CHAPTER XXVIII.
PARKES, GUY, SIMON, AND PUBLIC HEALTH.

“Prevention is better than cure” is the homely proverb which marks out a large proportion of the work of sanitary science. The prevention of disease and of its spread, and the promotion of the general healthiness of the people—these are objects which modern progress has brought into view. When they are completely attained we shall all die of old age unless cut off by accidents or violence; and this is a goal which many sanitarians of the present day have vividly before their mind.

The public health and the public welfare have been sought by no man more earnestly than by Edmund Alexander Parkes. Of him Dr. Russell Reynolds said:[24] “In the combination of moral, mental, and physical beauty, Dr. Parkes was to my knowledge never equalled, to my belief cannot be surpassed. Pure as a sunbeam, strong as a man, tender as a woman, keen as any scientist to unravel the hidden mysteries of life in its minutest detail of chemical and physiological research, yet practical in the application of his knowledge to the cleansing of a drain or the lightening of a knapsack; he made the world much richer by his life, much poorer by his death.”

Parkes was born on March 29, 1819, in the village of Bloxam, Oxfordshire, his father being Mr. William Parkes, of the Marble-yard, Warwick, “a man of superior mind, remarkable alike for industry, firmness, and nobility of character.”[25] His mother, Frances Byerly, daughter of Mr. Thomas Byerly of Etruria, Staffordshire, was much occupied in literature, and her sister, wife of Professor A. T. Thomson of University College, London, was a well-known biographer and novelist.

Under such favouring influences young Parkes grew up a gentle but unusually merry and happy boy. After being educated at the Charterhouse, he entered as a medical student at University College, and spent much time in his uncle’s laboratory, becoming an excellent manipulator, and already showing a fondness for research. At the first M.B. examination at London University in 1840 he was exhibitioner and medallist in anatomy, physiology, and chemistry, and medallist in materia medica. In 1841 at the final M.B. he was medallist in physiology and comparative anatomy, and gained honours in medicine. He had taken the College of Surgeons’ diploma in 1840.

Of this period of Parkes’s life Sir William Jenner, an intimate fellow-student at University College, says:

“As a student he was distinguished by brightness and cheerfulness, amiability, unselfish willingness to help others at any cost of trouble to himself, energy in work, diligence in the using of each hour for the studies of that hour, the high moral tone that pervaded his converse, and above all, and crowning all, by the real living purity of his being.”

Early in 1842 Parkes entered the army medical service, and went as assistant-surgeon to the 84th regiment to Madras and Moulmein. Here he prosecuted inquiries which bore fruit in two small publications on the Dysentery and Hepatitis of India (1846), and on Asiatic and Algide Cholera (1847). But before this period he had retired from the army and entered upon practice in Upper Seymour Street, Portman Square, becoming further known as a physician by editing and completing Dr. Thomson’s work on Diseases of the Skin (1850). This was only a portion of his literary and original work at this time, during which he contributed largely to the Medical Times, and from 1852 to 1855 edited the British and Foreign Medico-Chirurgical Review, for which difficult task he was exceedingly well fitted.

Having been appointed one of the physicians to University College Hospital, his influence was very marked, both on his students and his colleagues. One of his pupils, afterwards a distinguished physician, said that he never went round the wards with him without feeling an intense wish to become better, and at the same time feeling that he could become so. In 1855 Parkes delivered the Gulstonian Lectures at the College of Physicians, taking the subject of Pyrexia, or the State of Fever.

During the Crimean War, when great pressure existed upon the hospitals at Scutari, Dr. Parkes was selected by Government to proceed to the seat of war to establish an additional large hospital. He fixed upon Rankioi on the Dardanelles, and his choice proved excellent. He worked most zealously to make everything as perfect as possible, and he accomplished much in spite of the red-tape which was so disastrously prominent in the war administration of that time. He did not in any way spare himself, though his constitution had shown serious signs of weakness in London, when he had had severe attacks of pneumonia and phlebitis. His report on the work of his hospital at the conclusion of the war was a most valuable one, and he gained the high esteem of Mr. Sidney Herbert, afterwards Lord Herbert of Lea.

One result of the Royal Commission of Investigation into the administration of the war was the foundation of the Army Medical School, and Mr. Herbert never showed better judgment than in selecting Dr. Parkes to be Professor of Military Hygiene in connection with it. Consequently he gave up in 1860 his post at University College; he was appointed Emeritus Professor, and a marble bust of him was placed in the College museum.

