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THE SERJEANT-SURGEONCY
51
arrangement and perceptive
power, and sanctioned a chaoticc confusion which has invoked universal censure. The reporit makes useful suggestions for avoiding these errors on a futurte occasion. It is a document of historical value-the first of it:s kind; and of unusual interest to surgeons in this and otherr countries. The jury may be congratulated on having had s< o able an interpreter of their sentiments as Mr. HADEN.
Medical Annotations. "Ne quid nimis:’
THE SERJEANT-SURGEONCY
determined. Finally come! the announcement that, under the advice of M. Nelaton, the wound would be dilated to allow the escape of the ball Ther the ball is actually there, and the glory of our country pale, through the error of its representative. That is really thE popular feeling. And of all the follies of this foolish business it is really not the greatest. Nothing can be more absurd thai to depreciate the surgical reputation of Mr. Partridge because he may have formed an erroneous opinion on the subject, whicl is often one of difficulty and doubt. But Mr. Partridge wa: pushed into a false position in the matter from the first, and to have occupied it with anything like dignity or comfort, h ought to have been infallible. He suffers now one of th, penalties of the invidious character of the mission which h accepted. The issue fully justifies the general remarks whicl thought it necessary to make upon this affair in a distinguishe d earlier stage. of the deat ALCOHOLIC THERAPEUTICS. for so man
dwe
THERE is at present a vacant appointment to this will have to be filled in consequence of the late Sir Benjamin Brodie, who had been years decorated with the honourable title of Serjeant-Surgeor It has been usual to promote one of the Surgeons Extraordinar y to that honour, and it is probable that the choice will fall upo il either Mr. Fergusson or Mr. Caesar Hawkins. Mr. Fergusso n has, we believe, seniority of appointment as Surgeon Extr: ordinary, and of course his rank as a practical surgeon is of tl e highest. Mr. Caesar Hawkins, on the other hand, has a cons derable seniority in College standing. He has been more tha n once president; and as consulting surgeon of St. George’s and a distinguished man of science in his profession he has powerfi claims. Of course the question as to the probable incumber t of the post of Surgeon Extraordinary which will then becom - .acant is also discussed. The appointments will no doubt 1 e made with the judgment and good sense which have marked a the selections of the medical attendants of the Court of lat ’’ The names mentioned in surgical circles may not be tho: e which suggest themselves to those entrusted with recommen( ing for the appointment; but we may say that the names mo ;t on the lips of their confrères are those of Mr. Prescott Hewe ;t and Mr. Erichsen. Other surgeons may be found who wou] d well deserve the honour, but there can be no question that tl appointment of either of these gentlemen would be satisfactoi y to the -profession.
post, which
THE
WOUNDS OF
might be accurately and certainly
GARIBALDI.
THE published accounts of the result of the consultation oin Garibaldi to which we last week referred, have given rise to muelh comment. In the first instance it had been positively stated1, on the dictum of Mr. Partridge, that the ball was not in th,.e wound, and that the recovery could not, therefore, be impededL Flying rumours of a difference of opinion on the subject hae gained so much currency that it came to be almost an interrnational as well as a surgical question. If the Italian surgeonis were wrong, and the ball was not in the wound, it was a perrsonal triumph for Mr. Partridge; if they were right, and it wa in the wound, the secretly ruffled sensibilities of the Italiann profession would be smoothed, and Italian surgeons woul(d triumph at thus correcting ce chirurgien celebre Anglais wh.o had been somewhat arbitrarily imposed upon them. A conisultation of seventeen surgeons was held, amongst whom wer’e M. Nélaton and Mr. Partridge. Seventeen surgeons i Wha a powerful constitution must his friends attribute to Garibaldli to submit him to such an ordeal! The published bulletins of thte seventeen surgeons are not, it must be confessed, couched in .a Wewere told that a prolongedd manner to escape criticism. examination of the wound had been made ; that Garibaldi hacd suffered great agony ; and that the question of the presence o)r absence of the ball was undecided. It is natural to ask, thouglh it may be easy to answer, why chloroform was not adminisstered. Under its influence an examination need not be tedious it need not cause a pang. The existence of a foreign bod;y
