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THE GULSTONIAN TRUST AND ITS FOUNDER: A HISTORICAL NOTE. Public Health and Poor Law.

THE following account of the founder of the Gulstonian LOCAL GOVERNMENT DEPARTMENT Lectureship at the Royal College of Physicians has been forwarded to us from a reliable source. It contains some REPORTS OF MEDICAL OFFICERS OF HEALTH. of his in addition to those to be found particulars biography Rural the in Dr. Munk’s Roll of the of it Uxbridge District.-Estimating population up College Physicians, where, to the end of the first half of the year 1889, Mr. C. may be remarked, the name is spelt Goulston. Roberts calculates the general death-rate at 16 8 per 1000. Among the archives at the Heralds’ College there is, it The zymotic rate was high-namely, 3’4 per 1000- appears, safely stored away the funeral certificate of and, as will be remembered, diphtheria, which last year Dr. Theodore Gulston, M.D., dated 1632, and which sets caused 20 deaths, materially contributed to this end. The of is discussed in con- that he was son of epidemic diphtheria mainly forth the third William Gulston, D.D., nexion with the parishes of Hillingdon and Cowley, rector of Wymondham in Leicestershire ; that he married and apart from the question of infection contracted at Ellen, daughter of George Southerton (Governor of the school, it is evident that the prevalence of the disease Merchant Adventurers’ and Master of the Merchant Taylors’ was at least associated with, if not due to, a number of Company), by whom he had no issue, she dying in 1637. serious sanitary conditions. Attention seems, at the time In Wood’s "Athena Oxoniensis"l he is thus quaintly de- in question, to have been a good deal drawn to offensive scribed :-" Theodore Gulston received his first breath in circumstances about houses. A regular house-to house the county of Northampton, became probationer Fellow of visitation and record will now, it is to be hoped, secure Merton College in 1596. ’ Applyed his muse’ to the study both the knowledge and the remedy before the advent of of medicine (after he had been adorned with the magis- infectious disease. In Ickenham there were 4 diphtheria terial degree), in the practice of which, having been initiated deaths. The joint hospital received 151 patients, of whom in these parts, he lived afterwards at Wymondham, where, 56 from the urban district and 27 from the rural district as also in the neighbourhood, he became famous and much were suffering from diphtheria. Recommendations and frequented for his faculty. At length, taking the degrees action in such matters as unhealthy dwellings, v.’ater- of Physic in this (Oxford) University in 1610, was made a supply, &c., are evidently being pressed ; and the need for candidate of the College of Physicians at London, and the drainage works and the prevention of pollution in regard to year after Fellow thereof, and afterwards Censor, being at streams are put forward as urgent. Obviously this autho- that time in great esteem of his practice in the metropolitan rity has arrears of work to make good. city. He was an excellent Latinist and a noted Grecian, Exeter Urban District.-According to a report on the but better for theology, as it was observed by those that city sanatorium, it would appear that 41 patients were knew him. He hath published ’Versio Latina’ and under treatment during 1889, 8 of these coming from with- ’Paraphrasis in Aristotelis Rhetoricum,’ London, 1619 out the city. In all, 559 patients have been received since and 1623; also ’Aristotelis de Poeticâ,’ ’Liber Latinæ 1882, the death-rate over the eight years amounting to 6 2 Conversus,’ and ’Analytica Methodo,’ Illustratus London, per cent. of the admissions. To prevent needless personal 1623; also ’Versio variæ Lectiones’ and ’Annotationes communication with the establishment, the telephone has Critica in Opusculæ variæ Galeni,’ London, 1640, which been brought into use. last was published by his good friend, Thomas Gataker, Bac. of Div. Doctor Gulston ‘dyed’ at his house within the parish of St. Martyn’s by Ludgate, within the city of VITAL STATISTICS. London, 4th May, 1632, and was baried with great in the church