Parkes found that in order adequately to teach the subjects involved in preserving and promoting the health of the army, he must not only study the special features of army life and the peculiar liabilities attaching thereto, but also the general science of hygiene, then almost new. He organised at the cost of immense labour a detailed system of instruction, based on the principle of making the student apply practically what he taught. All the special questions which came up relating to air, water, food, temperature, clothing, house construction, drainage, &c., were as far as possible illustrated in the laboratory, and individual instruction was most carefully given.

In 1864 was published the first edition of Parkes’s “Manual of Practical Hygiene,” a masterly book, accurate, learned, clear, full, and of the highest interest to the thoughtful mind. The introduction to this work opens with a clear definition of the subject. “Hygiene is the art of preserving health; that is, of obtaining the most perfect action of body and mind during as long a period as is consistent with the laws of life. In other words, it aims at rendering growth more perfect, decay less rapid, life more vigorous, death more remote.”

Later he says: “It is undoubtedly true that we can, even now, literally choose between health and disease; not, perhaps, always individually, for the sins of our fathers may be visited upon us, or the customs of our life and the chains of our civilisation and social customs may gall us, or even our fellow-men may deny us health, or the knowledge which leads to health. But, as a race, man holds his own destiny, and can choose between good and evil; and as time unrolls the scheme of the world, it is not too much to hope that the choice will be for good.” He further powerfully indicates the basis of state medicine, to secure for all individuals the conditions of health which they often cannot secure for themselves. He shows too that self-interest, state-benefit, and pecuniary profit are at one in these matters when rightly understood. “It is but too commonly forgotten,” he says, “that the whole nation is interested in the proper treatment of every one of its members, and in its own interest has a right to see that the relations between individuals are not such as in any way to injure the well-being of the community at large.” It is almost needless to add that numerous editions of Parkes’s Practical Hygiene have been called for; it has also been translated into several foreign languages.

We have enumerated, however, but a small portion of the subjects upon which Parkes’s unceasing philanthropic activity was exercised. For many years he wrote an annual review of the Progress of Hygiene, contributed to the Army Medical Reports. He served on many public inquiries relating to matters of health, and did more for the diminution of mortality in the army than any other man. He carried on many protracted and difficult physiological investigations, such as those on the effects of diet and exercise, on the elimination of nitrogen, on the effects of alcohol on the human body, on the effects of coffee, extract of meat, and alcohol on men marching, chiefly contributed to the Royal Society. As a member of the Senate of London University, and of the General Medical Council, and as Secretary to the Senate of the Army Medical School, he performed detailed work of the highest value, and all in spite of delicate health.

“With increase of years,” says Sir William Jenner,[26] “his mind ripened, his sphere of action widened, his influence over others operated in new and perhaps more important ways; but in all moral and intellectual essentials Dr. Parkes was as a man what he was as a youth—he was animated by the same principles and stimulated by the same faith. As years went on his mind proved itself to be singularly well balanced; he possessed an extraordinary power of acquiring information; his memory was very retentive; he was the best-informed man in the medical literature of the century I ever met; he was unprejudiced as he was learned; he could use with ease the information he acquired, and could express his ideas clearly and simply; his language was always elegant, and on occasions eloquent. His powers of observation, of perception, of reasoning, and of judgment were all good, and equally good. But as in his youth, so in his manhood, the beauty of his moral nature, his unselfish loving-kindness, his power of inoculating others with his own love of truth, with his own sense of the necessity of searching for the truth, of questioning nature till she yield up the truth, of earnest work, were his most striking characteristics.”

At last the seeds of weakness which were constitutional in Parkes developed into acute tuberculosis, and he died on March 15, 1875, after an illness of four months. His domestic life had been a very happy one, but his wife, a Miss Chattock, whom he married in 1851, had died in 1873, and he was much broken by her loss. He left no children. His monument is in the Parkes Museum of Hygiene, which enforces eloquently the lessons of his life.

Dr. William Augustus Guy, F.R.S., is one of the most eminent of modern promoters of the public health. He was born at Chichester in the year 1810, his ancestors for three generations having been medical practitioners there. His grandfather, William Guy, was a pupil of John Hunter, and in Hayley’s life of Romney it is stated that “Cowper said of him that he won his heart at first sight, and Romney (who painted his portrait) declared that he had never examined any manly features which he would sooner choose for a model if he had occasion to represent the compassionate benignity of the Saviour.”[27]

After a childhood spent with this estimable grandfather, young Guy was educated at Christ’s Hospital, and later studied for five years at Guy’s Hospital. Winning the Fothergillian medal of the Medical Society of London for the best essay on Asthma, in 1831, at the early age of twenty-one, he was encouraged to enter at Cambridge, where, after a further period of two years spent at Heidelberg and Paris, he took his M.B. degree in 1837.

