic arches. The mammalian heart is at no time comparable to that of the teleosts fishes, for the heart of the latter has no part homologous with the truncus of the mammalian embryonic heart, the truncus belonging to the heart and becoming finally partly incorporated in it. This is interesting, for the teleosts are a highly specialised group which have branched off from the straight line of mammalian descent. Towards the end of the fourth week the transverse auricle is imperfectly divided into two chambers by the septum superius; at the same time the opening of the sinus venosus is shifted from its median position, so that it finally opens into the right auricle. The arches are being gradually differentiated, some disappearing, whilst other assume a great importance. The third and fourth pairs of arches become the carotid and aorta, so that in this early stage we have two systemic arches, a right and a left. The heart at this time is amphibian, as it consists of a sinus venosus opening into the right auricle, two auricles partly separated (as in salamander), and a single ventricle. The upper longitudinal connection between arches three and four also persists in salamander as ductus botalli. It is to be remembered that the embryonic heart is most nearly related to a more generalised type, such as a salamander, than to a highly specialised type, such as a frog. At this stage of development of the fœtal heart a portion of the truncus is partly divided into two chambers, a division which is also incipient in an amphibian. During the fourth week the sinus ceases to grow, and hence it appears small compared with the auricles which have rapidly increased in size. By the beginning of the fifth week the sinus is THE WOMEN STUDENTS' MEDICAL MAGAZINE. 15 incorporated into the right auricle. The inter-auricular septum, except at foramen ovale, now completely separates the right and left auricles, and a septum has begun to grow down into the ventricle. Only arches three and four and left arch five have persisted. In this early fifth-week stage the heart is reptilian. Here again the resemblance is to the more generalised type rather than to a specialised. In the lizard as in salamander there are ducti botalli. These portions of the aortic arches disappear early in mammalian embryo, but an equivalent part between fourth and fifth arches persists till birth as ductus arteriosus. Two steps now take us to the typical mammalian heart. The right systemic arch disappears, leaving the left arch as the persistent aorta; the ventricle is completely divided into two chambers. These changes are complete at end of fifth week. Owing to the needs of the fœtal circulation, two developmental remnants remain until birth. They are, the foramen ovale and ductus arteriosus. The heart during its development moves backwards. Thus at its first appearance it is in cervical region, but in the adult the apex is situated opposite fifth intercostal space. At birth the heart has not taken up its final position, for the apex is in fourth interspace. No mention has been made of birds; this is because they are a highly specialised side branch of the reptilian stock, and are in no way directly related to mammals. That mammals and birds have diverged in very different directions is shown by the fact that the right systemic arch persists as aorta in birds, but the left persists in mammals. From the above facts we see that the heart of the mammalian embryo passes through stages which are comparable to the state of adult heart in amphioxus, elasmobranch, emphibia, reptilia. We may as well ask, what do these changes mean? Why do parts such as sinus, bulbus, and five arches appear to only to disappear? Are these parts of any use to the organism during the few weeks they are present? The answer to these questions is the theory of recapitulation. These stages are not the result of use, but of a tendency of the organism to epitomise the phylogeny. Thus, in five weeks the fœtal heart passes through many of the stages and has attained a condition of perfection which the race has evolved only through thousands of generations and after thousands of years. This theory of recapitulation has been enunciated as the result of studies in Embryology, Comparative Anatomy, and Palæontology. Each of these sciences suggests recapitulation, but it is only by combining the evidence of all three that recapitulation can be stated as a fact. In looking at the anatomy and development of B16 THE WOMEN STUDENTS' MEDICAL MAGAZINE. every organism this law of recapitulation must be continually borne in mind, for only by realising it can one appreciate the value of the development changes and of the vestigial organs which are so frequent. Knowing the anatomy and development of an organism, it is usually justifiable to deduce its phylogeny, and hence its relation to other groups. On the other hand, one must never forget that every embryo has a special environment which must modify it as much, even perhaps more than environment modifies the adult. Multitudinous facts have made a racial tree for mammals by which it is shown that mammals are descended from a simple generalised reptile, that from an amphibian, and that from a fish. We can deduce the same descent form the heart. but that deduction from development of heart is only trustworthy in so far as other organs point to the same line of evolution. No great laws can be founded on isolated facts, only upon many and various facts, from many and various sources. THE WOMEN STUDENTS' MEDICAL MAGAZINE. 17 Medical Study in the University of Calcutta. BY ELIZABETH M. CARDOZO. I HAVE been asked to give, as my first contribution to the Medical Women's Magazine, a sketch of the principle of medical study in the University of Calcutta. Before I begin my sketch, it would be well, I think, to explain the relation of the women medical students to the University. Women have equal rights with men to qualify for the degrees of M.B. and M.D., but before any one is allowed to commence her studies it is required that she should pass the First Arts Examination. This was, at the time the Countess of Dufferin started the Dufferin Association for female medical aid, a great drawback, as the standard of preliminary education was then not sufficiently high among the majority of the educated women of India. It was found necessary, if Lady Dufferin's charitable enterprise was to be a success, to make some compromise. The decision arrived at was that the Entrance Examination of the Calcutta University or a Preliminary Examination of the College should suffice, and only the Diploma of the College would be open to such. In consequence the greater number of the women have qualified, and are still qualifying for the Diploma of the College, but there are a few who have taken the degree of the University, and are now holding responsible posts under the Dufferin Association, or else set up as private practitioners in the large cities of India. They form, however, a small fraction of the women practitioners in India. To turn to the principle of study which is the subject of my sketch: the academic period consists of five years, each year being divided into a summer and a winter session. The summer session begins usually about the 15th June, and comes to a close on the 31st October, whilst the winter session lasts from 1st November to 1st March. The curriculum of study is based on the same principle as in the English Universities, and so I do not think there is any need to enlarge on it. The great drawback with us in India is the mixed classes, an evil which may would like removed if it were possible. The work in the hospitals is different. All the wards are open to women, but the gain seems very doubtful. They have to take their chances with the men, and being in the proportion of about 1 to 25, they have to push and edge along if they wish to benefit by all that is to be seen and heard in the wards and theatres, and this is but a small item of the evils of mixed classes. 18 THE WOMEN STUDENTS' MEDICAL MAGAZINE. The wards of the Medical College Hospital are divided between two physicians and two surgeons, and the students have to put in six months under each. From there they are sent to the Ophthalmic Hospital for three months to learn the use of the ophthalmoscope and the diagnosis of eye-diseases; three months at the Medical and Surgical Out-patients' Department, with attendance twice weekly at the Dental and Ear and Throat Departments; and six months at the Maternity and Children's Hospital. Besides the usual morning routine of work, the students are put on duty in the Emergency and Admission Wards in weekly turns. There are no evening tutorial classes as here, and I trust this will soon be remedied. A word on the examinations. Apart from the usual class examinations held at the end of the winter session, there are on the whole eight professional examinations held once in twelve months. All the subjects of each examination must be passed at one and the same time. Before a student is allowed to sit for any of the examinations for the degree of M.B. she must first pass the corresponding examination for the Licentiate of the University. The examinations, difficult and tedious as they are, are rendered more so by the resources of the laboratories being inadequate as compared with those here. To add to this is the disadvantage the professors find in keeping pace with the scientific researches and improvements of the day in that distant land. So long as these difficulties and disadvantages exist there will be a steady influx of Indian students to Edinburgh! THE WOMEN STUDENTS' MEDICAL MAGAZINE. 19 The Ceylon Medical College. BY CLARIBEL F. VAN DORT, COLOMBO, CEYLON. IT was at the Edinburgh Medical College for Women that I spent the first year of my medical course, attending lectures, &c., there for one winter and one summer session; then after a couple of years' intermission I continued my work under different conditions and amid other surroundings in the Ceylon Medical College. I may therefore perhaps be excused for endeavoring in the following account to compare the educational advantages and disadvantages of the two Colleges by giving a short account of the College here, and the nature of the work done by the students. The Ceylon Medical College is a mixed College in the sense of there being both men and women studying together within its portals, attending (with few exceptions, such as Midwifery and Practical Anatomy) all the lectures together, sharing the same privileges and restrictions, and observing the same rules and regulations. The College was started comparatively recently (i.e., about thirty years ago) for men students, but about ten years ago women students were admitted for the first time, when two joined, and since then there have always been women students at the College, though the number has at no time been greater than eight, and has even been reduced to three. Of the original eight lady students who studied at this College at various periods, four obtained the Licentiateship of the College, and three of that number proceeded to Edinburgh and there obtained the Triple Qualification, and have now secured posts under the Ceylon Government. The remaining four gave up the study of Medicine here for various private reasons, such as marriage, preference of study in Great Britain, &c. Unfortunately, Ceylon does not present many openings for lady doctors. We have two European ladies with British and Canadian degrees in Colombo, one in private practice, and the other in charge of a small Government Hospital for Women and Children, who seem to do fairly well; but it cannot be said that there is any demand for the services of a lady doctor in preference to that of a man in Ceylon. It is true that a good many of the Moorish women and even some of the Samil women settled in Ceylon prefer having a lady doctor attend on them when they are ill, but they are becoming fairly enlightened in their views, and little of that prejudice and feeling against men doctors prevails in Ceylon as it does in India for example. And as for the native women of the country, the Sinhalese -20 THE WOMEN STUDENTS' MEDICAL MAGAZINE. the uneducated are quite indifferent to any feeling of that sort, and in fact prefer their own native doctors ("Vederalas") to European doctors, whether of the masculine or feminine sex, often only resorting to European treatment when native treatment has failed, and when it is almost impossible to undo the mischief done by the native Vederalas, and the case has become perhaps hopeless! The Ceylon Medical College consists of buildings in blocks, the central or main building containing two class-rooms, a laboratory, and two or three offices, while the adjoining block contains the physiological and pathological class-room and laboratory, with the museum and colonial medical library attached. Then at the back of the premises there are the registrar's office and senior class-rooms on one side, with the students' library adjoining, the men's dissecting- room in the middle; and on the other side the ladies' room, and their dissecting-room, &c. The lecturers of the College are principally physicians and surgeons holding Government appointments, or those who have held them at some period, and are all able men who endeavour to keep the students abreast of the latest improvements and discoveries in science in their lectures. The College is particularly fortunate in having the services of a very energetic and highly qualified registrar, who is also Lecturer on Physiology and Pathology; and it is since his arrival here about a year ago that the College has made great strides in advancement in every respect. The standard of the examinations has been raised, and the rules and regulations revised with the sanction and approval of the General Medical Council in England. Prize (medal) examinations have also been introduced, after donations towards these medals and prizes were solicited and obtained from people interested in the College work. There are four scholarships in connection with the College—two for men and two for women—chiefly for natives, which secures a free course of education for three and five years respectively. The curriculum was similar to that of the Scotch Colleges, but has been raised to that of a University, for the standard has been very greatly advanced, and is being improved session by session. Our Physiology Course, for instance, includes Chemical Physiology and Histology, but also a series of lectures during the summer session on Embryology, which is quite a new departure here, at all events. The advantages which the students here possess are few in comparison with the disadvantages we labour under, but I shall content myself with enumerating a few of the most important of each, in order that they may be contrasted by past and present students of the Edinburgh Medical College for Women with those of their own THE WOMEN STUDENTS' MEDICAL MAGAZINE. 21 Alma Mater. The following are the chief advantages of the Ceylon Medical College:— 1. Moderate fees. 2. Facilities for Practical Anatomy, and hospital practice. 1. The fees are very much lower than in Europe owing to the fact of the College here being a Government institution, and therefore not depending on students' fees alone for its upkeep. In fact, it is possible for a student to study here for five years with a total outlay of only about Rs. 1,070, roughly equivalent to about £72 sterling for all College fees (exclusive of the cost of text-books, living, and so on, of course). The compounding of fee of Rs. 180 per annum is paid in two half-yearly instalments of Rs. 90; then there are other fees, such as entrance fees for the examinations, library fees, &c., which make the total expenditure about the sum I have already stated. 2. (a) Practical anatomical work, and (b) hospital practice. (a) We have been told by those who have had experience in Colleges in Scotland and elsewhere that we in Ceylon are most fortunate in being so well supplied with subjects for dissection, being able to get them at all times of the year, and then being able to dissect (without any unpleasantness at all in our dissecting- rooms) well-injected and prepared subjects. (b) The hospital practice is also very good, for the clinical material is abundant. There is a large General Hospital which we attend (opposite the College buildings) with 400 beds, and there are other hospitals, such as the Hospital for Women and Children under a lady doctor, which the lady students attend, the Infectious Diseases Hospital, the Lunatic and Leper Asylums, where we are allowed to see the cases, and clinical lectures, &c., are given. The disadvantages we have are many, but the most important are the following:— 1. The climate. 2. Difficulty in obtaining books, instruments, &c., at short notice. 3. Lack of requisite physical and physiological apparatus. 1. As regards climate, it is decidedly warm at certain seasons and wet at others, but on the whole not disagreeable. However, it is a climate which saps one's energy, and prevents one from steady application to hard work, which is one of the chief requirements in a medical student We have to work from 8 A.M. to 4.30 or 5 P.M., with a break for lunch, all the year round, holidays excepted, and it is almost impossible to do so in the hot steamy days which we22 THE WOMEN STUDENTS' MEDICAL MAGAZINE. nearly always have without feeling quite tired and worn out on our return from College. I know by experience the amount of work which one is capable of doing in Edinburgh, and I feel quite ashamed of not being able to accomplish the same amount here in Colombo; but it is not possible for women students at all events, as I know to my cost. Even the people of the country, born and bred here, are in the habit of resting during the hottest hours of the day; so that it is not to be wondered at that we feel quite enervated when we have to keep steadily on, from hour to hour, listening to a continuous stream of lectures without pause or rest. 2. It is a great and serious drawback that we are unable to procure text-books at short notice. We have to write to India, and if they are not in stock we have to wait six or seven weeks until we write to England, and get the books, &c., out by post. It has not been thought worth while to stock medical text-books and apparatus here, for the demand is not very great on the whole, since students find that the local booksellers charge much more than the price of the books, plus the exchange, warrants, so they prefer to wait and pay less. 3. The stock of apparatus is very inadequate to meet the requirements of a fairly large College like this one in Ceylon, but I understand that application has been made to Government for a grant for new apparatus, and we are shortly to have everything necessary for physiological and other work. Our College will therefore sooner or later take its place as one of the finest and cheapest Medical Colleges in the East, and we may even hope perhaps that our standard will be recognised as equal to that of such Universities as St Andrews, Durham, and Victoria, and that in the not far remote future be even able to obtain degrees from the Examining Boards of those Universities. THE WOMEN STUDENTS' MEDICAL MAGAZINE. 23 On the Recording of Anatomical Abnormalities. BY V. A. P. COGHILL, M.B. THAT Anatomy is a science of averages is a fact often lost sight of, though any one comparing an early and late edition of Gray's Anatomy can easily see how greatly opinion as to the normal (that is to say, the most frequently occurring) anatomical arrangements has been modified by the observations made in dissecting-rooms year by year. In this work it is clear that students can give most valuable help by taking careful notes of each part as it is dissected, and not until each dissector does so can we get the maximum amount of information available. Unluckily for an accurate calculation of averages, the ordinary students has quite another ambition, namely, that of making the part conform in as many particulars as possible to the text-book description. Bewildering are the difficulties inherent in this method, as many a student can testify, for what is then to be made of arteries which refuse to branch from the orthodox vessel, or of muscles which show attachments not answering to any of those described in the Dissecting Manual? Often enough the result is that the abnormality is treated with contemptuous neglect, as a meaningless and inconvenient freak of nature, while the student learns the true faith concerning the region from a book. Especially perturbing are these "abnormal" parts to the student demonstrator, who, confronted with an unexpected slip of muscle, may see no better way of dealing with the unwelcome fibres than that of cutting boldly through them, with the explanation that at any rate there ought not to be such an attachment. Apart from the fact that a spirit of lazy submission to a preconceived idea is wholly antagonistic to all possibilities of advance in science, there can be little interest found in the dissecting- room under such conditions. We shall have a different way of looking at abnormalities, and find a reason for trying to explain them, when we realise that adult Anatomy is not an isolated science, a dry list of unchangeable facts concerning man as he is, but a chapter in a book comprising Embryology, Anthropology, and Comparative Anatomy, an historical document where we can not only read by what stages man's present form has developed from the foetal condition, not only compare our European Anatomy with that of other races, but where we also get glimpses 24 THE WOMEN STUDENTS' MEDICAL MAGAZINE. of connections only partly obliterated between man and the earlier forms of animal life. Most of the so-called abnormalities point in one or other of these directions. Many have already been explained, many still await explanation, and in noting here some of the specimens recently found in the dissecting-rooms of the Birmingham University, I have not selected them because of any special rarity —the first indeed hardly deserves the name of abnormality—but merely by way of illustration, and with the hope of stimulating some student to keep a record to any variations met with, to find, or at least seek their probable explanation, and to publish the result in a future number of this magazine. 