____
IN a late article on the " Habitual Use of Alcohol" (see THE LANCET of Sept. 27th, 1862) we made allusion to the great change which has come over the practice of society as regards the quantities and the strength of alcoholic liquors consumed We sip ; our fathers drank. They went on social occasions. in for the physiological action, and considered the survival of cerebral or muscular competency at the close of a dinner a sort of unsuccess; we are concerned at the slightest indication of the physiological action in the social circle, and would hesitate to invite again a gentleman who should once be incautious enough to exhibit a vinous effect on his tongue or muscles. Curiously enough, coincidently with this comparative social disuse of alcohol there has occurred a great extension of the medical use of it, so that at the present time, in London especially, it is in great professional fashion. Few, indeed, carry this practice so far as Dr. Todd did in the later years of his life. Few deem the frequent administration of large doses af brandy likely to increase the comfort or the chances of recovery of a young patient in the febrile distress of a pneumonia or a pericarditis. But the whole rising race of medical men are disposed to a generous treatment of disease, and of this disposition the allowance of alcoholic liquors in some form or other is the expression. Disease is associated constantly with debility, or a want of vital power. The circumstances of the patient, and even his constitution, may give little plausibility to the notion of pure and real debility being at the root of his complaints. His house may be one of those picturesque villas which are the ornaments of our airy and salubrious suburbs ; his table may be ready to break down under its daily load of luxurious plenty; he may betray no appearance of the evil diatheses, and vigour and longevity may have been the habit of his family in generations gone by, when men lived on homelier fare and in humbler houses than now. And yet, in the present state of medical doctrine, any ailments he may have-and he is likely to havenot a few-are pretty sure to be regarded as some form or other of debility, which, Proteus-like, is thought to have the power of assuming the most diverse shapes ; and the chances are that his physician will include in his generous prescription, suspension of business, great attention to diet, and a liberal allowance of stimulants or of stout. This theory of disease has its advantages. It is a great improvement upon the theory which is being rapidly displaced by it, according to which all disease was to be attacked by strong weapons, and driven, as an enemy, from the system. But one theory may be better than another, and yet not be the true It is short and simple; but short and simple theories of one. complex facts are almost sure to be false. It is rather in favour with patients, who perhaps enjoy being considered weak, and are very apt to like the remedies prescribed to make them strong; but patients cannot judge. That there is an element of debility in the ailments of the comfortable classes is, no
arrangement and perceptive
power, and sanctioned a chaoticc confusion which has invoked universal censure. The reporit makes useful suggestions for avoiding these errors on a futurte occasion. It is a document of historical value-the first of it:s kind; and of unusual interest to surgeons in this and otherr countries. The jury may be congratulated on having had s< o able an interpreter of their sentiments as Mr. HADEN.
Medical Annotations. "Ne quid nimis:’
THE SERJEANT-SURGEONCY
determined. Finally come! the announcement that, under the advice of M. Nelaton, the wound would be dilated to allow the escape of the ball Ther the ball is actually there, and the glory of our country pale, through the error of its representative. That is really thE popular feeling. And of all the follies of this foolish business it is really not the greatest. Nothing can be more absurd thai to depreciate the surgical reputation of Mr. Partridge because he may have formed an erroneous opinion on the subject, whicl is often one of difficulty and doubt. But Mr. Partridge wa: pushed into a false position in the matter from the first, and to have occupied it with anything like dignity or comfort, h ought to have been infallible. He suffers now one of th, penalties of the invidious character of the mission which h accepted. The issue fully justifies the general remarks whicl thought it necessary to make upon this affair in a distinguishe d earlier stage. of the deat ALCOHOLIC THERAPEUTICS. for so man
dwe
THERE is at present a vacant appointment to this will have to be filled in consequence of the late Sir Benjamin Brodie, who had been years decorated with the honourable title of Serjeant-Surgeor It has been usual to promote one of the Surgeons Extraordinar y to that honour, and it is probable that the choice will fall upo il either Mr. Fergusson or Mr. Caesar Hawkins. Mr. Fergusso n has, we believe, seniority of appointment as Surgeon Extr: ordinary, and of course his rank as a practical surgeon is of tl e highest. Mr. Caesar Hawkins, on the other hand, has a cons derable seniority in College standing. He has been more tha n once president; and as consulting surgeon of St. George’s and a distinguished man of science in his profession he has powerfi claims. Of course the question as to the probable incumber t of the post of Surgeon Extraordinary which will then becom - .acant is also discussed. The appointments will no doubt 1 e made with the judgment and good sense which have marked a the selections of the medical attendants of the Court of lat ’’ The names mentioned in surgical circles may not be tho: e which suggest themselves to those entrusted with recommen( ing for the appointment; but we may say that the names mo ;t on the lips of their confrères are those of Mr. Prescott Hewe ;t and Mr. Erichsen. Other surgeons may be found who wou] d well deserve the honour, but there can be no question that tl appointment of either of these gentlemen would be satisfactoi y to the -profession.
post, which
THE
WOUNDS OF
might be accurately and certainly
GARIBALDI.
