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INADEQUACY OF THE PAYMENT TO MEDICAL WITNESSES FOR ATTENDING AT TRIALS IN CRIMINAL COURTS.
633 and more distant. parts; it first appeared in the elevated, hard, inflamed pimples, about as large as- peppercorns, and these spread laterally, until the entire surface became one black mass. The pulse was feeble, the patient lay prostrate, and exhibited the usual symptoms of low spotted fever.
in the
shape
legs
of
The PRESIDENT remarked that the headach in this case was associated with venous congestion, as supposed by Dr. Hartry, and others. Upon this had employed bleeding and drastic principle, that practitioner purgatives with the best effect. Connected with this congestion, no doubt there was some change in the circulating fluid itself, the crasis of which had been broken up, so that it became like the mere liquor sanguinis. In reference to the nature of purpura generally, Mr. HILTON had recently found it associated with a low condition of .the system and a reduced quantity of the blood. Treatment to improve this condition was usually beneficial. He had seen, however, one or two cases in which there was a large quantity of blood in the system. These were benefited by depletion, generally, but were the exceptions to the rule. Mr. ROBERTS did not believe there was any analogy between purpura and scurvy; in purpura there was no sponginess of the gums. Mr. DENDY made some remarks, to show that apparently modes of treatment, as adopted by various practitioners in this disease with equal success, might be explained, by the fact of these modes tending to produce the same result-viz., an improved state of the secretions, by which the general
tended to show that the disease
I assure you, Sir, that mine were not benefited by being exercised twenty-four miles a day, in addition to their usual work. It must be obvious that, under such a system, not only must medical men be great pecuniary losers; but, putting .6. s. d. aside, the public must suffer, when the sick are thus violently deprived, for days together, of their doctor. Every one can estimate the importance of medical evidence in a court of justice, and must believe that the giver of it feels the heavy responsibility of his duty; yet he is put to groat extremes, suffers losses, and undergoes much fatigue, without any adequate remuneration; although, so important is his evidence, that life or death commonly depends on its issue. What vexed me still more was to find that a physician was allowed double fees! This is ridiculously unjust,-not that the physician has 2l. 2s. a day, but that the surgeon has only half this sum; although, by being taken from his practice, he might lose in one day more than an M.D. would forfeit in a week. In the country, generally speaking, the M.D. does not make a fortune by his practice. I enclose my card, in authentication of my communication; and I hope, Sir, that you will make an effort to claim justice for us in these matters.-Iremain, your obedient servant, A. S. April, 1846.
EMPLOYMENT OF CAJEPUT.—LEECH-BITES. To the Editor of THE LANCET.
opposite
subscriber to your excellent journal of more years’ standing, and having been permitted, some cases that were cured by through your urbanity, to publish in THE LANCET several of small repeated bloodlettings, which tended to show, as the my lucubrations, I trust you will not think me intrusive in President had formerly remarked, that the disease depended making a remark upon the case at Charing-Cross Hospital, on congestion. entitled, " Ulcer of the Leg treated with Cajeput," and upon Dr. L. STEWART mentioned a case of malignant small-pox the " Treatment of Haemorrhage from Leech-bites" published which proved fatal in thirty-eight hours. The pock did not in the number of the 23rd of May. On reading the heading to the article, " Case of Ulcer, acmaturate, and the entire surface assumed a purple hue like that present in purpura. companied with Varicose Veins of the Leg, treated with Mr. BARLOw believed that facts were against the suggestion Cajeput," I concluded that the cajeput had been applied exthat purpura depended on venous congestion, inasmuch as ternally ; but, on reading further, I found that the vaunted anasarca and other results of obstructions to the veins were remedy had been administered internally, and that the usual not associated with purpura. treatment for varicose veins with ulceration, rest and cooling After some remarks from various members on certain terms applications had been resorted to, in conjunction with the inused in describing disease, the meeting was adjourned. ternal administration of cajeput." Now, as cajeput is a powerful diffusible stimulant, and as the man had been accustomed to " drink largely of rum," it appears to me that rum, brandy, INADEQUACY OF THE PAYMENT TO MEDICAL or any other stimulant, properly administered, would have WITNESSES FOR ATTENDING AT TRIALS IN answered the same purpose as cajeput, and would have been as fairly entitled to the heading, " Case of Ulcer, accompanied CRIMINAL COURTS. with Varicose Veins of the Leg, treated with Rum and Brandy," To the Editor of THE LANCET. or other stimulants, as the medicine in question. The plain statement of the case appears to me to be, that John C-,, an article in THE LANCET of the 25th of April, SIR,-Seeing headed, " Non-payment of Medical Men for Medico-legal aged thirty-two, had severe ulcer of the leg, arising from variInvestigations," I beg to send to you the following narrative. cose veins and impaired constitution; that he was treated in Many other medical men have most probably experienced the usual way-i. e., entire rest in bed, and the constant application of some cooling dressing; that, as he "had been accus. similar injustice. I was called to view the body of a murdered man, (riding a tomed to drink largely of rum," it was deemed expedient and considerable