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Obituary.SIR RICHARD THORNE THORNE, K.C.B., F.R.S.,

M.B., F.R.C.P. LOND., LL.D. EclN., D.Sc.R.U.I.THE sudden death of Sir Richard Thorne Thorne, Principal

Medical Officer to the Local Government Board, whichoccurred on Monday afternoon last, has come as a greatshock to his friends as well as to the medical world at large ;for although during the last three or four years he had notbeen in very robust health, the indefatigable manner inwhich he discharged his onerous and responsible duties

precluded the idea from crossing any minds that thelife-work of so energetic a man was nearing a suddentermination.

Sir Richard Thorne was born at Leamington in 1841, hisfather, Thomas Thorne, being a banker in that town. Hewas the second and eldest surviving of four sons, all ofwhom became medical men. He received his early educa-tion at Neuweid in Prussia and at a Parisian lycée, whencehe proceeded to the Mill-hill Grammar School when about 17years of age. In Paris, where he was a schoolfellow of M.Waddington, he took two first prizes in science, thus earlyshowing the bent of his mind, while the internationalcharacter of his education as much as his other qualitiesmade him later so great a force in representing British ideasat International Conference Boards. On leaving Mill-hillGrammar school he served-as was very usual 35 years ago-an apprenticeship with a general practitioner, Dr. Burt ofLeamington, after which he entered at St. Bartholo-mew’s Hospital. There he had a distinguished career

as a student, culminating in his obtaining a doublefirst in 1866 at the final examination for the degree ofM.B. at the University of London. He then held the usualminor appointments at the hospital, became physician to thecasualty department and demonstrator of microscopicalanatomy, and lectured on psychology in the medical school.He was also elected physician to the Royal Hospital forDiseases of the Chest (City-road) and to the London FeverHospital. About this time he was employed by the MedicalDepartment of the Privy Council to make several in-quiries and as a result Sir John Simon offered him a

permanent post in the department, which was a littlelater transferred to the Local Government Board. Fromthat time until the day, we might almost say the hour,of his sadly sudden death his name has been associated, assubordinate or chief, with most of the valuable work whichhas been done by successive British Governments of varyingpolitics to preserve the public health and to render thiscountry the acknowledged pioneer in matters of sanitaryscience and its legislation.The earliest thing to bring Dr. Thorne’s name prominently

before the public was his work with regard to quarantineand the international regulations for the prevention of theimportation of disease from country to country along the linesof intercourse. In 1885 there was held at Rome an Inter-national Sanitary Conference and at this Great Britainwas represented by Sir J. Savile-Lumley, the BritishMinister at Rome, Sir W. Guyer Hunter, and Dr. Thorne,and British India by Sir Joseph Fayrer, and the late Dr.Timothy Lewis. Dr. Thorne was at that time one of the

junior members of the medical gtafE of the LocalGovernment Board, and doubtless owed his selectionto his mastery of French, the official language of the

Congress, as much as to his general merits. At this con-ference a series of proposals was formulated by the repre-sentatives of different nations with respect to the passageof vessels from the East to the Mediterranean bythe Red Sea and Suez Canal. One of these resolu-tions aimed at the compulsory medical inspection atSuez of all vessels by an officer invested with inter-national authority, the officer to be empowered to decideif any vessel could be regarded as "suspect" or no.

The British and Indian delegates opposed the resolution,stating plainly that any measure which might impede thefree passage of British ships under all circumstances throughthe Suez Canal was foolish from a public health pointof view. Dr. Thorne in particular maintained that thesuggestion of the delegates would not stop at inspec-tion only but was the first step towards the imposition

of quarantine, which England had always opposed and whichhe maintained had proved to be useless. The resolution wascarried, but amended by the adoption of a proposition thatif the visiting medical officer suspected any case of choleraon board any ship all passengers and crew should be landedand the ship detained for five days to see if any further caseoccurred. Again Sir Joseph Fayrer, Dr. Lewis, and Dr.Thorne protested against the reversion to a quarantinesystem, Dr. Thorne maintaining that if vast masses of

passengers and crew were landed in the horrible lazarettos ofthe Red Sea shore the disease would not be stayed butspread, and urging that the Conference had no right to

