Chapter V: S. ad ℥xxx

During the bleeding he looked wildly at the basin, and begged that no more might be spilt (a drop or two had fallen), repeating frequently, in great agitation, as the blood was running, "Take care! take care!"

Between two and three o'clock next morning my assistant (Mr. Davies) visited him. He found him tolerably passive, but observing every movement with intense anxiety. Pulse full and hard, face flushed, eyes denoting cerebral irritation. He had been at times outrageous. On its being intimated that bleeding was again necessary, a paroxysm came on more intense than any preceding,--and with great effort he submitted. As the blood flowed he became more and more alarmed, till at length he got quite unmanageable; he raged violently at his nephew, who was holding the basin, and ordered it peremptorily to be removed. 30 or 40℥. were taken away. It was found necessary to put on the straight waistcoat. About four o'clock Mr. Davies wished him to take some more of his medicine. He said, "I can take no more," and on reaching the bottle to put out a few drops, he became violently agitated, threw himself from side to side, and, as well as the incessant spasmodic sobbings would allow, he begged that not one more drop of any thing might be offered him, and that the bottle might be taken from his sight. He did not become tranquillized until its removal. He lingered on till ten A.M. in the same state, a few minutes before which he insisted on getting up, and walked a short way down his garden, returned, laid down on his bed, and died.

Mr. Frederick Salmon, of Old Broad Street, and Mr. Wilson, of Chelsea, were kind enough to assist me in conducting the post mortem examination. On opening the chest, the heart was free from disease, with rather more water in the pericardium than natural; the lungs were completely gorged with grumous blood, and the pleura adherent on the right side. On removing the cranium, which was remarkably thin, and cutting the substance of the brain, numerous red spots presented themselves in the medullary portion; about a table-spoonful of water in each ventricle; the plexus choroides was turgid; the corpora, striata, thalami, and basis of the brain every where preternaturally injected; the cerebellum, crura cerebri, and cerebelli, in a high state of inflammation. On removing the spinous process of the vertebra, the whole cord was considerably inflamed; and opposite the two last cervical and dorsal vertebræ the cellular substance was studded with dark patches of coagulated blood, the theca vertebralis thickened, and the cord in an active state of inflammation. The larynx and pharynx bore not the slightest vestige of disease. The preparation of the cord is deposited in the museum of the London University.

The post mortem examination of this case tends to prove the correctness of Professor Thompson's theory of the proximate cause and seat of this afflicting malady; and the plate accompanying a case recorded by him, in the 13th volume of the Med. Chir. Society, gives a faithful delineation of the state in which the spinal cord was found in this case.

CASE OF LONG PROTRACTED CONSTIPATION.

_To the Editors of the London Medical Gazette._

GENTLEMEN,

Perhaps the following case may interest some of your readers, and if you think so, its insertion in your Journal will oblige

Your obedient and
humble servant,

S. D. BROUGHTON.

12, Great Marlborough Street,
Dec. 3, 1828.

On Tuesday, Nov. 25, I was called upon at the St. George's and St. James's Dispensary to advise for an infant at the breast, of five months and fourteen days of age, that had not passed any fæces during six weeks up to the day before I saw it. After its birth it had no passage till the fifth day, and this had apparently been effected by the introduction of a bougie, and which was subsequently continued at intervals for a short time. The infant was otherwise healthy and strong at its birth, and remained so until it had gone about three weeks without any evacuation, when it was observed to be weak in the lower extremities; and at the period of my seeing it the legs were much fallen away in flesh, hanging flaccid and inert. Many aperient enemas and medicines had been given, and, as a last resource, one drop of the croton oil had been prescribed the preceding evening. The infant appeared to suffer from distention, and to be disposed to coma, and the croton oil had distressed it much some hours after it was given. The fæces could be felt blocking up the intestine, but the irritation of the finger produced no attempt at evacuation; very small pieces only having been brought away. Hot baths also had frequently been used some time ago.

Considering the case as one of paralysis in the parts naturally employed to relieve the bowels, I recommended the suspension of all purgative remedies by the mouth, and a table-spoonful of the following injection to be substituted, and to be thrown up with three table-spoonfuls of thin gruel occasionally during the day, by means of a syringe.

℞ Spir. Terebenth. ʒiij.
Træ Zinzib. ʒj.
Aquæ, ℥iss. M.

The following liniment was also directed to be rubbed in frequently along the course of the spine.

℞ Linimenti Saponis, ℥iss.
Liquor. Ammon. Comp. ℥ss. M.

The result justified my expectations; for, during the night after this prescription, two injections having been given, some large and hard ash-coloured lumps came away, and these were shortly followed by a forcible spouting out of a continued stream of feculent dark liquid; a brisk diarrhœa having been kept up till the Saturday following. The infant's appetite is become voracious, its appearance lively and healthy, and its legs as firm and strong as is usual at such an age. Cold water is recommended to be dashed upon the loins, the liniment to be continued occasionally, moderate doses of magnesia and rhubarb to be given when required, and the turpentine injection to be used if any return of the complaint should be threatened.

DISLOCATION OF THE PATELLA.

_To the Editor of the London Medical Gazette._

SIR,

Having seen a case of dislocation of the patella, reported by Mr. Mayo, in your Journal a few weeks since, in which there was experienced some difficulty in the reduction of the bone, I beg leave to send you the following, in case you may think it worth insertion.

On Saturday last, I was called to a young woman who had dislocated the patella of the left knee joint outwards; the inner edge rested upon the outer surface of the external condyle, and was immoveably fixed, and caused great pain when touched. She says it was occasioned by her foot slipping backwards from one stair to another, and she immediately fell down.