to that solemnity belonging parish." HEALTH OF ENGLISH TOWNS. "By his will Dr. Theodore Gulston bequeathed £ 200 to pur- chase a rent-charge for the maintenance of an ’Anatomy Lec- IN twenty-eight of the largest English towns 5852 births ture’ in the College of Physicians at London, besides other and 3982 deaths were registered during the week ending donations, which were mostly, if not all, performed by his March 29 the. The annual rate of mortality in these towns, virtuous and religious widow Ellen Gulston. She, being which had declined from 26 6 to 21-7 per 1000 in the pre- possessed of the impropriate parsonage of Bard well, in ceding three weeks, further fell last week to 21’4; the Suffolk, did procure leave from the King (Charles I ) to rate was 18’5 in London and 23’8 in the twenty-seven annex the same to the vicarage, and to make it a pre- provincial towns. During the thirteen weeks of the sentative, which, being so done, she gave both so annexed quarter ending on Saturday last the death-rate in (for she had the donation of the vicarage before that time) the twenty-eight towns averaged 247 per 1000, and freely to St. John’s College, Oxon." exceeded by 1’7 the mean rate in the corresponding Dr. Theodore Gulston was third great-nephew to Thomas periods of the ten years 1880-89. The lowest rates in these Goldstone Gulston, Prior of Canterbury (the second Prior bowns last week were 17’9 in Nottingham, 18 5 in London, of that name2), and was uncle to William Gulston, D.D., 19 .1 in Bristol, and 19 4 in Bolton and in Birkenhead. The Bishop of Bristol, who died 1681 ; and Dr. Lancelot rates in the other towns ranged upwards to 28 ’7 in Brighton, Addison’s wife was his niece, Jane Gulston, mother to the 28.8 in Newcastle-upoii- Tyne, 29 3 in Sheffield, and 31’9 in famous poet and writer, Joseph Addison. Manchester. The deaths referred to the principal zymotic The present senior representative of Dr. Theodore iiseases, which had declined from 379 to 363 in the pre- Gulston (the founder of the well-known lectures) is Alan ceding four weeks, rose again last week to 424; they in- Stepney-Gulston of Derwydd, Esquire, in the county of cluded 164 from whooping-cough, 97 from measles, 64 from .carmarthen (lineally descended from the doctor’s elder scarlet fever, 46 from diphtheria, 33 from diarrhoea, 20 from brother John), through whose courtesy we have obtained "fever" (principally enteric), and not one from small-pox. the foregoing particulars. - The lowest death-rates from these diseases were recorded in and 1 Huddersfield, Leicester, Portsmouth, Birkenhead ; Vol. i., pp. 567-9, %c. while caused the rates in 2 In Somers’s "History of Canterbury" we learn that Thomas Gold- they highest Birmingham, stone Gulston, born in 1442, became prior of Canterbury Cathedral, and Preston, Brighton, and Salford. The greatest mortality was known as Prior Thomas Goldstone, "the second of that name." from measles occurred in Liverpool, Birmingham, and He was prior during twenty-four years, eight months, and sixteen days. from scarlet fever in and He died in Derby; Salford, Sheffield, 1517, and was buried in the cathedral (see his tomb there); and from in and he was the senior ecclesiastic sent in charge of the embassy appointed Preston; whooping-cough Wolverhamp- by Henry VII. (see "Letters and State Papers of the Reigns of ton, Liverpool, Oldham, Bolton, Salford, and Brighton. Richard III. and Henry VII.," vol. ii. &c., by Jas. Gairdner) to No marked excess of "fever" mortality was recorded arrange the terms of the peace which was concluded with the French n of towns. The 46 deaths from Charles A.D. and the Commissioners who any these great king, VIII., 1492, amongst in accompanied him was Sir Rice ap Thomas, K.G., who also was a direct iiphtheria in the twenty-eight towns included 30 London, ancestor of the Stepney-Gulstons of Derwydd, of the Stepneys of tin Salford, 4 in Hull, 2 in Manchester, and 2 in Sheffield. Llanelly, of the Dynevors of Dynevor, and of many other Carmarthen- No death from was in of the shire families. Some and relics of the renowned small-pox registered any interesting personal towns. Seven cases of this disease were Sir Rice ap Thomas are still preserved at Derwydd. twenty-eight 774 under treatment in the Metropolitan Asylum Hospitals, and not one in the Highgate Small-pox Hospital. The number of scarlet fever patients in the Metropolitan Correspondence. Asylum Hospitals and in the London Fever Hospital further declined last week to 1083; 91 cases were admitted to 11 Audi alteram partem." these hospitals during the week, against 76 and 87 in the preceding two weeks. The deaths referred to diseases of the RELATIVE SAFETY OF ANÆSTHETICS. respiratory organs in London, which had declined from 510 to To the Editors of THE LANCET. 