LETTER FROM DR. RYAN.

DR. RYAN’S REPLY TO THE

222

ledgment, pretty liberally, from Dr. CHRIS- : merated. Allusion was made to the "pruTISON’S Essay on Toxicology ; he extract- riency," "little short of disgusting," of the ed from Dr. RYAN’S section on ethics a language adopted in the discussion ofsome passage in which it is asserted that" those of the obstetric subjects ; the chapter on who, on account of friendship or acquaint- asphyxia was pronounced imperfect because ance, expect attendance gratuitously, are death by incomplete suspension and burkworthy of neglect;" and he objected to Dr. ing," was passed over, and because a set of RYAN’S abusive strictures on phrenologists, gases were described as asphyxiating, "all atheists." The being irritant," and again all acting ’ negawhom he designated Doctor, again, was censured for having in- tively, or by defect of oxygen,"—things in. discriminately condemned the institution of compatible being thus confounded together. clinical experiments with new medicines, Lastly, Dr. RYAN’S definition of poison was all experi- described as and for having asserted that laughable and unlucky." ments are (in this age) made upon the in- The definition stood thus -" Homicide by "

"

"

the

ferior animals." With reference to poisoning.—The name of poison is given to " of the it third part" was observed all substances which, when applied to the work, that no classification had been adopted, and organs of the body, cause death;"-which it was stated that Dr. RvAN’s first six induced the reviewer to remark that, if this chapters on obstetric legal medicine (73 explanation were correct, fire and boiling pp.) were copied, verbatim, fi-om that au- water are poisons, and that the rope by thor’s work on midwifery. Here it waswhich a man is hung is a poison ! objected by the reviewer that Dr. RYAN referred from his " Medical Jurisprudence" LETTER FROM DR. RYAN. to his " Midwifery," for a full discussion of

included under « medico-legal " To the Editor of THE LANCET. obstetrics," while in that work no fuller "SIR,—I trust you will perceive the nenotice of these subjects was given than in of inserting the following observacessity the former, but, on the contrary, reference tions in your next Number, in reply to the was made from it to the ’° Medical Juris- i review of my work on Medical Jurisprudence, which appeared in your Journal of prudence" for "more particulars." Fur- this day, and which I know, from a source thermore, the reviewer pointed out the you can never discover, was not written by you ; and as this review is a base piece of omission of a statement of those the

topics

principles personal spite, intended not only to pathology which alone my work, but to blight my prospects injure in ancan enable the practical jurist to investi- other way, I lose no time in showing it in which will frustrate its magate cases of homicide ;he also showed that its proper light,in a lignant object quarter your reviewer no means were afforded of distinguishing was short-sighted enough to suppose it imbetween cases of real and apparent death; possible for me to reach, except through that the osteology of the- human skeleton, your periodical. It is lamentable to observe, that medical the progress of putrefaction under water, students, and young physicians, and surwho have just escaped from school," the influence of interment on the pathology should be the reviewers in your Journal, and chemistry of forensic medicine, as inpersons unacquainted with the arduous revestigated by Orfila and Lesueur in theii search, and the unceasing anxiety, of those work on judicial exhumations, were equally engaged in the cultivation of science for years, and who have some character to lose; neglected. It was also stated that the sub- and that these critics, for they do not deserve the name of reviewers, should have ject of wills and survivorship had beer the consummate audacity, under your aupassed over. The remaining objections tc spices, to condemn, indiscriminately, the the work of Dr. RYAN may be quickly enu. writings of men well known to the profes" of

physiology

and

"

geons

11

’