I commenced the reduction, as stated by Mr. Mayo, but I could only produce semiflexion, and that gave her great pain; insomuch that I was obliged to desist, and the patella remained in _statu quo_. But when the knee was thus semiflexed, I desired my assistant to extend the leg suddenly; and having my fingers on the patella at the time, and pressing it inwards, it immediately returned to its natural position.

I must confess, sir, that I should have been afraid to have continued the flexion as described in Mr. Mayo's case, "by bending the knee to the utmost," fearing that the remedy might be worse than the disease, and the result proved that in this case it was not necessary.

I remain, Sir,
Your obedient servant,

P. M. HOSKINGS.

168, Fleet-Street,
Dec. 3d, 1828.

VACCINATION.

_To the Editor of the London Medical Gazette._

SIR,

The mistake of the printer in substituting the word "every" for "even," in the paper on Vaccination (p. 40), so materially affects the sense of the passage, that I must request the favour of the following insertion:--

"3d. That while the vaccine cicatrix retains even one distinct fovea or depression, the individual continues unsusceptible both of small pox and of re-vaccination; but that," &c.

I am, Sir,
Your obedient servant,

THOS. H. BURDER.

2, Brunswick Square, Dec. 15, 1828.

SINGULAR BICEPS MUSCLE.

_To the Editor of the London Medical Gazette._

SIR,

The valuable paper communicated to your Journal, by Mr. Stanley, last week, has brought to my recollection a singular appearance of the parts in front of the shoulder-joint which I dissected about two years ago. It is a fact worth recording; and perhaps you will be kind enough to insert it in your next number.

The circumstance was this--that in the right arm, instead of there being a biceps muscle having two origins, the one the shorter from the corocoid process, the other the longer from the upper part of the glenoid cavity of the scapula, there was simply a one-headed muscle arising from the corocoid process. I could find no tendon passing through the joint answering to the long head of the biceps, neither was there any appearance of a biceptical groove; the capsular ligament was, perhaps, thicker than it is found in ordinary cases.

I knew nothing of this man during life, and am therefore unable to give any account of the use which he made of this arm.

I am, your obedient servant,
C. M. BURNETT.

House Surgeon's Apartments,
St. Bartholomew's Hospital, Dec. 8th.

STETHOSCOPE.

_To the Editors of the London Medical Gazette._

GENTLEMEN,

As you did me the honour, on a former occasion, to publish some remarks in defence of _auscultation_, against its enemies and detractors, I trust you will permit me to say a few words in reference to a communication in a late number, from a gentleman who appears to be a friend of that method of diagnosis, but whose ignorance of the subject is likely to be more injurious to the cause than either open enmity or secret detraction. The case in question (page 780, vol. ii.) appears, from the dissection, to have been clearly _emphysema of the lungs_, as there stated; but I appeal to every one practically acquainted with the physical signs of diseases of the lungs, whether the results of the exploration with the stethoscope, as narrated in the case, were those pathognomonic of that disease? I say they were not only not pathognomonic of this affection, but they were actually incompatible with its existence. The same ignorance of the subject is shewn in relation to the disease of the heart, which, I boldly maintain, no one was justified in pronouncing to be _hypertrophy of the left ventricle_ from the stethoscopic indications stated in the case.

It is just possible that the writer of the case may have made further explorations on which his diagnosis was founded; but if he had such in his case-book, it is equally unfortunate for the credit of the stethoscope and his own, that he suppressed them in his printed case.

I have the honour to be,
Gentlemen,
Your obedient servant,

A STETHOSCOPER.

Nov. 25, 1828.

MECHANISM OF VOMITING.

_To the Editor of the London Medical Gazette._

Glasgow University, Nov. 26, 1828.

SIR,

Having lately perused, in the 35th Number of the Medical Gazette, some observations "on the mechanism of the act of vomiting," by Dr. Marshall Hall, in which, after controverting the different opinions which have been entertained by physiologists on this question, he endeavours to prove that vomiting is an effort, not of _inspiration_, but of _expiration_, and advances this opinion as having originated in himself, I beg, through the medium of your Journal, to refer that gentleman to Richerand's Physiology, where, on the subject of vomiting, page 70, he says, "Sometimes the action of the muscular fibres of the stomach is quite inverted; they contract from the pylorus towards the cardia; and this antiperistaltic motion, in which the contractions act with more force and rapidity, and in a manner decidedly convulsive, produces vomiting. The action of the abdominal muscles then connects itself with that of the stomach; the viscera are propelled upwards and backwards, by the contraction of the large muscles of the abdomen; _the diaphragm ascends towards the chest; if it descended, in contracting, the œsophagus that passes between its two crura would be compressed, and the expulsion of food through the cardia could not be effected_. It is also observed, _that during expiration only, any thing can pass from the stomach into the œsophagus_." Again, on respiration, page 147--"_In every effort of expiration_, as coughing and _vomiting_," &c. Here, then, we see that Dr. Hall's views, as far as regards vomiting being an effort of expiration, have long since been advanced by Richerand.

The profession are certainly much indebted to Dr. Hall for his corroboration of these views; at the same time he should not have taken to himself the merit of having first suggested them.

Sir,
Your most obedient servant,

A SUBSCRIBER.

CHARACTER OF THE LANCET.

_To the Editor of the London Medical Gazette._

Dec. 19, 1828.

SIR,

The events disclosed during the late trial in the Court of King's Bench, must fill every well-disposed mind with astonishment and horror. The moral aspect of the case is marked by every feature capable of exciting a sense of shame for our profession, and of sorrow for our kind. Can it be that a publication conducted in the spirit of the extracts produced at the late trial of Cooper against Wakley should be fostered and encouraged by a large proportion of the medical public? Is it indeed true that no feeling of loathing and disgust should have induced the purchasers of the Lancet to protest against its glaring injustice, its undisguised ferocity and malignity?

