110 into
My own impression is, that youhave been hardly dealt with under all the circumstances, and those who know you as I do, and who appreciate your gentlemanly bearing and excellent surgical knowledge generally, will hope with me that no serious evil will ultimately arise out of this painful incident in your
beer to dissolve, technically to cut, which takes different times, according to the kind of isinglass made
some sour
place in
of. A small
use
portion of this solution is added to every cask of beer, and well mixed with it. It being lighter, it almost immediately ascends, and carries up with it much impurity, surgical career. Believe me,‘my dear Sir, yours very faithfully, leaving the beer as clear as wine. It may, perhaps, be well to WM. FERGUSSON. WM T. weedon Cooke, Esq. mention, that the brewer sends finings, prepared as above described, to each of the publicans he supplies, and they are, by them, added to the beer as may be found requisite FROM MR. BEDINGFIELD, NEEDHAM-MARKET, SUFFOLK.] For many of the preceding details respecting the different [LETTER To the Editor of THE LANCET. varieties of malt and hops, and their uses in the preparation of several kinds of porter and ale, we are indebted to Mr. Thomas admire SIR,-I equally with yourself the manly, straightDruce, of the old and highly respectable firm of Druce and Sons, forward, and ingenuous manner in which Mr. Weedon Cooke Hans-town Brewery, Chelsea. gave his evidence at the late miserable inquest upon the
remains of Alfred Richardson. Callous indeed must the heart of that man be who could hear without emotion the selfaccusing exclamation wrung from the tortured witness-‘It was a sad mistake altogether." The sad mistake or accident (for I think it will not be contended even by Mr. Skey that it was done by design) was in supposing that the staff had passed into the bladder at alL This is evident from the statements of all the parties, as well " Audi alteram partem." The knife did not as from the post-mortem examination. from the groove," as imagined at the time by Mr. Cooke, ’’ slip THE LATE INQUEST AND THE PROFESSION. but unfortunately passed along the groove between the bladder and the rectum; in fact, the staff ruptured the membranous [LETTER FROM MR. WEEDON COOKE.] part of the urethra, (which in a child is very small, thin, and To the Editor of THE LANCET. delicate,) and passed between the bladder and the rectum. This is not a very rare occurrence. Accidental circumSIR,—Would you permit me space in your journal to hold such as a spasmodic state of the urethra, in connexion to stances, of the and record to the admiration publicly up profession, my thanks to, the following eminent men, who most kindly with the small calibre and tenuity of its membranous portion, and generously put aside their engagements and their duties may give rise to it, even in the most skilful hands. When the accident has occurred, it may be known, first, by to give me the benefit of their testimony at the late inquest. The protracted nature of the inquiry obliged me to ask their the immobility of the staff itself; it appears to be, as it were, attendance on many occasions, and I have much cause to be bound down; you cannot move it about with the facility with it can be moved when it is in the cavity of the bladder; grateful to them for always promptly answering my call. One which and all of these excellent men would have spoken to the diffi- neither can you by any possibility make it strike distinctly culties and accidents occurring in lithotomy; but their testi- upon the calculus. Thirdly, if pushed forwards, it will be mony, although most valuable, was finally not considered found to rest upon the prominence of the sacrum, as it did in absolutely necessary by my counsel, Mr. Clarkson, and they theTopresent instance. were therefore not called, much to my regret. prevent the possibility of this accident, the index of the The profession will, I am sure, rejoice with me that so much left hand of the operator ought to be passed into the rectum, kindly feeling was shown by men who hold the highest places in order to direct the point of the staff as it is passing along in our ranks, and who have consequently the largest oppor- the membranous part of the urethra into the bladder. Not only have I read and heard of these cases, but I was tunities of appreciating the difficulties and chances of a mishap in a serious operation. Their honourable names are-Mr. present at a case precisely similar to Mr. Weedon Cooke’s forty years ago. It occurred at the Bristol Infirmary. Fergusson, of King’s College Hospital; Mr. Edward Cock, of some Guy’s Hospital ; Mr. Erichsen, of University College Hospital ; The operating surgeon passed the staff through the membranous Mr. Alex. Ure, of St. Mary’s Hospital ; Mr. Solly, of St. part of the urethra, between the bladder and the rectum. The Thomas’s Hospital; Mr. Adams, of the London Hospital; nature of the accident was not detected; the boy remained and although Mr. Coulson, of St. Mary’s Hospital, was called about fifty minutes upon the table; he was then removed to ward, and died two days after the operation. At a postby the coroner, I feel that I am deeply indebted to him for his the kindly and professional feeling he exhibited in the witness- mortem examination, it was found that the bladder had not box. Mr. Henry Smith also would have given valuable testi- been opened. The stone was taken from it, and the poor boy mony. Myfriend, Mr. Obre, of Dorset-square, kindly attended to was " quietly inurned" without any one so much as dreaming state a case of protracted operation, and some other old andvalued of an inquest, or casting the slightest censure upon the friends, to whom I need not publicly allude, were present, and operator or his assistant. All present regretted the lmforready with valuable testimony had it been necessary to call them. tunate result, but had any oneI hinted at a public exposition of Since the termination of the inquest, I have to be grateful for many the circumstances, he would, feel assured, have been treated most kind intimations from gentlemen unknown to me before, with contempt, and his name branded with infamy. Before I conclude, allow me to make one more observation. of their warm sympathy, and I am glad of this opportunity to the staff has been withdrawn, after the incision into publicly acknowledge my thanks. I can scarcely ask you to When the membranous from but send a letter Mr. will a most kind part of the urethra, it is perfectly useless to Fergusson, print endeavour to reintroduce it into the bladder through the copy of it in case you should feel justified in giving space to it natural passage. The attempt should be made by passing a in your journal. I am sure if you do it will honour your pages, straight director through the external wound, under the arch and gratify exceedingly of the pubis, into the bladder. Your most obedient servant, I am, Sir, yours respectfully, T. WEEDON COOICE. COOKE.