1. Vena Azygos Minor Inferior joining the Left Renal Vein.— This not uncommon condition is easily explained by reference to development. In early fœtal life blood is returned to the heart from the kidney and parietes by two large vessels, the posterior cardinal veins; that part of the vein above the kidney being known as pre-renal, and the part below as post-renal. As development proceeds, and the inferior vena cava is formed, many changes take place, one being the obliteration on both sides of that part of the pre-renal vein immediately above the kidney, the renal blood being now returned to the heart by the inferior vena cava. The upper part of the pre-renal vein on the right forms the vena azygos major; that on the left forms the vena azygos minor inferior. In such specimens as these, the usual obliteration of the connection between the renal vein and the vena azygos minor inferior has not taken place. 2. Frontal Bone, showing Metopic Suture.—This condition, in which the two lateral halves of the frontal bone fail to unite, seems to be more common in European than in other races. Anutschin gives the following percentages:— European skulls . . . 8.7 per cent. Mongolian skulls . . . 5.1 " Negroes' skulls . . . 1.2 " Australian skulls . . . 1 " 3. Muscular Slip from Flexor Longus Pollicis to the Index Tendon of Flexor Profundus Digitorum.—This is of interest, as man alone possess a completely separate flexor longus pollicis. It is considered to be a human characteristic. In other primates, it is found, as in this specimen, connected with the flexor profundus digitorum. THE WOMEN STUDENTS' MEDICAL MAGAZINE. 25 Chloroform Narcosis. BEFORE the introduction of chloroform as a general anæthetic there were several methods in vogue whereby a surgeon endeavoured to obtain insensibility to pain while he was operating Most of the drugs tried acted with more or less success, but until the introduction of ether and chloroform no drug was known which would invariable induce complete anæstheisa. Centuries ago, Indian hemp (haschisch) was used by the Chinese, but with our present knowledge of the drug it will be seen that anæsthesia by no means always results. The idiosyncrasy of different patients to haschisch is great—sometimes it only stimulates, sometimes it depresses. Moreover, the strength of the preparations varies. As in alcohol, the first stage of the action of haschisch is one of cerebral stimulation—intoxication, in short. The second stage is one of decreased general sensibility, so marked that a patient may not respond to the prick of a pin. The description of a man under the influence of haschisch is to be found in "Monte Cristo," to the pages of which fascinating book we advise our readers to turn. Towards the end of the eighteenth century, Moore, a London surgeon, adopted the means of compressing the nerves of the limb on which he was operating. As can he imagined, this means of inducing anæsthesia of a limb was too painful a method to be of much use. Nitrous oxide (laughing gas), which is now in general use in dentistry, was introduced by Sir Humphry Davy in 1800. In 1846, a Boston dentist, Morton, used ether during an operation. The same year, that is, as soon as he heard of the success which Morton had had with ether, Liston used it during his operations. About a year later, J. Y. Simpson discovered the anæsthetic properties of chloroform, which was first used in Midwifery, but which presently became the general anæsthetic it now is. At the present date, one of four preparations is given by inhalation before an operation—chloroform, ether, chloroform and ether, or the A.C.E. mixture, namely, alcohol, chloroform, and ether. Let us refer to chloroform shortly, for that is the anæsthetic most generally given in Edinburgh. There are three stages of chloroform narcosis, namely, stage 1, which is the period of stimulation; stage 2, which is the stage of surgical anæsthesia; and stage 3, when even the involuntary muscles are paralysed. In the first stage the higher centres are chiefly affected, but— to use Hale White's expression—unevenly so, and hence the confusion of ideas. In a minute or two all the centres are stimulated,26 THE WOMEN STUDENTS' MEDICAL MAGAZINE. represented thus—the patient hears sounds, sees flashes of light, talks or shouts, and generally throws himself about. There is stimulation of both voluntary and involuntary muscles, of cardiac and respiratory centres. The pupils are dilated owing to stimulation of the sympathetic, but if the lid be raised the pupil is seen to contract in response to the light reflect, for the third nerve is not yet paralysed. This light reflex is the great test of the first stage. In the third stage the pupil is again dilated, but it no longer contracts to light, for the third nerve is then paralysed. Before beginning to drop the chloroform on to the towel or cage, the anæsthetist should note how high the chloroform stands in the bottle, for one never knows when an accident may occur, and she may have to tell how much of the drug she used. We will now refer to one or two points to be attended to in the giving of chloroform. The anæsthetist should have her fingers behind the angle of the patient's jaw, pushing the lower jaw forwards until it protrudes beyond the upper. In this way there is no chance of the tongue falling back and blocking the orifice of the larynx, for the genio-hyoglossus is attached to the lower jaw. Once the jaw has been pushed forwards, the little finger on both sides is sufficient to keep it forwards. At the same time one can feel the facial artery against the lower border of the jaw, and thus gain information as to the condition of the pulse. Information as to breathing is obtained in several ways. Some patients breathe sufficiently loudly to be heard; one can see the even up and down movements of the chest; or lastly, one can put one's hand in front of the patient's mouth and feel the warm breath. The conjunctival test is a very favourite one, but it has its disadvantages, and is, moreover, not always true. In children especially, should the conjunctival reflex be absent, it is no criterion as to the stage of narcosis. It may be absent and the child not sufficiently well under, or vice versa. The light reflex is always a true test, and if anything it is easier to raise the lid and watch the result on the pupil than to raise the lid and dab the conjunctiva with the finger. Moreover, very probably the finger is covered with chloroform, which is irritating to a delicate surface like the conjunctiva. One would think it unnecessary to say that if the patient's lid resists being raised, one need pursue the test no further, the patient having given sufficient proof that he is not yet under. But that is not so, for we have watched anæsthetists more than once insisting upon raising a resisting lid to try the conjunctival test. Should a patient retch during the administration of chloroform, it is of course a sign that he is not fully under. The indication is to push the chloroform, but never without so laying the patient that his œsophagus and fauces shall lie in one continuous line, otherwise THE WOMEN STUDENTS' MEDICAL MAGAZINE. 27 there is danger that the vomited matter does not gain exit, and lying perhaps in the pharynx, may be drawn into the larynx. In the second stage the voluntary muscles are paralysed, but not the involuntary. The stage is best recognised by the contraction of the pupil, due to stimulation of the third nerve. A test which is often employed, and which we have found to be frequently misleading in children, is the raising of a limb to see if it fall again by gravity, quite flaccid, and lifeless as it were. There are two fallacies at work. The first is that a child often goes to sleep, when he does not go under so quickly, and when one believes him to be under when he is only asleep, ready to awake with a start as soon as he feels the surgeon's knife. To prevent him from going to sleep, give him a sharp pinch now and then. But the second fallacy is even more dangerous than that of sleeping. Several times in the writer's experience a child raised his arm when in the stage of surgical anæthesia, letting it drop again at once— evidently a reflex act. We believe this sign, however, to be one of rare occurrence. In the third stage, which is excessively dangerous, there is paralysis of the involuntary muscles, as represented, for example, by paralysis of the sphincters, with passage of fæces and urine. The pupil is dilated, the third nerve being paralysed, and will not contract to light. Rapid dilatation of the pupil after a period of contraction is the signal of danger. Take the chloroform away at once, and throw in light to the pupil. If it contract, your own heart, which had momentarily stopped to beat, recommences to contract. The much-vexed question of the cause of death from chloroform was, as you know, discussed by the Chloroform Commission. The question is, does the heart stop beating on account of the direct action of the chloroform on its centre, or by the paralytic action of CO₂ present because of the depressant action of the chloroform on the respiratory centre? The dictum of the Hyderabad Commission was that death was due to paralysis of respiratory centre. Most surgeons are, we think, agreed that it is so most frequently, but that occasionally it is the heart which stops first. Peculiarly so does one see the latter in such a case as this—if the patient be not fully under when the operation is commenced, the reflexes are not abolished, the sensory nerve stimulated by the incision carries the message up to the cardio-inhibitory centres, whence by the inferior cardiac to the heart, which stops. You will often hear a surgeon say, and especially if the patient have a heart lesion, it is safer to have him fully under than only to give a "whiff." 28 THE WOMEN STUDENTS' MEDICAL MAGAZINE. Editorial Notes and News. WE have long wished that the Edinburgh women students would wither have a Medical Magazine or a Debating Society at which medical subjects might be discussed by them, for we believe that there is no better training than either of those methods whereby they may prepare themselves to engage in original work after qualifying. It is, in our estimation, essential to have some form of training for this. It would seem that, in the Edinburgh School more than in any other, the students are too apt to depend on our reason for having suggested their having a Medical Magazine, that they may be stimulated to make original observations in a lucid manner to their fellow-students. There are other than women medical students who have been good enough to become subscribers to our magazine, but let us state at the outset that, though we hope all will find the magazine of interest, nevertheless its value will be to the students alone. Having thus stated its raison d'etre, all we can do in introducing this first number is to express a hope that the magazine will fulfil its object, and that the students will take advantage of it. We wish to make the magazine almost entirely medical or scientific, and such a variety of subjects will be dealt with that both junior and senior students will find something to interest them. * * * * * * THE Minto House roll this session shows a slight increase in the number of women students as compared with the corresponding time last year. There are 110 names on the list, and of these 102 are studying with the view of taking a degree in Medicine. * * * * * * THE competition for the Bathgate Gold Medal for Materia Medica was held this year under new conditions. It was formerly open only to students working for the Triple Qualification, and was held by special examination. Under the new rules all students attending the class of Materia Medica at Surgeons' Hall are eligible, and the result is decided upon the work of the last class examination. The prize is now given in the form of books, and was this year awarded to Rose Greenfield. * * * * * * THE WOMEN STUDENTS' MEDICAL MAGAZINE. 29 THE Edinburgh University is granting a new diploma in Tropical Diseases and Bacteriology. The classes recognised for women students are held by Dr Davidson and Dr Taylor Grant. * * * * * * RECENT APPOINTMENTS. H. I. C. MACLAREN, M.B., Ch.B., Resident Medical Officer, Sanatorium, Kingussie. C. M. RICHARDSON, M.B., Ch.B., Medical Assistant, Private Practice, Burnley. E. R. HENDERSON, M.B., Ch.B., Junior Medical Assistant, Victoria Hospital for Sick Children, Hull. MERRY SMITH, M.B., Ch.B., Resident Medical Officer, Craigleith Poorhouse. E. T. SELKIRK, M.B., Ch.B., has been appointed medical missionary at Sialkot, India, where Alice Hutchison, M.B., Ch.B., is already working. M. M. STEVENSON, M.B., Ch.B., also leaves to take up medical missionary work in India in the autumn. A. M. HAMILTON, M.B., Ch.B., is to sail in August (as Mrs. B. L. Livingstone Learmonth) for Neuchwang, Manchuria, where she will take up medical missionary work. * * * * * * VACANCIES. LADY wanted as Missionary Doctor in the Charlotte Hospital, Ludhiana, Punjaub, India. Professor and Mrs Greenfield will gladly supply all particulars. DEMONSTRATOR OF ANATOMY wanted in October, North India School of Medicine. Mrs Ballantyne (Treasurer), 24 Melville Street, may be referred to for full particulars. MEDICAL OFFICER for Papa Westray, Orkney. Apply to Miss Mackay, Minto House, Chambers Street, Edinburgh. MEDICAL MISSIONARY for Indur, Hyderabad, India. Apply to Miss Mackay. CLINICAL ASSISTANT, City Asylum, Birmingham. Apply to Dr Whitcombe, Asylum, Birmingham. 30 THE WOMEN STUDENTS' MEDICAL MAGAZINE. MEDICAL ASSISTANT, Maternity Hospital, Clapham or Battersea, London. Apply to Dr MacCall, 165 Clapham Road, London. LOCUM wanted by a Bradford Medical Woman for three weeks from middle of June or beginning of July. Expenses guaranteed. Apply to Miss Mackay. * * * * * * * * * * * * BOARD offered for any period; comfortable house; moderate terms. Mrs Wheeler, 118 Lauriston Place. * * * * * * * * * * * * COMMUNICATIONS from Edinburgh are to be addressed to Dr G. H. Giffen, 41 Chambers Street, and those from other parts of the United Kingdom and from abroad are to be addressed to Dr V. A. P. Coghill, The University, Birmingham. Subscribers are requested to intimate any change of address to the Publisher. MEDICAL TUTORIAL CLASSES. Dr. KNIGHT'S CLASSES FOR UNIVERSITY AND COLLEGE EXAMINATIONS MEET DAILY AT 7 CHAMBERS STREET * * * * * * * * * * * * These Classes are open to Lady Students. Medical Text-Books. Catalogue Gratis. Books Exchanged. All the Books recommended for Study are supplied on the most favourable Terms, New or Second-hand, . . . . . . BY . . . WILLIAM BRYCE, Student's Bookseller, 54 and 54a LOTHIAN STREET, Adjoining M'EWAN HALL. Printed at THE DARIEN PRESS, Edinburgh.The Shield THE OFFICIAL ORGAN OF THE BRITISH COMMITTEE OF The Federation for the Abolition of State Regulation of Dice Office:--17, TOTHILL STREET, WESTMINSTER, S.W. New Series. Vol. III. No. 30. January, 1900. Price 1d., or 1/6 per ann. post free. ANNOUNCEMENTS. Letters for the Editor will be received and forwarded by F. Burfoot, 55, Ellerdale Street, Lewisham, S.E. SUBSCRIPTIONS, 1/6 A YEAR POST FREE, should be sent to F. Burfoot, 55, Ellerdale Street, Lewisham, S.E., who will also quote for advertising space, transact all the business of the paper, and supply single copies 1 1/2d. post free. Correspondents in Europe, America, and British Colonies are invited to write in confidence, or to send information cognate to our subject. WINGED SEED. A NEW YEAR's MESSAGE FROM MRS. BUTLER WE have often watched the light thistle-down, the winged seed, mount in the air and disappear, carried by the breeze, who knows where? We only know it will settle somewhere, drop, die, live again, and spring up to bear in its turn "fruit after its kind." The career of that special seed is denounced by cultivators as mischievious. But there are good seeds also with wings, which silently travel about the world, plant themselves and bear fruit for which all men bless them. It is of the latter kind that I want to say a word. Never in my life, dear English friends, has my heart turned with so profound a sympathy as now towards my beloved country. Though cosmopolitan in a sense, I know too well what a patriot heart suffers when the people it loves are mourning, when a cloud of deepest sorrow hangs over their land, when it is giving of its life-blood in a war of which no one can yet see the end. This time of mourning is no time for passionate outcry or unripe judgment, but rather a time for patient waiting in the presence of Him who alone is the unerring Judge of the motives and act of our public advisers and of all. On His judgment, history will set its seal sooner or later. Many lessons are being learned just now. The new year it brings with it very solemn thoughts, and a retrospect which we do well to ponder. Athwart the clouds which overshadow us there are gleams of light ; among the moral lapses and defeats which we must record there are victories, which are themselves promises of further victory ; and we must not overlook these. I do not think that as yet any adequate appreciation of the character of our last September Conference, in Geneva, and its results has appeared in our English Abolitionist Press. I should like if possible in some degree to supply that omission ; and I am perhaps the better able to do so, having remained in Switzerland since that event, and followed to some extent its consequences there and in other countries. The Geneva Conference has been spoken of in several English reports as "a Conference of members of the Federation." It was not exactly so. It would be quite correct to say it was a Conference organized by the Federation (and splendidly organized it was by the brave little group of members of the Federation in Geneva). But we have never yet had such a crowded Conference organized by us, at which were present so few members of the Federation. We were a mere handful from England. Several of our allied whom we generally see from other countries did not appear, while many of our prominent members on the Continent and in England were prevented coming by illness or other circumstances. Yet we had crowded sessions every day and all day. The striking feature of that Conference was the influx to it of new adherents to our principles, many of whom we had never seen, or never even heard of. Adherents to our principles they were, but not members of the Federation ; nor did they, with very few exceptions, become there and then members of the Federation. And herein lies the encouragement of which I wish to speak. It is in connection with this fact that I wish my English friends to take courage and thank God with me. They flocked to us--these new adherents to our principles--from France, from Belgium, from Germany, from Italy, &c. There were among them Socialist, Freethinkers, Jews, Catholics, and Protestants, and an extraordinary number of leaders or the press from different countries, more especially of that enlightened press minority in France who fought so hard and so noble a battle (in the Dreyfus case) in favour of justice. There were with us also many distinguished ladies-- distinguished morally and intellectually--who for the first time greeted us as allies. Those who were at the public evening meeting in the Great Hall of the Reformation, must have been struck by the immense variety of nationality, character, creed, and opinion of those who took part in it ; and at the same time by the perfect unity, heart, and down- righteousness of that vast assembly in regard to the great question of Justice for which the Federation labours. Many were asking: "How has this come about? What energizing and purifying wind has been blowing through Europe to bear toward us this new unexcepted 'cloud of witnesses' to testify that truth gains ground in its own mysterious way?" It seems to me that we--the Federation--are like persons who, wishing to propagate some beautiful flower, should have carefully laid out a garden, hedged it round, dug it well, and then sown in it abundantly the seed which was to produce the beautiful flower. We took great pains with our garden. We sowed our seeds in rows, neatly and measuredly, perhaps a little formally. We arranged with our under-gardeners, training them, and turning them off it they did not suit. Perhaps we pottered a little sometimes, but always with the one desire at heart of seeing some day a great harvest of this beautiful flower,--a flower of such pure colour, and wholesome hygienic qualities! Sometimes we sighed, in times of drought or of failure of "hands" for the work. But lo! a day came when the assembled gardeners coming together to reckon up the results of their work, happened to look over the hedge, and with astonishment noted that the country all round, fields and hillsides, on which they had not bestowed any personal labour, were ablaze with the azure of the beautiful flower which they had cultivated so carefully in their garden. They had forgotten that seeds have wings, and that they could silently distance the garden fence and fly afar. So with the principles which we have cultivated. There were at Geneva young men, pastors from the French Provinces, whose prayers at our morning devotional meetings were an echo of the depths of my own heart ; and there were young women, some very young, looking in whose faces, I asked myself: "How2 THE SHIELD. [JANUARY, 1900. and where have these young people learned that zeal for justice, that pity for oppressed womanhood, and that grave view of life which we of the Federation could however never, and less now than ever, imagine to be the monopoly of experienced workers?" The Conference of Brussels pre-eminently brought to us the lesson of the "Wingèd Seed." The speech of Dr. Fiaux of Paris, who came from that Conference to Geneva, to tell us its results, was to me full of teaching of which possibly the speaker himself was not wholly conscious. It told of the power and silent progress of a truth, carried abroad by the Spirit which "bloweth where it listeth," planting itself and taking root in every "good and honest heart." The lesson of the "Wingèd Seed" goes far beyond our own special Crusade. We may apply it in the darkest times. For Truth (like Love) cannot die. Therefore we will take heart and labour on, though the End is "not yet." Lausanne, January 1st, 1900. GUARDIANS AND STATE REGULATED VICE. THE following resolution has recently been adopted by the Medway Board of Guardians, and sent round by their direction to other Boards of Guardians in England. That it is desirable in all cases where persons of either sex become inmates of the Workhouse as Lock Ward Patients that they should be detained until in the opinion of the Medical Officer they are fit to be discharged and that this resolution be communicated to other Boards of Guardians, asking their support in memorialising the Local Government Board to obtain the necessary powers to enable this to be done. In addition to this, a number of signatures to recent memorials tending to the re-opening of the question of State Regulated Vice have been those of Guardians.