223

sion, their superiors in years, in experience, layed,

so

that the

degradation of one of

Ug

the interests of the other. Here then is the clue to the review in THE LANCET, and nothing but the preservation and defence of my professional character, which is as dear to me as my life, could induce me to expose it. As to the strictures on the work, they are so puerile, so futile, so despicable, that they scarcely deserve the slightest notice. " Thus the reviewer states,Did we speak of this department’ (the section on jutors. He states, that having submitted my Medical Ethics) ’in the condemnatory terms work on Jurisprudence to rigid scrutiny for which even the mildest judgment would the last six weeks,we refuse the volume dictate, we should do violence to our feelthe least share of our approbation.’ As a mgs.’ That the writer should feel at proof of the justness of this decision, I the ethics of our profession, which condemn refer the reader to Dr. Johnson’s opinion, in the strongest manner calumny, slander, in a former page of this Journal (p. 378). and unprofessional behaviour, is by no ,It is a task,’ quoth he, =we fulfil with means wonderful, and requires no further extreme reluctance, from many motives, comment. That he should condemn my which it would be perhaps impertinent to statement, that the laws of this empire are explain on this occasion; But which may humane and unequalled, and accuse me of find an apt illustration in the sentence pro- having includedthe game laws, forgery minently adduced by Dr. Ryan at the outset laws, &c.’ is so monstrously absurd as to of his work,Amicus Socrates, amicus deserve nothing but pity for the obliquity Plato, sed magis amica veritas.’ Such ever of the intellect of the writer. His object is has been, such ever will be, the canon of so obvious, and his intention to injure me so our critical demeanour; and, while we manifest, that no one of common comprehenobserve it honestly, carrying it into prac- sion can mistake them. " The first tangible charge is, that I have tice with a cautious, unbiassed, and unflinching hand, the progress of true medical copied largely from Professor Christison’s literature will suffer not the least impedi- valuable work without acknowledgment, but the uroofs offered are most unsatisfacment from our strictures.’ reluctance The of expressing tory, and require no answer. I have esingenuity " in censuring my work, is amply attested by teeined toxicology a- minor branch of state the caustic comments that follow, and the medicine, while the celebrated Edinburgh reader must be extremely stupid who does Professor believes it to be the most impornot perceive the cloven foot in the article. tant. I have stated in my preface, that I 1 am at a loss to discover the motives to borrowed from all works of value, and have which the writer alludes ; but I do not con- always acknowledged my quotations when sider it impertinent to explain those which given in the author’s words, but, in many actuate him. instances, I found it necessary to condense really " The fact is, that on many occasionsI the language of others, and in such cases have censured works, solely on the grounds would not be justified in using inverted of error, which have been lauded to the commas. As a reviewer and an author, I stars in THE LANCET; I have repeatedly have spoken in the highest terms of comargued against the ultra reform supported mendation of Dr. Christison’s work; but as in that Journal ; and worst of all, this work the greater part of that production is a comof mine under notice has had such success pilation from the German and French pewith the public and the profession as to riodicals, the facts stated are as much my extinguish one, of which two sheets were property as Dr. Christison’s. It would be printed, by one of the conductors of THE impossible for any physician in existence to LANCET, and hine illae lachrymæ. The write a complete work on Jurisprudence condemnation, therefore, of my work is to without extracting from his contemporaries. " be expected from the friends of those who The reviewer is so witty as to sneer at have reason to feel sorely at its success. the terms gynaecology, &c., taking the hint But its depreciation serves another purpose, from the classical editor of the Medical Gabesides making room for the intended zette, who hopes the Greek words used by production, and that is to lower me in. me will not come into use, though these have elicited the praise of some of the the estimation of a certain public body, before whom my abilities and testimo- best reviewers on the continent, which only nials, however slender, have been rigidly’ shows the ignorance of both these seers as examined, as well as those of the individualto the state of scientific terminologv in all wh’ose work has for the -present been de-countries. If either of them had had the and in science. This arises from your attention being directed to other matters besides the editorship of THE LANCET, in the management of which you have also displayed a degree of energy and talent which all must admire. " But time presses, the printer’s devils are in crowds at my elbow at the end of the month, and, therefore, a few words to your able and impartial reviewer, and his coad-

may be

supposed to

serve

galled

, terms

224

good luck to have seen Professor Carus’s splendid System of Gynaecology, be would