381 in the preceding three weeks, further fell to 375 last week, and were 106 below the corrected average. The causes of SIRS,—In THE LANCET of Feb. 8th and 15th, 1890, there are letters on the relative of 84, or2-1 per cent., of the deaths in the twenty-eight towns important safety anaesthetics. Mr. Williams certain statistics of the adminis- last week were not certified either by a registered medical Roger gives tration of anaesthetics and of the fatalities which have practitioner or by a coroner. All the causes of death were duly certified in Portsmouth, Norwich, Bristol, Newcastle- occurred at St. Bartholomew’s Hospital, which, he says, and in five smaller towns ; while the largest may be accepted as reliable averages at the other London upon-Tyne, From these it that deaths from chloro- proportions of uncertified deaths were recorded in Liver- hospitals. appears pool, Sheffield, and Blackburn. form in the London hospitals amount to about 1 in 1236;, Birmingham, and from ether to 1 in 4860 administrations. The late Mr. Syme’s cases and my own form a continuous series of administrations1 of chloroform in and in HEALTH OF SCOTCH TOWNS. daily Europe India" from 1847 to 1890, without any deaths, and if Mr. Roger The annual rate of mortality in the eight Scotch towns, Williams’s reasoning from statistics is correct, it is logical which had declined from 28’7 to 24’8 per 1000 in the preceding to infer that the administration neither of chloroform nor six weeks, further fell to 24’2 in the week ending March 29th, of ether, as conducted in London, is as safe as the administra. but exceeded by 2’8 that which prevailed during the same tion of chloroform on the principles advocated by Mr. Syme. week in the twenty-eight English towns. The rates in the There can be no doubt that there is a flaw somewhere in eight Scotch towns ranged from 17 -2 in Perth and 18 0 in the London teaching with reference to anaesthetics, and Paisley to 25 -8 in Leith and 28-0 in Glasgow. The 627 deaths evidence on this point is supplied by the letter of Mr. in the eight towns showed a decline of 14 from the number Woodhouse Braine, who maintains that it is far more im- in the previous week, and included 31 which were referred portant to watch for pallor of the face than for partial to measles, 26 to whooping-cough, 11 to diarrhoea, 6 to interference with the breathing in chloroform administra- scarlet fever, 5 to diphtheria, 4 to "fever" (typhus, enteric, tion, having previously stated that pallor of the face is one- or ill-defined), and not one to small-pox. In all, 83 deaths of the signs that the patient is dead. Mr. Braine writes resulted from these principal zymotic diseases, against as if the acceptance of the truth about chloroform would be 103 and 101 in the preceding two weeks. These deaths disastrous to anaesthesia specialists. The reverse of this. were equal to an annual rate of 3-2 per 1000, which would be the case, as it is well known that immense exceeded by 0-9 the mean rate last week from the same numbers of people are deterred from having operations per- diseases in the twenty-eight English towns. The highest formed on account of the dread of anaesthesia caused by death-rates from these diseases last week were 4-1 in the present position of anaesthetics. Glasgow and 4’2 in Aberdeen. The fatal cases of measles, It is for anaesthetists themselves, however, or for the which had been 28 and 34 in the preceding two weeks, surgeons who employ them, to decide which policy is likely declined to 31 last week, and included 16 in Giasgow and to be more conducive to their own interests; to persevere