* Some of these memorials have advocated a general compulsory notification of venereal disease. The whole of these movements are based on the allegation that venereal maladies should be placed in the same category of infectious disease. That this CANNOT CORRECTLY BE DONE will be admitted on reflection by every thoughtful man or woman. There is a great gulf fixed between the character and treatment of the maladies caused by vice and other complaints. The following may be specified as serious points of difference:— 1. The method of contraction. 2. The method of discovery. 3. The results of a false diagnosis. 4. The nature of the infection. 5. The period of infection. 6. The proposed detention in hospital. 1. THE METHOD OF CONTRACTING THE MALADIES CAUSED BY VICE. In the vast majority of cases the maladies are contracted by actions within the patient's own free will.† 2. THE METHOD OF DISCOVERY. Scarlet fever, diphtheria, small-pox, &c., are diagnosed by the appearance of the throat and face, the pulse, etc., but the maladies in question require a personal examination, which in the case of an unwilling suspected woman amounts to a most serious outrage; and this may be brought about by false and malicious notification. 3. THE RESULTS OF A FALSE DIAGNOSIS. In the case of such maladies as scarlet fever, typhus, diphtheria, ordinary infectious maladies, a mistaken suspicion involves no injury to character and reputation. In the investigation of maladies due to misconduct, irreparable injury of this kind may be done. It is to be noted that doctors of the widest experience gave evidence before the various Parliamentary Committees that the most skilful medical men could not detect the difference between certain complaints of an innocent origin and certain forms of the maladies caused by vice.* 4. THE NATURE OF THE INFECTION. In ordinary cases the convalescent, if discharged before the period of infection is over, becomes a source of danger to all who surround him. In these special cases, on the contrary, there is only occasional and exceptional danger of such accidental infection, and, with this exception, the only persons liable to suffer are those who wilfully take part in an immoral act. 5. THE PERIOD OF INFECTION. We now come to a point which is of the first importance in considering the question of detention in hospital. By the "Infectious Diseases Notification Act," passed in 1889, the head of a household and the medical attendant are directed to send to the medical officer of the district a notification of the occurrence of such maladies as scarlet fever, typhus, and small-pox. In 1890 the Infectious Diseases Prevention Act, and the Public Health (London) Act, 1891, provided for the detention in hospital of persons suffering from any of these maladies, in cases where such person was not able to return to a lodging or home where suitable provision for isolation could be made until the period of infection was passed. The difference between the periods of infection of the maladies dealt with under these two Acts, as compared with the maladies caused by vice, is enormous. The quarantine needed for such maladies as scarlet fever, typhus, diphtheria, and small-pox lasts from two to nine weeks.† After this time perfect immunity may be guaranteed. But in the maladies caused by vice a period of detention ranging from months‡ to a number of years would be needed. 6. DETENTION IN HOSPITAL. In other infectious complaints the patient is for an important period of the illness physically prostrated, and is laid aside from work. The case is very different with the maladies in question. The great majority of * There are reasons for Guardians specially interesting themselves in these questions. At military and naval stations Guardians of the Poor have to deal with a good deal of the malady caused by vice, for which the general population of the district is not responsible. In addition to this, in non-military districts all the more serious cases of the maladies amongst the poorer classes tend to drift to the workhouse, and some of the Poor-law Guardians in consequence see a good deal of the maladies. Dr. Nevins' figures, however, show that there are large districts where the maladies are but slightly known. Figures from the House of Commons' returns quoted by him before the Select Committee of 1880 (page 22) showed that out of 649 workhouse hospitals there was not a single case of the malady in 437. In the whole 649 hospitals the average was less than two per cent. of the patients. † There are a few exceptions, such as the hereditary form of the evil, doctors accidentally contracting the malady in hospital work, contamination through use of the same drinking cups, and similar causes, and the infection of nurses by children hereditarily tainted, and of children by nurses. All but the first of these are of extraordinarily rare occurrence, and the hereditary form of the evil, as far as the obtainable evidence shows, has been greatly exaggerated. Much has been said about children who have contracted the malady through the father. But, as far as statistics show, the number of hereditary cases is not large. Dr. Nevins' figures show that in 1895 only 8 out of every 1,000 patients in children's hospitals throughout the country suffered from this complaint. Most of the deaths recorded in the Annual Returns of the Registrar-General as due to this cause are those of children under one, and probably largely consist of illegitimate cases in workhouses. The number of such deaths (of children under one) is shown on pages 136 and 137 in the latest return published in 1899 (figures for 1897) to be 1,286, and may be compared with 38,989 deaths of children under one during the same twelve months, caused by diseases of the respiratory and digestive organs (see pages 134 and 135). * Dr. Frederick Row, Royal Commission (1871), Evidence, page ix. Mr. Sedley Wolferstan, " " " 96. Dr. Prosser James, " " " 689. Dr. Drysdale, " " " 737. Professor Henry Lee, Select Committee (1881) " " 43. The last named speaks not only from his own vast experience, but also quotes the celebrated surgeons Hunter and Babbington. In the aggregate all these doctors represent an experience of scores of thousands of patients. † See pp. 274, 278, 304, and 402 of "Hygiene and Public Health," by Stephenson and Murphy. London. 1893. ‡ The Contagious Diseases Act of 1864 provided for the detention of patients in hospital for three months, the Act of 1866 for six months, the Act of 1869 for nine months, whilst the Detention in Hospitals Bill, brought forward by the Government in 1883 as a substitute for the suspended C.D. Acts, provided for detention in hospital for an unlimited period. JANUARY, 1900.] THE SHIELD. 3 the patients, as far as the civil population are concerned, are out-patients, and go about their work as usual. Serious cases in which the patient is perforce laid aside, form quite a small minority. The only object in detaining a patient is to keep him from wilfully spreading the infection, and to make this effectual it must, in some cases, be continued for years. Is it proposed practically to imprison the breadwinner for a period of years? If so, who is to maintain his family? And how is accommodation to be found for the vast number concerned, if the maladies in question be as prevalent as is supposed by some? Yet absolute incarceration is the only means of compulsorily preventing these patients from spreading infection. PRACTICAL RESULTS. The net result of the various proposals would doubtless be that men and women, of whatever character, in the position of private patients, would be left to the treatment and influence of their own medical attendant; that men of the working class would be treated as out-patients, or discharged after a brief detention, with a warning against communicating the infection; and that the only persons subjected to compulsory detention for the purpose of preventing the spread of the malady will be the poorer women of a certain class. Even this would require a large addition to the present available hospital accommodation. The pressure of the Act being thus practically restricted—in spite of its nominal application to persons of all classes and both sexes—to a certain class of women only, the immediate effect would be that the law would be seen to concern itself (as in the case of the Contagious Diseases Acts) with the sanitation of public immorality, for the indirect protection, perhaps, of innocent wives and children, but much more obviously for the direct protection of immoral men. The result would naturally be the same as before: imperfect and partial control of infection; encouragement of immorality; the lowering of respect for women; together with all those concealments and evasions of the law which have led many foreign supporters of compulsion to review their opinions, and (practically adopting the platform of Abolitionists in this regard) to urge, as better fitted to diminish the prevalence of disease, the adoption of voluntary methods, i.e., absence of police control. provision of voluntary hospitals with gratuitous treatment, and measures to be taken to warn all persons against the dangers attending the practice of immorality. (See transactions of the 1899 Conference at Brussels, etc., etc.)* DR. FIAUX ON THE BRUSSELS CONFERENCE. (A medical correspondent has favoured us with the following summary or review of a paper by Dr. Fiaux, of Paris.) In the December number of the Revue de Morale Sociale, our good friend, Dr. Fiaux, of Paris, contributes a long article on the International Conference at Brussels. Its salient points are as follows: After praising the Secretary, Dr. Dubois-Havenith, for the sagacity with which he had planned the Conference, so as to have the question impartially considered, from the points of view of medicine, law, morals, and economics, Dr. Fiaux points out that it might have been expected that the Conference would merely set about ameliorating the existing systems, and this was indeed what was desired by some of the members. The supporters of abolition of Regulation were present only in a small minority, but by the firmness and impartiality of the President, M. Le Jeune, and of the Secretary, the Conference became of the nature of a re-union, where scientific results were calmly stated and discussed; a veto was placed on all propositions to which general assent could not be given, and which were not grounded on the results of general evidence, but from some particular case. Thus the partisans of the Police des Mœurs were obliged to be contented with an exposition of facts, and could not hope to see their failing cause strengthened, but had to withdraw the papers they began to circulate even in the first sitting, asking signatures in favour of their methods. "Surely it is impossible," says the Doctor, "to give enough praise to the great 'International Federation for the Abolition of Regulation,' which has thus aroused public opinion, so that even this assembly, composed as it was of doctors, magistrates, and functionaries belonging to Sanitary Bureaux, was itself led to question the systems of Regulation, rather than to affirm its virtues." The questions for decision and discussion were reproduced in the October number of the SHIELD. On each point several people of differing opinions and professions were asked to read papers, bringing in as much statistical, documentary, and pathological evidence for their facts, as possible. From these treatises was formed a body of evidence to which every doctor and sociologist can, and should, have recourse when seeking well authenticated, or instructive facts. Unfortunately statistics were not in all cases forthcoming, as, for example, Paris possesses no statistical bureau. By the means of this compilation of evidence, those who attempted to raise a panic by insisting on the increase of disease, were silenced at once, while the supporters of the systems of the Police des Mœurs remained silent when called upon to justify their proceedings otherwise than by a noisy declamation of opinion. This system of a Police des Mœurs was condemned even by its own supporters; take, for example, the remark of Professor Augagneur of Lyons, that "those who defend Regulation, defend it rather on the score of what it might do, than of what it has done." And yet this system's partisans wish to reinforce and increase its severities, as if these very severities were not the obvious causes of its impotence and uselessness! Several upholders of the system, however, attack it in its present form, and would so reconstitute it that the Police des Mœurs, as we have known it, would exist no longer. Thus Professor Fournier would submit the action of the police to the authority of the law and the Courts of Justice; Professor Barthelmy of Saint Lazare, and others, decried the treatment of the women, who were lodged as malefactors, though they themselves shared in the management which so arranged matters! Prof. Lassar of Berlin and Neisser of Breslau, are also in favour of reform. Prof. Amicis and Prof. Tommasoli of Naples do indeed call attention to the increase of disease after Signor Crispi's reforms in the Italian system, as evidence in favour of the old state of the Police des Mœurs. But against these very reforms, the staff of the Police des Mœurs, hospital directors, the heads even of the Public Health Offices, leagued themselves together, and royal decrees remained dead letters. How then can the fact that they resulted in failure be quoted as an argument against reform? One of the most interesting communications was from Dr. Blaschko of Berlin with regard to the state of affairs in Germany. He showed that in towns like Stuttgart and Breslau, where the medical examination of women was rigorously enforced, the amount of disease was always great. Again, where the lauded "registered houses" were, the amount of disease varied in an inconsequent fashion, which showed it depended on ulterior and unknown facts. Several doctors, especially Dr. Kromayer of Halle, spoek of the uselessness of Regulation with regard to gonorrhœa. One of the most important incidents during the first portion of the Conference was the evidence given by Professor Fournier and Dr. Jullien of St. Lazare, and their colleagues, which was corroborated by the doctors from Kief and St. Petersburg, with regard to the disproportionately large amount of disease among * This article has been published in leaflet form by the BRITISH COMMITTEE OF THE INTERNATIONAL FEDERATION FOR THE ABOLITION OF STATE REGULATION OF VICE, and may be obtained at the Office: 17, Tothill Street, Westminster, S.W. Price 2d. per doz.; 1s. 1d. per 100, post free.4 THE SHIELD. [JANUARY, 1900. minors. This brings in the question of the man who is diseased, and yet left free and unpunished, to infect whom he pleases. With regard to improvements in methods of medical examination and inspection, two parties arose in the Conference, the one declaring such a system quite beyond improvement, unless the true functions of the doctor were to be impaired; the other party condemning the exaggerations and inhumanity of the system, but putting forward no appreciable improvements in matters of detail. Such Reforms were mentioned as an increase of humane treatment, quicker means of information for the doctors in cases of infection, more facilities for Hospital treatment, more dispensaries for out-patients, etc. Mr. Hutchinson's striking speech has already been summarised in the October number of the SHIELD. The next point raised was in connection with the "Registered Houses," which excited much discussion. The general evidence was quite against them, special stress being laid upon their rapid diminution in number, and the fact that these houses were perfect centres of disease, their staff needing renewal yearly. The evidence with regard to this in Germany, which as a whole keeps to the system of filles en carte, was entirely unfavourable to them, only Wolff of Strasbourg, holding other opinions. Professor Augagneur of Lyons, regarded them with disfavour, as did Dr. Sperk of St. Petersburg, in his valuable memoir. However, the two Prefects of Paris, Blanc and Lépine, contested these views, showing statistics as to the healthy condition of Registered Houses in Paris. This seems so remarkable, taken in connection with the fact that their number has fallen from 200 to 40 in 30 years, and that the number of married women attacked by these diseases in Paris is very large, that these statistics can only be regarded with suspicion, especially when the reader remembers that Paris possesses no especial statistical bureau, such as exist elsewhere. It is true that Dr. Commenge, in his last treatise on clandestine Prostitution, while especially laying stress on the remarkable decrease everywhere noticeable in the number of "registered houses," remarks:—"If morals have gained nothing by this decrease, and the increase of clandestine Prostitution, it is quite certain that Public Health has lost." But of this the reader can judge for himself, with the help of existing facts. Thus closed the first portion of the Conference, which had not so much been divided into two camps, for and against Regulation, as split up into various small parties. The questions discussed in the second part of the Conference proved capable of leading to much more accord, namely, the measures for diminishing the total numbers of prostitutes, and the general measures to be taken for prevention of disease. Prof. Fournier laid stress on the medical reforms above mentioned, especially on the humanity that should be observed during the treatment of the women. Increase of institutes providing medical instruction, and examinations in this branch of medical knowledge, were unanimously recommended, and no prejudice was allowed to obscure the just and scientific view of the question. "All these points, treating of technical as well as public matters of hygiene, on which we have just laid stress, possess a special interest, particularly in view of the ridiculous and odious prejudices existing still almost everywhere (even in medicine) against these patients and their diseases. But the splendid