(To Le continued.)
Correspondence.
.
,
.
Upper Berkeley-street, Portman-square, August,
[NOTE
Longville-house, Needham-market, Suffolk, July 29th, 1854.
1854.
FROM MR. FERGUSSON TO MR.
COOKE.]
[LETTER FROM MR.
J. POWELL WILDING, MONTGOMERY.] To the Editor of THE LANCET. SIR,-I beg to enclose for publication in your next LANCET (if you think proper) the copy of a letter I have this day sent to the Association Journal. At the same time I wish to express my deepest regret that a much traduced profession should be still more traduced by the editor of one of its own journals, deliberately stating "That the jury had apparently a clear course to follow, so far as the cause of death and the skill of the operators were concerned!’ A legal journalist might just as well say a lawyer ought to be t prosecuted in a criminal court for losing a trial. For the sake
COPY.
16, George-street, Hanover-square, July 24th, 1854. MY DEAR SIR,-Now that this unhappy inquest has come to an end, I beg to offer anew my sympathy with you on the occasion, as throughout the whole investigation nothing more appeared against you than you yourself originally admitted, viz., that you had an unsuccessful operation for stone, having committed a blunder which has often occurred before in the hands of others both older and more experienced. The evidence on all other points clearly showed that you had acted with great kindness and attention to the poor child, both before and after
the
operation.
J. BEDINGFIELD.
_
111 of our profession, I hope you will, for once in your life, step out of your beaten track, and issue a second edition of your last number gratuitously, and send a copy to every professional man in the kingdom, otherwise thousands will never see the coroner’s splendid address to the jury. I remain, Sir, your very obedient servant, J. P. WILDING. J. Montgomery, July 31st, 1854. " To the Editor of the Medical Association Journal. " SiR,—I hope, as I am a member of the Medical Association, you will publish a short letter for me in our next journal, a of which I have sent to THE LANCET. copy " I will not for one moment inquire your reasons for taking up the cause of Mr. Gay so strongly, nor will I at present make further remarks upon your conduct as editor than this :However honest and well-intentioned it might have been, it has, in my opinion, more than anything, tended to promote disunion in the Association, and the profession at large. 4 9 as regards your editorial remarks on the low moral tone given to the profession by certain publications, and that we (its members) must become contaminated by reading (I presume) THE LANCET, I beg to say that I havetaken that journal for twenty years, that I still do so, and remain, I hope, uncontaminated. I think it is hard for us, possessing (I hesitate not to say) at least as much general knowledge and good feeling as any other professional body, to be taxed by you with not being capable of selecting our own literature. "Now for the ’suppressed inquest.’ The jury returned a verdictThat the child, Alfred Richardson, died of inflammation, caused by an operation unskilfully performed by Mr. Thomas Weedon Cooke and Mr. Thomas Wakley, jun.’ " The jury had a right to return that or any other verdict they thought proper; but, Sir, had you the right (occupying the position you do, and in which you ought to hold up the honour and dignity of our much maligned profession)-had you the right, I say, to stab one of its members when down, by saying’that the jury had apparently a clear course to follow, so far as the cause of death and the skill of the operators were concerned’? Proh pUd01’! Who in future will carry out the blessed command of our Saviour-’ Go forth and heal the sick.’ Mr. Cooke in this (his maiden) operation did not enter the bladder; so far he was unfortunate, not criminal. Coupled with the evidence of Mr. Coulson, to the effect that expert operators have failed to enter the bladder, and the testimony of the late Sir Astley Cooper, who had known twelve such cases, I think such an editorial remark ought not to have been made in a journal purporting to be the organ of provincial medical men. " I have performed several of the capital operations-in fact, am compelled to do so whether I wish or not, as I reside more than twenty miles from a consulting surgeon-and if I cannot calculate upon our own medical journals to defend my professional character when assailed, I shall only be thrown back ’upon my own resources, and will willingly abide the conseno doubt the result will be as triumphant quences, and have in my case as I am sure it will be in Mr. Cooke’s. "I remain, Sir, your obedient servant, ".T. "J. P. WILDI::
NAVY
MEDICAL THE WARNING
OFFICERS. VOICE !