in 10 in Edinburgh. The 26 deaths from whooping-cough announcing publicly that anæsthetics cannot be given safely a further those recorded in the showed decline from pre- in London, or to give a fair trial to Syme’s principles, which vious three weeks ; 15 occurred in Glasgow, 5 in Edinburgh, have stood the test of experience, and have been proved and 4 in The 6 fatal ca’3es of scarlet fever ex- Aberdeen. by the Hyderabad Commission to rest on a secure physio- ceeded by 3 the number in the preceding week, and included logical foundation. The question of chloroform administra- 2 in The deaths from which had Glasgow. diphtheria, tion is no longer one of doubt or of opinion, and moreover been 10 and 12 in the two to 5 previous weeks, declined it is one of common sense. If Hyderabad students can last of which 3 occurred in and 2 in Edin- week, Glasgow be taught to give chloroform as they do day after day, The deaths to diseases of the burgh. referred respiratory with guaranteed safety, a fortiori it must be a much more had from organs in the eight towns, which declined 203 to easy task to teach London students to do the same. 129 in the preceding five weeks, rose again to 141 last week, I am. Sirs. vour obedient servant. and slightly exceeded the number returned in the corre- EDWARD LAWRIE, sponding period of last year. The causes of 48, or nearly Surgeon-Major. 8 per cent., of the deaths in the eight towns were not certified. ___ THE CHLOROFORM COMMISSION. HEALTH OF DUBLIN. To the Editors of THE LANCET. in had from 28 ’2 The death-rate Dublin, which increased raised Deane in hi9 to 30-9 1000 in the three weeks, declined SIRS,-The point by Surgeon-Major per preceding again letter in THE LANCET of Jan. 25th is no doubt to 25’9 in the week March 29th. the thir- published ending During to the medical both in the teen weeks of the on last very important practitioner quarter ending Saturday the United and in other of Her death-rate in the the mean Kingdom parts Majesty’& city averaged 37 -0 per 1000, dominions. After the of the for same 6 in promulgation Hyderabad rate the period being 23 London and 25 9 in Chloroform Commission the administrator of Edinburgh. The 175 deaths in Dublin last week showed Report, chloroform in a case which may unfortunately be fatal will a decline of 34 from the number in the week; preceding they be in a very awkward before the coroner’s court. included 5 which were referred to 3 to position whooping-cough, We hear very often of "death from chloroform " in large measles, 1 to diphtheria, 1 to "fever," 1 to diarrhoea, and in the United that not one either to or scarlet fever. Thus the deaths hospitals Kingdom. Considering greatest- small-pox care is taken to entrust the to trained and from these which had been 18 always duty expe- principal zymotic diseases, rienced it is to believe that no other factor and 14 in the two further declined last men, impossible preceding weeks, but want of sufficient care in such casualties. to were an of 1-6 plays part week 11 ; they equal to annual rate per While the and work done from same fully appreciating great good by 1000, the rate the diseases being 2-4 in London the Commission, I believe I in that and 3’8 in The fatal cases of am justified saying Edinburgh. whooping-cough, there is one new recommendation contained in the which had and 4 in the two were 5 hardly been 7 previous weeks, conclusions in the end of the which last week. The 3 deaths referred to measles showed practical given Report is not known to the and which careful a decline of 3 from the number in the already profession, preceding week, do not observe in their work in the and the from "fever" showed a further decline surgeons every-day mortality room. from that recorded in recent weeks. cases, operation Two,inquest Dr. Deane says :-" For the last fourteen years I have and 4 deaths from violence, were registered ; and 41, or administered chloroform precisely as the Commission nearly one fourth, of the deaths occurred in public insti- tutions. The causes of 32, or more than 18 per cent., of 1 By daily administrations must be understood several administra- the deaths in the city were not certified. tions every day.—ED. L.