858
Key, HORSENELL
take it for
granted
both bones
were
broken, for you reply, " The eversion was
occasioned by the fibula having united shorter than the tibia, the latter being Court of King’s Bench, Feb. 24, 1832. twisted round." In answer to the 4th question, you reply, " He bears on the small part of the foot." LETTER FROM DR. BLICKE TO MESSRS. KEY AND TYRRELL, ON EVIDENCE GIVEN BY A curious result this, and no doubt a philo. THEM AT THE ABOVE TRIAL. sophical one, that the shortening of one of two previously equal props should make the short one take more weight. It is remark. TO MR. C. ASTOB KEY AND MR. F. TYRRELL. able, however, that Mr. Key flatly contraGENTLEMEN,—I deem no apology neces- dicts this. The 25th question. Is the eversion of sary for thus publicly addressing you, as the subject has already been made one of the foot permanent? Answer-°’ I think public notoriety by the publication of the it will be so." trial of HORSENELL v. BLICKE, which took Would it not be better to doubt where place in the Court of King’s Bench, at there is a ppssibility of doubting’ ? In your answer to the tenth question, Guildhall, on the 24th Feb. A short delay has taken place since that trial, occa- you reply you have not heard whether it sioned by my inability to procure ar. au- was all oblique fracture or a transverse one ; thentic copy of the minutes of evidence on here then it appears you could not rely on the trial, which I deemed necessary to en- your own inspection—a clear proof that sure a strictly correct basis for the stric- the opinion you gave of the condition of tures I am about to make on that evidence the limb, in reply to the fourth question, and your subsequent conduct, which I trust, was purely speculative, or founded on hearfor your own sakes, you will feel called say. Would it not have been wiser to have gone on (the better to support your upon to answer. I am informed by two of our mutual theorv) with your original speculation, and friends, whose names I am at liberty to use stated it as an oblique fracture, in lieu of if necessarv, that you, Mr. Key, have men- allowin- the learned sergeant to call the tioned with regret, that you were not in tyro Mackenzie to commit himself by possession of the* nature* of Dr.* Titley’s-)R stating it was a transverse ? For proof of this I refer you to a frrsh inspection, or to evidence. * * * Am I to Mr. Calloway, a surgeon of no mean emiunderstand, Sir, by this that your evidence, nence, who stated to me the night before from an ex-parte statement, was so arranged the trial, that he had just examined the leg, in vour mind that you could not divest your- and could distinctly feel the edge of an or that you were so oblique fracture. self of the To the fourteenth question, Supposing or ill as to advance advised, thoughtless, evidence on speculation and theory which the limb had been properly secured, could you now find is untenable, and which, had the large bone have become twisted ! &c., it been true, would have blasted the repu- you reply-°’ It is quite impossible,"-in tation of a professional brother ? other words, " When the left, no" Utrum horum mavis accipe." thing could undo what he had done till his I envy not your feelings, though you are next visit." said by the same person to have rejoiced at To the fifteenth question, Was the application of hot water, when Mr. Mackenzie my success. And that you, Mr. Tyrrell, havegone so saw it, a proper remedy you reply-,,I far as to say I have been very ill used ; have never heard of hot fomentations of and had my counsel put proper questions water being applied to any fracture of the to you, you could have shown clearly I kind." Am I to understand by this, that * * ’ could not be inculpated. vou have really never read a single work on inflammation? For none that 1 have ever * * * I shall endeavour to read, has been without its comparison of examine presently how far you are borne the relative value of hot and cold appliout in the assertion. I am sorry I cannot cations. I would recommend you to try give you credit for it. I shall now, how- warm fomentations to your next patient, and ever, submit Bour individual conduct to be see which he prefers, and then I am sure you judged of by the world and your own con. will admit we have ample testimony as to science, and proceed to a critical exami- which you ought to use in future. Perhaps nation of the remarkable parts of both evi. you will tell me there was only swellmg of the limb and not inflammation, and theredences, commencing with Mr. Key’s. In answer to the third question, to de- fore I refer you to your answer to the scribe the condition of the leg, you, Mr. nineteenth question, as to the occasion of v.
BLICKE.
