Hospital tables “should prompt authorities to investigate”

Sir,

"In the year 1854 a terrible recrudescence of cholera, due, as was
supposed, to the contamination of the water furnished by the notorious
Broad Street pump, in the parish of St James's, Westminster, ravaged the
Metropolis and particularly the immediate neighbourhood of the Hospital
(Golden Square). Twenty-two years before, cholera had sprung suddenly upon
a profession utterly unprepared to deal with it and destitute of a
principle to guide them in organising the best defence against the new
foe. In 1849 it was found that their experience had not taught them much.
In 1854 they had still to search among their record of cases for any
agreement as to the best way out of their perplexities. Mean-while the
homœopathic section of the profession, relying upon the principle which
directs them to seek for medicines capable of producing physiological
phenomena similar to those exhibited by the disease, had never been in
doubt. Hahnemann, on receiving a detailed description of the disease in
its various stages from a disciple who sought his guidance, had, without
seeing a case, but relying solely on his law of drug-selection, prescribed
a course of remedies which, alike in 1832, 1849, and 1854, proved pre-
eminently successful, and which to the present day constitute the
treatment mainly relied upon by homœopathic practitioners. Thus fortified
the homœopaths did not shrink from the issue offered by the cholera
outbreak of 1854. The whole of the wards of the London Homœopathic
Hospital were devoted to the treatment of the epidemic, and 64 cases of
cholera and 331 of choleraic and simple diarrhœa were treated.

Of the 61 cases of cholera treated, 10 died, a percentage of 16.4; of
the 331 cases of choleraic and simple diarrhœa treated, 1 died. The
neighbouring Middlesex Hospital received 231 cases of cholera and 47 cases
of choleraic diarrhœa. Of the cholera patients treated 123 died, a
fatality rate of 53.2 per cent., among the victims being one of the
nurses.

Dr Macloughlin, one of the medical inspectors appointed by the
General Board of Health, visited the wards, examined the cases under
treatment, and watched their progress. His statement, addressed to Mr.
Hugh Cameron, a member of the medical staff, was as follows

"You are aware that I went to your hospital prepossessed against the
homœopathic system, that you had in me in your camp an enemy rather than a
friend... and I need not tell you that I have taken some pains to make
myself acquainted with the rise, progress and medical treatment of
cholera, and that I claim for myself some right to be able to recognise
the disease, and to know something of what the medical treatment ought to
be, and that there may, therefore, be no misapprehension about the cases
saw in your hospital, I will add that, all I saw were true cases of
cholera, in the various stages of the disease, and that I saw several
cases which did well under your treatment which I have no hesitation in
saying would have sunk under other. In conclusion I must repeat to you
what I have already told you, and what I have told everyone whom I have
conversed, that although in allopath by principle, education and practice
yet were it the will of Providence to afflict me with cholera, and deprive
me of the power of prescribing for myself, I would rather be in the hands
of a homœopathic than an allopathic adviser."

Dr. Macloughlin, as shown by his researches and publications, was
undoubtedly well informed as to the nature of cholera.

Now, a circular was addressed by the President of the Board of Health
to various Metropolitan hospitals and to qualified practitioners,
requesting returns of cholera cases, with details of the circumstances,
treatment and results. The object was to determine by comparison, for the
public good, what treatment experience showed to be the best for the new
plague. Returns were sent in from the London Homœopathic Hospital, giving
the names and addresses of the patients treated, the symptoms, remedies,
and result in each case, and a summary of those results. This was not a
question of theory, or of any particular school; it was a question of
facts and statistics affecting the public health. But the report of the
Board of Health was presented to Parliament without the slightest
reference to the London Homœopathic Hospital or to the brilliant results
which its physicians had achieved by undaunted self-sacrifice in a time of
great public calamity. Complaint was, of course, made to the Board of
Health and duly referred to its Medical Committee, with the result that
the Board received from the committee a resolution, which, for ingenuity
of disingenuousness and illiberality, can hardly ever have been equalled.
It was this :

"That by introducing the returns of homœopathic practitioners they
(the Treatment Committee) would not only compromise the value and utility
of their averages of Cure, as deduced from the operation of known
remedies, but they would give an unjustifiable sanction to an empirical
practice, alike opposed to the maintenance of truth and to the progress of
science."

In the first place, the remedies "unknown" to the Treatment Committee
were such as Camphor, Copper, Hellebore, Arsenic, and other drugs well
known to medicine. In the second place, it was their bounden duty to
"compromise" the averages of old methods by more successful new methods in
their search for the best results. Thirdly, the interference with
empirical practice was no part of the statistical duty before them. And
lastly, the "progress of science" was de facto obstructed by their refusal
to "compromise" their averages by a factor which contained the very object
of their search. The perversity was too plain, and Lord Robert Grosvenor
(afterwards Lord Ebury) moved on May 17, 1855, in the House of Commons for
"Copies of Letters addressed to the General Board of Health complaining of
the omission of any notice of certain returns in relation to the treatment
of cholera and correspondence between the President of the Board and the
Medical Council, with copies of the returns which have been rejected by
the Medical Council." The House of Commons, which was more anxious for the
"progress of science" and the "value and utility of averages" than for
"the operation of known remedies," to say nothing of its great duty to the
people it represented, forthwith ordered a special return of the ignored
homœopathic statistics, which was in due course made by the Board of
Health, and these returns were ordered by the House to be printed on May
21, 1855. They remain among Parliamentary Papers to this day, a standing
monument alike of the success of the new policy and of the obscurantism of
the old."

[from "Sixty-five years work, An Historical Sketch of the London
Homeopathic Hospital", 1914]