CHARGE AGAINST A HOSPITAL SURGEON.

931

portion

of males to females exhibiting

hyperpyrexial

manifestations is 1’8 to 1. But that as to age marked difference exists ; nor as to occupation. 3. That the

subjects

rheumatic tendency 4. That

cases

of

as

of

hyperpyrexia

show

no

no

such

undue

regards family predisposition.

hyperpyrexia preponderate in first attacks

of rheumatic fever.

,w 5.. That hyperpyrexia is not necessarily accompanied by any visceral complications, but may itself be fatal. The complications with which it is most frequently associated are pericarditis and pneumonia. 6. That the mortality of these cases is very considerable, hyperpyrexia being one of the chief causes of death in acute

rheumatism. 7. That although present in a certain number of cases, and then of much value from their prodromal significance, neither the abrupt disappearance of articular affection, nor the similarly abrupt cessation of sweating, is an invariable antecedent of the hyperpyrexial outburst. 8. That the supervention of delirium or other symptom of nervous disturbance is very frequent either antecedent to

simultaneous with the hyperpyrexia. 9. That there is considerable variability in the date of the occurrence and in the duration of the hyperpyrexial condition, ranging, according to our observations at least, from the 4th to the 30th day. 10. That when death results it has occurred mostly in the 2nd and 3rd week of the rheumatic attack. 11. That the post-mortem examinations in a certain proportion elicited no distinct visceral lesions, and that when present the lesions are not necessarily extensive. 12. That the prompt and early application of cold to the surface is a most valuable mode of treatment of hyperpyrexia. That the chances of its efficacy are greater the earlier it is had recourse to. That the temperature cannot safely be allowed to rise above 1050. That failing the most certain measure-viz., the cold bath-cold may be applied in various other ways : by the application of ice, by cold affusions, ice-bags, wet sheets, and iced injections. The Committee did not think it advisable in the present report to enter into theoretical considerations, and limiting the study of hyperpyrexia to the records of 67 cases of acute rheumatism, deemed it premature to enter into physiological reasonings until the same conditions had been reviewed in other acute febrile diseases. The report is signed bv Drs. R. Southey, H. Weber, W. M. Ord, F. Taylor, T. Barlow, and S. Coupland. or

.

CHARGE AGAINST A HOSPITAL SURGEON. AT Bow-street Police-court on Friday, the 26th ult., Mr. Angel Monev, surgeon at the Great Ormond-street Hospital for Sick Children, was summoned before Mr. Flowers to answer a charge of having improperly interfered with the dead body of an infant named Robert John Mddick, on March 7th, by cutting it. Mr. Besley appeared for the Vigilance Association, who were the complcdnants in the case; and Mr. Horace Avory for Mr. Money. Mr. BESLEY said that Mrs. Maddick, the mother of the an application at the police-court respecting this matter in March last. The Vigilance Association had taken up the case, and had given instructions for these proceedings to be instituted. He hoped that nothing he might say would be construed either against the hospital or Money. The sole object of the proceedings was to learn whether, in the absence of a coroner’s order, there was a right on the part of any person to make anatomical examinations without having previously obtained the consent of the nearest relative. Mr. Besley referred, among other things, to sections of the Anatomy Act, 2 and 3 William IV., cap. 75, which provided against improper interference with, or indignities to, a dead human body, whether buried or not. He also pointed out that by the 7th section the consent of the nearest relative to an anatomical examination must be obtained. The case of the " Queen v. Feistwas cited, and Mr. Besley contended that no post-mortem examination should be made except by the coroner’s order, or under the

child, had made

conditions of the

2mong the

Anatomy Act. A notion seemed to prevail hospital authorities that a post-mortem exami-

nation was taken as authorised unless notice to the contrary had been given previously in writing by the nearest relative. The Vigilance Association in all probability would not have thought it necessary to have the law determined in this’case if that notion had not been general. They felt that thesé authorities were in error, and that the sooner they acted in accordance with the Act the better. Nothing could be more likely to destroy the benefits of hospitals than repetition of such cases. Mr. Besley added that the prevailing notion would act in favour of the defendant. Mrs. HARRIETT MADDICK deposed that she was the wife of John Maddick, of 46, Wych-street. In February last their son, Robert John Maddick, two years of age, was ill, and was taken to Dr. Welch, of Blackmore-street, subsequently to the Clare Market Dispensary, and on the 7th of March to the hospital in question. She remained with the child until midday, and then left. Before leaving she told Dr. Reed that the child had had a fall. She returned at six in the evening, and after being detained for some time, owing to some alleged mistake in the name, she was inthat her child had died at twenty minutes past one. She was advised not to see the child that day, but to call the next morning at nine. She went at twelve with her sister. She was told that she could not see the body of her child, as the doctors were engaged. According to arranoement made she had the child removed that evening by an undertaker. Upon looking at it she found that thebody and head had been cut open. In cross-examination by Mr. Avopy the witness said she knew a certificate as to the cause of death had to be given. No one had suggested the dissection of the child. The post-mortem examination-book was produced by Mr. WHITFIELD, the secretary of the hospital. It contained an entry as to the result of the examination. Mr. AvORY thereupon addressed the magistrate, pointing out that it was the practice in hospitals to make post-mortem examinations unless a request to the contrary was received from the parents. Requests of this kind had frequently been complied with by the authorities at the hospital in question, but in this case it was necessary to make an examination before a certificate showing the cause of death could be given. If this had not been done the child could not have been buried unless an inquest had been held, and in that case Mrs. Maddick would have found that an examination would have been ordered by the coroner. It was suggested that the Anatomy Act did not apply to the case in Mr. BESLEY submitted there had been a contravention of the 7th section of the Act, forty-eight hours’ notice not having been given for the examination conducted by the directton of the coroner. Mr. FLOWERS adjourned the case in order that he might consider it fully.

formed

question.

Correspondence. "Audi alteram partem."

VARIOLA AND VACCINIA. To the Editor of THE LANCET.

SiR,-Had delayed till the sixth day in writing to you the above subject, I would, probably, not have written at all, and my experiment, like that of my late uncle, Surgeon G. G. McPherson, H.E.I.C., would have begun and ended with the first attempt; instead of this, however, I felt some important issues were at stake, and therefore decided upon carrying on these experiments, and I have been amply rewarded for my perseverance, though it has ended in the complete overthrow of my theory regarding I

on

the artificial production of cow-pox, and left me no other refuge than the acceptance of the spontaneous origin of cow-pox. It is my intention at an early date to lay the results of my experiments before the public in detail, but I feel some explanation is due to your readers for this sudden and entire change of opinion, and I shall now endeavour to do this in such a manner as will take up the smallest amount of your valuable space, consistent with clearness of detail. On the morning of the sixth day the eruption in all three