I am not a reader of that work myself, and but for the disclosures recently made in our courts of justice, together with what I have learned from your own pages, I should know little about it. Some of its early numbers convinced me that it was a production not deserving of support, whatever ability there might be connected with it; subsequent events have amply justified this decision, and I now address these few hasty lines to you, to express my humble hope that all the respectable medical men throughout the kingdom will arise, and with one voice oppose this moral pestilence, which at once corrupts and degrades their profession.

The _odium medicum_, bitter and vindictive as it unfortunately has been, never, I believe, appeared in a form so repulsive. Are we living in the nineteenth century? Have arts and sciences, which are asserted of old to soften the manners and temper the violence of our nature, produced no such fruits amongst us? Is serious, and perhaps irremediable injury, to be inflicted on reputation; and is the sufferer thereafter to be dared to mortal combat, and this too by the wrong-doer? Is it thus that professional justice is to be awarded? Is it thus that knowledge is to be advanced, the dignity of our profession to be maintained, its benefits enlarged, and its usefulness transmitted? Is it thus that the young men are to be taught how to acquire an unworthy and discreditable notoriety; to disregard all the decencies, charities, and higher virtues of life; and to bring into the exercise of our art the insidious cunning of the knave, the vulgar dishonesty of the pilferer, and the audacious bearing of the bravo?

I know not how others may feel on the present occasion: I am entirely unacquainted with the parties who have been at issue in the late suit--I have no bias of any kind, but what must arise in the mind of every man who has any regard for the profession to which he belongs, or who loves truth and fair dealing--I am sure that it is not less for the interests of society at large than for the advancement of medical science, that just principles should regulate all our dealings, both with the public and with each other. It is manifest that of late we have signally and woefully departed from them; and it is most distressing to know that this departure has been sanctioned by so many members of the profession. I now entertain a confident hope that all who reflect on the character of the late libel will feel that their own _character_ is at stake if they do not mark their disapprobation of it in every possible way. Sure I am that, if the principles which guide the Lancet become generally acceptable, it will mark an æra of moral degradation which no surgical dexterity, no medical acquirements, however eminent, could possibly redeem.

VERITAS.

DURATION OF HUMAN LIFE IN RUSSIA.

Cases of longevity are not only much more common, but also more extraordinary in respect to a greater duration, in Russia than in any other part of Europe; thus, from the report of the holy synod, published in 1827, it appears that there were living in 1825, among those who professed the Greco-Russian religion throughout the empire, not fewer than 848 males who were 100 and more years old; among whom, 32 had passed the age of 120, 4 were between 125 and 130, and 4 others between 130 and 135 years of age. Out of 606,881 males who died in 1826, 2785 had passed the age of 90 years; 1432 that of 95; and 818 that of 100. Among the latter, 38 were more than 115 years of age; 24 more than 120; 7 more than 125; and one was 160 years old at his death.

MEDICAL GAZETTE.

_Saturday, December 27, 1828._

"Licet omnibus, licet etiam mihi, dignitatem _Artis Medicæ_
tueri; potestas modo veniendi in publicum sit, dicendi
periculum non recuso."--CICERO.

ANALYSIS OF WAKLEY'S DEFENCE ON THE LATE TRIAL.

We last week presented our readers with a full[20] and, we trust, accurate account of the trial for libel, which has recently excited so much interest; and we offered some remarks of a general nature upon its result and tendency. We had purposed at the same time to subject Mr. Wakley's mode of conducting his cause to a critical investigation, but this we were prevented from doing by want of time and space. We thought it likely, too, that the Editor of the Lancet would have fairly met the question in his next publication, and himself put the facts of the case, at least, on record: instead of this, however, he has devoted his pages to compliments to himself, and scurrilous and absurd abuse of Sir James Scarlett, in which he informs us that in his opinion that gentleman is "prodigiously overrated even as a lawyer," and says many other things, which serve only to shew how dreadfully Wakley himself had smarted under his lash.

We find the general opinion to correspond with that which we expressed last week--that the defendant had managed his cause in a very bungling manner; and the estimation in which he and his witnesses were held by Judge and Jury is apparent from the charge of the one, and decision of the other. Both, indeed, regarded the asseverations of his whole _family party_ as dust in the balance against the testimony of one single competent and honourable man--Mr. Callaway; for on his evidence the result obviously hinged. Our contemporary affects to look upon the verdict as a triumph on his part--so he would if the damages had been five hundred or a thousand pounds, for in truth he has nothing else for it; and with all our hearts we wish him many such victories.

With regard to the amount of damages, we certainly should have been better pleased had it been larger; but we did not expect that it would--nay a reference to our number which was published while the trial was going on, will shew that we were even doubtful of the verdict, because we know how extremely difficult it is for a jury to comprehend such a complicated question--how easy for a knave to impose upon their ignorance by misrepresentation and falsehood. It is quite obvious that if the jury had believed one syllable of the evidence of Wakley's witnesses, they must have given the verdict in his favour. In a case like this, where _one individual only_, and he the plaintiff, can be fully aware of the difficulties which had to be overcome, it is almost impossible to bring evidence into a court of justice capable of satisfying the minds of twelve unprofessional men. From this circumstance alone it was that we expressed a doubtful opinion of the result. But besides all this, it is well known to all--_that one talesman might go determined to starve out the rest--that ten special jurymen might wish to give 500l. and yet that, by the absurd constitution of the English law, their verdict might be thus controlled by one individual friendly to the defendant_.