Mr.
impression,
surgeon
859
the unusual extent of callus-viz. "I should not the man on getting up from the ground think it was produced more by the extent fracture the fibula?" and you reply, " It is of inflammation that attended the acci- very unlilel3,, because the fibula being the weaker bone of the two, it would give way dent." * *’ f(< In reply to the twenty-fourth question, first." *’ * ’II< ‘ extent of him an think but, suffering pain. you The pain will Sir, you are a senior surgeon of Guy’s HosAnd to the wear off as the bone recovers its strength," pital, and I cannot believe but that, on reI ask, Did you try its strength1 Mr. Cit ’I- flection, you will admit your practical expelowav made him, at the time before alluded rience has taught you otliervvist-, and that to, hop off the sofa on this weak bone, and you were bewildered by the recollection of *’ *’$ told him, as 1B1r. Earle had previously done, what you had to prove. * * ’"$’Ii* and see if the tibia but without concert-he had no pain. In reply to questions 27 and 23, relative does not wholly support the body, and neto the bones yielding bv persons walking cessarily bear all the shocks in its own axis, about before the callus is hard, you say, This and most of those in a transverse direction ; On what a little reflection and common sense will case is not occasioned by that. do you ground this opinion? To question then tell you that fact which is laid down in 30 you reply, The average period at whichmost authors, ‘° that when both bones are a man may walk moderately is between two broken, the fibula is always broken subseor three months. Now it was proved this quent to the tibia, and of course at its weakman was seen before the end of the month est point, the upper part of the bone." Two in the tap-room, and walking in the street exceptions only occur, and these are rare ; at his master’s house,-sworn, it is true, to first, where both bones are broken by a blow be under a quarter of a mile from his resi- applied so as to act transversely on each dence, but is it not a good specimen of what bone at the same moment, when the frache did before your perznd had elapsed?tures are always in a line; and, secondly, Would it not have been better to doubt " where the force operating on the fibula is where your positive opinions, if credited, the outer side of the foot, neither of which might in the minds of the jury have affected cases can this be, because you state that the the reputation of a surgeon, your senior in man broke his leg by kicking his toe against years, and one whose practical experience the gate or stile he was leapingover. The must have been infinitely greater than your tibia you say was broken four inches above own, and when in truth your assertion is the ankle, and the fibula not quite in a line. proved by Dr. Titley, on his oath, to have Now if broken below the line of the fracbeen an erroneous one1now come to your t’.ired tibia, could you not have ascertained it cross-examination; your evidence in chief with precision? But before you answer this, most people will perhaps think ought to let me remind you, that if you say "above," have sut1:iced me, but, unfortunately for it would just be about the thickest part of you, I was early accustomed to hard read- the bone, and the least likely to break. I ing’, especially the ancient authors, ani ask you then, Sir, again, What bewildered there I learned that to acquire a true not;on you so, with every-day facts before your of men and manners, and boldly to announce eyes? Let me refer you to Lawrence, Did you not them to the world, was an indispensable Cooper, Dupuyten, c. &c. obligation on every individual. I therefoe go into the witness-box impressed with the must proceed. liaving stated, in reply to idea that you had to prove a fact of which. the 31st quest., that you had examined the you now confessedly know nothing? leg, the 3sd question asks if you had dis- In answer to the 62d question as to Dr. tinctly ascertained a fracture of both bones, Blicke’s qualifications, &c., you reply you and you reply,—The part where the fibula do not know Dr. Blicke (the question e?iappears to be broken is so well covered with dently not meaning personally). It is pussimuscle that you could not so well ascer- ble if you are so ill-read as you tain it. In answer to the 34th question, as would make it appear, that you might never to whether it was broken at all, you have have heard of me ; here, however, I confess no doubt of it whatever. The 3:th question my vanity is a little hurt, bat 1 live in hopes asks if you had any means of ascertaining the short-hand-writer has omitted the verb the precise way the fibula was broken, and wish which would have governed the infiniyou reply, "Not with precision." The tive mood, and made your assertion quite 36th question asks if the fracture of the intelligible, and at all events I am sure this fibula was oppo-ite or in a line with the is your feeling now, and therefore I will only fracture of the tibia, and you reply, "Not refer to two of the remaining twenty-nine in a line." questions. And first the 74th question :Dumvitantstulti vitia, in contraria current. "May not any eversion or shortening The 38th question asks, "If a man frac- that has taken place, have arisen from a dislocation of the tibia subsequent to the fotma. tures the tibia by any accident, and falls,
twenty-sixth—"
certainly,
may