work on Midwifery ; but lie, forgets that the latter is in the hands of almost all students, have been more cautious in his strictures on and the former will not be possessed by this or the other terms. No doubt these them until the subject of which it treats terms are not to be found in common lexicons; shall be peremptorily required, as a branch and, therefore, must be sad stumbling-blocks of education. to those who feel the want of a classical "In introducing the questions of infanticide, education. But need I refer to the termi- delivery, &c. into my Midwifery, I followed nology now in use in France in support ofProfessor Capuron, and placed them before my own ? For the benefit of the illiterate, students, who as yet pay no attention to juridical medicine, and in so doing I thought it is explained in my preface. But in the succeeding paragraph, I am I acted right, when I considered the num. accused of. not keeping pace with science, bers of unfortunate women who had been and am outrageously censured for my de- executed unjustly in this country, upon the fence of Christianity, against the attacks oferroneous evidence of ignorant medical wit. Materialists, in my strictures on phrenology. nesses.. Nor do I regret what I have done, If this be a crime, I glory in it, and can so obtuse is my mind to the lucid remarks of assure the reviewer, notwithstanding all his this brilliant reviewer. The sections on asabusive declamation about my prejudices, phyxia are considered erroneous, though that he must enlighten my mind by sober copied from the standard works of this coun. argument and strict logical induction, and try and France. The definition of poisons, taken from a late foreign incomparable ma. not by vituperation. " Again ; I am censured, for having in- nual, is ridiculed, and "burked"! ! by this serted the ethics of Hippocrates, promul- sapient critic. In a word, there is not a regated more than 2000 years ago, for which deeming feature in the work, though I have I am wisely held accountable ; and for hav- received more than one hundred letters from ing stated the rule laid down by the profes- some of the most scientific physicians laud. sion in all ages and countries, that dangerous ing this good-for-nothing production, and experiments should not be made on the sick, the professions of law and medicine are so without their consent.Iam told that the deplorably stupid, as to have already nearly effects of arsenic, hydrocyanic acid, and consumed the impression. "Ihave only to observe, in conclusion, that other valuable medicines, could not have been discovered according to my position ; being attacked so furiously in the pages of but the writer forgets that these, and all THE LANCET, I am reminded of the fate other dangerous medicines, were in general of the most eminent physicians and surgeons first tried on animals. Perhaps he, in his in the kingdom, and so far from deeming zeal for science, would allow a few experi- it an injury, the attack is so barefaced, so unments te be made upon himself, with the cloaked, so manifestly malicious, I deem it poisons alluded to, or with the virus of a an essential service. However unpalatable rabid animal, or a little upas tieute. Or this declaration may be to you, I trust to would he prefer the application of these your candour and justice, either to copy this article which I should have sent in maon the poor? things tc I am also accused of omitted the nuscript, had time permitted, or to allow leading principles of the science of Me- me an opportunity of replying to your redical Jurisprudence, and of the badness of viewer. You will recollect that the editor my classification ; though I have strictly of the Medico-Chirurgical Review, whose followed the best French jurists, Orfila, opinion with the profession isjustly of the Briand, Sedillot, &c., with whose writings highest authority, and nearly the whole of the reviewer is clearly unacquainted. He the most influential part of the public press, charges me with having omitted the physio- have lauded this production, and are at valogy of the causes of sudden death, the means riance with your reviewer. You therefore of distinguishing between real and apparent perceive that authority, as high as the dicdeath, the osteology of the skeleton, &c. tum of your critic, is in my favour, and it is Had I discussed these matters, I should only fair and just that you should place the have exceeded the limits I prescribed for my- antidote as well as the bane before your self, in arranging a manual for students, readers. I hope your usual press of matter and would have done little good, inasmuch will not exclude its insertion for four or five as the study of Medical Jurisprudence is as weeks, for it will then be worse than useless. I am, Sir, in this country; and its geyet in its Your most obedient servant, neral principles are scarcely attended to. M. RYAN. He says, I have passed over the subjects of October 30, 1831. wills and survivorship, which is a gross misrepresentation. The next charge is, This reply calls for a few brief remarks, that the obstetric questions connected with forensic medicine, are the same as in my which we now proceed to make. In

having

fancy

225 the first place, it is of no consequence in a state of disease, in minute and gradually who wrote the review-no matter whether, increasing doses. We must again repeat, it be the work of a child, or the production that no specific could have been discovered,of a philosopher ; the only question for con- that arsenic could not have been recognised sideration is this :-Is the Reviewer right, as a remedy for ague-iodine for scrofulaor wrong, in his strictures upon Dr. RYAN’S or mercury for syphilis-by experiments on

I

manual ? Now,

the lower animals, simply because in them we ask our readers seriously, and the pathological condition is totally absent. without the slightest approach to badinage, How does Dr. RYAN meet the charge of Has Dr. RYAN refuted one of the charges imperfect classification, and the omission of brought against him? Is it an answer to the very cases upon which state medicine

objection to his complimentary epithets rests ? Why, by throwing the blame on the laws of this realm, to declare " our " ORFILA, BRIAND, and SEDILLOT," and by condemnation monstrously absurd," and that the omissions of all but one he 11 pieties the obliquity of the writer’s in- of our items, viz., that of " wills and surtellect? Is it an answer to the=charge of vivorship." He innocently imagines,that beplagiary, to say that Dr. CHRISTISON com- cause BRIAND, SEDILLOT, and ORFILA, may piled from others, which, by the way, in ’, have neglected classification, he (Dr. R.) is . this special instance, is not the fact? Dr. perfectly correct in following their example. RYAN finds fault with abusive declamation If Dr. RYAN would take the trouble to proour

on

acknowledging

prejudices against phrenology. He cure a copy of Dr. CHRISTISON’S syllabus requires us to reason him out of his false of lectures, he would then learn the value position, forgetting that, according to the of arrangement, and perhaps estimate more should have correctly the importance of his own omiscommon rules of logic, he the his case against phrenologists by sions. Dr. RYAN states, that their inserproved on

his

rational induction alone. Dr. RYAN ironically says, that he is wisely "held accountable for the opinions of Hippocrates respecting therapeutic experiments on mankind." Why, in the name of wonder, should he not, when he adopts them - In