distance,) for which I was not paid a farthing. proper for him to have a stimulant continued; that cajeput, as On another day, I attended before the coroner, wasting a a powerful diffusible stimulant, was tried, and it had the dewhole day, for which I was paid 11. Is. I may with truth say, sired effect. that I lost, during that day, double the fee I received; for as Such, I conceive, Sir, would have been the fairest way I had, at this particular time, no assistant to attend my patients of making out the case, and not the puffing off of cajeput as for me, I suffered the consequences. This was annoying and a remedy for ulcered leg and varicose veins. If your journal inconvenient enough; but I do not complain chiefly respecting were read only by the profession, I should not have deemed it. Some months afterwards, however, the presumed murderer the case worth notice; but as I know it is extensively read was taken, and I was compelled to ride to the town where the by the non-professional world, I am fearful lest an evil might magistrates sat, receiving 1l. 5s. 8d. for my fee and travelling arise from the false colouring given to medicines, which, when expenses. This also was bearable; but, in due course, I was not thoroughly understood, might do considerable mischief. subpcena’d to attend the trial. The assizes are held at a disAgain, in " the Case of Haemorrhage from Leech-bites," it tance of twelve long miles from my house, and I was compelled appears to me very odd that so much trouble should be exto dangle there six successive days before the matter was pended in seeking for remedies to put a stop to a dangerous concluded. Doubtless many of your readers can speak feel- bleeding from so small an orifice, and that so many remedies ingly of the trouble and annoyance of waiting about criminal should be vaunted as specifics when they so frequently fail; courts, going before grand jurymen and clerks of assize, and I believe much injury is often permitted to take place, breathing poisonous air, andfinishing with the chance of a especially in infants, by trusting to them. Why not " take good rasping by some unmannerly advocate in a black gown the bull by the horns" at once? What I always do in such and wig. For the six days, I was paid 61. 14s. 4d., which in- cases is this. I obtain a fine needle, bend it slightly, then cluded ll. paid to me with the subpoena-that is, they allowed pinch up the skin, and pass the needle through it, bringing me ll, 18. a day, and 8s. 4d. travelling expenses, and I was the lips of the wound together, and leaving the needle in the liable to a fine of 501. if I was absent when called upon. At skin; I then wind some fine silk or cotton around the wound, the same time, I had patients whom I was compelled to see underneath the needle, and allow it to remain until all further daily, so that I had to ride twenty-four miles a day, in addition fear. of bleeding is over. This is a remedy always at hand, to the labour my practice entailed, and there were no coaches and I have never known it to fail.-I am, Sir, your obedient or railroad to serve me on this occasion. Medical men do not and faithful servant, E. V. MAINWARING. Bournemouth, May, 1846. generally keep more horses than their practice demands; and
health was improved. A Member mentioned
SIR,-As
I
a
than sixteen
in the
shape
legs
of
The PRESIDENT remarked that the headach in this case was associated with venous congestion, as supposed by Dr. Hartry, and others. Upon this had employed bleeding and drastic principle, that practitioner purgatives with the best effect. Connected with this congestion, no doubt there was some change in the circulating fluid itself, the crasis of which had been broken up, so that it became like the mere liquor sanguinis. In reference to the nature of purpura generally, Mr. HILTON had recently found it associated with a low condition of .the system and a reduced quantity of the blood. Treatment to improve this condition was usually beneficial. He had seen, however, one or two cases in which there was a large quantity of blood in the system. These were benefited by depletion, generally, but were the exceptions to the rule. Mr. ROBERTS did not believe there was any analogy between purpura and scurvy; in purpura there was no sponginess of the gums. Mr. DENDY made some remarks, to show that apparently modes of treatment, as adopted by various practitioners in this disease with equal success, might be explained, by the fact of these modes tending to produce the same result-viz., an improved state of the secretions, by which the general
tended to show that the disease
I assure you, Sir, that mine were not benefited by being exercised twenty-four miles a day, in addition to their usual work. It must be obvious that, under such a system, not only must medical men be great pecuniary losers; but, putting .6. s. d. aside, the public must suffer, when the sick are thus violently deprived, for days together, of their doctor. Every one can estimate the importance of medical evidence in a court of justice, and must believe that the giver of it feels the heavy responsibility of his duty; yet he is put to groat extremes, suffers losses, and undergoes much fatigue, without any adequate remuneration; although, so important is his evidence, that life or death commonly depends on its issue. What vexed me still more was to find that a physician was allowed double fees! This is ridiculously unjust,-not that the physician has 2l. 2s. a day, but that the surgeon has only half this sum; although, by being taken from his practice, he might lose in one day more than an M.D. would forfeit in a week. In the country, generally speaking, the M.D. does not make a fortune by his practice. I enclose my card, in authentication of my communication; and I hope, Sir, that you will make an effort to claim justice for us in these matters.-Iremain, your obedient servant, A. S. April, 1846.