860 tion of the callus; in short, may not those like a woman’s chastity, it must not be effects you describe have resulted from that breathed upon, independent of the known and a subsequent fracture of the fibula at prejudice of juries, and the ruinous expense it puts defendants to, even where they are the period of dislocation 1" Ails. I think not, because the callus of sure to obtain a verdict), 1 cannot but hold up both bones is consolidated together, and I you and your conduct as a beacon, to assist do not see how the fibula could have joined in avoidingthe dangers to which, from the shorter; it appears to me to have been a very nature of our profession, we are all exposed. Every one knows the philanthing that originally took place. Question 76th. Suppose it had been found thropy induced by the practice of our proupon taking off the splints six weeks after fession, and how blind we are in not lookthe accident, that the callus was evidently ing more to the support of each other’s chasoft and imperfect, may not any irregular racter; but it is the infirmity of human position of the limb have occmrcd subse. nature arising from that all-powerful c;.use, the never-ceasing necessity of establishing quent to that period? Ans. The difficulty is the shortening of and watching our own reputation and chathe fibula. I cannot think how the bones racter, to enable us to supply the common wants of nature, and which too often make could have joined as they have done. Now, Sir, these two answers exhibit the us blind to the effect produced on the chaprincipal cause which led you into error, racter of others by the maintenance of our and which to rectify, and serve yourself, own. I have said blind, because I really you floundered about and got deeper and believe, nine times out of ten, it is most deeper into the mire. You were told by innocently done. I have now. Mr. Tyrrell, to examine how the lawyer, the patient, and the medicolawyer,—as Mr. Earle termed him on the far you are borne out in your assertion : trial-the general practitionpr who hawked Had mycounsel put proper questions toyou, the plaintiff about from surgeon to surgeon, you must have exculpated me. selecting those that answered his pur- In reply to the 25th question, whether pose, and rejecting those who did not,- both bones were broken, you answer, "Dethat the fibula was broken, and very possi- cidedly," and no doubt came to this convic. bly also by the tyro Mr. Mackenzie, and tion for the same reasons as Mr. Key. In reply to the 26th question, whether you believed it. Remore this fact from your mind, and all is plain and easy, as it would the fibula was broken at the time of the first appear ; but, Sir, was this the duty of a accident, or at a subsequent period, by overmedical witness? Was this to be expected exertion, you say, you can only state there from a senior surgeon of Guy’s, to give has beena fracture of the tibia and fibula; evidence on any other facts than those ex- and to the 27th question you reply, it is hibited by the limb itself?" And will you your opinion they were broken together; It was impossible for now hare the temerity to assert the fibula to the 23th was broken, in face of the positive fact the tibia to have united as it has done, if stsorn to the contrary by Mr. Dalgleish, a the fibula had remained sound ; it might surgeon of ten years practice, f,nd who saw have yielded, but not to the extent. To the the limb and examined it immediately after 40th question, Supposing the fibula to have the accident?—in face of the recorded fact been fractured, might not that have been at exhibited by the entry in my-day book at a subsequent period after the first injury? It might have been ;" and to the time, and when no sinister motive could you reply, have occasioned such an entry, and in face the 41st question, a consecutive one, "And I may now say of vour own evidence ? For have produced the effects you see in the leg be it remembered, Dr. T itley has sworn to now’!" you reply, "No, I do not allow the leg having been straiglit on the 18th of’ that." Now, Sir, according to this eviJuly, which precludes the fibula havingdence, and if it be still your opinion, how been broken, if your evidence be correct. can any questions put to you prove my inI feel certain you will not ; nay more, Sir, nocence of the charge alleged against me ? I feel convinced the regret you have exThe fibula having been proved not to pressed is sincere, and I am only sorry that have been broken in the first instance, u sense of public justice, a sense of what I yours and Mr. Key’s evidence is chaff The truth is, you fell owe to the profession at large, compels me before the wind. thus to address you ; for when I am in- into the same error as Mr. Key; your formed hardly a term passes over without minds were made up on the point; otherthese actions being brought by some petty- wise, had either of you paid attention to fogging lawyers against mv professional the evidence adduced by the plaintiff of trethren, and that almost all compromise my attendance, it would, I should have by paying a sum of money, however inno- thought, have put you on your guard; for cent they may know themselves to be (for after Sergeant Wilde had asserted I had be it remembered, a surgeon’s reputation is only seen theplaintiff four times, the first
question,
"
HOSPITAL SURGEONS AND GENERAL PRACTITIONERS. witness he called, Watson, swore to his having seen me five times, and proved, by more than double, for he was more from home than at home, and had heard of my beingthere when he was from home, whilst other witnesses proved I must have been there eleven times. Or, again, if you had attended to the discrepancy of the evidence about the
infereuce, I was there he
861
THE LANCET.