Most fortunately for the cause of truth, Wakley had the vanity and folly to conduct the defence himself, and, judging of other men's estimation of moral character by his own, he did not hesitate to place in the box witnesses whom no counsel would have suffered to go there, and who, being unable to stand the cross-examination, led to what must have been to Wakley a most humiliating exposure. Next to this, the most beneficial effect produced was that of the defendant's cross-examination of his opponent's witnesses: it was amusingly absurd, and shewed a lamentable want of tact, always eliciting something which he ought to have avoided. Lastly came the reply, of which he tells us he is himself ashamed--"We may state most unfeignedly," says he, "that we look back with regret to our errors in point of omission." Nor is this the only part of it for which he has cause to blush, for any thing more miserably deficient we never heard: it was a mass of confusion throughout--a repetition of the same ideas and expressions--and a most injudicious betrayal of rancorous feeling, at the very moment he was profanely invoking heaven to witness that he bore enmity to no man. In speaking of his reply in our last number, we declared it to be "false in statement--sophistical in argument--coarse in language--and diabolical in tendency;" and we now proceed to illustrate these several qualifications, in doing which little more will be necessary than to select a few passages, and arrange them under their appropriate heads.

_False in Statement._--One of Wakley's principal objects was to impress upon the Jury a belief that he had not in any way attempted to influence his witnesses, nor even spoken to most of them, anterior to the trial. "Out of nine witnesses I have placed in the box, (says he) I never saw five of them, nor even spoke to five of them till yesterday." We appeal to any man of common sense, whether it be probable that this is true. It is possible indeed, and only just possible, that he was contented with employing others to question his witnesses, and ascertain what evidence they would give; but even if it were so, the assertion was not the less false in a moral point of view, because his intention was to convey the belief that he had inquired no farther than merely whether or not the witnesses had been present at the operation. But incredible and absurd as this was, he ventured a step farther, and assigned a reason for the choice made of one witness--(Lee the potatoe-merchant.) "I had heard (said Wakley) he was present at the operation--an honest man, and that he was a friend of Mr. Bransby Cooper, under the highest obligation to the Cooper family. Without asking him a single question I put him into the box, as I was most anxious you should hear all the evidence that could be adduced, and from _unsuspected and untainted quarters_." This lie carried with it its own refutation; for Lee swore that he had never even spoken to Mr. Cooper; and we are therefore amazed that Wakley should have hazarded so gross an assertion, as it could only have been effective on the supposition of his addressing a jury of absolute simpletons. But again--"Who were my witnesses? not men whom I had trained and lectured on models, and sketches, and drawings. Has it been shewn to you that I was closeted with any person or set of persons?" Yes, Mr. Thomas Wakley, it has been shewn, and by no less an authority than that of your _fidus Achates_, Mr. James Lambert. "The defendant (says the worthy author of the libel), the defendant was there whilst I was explaining the parts to persons who were to be witnesses--_the defendant also explained them to the same persons_." And again, "I have heard explanations given to persons who were to be witnesses in this cause FOUR OR FIVE TIMES within the last six weeks." So also that excellent thorough-going witness, Mr. Jeffry Pearl: "a _gentleman_ of the name of Lambert introduced me to the defendant; THE DEFENDANT _and Mr. Lambert endeavoured to shew that the forceps had passed between the bladder and the rectum_." So much for placing men in the box because they are friends of Mr. Cooper--so much for procuring evidence from "untainted quarters!"

This is only to be matched in effrontery by the statement of some wise-acre at the radical meeting on Tuesday night. Being asked why no notice had been taken in the Lancet of a successful operation of lithotomy performed by Mr. B. Cooper, soon after the publication of the libel, he assigned as the reason that Mr. Wakley thought it might increase the damages, and otherwise injure Mr. Cooper! What a noodle the man must be to expect any one to believe him[21]!

Mr. Wakley asserted that the evidence of his witnesses remained "untouched--wholly uncontradicted;"--whereas there was scarcely a single point in their statements which was not contradicted either by Mr. Callaway, who was present at the operation, or Mr. Key and Dr. Hodgkin, who examined the parts after death. But what is more remarkable, there was scarcely a circumstance on which his own witnesses agreed--for example, they differed with regard to the nature and direction of the incisions; with regard to the manner and frequency of introducing the forceps; with regard to the number of instruments used, and the mode of applying them; with regard to the size of the wound; with regard to the degree of force employed, and with regard to the appearances after death. Yet, in the face of all this, Wakley had the impudence to tell the jury that his evidence remained "uncontradicted." We have no hesitation in asserting that his own witnesses (putting Mr. Cooper's out of the question) advanced no charge of which they did not also furnish the refutation.

Mr. Wakley asserted that Mr. Cooper was incapable of telling why he could not extract the stone, even "while he had his finger in the bladder." This is false: neither Mr. Cooper nor Mr. Callaway were able to reach the bladder with the finger at all, owing to the depth of the perineum.

Mr. Wakley told the jury that the plaintiff did not like the bladder to be exposed, "because to surgeons there is indisputable proof that Bransby Cooper did not perform that operation as he ought," and that "Mr. Key and Mr. Callaway knew it." This is false: Mr. Key, Mr. Callaway, and Dr. Hodgkin, who had examined the parts, all deposed that there was nothing in them indicative of the operation having been improperly performed. Indeed, had it been as Wakley asserted, the plaintiff would not have been so foolish as to have had the parts preserved at all.