suggest that Great Britain should deposit in the midstof the Egyptian populations that which other nationsfeared to receive and deal with on their own shores. Heexplained that in her action against quarantine Englandwas not influenced by pecuniary motives and that theauthorities had within a short space of time spent over27 millions of money in the interests of human life andhealth, and he showed by statistics of mortality how remune-rative this expenditure had been, adding that it would be alamentable day for England if she should ever think of

changing such a system for the useless delays of quaran-tine which seemed to find favour with the Conference.Although the British and Indian representatives were

overruled on that occasion there can be no doubt that theirvigorous presentment of modern ideas were effective in caus-ing the time of detention to be very short and may really besaid to have given the death-blow to any universal faith inthe old-fashioned panacea of quarantine. The InternationalSanitary Conference at Rome was followed by othersat Dresden, Paris, and Venice, in all of which ConferencesDr. Thorne represented Great Britain and was recognised byhis brother delegates as the leading voice in favour of theviews, now generally accepted, that quarantine measures arecomparatively futile and that every nation should have properprovision at its ports for dealing with infected shipping.At Dresden an international agreement was arrived at in1893 on a basis giving rise to the smallest amount ofrestrictive legislation compatible with security to thepopulations concerned, an agreement which tended to relaxsuch quarantine restriction as was still existent and toreplace it by the application of approved remedies ofhygiene. At Paris in 1894 the proceedings of the Conferencewere marked with the greatest cordiality, and although somerestrictions were still maintained, to the regret of the Britishrepresentatives, its decisions were on the whole progressive.And now since the conference at Venice in 1897 all the first-class powera of Europe are acting under a Conventionlasting five years from the date of notification, and renewableevery five years, under which they contract to use uniformmeasures to prevent the incursions of cholera, &c. Themeasures are those of notification, medical inspection, purifi.cation of infected material, and isolation on shore of infectedpassengers and crew; so that by international consensus ofopinion quarantine in its old-fashioned sense is abolished asfar as these nations are concerned. There is no exag-geration in saying that by the part which Dr. Thorneplayed in advocating a quarter of a century ago andpersistently since that date the abolition of the inhumaneand short-sighted regulations of quarantine he has conducedto the alleviation of an enormous amount of misery in allcountries as well as to the arrest of the spread of disease-things which constitute him a public benefactor in thebroadest sense of the words.

In 1892 Dr. Thorne succeeded the late Sir GeorgeBuchanan as Principal Medical Officer of the Local Govern-ment Board, and five years later had the distinction of K.C.B.conferred upon him, having received the C.B. several yearspreviously. His period of office as head of his department,though brief, was crowded with matters of the first sanitaryimportance and he brought to bear upon his duties an appe-tite for work, a judgment, a tact, and a knowledge of detailwhich proved him to be a remarkable amalgamation of theman of business with the man of science. Nothing was toolarge for his grip and nothing too small for his attention,and to give a complete account of his work at the LocalGovernment Board would be, in a way, to write the medicalhistory of the Board during the years in question. We may,however, single out three subjects of the first public andsanitary importance where the principles of preventivemedicine, as understood by the scientific world, have beenmuch revolutionised of late. and where Sir Richard Thorne,as heacl of the public health bureau of the country,

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SIR RICHARD THORNE THORNE, K.C.B., F.R S.,PRINCIPAL MEDICAL OFFICER TO THE LOCAL e0’ERBIET BOARD.

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showed himself to be the right man in the right place,as much by his individual work as by his power ofadministration. Firstly, there is the increased prevalenceof diphtheria, running hand-in-hand with the increase ofour knowledge as to its origin and prevention and as tothe measures which should be taken against it. Next,we have the general recognition of the infectious nature.of pulmonary tuberculosis, of its preventability no lessthan its curability. And, lastly, there are the modifi-cations in the law of vaccination. In dealing witheach of these weighty subjects Sir Richard Thorne

