At Pajamas Media, Dalrymple takes issue with a paper in the Lancet that concluded that “every additional 15 minutes of daily exercise beyond the minimum of 15 minute per day further reduced all-cause mortality by 4 percent”:

In the new edition of the New Criterion, Dalrymple reviews a new biography of Margaret Sanger by Jean H. Baker. Sanger founded the organization that later became Planned Parenthood, the largest provider (by far) of abortions in the United States and a focus of political controversy. Dalrymple praises the biography, and while his criticism of Sanger herself is firm, it is not quite as scathing as one might expect:

Dalrymple praises Alice Arnold for upbraiding a litterer — and discusses his own similar experiences.

It is not surprising, then, that opium dreams, and illusions and hallucinations, are important in his first works of fiction—for example in The Phantom Rickshaw. The very first of his fictional works, written and published when he was only 19, is “The Gate of a Hundred Sorrows,” an account of an opium den in Lahore narrated by a Eurasian habitué of it. Very brief, it is an astonishingly assured piece of work.

The narrator, Gabral Misquitta, is in receipt of a legacy that yields sixty rupees a month, which he entrusts to the owner of the opium den known as the Gate of a Hundred Sorrows, an old Chinaman called Fung-Tching. In return Misquitta has unlimited access to opium, which he calls the Black Smoke. Under the influence of the drug, the black and red dragons “and things” that adorned the pillows “used to move about and fight.”

Misquitta’s notion of happiness is that of many people today, and perhaps explains why they go in for intoxication of one kind or another:

Sometimes when I first came to the Gate, I used to feel sorry for it; but that’s all over and done with a long time ago, and I draw my sixty rupees fresh and fresh every month, and am quite happy. Not DRUNK happy, you know, but always quiet and soothed and contented.

Johnson, whom Voltaire (wrongly) called a superstitious dog, believed that science would help to relieve mankind of much misery, but not of misery as such. Living at a time when poverty meant not an income lower than 60% of the median income but having little to eat and rags to wear, it was perhaps prescient of him to realise that, notwithstanding the horrors of poverty that he never underestimated, material progress would not mean full and final happiness.

A religious man, or perhaps (better) a man striving to keep his religious belief intact, one of his preoccupations was the problem of how an infinitely wise, powerful, knowing, and benevolent God could permit such suffering in the world. Among the great causes of suffering, of course, were disease and illness. When Johnson was writing his great Rambler, Idler, and Adventurer essays, half of all children in London died before their fifth birthday, and the city was so unhealthy that its population grew only because of migration from the countryside. The search for good health is not a cause of mass migration.

In one of his lay sermons, Johnson tackled the question of how much suffering was attributable to God’s will. He wrote:

In making an estimate, therefore, of the miseries that arise from the disorders of the body, we must consider how many diseases proceed from our own laziness, intemperance, or negligence; how many the vices or follies of our ancestors have transmitted to us; and beware of imputing to God, the consequences of luxury, riot, and debauchery. There are, indeed, distempers which no caution can secure us from, and which appear to be more immediately the strokes of heaven; but these are not of the most painful or lingering kind; they are for the most part acute and violent, and quickly terminate, either in recovery or death; and it is always to be remembered, that nothing but wickedness makes death an evil.

The last sentence makes sense, of course, only if there is a future state of being whose felicities are handed out according to our desert in this life; and perhaps pedantically inclined philosophers might say that otherwise it is not death itself that is an evil, but only the truncation of existence that might have been more prolonged and is foregone by the intervention of death.

Circumstances, then, alter both medical conduct and ethics.

Of course, 16 percent of the refugees given the drug benefited from it, in that their worms were eliminated and infestations are deleterious for health. Moreover, there would have been possible public health benefits to the administration as well, because people who do not have worms cannot spread them to others.

It is difficult to work oneself into a lather of indignation about the whole business; but from the point of view of medical ethics, the paper is certainly not without theoretical interest.

Dalrymple recounts an infamous medical malpractice trial in this BMJ column (subscription required):

Dalrymple’s new essay for the New English Review is summed up nicely by a couple of its closing lines.

It is important first to distinguish between unfairness an injustice, but it is also necessary to be aware that the righting of injustice has to be weighed against other considerations. It is possible – I think likely – that a totally just society would be a horrible one. One that was fair would be intolerably dull, for it would eliminate difference.

Dalrymple’s answer is simple: So long as the user is human, probably not.