_Sophistical in argument._--One of the pieces of sophistry on which Wakley seems chiefly to have depended, inasmuch as he went over it _six times_ in the course of his speech, was, that if his account of the operation had been incorrect more of those who were present would have been brought forward to prove it so. But, as we stated in our last Number, to have objected to Wakley bringing forward pupils, on the ground of their being incompetent, and then to have done the same thing, would have been grossly inconsistent. Lord Tenterden, in his charge, said, "he did not see whom he (Mr. Cooper) could, with propriety, have called besides Mr. Callaway; the others were all young men, only pupils, and probably too young and inexperienced to form any judgment on the case that could be relied on." There is also another person who has objected to these witnesses whom we may mention--not, indeed, one for whose authority we have the highest possible respect, but of whom the defendant in this case probably thinks more favourably--we mean Mr. Thomas Wakley, who, speaking of the Letter formerly published by Mr. Cooper's pupils on the subject of this operation, says, "their united opinion of the skill, dexterity, and self-possession exhibited by Mr. Bransby Cooper on this occasion, is not likely to influence the judgment of the profession, whatever it may effect with the public."

The use made by Wakley of Sir Astley Cooper's expression, "give him time," is another specimen of sophistry. Sir Astley evidently meant merely to say that, _ceteris paribus_, a man who had been twenty years surgeon to an Hospital would be more experienced than one who had held the situation but one-fourth of that period. This we believe to have been his sentiment, though nothing was ever less happily expressed. Accordingly it was not lost upon the defendant, who exclaimed, "Is that the way in which our hospitals are to be conducted? Is that the mode in which your poor patients are to be treated?--that young and inexperienced men are to be placed there to _learn their profession_--not to know it before they get there, but are to go there to learn it--and learn it upon whom?--upon individuals who are as much entitled to the best and most scientific practice of surgery as any nobleman in this land." All very fine--but we should be glad to know how or where a practical acquaintance with surgery is to be acquired but in public hospitals--and if no man is to be appointed till after he has gained experience, where are such men to come from? Where are ready-made surgeons to be found fit to operate even before Lambert, without his being able _to make a hole_ in their reputation?

One of the most knavish attempts in the whole speech, to take advantage of the jury, was exhibited in his description of the operation. How different from the clear, perspicuous, and candid narrative of Sir James Scarlett. You are told, says Wakley, that the stone was shelved _above_ the pubes and _behind_ the pubes; but, continued he, (placing a pelvis in the position in which it is during the operation,) a stone cannot be lodged above the pubes, because, you see, the pubes is above the bladder! This was, indeed, calculated to confuse men unaccustomed to the subject, and who did not probably reflect that above and below are merely relative terms, which must change with every change of position, and that it was not meant that the stone was between the pubes and external integuments, which, in the position for lithotomy, would be the literal meaning of _above the pubes_, but that it was in such a situation as, in the ordinary position of the body, was above the pubes. But Wakley assured the jury that it was impossible for any stone to be _above_ the pubes, for there was a tendon to prevent it which no force could overcome; and he affected to ridicule the idea of there being anything unusual, any extraordinary shelf behind the pubes, in which the stone could have been lodged. "Had there been a shelf here," said he,--"had there been a crooked passage--had there been a cavity, or any place for the deposition of the stone, do you suppose that shelf would not have been produced? Had there been any thing particular in the formation of the pubes, would they not have cut out the man's bone as well as the bladder?" It is probably impossible for any but medical men to appreciate fully the impudent imposition--the fraud of this statement,--this knavish artifice to mislead the jury. No attempt was made in any part of Mr. Cooper's case to show that there was such malformation, or that the stone was in the position which Mr. Wakley demonstrated it could not occupy--_thus answering an argument which had never been advanced_.

The following is a good specimen of sophistry and stupidity. Finding it proved that there was no opening between the bladder and rectum, Wakley wanted to make out that he never had said otherwise, having stated the cellular membrane to be _lacerable_, and therefore not _lacerated_. And then, forgetting the nature of his argument, immediately added, "remember this; the gorget is not as wide as the finger, and that it is not an uncommon thing for an unskilful operator to drive the gorget in between the bladder and rectum." Thus insinuating what had been proved to be false, and what he had just argued, from the words of the libel, he could not have meant.

_Coarse in language._--This scarcely requires illustration. But as specimens, on the present occasion, of vulgar slang and miserable attempts at wit, we may mention his talking of "hole and corner" proceedings,--his comparing Sir James Scarlett to sour milk, and which happy thought he has, in hand-bills pasted about the town, converted into "Knight and Professor of Sour Milk,"--his explanation of the term _bat_ as applied to surgeons, "because they live in the dark, they suckle their young, and live in creaks and crevices of old walls, hospitals, and dungeons, _thriving and fattening on their own species_,"--his address to the "_gang_" of hospital surgeons, whom he represented as wading "through blood up to the neck,"--and lastly, his exclamations, several times repeated, perhaps with _prophetic_ phrenzy, that he "would die in a dungeon and expire in a ditch."

_Diabolical in tendency._--The general tendency of Wakley's writings, and especially of his address to the Jury on this occasion, so far as such ravings can have any influence, is to sow distrust between men in every class of society and their medical attendants; to poison the sources of public charity, and arrest the hand of benevolence; to contract the relief afforded to human suffering, leading the poor and uninformed to suppose themselves the objects of cruel and wanton experiment, thus encouraging them rather to suffer disease to run its course than seek relief in such abodes of blood and horror as he most falsely represents our public hospitals to be.