conferences of this assembly of doctors, when the spirit of a noble humanity (not always expected from men inured to the spectacle of human suffering) was shown to be one with the spirit of scientific investigation, were occupied with questions of legislation and of moral or economic institutions, with women as mothers, workers, or protectresses of young girls. . . . . When a Fournier, a Neisser, speaks with repressed but deeply felt indignation, almost in the same terms as would a Louis Bridel, of the iniquitous and noxious inequality weighing on man and woman in their treatment by the Police des Mœurs, it may be said that a step has been take on the road of good progress towards justice as well as towards hygiene." Underlying the words "Prostitution of women" are many facts, institutions, and reforms, to be considered and studied, and M. Fournier understood this when he effected the transformation of the Congress of September, 1899, into a medical and moral society. A provisional bureau will prolong the studies begun at Brussels, will follow up new facts, and place itself in communication with municipal authorities, and endeavour to effect the reforms demanded by the Conference. It will collect documents, and trace out a universal statistical method, such that it may become a language one and the same for all nations. Further periodical re-unions of the Society will be arranged, in a word, to quote Buffon, "facts will be collected, that from them ideas may develop." In conclusion Dr. Fiaux remarks:—These results of the Conference are full of hope for us; let us then continue our scientific researches, in matters of hygiene and social science, avoiding that declamatory stage which marks the infancy of a movement. The King of the Belgians officially received this assembly which had been convened on his territory to discuss, by the aid of medical specialists, "delicate" social problems. Surely this prince gave a lesson in intelligence and wide-mindedness, to the general public, such that it elicits praise from a French Republican. THE ARMY PURITY ASSOCIATION. THE Army Purity Association, under the care of the Rev. C. M. Becker, M.A., of Murree, and Rev. J. H. Bateson, of Simla, continues its excellent work among soldiers in India and bids fair to achieve as conspicuous success as has already been attained by the Army Temperance Association. A monthly four-page paper on the work of the Army Purity Association is published as a supplement to On Guard, and one is glad to read the following plain and excellent advice to the British soldier, which occurs in an article on the Rangoon outrage, entitled "A Crime—and its Lesson." "The soldier," says the writer, "is a marked man, and he should be found in no place and in no condition that can possibly bring disgrace upon the uniform, which he should be proud to wear. The uniform has been, and is, worn by some of the noblest and best of men, and the people of this country should be made to learn, by the self-controlled lives of all soldiers, that under the uniform there beats a true and pure heart, and that the wearer is the essence of manliness, honour, and chivalry. If it is otherwise the uniform is disgraced and all its wearers are judged by those who are unworthy to wear it. The soldier should think it as dishonourable to disgrace his uniform by licentiousness and immorality as by cowardice and disloyalty. . . . . Little do some men realise the harm which their sinful habits do, not only to their comrades and their country but to their religion. . . . . . Nearly every missionary wishing to spread the knowledge of Christianity among the natives, and of setting forth the excellencies of Christ and his religion, has been referred to the immorality of our soldiers. Of course the missionary can reply that those who practise such things are not true Christians and are unworthy of the name, and will possibly be advised to go and make Christians of them before coming to the heathen, but how much easier his task, and how much greater his chance of making converts if every Englishman in India, boasting himself a Christian, manifested the character of Jesus, His goodness, His purity. . . . . "And as for the manliness of the soldier, it can be revealed in no more striking way than in the resistance of every temptation to injure and degrade woman. Woman may be degraded and outcast, but no man should be party to her further degradation and wrong. The true man will respect himself as called to be a son of God, his body as meant to be a temple of the living God, and his neighbour as one redeemed by the blood of Christ and never to be wronged in any respect." Dr. Welldon, the Lord Bishop of Calcutta, is profoundly interested in the whole question of Purity Work in the Army, and has addressed large gatherings of soldiers at Rawal Pindi, Lucknow, and other places in the course of his visitation in Northern India. JANUARY, 1900] THE SHIELD. 5 THE BRUSSELS CONFERENCE AND THE SITUATION IN ENGLAND. (FROM A CORRESPONDENT.) THE new year opens for us on a new and somewhat curious situation. The accounts of the Brussels Conference, and of Professor Fournier's paper at the Paris Academy of Medicine, given in recent numbers of the SHIELD, show what we may hope is the beginning of a profound reaction on the Continent. Experience is at last teaching the Continental experts that Regulation, however large a place it may fill as a factor in the social and moral life of a people, fills but a very small one as a prophylactic agent. The bitter cry which is being raised by English agitators with regard to the prevalence of disease among our own population—a prevalence very commonly attributed to the absence of administrative measures—is outrivalled both in volume and intensity by the still more bitter cry from countries where administrative measures have been carried to their utmost length, and where, in the terms of the invitation to the Brussels Conference, "the increasing spread of syphilis is become a serious danger to society, and it is necessary, while there is yet time, to take measures to endeavour to arrest the invading march of the enemy." The mixture of alarm and hopelessness implied in these sentences is the outcome of a bitter experience. The trusted and vaunted measures which were said to "stand to common sense," to "have excellent results"—or to "only need a firmer and more general application" in order to have them—have arrested, and detained, and medicated, and "controlled" in vain. The evil continues to increase in defiance of all regulations, and, after rather more than a fair trial for something like a century, the means so hopefully and energetically applied have proved powerless to check it. So far as administrative action is concerned, there are no known means of arresting its spread. This was the situation with which the Conference was called upon to cope, and each member was invited to bring whatever light he had to the discussion of the problem. The debates revealed a chaos of statistics and a wide divergence of opinion. Everybody admitted that a satisfactory solution was still wanting, but nobody could specify the direction in which it was to be found. Many held that the Regulation ought to have succeeded, and some, in the teeth of everything, thought it should be gone on with till it did succeed. But as each laid down his contribution of facts, the disproportion—not to say the divergence—of effort and success became more and more conspicuous, and however plausible the theory, it was plain that the working of it was impracticable. In the resolutions it passed and did not pass, the Conference virtually registered a blank uncertainty. It offered no opinion, good or bad, on any sort of compulsory measures for restricting contagion; and the only conclusions it adopted were a series of conclusions in favour of the repression of some forms of immorality and immoral profit-making, the moral training of the young, public warnings against the risks attending immorality, and medical instruction, investigation and research. Such was the character of the proposals—of all the proposals—emanating from an assembly of some three hundred experts of thirty-three nationalities, an assembly of which (according to Dr. Fiaux's estimate in the Revue de Morale Sociale) 95 per cent. of the members were medical men, and the great majority of these were from Regulationist countries. The Conference thus marked progress at three distinct points. It recognised the necessity of combating immorality itself as the prime source of disease, and this by educational as well as legal means; it admitted the powerlessness of Governments to protect the individual from the consequences of his own actions, and, by warning him of his danger, threw back the responsibility on his own shoulders; and finally, by constituting a new international "society of sanitary and moral prophylaxis," and by urging the more thorough training of medical students in this branch of study, it prepared the way for fresh efforts of a purely medical kind, and also for a broader survey of the question which should take into account the practical bearing of moral influences on the hygienic situation. Professor Fournier's paper gives a fresh lead along similar lines. It takes up the neglected question of thoroughness of treatment, and of treating the patient from a disinfectant as well as a curative point of view. It is interesting to note that, in order to secure early, thorough, and prolonged treatment, Professor Fournier does not propose to make the treatment compulsory, but to make it voluntary. He would endeavour to meet the patients' convenience, and to persuade them not only to seek relief for their own sakes, but to do all in their power to avoid contaminating others. These propositions apparently do not refer to women at present under police control, but to the other classes of the population. But, in propounding them as a reasonable scheme of prophylaxis, he contrasts them with those coercive measures which have been carried to their utmost limit with little real success, and which, he says, seem likely to be even less successful in the future than in the past. At the same time, he points out that the most efficacious protection of all is that afforded by moral and religious principles. This certainly is a very remarkable utterance, coming from a man like Professor Fournier, the leader of the French delegation at Brussels; and it is the more gratifying because it may be regarded as the first- fruits of the Conference, and as proving that that attempt to deal with the problem on a really fair and scientific basis has succeeded in rousing the energies of scientific men and throwing them forward in a new direction. Nevertheless, one swallow does not make a summer, and we must not overrate the progress yet achieved. If the defence of the system has practically collapsed, it is still a far cry to the collapse of the system itself, or of its hold on the ideas and prepossessions of men who have grown up under its influence, and who, so to speak, can think of the prevention of disease in no other terms.That it is actually decaying at the core is proved by the gradual effacement of the licensed houses; but it will take time—even with the help of the Brussels Conference—for this fact to cut its way into the minds of the more backward. It will take longer still to carry home its true corollary—that it is no accident, but the very essence of coercion in a matter like this, and not a mere accident of this or that form of coercion, that it defeats its own object, by leading to concealment and evasion on the one hand, while on the other it fosters, by undertaking to protect, that very immorality with whose consequences it finds it so impossible to cope. Until this conviction is firmly rooted in the minds of men, we must expect to see, alongside of any new developments of a better kind, a variety of fresh suggestions animated by the same coercive zeal which gave birth to the old regulations, and we must be ever on the alert to seize and expose the true character of any such suggestions. None the less we may discern, beneath these late off-shoots from a decaying root, the growth of a more enlightened and a better spirit. And we, to whom the moral deterioration of a race seems a still more terrible calamity that its physical deterioration, shall be content that the march of practical conviction should be comparatively slow, in order that it may carry with it a real advance in the moral ideas and habits of the peoples. Nor must we expect too much from the new departure suggested in Professor Fournier's paper. As a matter of fact, the exigencies of the case seem to have become so desperate on the Continent that there is reason to fear an even exaggerated enthusiasm for measures that hold out any new hope, and a proportionate reaction when the good effect of these measures is found to be as limited as— at first—it assuredly will be. It has been the misfortune of this conflict with disease, wherever and however waged, to be judged always at short range. It was so with the old methods, it will be so with the new. The cry for voluntary hospitals and gratuitous treatment is all very well, but the first effect of opening such hospitals and dispensing such treatment may very possibly be disappointing in the extreme, and may even6 THE SHIELD [JANUARY, 1900. produce a reaction in favour of sharper methods which, whether effectual or not, at least have the look of doing something intended to be effectual, and not leaving people to please themselves. We must be prepared for these disappointments, and must insist that whatever the measures taken, they must be judged, not by their instantaneous but their prolonged and progressive results, and by the whole of their action, indirect as well as direct, upon the national life. It is here that the old methods have conspicuously failed ; it is here, above all, that any true method must succeed. The bearing of all this upon our own position at home is sufficiently obvious. The Conference at Brussels was a meeting of two streams. A little company of English and American doctors was there, apparently for the purpose of learning to emulate Continental successes. They were met, as it were, on the recoil, by the Continental experts who had gone to the far end and were beginning to come back. Will their experience avail to check the current of English thoughtlessness, eager for an untried experiment? It is very doubtful. People at home are agitated and restless; they have an idea that something ought to be done. They understand that the innocent suffer as well as the guilty, and they think the innocent should be "protected." They do not realize that nobody in the wide world knows how to protect them, if those to whom they should be nearest and dearest insist on endangering them. They believe that in India these diseases were put under the Notification Act, and that that was perfectly unobjectionable. They do not know that no sooner were these diseases put under the Act than the Act was altered to suit them, and altered, virtually, at the very points which had been emphasized as making it unobjectionable. They are told that at any rate the plan has been successful in India; and that the statistics show an extraordinary diminution in 1898. And besides they think it is only fair that if other infectious diseases are notified, these diseases should be notified too. Yes, but what is the object of Notification? To compel segregation and treatment; to prevent the infection from spreading. Would it do that in the case of these diseases? They do not know; they have not thought it out. Those who have thought it out believe that it would have a precisely opposite effect. They think it would lead to more concealment, less treatment, and the aggravation of disease. But will the Government lend itself to such an agitation? There are eminent doctors who will tell you it is impossible. "The thing is too absurd," they say, "for any Government to pass." But the Government lent itself to the Indian agitation three years ago. It lent itself to Lord Onslow's absurd report, to Lord George Hamilton's despatch, to the tinkering of the Notification Act by the Indian Government. All that is asked for now is a Departmental Committee, to enquire into the extent of the disease and the means of combating it. What could be more innocent? ------------------------------------------------------------------- *The number of admissions to hospital recorded in 1897 was 486, in 1898, 363. This is a reduction of almost exactly 25%. An article in the British Medical Journal of December 30th, while attributing the result mainly to the new rules and the placing of city bazaars out of bounds, except for men armed with a pass- - a measure which it says is strictly enforced - draws attention to another point, of no small importance both as regards any deductions that may be drawn from statistics past or present, and as regards the actual diminution of disease itself. "There is another measure," it says, "which we venture to think has had some effect in reducing the figures. . . . . and that is more efficient treatment. We had occasion some eighteen months ago to call attention to the fact that in very many instances soldiers were only treated for syphilis as long as there was some outward sign of the disease. . . . . After the secondary symptoms had disappeared temporarily, and the man was discharged from hospital, only too often no further medicine was taken until the disease broke out again, probably in a more virulent form. . . . . It is obvious that under such conditions the same men were being repeatedly admitted from relapses of the disease, and in this way the admission-rate per mille was greatly swollen. . . . . We have since that time, by frequent enquiries, learnt that the regular and systematic treatment of syphilis, in the Indian army more especially, has recently been greatly extended. . . . . "This must have prevented many relapses of the disease, and so have blessed the admission-rate." It seems strange that so obvious a measure should not have been thought of before. The British Medical Association and the Royal College of Surgeons memorialised the Government in this sense; they are not ignorant persons. The British Medical Association threw the substance of its Memorial into the form of a resolution, and proposed it at the Brussels Conference, and the Brussels Conference passed it unanimously. May not the Association go back to the Government and say: "You deferred your answer till you should have received the Report of the Brussels Conference; the Brussels Conference has itself adopted our Memorial; we renew our request; you have hardly refuse it now." What can we say to this? We say that what the Brussels Conference really did was to throw the whole question into the melting-pot; that it is simmering there still, and nobody knows what shape it will be when it comes out; that we can better afford to wait a little than to make a mistake in a hurry; and that, while there is no objection to an enquiry pure and simple, there are strong objections to having such an inquiry utilised to force the hand of the Government and compel it to premature action. On the purely medical side of the subject there are regions as yet almost unexplored; The Brussels Conference and the formation of the new International Society cannot but lend a powerful stimulus to research; and within the next few years the question which, as far as administrative channels are concerned, seems to-day to have ended in a cul de sac, may have opened out new avenues on the scientific side which will revolutionise the whole position. Things are not so bad in England that we cannot afford a little patience; and if they were ten times worse than they are, we should not mend them by making a fresh blunder. The evidence is strong that, among us, disease is diminishing on the whole, though slowly; and the very scare on the subject will serve as a warning and a deterrent. Most of all, we may and do look to the higher forces of our social life, the persistent effort to improve the tone of our public schools, and in particular to a truer and braver attitude of the medical profession in regard to the inculcation of pure living, and the awakening of conscience as to the communication of infection, to bring about not only a steady, but a progressive and permanent diminution of disease. Lastly, we ask our readers to remember how largely the fate of this question rests with them. The situation is at once full of hope and full of peril; its development in one direction or the other will depend on how many possess the requisite knowledge to inform and influence others, and how much pains they are willing to take to do it. Facts which to us are obvious and trite enough have no place at all in the minds of many who are exerting a positive influence on the development of affairs. Everyone of us has access to some one whom it is our duty to set thinking. If the twentieth century should indeed see the first links of that hateful chain of bondage riveted on our own country, it will be the fault of somebody's supineness. A TIMELY PROTEST DR. GUSTAVE BEHREND, Professor of the Faculty of Medicine at the University