THE published accounts of the result of the consultation oin Garibaldi to which we last week referred, have given rise to muelh comment. In the first instance it had been positively stated1, on the dictum of Mr. Partridge, that the ball was not in th,.e wound, and that the recovery could not, therefore, be impededL Flying rumours of a difference of opinion on the subject hae gained so much currency that it came to be almost an interrnational as well as a surgical question. If the Italian surgeonis were wrong, and the ball was not in the wound, it was a perrsonal triumph for Mr. Partridge; if they were right, and it wa in the wound, the secretly ruffled sensibilities of the Italiann profession would be smoothed, and Italian surgeons woul(d triumph at thus correcting ce chirurgien celebre Anglais wh.o had been somewhat arbitrarily imposed upon them. A conisultation of seventeen surgeons was held, amongst whom wer’e M. Nélaton and Mr. Partridge. Seventeen surgeons i Wha a powerful constitution must his friends attribute to Garibaldli to submit him to such an ordeal! The published bulletins of thte seventeen surgeons are not, it must be confessed, couched in .a Wewere told that a prolongedd manner to escape criticism. examination of the wound had been made ; that Garibaldi hacd suffered great agony ; and that the question of the presence o)r absence of the ball was undecided. It is natural to ask, thouglh it may be easy to answer, why chloroform was not adminisstered. Under its influence an examination need not be tedious it need not cause a pang. The existence of a foreign bod;y
____
IN a late article on the " Habitual Use of Alcohol" (see THE LANCET of Sept. 27th, 1862) we made allusion to the great change which has come over the practice of society as regards the quantities and the strength of alcoholic liquors consumed We sip ; our fathers drank. They went on social occasions. in for the physiological action, and considered the survival of cerebral or muscular competency at the close of a dinner a sort of unsuccess; we are concerned at the slightest indication of the physiological action in the social circle, and would hesitate to invite again a gentleman who should once be incautious enough to exhibit a vinous effect on his tongue or muscles. Curiously enough, coincidently with this comparative social disuse of alcohol there has occurred a great extension of the medical use of it, so that at the present time, in London especially, it is in great professional fashion. Few, indeed, carry this practice so far as Dr. Todd did in the later years of his life. Few deem the frequent administration of large doses af brandy likely to increase the comfort or the chances of recovery of a young patient in the febrile distress of a pneumonia or a pericarditis. But the whole rising race of medical men are disposed to a generous treatment of disease, and of this disposition the allowance of alcoholic liquors in some form or other is the expression. Disease is associated constantly with debility, or a want of vital power. The circumstances of the patient, and even his constitution, may give little plausibility to the notion of pure and real debility being at the root of his complaints. His house may be one of those picturesque villas which are the ornaments of our airy and salubrious suburbs ; his table may be ready to break down under its daily load of luxurious plenty; he may betray no appearance of the evil diatheses, and vigour and longevity may have been the habit of his family in generations gone by, when men lived on homelier fare and in humbler houses than now. And yet, in the present state of medical doctrine, any ailments he may have-and he is likely to havenot a few-are pretty sure to be regarded as some form or other of debility, which, Proteus-like, is thought to have the power of assuming the most diverse shapes ; and the chances are that his physician will include in his generous prescription, suspension of business, great attention to diet, and a liberal allowance of stimulants or of stout. This theory of disease has its advantages. It is a great improvement upon the theory which is being rapidly displaced by it, according to which all disease was to be attacked by strong weapons, and driven, as an enemy, from the system. But one theory may be better than another, and yet not be the true It is short and simple; but short and simple theories of one. complex facts are almost sure to be false. It is rather in favour with patients, who perhaps enjoy being considered weak, and are very apt to like the remedies prescribed to make them strong; but patients cannot judge. That there is an element of debility in the ailments of the comfortable classes is, no