One of the first ebullitions of this demoniacal effort consisted in representing to the Jury, which he did in two different parts of his address, that the patient had been kept _bound_ during the operation, as if some unusual degree of coercion had been employed. "Yet, in opposition to the patient's cries--in opposition to his repeated entreaties to be unbound, still the operator kept him upon the table."--"Gentlemen," continued he, "I should like to know upon what principle it was that the man was kept _bound_ upon the table when he implored to be loosened. Was he not a free agent?" And then he goes on to put into Mr. Cooper's mouth not only words, but a sentiment he never uttered.--"No, no, (says the operator,) my _reputation_ is concerned. You were brought here to have the stone extracted, and extracted it shall and must be--_if you were to die upon the table_." Unless Wakley was intoxicated we cannot in any other manner account for an argument at once so absurd, so unprofessional, and so malignant. It evidently excited no feeling but that of disgust in the minds either of the Judge or the Jury.

The next paragraph to which we shall allude is a masterpiece of hypocrisy--"Let me ask you (said he) what you have heard respecting the miseries of the individual on whom the operation was performed? Not one word has escaped the lips of the counsel on that subject--not one word from the mouth of one of the witnesses. No, gentlemen, they are hospital surgeons themselves, and they know too well what the practices of our hospitals are, and the sufferings _patients are in the habit of enduring at their hands_, to feel for this man, or for any other man placed in a similar situation!" Canting hypocrite! this from the man who in the very case before us published his account of the patient's sufferings in the form of a drama, mingled with low and scurrilous gibes. Mark also the following--"Give such a verdict as shall satisfy the _poor_--as will shew that men are not to go into offices of this sort where the _poor are to be killed_, and that they shall not be at liberty to wade and ride through blood up to their necks to eminence in their profession. Ah! gentlemen, give such a verdict as shall satisfy the _poor_!"

There is in the various paragraphs we have quoted, more deep-rooted malice--more abandoned violation of the truth--more hypocrisy--and more open outrage of common sense, decency, and feeling, than we ever remember to have met with, even in the pages of the Lancet. It is now quite obvious that Wakley, alarmed at the change which has taken place in the estimation of his work within the last few months, finds it necessary to adopt a new system; he therefore throws off the mask, and openly declares himself the champion of the ignorant and illiterate[22]--conjuring up to their imaginations evils which do not exist--denouncing the medical profession as one of blood and murder--medical men as "thriving and fattening on their fellow-creatures"--and calling upon the "humane contributors to our hospitals and infirmaries" to support him.

Why really now, if the times of political turbulence were to return, and radical reform again to come into vogue, Cobbett and Hunt would have a most valuable coadjutor; but as it is, we almost think the sphere he has chosen is too limited for such a genius. Humbug, to be successful, ought not to be very open to detection; alleged abuses ought not to be of a kind which every man can satisfy himself are entirely without foundation; and he who professes disinterested motives ought not to begin by raising a subscription for himself. We offer these few hints to Wakley, in hopes they may be of use to him in his new career; above all, we advise him to be sparing in protestations: there are some already who look upon his sincerity with a suspicious eye; for although it is no doubt true, that he would "rather die in a dungeon, and expire in a ditch," than injure any man, yet somehow an idea has got abroad, that his constant habits of lying and slandering are not quite in keeping with these assertions. Nay, we have heard of some even of the "humane contributors" to our charitable institutions, who have been so unreasonable as to disbelieve all Wakley's stories about the _cannibalism_ of hospital surgeons, and to look upon the whole system of the Lancet as one of knavery and imposition.

WAKLEY'S SUBSCRIPTION MEETING.

A most amusing scene took place at the Freemasons' Tavern on Tuesday evening, of which we subjoin an account. The object of the meeting was, "to present Mr. Wakley with some decided mark of their approval of his spirited conduct in his late trial;" or, in other words, if possible, to raise a little money, and bolster up the Lancet a little longer. The persons present were small in number, but great in zeal; and as much noise, hissing, laughter, and shouting, took place as would have done credit to a much larger assembly. As this is a merry season, and it may amuse our readers, we subjoin the speeches of the principal orators on either side: it will be perceived that both the Gazette and Lancet had some handsome compliments paid them; and that Wakley got thoroughly abused even by some of those who went to the meeting as the champions of reform. There was not a single individual present of any weight in the profession, and the chair was occupied by a young man wholly unknown, except as secretary to the meetings held two years ago on the subject of surgical reform. Could no one whose name might sound familiar in the public ear be prevailed upon to go?--could none be found but Pateys, Wallers, Mills, Elliots, Childs, and the Lord knows who? Where was he, the idol of the Lancet, who on other occasions graced the chair--where he who first ycleped that Journal the "invaluable"? Alas! poor Wakley, what an exposure of a sinking cause! even thy former friends tremble for their reputations, and desert thee.

SURGICAL REFORM.

A meeting was held yesterday evening at the Freemasons' Tavern, in pursuance of an advertisement calling on the "Friends of Surgical Reform, the Supporters of a free Medical Press, and the humane Contributors to our Hospitals and Infirmaries," to meet there, in order to adopt measures for presenting Mr. Wakley, the Editor of the Lancet, with some decided mark of their approval of his spirited conduct, in his late trial in the Court of King's Bench, at the suit of Mr. Bransby Cooper, and of the principles which he so powerfully advocated on that occasion.

[Mr. Patey, who was called to the chair, stated the object of the meeting; but as his speech was rather long, and contained nothing of the least interest, we omit it.]

_Mr. Waller_, in proposing the first resolution, adverted to the terms of the advertisement, and remarked that the question for them was not whether they would support Cooper against Wakley, or Wakley against Cooper; but whether they would have a free medical press or not--(cheers). Every body must admit that there was only one medical publication that was entitled to be considered free--only one that dared to tell the truth. Another had been attempted to be set up against it, but this wretched rival was gagged and manacled, and its reports were only a medium which distorted truth, and were almost unintelligible. It was not, however, to support any particular man, or publication, that he came to that meeting, but to support the general cause in which they were all interested. He concluded by moving, as the first resolution, that "the best interests of the medical profession and of the public are identified with the cause of medical and surgical reform; and that Mr. Wakley, as Editor of the Lancet, having given the first impulse to that cause, and having subsequently advocated it with undeviating firmness and fidelity, is entitled to the cordial thanks and support of this meeting."