swore
London, Saturday, March 17, 1832.
A CAUSE which was tried in the Court of Common Pleas, on Friday the 24th ult., bowels not having acted for fourteen days, has the had effect of again directing our atcoupled as it is with the fact that a teacastor oil him. of went through spoouful tention to the caves of the BATS, and of inI am now, gentlemen, about to take my I leave of you for the present; but as it is ducing us to observe with re-excited inmost probable, after the evidence you have e dignation the conduct which those misgiven in this case, you will of all others, chievous animals appear resolved to pursue, by counsel for plaintiffs in these actions, in order to be selected, it is right you should be inaccomplish the overthrow of the formed that the dictum of hospital surgeons respectable portion of the profession. How at an end, and must be so for at least thirty we have been reviled for the strictures years more, if not for ever. The superior advantages military and naval surgeons which we have offered upon the zig-zag have had, during the late protracted war, movements of this pernicious race ! How on all practical points of surgery, have inhas the duced a habit of independence of thought profusely gall of literary hirelings which will never brook the dictum of any been bespattered on our heads ! How inPrevious to this man, or set of men. numerable have been the falsehoods they there was a passive obedience to hospital surgeons, and necessarily so, surgical prac- have uttered ! How interminable the calum. tice being wholly engrossed by them. One nies they have promulgated! And with other point in our profession, perhaps of what avail? Why, their attempts at deeven more importance, however, still remains to be overcome ; and as even you hos- traction have been useless and despised, pital surgeons have on many occasions lately their falehoods rejected, their calumnies fallen victims to it, perhaps you may be roused to avert it when it is exposed to you. exposed, and the venal writers and their I mean the prejudice of the world on cer. employers are now reduced to that low tain points of practice; and this is thE state of degradation, which, whilst it marks more extraordinary, as in every trade m art but physic, where it is more imperativethe depth of the infamous course they have from the deeper research necessary in its ! pursued, leaves them impotent as the fangacquirement, the maxim of less reptile or stingless wasp. " Cuilibot in arte sua credendum est," to the 5th of October, 1823, the bulk is ever on the lips. Look to the prejudice Up against myself on the minds of the jury- of English medical practitioners were deatithe perfect horror with which they heard tute of the protection afforded by an indethe man’s bowels were not open for fifteen pendent Journal ; the press, up to that day, days, though told at the same time I know- had never been employed for them, but alingly permitted it ! It is for master-minds to bereave of such themselves strong ways against them; at least, if any efforts only impressions ; and therefore the evidence had been hazarded in their favour, those I subsequently produced to prove the falsity of the fact not being direct, was insufficient efforts were either so feeble or misdirected, with the whole of the jurv, though to a that their only effect was to exhibit to the man of education it was far stronger than world the overwhelming influence of the any direct evidence could possibly be, and more especially so, as you yourselves swore power which was wielded against all ranks it could not have aff..cted the limb, but as )f surgeons in general practice. No sooner, far as it went, abstractedly considered, was beneficial. I am, Gentlemen, your obe- therefore, was a publication sent fortfz, dient servant, (vowed1y devoted to the interests of the W. F. BLICKE. great body of the profession, than the select Walthamatow, March 5,1832. md favoured tribe—the college monopoists