154 



NATURE 



[June 13, 1907 



if he would like me to investigate fevers during my 

 abundant leisure; he replied that mv duty was not 

 to investigate, but to cure — as if we could do the 

 second without the first ! Many nun have told me 

 that they have received similiu- replies, and two 

 biothers of mine quite rijjhtly left the naval medical 

 service because of this attitude in the authorities. A 

 man who discourages enthusiastic juniors from doing 

 gr.-ituitous work in addition to their duties must be 

 a fool of a very advanced type, and it is surprising 

 that such men should ever be able to find their wav 

 into administrative posts. In addition to the actual 

 discouragement of voluntary research (which 1 will 

 discuss further presently), the organisation made no 

 adequate provision to ensure scientific efficiency in 

 the st.ilT. There were no examinations for pro- 

 motion. Leave and opportimities for study could 

 scarcely be obtained, and even now there are diffi- 

 culties—see, for instance, British Medical Journal, 

 May II, iqo7, p. 1150. That first essential, recent 

 scientific literature, was most difficult of access, and 

 the authorities still seem to have made no adequate 

 attempt to improve matters in this respect. Micro- 

 scopes and bacteriological apparatus were generally 

 wanting, although they are absolutely necessary in 

 tropical clinical practice for the detection of numerous 

 parasites, and this fault has not even yet been 

 entirely removed, to judge by the report of the Army 

 Medical Department for iqoj, p. 224. The heads of 

 the department frequently showed ignorance of recent 

 scientific advances, as was apparent from their anti- 

 quated statistical methods and regulations for dealing 

 with epidemics and their general lack of ideas; and, 

 lastly, the annual " Records of Service '" of officers, 

 upon which their preferment was supposed to be 

 based, was a hopelessly stupid form which made no 

 attempt to distinguish their real scientific and pro- 

 fessional ability — so that, as evervone remarked, 

 appointments, like kissing, went by favour ! 



.About the year 1880 occurred th:it important epoch 

 in human history when we first learned the nature 

 of the great transmissible diseases which atllict us — 

 when Koch and Laveran threw open the gates of 

 medical bacteriology and protozoology, and special 

 laboratories sprang up everywhere in Europe and 

 .America, and even at last in Britain. As may be sup- 

 posed from the foregoing, India was not in haste to 

 follow, and the authorities, who had done so little 

 for research themselves, did not trouble to utili.se the 

 researches of others. In 1885 Koch discovered the 

 cause of cholera, that scourge of India, and the dis- 

 covery should have been immediatelv followed bv 

 numerous otiicial investisrations. But. though the 

 disease destroys about half a million people annuallv 

 in India alone, little was done in that countrv, and 

 neither the Government nor the people have, I believe, 

 ever taken the trouble to thank Koch for his work. 

 Ten vears later, however, Hankin, of .\gra, carried 

 out his admirable researches on the mode of pro- 

 pagation, and enunciated his method of prevention bv 

 the treatment of wells. This again should have re- 

 ceived close official scrutiny with a view to its general 

 adoption or rejection, but from recent reports it 

 appears to be still siih jiidicc- as if it were not worth 

 troubling about ; and no one has ever dreamed of ac- 

 knowledging indebtedness to Hankin. Tyhpoid, perhaps 

 the principal enemy of Europeans in India, has never 

 received adequate oflicial inquiry as regards its modes 

 of propagation in that countrv, and the discoverer of 

 the prophylactic no longer enjovs State employment. 



.An amceba which is probably the cause of one 

 form of that important disease, dysenterv, was well 

 studied for the Indian Government bv rimningham 

 long ago, but the matter was not followed up. The 

 cause of another form was discovered bv Sliiga in 



Japan. Some of the most prevalent and distressing 

 complaints in many parts of India are those caused 

 by h'itaria bancrofii ; but Manson's discovery of the 

 carrying agent, a mosquito, though confirmed in 

 India by Maitland, J.imes, and others, has never, to- 

 my knowledge, been followed by sufficient practical 

 action. The spiroch;i'tes of relapsing fever, though 

 finely studied by A'andyke Carter, of Bombay, many 

 years ago, still require a determination of their 

 carrying agent. Sprue, ankylostomiasis, beri-beri,: 

 unclassed fevers, guinea-worm, and other parasites? 

 received little ofiicial attention. The case of malaria 

 is perhaps the most astonishing. It causes about a 

 third of the admissions into hospital, and a mortality, 

 directly and indirectly, possibly of some millions a 

 year in India; while nothing does more to hamper 

 military, engineering, and agricultural undertakings. 

 Its cause was discovered in 1880 by Laveran in 

 .\lgeria — a discovery which enabled us generally to 

 make an immediate definite diagnosis with the micro- 

 scope. Excepting A'andyke Carter's confirmation, in 

 1887, literally nothing of consequence was done on 

 the subject in India for fifteen years, though during 

 that period the Italians and others were piling 

 lesearch on research. Not only did these momentous 

 advances seem to be quite unknown to the authori- 

 ties, but they were almost entirely neglected in the 

 hospitals, and not even the necessary microscopes 

 were provided equivalent to a failure to supply 

 surgeons witl) instruments. 



My own researches on this subject, commenced 

 about 1901, gave several illustrations of these curious 

 defects. Literature and apparatus were for the most 

 part unobtainable, except by purchase from England, 

 and advice or instruction on scientific details w'ere 

 equally hard to acquire, though arrangements for 

 these should have been organised long previously. 

 In i8()5 a rich n.itive State a.sked for my services to 

 investigate the malaria which seriously incommoded 

 its population, and offered to pay the expenses; but 

 the presiding Civil Service genius vetoed the sugges- 

 tion. I was even refused ordinary leave of absence 

 to undertake researches at my own cost, although my 

 ser^'ices could easily have been spared. In 1897,- just 

 at the moment when I had at last succeeded in cul- 

 tivating the parasites of malaria in gnats, and after 

 I had reported this important fact, to my surprise I 

 was suddenly ordered off for months to a plnce where 

 malaria was almost absent. I was then, very wisely, 

 placed on special duty to continue my work, but, a 

 year later, after I had worked out the life-history of 

 the parasites in mosquitoes, as I could not obtain 

 definite assur.incc that my special duty would be pro- 

 longed, I left the country. Before doing so I gave 

 advice as to the best metliod of dealing with malaria 

 (by appropriate drainage), but for years no serious 

 effort was made to act upon the advice. It is, or 

 was, usual to thank officers who had been placed on 

 special duty for tlieir services if successful, but mine. 

 I suppose, were not thought to be sutliciently im- 

 portant for this little douceur. 



I have mentioned some cases of neglect to recognise 

 work done because they involve an important general 

 principle. .A scientific administration, if it cannot 

 afford to pay for research, would at least attempt to- 

 encourage voluntary investig.ations by such inexpen- 

 sive methods as promotion, good conduct pensions, 

 special thanks, .ind recommendations for State 

 honours. But I cannot remember a single instance 

 in British administration in which the two former 

 have been given for medical researches, even of the 

 most distinguished character (though it is done in 

 .America); while the two latter, if offered at all, are 

 otTered on the lowest scale. While soldiers, judges, 

 and governors who have merely performed their 



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NO. T963, VOL. 76] 



