June 13, 1907] 



NATURE 



15: 



SOME INSTAXCES OF UNSCIEXTIFIC 

 ADMIXISTRATIOX. 



IN' recent letters to Nati-re and the Times, I had 

 occasion to criticise the lack of science displayed 

 by the Indian authorities during- their conduct of the 

 operations against plague in the great outbreak of 

 1S96. The Editor of Nature, who has so frequently 

 and ablv urged the claims of science on the public, 

 now asks me to give any more instances of the same 

 n.'iture which I may have observed. 



Probablv few any longer accept the teaching of 

 Hume, that the object of government is no other than 

 "the distribution of justice." The function of an 

 ideal civilised government might be described as the 

 performance of all acts for the good of the public 

 which individual members of the public are bv them- 

 selves unable to perform — that is, the organisation of 

 public welfare. The individual can certainlv add 

 much bv intelligence and virtue to his own welfare ; 

 but these qualities do not suffice to protect him alto- 

 gether against those evils which can b? combated onlv 

 by concerted action, such as the depredations of 

 disease and of e.Ktcrnal and internal human enemies ; 

 and where he is powerless, the Government, and only 

 the Government, can help him. Now such concerted 

 action is likely to be successful only when it is based 

 on sufficient knowledge; and a scientific administra- 

 tion differs from an unscientific one just in this pr.r- 

 ticular, that it seeks the necessary knowledge, while 

 the other acts blindly. In nothing is this more mani- 

 festlv the case than in connection with that depart- 

 men of public administration which is charged with 

 the protection of the public against disease — a depart- 

 ment second to none in importance, because it con- 

 cerns not only our sentiments and our pockets, but 

 our health and our lives. Before such protection can 

 be obtained, two things are absolutelv necessary — 

 first, an exact knowledge of how diseases are caused 

 and how best they may be checked, and, secondlv, an 

 efficient organisation to act upon that knowledge 

 when it is obtained. I will now try to examine how 

 far, within the range of my own subject and ex- 

 periences, this ideal of a scientific administration has 

 been reached. 



My experiences commenced in the Indian Medical 

 Service in i88r. The Indian governmental machine 

 is a bureaucracv placed niostlv in the hands of 

 soldiers and Indian civili;ms, who are selected from 

 the British middle-classes by competitive examinations 

 in branches of knowledge among which (be it noted) 

 science, except mathematics, does not hold a very 

 prominent position. The medical establishment, to 

 the care of which the health of about three hundred 

 millions of people is mostly entrusted, is divided into 

 a civil and a militarv br.-inch Avith corresponding duties. 

 and contains, I think, more than a thousand qualified 

 medical men, chiefiv British, belonging to the I. M.S. 

 and R..\.M.C., with a large subordinate staff of 

 apothecaries, hospital assistants, and so on. The 

 heads of this organisation are medical men, but they 

 do not generallv, I think, have seats on the supreme 

 executive councils. 



When I entered the I. M.S. it had a great reouta- 

 tion, which it still possesses, and, together with the 

 Army Medical Department, had done fine work. 

 Both these services were on the whole very well 

 organised; but I could not help noticing several 

 anomalies. Manv of the Indian diseases are, of 

 course, different from those met with at home. Our 

 knowledge of them was then chiefly in the clinical 

 stage, and verv insufficient, both for treatment and 

 prevention ; and what we oossessed was due, not to 

 any organised official inquiries, but to the efforts of 

 individuals. I remember being struck even then with 

 the absence of organised research. It is true that 



NO. 1963, VOL. 76] 



pathological laboratories existed in the universities 

 (under men burdened with other duties) ; that Govern- 

 ment had specially appointed two commissioners, 

 Lewis and Cunningham, to study this subject; that 

 temporary inquiries had been made on leprosy and on 

 certain local outbreaks ; and that there was a good 

 Indian medical journal; but these were obviously in- 

 sufficient to enlighten us on the multitude of strange 

 and mvsterious diseases we were called upon to deal 

 with. Why did not Government carry on much more 

 extensive researches? The time-worn answer always 

 was, because they could not afford it. But, surely, if 

 they could afford such a large and expensive medical 

 establishment, thev should also be able to afford those 

 researches which were essential to making that estab- 

 lishment effective. Of what use was the one without 

 the other? An inefficient machine is the most ex- 

 pensive of all. Did they think that we medical men 

 should know all about these diseases by intuition? 

 But no! — content with having appointed a legion of 

 " doctors " to fight disease, they never seemed to 

 consider that it was necessary for those doctors to 

 know how to do it. 



But this invariable cry of " no funds " was palpably 

 untrue. Manv of the' administrative and judicial 

 offices in India were being paid above their market 

 value, and were of little public importance compared 

 with medical research. Huge sums, which would pay for 

 such research for vears, were being soent on engineer- 

 ing works of onlv local value. Even within the medical 

 budget, monev was being wasted on certain sinecures 

 and' useless administrative posts. Indeed, logically it 

 would have been wise in the Government to sacrifice 

 almost anything in the department in order to obtain 

 the neces'sarv information about disease, for the 

 simple reason that without such information the work 

 of the department was largely useless— the old castor- 

 oil treatment and conservancy-cart sanitation had 

 their limits! But what struck'me most was the fact 

 that Government failed to make use of literally hun- 

 dreds of potential investigators whom it could have 

 s"t to work for almost nothing. The medical services 

 in India must be alwavs kept on something approach- 

 ing a war footing—that is to say, with a staff in 

 excess of peace requirements. In other words, there 

 must alwavs be a large number of medical men, 

 p-encrally juniors, who in times of peace have little to 

 do and 'are employed doing it in the military hos- 

 pitals. I was one of these for about twelve out of my 

 eit^hteen years' service, and therefore know the facts 

 about which I write. For most of this time my 

 oOicial duties occupied me for less than, say, two 

 hours a day, and I knew scores of my colleagues 

 who were equally busy— we amused ourselves for the 

 rest of the time.' No'w why did not, and why does 

 not the Government make use of all these men for 

 investit'ation ? Young, ardent, vigorous, intelligent, 

 "spoiling" for work thev were, and are, of trif" /'"" 

 that is now doinsr most of the scientific work of the 

 country- precisely the same as those who have been 

 labouring in mv' department in this university— who 

 have even sacrificed their lives for Athena Hygieia. 

 They had, and have, leisure and opportunities un- 

 paralleled. A microscope, a few test-tubes, a word 

 from the chief, a little approbation, some evidence 

 that scientific work leads, if successful, to preferment, 

 and the authorities could have had almost for nothing 

 scores of enthusiastic and, I will expressly add, 

 capable workers for the great cause of medical 

 science. But the pit'eon-holed report and the official 

 snub awaited us, and we returned disappointed to our 

 idleness. 



It is advisable to emphasise this point, because it 

 illustrates the brainless character of much of the 

 administration. In 1884 (I think) I asked my chief 