_Mr. Mills_ seconded the resolution.

_Dr. Shiel_ said this was an important meeting, in his opinion; for, if this resolution were passed, it would identify the medical profession with the Editor of the Lancet. If the principle embodied in that resolution went forth to the world, it would be attended with consequences deeply injurious to the profession. He knew neither Mr. Bransby Cooper nor Sir Astley, and therefore he was perfectly impartial. The first question was, how far the medical press was conducted with advantage to medical science and the members of the profession. Now he contended, but with great respect, and disclaiming all personal hostility, that the Lancet had nowise contributed to the progress of medical science or the improvement of the profession--(loud hissing, and some cheers). He trusted that the meeting had not been got up by a few of the friends of Mr. Wakley, and he was sure that that gentleman was too respectable and too dignified in his proper person to need any such attempt--(applause). He trusted that the meeting was before the British public to ascertain how far the Lancet was useful or advantageous to medical science; and he hoped that, however partial the gentlemen present might be to Mr. Wakley, they would be governed in what they should do by the real interests of science--(hear, hear). The question was one of great interest; for it was one that embraced not only the freedom of the press but the advancement of medical science. With respect to the freedom of the press, they lived in a country where the law always maintained that principle. When Mr. Abernethy had applied for an injunction against the Lancet, Lord Eldon said that there could be no doubt that the Lancet was a most useful publication--(applause). He did not know whether that observation had been brought forward at the late trial; but taking the case--what was it? It appeared that the operation was one of peculiar difficulty, as stated upon oath by some of the most experienced surgeons of the day. This operation was laid hold of by the Lancet, and published not as a medical but as a tragical performance, in which all persons without science or knowledge were appealed to, and no opportunity afforded to Mr. Cooper to vindicate himself. Here, then, was a low and pitiful attempt made through the medium of malice and calumny (loud hisses and uproar). Here was a rude and pitiful attempt by malice and calumny (renewed signs of disapprobation). And yet it was contended that this had advanced the medical profession. The evidence on the trial went to shew that the dangers by which the operator had been surrounded were not small, and that there was no just reason to accuse him of unskilfulness in what he did; and was it then to be said, in the face of the British public, that a Meeting had been held at the Freemasons' Tavern to offer praise and reward to the individual whose conduct had, by the verdict of the Jury, been stamped with the accusation of untruth (hear, hear! and hisses)? He would not deny that there was a degree of talent displayed in the Lancet; but neither could it be denied that it was a public depredator by means of reports surreptitiously obtained; and the title of "literary raven," which had been applied by Sir James Scarlett, appeared to him to truly depict its character (great hisses and uproar). Was it to be contended that any one had a right to come into a private lecture-room, and catch up all he could hear, and then to publish what he had thus surreptitiously and fraudulently obtained (immense uproar and hisses)? As far as the medical interest was concerned, he looked upon the Lancet as one of the most injurious publications that had ever appeared (hisses). All the best writers on the subject had dwelt with peculiar emphasis on the necessity of secrecy among the members of the profession, but the Lancet broke through this good rule, and made public whatever came within its notice; and he had no doubt that if it could get at the cases that occurred in private practice, it would give them without any scruple (uproar).

The _Chairman_ begged to remind the speaker that at all events Mr. Wakley had not as yet done so.

_Dr. Shiel._--I am arguing on the principle which appears to actuate Mr. Wakley.

_Mr. John Elliot_ rose to order. He could not allow Dr. Shiel to be going upon suppositions; the thing that he supposed had never been done.

_Dr. Shiel_ was sure that whatever turn might be given to the subject in England, that at all events the conclusions that the Meeting appeared to be coming to would be resisted abroad. The weight of Sir Astley Cooper's name abroad would overpower any such attempt, and, in fact, would render it contemptible; so that any attempt to prop up so low, pitiful, and mean an attack, must inevitably be attended with disgraceful failure (hisses).

A gentleman observed, that he was much surprised at what had fallen from Dr. Shiel. He had been induced to suppose that the Lancet possessed talent, as he had heard it praised in so many directions, and he certainly had never heard till that evening that it was only to be found in the hands of the illiterate (hear, hear! and a laugh). He had always understood that it was only destined for the use of students and other members of the profession, and that it was likely to be of great use in reforming the abuses of the medical practice (hear, hear! and cries of "So it will!"). For his own part, he was glad that medical men were occasionally cut up, because when they did what was wrong it was proper that they should be told of it; and when they did what was right, it added a fresh stimulus to their exertions (applause).

_Mr. Thomas_ observed, that he had not intended to say any thing at the present meeting; but as Dr. Shiel, in the course of his speech, had thought proper to make some remarks tending to calumniate Mr. Wakley's witnesses on the trial, of which he was one, he felt called upon to say a few words (hear, hear!). Dr. Shiel seemed to consider them all as the mere scum of the earth--as a miserable band, collected together to support Mr. Wakley, whatever might be the consequence; as though he was desirous of going the whole length of the Medical Gazette, which stigmatised them for what it called "their deep-laid contrivances--their rankling enmities, and their bitter revenge." For himself he could say, that it was not till the evening previous to the trial that he had been supœnaed, and that he had previous to that time never seen Mr. Wakley.

