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sically philanthropic; and instances bave occurred of murders committed to acquire means for relieving the wants of others.
Many, if I do not err, suppose that one flagrant criminal act implies a character radically and totally bad, the only restraining force being the fear of legal punishment, and a dread of the odium of public opinion. Physicians, more than those of any other calling, know this to be untrue, they, more than others, having the opportunity of observing not unfrequently, conjoined with certain defects or perversions of character, traits which do honor to human nature.
The natural history of crime touches that department of jurisprudence which deals with the punishment of criminal acts. The question arises, has not the time come for a reconsideration of the principle which inflicts penalties exclusively to frighten evil-doers? This principle, while the object is very imperfectly fulfilled, takes no cognizance of the welfare of the criminal, and, as is well known, often tends to place irretrievably without the pale of sympathy and brotherhood, those who have fallen under the ban of legal justice. Might not more knowledge of the laws and causes of crime lead to modifications of the modes of dealing with offenders against society and law more consistent with true Christian philanthropy?
The natural bistory of crime, finally, is the proper basis of the best means for its prevention. As the power to prevent disease is commensurate with our knowledge of etiology, so a thorough acquaintance with the laws and causes of crime must be the foundation of effectual measures for preventing it, thereby, at the same time, reaching the welfare of those who without these measures would become criminals, and affording the safest and best protection for society.
I am deterred from giving further expression to thoughts pertaining to this subject, not alone by the fear of occupying too much time, but by some doubt whether the subject will be regarded by all who hear me as appropriate for this occasion. I would have the remarks which I have made, considered in the light of a plea for the study of the natural history of crime to be admitted within the domain of medicine. If the claim be acknowledged, what is needed is, not discussion, but work. It has been with me a dream in the past to be able to become a worker in this field of study. This dream cannot be realized, and I must be content with the hope of communicating to others, in a measure, my convictions of the importance of the subject.
REPORT ON THE NECESSITY FOR COINCIDENT CLINICAL AND
METEOROLOGICAL OBSERVATIONS AND RECORDS IN THE STUDY OF ETIOLOGY; AND ON THE INFLUENCE OF ATMOSPHERIC CONDITIONS IN THE DEVELOPMENT OF BOWEL AFFECTIONS OF CHILDREN.
No department of medical science presents to the careful student less satisfaction than etiology in its present condition. With a steadily increasing tendency to refer all acute diseases, whether epidemic, endemic, or sporadic, to specific causes, or viruses, capa. ble of propagation by fermentative or zymotic action, there is an equal tendency to indulge in hypotheses instead of carefully observed facts. That the prevalence of many important diseases is influenced to a very great degree by season of the year and local sanitary conditions, is apparent to all. For instance, the bowel affections of children, cholera, periodical fevers, yellow fever, etc., prevail almost wholly in the summer and autumn; while pneumonia, croup, catarrh, and rheumatism prevail chiefly in the winter and spring.
But if we attempt to go beyond these general and easily recognized facts, and inquire for the particular element or elements more immediately concerned in the production of any one of these diseases, we are met by difficulties not easily overcome. Chief among these difficulties, is the absence of continuous carefully recorded facts, both in regard to the appreciable conditions and qualities of the atmosphere, and the date of the initial symptoms of diseases.
We have an abundance of meteorological tables, presenting the mean daily, monthly, and annual temperature, the moisture, the rain fall, and the extremes of heat and cold; but the equally important items relating to the direction and velocity of the winds, the daily variations of temperature, and the electric and ozonic conditions of the atmosphere, are either omitted, or so imperfect as to be of little value. On the other hand, recorded
observations in regard to the date of the commencement of the active phenomena of disease, are almost entirely absent from the pages of our medical literature. The statistics of mortality give us only the date of deaths, but neither inform us correctly concerning the whole number of cases of sickness, nor the date at which any cases begin. To study satisfactorily the causes of all acute diseases not known to be propagated by specific contagion engendered in the body of the sick, we need three distinct series of observations and record, made simultaneously, in a sufficient number of places, and continued through a series of years. One of these should consist of a complete registry of atmospheric conditions, including electricity and ozone. The observations and records now made under the direction of the signal service bureau of the general government, include a sufficient number of stations, and are sufficiently complete, except in regard to electricity and ozone. And we are glad to learn that a committee appointed by this Section of the Association at Detroit, of which Dr. J. M. Toner is Chairman, has succeeded in inducing the superintendent of that governmental bureau to add these two important items for observa. tion and record, to those already made by the men in charge of the several stations. Another series of observations should be made in the same localities where the meteorological records are kept (so far as these are inhabited), by active and intelligent practitioners of medicine, who should endeavor to ascertain and record the exact date of the commencement of active symptoms in all attacks of acute disease coming under their observation, and the date of relapses, when such occur.
A third series should consist in a systematic microscopical examination of the atmosphere, in accordance with a uniform plan in regard to the times of day and method of observation, and in as many of the same localities where the meteorological and clinical observations are made, as competent observers could be found who would faithfully carry on the work. It is obvious that a comparison of the results of the first two series of observations would enable us to know the exact relation between given conditions of the atmosphere and the development of different forms of disease. It would enable us further to trace the relation between the degree of certain atmospheric conditions, and the severity of the attack of disease.
While the third series of observations, compared with the results of the first and second, would go far to decide the question whether the coincidence of certain atmospheric conditions developed special organic germs; and whether these bore any direct relation to the commencement, progress, and decline of certain forms of disease; it is only by carefully considered methods of investigation, established in many localities, and executed faithfully through a series of years, that all the data can be obtained for determining the true etiology of all acute diseases whether endemic, epidemic, or sporadic.
It seems to us that, with the aid now obtainable from the signal service bureau of the government, covering the most expensive part of the series of investigations needed, this Association could easily plan and execute such arrangements as would secure the coinci. dent clinical and microscopical observations and records. Let this Section continue the appointment from year to year of a well. selected committee, charged with the duty of selecting, from the whole number of signal service stations, those in each part of the Union most important in a medical aspect, and of engaging in each of these selected places one or more competent practitioners to keep the necessary clinical records in regard to the initial stage of acute diseases; and as far as possible one to make daily microscopic examinations of the atmosphere. Let the committee of the Section receive, semi-annually, the detailed reports from all the selected stations, and after carefully comparing the meteorological, clinical, and microscopical series with each other, tabulate the results and present them at each annual meeting of this body.
It is true that such a scheme would require on the part of all engaged in it much patience and pains-taking labor. And this, above everything else, is just what the science and literature of our profession most need. At present we are overwhelmed in every direction by detached facts, partial or incomplete observations, imperfect records, and basty generalizations. And if the several Sections of this Association would give more time to the devising of more complete methods of investigation, and the patient supervision of their execution until completed, they would do more to advance the science and art of medicine in five years, than could be accomplished in fifteen by receiving and discussing reports and. papers presented by individuals in the ordinary way. It was in accordance with these views, that this Section of the Association at the last annual meeting appointed two committees, one to super-intend the meteorological series of observations, and another the clinical.