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professors of surgery were quite ignorant of cleanliness and antiseptics, and were so fearful of anaesthetics that most major operations, including lithotomy, were usually done without them. Three hundred pounds worth of surgical instruments lay neglected in the hospital, because no one in Egypt was capable of repairing them, until we introduced an English * instrument-maker. Refractory patients were punished by confinement and by chains, anklets, and handcuffs."
This quotation affords as striking an illustration as could be found anywhere of the cruel parody of civilisation with which Ismail deceived Europe, and perhaps sometimes deceived himself, whilst he was heading straight to the ruin of his country and Ms own. Everything was to be on the European model, but seldom was anything more than the label copied. Laws and regulations were drawn up, often with the help of European experts, and duly promulgated by the Khedivial decree. But they never took effect. They looked well on paper, but in practice Ismail had no use for them, and, as Lord Cromer has written, who was himself an eye-witness, no one ever thought of obeying them. The principal officials concerned were indeed often ignorant of their existence. New taxes were levied, old taxes were increased, and changes introduced without any formal authority., The village Sheikh executed the orders of the Mamour, the Mamour those of the Mudir, and the Mudir those of the Inspector-General, who, again, acted " under superior order.'5 The " superior order," which was the Khedive's, in fact constituted the law. The officials obeyed it even if it were only communicated verbally ; and no taxpayer ever dreamt of challenging it. The Inspector-General of Upper Egypt, on being asked by the Commission of Inquiry to whom the taxpayer could address himself if lie had any complaint to make, answered, with a na/ivete arising from long familiarity with- a system which he considered both just and natural, "With regard to the taxes, the peasant cannot complain ; he knows that they are collected by c superioreen dismissed from the army, with, of course, no moral control over the patients. Serious cases could not be kept in bed, and trivial cases were allowed to lie in bed all day if they wished it. There was a systematic absence of clinical teaching, note-taking, temperature records, urine testing, or any thorough physical examination. The medical diagnosis seldom advanced beyond ' anaemia' or * gastric catarrh.' The dispenser accompanied the doctor on his round, wrote the prescriptions on a. sheet of paper, copied them afterwards into a book, and then administered the medicine of twenty-four hours all in one dose. Theheir articulate