proved himself to be, not only the official who couldassist the Government by devising measures to carryout new legislation, but also the scientific man whowith deep knowledge could discuss the various problemsthat presented themselves from an extraordinarily highrange of instruction. The general instruction enjoyed bythe medical profession in this country and no less by thepublic on the subject of diphtheria is largely due toSir Richard Thorne. In 1891 he delivered the MilroyLectures before the Royal College of Physicians ofLondon, taking as his subject the Natural History andPrevention of Diphtheria. In these lectures he toldthe story of the disease, furnishing details whichhad not until that time been available for many, forthey were derived from the official reports made to theLocal Government Board and the reports of medical officersof health, which are not easily accessible to the generalreader. As a result he was able to give information con-cerning diphtheria not to be found either in the workof one author or in the more familiar systems of medi-cine written by many authorities in collaboration.No one who was not himself a trained and skilfulobserver could have unravelled, as Sir Richard Thorne didin these lectures, the intricacies of a subject whichhad for years been obscured in a mass of literatureoften containing apparently conflicting statements. He had

carefully to compare and weigh both new facts and old factspresenting themselves in the light of newer knowledge, andhe showed himself to have a peculiar fitness for the workwhich he undertook. Familiar with his authorities, accus-tomed in the ordinary course of his duties to sifting theevidence of others, and himself a contributor to the know-ledge which he was codifying, he summed up in his MilroyLectures all the circumstances of diphtheria as it was thenunderstood and placed before the profession a volume ofthe first importance, thereby doing great service to thewhole of the sanitary organisation of the kingdom as wellas to every general practitioner whose duty it is to workhand in hand with that organisation.With regard to tuberculosis Sir Richard Thorne’s

individual work was hardly less valuable. During the last10 or 15 years our methods of regarding tuberculosishave undergone a great change, whether its therapeuticsor its prevention or its causation be considered, andin each department of recent research or conjecture wefind Sir Richard Thorne in the van, every whit as much inthe character of a man of science giving instruction as inthat of an official to whose department the administrationof future legislation will be confided. In 1888 a Depart-mental Committee inquired into the cause of pleuro-pneu-monia of cattle and tentatively recognised the contagiousmature of the disorder. As a result a Royal Commission wasappointed in 1890 to inquire into the effect of food derivedfrom tuberculous animals on human health. A valuablereport proving that an appreciable part of the tubercle thataffects man is obtained from food was the result, but duringthe time of the sitting of the Royal Commission scientificand general knowledge upon the subject became greatlyextended, so that the subject was ripe for re-considerationalmost immediately. In 1896 Sir Herbert Maxwell’s RoyalCommission was formed with a similar reference uponwhich Sir Richard Thorne sat. This Commission, it shouldbe remembered, rendered an exhaustive report upon verysound evidence. Its members gained first-hand informa-tion on their subject by continental inquiries and they madea series of recommendations with regard to the infectionof meat and milk by tubercle, as well as to the manage-ment of slaughter-houses, of cowsheds, and of dairieswhich should form the ground plan of some of the mostbeneficent sanitary legislation of the reign. On thisCommission there was no more energetic and helpful Com-missioner than the late Sir Richard Thorne, and thisbecause he held the view that the source of danger,

especially with regard to infection of man by meat, hadbeen over-rated. He considered that measures of stringencyhad been demanded by some sanitarians which were entirelyimpracticable and which only appeared necessary whenconsidered in the light of certain laboratory experimentshaving little or no parallel in everyday life. By thus takinga stand against alarmist counsels he served the truepurpose of this Commission, for he brought their wiserecommendations within the range of politics. He

adopted a similar policy when he took a decided line

against the compulsory notification of pulmonary tuber-culosis. His views will be found in the Harben Lectureswhich he delivered in 1898, where he pointed out thatthere was no similarity between pulmonary tuberculosisand the diseases now notifiable that would justify com-pliance with the demand to add the disease to the listof infectious diseases included in the schedule of theNotification Act of 1889. The Notification Act, he said,was passed in order to enable authorities to control themovements of persons who for a few weeks of their liveswere in a state which constituted a danger to public health.Such persons were, by reason of a temporary and acuteillness, unfit to follow their usual avocations. In the caseof phthisis he considered that any corresponding sanitarycontrol would have to be exercised for a series of years,during which time the phthisical persons were not only quitecapable of continuing in their employment but it might beand generally would be absolutely essential that theyshould be able to maintain themselves and their families aswell. He considered that any system of notification of