of Berlin, on his return from the International Medical Conference at Brussels, commenced a course of lectures on Prostitution, from the Social, Moral, Legal, and Hygienic points of view. Ladies were admitted, for, to quote the Professor, "they not only had the right to occupy themselves with this question, but they took a lively interest in it, and much good had already been accomplished by their activity in this department." But the students were not of this opinion; they indulged in demonstrations which ended, says the Lokalanzeiger of November 18th, in the withdrawal, by the Rector of the University, of the authorisation granted to a lady to take part in that course of study. Our valued fellow worker, Mile. A. Pappritz, in the name of the Berlin Branch of the International Abolitionist Federation of which she is President, has addressed the following spirited protest to the Senate JANUARY, 1900.] THE SHIELD 7 of the Royal Frederick William's University in Berlin against the exclusion of the lady in question:- "According to a newspaper note (Lokalanzeiger, of 18th November), His Magnificence, the Rector of the University, has withdrawn from a lady his consent, previously granted, to her attendance on a course of lectures by Professor Behrend, in consequence of representations by the body of students, although the Professor emphatically declared that, according to his opinion, 'ladies were not only justified in taking up the question of prostitution, but had a great interest in it, and that their activity in this matter had already been a source of great blessing.' "This is also the position taken up by the International Federation, in whose name the undersigned hereby enters a protest against the exclusion of this lady. In order effectively to combat the causes of prostitution, there is need of the joint work of men and women. But where should men and women gain the knowledge and information necessary to this fight if not in the lecture halls of the University, where naturally these questions are treated from the purely scientific standpoint, and therefore cannot offend the moral sentiments of any person? The undersigned had the opportunity of attending, in the course of this year, two large International Congresses on Morals, in London and Geneva. At both the question of prostitution was discussed in public popular meetings; anyone could take part in the discussion, and although there were many young people in the audience whose level of culture was not so high as might be expected of German students, no word was uttered, no statement was made, which could have offended anyone's sense of propriety. "We women have recognised the danger which threatens, through prostitution, our whole people; we are therefore going to break with the hushing-up system; we demand information, we demand to be allowed to discuss these serious questions jointly with men, in order to be able to help with them to their solution. Therefore it is necessary that our young men should be trained to such a moral standard as to hear serious, scientific questions discussed before and with women. This can only come to pass through the influence of University Professors, and we therefore beg the High Senate to exert itself, on grounds of morality and righteousness, to the end that lady-students may no longer be excluded from such lectures. ''Most obediently, ''A. Pappritz ''(President of the Berlin Branch of the International Federation).'' We heartily congratulate Miie. Pappritz and the Berlin Society on their courageous action. ======= NOTES. ---------- We are glad to announce that Mr. Josephine Butler's ''Personal Reminiscences of a Great Crusade'' has been translated into French by M. R. Bergner, of Lausanne, and is on the eve of publication. It will contain the same portrait as the first English edition, and may be obtained from M. Henri Minod, Bureau de la Federation, 6, Rue St. Leger, Geneva, price 3 fr. 50. We take this opportunity of reminding our readers that the second English edition of this unique work, dedicated to the memory of Sir James Stansfeld, though smaller in bulk and therefore more convenient to handle than the first edition, is printed in excellent type and attractively bound, and may be obtained from the Secretary of the British Committee, 17, Tothill Street, Westminster, S.W. Price 3s. 6d. Friends desirous of interesting outsiders in the principles and history of our great abolitionist struggle, cannot adopt a better means than to circulate this book which, with its graphic personal touches, its heart earnestness, and high moral purpose, will claim and hold the attention of those who would not study our pamphlets or read the SHIELD, or search into blue-books, but whose adherence to out principles it is of the utmost importance to secure. --------- Another very interesting volume of ''Reminiscences'' is before us-- a volume unhappily left unfinished by its author, our valued fellow-worker, the late Aaron M. Powell, of New York, and now published by Mrs. Anna Rice Powell in memory of her husband. These ''Reminiscences'' chiefly relate to the American Anti-Slavery struggle, in which Mr. Powell took a prominent part, sacrificing his most cherished ambitions to champion the cause of the slave. When the struggle ended in victory, his energies were enlisted in the cause of ''The New Abolitionists'' who were combating a worse than negro-slavery--the enslavement of women for the purposes of vice. His active co-operation in this work dated from the visit to America in 1876 of Henry J. Wilson, Esq., M.P., and the Rev. J.P. Gledstone, as delegates from the newly formed ''British, Continental and General Federation''; and in the following year, Mr. Powell was present at the memorable Congress of the Federation held at Geneva. He took part in seven subsequent Conferences of the Federation, including that in London in 1898, and it was evidently his intention, as shown by his notes, to have recorded his recollections of these and of the notable men and women engaged in the work. But this was not permitted. The last words he wrote in his ''Reminiscences'' (with singular appropriateness as we now know) were those which his friend, Maria Child had directed to be placed on her gravestone:-- ''You call us dead; we are not dead; We are only truly living now.'' ----------- WE desire to call our readers' attention to three important leaflets just issued by the British Committee of the Federation. The first is that on "Guardians and State Regulated Vice," which we reproduce in this issue of THE SHIELD. The second is a four-paged leaflet entitled "The Brussels Conference of 1899," giving in concise form the history and results of that memorable medical Conference. The third, "What is Regulation of Vice?-A Clear Answer," is a reprint of the admirable speech delivered at Manchester in October last by the Ven. Archdeacon Wilson, M.A. These leaflets can be obtained from the Secretary, 17, Tothill Street, Westminster, and we claim the cooperation of our fellow workers in circulating them throughout the length and breadth of the land. They meet the pressing need of the hour, and thoroughly up to date, and state the case briefly. ------------ THE Friends Association for Abolishing State Regulation of Vice (47, Devonshire Chambers, Bishopsgate Without, E.C.) have also issued a very timely and valuable pamphlet of 24 pages, "A Short Summary of the Parliamentary History of State Regulated Vice in the United Kingdom," with special reference to the recent advocacy of the re-introduction of the system into this country. In a note attached to the cover attention is called to the fact- "that the return of large bodies of troops from South Africa on the conclusion of the war may bring about a similar state of things to that shown in the pamphlet as having existed between the years 1857-60, which was made the pretext for the original introduction of State Regulated Vice into this country. "In view of this probability, and of attempts in 1898-99 to reintroduce the principle of this evil system into England, the Friends' Abolitionist Committee is desirous of impressing the importance of watchfulness. In a country like England, with centuries of training in the principles of justice, morality, and freedom, the introduction of such legislation as that of the Contagious Diseases Acts, repealed in 1886, can only be accomplished under a more or less plausible covering foreign to the real object of the legislation. Hence the need of the most careful examination of all schemes put forward for dealing with the question." ========== SYNOPSIS OF THE HISTORY OF REGULATION OF VICE, AND OF OPPOSITION TO IT. ----------------- (Continued from the SHIELD, June 1899.) 12th January, 1886.--The new Parliament, elected after a re-distribution of seats and the extension of Household Suffrage to the Counties, met, and the House of Commons proceeded to the re-election, as Speaker, of the Right Hon. Arthur Peel, M.P. The friends of Repeal in the House of Commons lost no time in conferring together and deciding on a plan of action, guided largely by the experience of the Right Hon. James Stansfeld, M.P., and Prof. Stuart, 8 THE SHIELD. [JANUARY, 1900. M.P., the long experience of the former in Parliament being of invaluable service to the newer men. It was determined to ballot for a resolution declaring that the Contagious Diseases Acts ought to be repealed, and also for a Repeal Bill. 22nd January, 1886.—The balloting which took place for precedence, gave Mr. H. J. Wilson the opportunity for giving notice that on the 16th February he would move:—"That, in the opinion of this House, the "Contagious Diseases Acts, 1866-1869, ought to be "repealed;" while Prof. Stuart gave notice of a Repeal Bill. But the early defeat of the Conservative Government prevented the debate on Mr. Wilson's motion from coming on, and it was not until the 16th March, 1886, that Mr. Stansfeld got the opportunity of moving the same resolution in an able speech which might well deserve re-production. He was followed by Mr. (now Sir Henry) Campbell-Bannerman, who, speaking on behalf of the new Liberal Government, accepted the resolution, declaring in the most emphatic manner "that the country has pronounced against State interference in this matter." Sir John Kennaway then moved an amendment, which was seconded by Sir Joseph Pease, desiring that along with Repeal there should be "due provision for the "continued maintenance of hospital accommodation "with adequate treatment of women voluntarily seeking "admission and medical care." The amendment was defeated by 245 votes against 131. Then came the astonishing result of the agitation that had been carried on in the country, and of the debate in the House, that Mr. Stansfeld's motion was agreed to without one single member venturing to go into the Lobby in opposition to it. 17th March, 1886.—Mr. Stansfeld moved for leave to bring in a Repeal Bill, but was obstructed under the Rules of the House by Mr. Cavendish-Bentinck. The same evening a meeting of Repealers was held in St. James' Hall. Mr. Stansfeld presided, and referring to the debate of the previous day, said in concluding his speech:—"Nothing could have been more marked, more deeply interesting and satisfying to my mind, than the spectacle which the House of Commons afforded during this debate. It seemed to me (I do not think it is pure imagination, because I am what may be called an 'old parliamentary hand') that there was an expectation in the air, the sense of the coming death of these measures—measures which have been upheld so long. There was by common consent that calm attention, listening and looking in the direction from which the fate of these measures was supposed to be about to proceed. The very fact that no attempt was made to divide, hardly any attempt made to discuss, and the only division, and the only discussion, was upon an amendment which would not have been in the least fatal to my resolution, and hardly injurious to my resolution if it had been added—all this was a sign to me of the absolute revolution which has taken place in the condition of the House of Commons, ever since the time of the well- remembered resolution of the 20th April, 1883. In April, 1883, I succeeded in convincing the conscience of the House of Commons, and a sufficient number of men determined that they would vote with me on that great question irrespective of party. Some stayed away, intending by their abstention to give me some kind of support. But, upon this occasion, the scene even in that respect had changed. In the new House of Commons, I found that these new members who are in favour of Repeal are in favour of absolute Repeal. They do not want any conditions, any clauses, any amendments, they want a single clause Bill; and they are in favour of getting that at the earliest possible moment. And they are against any prolonged discussion. That gratifies me more than anything else. I think the best response I got from both sides of the House last night was when I said,—I have borne the brunt of this task in years past and am able at this moment to renew it, and am able from the very last statistics to prove more than ever the failure of these Acts; but I do not intend to go into this question, and I do not believe that this House will desire me to go into this question, and because the old House of Commons and the country, and those who sent the present House of Commons here, have judged and decided that upon the higher and different ground, upon the ground that, failure or no failure, they will not have immoral and unconstitutional Acts, and—as I expressed it yesterday—if the Army and Navy authorities are desirous, as they ought to be, to reduce the amount of diseases which are the consequence of sexual vice in the Army and Navy, they must find other means, they shall not be permitted to take means which seem to sanction and which stimulate vice, and which are inconsistent with every principle of liberty and morality itself. Well, I had the greatest and most spontaneous response to such a proposition as this, and that I say is a sign that this House of Commons has risen above the mere hygienic question, that it has permanently raised the level of its own thoughts to that of the moral and constitutional considerations which have been our greatest motives from the first; and it is impossible to conceive, or suspect, or fear that in these days of the people coming into power, any future House of Commons is in the least likely ever to descend from that altitude, or to stoop to the technicalities, and excuses, and pretences of former Parliaments and former times." 25th March, 1886.—The second reading of the Repeal Bill, put down for this day, was not reached until after midnight. Mr. Stansfeld moved it without making any speech. It was opposed by Mr. Cavendish- Bentinck in a characteristic speech, and was seconded by Mr. Pulleston. There was only one other speech— that of Sir Wm. Harcourt on part of the Government. The SHIELD at that time said:—"Sir Wm. Harcourt's speech was a confession that the matter had been settled by the constituencies; and he drew attention to 'the eloquent absence of all the leaders of the Conservative party,' in order to show that all parties in the House were agreed on the necessity of Repeal. When he sat down, the Speaker put the question, 'That the word "now" stand part of the question.' On his declaring that 'the Ayes have it,' Mr. Cavendish-Bentinck called out 'No!' The House was then cleared for a division—a division which would have given an overwhelming majority for Repeal; but, when the question was put a second time, no opposition was raised to the second reading of the Bill. We understand that Mr. Cavendish-Bentinck was unable to induce anybody to 'tell' with him. "So ended this memorable debate. Mr. Stansfeld said not a word; but he looked very happy as he deserved to be. The House had always acknowledged his self-denying earnestness. It now seemed to recognise in him a leader of men." The final stages of the Bill in the House of Commons, as well as in the House of Lords, were got through with scarcely any opposition, and on the 16th April, 1886, the Repeal Bill received the Royal Assent. ========== HADFIELD WOMEN'S LIBERAL ASSOCIATION.—Under the auspices of the Hadfield Women's Liberal Association a well attended meeting was held on Monday evening, November 27th, in the Liberal Hall, Hadfield. The Rev. Kenneth Mackenzie presided, and the Rev. T. W. Pinn, M.A. (of the Manchester and District Association for the Abolition of the State Regulation of Vice), delivered a logical and convincing address on the "Indian Cantonments Acts." At the close of the address Councillor Greaves proposed that a resolution be drawn up and signed by the Chairman of the meeting, protesting against the sanction given to the authorities in India to restore the condemned Cantonment regulations and practices, and that a copy of the resolution be forwarded to the Marquis of Salisbury and to Lord George Hamilton. This was seconded by Councillor Martin and carried unanimously. A cordial vote of thanks to the lecturer and to the chairman for presiding brought the meeting to a conclusion. ---------- A REPORT of an important meeting in connection with the Manchester and District Association for the Abolition of State Regulation of Vice is held over for want of space. =========== Printed by PEWTRESS & CO., 28, Little Queen Street, W.C., and published by FREDERICK BURFOOT, 55, Ellerdale Street, Lewisham, London, for the BRITISH COMMITTEE OF THE FEDERATION FOR ABOLITION OF STATE REGULATION OF VICE, 17, Tothill Street, Westminster, London.—JANUARY, 1900. THE ELEVENTH ANNUAL REPORT OF THE LADIES' SANITARY ASSOCIATION. ----------------- "I conclude that all our endowments for social good, whatever their especial purpose or denomination— educational, sanitary, charitable, penal—will prosper and fulfil their objects in so far as we carry out the principle of combining, in due proportion, the masculine and the feminine element; and will fail or become perverted into some form of evil, in so far as we neglect or ignore it."—MRS. JAMESON. ----------------- LONDON: PUBLISHED BY THE LADIES' SANITARY ASSOCIATION, AT THEIR OFFICE, 8, PONT STREET, BELGRAVE SQUARE, SW. 1869.[Gradual use of Hygien as on] Science Necessity of empirical Hygiene always recognized in pathogen. The gradual ease of Hygiene into a Science from the progress of the natural sciences and study of Vital Statistics. Lesson taught by Vital statistics Methods of [diffusing] spreading hygienic Knowledge [by] and practice - through Govt action through the Medical Profession; through Education. A Natural Health Society.Dearest Barbara, I am very glad that a different arrangement will be made about physiology - a nicePOPULAR TRACTS ON HEALTH, ISSUED BY THE LADIES' SANITARY ASSOCIATION, 8 Pont Street, Belgrave Square, S.W. On Dress. 2d. A Model Wife. 2d. Wasps have Stings; or, Beware of Tight- lacing. 1d. Sowing the Seed. 2d. Dress and its Cost. 1 1/2d. Evils resulting from Rising too Early after Child-birth. 2d. How to Rear Healthy Children. In Packets of 50 copies. 1s. each Packet. The Sanitary Duties of Private Individuals. 2d. Measles: a Tract for Mothers. 1d. Village Work. 2d. Hand Feeding. 2d. Fun for the Young; Facts for the Old. In Two Parts, 1 1/2d. each. Mrs. Findlay's Tea Party ; or, Duties of Mother, Mistress, and Maid. 2d. What can Window Gardens do for our Health? 2d. The Worth of Fresh Air. 2d. The Use of Pure Water. 2d. The Value of Good Food. 2d. The Influence of Wholesome Drink. 2d. The Advantage of Warm Clothing. 2d. Trouble and Trials, and how to meet them. 2d. Never Despair. 2d. The Sick Child's Cry. 2d. Work and Play. 2d. The above Three in One Vol. entitled Household Verses on Health and Happiness Embossed Cloth. 9d. The Health of Mothers. 2d. How to Manage a Baby. 2d. The Power of Soap and Water. 1 1/2d. About to Marry: a Chat with an Old Friend. 1d. The Cheap Doctor ; a Word about Fresh Air. 1/2d. Black Hole in our Bed-rooms. 1/2d. The Mischief of Bad Air. 1/2d. Every-day Wonders of Bodily Life. In Three-Parts, 2d. each ; or in One Vol. Embossed Cloth, 1s. Washing the Children. 1d. The Bride's New Home. 1d. The Mother. 1d. The Inspector. 1d. Children going to School. 1d. A Day in the Country. 1d. Lost and Found. 1d. The above Six in One Volume, with frontispiece, entitled. The New Home. Wedded Life: its Duties, Cares, and Pleasures. Embossed Cl. 1s. Something Homely. 2d. Whose Fault is it? 2d. Sanitary Defects. 2d. Healthy Dwellings, and Prevailing Sanitary Defects in the Homes of the Working Classes. 4d. Woman's Work in Sanitary Reform. 2d. The Massacre of the Innocents. 1d. How do People Hasten Death? 2d. The Secret of a Healthy Home. 2d. The 'Home Almanac.' 2d. Small Pox and Vaccination. 1s. LADIES' SANITARY ASSOCIATION, 8 PONT STREET, BELGRAVE SQ. S.W.; S. W. PARTRIDGE & CO., 9 PATERNOSTER ROW, E.C.; JARROLD AND SONS, 12 PATERNOSTER ROW, AND LONDON STREET, NORWICH.From the ARCHBISHOP OF CANTERBURY. 