AS HIS

our

OWN, without note

review

or

hydrocyanic

tion would have caused him to exceed the

limits

prescribed in arranging a manual for students. May we ask him, would they not be more valuable than abuse of phrenology and the ethics of ancient medicine’!? The reader will mark how Dr. RYAN shuf charge of double reference from one of his works to the other for additional

comment. fles off the

acid

was

mentioned, so this ingenious amplifi- information, while the amount was the same cation of our alleged severity will avail the in each. We never at all objected to the inDoctor nothing. He states, that the effects sertion of the articles in his " Midwifery," of the remedies we mentioned were first nor did we even offer the objections to the tried on animals, thereby meaning the articles themselves, which a reviewer, were lower. Had he known anything of the he so disposed, and had a sufficiently large history of the alchemists, he would have re- space at his disposal, could have readily collected that arsenic and mercury were first pointed out. not

their deleterious agency on But to waive this worthless subject,

recognised by

Regarding

the definition of

a

poison, it

seems that Dr. RYAN borrowed it from an How readers. " incomparable manual !" Its ludicrous abappeal practical would they investigate the curative effects surdity is not, therefore, the less on that of any unknown substance ? The obvious account, nor is the author less culpable for man.

let us

answer

to

our

is, by its administration

to persons its

adoption.

226 that the charge of viewer, he is either the most unmerciful the subject of wills that ever handled a critic’s pen, or having passed and survivorship is a gross misrepresentation." else he believes that Dr. RYAN never felt It is perfectly true that, at p. 156, Dr. thatRYAN devotes fourteen lines to the con" Praise undeserved is satire in disguise." sideration of the survivorship of " mother Another remark and we quit the subject. or infant," but to the presumption of surDr. RYAN, with his usual modesty, speaks vivorship of different persons, of different of two sheets ofa work which was ex. ages, destroyed by a common accident, as tinguished by the mere announcement of in the case of General Stanwix and his his incomparable manual! A mere fiction, daughter, we repeat, not one word is de- Doctor!Some malicious wit has made you voted-at least a rigid examination of the the victim of a hoax. There is not one index of the work, and of all the chapters word of truth in the statement. Enough. in which the subject might find a corner, We must quit this disagreeable subject. has failed to detect its presence. As to wills, the author alludes, under the head of mental alienation, to the mental condition SINCE the foregoing remarks, however, * which renders a will valid or invalid ; but he were committed to paper, we have reentirely neglects nuncupative wills, and the ceived from Dr. RYAN another communicadistinction between wills and testaments, a tion, containing additional strictures upon topic so all-important to the physician, who, the review of his work-an article oceupyin ninety-nine cases out of a hundred of ing no less than seven closely-written pages of rapid death, becomes the witness of the letter paper, actually accompanied by printed disposal of property, whether personal or commendations of his work, extracted from real. These distinctions, we repeat, we the Medico-Chirurgical Review, 3fonthly Recan no-where find in Dr. RYAN’S volume, view, Herald, Courier, Sun, Globe, Literary while they stand prominently forward in ’Gazette, Sunday Times, Morning e4ronicle, the works of Beck, Forsyth, and other Weekly Dispatelt ! Now to give inserwriters. It was to these points that allution to such documents as these, would be sion was made, so webelieve the charge of imposing a very unjust, and we are sure a. misrepresentation" is now fully answered. very unsatisfactory, tax upon the patience As for the abusive terms directed so coand pockets of our readersbe’sides, the pubpiously against the reviewer, it is surpris- lication could prove of no advantage to Dr. ing that Dr. RYAN does not perceive the for with such high authorities in RYAN, imprudence of exposing himself to the ridi- his favour as the non-medical critics just cule ever consequent upon the scoldings of mentioned, surely he may rest quietly on authors smarting under the deserved and his pillow, and utterly’ disregard the cenrational criticism of their works. sures of this medical Journal. However, Dr. RYAN considers that Dr. JOHNSON’S should the Doctor still press for the inseropinion, coupled with that of the public tion of his paper, why then to our pages it press (the Iferald, Courier, Sun, Globe, shall be committed ; but, in taking this step, Weekly Dispatch!! &c.), should be amply it is only right to acquaint the Doctor that sufficient to shield his work from further it must be accompanied by a searching rereview. We of course admit the great view of those portions of his work which, in weight which the learned medical jurists of our former article, were passed over, almost the daily and weekly papers should have in without any discommendatory notice. the decision ; but as for Dr. JOHNSON’S reOur author

his

alleges,

over

wag

and

227 Second Day. A visit and detention ..............

Ws regret to state, that well-aitthenticated accounts have reached London of the occurrence of the plague in Moscow and Dantzick. The same event, it will be remember. ed, marked the decline of cholera on the

................