phthisis should be voluntary and might well be supple-mented by the construction out of public funds of sanatoriafor the temporary sojourn of the invalids. He was unable tobelieve that any system of compulsion could be devised thatwould be free of espionage, and his official experience toldhim that to obtain legislation that promised to infringe theliberty of the subject was nowadays very difficult.During 1898 Sir Richard Thorne’s department had before

it the momentous question of vaccination. As a result of thefinal report of the Royal Commission, which had sat forseven years and had considered the subject from everypossible aspect, the Government had concluded that freshlegislation was necessary. They accordingly introduced aBill into the House of Commons which, when it finallypassed, altered the existing law, not merely with regard toits so-called compulsory provisions, but the alterations, suchas the system of domiciliary vaccination and the use ofglycerinated calf-lymph, may, taken together with the-con-science clause, have the result of making vaccination moreacceptable than before and of rendering organised oppositionless effective. This measure entailed upon Sir Richard Thornean enormous mass of work and of anxiety. It was asimpossible for him as for any of us to estimate exactly whatthe results of the new vaccination law would be, but henever disguised his misgivings at the abolition of the com-pulsory clauses, although he recognised that a compulsionwhich was only verbal and not effective was worse than nocompulsion at all. For one thing members of the profes-sion have to thank Sir Richard Thorne mainly, whatevertheir views may be with regard to the new Vaccination Act:he doubled the scale of fees which was intended by Govern-ment to be offered to the public vaccinators. In so doing hefollowed his invariable line when dealing with the medicalprofession. Whether they were or were not members of theservice of which he was the official head he always strove toobtain for them fair remuneration and a proper recognitionof the value of their services to the community.We have given the salient points of Sir Richard Thorne’s

career and from them, as well as from the excellent

portrait which accompanies this memoir, we think that ourreaders, who were personally unacquainted with him,can deduce a true idea of the manner of the man that hewas. His portrait conveys exactly the impression of firm-ness and ability which with lucidity of judgment were hischaracteristic qualities. He owed it to his official positionto preserve a strict neutrality upon many questions con-

cerning which his scientific training would have promptedhim to take a strong line ; but where he was untrammelledhe showed himself to be a man of strong opinions. Forexample, at the meetings of the General Medical Council,to which body he was recently elected as a Crown Representa-tive, his was an influential voice, for although not a frequentspeaker his words were always to the point and founded uponaccurate information. For he was at the time of his decease

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lecturer on public health at St. Bartholomew’s Hospital andexaminer at Cambridge University on the same subject, sothat he had personal experience to add to his other claimsupon the Council’s ear. In his writings, also, he displayedconsiderable independence. Although no big book bears hisname he was a prolific author, for the reports which he madeduring his long official career to the Privy Council and theLocal Government Board would be sufficient to fill manyvolumes. In his annual reports on the progress of nationalsanitation he wrote with extreme clearness and cogency,forcing upon the attention of his department and of thewhole country the needs of public health as evidenced by itspresent conditions. One of his blue-books on the Use andInfluence of Hospitals for Infectious Diseases has had im-mense influence in establishing these valuable adjuncts topublic health throughout the country. In short, by thedeath of Sir Richard Thorne at the comparatively earlyage of 58 years the nation is deprived of a man whosesteeling public worth it is difficult to estimate too highly.He succeeded admirable predecessors and proved himselffit to sit in their chair, not only by continuing theirwork, but by infusing into it new spirit. His dream wasthe formation of an international scheme of preventivemedicine, and by his personal exertions as well as bythe influence that he exercised over a small but very com-petent band of assistants he made his dream a possibility,while he insured for England a leading part in the councilsof any such federation that may be formed in thefuture.

Sir Richard Thorne, in addition to the honour which wehave mentioned, was awarded the Stewart prize of theBritish Medical Association in 1893, about which date hewas elected a Fellow of the Royal Society. In 1898 the degreeof LL.D. Edinburgh was conferred upon him and in thesame year he received the degree of D.Sc. from the RoyalUniversity of Ireland and the honorary Fellowship of theRoyal College of Physicians of Ireland. He was also anhonorary member of the Royal Academy of Medicine ofRome and Foreign Associate of the French Society ofHygiene, and in 1887 was President of the EpidemiologicalSociety.