'I have been extremely pleased with the little packet of sanitary poems which I am sure will be likely to gain for the Association at least one class of the community, and that a most important class--the children. I have seen how one of my own children has been pleased with these poems, and I am quite sure that if you can get the children to like them, there must be something in them which is really attractive; and if you enlist the children on the side of cleanliness and other healthy habits, I think you will very soon find that you enlist their mothers too, and through the mothers you may hope to influence whole families." The LORD BISHOP OF OXFORD. 'The law laid down for us, the golden writing to be read everywhere, is that the way to help a man is to teach him to help himself, and this is the great principle of this Assocation. It aims at the dissemination throughout the land, and especially amongst the poor, of sanitary knowledge, put in a form in which it will easily reach them, so that they themselves may begin intelligently to co-operate with those who desire to help them to raise their physical condition.' The EARL OF SHAFTESBURY. 'I must say that the class of literature this Association has originated is as interesting and valuable as it is novel. It shows considerable talent, wonderful penetration and acuteness, and great power of composition. I have read some of the little books which have been issued by this Association, and I declare I have found them some of the most interesting, picturesque, and agreeable writings I have ever read. I do from the bottom of my heart wish God-speed to the Ladies' Sanitary Association; God-speed to all its efforts, practical and literary.' The ARCHBISHOP OF DUBLIN. 'I think this admirable Association has taken to itself one province of the evil under which the world groans, upon which it is most successfully making war. I think we (the clergy) may especially rejoice in hearing of that enormous circulation of tracts, the mere names of which at once tell us how genial, how hearty, how healthy, they are likely to be; how they are not abstruse writings and addressed to the few, but popular ones addressed to the many, bringing knowledge, instruction, and warning, and comfort, and health, into innumerable households throughout the land.' The Rev. CHARLES KINGSLEY. 'Now, I do believe that if those tracts which you are publishing, and which I have read, and of which I cannot speak too highly, are spread over the length and breadth of the land; and if women, clergymen's wives, the wives of manufacturers, and of great employers, district-visitors and school-mistresses, have these books put into their hands, and are persuaded to spread them, and to enforce them, by their own example and by their own counsel, in the course of a few years, this system being thoroughly carried out, you would see a sensible and large decrease in the death-rate.' The Rev. BALDWIN BROWN. 'I have read a great many of these tracts myself; I have heard them read to hundreds--I may say thousands--of working men and women, by ladies during the year, and always I have seen that they went home. Most of them are written in a style which is very calculated indeed to come home to the understanding, and to the best sympathies and affections of the working people; and I am quite sure that the seed which is sown by means of these tracts, the healthy public opinion which is created, will bear very large and blessed fruits.' DR. LANKESTER. 'It is the ignorance of the poor, this want of knowledge of sanitary laws, a knowledge of the laws of life, the life by which God governs the life of the community, their ignorance of the value of fresh air, the value of pure water, the value of warmth, the value of many things which they could use and employ, which causes them to die. "My people die," said the Prophet, "and there is no man to consider." ' LADIES' SANITARY ASSOCIATION, AFFILIATED WITH THE NATIONAL ASSOCIATION FOR THE PROMOTION OF SOCIAL SCIENCE. PATRONESSES. Her Royal Highness the Crown Princess of Prussia Her Royal Highness the Princess Mary Adelaide The Duchess of Argyll The Duchess of St. Albans The Countess of Airlie The Countess of Bernstorff The Countess de Grey The Countess Russell The Countess of Shaftesbury The Viscountess Palmerston The Lady Stanley (of Alderley) The Lady Herbert of Lea The Baroness Mayer de Rothschild The Hon. Mrs. R. C. Trench Mrs, William Gladstone Lady Verney Miss Burdett Coutt COMMITTEE. Lady Margaret Bourke The Lady Ebury Mrs. Gregory Miss Garrett, L.S.A. Miss F, Holland [Mrs. Lankester] La Comtesse A. de Noailles Mrs. Roth Mrs. Sutherland Mrs. Hensleigh Wedgwood Mrs. Garth Wilkinson EDITING COMMITTEE. Dr. John Brown Dr. William Farr, F.R.S. J. Marshall, Esq., F.R.S. Dr. Richardson, F.R.S. Dr. Edward Smith, F.R.S. Dr. John Sutherland TREASURERS. Right Hon. Russell Gurney, Q.C. Recorder of London The Hon. Mrs. Dutton HONORARY AUDITORS. The Rt. Hon. W. F. Cowper, M.P. Viscount Kirkaldie BANKERS. Sir Samuel Scott, Bart. & Co., 1, Cavendish Square, W. Messrs. Williams, Deacon, & Co., Birchin Laue, Cornhill, E.C. HONORARY SECRETARIES. The Hon. Mrs. W. Cowper Lady Burrell SECRETARY. Miss E. S. Griffiths OFFICE. 8, Pont Street, Belgrave Square S.W. This Association has been formed by a few Ladies, who beg earnestly to recommend it to the attention of all who desire to promote the Physical and Social well-being of those around them2 It is an acknowledged fact, that by far the greater part of the debility, disease, and premature mortality in this country, results from preventible causes; but very few preventive measures, bearing upon the personal habits of the people, have yet been adopted. The Promoters of this Association, convinced that one of the principal causes of a low Physical condition, is, ignorance of the laws of health, have combined to extend and popularize Sanitary knowledge. For this purpose: -- 1st. -- They write and distribute simple interesting tracts on Sanitary and domestic subjects. The greater part of these are written specially for the poor. 2nd. -- They establish Loan Libraries, or popular books, on subjects relating to Health and Social well-being. 3rd. -- They arrange for the delivery of practical Lectures on Health, Sanitary Improvements, and Domestic Economy. 4th. -- They form Branch Associations in various localities for carrying on practical Sanitary work. a. By Distribution of the Tracts among the Poor of the District, and in Schools, Hospitals, and Mothers' meetings. b. By collecting money for Sanitary improvements, such as opening windows, curing smoky chimneys, removing nuisances; giving soap, and lime for whitewashing; lending books, patters of clothes, scrubbing brushes, saucepans and cooking recipes. c. By requesting the Medical Officers of Health, and other professional and well-educated gentlemen, to deliver popular free lectures. d. By instituting Mothers' meetings and classes of adult girls, and giving them Sanitary and domestic instruction. e. By forming, or aiding, Penny Clothing Clubs, Coal Clubs, Baths and Wash-houses, Temperance Associations, Cooking Depots, and Work- ing-Men's Clubs. f. By establishing Nurseries for motherless babes, which may serve as Schools, for Mothers of all classes, School-mistresses, and Nurses. The Association is entirely dependent upon voluntary contributions, and the Committee earnestly solicit the aid of all who are interested in Sanitary Reform. Subscriptions, Donations, Books for the Libraries, Manuscripts for Tracts, &c., will be gratefully received by the Treasurers, Right Hon. RUSSELL GURNEY, 8, Kensington Palace Gardens, W., and the Hon. Mrs. DUTTON, 16, Halkin Street West, Belgrave square, S.W.; Miss E.S. Griffiths, Secretary, at the Association's Office, 8, Pont Street, Belgrave Square, S.W.; Messrs. WILLIAMS, DEACON, & Co., Bankers, Birehin Lane, E.C.; and Sir SAMUEL SCOTT, Bart., and Co., Bankers, 1, Cavendish Square, W. Communications may be addressed to the Secretaries, at the Office, where also enquiries may be answered personally. Office hours from Eleven to Five; on Saturdays, from Eleven, to Two. The Secretaries will very gratefully receive suggestions on any subject connected with the objects of the Association. 3 RULES 1. -- The Association is formed for the diffusion of sanitary knowledge, and the promotion of sanitary reform amongst all classes, but specially the poor. 2. -- The Association is affiliated with the National Association for the Promotion of Social Science, to which the Committee shall report yearly. 3. -- Any person paying a donation of L10, or an annual subscription of 10s., shall be a member. The subscription is payable on the 1st of January. 4. -- Any member whose subscription is more than one year in arrear shall forfeit the privileges of membership until it is paid; and any member whose subscription is three years in arrear shall be struck off the list. 5. -- Each member shall be entitled to one of each of the Association's tracts published during the year, and shall be allowed to purchase any number o the tracts at a reduced price -- one-sixth less than the retail price -- and be entitled to borrow two volumes at a time from the Library. 6. -- The business of the Association shall be carried out by a Committee of twelve or more ladies, with secretaries, and two treasurers. 7. -- The Committee shall be assisted in the literary part of their work by an editing committee of six of more medical gentlemen, and every publication issued shall be revised and sanctioned by one of more of its members. 8. -- For meetings of the Committee, three members form a quorum. 9. -- A statement of the receipts, disbursements, and operations of the Association shall be drawn up annually by the Committee, and a copy shall be forwarded to each member. 10. -- The accounts shall be balanced monthly by the secretaries or one of the treasurers. 11. -- All cheques shall be signed by one member of the Committee, and countersigned by one of the treasurers. 12. -- The Committee shall in no case incur expenses that cannot be met by the funds in hand. LIST OF TRACTS. Prepared specially for Distribution among the Poor. THE WORTH OF FRESH AIR --------------------------Price 2d., 16s. per 100 THE USE OF PURE WATER ----------------------------Price 2d., 16s. per 100 THE VALUE OF GOOD FOOD -------------------------Price 2d., 16s. per 100 THE INFLUENCE OF WHOLESOME DRINK -----------Price 2d., 16s. per 100 THE ADVANTAGE OF WARM CLOTHING -------------Price 2d., 16s. per 100 TROUBLES & TRIALS & HOW TO MEET THEM -------Price 2d., 16s. per 100 NEVER DESPAIR ---------------------------------------Price 2d., 16s. per 100 THE SICK CHILD'S CRY --------------------------------Price 2d., 16s. per 100 WORK AND PLAY -------------------------------------Price 2d., 16s. per 100 The above three in one volume, entitled HOUSEHOLD VERSES ON HEALTH AND HAPPINESS, embossed cloth, 9d. THE HEALTH OF MOTHERS ---------------------------Price 2d., 16s. per 100 HOW TO MANGE A BABY -----------------------------Price 2d., 16s. per 100 THE POWER OF SOAP AND WATER ---------------Price 1 1/2 d., 12s per 1004 ABOUT TO MARRY: A Chat with an Old Friend Price 1d., 8s. per 100 THE CHEAP DOCTOR; A Word about Fresh Air Price 1/2d., 4s. per 100 THE BLACK HOLE IN OUR BED ROOMS . . Price 1/2d., 4s. per 100 THE MISCHIEF OF BAD AIR . . . . . . Price 1/2d., 4s. per 100 EVERYDAY WONDERS OF BODILY LIFE. With number Engravings. In 3 parts, at 2d. each; or in one volume, embossed cloth 1s. WASHING THE CHILDREN . . . . . . Price 1d., 8s. per 100 THE BRIDE'S NEW HOME . . . . . . Price 1d., 8s. per 100 THE MOTHER . . . . . . . . . . Price 1d., 8s. per 100 THE INSPECTOR . . . . . . . . . . Price 1d., 8s. per 100 CHILDREN GOING TO SCHOOL . . . . . . Price 1d., 8s. per 100 A DAY IN THE COUNTRY . . . . . . Price 1d., 8s. per 100 LOST AND FOUND . . . . . . . . . . Price 1d., 8s. per 100 THE NEW HOME. Wedded Life : Its Duties, Cares, and Pleasures. The above six in one volume, with frontispiece. Embossed cloth, price 1s. SOMETHING HOMELY . . . . . . . . Price 2d., 16s. per 100 WHOSE FAULT IS IT? . . . . . . . . Price 2d., 16s. per 100 SANITARY DEFECTS . . . . . . . . Price 2d., 16s. per 100 HEALTHY DWELLINGS, and Prevailing Sanitary Defects in the Homes of the Working Classes. Price 4d. WOMAN'S WORK IN SANITARY REFORM . . Price 2d., 16s. per 100 THE MASSACRE OF THE INNOCENTS. By THE REV. CHARLES KINGSLEY, F.S.A., Rector of Eversley. Price 1d., 8s per 100. HOW DO PEOPLE HASTEN DEATH? . . . . Price 2d., 16s. per 100 THE SECRET OF A HEALTHY HOME . . . . Price 2d., 16s. per 100 ON DRESS . . . . . . . . . . . . Price 2d. A MODEL WIFE . . . . . . . . . . Price 2d., 16s. per 100 WASPS HAVE STINGS; or, Beware of Tight Lacing Price 1d., 8s. per 100 SOWING THE SEED . . . . . . . . Price 2d., 16s. per 100 DRESS, AND ITS COST . . . . . . . . Price 1 1/2d., 12s. per 100 EVILS RESULTING FROM RISING TOO EARLY AFTER CHILDBIRTH 2d. HOW TO REAR HEALTHY CHILDREN. In Packets of 50 copies, 1s. each Packet THE SANITARY DUTIES OF PRIVATE INDIVIDUALS Price 2d., 16s. per 100 MEASLES: A TRACT FOR MOTHERS . . . . Price 1d., 8s. per 100 VILLAGE WORK . . . . . . . . . . Price 2d., 16s. per 100 HAND FEEDING . . . . . . . . . . Price 2d., 16s. per 100 FUN FOR THE YOUNG ; FACTS FOR THE OLD Part I., 1 1/2d., & II., 2d. MRS. FINDLAY'S TEA-PARTY ; OR, DUTIES OF MOTHER, MISTRESS, AND MAID . . . . . . . . . . Price 2d., 16s. per 100 WHAT CAN WINDOW-GARDENS DO FOR OUR HEALTH? Price 2d., 16s. per 100 THE "HOME ALMANAC" . . . . . . . . . . . . Price 2d. "SMALL POX AND VACCINATION" . . . . Price 1s. Published at the Association's Office, 8, Pont Street, Belgrave Square, SW., and may be obtained throughout any Bookseller. *** A series of other Tracts will shortly be published. Printed by B. W. GARDINER & SON, Princes Street, Cavendish Square, W.LADIES' SANITARY ASSOCIATION, AFFILIATED WITH THE NATIONAL ASSOCIATION FOR THE PROMOTION OF SOCIAL SCIENCE. PATRONESSES. Her Royal Highness the Crown Princess of Prussia Her Grace the Duchess of Argyll Her Grace the Duchess of St. Albans The Countess of Airlie The Countess of Bernstorff The Countess de Grey The Countess Russell The Countess of Shaftesbury The Viscountess Palmerston The Lady Stanley (of Alderley) The Lady Herbert of Lea The Baroness Mayer de Rothschild The Hon. Mrs. R. C. Trench Mrs. William Gladstone Lady Verney Miss Burdett Coutts COMMITTEE. Lady Margaret Bourke The Right Hon. Lady Ebury Mrs. Gregory Miss Garrett, L S.A. Miss F. Holland Mrs. Lankester La Comtesse A. de Noailles Mrs. Roth Mrs. Sutherland Mrs. Hensleigh Wedgwood Mrs. Garth Wilkinson EDITING COMMITTEE. Dr. John Brown Dr. William Farr, F.R.S. J. Marshall, Esq., F.R.S. Dr. B. W. Richardson Dr. Edward Smith, F.R.S. Dr. John Sutherland TREASURERS. Right Hon. Russell Gurney, Q.C., Recorder of London The Hon. Mrs. Dutton HONORARY AUDITORS. The Rt. Hon. W. F. Cowper, M.P. Viscount Kirkaldie BANKERS. Sir Samuel Scott, Bart. & Co., 1, Cavendish Square, W. Messrs. Williams, Deacon, & Co., Birchin Lane, Cornhili, E.C. HONORARY SECRETARIES. The Hon. Mrs. W. Cowper Lady Burrell SECRETARY. Miss E. S. Griffiths OFFICE. 8, Pont Street, Belgrave Square S.W. Subscriptions, Donations, Books for the Libraries, Manuscripts for Tracts, &c., will be gratefully received by the Treasurers, the Rt. Hon. RUSSELL GURNEY, S, Kensington Palace Gardens, W.; and the HON. MRS. DUTTON, 16, Halkin Street West, SW.; MISS E. S. GRIFFITHS, Secretary, at the Association's Office, S, Pont Street, Belgrave Square, SW.; MESSRS. WILLIAMS DEACON &Co., Bankers, Birchin Lane, EC.; and SIR SAMUEL SCOTT, BART., & Co., Bankers, 1, Cavendish Square, W. Post Office Orders to be made payable to ELIZABETH S. GRIFFITHS, at the Vere Street Post Office. SUB-COMMITTEES. FINANCE. The Hon. Mrs. Dutton Lady Burrell TRACTS. The Hon. Mrs. W. F. Cowper Lady Burrell La Comtesse A. de Noailles Mrs. Sutherland COLLEGE AND LECTURES. The Right Hon. Lady Ebury Mrs. Garth Wilkinson Miss Garrett, L.S.A. Miss Holland PARK PARTIES. Lady Margaret Bourke The Right Hon. Lady Ebury La Comtesse A. de Noailles Mrs. Garth Wilkinson GYMNASTICS. The Right Hon. Lady Ebury Mrs. Gregory La Comtesse A. de Noailles Mrs. Roth BRANCH ASSOCIATIONS. The Hon. Mrs. Dutton Mrs. Garth WilkinsonLIST OF HONORARY MEMBERS. ARCHBISHOP OF CANTERBURY, THE RIGHT REV. THE LORD ARCHBISHOP OF DUBLIN, HIS GRACE THE LORD ALDIS, CHARLES, M.D., Chester Square. BISHOP OF OXFORD, THE RIGHT REV. THE LORD BALFOUR, MRS. CLARA L., Reigate BALLARD, EDWARD ESQ., C.B., Richmond CHAMBERS, THOMAS, ESQ., M.P., Q.C., B.C.L., Gloucester Place, Portman Square COWPER, THE RIGHT HON. W. F., M.P., Curzon Street, Mayfair CRAUFURD, E. H J., ESQ., M.P., Belgrave Road DRUITT, DR. ROBERT, Hertford Street, Mayfair EARLE, DR. EBURY, THE RIGHT HON. LORD, 35, Park Street, Grosvenor Square FARR, WILLIAM, M.D., Bromley FURNIVALL, F. J., ESQ., 3, St. George's Square, Primrose Hill GARRETT, MISS, L.S.A., 20, Upper Berkeley Street GILLET, REV. EDWARD, Norfolk GODWIN, GEORGE, ESQ. F.R.S., Strand GREENHILL, DR. W. A., Hastings GURNEY, Rt. Hon. RUSSELL, Q C., Kensington Palace Gardens GUY, W. A., M.D., Gordon Square HARDING, T. MASSEY, ESQ., F.R.S. HOUGHTON, LORD, 16, Upper Brook Street, Grosvenor Square HUGHES, THOMAS, ESQ., M.P., Park Street, Grosvenor Square KINGSLEY, THE REV CHARLES KINNAIRD, The HON. ARTHUR, M.P., Pall Mall East LANKESTER, EDWIN, M.D., Great Marlborough Street LETHEBY, HENRY, M.D., 17, Sussex Place, Regent's Park LEVISON, DR. J., St. John's Wood MACGREGOR, JOHN ESQ., Hyde Park MILROY, GAVIN, M.D., Strand NOURSE, W. E. C., ESQ., Brighton OWEN, The REV. J. B., Chelsea PHENE, J. S., ESQ., F.R.G.S., Chelsea RADSTOCK, LORD, Bryanston Square RAWLINSON, ROBERT, ESQ., C.E., Whitehall RENDLE, DR. WILLIAM, Southwark RICHARDSON, B. W., M.D., 12, Hinde Street, Manchester Square ROUTH, C. H. F., M.D., Montagu Square ROWSELL, The REV. T. J., 3, Westbourne Square Hyde Park SHAFTESBURY, The RIGHT HON. THE EARL OF, K G., Grosvenor Square SIEVEKING, E. H., M.D., Manchester Square SMITH, EDWARD, M.D., F.R.S., 140, Harley Street STANLEY, The HON. LYULPH SUTHERLAND. JOHN, M.D.. Dulwich TILT, E. G., M.D., Grosvenor Street VERNEY, SIR HARRY, BART., M.P., South Street WHITE, The REV. EDWARD. Tuffnell Park WILKINSON, JOHN GARTH, M.D., 76, Wimpole Street The following Donations of Patterns, &c., received in 1868, are thankfully acknowledged:— LA COMTESSE A. DE NOAILLES—Patterns of Clothing, Books, &c. ROBERT CROFT, M.D., One Book. ALFRED DAVIS, ESQ., One Book. REPORT. THE COMMITTEE, in presenting their Eleventh Annual Report, have very great pleasure in informing their friends that Her Royal Highness the Crown Princess of Prussia has joined the Association, and has kindly expressed her high opinion of the useful and beneficent influence of such work, and of her great interest in the Society, and warm sympathy with the truly benevolent and enlightened ends it pursues. Her Royal Highness has very graciously allowed her name to head the list of Lady Patronesses, and has sent a handsome donation to the funds of the Association. Her Royal Highness has requested permission to have the Sanitary Tracts translate into German, and expresses a hope that the truly philanthropic principles of this Association will find adoption all over the Continent. And in Germany it will be Her Royal Highness's special endeavour to help to carry out and pursue the same works in the same manner. Her Royal Highness requests the Secretary to continue sending the Tracts, Reports, and other Papers of the Society as soon as they appear ready for circulation. Her Royal Highness honoured the Committee by a visit to their Office on the 27th of November, and requested that complete sets of the Tracts, Patterns, &c., might be sent to Windsor Castle for Her Royal Highness. The Committee have been greatly encouraged by the valuable and kindly expressed opinion of Her Royal Highness, and feel sure the Members of the Association will be stimulated to fresh exertions in the work, which much needs the earnest zeal of all who are interested in it. The Committee take this opportunity of requesting the help of each Member, in obtaining new Members; and will be glad to supply Papers and Tracts for distribution for this work. The Committee have to regret the loss of many kind Members during the past year by death, and of many through the distress prevailing among the poor. The work flags from want of funds. The sale of Tracts has been very small, and the Committee have been unable to print the manuscripts waiting to be issued. Shortly they will publish some new Tracts, which they hope will increase the sale of Tracts already issued. Miss Garrett kindly gave a Lecture on Sanitary Work to the Mission-women and their Superintendents, at the house of Lady 6 Burrell, in Berkeley Square, which was well attended. Lady Burrell kindly provided refreshment, and all present were pleased and instructed. The Committee are very glad to know that Mr. Twining's Illus- trated Lectures continue to draw a large audiences among the working classes, and that this part of the work has not been left entirely undone through their want of means. For the year 1869, 5,000 copies of "The Home Almanac" have been printed, 500 Essays on "Small-pox and Vaccination," 1,000 copies of the Association's Tenth Annual Report, 1,000 large List of Tracts, and several thousands of Tracts have been re-printed. Several meetings in connexion with the Gymnastic Classes, which are continually forming and exercising in the British and