for a return of the assistant-surgeons of the navy who, within the last twenty years, have committed suicide, together with a list of the medical officers who have left the navy after reaching the rank of full surgeon within the same time, he would, by comparison with the same data from the army, produce some startling facts. One would suppose, that when the Admiralty is so strict with their medical officers, they would also give them corresponding encouragement. Now, how do they show this? Compare the medical peï’8onnel of the two branches now employed. A naval friend has furnished me with the following comparison, which please to insert in columns opposite each other, to show the disparity, and then even " Brummagem" will be able to decide if it were creditable to apply for naval
assistant-surgeoncies.
Fleets in the Baltic and Black Sea. One Inspector-General of Hos- Inspector- General of Fleett afloat-none. pitals, receiving 08700 per annum, with 20s. per diem One Inspector of Hospitals and Fleets in the Baltic Fleet, allowances, and ranking with a full Colonel in the army. receiving .S574 per annum, without any allowances, and ranking with a DeputyInspector in the army. Four Deputy - Inspectors of One Deputy-Inspector of Hos. Hospitals, receiving from pitals and Fleets in the Black Sea Fleet, receiving X520 to .6550 per annum, with allowances of from 10s. ae365 per annum, without to 20s. per diem, and ranking any allowances, and ranking with a Lieutenant-Colonel in with a Staff-Surgeon of the the army. 1st Class in the army. Fourteen Staff-Surgeons of the Surgeons of the 1st Class-1st Class, receiving each from none.
T7te
A rmy in Turkey.
08400 to X440 per annum, besides allowances, andrank. ing witha Major in the army, or a Deputy-Inspector of Hospitals in the Navy. ’
PRIZE MONEY.
Surgeons
of the 1 st Class receive the same share as a Major in the army. All other Surgeons the same as
I
Captains. Assistant-Surgeons the same as
Navy Surgeons, old and young; receive the
same as a
R. N. ; relatively the an
Mate
same as
Assistant-Surgeon in
the
army.
Lieutenants.
WIDOWS’ PENSION. Widow of Assistant-Surgeon Widow of a fall Surgeon re. in the army, .;840 per annum, ceives X40 per annum, the the same as the widow of a same as the widow of an full Surgeon R.N. Assistant- Surgeon in the army.
Add to this the average ten years in a midshipman’s mess, and the list of inducements to enter the navy is complete. I see, by a contemporary journal, that the ships, instead of extra assistants, as they should have, are absolutely on peace numbers. Put the two services on the same footing, and then it nccy be possible to command medical talent and skill of the first class for the navy, but not until then. Thanking you for your untiring opposition to all abuses, I remain, your old subscriber, PATER FAMILIAS. Manchester, My, 1854.
having
To the Editor of THE LANCET. SiR,—Alas! what degradation seems to hang over this branch of our profession. Not many years ago, we read in the public prints of an old assistant-surgeon in the Mediterranean taking poison to close a long and weary servitude; then of another who, goaded to desperation by ten years of a midHOSPITAL ABUSES—THE ROYAL MAN. shipman’s mess, was found in a Portsmouth hotel with his CHESTER INFIRMARY. throat cut; then another became an incurable lunatic. These, varied with continual dismissals of assistants for drunkennessTo the Editor of THE LANCET. and within the last month it has reached the full surgeons, all two of whom havebeen dismissed by a court-martial for inthe questions calculated to engage the attention SiR,—Of toxication, their characters ruined and blasted after many and call forth the active energies of the students thoroughly to investigate, perhaps that of the irregularities exhibited by years of the best part of their lives spent in the navy. Happy, happy system ! Delude young professional men into heads of hospitals, in conducting the surgical department, will the public service, insult and degrade them in every way, and be found the most important, although, as far as my knowledge when driven by disgust and despair to habits of intemperance, has gone, it is one respecting which the students have offered ruin them for ever by a court-martial ! I am informed by-naval but comparatively little public opinion, and to which they have surgeons that such is the case of the two unfortunates lately presented still less actual opposition. To what can this cirdismissed; they were both, on their entry into the navy, young cumstance be attributable? Can we ascribe it to direct indolence of disposition? It is to be feared, indeed, that there men of the highest respectability and the best attainments. Mr. Brady has moved for certain Parliamentary returns of might be assigned to a ee1’tain few a still more despicable_. the naval medical ofncers. From what I can learn, if he moved reason. But, although it is not easy to account for the’