In 1838 Dr. Guy became Professor of Forensic Medicine in King’s College, London, and later Assistant-Physician to King’s College Hospital. He early directed his attention to statistics, and joined the Statistical Society in 1839, and became one of its honorary secretaries in 1843. 1844 he contributed important evidence before the Health of Towns Commission, on the state of the London printing-offices, and the consequent development of pulmonary consumption among printers. He co-operated in founding the Health of Towns Association, and has been incessantly occupied in public lectures, investigations, and writings, in calling attention to questions of sanitary reform. He has been notably concerned in the improvement of ventilation, the utilisation of sewage, the health of bakers and soldiers, hospital mortality, and many other like subjects. In 1873 he was President of the Statistical Society, and he has successively been Croonian, Lumleian, and Harveian Lecturer at the College of Physicians. His various publications and papers are too numerous to recount. We may, however, mention the “Principles of Forensic Medicine,” and successive editions of Hooper’s “Physicians’ Vade Mecum.”

Mr. John Simon, C.B., F.R.S., is one of the veterans of the present day in matters of public health, besides having the highest reputation as a surgeon and pathologist. Born in 1816, Mr. Simon was a student of King’s College, London, and was elected a fellow of the College of Surgeons in 1844. He was appointed in 1847 lecturer on Pathology at St. Thomas’s Hospital. His subsequent researches and writings, especially those on Inflammation, have proved his great fitness for the post. In 1850 he published a very original course of lectures on General Pathology, as conducive to the establishment of Rational Principles for the Diagnosis and Treatment of Disease.

Mr. Simon’s career in connection with public health began with his being appointed the first Medical Officer of Health to the City of London. He was before long selected as medical adviser to the General Board of Health, and was thence transferred to the important post of medical officer to the Privy Council. In this capacity his labours, ably seconded by a crowd of zealous workers, have been of priceless value to the nation at large. The successive annual reports published by the Privy Council sufficiently attest this.

In his first report to the Privy Council, Mr. Simon stated “that more than half of our annual mortality results from diseases which prevail with a very great range of difference in proportion as sanitary circumstances are bad or good; that, according to the latest available evidence, some of these diseases prevail twice or thrice, some of them ten or twenty times, some of them even forty or fifty times, as fatally in some districts as in other districts of England; that the result of their excessive partial development is to render the mortality of certain districts from 50 to 100 per cent. higher than the mortality of other districts, and to raise the death-rate of the whole country 33 per cent. above the death-rate of its healthiest parts.”

In his eleventh report Mr. Simon was able to write as follows: “It would, I think, be difficult to over-estimate, in one most important point of view, the progress which, during the last few years, has been made in sanitary legislation. The principles now affirmed in our statute-book are such as, if carried into full effect, would soon reduce to quite an insignificant amount our present very large proportions of preventable disease.... Large powers have been given to local authorities, and obligation expressly imposed on them, as regards their respective districts, to suppress all kinds of nuisance, and to provide all such works and establishments as the public health primarily requires; while auxiliary powers have been given for more or less optional exercise in matters deemed of less than primary importance to health.... The State ... has interfered between parent and child ... between employer and employed ... between vendor and purchaser; has put restrictions on the sale and purchase of poisons; has prohibited in certain cases certain commercial supplies of water; and has made it a public offence to sell adulterated food, or drink, or medicine, or to offer for sale any meat unfit for human food.... Its care for the treatment of disease has not been unconditionally limited to treating at the public expense such sickness as may accompany destitution; it has provided that in any sort of epidemic emergency, organised medical assistance, not peculiarly for paupers, may be required of local authorities; and in the same spirit requires that vaccination at the public cost shall be given gratuitously to every claimant.”

Mr. Simon has been a distinguished surgeon to St. Thomas’s Hospital, and attained some years ago the Presidency of the College of Surgeons. He is also a member of the General Medical Council. In 1878 his bust in marble was presented to the College of Surgeons by public subscription, in recognition of his eminent services in sanitary science.

FOOTNOTES:

[24] See the Lancet, March 25, 1876, p. 481.

[25] Medical Times and Gazette, March 25, 1876, p. 348.

[26] Lancet, July 8, 1876, p. 41, supplement to Harveian Oration.

[27] See Photographs of Eminent Medical Men, ii, 59.

INDEX.