Foreign Training Schools, have been held at the house of the Countess de Noailles in Regent's Park, for the purpose of considering the best means of introducing Sanitary Instruction into the Training Colleges. Invitations were sent to the Committees and Secretaries of the various colleges. There were present at these meetings –– the Countess de Noailles, the Hon. Mrs. Cowper, Lady Burrell, Miss Partridge, Dr. Garth Wilkinson, Dr. Richardson, Mr. Chadwick, Mr. Adams, Dr. Roth, Mr. Bourne, and others. A grant of fifty pounds has been made by the Countess de Noailles (per Ladies' Sanitary Association) to the British and Foreign Training College, Stockwell. The Committee of that college having agreed to the rules drawn up at these meetings. A gymnastic apparatus is being arranged at the college; time being given for daily exercise at the gymnasium. Prizes will also be given for examinations in Physiology; and for Flowers grown by the students. The teachers have received books and diagrams from this Association, and have entered heartily into the work. Next year we hope to announce that a gymnasium has been built and fitted up in connexion with the college. Thirteen thousand, two hundred and forty-three children were sent to play in the Parks last season in parties; and one day a can filled with infants, from St. Luke's, Berwick Street, were taken to Ken- sington Gardens, and had there buns and milk. The Baroness Mayer de Rothschild gave a treat to one of our Park Parties, num- bering 128 children, of tea and cake, and toys and music. The Baroness has paid the expenses of this party for the whole summer. Fifty girls were clothed for these parties. The clothing consisted of 50 calico shifts, 21 red flannel shifts, with Garibaldi tops and long sleeves, 21 linsey skirts, 29 blue serge dresses, 50 white straw hats, trimmed with blue riband. To some of the parties of girls, skipping- ropes were given. We hear that much good has been done by these visits to the Parks, and that the children are more healthy and happy. The Committee have sent out parties of poor children from the following schools, or districts, since 1861 :––St. Peter's District, Mile 7 End; Farm Street School, W.; St. Bartholomew's, Bethnal Green; Curzon Schools, Mayfair; St. Luke's, Berwick Street; Archbishop Tenison's Schools, W.; Stepney Meeting Schools, E.; Carr Street, Limehouse; St. Thomas's, Hackney; Homerton Dis- trict; St. George's, Hanover Square; Nightingale Street, Portman Market; Cudworth Schools, Bethnal Green; North Street, Bethnal Green; Calmel Gray's Yard, W.; Hinde's Mews, Marylebone Lane; Bryan Street, to field at Islington; Agar Town Free School, Russell Street, Rotherhithe, to Mr. Torr's field; Union Walk, Shoreditch; New Cut, Lambeth; Bacon Street, Bethnal Green; Deconshire Street, Commercial Road East; Dolphin's Court, Spitalfields; Duke Street, St. George's in the East; George Street, Spitalfields; Edward's Mews, Marylebone; Nicol Street, Spitalfields; Lansdowne Place, Southwark; Collingwood Street, Shoreditch; Dove Row, Bethnal Green, 2 Schools. Hackney District:––Pear Street and Duck Lane Schools, Westminster; Bedforbury, Covent Garden; Hope Street, Spitalfields; Bell Street, Edgware Road; Ogle Mews, Marylebone; Camden Town School; St. Mary's, Southwark; Wilkes Street, Whitechapel; Brewer's Court, Drury Lane; St. George's, The Martyr, Borough; Anchor Street, Shoreditch; Pell Street, St. George's in the East; Webber Row, Lambeth; Charles Street, Drury Lane; Lant Street, Southwark; Church Place, Paddington Green; Clare Market, Strand; Princes Street, Lambeth Butts; Little Saffron Hill, to the Temple Gardens; Waterloo Road, S.; Brent Court, Southwark; Fitzroy Market, Tottenham Court Road; Irish Free School, St. Giles; Vinegar Ground, City Road; Christ Church, St. George's in the East; Mullock's Place, Bermondsey; St. Paul's, Westminster; Wood's Place, Bermondsey; Grotto Place, Paddington; Moreton Street, Newington Causeway; Brill Schools (2), Somers Town; Nichol Street, Limehouse; St. Paul's, Portman Market; Kingsland School, N.; Perkin's Rent, Victoria Street; Cottage Place, Waterloo Bridge Road; Northey Street, Limehouse; Clarence Street, Rotherhithe, &c. Each School costs upon an average £2 each season. The Committee appeal to their friends for funds to carry on this part of their work, as they now have but £3 in hand for 1869. The Committee of the Destitute Children's Dinner Society, publish their Report every September. To September, 1868, thirty-seven dining rooms had been opened and supported, or partially supported by means of this Society in the poorest localities in London; the grants made amounted to 8847.; and 83,119 children had received a good meat dinner. The Chelsea Branch gave during the year 4666 dinners. It should be remembered that the people are not pauperized by the benefits their children receive from these weekly dinners; each child pays a penny for its dinner, and in this way the parents or frineds of the children have paid in to the funds of this Society during the year about 400l.1868.-CHELSEA DINNER FUND.-BALANCE SHEET. RECEIPTS. EXPENDITURE. £ s. d. £ s. d. Per Ladies' Sanitary Association:- Butcher 47 0 0 Lord Elbury 10 0 0 Baker 3 9 1 Lady Elbury 3 0 0 Rice 1 10 0 The Right Hon. W. Cooper 5 0 0 Wages for Cook, &c. 11 4 0 Mrs. Laurie 5 0 0 Coals 1 19 11 Mrs. F. V. Harcourt 1 0 0 Potatoes 4 8 10 Mrs. Hume 1 0 0 Washing 1 0 11 Miss Dawson 0 14 0 Sundries, Pepper, &c. 1 11 9 Mrs. Deey 0 5 0 £72 4 6 Mrs Brady 0 4 0 £27 3 0 Sir W. Farquhar 5 0 0 Countess de Noailles Fund 21 14 10 Children's pence 18 1 3 Paid dinners 4,359 Sale of bones 0 5 5 Given dinners 307 £72 4 6 Total 4,666 W. E. Cowper, Auditor 9 The London Dressmaking Company is succeeding admirably. The Rules for the conduct of the House and Business have been strictly observed. The business of the Company has increased during the past year. The Directors have great satisfaction in reminding the Shareholders that the Legislature has now enforced such a limitation in the hours of labour in the West end workshops, as this Company was formed to promote, and that the Workshops' Act was introduced by one of the founders of the Company. The branch Associations continue their practical work in Aberdeen, Brighton, Bristol, Cardiff, Paisley, Leeds, Reading, Romsey, &c., and at Birmingham a Branch Association has been started during the year, which promises to do a great work in that town. These Societies have been, as usual, circulating tracts and almanacs, delivering lectures, holding meetings and classes, cleansing and whitewashing houses, distributing bath tickets, supplying soap, brushes, pails, &c., lending water-beds, water-cushions, and baths to the sick, giving meat tickets, and warm garments to the needy, and holding flower shows, &c., for the young. In Paisley 370 houses have been cleaned, and 373 bath tickets given during the year. On behalf of their sick fund they acknowledge in their report, 5 dozens of wine, 3 iron bedsteads, 3 water-beds, several water-cushions ; and when we state that money expended in this department of the work has been distributed in 1,156 separate sums, and that each case has been thoroughly inquired into before being relieved, it will be seen that a very great amount of labour has been accomplished, by the treasurer and her zealous assistants, the Bib'e women. At Cardiff tracts and almanacs have been freely circulated, 898 houses have been limewashed, brushes have been lent out 3,068 times in the year. They have nine depots for those utensils, numbers of bath tickets have been given, and a working men's flower show held, at which prizes were given by the Association. Such work is truly woman's work, and the Committee would be thankful to know that Branch Committees were doing like work in different parts of London. In London people are discouraged, the work that needs doing is overwhelming, and we need to remember the power of one to influence and inspire others to earnest work. The Committee beg to thank Dr. Wyld, who very kindly arranged for an evening meeting at his house in Hyde Park, for the consideration of the improvement of the dress of women and children, to which physicians, artists, and some members of the Association were invited. Patterns of clothing, drawings, &c., were exhibited. The meeting was a very pleasant one, and the suggestions were very good. A tract, "On Dress," has since been written. The Committee would also express their thanks to their kind friends of the press for the good notices of the work of the Association which they have given in their daily and weekly papers. To the editors of 10 Punch, the Nonconformist, the Queen, the Star, the Standard, the Public Health, the Courier, &c. &c. The Committee would also be these good friends to continue their kinds notices of the work whenever their space will permit. There are a thousand institutions for the cure of disease, supported on a scale of munificence, which has made English charity proverbial ; but there is only once institution for the preventions of disease, instituted most fittingly by English ladies, since it is at the preventative period that female influence can best be bought to bear. All have an interest in this question. It is not known how much of the power of England is wasted by leaving the people in ignorance of the laws which govern life-the laws by which they live from day to day, and from hour to hour. which regulate every moment of their existence. The people are worn out, not so much from hard work and hard fare, as from the inevitable maladies engendered by their condition ; hence to whatever extent this Society is enable to circulate information bearing on those important points, it is engaged in promoting a humane work, which ought to lie dear and deep in the sympathies of every Christian. The work to be done is very great, and the fruits very small. - See Financial Statement. SHEET OF RECEIPTS AND EXPENDITURE From January 1st, 1868, to December 31st, 1868. RECEIPTS. £ s. d. To Balance in hand, January 1st, 1868 14 7 4 " Subscriptions 174 9 0 " Donations, General Fund 77 10 8 " Donations, Gymnastic Fund 50 0 0 " Donations, Parks Fund 24 14 6 " Donations, Clothing Fund 2 0 0 " Donations, Dinner Fund 27 3 0 " Donations, Almanac (Special) 40 0 0 " Tracts 47 19 3½ " Books 2 14 0 " Patterns 0 7 8 " Almanacs 31 6 4½ " Gymnastics 10 0 0 " Tickets 8 11 0 £511 2 10 EXPENDITURE. £ s. d. By Expenses of Office 77 3 5½ " Salaries and Travelling Expenses 129 14 7 " Postages, Stationery, and General Printing 29 0 9½ " Printing Reports 9 5 0 " Printing Essays 16 9 0 " Printing Almanacs 60 14 0 " Books 2 16 11 " Patterns 1 10 0 " Gymnastics 11 10 0 " Park Parties 21 13 7 " Dinners 27 3 0 " Clothing 3 14 9 " Hanover Square Rooms, &c. 8 11 6 " Advertisements 3 12 0 " Social Subscription 1 1 0 " Cheque Book 0 2 6 £404 2 1 Balance in hand Dec. 31, 1868 107 0 9 £511 2 10 Examined with vouchers and found correct, W.F. COWPER, E. H. J. CRAUFURD Auditors LIST OF SUBSCRIPTIONS AND DONATIONS. N.B.—(L.M.) prefixed to a Name denotes a Life Member. Subs. Dons. £. s. d. £. s. d. H.R.H. The Crown Princess of Prussia 30 0 0 Acton, Mrs 0 10 0 Airlie, the Countess of 0 10 0 Ashtown, The Right Hon. Lady 1 0 0 Anonymous, per Punch 0 10 0 Anonymous 0 3 6 Atkinson, George. Esq., per Punch 5 5 0 (L.M.) Baines, Mrs. W. Ball, Mr. 5 0 0 Barrett, Mrs. S. N. 0 10 0 Bartlett, Mrs. Robert 1 1 0 Bathoe, Mrs. Charles 2 2 0 2 0 0 Battersby, Mrs. 1 0 0 (L.M.)Beattie, MissStewart Bell, Lady 0 10 0 Bell, Miss 1 1 0 Bergmann, Mrs. 2 2 0 Birkbeck, Miss 1 0 0 Bischoffsheim, Mrs. 1 0 0 Blakeley, Mrs. Dean 0 10 0 Bligh, Miss 0 10 0 0 2 0 Boughton, Lady Rouse 0 10 6 Boughton, Miss Rouse 0 10 6 Bousefield, Henry, Esq. 1 1 0 Bowman, Miss 0 10 0 Bowyer, Mrs. 0 10 0 Braby, Mrs. 0 10 0 0 4 0 Branthwaite, Miss 0 10 0 Briggs, General 0 10 0 (L.M.) Brown, The Rev. B. (L.M.) Browth Mrs.Baldwin Brown, Mrs.Alexander 1 0 0 Bryan, The Rev. Guy 0 5 0 Bunsen, Madame de 1 1 0 Burrell, Lady 2 2 0 40 0 0 Buss, Miss 0 10 0 Butter, Mrs. 0 10 0 Byles, The Lady 1 1 0 Byrne, Mrs. H. B. 0 10 0 C. H. B. 0 2 0 Subs. Dons. £. s. d. £. s. d. Cameron, Lady Vere 1 1 0 Cameron, Dr. Fenton 1 1 0 Campbell, Mrs. 1 0 0 Cardiff Branch 1 1 0 Carter, Mrs. Bonham 0 10 6 Carter, A. Bonham, Esq. 1 0 0 Carter, Miss A. Bonham 2 0 0 1 0 0 Carter, Miss E. Bonham 0 10 6 0 10 6 Cartwright, Miss 0 5 0 (L.M.)Chance, Robt. Esq 2 2 0 Chesham, The Lady 0 10 0 Claxton, Miss 1 1 0 Clegg,Joseph,Esq., M.R.C.S. 0 10 0 Clendenning, Miss 0 10 0 Collins, The Rev. R 0 10 0 Collins, Mrs. 1 1 0 Collins, Mr. 0 10 0 Coombe, Mrs. 0 2 6 Corbet, Mrs. V. R. 0 10 0 Cornthope, G. C., Esq. 1 1 0 Coulson, Mrs. 1 1 0 (L.M.)Coutts, MissBurdett Cowper, The Hon. Mrs. W. 1 0 0 Cowper, The Rt. Hon. W. 10 0 0 Craufurd, Miss 1 0 0 Crewdson, Mrs. 1 0 0 Crook, Mrs. R. J. 0 10 0 Curtis, Miss 0 2 6 (L.M.)Daman, Miss Darnley, The Countess of 0 10 0 (L.M.) Davis, Alfred, Esq. 10 10 0 Dawson, Miss C. Kennet 0 10 0 0 14 0 Deey, Mrs. W 0 10 0 0 10 0 Deuce, Miss 0 10 0 0 10 0 Dew, The Rev. E. Parker 0 10 0 Dixon, Miss 0 10 0 Driver, Rolles, Esq. 0 10 0 Douglas, Mrs. 0 10 0 D'Oyley, Miss 1 1 0 Ducie, The Lady 1 1 0 Dudgeon, Mrs. 0 10 0 Duncombe, George, Esq. 1 1 0 Dutton, Hon. Mrs. 1 1 0 Dykes, Mrs. D. S. 0 10 6 13 Subs. Dons. £. s. d. £. s. d. D. L. 0 10 0 Ebury, The Rt. Hon.Lady 1 1 0 4 0 0 Ebury, The Right Hon. Lord 10 0 0 Ebsworth, Mrs. 0 10 6 Edwards, Miss 0 10 6 Edwards, Miss Gertrude 0 10 6 Edwards, Mrs. E. 1 1 0 Elliot, Lady 0 10 6 Elliot's Children, Lady 0 8 0 Elwyn, Mrs. 0 10 6 Erskine, Miss 1 0 0 Ewart, Mrs. 0 10 0 Fairfax, Lady 0 10 0 Fawcett, Mrs. 1 1 0 Finch, Miss 1 0 0 Fison, Cornell, Esq. 0 10 0 Fortescue, Lady 0 5 0 Franck, James, Esq. 0 10 0 Friend, per Miss Griffiths 0 10 0 Gillies, Miss Margaret 0 10 6 Gilkison, Miss 0 10 6 Godwin, George, Esq. 1 1 0 Goldschmidt, Madme Lind 2 2 0 Goldsmid, Miss Caroline 1 0 0 Goldsmid, Lady 0 10 6 Greaves, Miss Richard 0 10 0 Gregory, Mrs. William 1 1 0 1 0 0 Grey, The Countess de Guerin, Colonel 0 10 0 Gurney, Mrs. Russell 1 1 0 (L.M.)Gurney,Mrs. Edmd. Hamilton, Mrs. R. F. 1 11 6 Hamilton R. F. Esq. 1 11 6 Hands, Miss 1 1 0 Hardy, Miss 1 10 0 Harcourt, Mrs. 1 0 0 Hargreaves, Mrs. William 1 1 0 Hall, Miss 0 10 6 Harris, Miss 0 10 6 Harrison, Mrs. 1 1 0 0 10 0 Harrison, Mrs. James 1 0 0 Hastings, G., Esq. 1 0 0 Hawkins, Cæsar, Esq. 1 0 0 Hetherington, Mrs. 1 0 0 Hill, Mrs. F. 0 15 0 Hill, The Misses 0 15 0 Hill, Mrs Lewin 0 10 0 Hills, Mrs. F. C. 0 10 0 Hoare, Mrs. Joseph 0 10 0 Hobart, Lady 1 0 0 Hobson, Miss 0 10 0 (L.M.) Hodson, Mrs. Holford, Mrs. 1 0 0 Holland, Miss 1 0 0 Subs. Dons. £. s. d. £. s. d. (L.M.) Hope, Mrs. Houchen, Mrs. 0 10 0 Howard, Dilworth, Esq. 0 10 0 Hume, Mrs. 2 0 0 Ingram, Dr. Charles 0 10 6 Kay, Miss L 0 10 0 Kenrick, Mrs. 0 10 0 Laurie, Mrs. 5 0 0 L. D. 0 10 0 Leaf Mrs. C 1 1 0 Leeds Sanitary Association 1 1 0 Letchworth, Thomas, Esq. 1 1 0 Letchworth, Miss 0 10 0 Leigh, Mrs. Egerton 0 10 0 Lewes, Mrs. C. L. 0 10 6 Lister, Mrs. 1 1 0 Littledale, Mrs. 5 0 0 (L.M.) Lloyd, Mrs. G. A Londesborough, Lady 0 10 0 Mackworth, Miss F. 0 10 0 Macnaghton, Lady Emily 0 10 0 Major, Mrs. 0 10 0 Manners, The Right Hon. Lady John 1 1 0 Manning, Miss 0 10 0 (L. M.) Marshall, John, Esq., F.R.S Maurice, Rev. F. D. 0 10 0 Maurice, Miss 0 10 0 Meiklam, Mrs. J. 0 10 0 Michel, The Lady 1 1 0 Midleton, The Dowager Viscountess 1 1 0 Moilliet, Mrs. T. 2 0 0 Munro, Rev. A. 0 10 0 Nash, Mrs. Charles 0 10 0 Newman, Mrs. F. B. 0 10 0 (L. M.) Noailles, La Comtesse A. de 5 0 0 66 9 0 Noel, The Hon. Mrs. 0 10 0 Oakes, Mrs 0 10 0 Orton, T, Esq. 0 10 0 Page, Miss 0 10 0 Page, Miss S. E. 0 10 0 Paisley Sanitary Association 1 1 0 Palmerston, Lady 1 0 0 Palmer, Miss 0 10 0 Parkes, Miss 0 10 6 (L. M.) Parry, Mrs. Parry, Miss 1 0 0 POPULAR TRACTS ON HEALTH Issued by the LADIES' SANITARY ASSOCIATION 8, Pont Street, Belgrave Square, S.W. On Dress 2d. A Model Wife 2d. Wasps Have Stings: or, Beware of Tight-Lacing, 1d Sowing the Seed, 2d. Dress and Its Cost 1 1/2d. Evils Resulting From Rising Too Early After Child-Birth 2d. How to Read Healthy Children. In Packets of 50 Copies. 1s. each Packet The Sanitary Duties of Private Individuals 2d. Measles: A Tract for Mothers 1d. Village Work 2d. Hand Feeding 2d. Fun for the Young; Facts for the Old. In Two Parts 1 1/2d and 2d. Mrs. Findlay's Tea Party; or, Duties of Mother, Mistress, and Maid. 2d. What Can Window Gardens Do For Our Health? 2d. The Worth of Fresh Air 2d. The Use of Pure Water 2d. The Value of Good Food, 2d. The Influence of Wholesome Drink. 2d. The Advantage of Warm Clothing, 2d. Troubles and Trials, and How to Meet Them, 2d. Never Despair, 2d. The Sick Child's Cry, 2d. Work and Play 2d. The above Three in One Vol, entitled Household Verses on Health and Happiness. Embossed Cloth. 9d. The Health of Mothers 2d. How to Manage a Baby. 2d. The Power of Soap and Water 1 1/2d. About to Marry: A Chat with an Old Friend. 1d The Cheap Doctor: A Word About Fresh Air 1/2d. Black Hole in Our Bed-Rooms. 1/2d. The Mischief of Bad Air 1/2d. Every-Day Wonders of Bodily Life. In Three Parts, 2d, each; or in one Vol., Embossed Cloth 1s. Washing the Children 1d. The Bride's New Home 1d. The Mother 1d. The Inspector 1d. Children Going to School 1d. A Day in the Country 1d. Lost and Found 1d. The above Six in One Volume, with frontis-piece, entitled The New Home. Wedded Life: Its Duties, Cares, and Pleasures: Embossed Cloth, 1s. Something Homely. 2d. Whose Fault Is it? 2d. Sanitary Defects, 2d. Healthy Dwellings, and Prevailing Sanitary Defects In The Homes of the Working Classes. 4d. Woman's Work in Sanitary Reform. 2d. The Massacre of the Innocents. 1d. How Do People Hasten Death? 2d The Secret of a Healthy Home. 2d. The "Home Almanac," 2d. Small Pox and Vaccination. 1s.16 From the ARCHBISHOP OF CANTERBURY. "I have been extremely pleased with the little packet of sanitary poems, which I am sure will be likely to gain for the Association at least one class of the community, and that a most important class - the children. I have seen how one of my own children has been please with these poems, and I am quite sure that if you can get the children to like them, there must be something in them which is really attractive; and if you enlist the children on the side of cleanliness and other healthy habits, I think you will very soon find that you enlist their mothers too, and through the mothers you may hope to influence whole families. The LORD BISHOP OF OXFORD. "The law laid down for us, the golden writing to be read everywhere, is that the way to help a man is to teach him to help himself, and this is the great principle of this Association. It aims at the dissemination throughout the land, and especially amongst the poor, of sanitary knowledge, put in a form in which it will easily reach them, so that they themselves may begin intelligently to co-operate with those who desire to help them to raise their physical condition." The EARL OF SHAFTESBURY. "I must say that the class of literature this Association has originated is as interesting and valuable as it is novel. It shows considerable talent, wonderful penetration and acuteness, and great power of composition. I have read some of the little books which have been issued by this Association, and I declare I have found them some of the most interesting, picturesque, and agreeable writings I have ever read. I do from the bottom of my heart wish God-speed to the Ladies' Sanitary Association; God-speed to all its efforts, practical and literary." The ARCHBISHOP OF DUBLIN. "I think this admirable Association has taken to itself one province of the evil under which the world groans, upon which it is most successfully making war. I think we (the clergy) may especially rejoice in hearing of that enormous circulation of tracts, the mere names of which at once tell us how genial, how hearty, how healthy, they are likely to be; how they are not abstruse writings addressed to the few, but popular ones addressed to the many, bringing knowledge, instruction, and warning, and comfort, and health, into innumerable households throughout the land." The Rev. CHARLES KINGSLEY. "Now, I do believe that if those tracts which you are publishing, and which I have read, and of which I cannot speak too highly, are spread over the length and breadth of the land; and if women, clergymen's wives, the wives of manufacturers, and of great employers, district-visitors and school-mistresses, have these books put into their hands, and are persuaded to spread them, and to enforce them. by their own example and by their own counsel, in the course of a few years, this system being thoroughly carried out, you would see a sensible and large decrease in the death-rate." The Rev. BALDWIN BROWN. "I have read a great many of these tracts myself; I have heard them read to hundreds - I may say thousands - of working men and women, by ladies during the year, and always I have seen that they went home. Most of them are written in a style which is very calculated indeed to come home to the understanding, and to the best sympathies and affections of the working people; and I am quite sure that the seed which is sown by means of these tracts, the healthy public opinion which is created, will bear very large and blessed fruits." DR. LANKESTER. "It is the ignorance of the poor, this want of knowledge of sanitary laws, a knowledge of the laws of life, the life by which God governs the life of the community, their ignorance of the value of fresh air, the value of pure water, the value of warmth, the value of many things which they could use and employ, which causes them to die. 