Pur sayings and doings of the parochial clergy in small English towns, the peculiarities of manner and of bearing which distinguish one pastor from another, the brightness or dullness of each in society or in the pulpit, the confidence vor distrust that each -inspires, attract an amount of attention altogether out of proportion to the importance of the subject. Something of the same kind may be noticed in the case of medical practitioners established in foreign ettlements in the East wherein the parochial clerical element is not nearly so copiously illustrated as it is among communities of like wealth and size in England. Just as the clergyman has the reputation of dealing with the mysteries of an unseen world when he is not discharging his functions as an administrator or as a common member of society, so the doctor is known to deal with many of the most important mysteries of the world of experience, and in a certain sense to live an inner life withdrawn from that in which he has his ordinary being. He is, or is supposed to be a scientific man, and as, for a given strength, an Anglo-Indian or Anglo-Chinese community certainly contains a larger mumber of well informed and scientifically minded men and women than a community in England, his pursuits are followed, his investigations controlled, and his practice criticised with an interest, a sympathy or an acrimony unknown at home. Thus for a double reason it comes to pass that questions relating to medical practice are discussed by the laity at dinner tables and elsewhere, often with intelligence and always with confidence. That side of the practice of medicine which is turned to the public ly no longer befogged with mystery which usually means quackery. Doctor and patient alike find their account in intelgible explanations of reasons, and in frank acknowledgment of lack of reason for many orders which find their justification in bare experience.
We take as an example of the freedom and vivacity wherewith medical subjects are ventilated, the many discussions which have arisen round dinner tables on the lately vaunted treatment of hydrophobia. There are several reasons why this should engage popular interest. There is first the tendency above described; then the fact that this treatment has been proclaimed and alternately lauded and denounced in non-professional journals; then again the sporting proclivities of most foreign residents lend importance to any question in which dogs are largely concerned; and lastly the occurrence of cases of hydrophobia at several of the ports. Each of these cases has excited widespread sympathy and apprehension, and in at least two which happened not very long ago, criticism in some quarters took the form of enquiry why the treatment of Pasteur had not been adopted.
It is a sufficient general answer to say that it would be impossible, without a public physiological laboratory maintained at great expense, to keep in readiness the material necessary for the' so-called preventive injections. That material cannot be prepared like a chemical product once for all, and_ bottled up for future use. It involves the infection by a laborious process of at least one rabbit every day, and the preservation of its spinal cord under certain conditions for a certain time at the expiration of which it is useless. The work would be sufficient to keep one skilled person constantly employed, and luckily the demand among foreigners in China would never be held to justify the extravagance necessary to meet it. But there is a much stronger answer than this, and it is no less than the probability that the plan of preventive injection is never useful, is often harmful and is occasionally fatal. That it is never useful cannot of course be proved directly. It may fairly be inferred, however, if, after the unexampled enthusiasm with which the new treatment was received and the almost universality of its adoption in Europe, the total number of deaths from hydrophobia has not. diminished. And statistics establish beyond cavil that there has been no diminution. That it is occasionally hurtful without being actually mortal is proved by the occurrence of grave local and general symptoms after the injections. The most serious charge that can be brought against it is that it produces the very evil that it professes to extinguish; and to this we shall devote the remainder of our space. In 1886, of the French patients treated by Pasteur 25 died. In addition to these many Russians, Germans and English and one or two Spaniards succumbed, but we shall refer only to the 25 regarding whom accurate observations are available. It has to be remembered that with respect to the vast majority of those treated the only important fact in their history was that they had been bitten by dogs. Now of dogs which bite but a very small ratio are mad. This fact disposes of the danger supposed to menace an indefinite but exceedingly large majority of the patients. Further, of the bites received from mad dogs but a small ratio (1 in 6) induce hydrophobia. The sufferer is bitten through his clothes and receives none of the poison, or if bitten on an exposed
as it vigorously cantorised. The ratio, he immediately sucks the wound or therefore, of cases of hydrophobia to ordinary cases of dog bite is almost infinitesimal. But the ratio of cases of hydrophobia to cases of dog bite treated by Pasteur is about 1 to 80. This is an exceeding nificant fact, but there are two others yet more striking. One is that in some of the fatal cases there was every reason to believe that the. dog which inflicted the original wound was not mad. And as obviously he could not give what he had not got, the conclusion as to the cause of death is unavoidable. The other fact is that-
than one third died with symptoms of rabbit-rabies not of canine rabies. But rabbit-rabies is precisely Pasteur's infallible cure.
On the whole, we fear that the brilliant hopes conceived and expressed by Pasteur and his disciples are destined to utter disappointment. Five years hence, if the question still possesses any actuality, it will be judged more calmly and with fuller knowledge, both theoretical and practical, than is possessed now. But the chances are that by that time the method will have been relegated to the limbo of forgotten delusions.
Text read from the printed page and cleaned; old type leaves the occasional error.