An

opiate........................ Third Day.

A visit and detention..... Two

Malabar coast. Let our rulers look to this appalling fact in time. The collectors of customs in our ports should at once be taught the danger to themselves incurred by neglect of the quarantine, regulations.

draughts..... Fourth Day. and detention......

U

6 2

6 2 12 0

50 0

3 13 6 .............. 0 5 0tl 020 0 Laxative........................ Opiate.......................... 0 26

A

visit, night’s Dressing the blister

Fifth Day.

Castor oii........................ Dressing the blister ..

blister, and applying ditto Ananodyne...................... Day and night’s attendance Sixth Day. Dressing both blisters............ Attendance day and night

Another

......

WE have much pleasure in calling attention to the establishment of a rational Board of Health in the extensive district of

Camberwell, and recommend the

6 2 12

Bloodletting...................... 1 !0 0 A blister, and applying ditto...... 0 13 An anadyne...................... 0 3 G 1 Itl An evening visit

........

0 2 0 0 5 0 0 14 0 U 3 0 3 136 O 0 10 3 13 6 ti

Seventh Day.

Dressing the blistei7s ..............

Salve for ditto.................... Castor nil........................

proceed-

Day and night attendance

all concerned in the institution of such associations in other parts of the country.

ings as an example to

Ainoitntfor thefirst

........

0 100 0 26 0 2 0 0 3 3

week.... £ 29

9 6

In justice to the Scottish practitioner, it should be stated, that he lived a few miles from his patient, and the latter was not considered to be in indigent circumstances. second bill is of a different characALLEGED EXORBITANT CHARGES MADE BY from a general practitioner in MEDICAL PRACTITIONERS. lived in the same village with whose condition in life was To the Fditor of THE LANCET. ’, poor. The bill is for ten weeks’ London, 27th Oct. 1831.medicines, and the charges for one week SIR,—From your uniform discourage-are here subjoined :£. s. d. ment of every-thing sordid and rapacious in First day, a laxative..... 050U the profession, I am induced to lay before 0 4 6 ditto ................ Second, you the substance of two distinct bills for ditto ................050 Third, ditto ................ 0466 Fourth, professional attendance, presented by two 0 50 ditto general practitioners, both of which have Fifth, 0 0 5 ditto Sixth, me for payment out of the come to 050 U lately Seventh, ditto , estates of two departed friends, to each of For one week..... £ 1 14 0 whom 1. happen to be executor. These bills sufficiently prove that some other reThe charges, or " dittoes," for the nine and disthan the law of conscience medy subsequent weeks of daily purgation, are cretion is required to regulate medical precisely the same in every respect as for the charges, both for the credit of the profes- first week, amounting for ten successive sion and the protection of patients, or their weeks to 17L, independently of similar unsurviving relatives. I have no desire to! varying charges for other and distinct periods injure the characters, or hurt the delicacy, of time. of the no doubt worthy practitioners allud Mi’. Editor, such a mode ofmaked to. who both Mside in obscure parts of Surely, out bills to cover a surgeon’s expenses the country, and therefore I their ing is any-thing but the right one. I should names and addresses. The first bill, of , like to haveour opinion on it, and to see which I shall submit a part to your notice, the matter occasionally adverted to by your is from a medical man in Scotland. It is able I remain, Sir, pen. the more notable of the two, and extends Your constant reader, over a period of five weeks ; it amounts to PHILORTHUS. more than 1401. The detail of items for can be1no [There necessity for "occasionthe first 1veek is as follows ; and may be an able pen" to such a :-a of the whole taken as fair specimen ally adverting by matter as this, because we are compelled to First Day. £. s. d. To a visit and detention .......... 2 12 6 believe that our correspondent has either Bloodletting ,................... I t 0 been himself hoaxed, or that he has attempt6 0 2 An

andcame ter, ter,hand

England, his patient,who

exceedingly

................

................

................

,

suppress

aperient,.....,...............