'My people die,' said the Prophet, 'and there is no man to consider.'" Printed by B. W. GARDINER & SON, Princes Street, Cavendish Square, W. INFLUENCE OF MARRIAGE ON THE MORTALITY OF THE FRENCH PEOPLE. BY WILLIAM FARR, M.D., F.R.S. Read before the Public Health Department of the National Association for the Promotion of Social Science, 1858. LONDON: PRINTED BY SAVILL & EDWARDS, CHANDOS STREET, COVENT GARDEN. 1859.INFLUENCE OF MARRIAGE ON THE MORTALITY OF THE FRENCH PEOPLE. THE changes which age induces in the vital forces have been calculated. The differences in the mortality of the two sexes are known. Men have investigated the effects on life of air, water, hills, plains, and marshes - of the sun in various seasons and climates - of food, animal and vegetable - and of alcoholic drinks. The fatality of foul exhalations of every kind has been made manifest. But the life of man is affected by still more subtle agencies. Te action of the various parts of the body in industrial occupations produces specific effects. Every science modifies its cultivators. The play of the passions transfigures the human frame. How do they influence its existence? These are some of the higher fields of speculation which have not yet been explored by sanitary research. I have now, however, to submit to the department the results of an inquiry into intermediate phenomena. The family is the social unit; and it is founded in its perfect state by marriage. The influence of this form of existence is therefore one of the fundamental problems of social science. A remarkable series of observations, extending over the whole of France, enables us to determine for the first time the effect of conjugal condition on the life of a large population. The French people may be classed in three great groups, exclusive of minors under age: I. The married, consisting of two groups: (a) Husbands, 6,986,223; and (b) wives, 6,948,828, making a total of 13,935,051.* II. The celibate, who have never married - namely, (a) Bachelors * The French census includes many foreign husbands who have left their wives at home. The wives in Great Britain exceeded the husbands by 70,253 in 1851. 4 Influence of Marriage on Mortality. ...lors, 4,031,582 ; and (b) spinsters, 4,547,952, making a total of 8,579,534. III. The widowed, in two groups : (a) Widowers, 836,509 ; and (b) widows, 1,687,583 ; making a total of 2,524,092. Deparcieux, in the middle of the last century, investigated the relative mortality of monks and nuns in France ; and he compared their life with that of Tontine annuitants, consisting partly of married and partly of unmarried persons. From the age of twenty to forty the mortality of the monks and nuns living in 'single blessedness' was lower, and after the age of forty it was higher than the mortality of the annuitants. The excess of mortality was considerable in the monks. The condition of these members of religious houses is at all times peculiar, and besides their vows of chastity's involved a peculiar discipline likely to affect their lives. Many of them lived in Paris. We can now deal with the whole population of France, amounting, in 1851, to thirty-six millions of people, some dwelling against our southern coast, in Flanders, Picardy, and Normandy ; some in Brittanny, around the rugged shores of the Atlantic ; some in Orleans, Tours, and Nantes, beside the 'murmuring Loire ;' some on the Garonne, wandering from Toulouse to Bordeaux, through that old Guienne, famous in our history ; some climbing up the Pyrenees, or seated in Languedoc, or in Marseilles on the Mediterranean Sea ; some on the rapid Rhone, in Provence, the seat of the old Courts of Love-in Lyons and in Avignon ; some extending from the Alps and the mountains of Auvergne and the Vosges, over Dauphiny, Burgundy, Lorraine, and Champagne ; and some living in Paris, Rouen, Havre, and the region around the Seine. This country, covered by its millions of small proprietors living on the parcels into which the soil was divided by the great Revolution-by cultivators of the vine and the olive in the South, of the apples and the cereal crops ion the North-by pastoral families on the Landes and on the Mountains-by artisans and manufacturer in a few large cities, contained in the year 1851 nearly fourteen million married people of both sexes. What was their rate of mortality ? Under the French law, young men of the age of eighteen, and young women of the age of fifteen, can legally marry. Of the few young married pairs living, the mortality in both husbands and wives was excessively high under the age of twenty. Twice as many wives under twenty died in the years as died out pf the same numbers of the unmarried ; and the mortality was much higher than it was among husbands and wives in the subsequent decennial of life. The results confirms the common opinion of the evil consequences of marriage in many cases under the age of twenty, before the growth of the individual man or woman is completed. The wives of the next twenty years of age experience a rate of mortality half as high again as the husbands of those ages suffer. The mortality of the husbands is exceedingly low, 6.5 and 7.1, while wives of twenty to thirty die at the rate of 9.3 in 1000, in By William Farr, M.D. 5 rather higher proportions than the wives of the subsequent age, thirty to forty, when the mortality is 9.1. This excess is fairly ascribable to the sorrows of childbearing, and to no small extent to ignorant midwives. At the age of forty to fifty, the mortality of husbands (10.3) is slightly higher than the mortality of wives ; and so it remains higher ever afterwards, but the difference is not considerable. Age. Husbands. Wives. 50-60 18.3 16.3 60-70 35.4 35.4 70-80 88.6 84.9 80-90 183.6 180.4 Thus, to 1000 husbands living at the age of sixty to seventy, there are 35.4 deaths ; to 1000 wives 35.4 deaths. As so the old people go on in the table tottering down the hill till they 'sleep together at the foot.' How fares it with the unmarried-the celibate? At the younger ages under twenty, the mortality is, as I have already stated, much lower in the two sexes than it is in the married. Age. Unmarried. Males. Females. 15-20 6.7 7.7 in 1000 die. At all the ages from 20 to 60 unmarried men experience a much higher rate of mortality than unmarried women. The excess of the mortality of males at the age of 20-30 was in the ratio of 11.3 to 8.7. It was aggravated by the deaths of the soldiers dying in Algeria, and in the Casernes at home ; but in the subsequent periods this element does not interfere to any extent. Annual deaths to 1000 living :- Age of the Unmarried. Males. Females. 30-40 12.4 10.3 40-50 17.7 13.8 50-60 29.5 23.5 At the age of 60 and upwards, the unmarried of both sexes are nearly equally mortal. But how is as between the married and the unmarried women ? What at 20-25 the maidens have the advantage, and the difference is not inconsiderable. Of 1000 Females. Married. Unmarried. Annual Deaths 9.8 8.5 At the age of 25-30 the mortality of the unmarried is slightly in excess (9.2 to 9.0). At the next age (30-40) the wives are the halest ; the mortality of the wives being 9.1, and of the unmarried 6 Influence of Marriage on Mortality. women 10.3. At the age of 40 the married women experience a much lower rate of mortality than the unmarried :- Married. Unmarried. 40-50 10.0 13.8 50-60 16.3 23.5 60-70 35.4 49.8 and so it runs through the ages. The contrast between the health of the bachelors and of the married men is still more striking ; the young bachelors enjoying an advantage, the old ones suffering in comparison. Mortality per 1000 among married men and bachelors:- Married. Unmarried. 15-20 *29.3 6.7 20-30 6.5 11.3 30-40 7.1 12.4 40-50 10.3 17.7 50-60 18.3 29.5 60-70 35.4 49.9 And after the ages of 8-, the mortality of the two classes becomes nearly equal. If unmarried people suffer from disease in undue proportion, the have-been-married suffer still more. At the ages of under 40 the mortality of widows is higher than the mortality of unmarried women. At the earlier ages the mortality is doubled. At 40 and upwards their mortality is lower than the mortality of unmarried women of corresponding ages. At all ages widows are more mortal than wives. Young widowers under the age of 30, and even under the age of 40, experience a very heavy rate of mortality ; and after 60 the widowers die more rapidly, not only the husbands, but more rapidly than old bachelors. This is the general result :- Marriage is a healthy estate. The single individual is more likely to be wrecked on his voyage than the lives joined together in matrimony. In what respect do the married among the masses of the people differ from the unmarried classes ? Where the earnings of the two classes at the same age are equal the married man must have a smaller share of the means of living than then single man, for he shares his gains with his wife and children. His food and clothing may be of a lower description, or his lodging be more crowded ; but thus is often counteracted by his stimulated industry. The single man can move about more freely, and can carry his industry to the best market. Upon the other hand, his household comforts are less ; the watchful care of a woman does not direct the economy of his dwelling ; the very amplitude of his means exposes him to the temptations of intemperance and vice. His faculties fall, and sometimes rise. into excesses of various kinds. * This is accidentally an exaggeration ; the facts are insufficient. By William Farr, M.D. 7 The priests and the soldiers represent the unmarried classes. Men of letters, men prosecuting the abstract sciences, men of family and small means, probably figure in large proportion amongst their highest ranks : criminals, lunatics, vagrants, and mendicants among the inferior orders. If they contain some of the lowest, they contain also some of the highest members of their race, ascending from the idiot up to Newton. The saying of the great Chancellor Bacon has in it a colouring of truth :- "Certainly the best works, and of greatest merit for the public, have proceeded from the unmarried or childless men, who both in affection and means have married and endowed the public." The wife shares the fortunes of the husband ; he is exposed to violence, she to the incidents of childbearing. Nuns, religious sisters, many ladies of birth, are at the head ; grisettes, courtesans, at the bottom of the unmarried troops-which figure also in larger proportion than the married among the female criminals, lunatics, idiots, deaf and dumb, blind and deformed. They include some of the loftiest and some of the lowest of their sex. Is nay part of the excessive mortality of the single in France referable to vice ? Yes ; to vice and its attendance irregularities. Levy asserts that the colleges of France are infested by vices which induce debility, and death later in life. The French youth do not yet engage in strong athletic exercises, which it is well known are the safeguards of our public schools. Syphilis-the oidium of the human race-induces half the sickness, and, indirectly, some of the mortality of the army, which in this respect fairly represents the unmarried population.* Courtesans die of their various irregularities, but this class of causes operates chiefly in early life. It is known to everybody that all the species of cultivated plants, and all the breeds of domestic animals, have been greatly improved in Europe. The improvement is partly due to the favourable conditions in which each kinds has been placed. It is mainly due, however, to the constant elimination of imperfect types, and to the skilful selection of the finest individuals out of each successive generation. Now the same principle evidently regulates to a certain extent the marriages in France. Cretins do not marry ; idiots do not marry ; idle vagrants herd together, but rarely marry. Criminals by birth and education do not marry to any great extent ; formerly they were executed in great numbers, or they perished in the prisons, and now the galleys interrupt their career. † The children of families which have been afflicted with lunacy are * See Acton's works. † Of 100 French criminals, 60 are unmarried. Two in three suicides are unmarried. Of 1726 women insane, 989 were spinsters, 291 widows, and 397 wives. (Levy, vol ii. p. 74.) 8 Influence of Marriage on Mortality. not probably sought in marriage to so great an extent as others; and several hereditary diseases present practically some bar to matrimony. The beautiful, the good, and the healthy are mutually attractive; and their unions are promoted by the parents in France, who are usually on very friendly terms with their children, and often decide the choice of their daughters too absolutely and with too little reference to the affections. The Chancellor of the Exchequer, in one of his most delightful romances, tells us that falling in love at first sight is the only genuine way in which people do fall in love. But this is not opposed to the theory of selection; for it happens, as we see in the most authentic stories, that the lovers at first sight are invariably full of irresistible charms. Selection then - not such as the Insurance offices exercise - but a certain selection, does reduce, to some extent, the mortality of the married. And, upon the other hand, we shall be justified by our medical friends in admitting that a certain number of young women, and young men also, die directly or indirectly of disappointed affection - die of love, in fact. Some destroy themselves; others pine away most piteously; and others register secret vows in heaven never to marry. Finally, it is held generally that the suppression of a physiological function is prejudicial to health, which our tables confirm, and at the same time qualify. Chastity in itself does not, as in the case of Deparcieux's nuns, raise the mortality of women under forty; and not withstanding the consequences of vice in the vicious, the selection operating against the unmarried, and the pangs of disappointed love, the mortality of unmarried women in all France is lower than the mortality of married women. After that age the health of the nuns gave way to some extent; but this was, perhaps, as Deparcieux asserts, the consequences in that period of various kinds of austerities an absence of personal cleanliness, and the want of little comforts which were found in the dwellings of simple artisans who knew how to keep their houses in order. The effects of religious chastity in France have been recently discussed by Dr. Mayer, who with some Catholic authorities contends that it has in itself no prejudicial effect; but this is not the prevalent opinion. Levy professes the contrary doctrine. I cannot discuss this medical controversy here. But the poets, where the affections are concerned, possess an insight almost divine; which is as true in its indications as analytic science. Virginity in the poetical creed was ever proof against danger; the lion would not harm the 'heavenly Una.' So dear to heaven in saintly chastity, That when a soul is found sincerely so, A thousand angels lackey her, Driving far off each thing of sin and guilt. The body partakes of the soul's 'immortal essence;' but no sooner is By William Farr, M.D. 9 'defilement' let into the temple than the life grows 'clotted with contagion.' The reading of the allegory is evident. The poets, however, see all sides of character, and Shakespeare's Parolles, a 'great way fool' as he is, says all the evil that physiology has yet suspected in this estate. Lallemand describes vividly the suffereings of the French priests from celibacy---exposed to the fiery ordeal of the confessional. Vows of celibacy on the part of large bodies of young man and of young women are always dangerous ; but the question of marriage or of celibacy is a question of temperament and of circumstances ---so it is very properly left in England to individuals of full age to decide their lot on their own responsibility, under friendly, or if they please, professional advice. In France there is always a large number of unmarried women of a marriageable age. Thus, in the last returns, 2,231,535 women figure as spinsters, of the age of twenty to forty ; the wives of that age numbering 3,200,561. Is this the result of religious vows, or of the Catholic doctrine of celibacy ?---Not to any great extent. In Great Britain the proportions are not very different. Ultimately nine in ten who live marry. The notion that the number of women shut up in convents, had any direct effect in diminishing population was incorrect. In every society large numbers will not, and large numbers should not, marry. They have wide fields of life before them, and public works, devotion, noble foundations, 'friendly love,' will enable them to achieve those triumphs which Bacon has taught us to expect at their hands. Why is the mortality of young widows and widowers so excessive? 1. They share the pains of the unmarried and they have their own griefs. 2. The pairs, of which one dies prematurely, must in the aggregate be in more unfavorable sanitary circumstances than the rest of the population. 3. The one may take from the other fever, and, in crowded chambers, catarrh, ending in consumption, as the army returns show. 4. The widow with children, especially in France, where there is no poor law, suffers from privation; the widower from a disorderly house. The loss of a beloved wife is the heaviest affliction which a man can sustain. It unsettles many minds. Jacques Bonhomme is left desolate ; his wife no longer cheers his home, nurses him in sickness, shares his cares, consoles him, counsels him, loves him. The voice which followed Jacques to the cabaret, and reminded him of the hostages which he had given to fortune, is silent. He plunges into intemperance ; vice and disorder follow ; his plot of land is torn from his grasp by the mortgages : his body finds its way to the cemetery ; his soul, we may hope, soars to his companion in heaven. For Jacques Bonhomme was solely destroyed by her untimely death. Children supply in some respects the loss of the dead ; and where the surviving are childless they have the resources of their unmarried life to retreat on. But re-marriage is the popular consolation ; young widows in health marry at a faster rate than maids, and widowers marry three or fourfold as fast as bachelors. The weakly and sickly 12 Influence of Marriage on Morality TABLE II.--FRANCE. Population in 1851 (vide 'Statistique de la France," deuxieme series, tome II., pp. 200-1). Ages. Males. Females. Totals. Unmarried. Married. Widowers. Unmarried. Married. Widowers. Males. Females. All Ages 9,972,232 6,986,223 836,509 9,351,795 6,948,828 1,687,583 17,794,964 17,988,206 0-- 3,359,276 --- --- 3,257,764 --- --- 3,359,276 3,257,764 10-- 3,193,271 2,859 153 3,045,597 52,185 573 3,196,283 3,098,355 20-- 2,136,450 737,929 14,498 1,639,525 1,284,251 31,732 2,888,877 2,955,508 30-- 694,507 1,893,356 59,132 592,010 1,916,310 119,557 2,646,995 2,627,877 40-- 296,050 1,831,982 110,497 342,754 1,646,174 229,414 2,238,529 2,218,342 50-- 163,024 1,432,170 182,496 243,082 1,233,019 383,115 1,777,690 1,859,216 60-- 79,571 759,189 221,932 150,064 622,657 474,442 1,060,692 1,247,163 70-- 33,891 282,874 187,826 62,947 170,042 339,879 504,591 572,886 80-- 6,829 36,459 54,103 13,031 17,899 98,533 97,382 129,463 90-- 678 1,703 4,214 1,115 983 7,663 6,595 9,761 100-- 18 13 71 28 7 145 102 180 Not Stated 8,676 7,689 1,587 3,878 5,301 2,512 17,952 11,691 15-- 973,866 48 1 933,168 8,393 55 973,915 941,616 18-- 617,065 2,811 152 568,342 43,792 518 620,028 612,652 20-- 1,299,065 151,217 2,865 1,058,979 455,636 8,240 1,454,062 1,522,855 25-- 836,470 586,712 11,633 580,546 828,615 23,492 1,434,815 1,432,653 30 and upwards 1,274,559 6,237,746 820,271 1,405,031, 5,607,091 1,652,766 8,332,576 8,664,888 TABLE III.--FRANCE. Deaths in 1853 (vide 'Statistique de la France,' deuxieme serie, tome III., ire partie, pp. 31-39.) Ages. Males. Females. Total. Unmarried. Married. Widowers. Unmarried. Married. Widowers. Males. Females. All Ages 211,334 124,195 61,388 191,609 107,918 99,163 396,917 398,690 0-- 139,395 --- --- 120,422 --- --- 139,395 120,422 10-- 19,175 85 29 21,596 721 62 19,289 22,379 20-- 24,419 4,892 423 14,509 12,101 743 29,734 27,353 30-- 8,695 13,697 1,109 6,176 17,687 1,655 23,501 25,518 40-- 5,321 19,049 2,247 4,793 16,664 3,176 26,617 24,633 50-- 4,864 26,558 5,463 5,777 20,321 8,423 36,885 34,521 60-- 4,020 27,268 12,186 7,563 22,332 22,465 43,474 52,360 70-- 3,768 25,396 24,518 7,223 14,625 36,929 53,682 58,777 80-- 1,456 6,785 13,608 3,186 3,272 22,826 21,849 29,284 90-- 193 449 1,767 334 187 2,818 2,409 3,339 100-- 14 13 35 13 5 63 62 81 Not Stated 14 3 3 17 3 3 20 23 15-18 5,873 --- --- 7,113 221 25 5,873 7,359 18-20 4,897 85 29 4,631 500 37 5,011 5,168 20-25 15,152 1,246 167 9,110 4,544 248 16,565 13,902 25-30 9,267 3,646 256 5,399 7,557 495 13,169 13,451