EMPLOYMENT OF CAJEPUT.—LEECH-BITES. To the Editor of THE LANCET.
opposite
subscriber to your excellent journal of more years’ standing, and having been permitted, some cases that were cured by through your urbanity, to publish in THE LANCET several of small repeated bloodlettings, which tended to show, as the my lucubrations, I trust you will not think me intrusive in President had formerly remarked, that the disease depended making a remark upon the case at Charing-Cross Hospital, on congestion. entitled, " Ulcer of the Leg treated with Cajeput," and upon Dr. L. STEWART mentioned a case of malignant small-pox the " Treatment of Haemorrhage from Leech-bites" published which proved fatal in thirty-eight hours. The pock did not in the number of the 23rd of May. On reading the heading to the article, " Case of Ulcer, acmaturate, and the entire surface assumed a purple hue like that present in purpura. companied with Varicose Veins of the Leg, treated with Mr. BARLOw believed that facts were against the suggestion Cajeput," I concluded that the cajeput had been applied exthat purpura depended on venous congestion, inasmuch as ternally ; but, on reading further, I found that the vaunted anasarca and other results of obstructions to the veins were remedy had been administered internally, and that the usual not associated with purpura. treatment for varicose veins with ulceration, rest and cooling After some remarks from various members on certain terms applications had been resorted to, in conjunction with the inused in describing disease, the meeting was adjourned. ternal administration of cajeput." Now, as cajeput is a powerful diffusible stimulant, and as the man had been accustomed to " drink largely of rum," it appears to me that rum, brandy, INADEQUACY OF THE PAYMENT TO MEDICAL or any other stimulant, properly administered, would have WITNESSES FOR ATTENDING AT TRIALS IN answered the same purpose as cajeput, and would have been as fairly entitled to the heading, " Case of Ulcer, accompanied CRIMINAL COURTS. with Varicose Veins of the Leg, treated with Rum and Brandy," To the Editor of THE LANCET. or other stimulants, as the medicine in question. The plain statement of the case appears to me to be, that John C-,, an article in THE LANCET of the 25th of April, SIR,-Seeing headed, " Non-payment of Medical Men for Medico-legal aged thirty-two, had severe ulcer of the leg, arising from variInvestigations," I beg to send to you the following narrative. cose veins and impaired constitution; that he was treated in Many other medical men have most probably experienced the usual way-i. e., entire rest in bed, and the constant application of some cooling dressing; that, as he "had been accus. similar injustice. I was called to view the body of a murdered man, (riding a tomed to drink largely of rum," it was deemed expedient and considerable distance,) for which I was not paid a farthing. proper for him to have a stimulant continued; that cajeput, as On another day, I attended before the coroner, wasting a a powerful diffusible stimulant, was tried, and it had the dewhole day, for which I was paid 11. Is. I may with truth say, sired effect. that I lost, during that day, double the fee I received; for as Such, I conceive, Sir, would have been the fairest way I had, at this particular time, no assistant to attend my patients of making out the case, and not the puffing off of cajeput as for me, I suffered the consequences. This was annoying and a remedy for ulcered leg and varicose veins. If your journal inconvenient enough; but I do not complain chiefly respecting were read only by the profession, I should not have deemed it. Some months afterwards, however, the presumed murderer the case worth notice; but as I know it is extensively read was taken, and I was compelled to ride to the town where the by the non-professional world, I am fearful lest an evil might magistrates sat, receiving 1l. 5s. 8d. for my fee and travelling arise from the false colouring given to medicines, which, when expenses. This also was bearable; but, in due course, I was not thoroughly understood, might do considerable mischief. subpcena’d to attend the trial. The assizes are held at a disAgain, in " the Case of Haemorrhage from Leech-bites," it tance of twelve long miles from my house, and I was compelled appears to me very odd that so much trouble should be exto dangle there six successive days before the matter was pended in seeking for remedies to put a stop to a dangerous concluded. Doubtless many of your readers can speak feel- bleeding from so small an orifice, and that so many remedies ingly of the trouble and annoyance of waiting about criminal should be vaunted as specifics when they so frequently fail; courts, going before grand jurymen and clerks of assize, and I believe much injury is often permitted to take place, breathing poisonous air, andfinishing with the chance of a especially in infants, by trusting to them. Why not " take good rasping by some unmannerly advocate in a black gown the bull by the horns" at once? What I always do in such and wig. For the six days, I was paid 61. 14s. 4d., which in- cases is this. I obtain a fine needle, bend it slightly, then cluded ll. paid to me with the subpoena-that is, they allowed pinch up the skin, and pass the needle through it, bringing me ll, 18. a day, and 8s. 4d. travelling expenses, and I was the lips of the wound together, and leaving the needle in the liable to a fine of 501. if I was absent when called upon. At skin; I then wind some fine silk or cotton around the wound, the same time, I had patients whom I was compelled to see underneath the needle, and allow it to remain until all further daily, so that I had to ride twenty-four miles a day, in addition fear. of bleeding is over. This is a remedy always at hand, to the labour my practice entailed, and there were no coaches and I have never known it to fail.-I am, Sir, your obedient or railroad to serve me on this occasion. Medical men do not and faithful servant, E. V. MAINWARING. Bournemouth, May, 1846. generally keep more horses than their practice demands; and
health was improved. A Member mentioned
SIR,-As
I
a
than sixteen