Sir Richard Thorne married in 1866 Martha, a daughter ofthe late Mr. Joseph Rylands of Hull, by whom he leavesthree sons, all of whom are in the medical profession. Tohis family we are sure all our readers will join us in extend-ing sympathy under their sudden bereavement. He had forsome time suffered from varicose veins which were liable toinflammation and at the end of last week decided to remainin bed for a few days where he was able to transact muchof his official business. A clot becoming detached inone of these inflamed vessels he died suddenly fromembolism.The funeral, which was of quite a private character, took

place on Wednesday at Woking.

MATTHEW LOUIS HUGHES, L.R.C.P. Lord.,M.R.C.S. EXG., L.S.A.,

CAPTAIN, ROYAL ARMY MEDICAL CORPS.

CAPTAIN MATTHEW Louis HUGHES, of the Royal ArmyMedical Corps, who was killed at Tugela River, was one ofthe foremost scientific workers in the army and his deathcomes as a very severe loss to the profession. Captain Hugheswas the son of Colonel E. Hughes, C.M.G., and was educatedin King’s College School. In September, 1885, at the age of18 years, he joined the Medical Department of King’s College,and was one of the ablest scholars of his time. His practicalwork was excellent and he was soon appointed AssistantDemonstrator of Anatomy by Professor Curnow. He wasintended for the Army Medical Service and passedthrough Netley with distinction, being Parked Prizemanof his year. He was specially interested in Mediterraneanfever and had written many palers and articles on

the subject both in our columns and elsewhere. Hislast post before leaving for the Cape was at Aldershot,where he was assistant sanitary officer, and as suchhad charge of the patients who suffered from thecarious attacks of gastro-enteritis which occurred there inAugust and September. An account of this outbreakappeared in our issue of Nov. 4th, 1899, from the pen ofCaptain Hughes, R.A.M.C., assisted by Cap’ain C. W. R.

Healey, R.A.M.C. He had only recently been made anAssociate of King’s College and nobody was more thoroughly

CAPTAIN M. L. HUGHES, R.A.M.C.

popular with his fellow-students and teachers than MatthewLouis Hughes. -

DEATHS OF EMINENT FOREIGN MEDICAL MEN.-Thedeaths of the following eminent foreign medical men areannounced :-Dr. Mudd, Professor of Surgery in the St.Louis Medical College.-Dr. Hendricks, Professor of Anatomyin the University of Minnesota.-Dr. Woodbridge, Professorof Physiology, Williams College, Massachusetts -Dr. Lavisé,Professor ag’l’égé of Surgery in the University of Brussels.-Dr. A. Nascimbane, editor of the Gazzeta Medioa L01llbarda.- Dr. Georg. Krukenberg, privat-docent of Midwifery an(3Gynsecology in the University of Bonn.

REPORT ON PLAGUE IN CALCUTTA.1

FEW things have been more remarkable in the behaviourof the plague epidemic in India than the manner in whichcertain places have escaped with a comparatively slight visi-tation of the disease although presenting all the conditionswhich are usually thought to be most favourable for its pro-pagation. Calcutta is a notable instance. Apart from theoccurrence of certain doubtful cases of plague in that city inthe autumn of 1896-cases which gave rise to considerable

controversy at the time-the beginning of the epidemic theremay be said to date from the middle of April, 1898>From that time until the end of July in the same year-the period covered by Mr. Cook’s report-only 190 cases ofplague,were reported in the city, and of these 155 died.Mince then we know from other sources there has been a

considerably wider spread of the disease in Calcutta, notablyduring the months of April and May of the present year,and at the present time some 30 or 40 deaths from thedisease are reported weekly as occurring there. But this isobviously still a small figure for a city of some 700,000 OF800,000 inhabitants, and is insignificant in comparison withthe mortality in Bombay, where the weekly returns of plaguedeaths have frequently been between 2000 and 3000 forlong periods together. Whatever the explanation may bethe sum of the conditions obtaining in Calcutta is muchless favourable for the propagation of plague than the sumof the conditions obtaining in such places as Bombay,Karachi, Poonah, or Bangalore. That Calcutta does not owe

Report on Plague in Calcutta. By J. Nield Cook, M.R.C.S.Eng.,L.R.C.P. Lond., D.P.H., Health Officer, Calcutta. Printed at theCalcutta Municipal Press, 1898.