_Dr. Shiel_ said that he could not have alluded to the gentleman who was speaking, as he did not even know his name.

_Mr. Thomas_ then went on to observe, that as Dr. Shiel appeared to be the advocate of the opposite party, he also supposed that he was a contributor to the aristocratical (Medical) Gazette ("No, no!" from Dr. Shiel). If he were not, at all events he had put forward ideas that were quite consonant to the sentiments expressed in that Journal. In giving his testimony, he had not spoken of the instruments employed in the operation, but of his own impression on the subject, having been present thirty-five minutes; and that impression certainly was, that the operation had been performed in a bungling and unscientific manner (loud applause, mingled with hisses). Was he then, because he happened to be a witness on the occasion, to be put down, pell-mell, by the unfounded imputations of any one? The highly-principled, honourable-minded Medical Gazette, that had determined never to admit any personalities, had loaded Mr. Wakley and Mr. Lambert with all sorts of abuse. Was this what they intended to call acting on principle (applause, and cries of "No, no!")? He certainly had heard that Mr. B. Cooper was an amiable man in private life; but what had that to do with the question at issue? What had they to do with the private character of a man in a public office (cheers)? Surely the witnesses of Mr. Wakley were as competent to speak of the manner in which the operation was performed as those who had not been present (applause); and as he had seen many operations performed he conceived that he was a competent judge of the skill of the operator (applause).

A gentleman, who appeared to be a student, thought that the introduction of any attack upon the witnesses, or indeed of anything that occurred at the trial, was irrelevant (hear, hear!). The way to answer a speaker was not by hisses, but by disproving his arguments and rebutting his facts (applause). If questions were to be settled merely by strength of lungs, he was afraid that instead of the right side prevailing, success would uniformly attend those whose physical powers probably much exceeded their mental (laughter and applause). He could not agree with the gentleman who had stated that the law of England was the protector of the freedom of the Press; for it was well known that the Judges had decided, over and over again, that truth was a libel (applause). It was only the vehicle that conveyed public sentiment, and not the force that impelled it forward. He was convinced that any attempt to connect medical reform with Mr. Wakley should be studiously avoided and disclaimed. As a friend of free discussion in every case, and anxious to uphold the principle, whatever he might think of the instrument, he intended to propose, as an Amendment, "That the latter part of the Resolution, relating to Mr. Wakley, should be omitted." This would save the cause of medical reform from being identified with Mr. Wakley, of whose impartiality he would give a specimen. In the last number of the Lancet, the report of the late trial was given from the Times, but with a remarkable omission. The Lord Chief Justice had rebuked one of the defendant's witnesses for not answering the questions in a straightforward manner, and this passage was omitted. If Mr. Wakley would do this on such an occasion, would he be more candid when the public eye was less upon him? He, therefore, wished to have the question of medical reform kept separate from Mr. Wakley individually. The first part of the Resolution would be carried without a dissenting voice, as on that principle they were all agreed, whatever they might think of the conduct of individuals.

[One or two persons then made speeches for or against the amendment; which was negatived, and the original motion carried.]

_Mr. Hensley_ then, after observing that Mr. Wakley's conduct was highly praiseworthy, because it tended in every way to the benefit of humanity, moved the second Resolution, which was to the following effect:--

"That the purposes for which the Hospitals and Infirmaries of the Metropolis were founded, and that the views of the humane contributors to their funds, are materially promoted by the weekly publication of reports detailing the medical and surgical treatment of the unfortunate patients; and that Mr. Wakley having originated the practice of publishing Hospital Reports, has conferred important benefits on Medical Science, and on the cause of humanity."

The resolution was then carried unanimously.

_Mr. John Elliott_, on moving the third resolution, said that he did not come there to interfere in the quarrels of Wakley and Cooper. They had acknowledged that Mr. Wakley's exertions had been very conducive to medical reform, by the last resolution they had passed. Indeed, there could be no doubt that he had greatly served the cause of humanity, by preventing idleness on the part of medical persons, and compelling attention to the poor placed under their care. It was his opinion that the editor of the Lancet ought to be indemnified for the whole expense entailed on him by the late trial, including the damages awarded against him. This would not be a private subscription, like Brodie's, but one open to the world, and not to be questioned in a court of justice. He would not support Mr. Wakley if he had attacked private character; but he would, as the editor of the Lancet and the representative of the medical free press. He concluded by moving--

"That the independent and impartial principles on which the Lancet was first established, have been preserved by Mr. Wakley at all risks; and as it was acknowledged at the late trial, that the legal expenses of his opponents on another occasion have been defrayed by certain hospital physicians and surgeons[23], it is farther resolved, that a subscription be opened for the purpose of defraying the expenses of the late action."

[Dr. Shiel here spoke very strongly against entering into a subscription--while some spoke in its favour.]

A discussion then arose about the question of whether an account of a second operation for lithotomy by Mr. Cooper (in which he had been successful) had been sent to Mr. Wakley? It was stated that such was the case, but as the action for the present libel was then commenced, _Mr. Wakley thought that he perceived something in that second report that might tend to aggravate the damages, and which, at the same time, would be farther injurious to Mr. B. Cooper_.

The third resolution was then carried by an immense majority, only five hands being held up against it.

_Mr. Evans_ moved, "That the statement of professional facts in an unprofessional form, such as the dramatic instead of the narrative, is highly reprehensible in the individual, and detrimental to the best interests of science."

This resolution, after some turbulent discussion, was withdrawn.

_Mr. J. L. Stevens_ then moved, as the fourth resolution, that "In accordance with the feelings this meeting has expressed, Mr. Wakley be invited to attend a Public Dinner, and that a Committee be forthwith nominated to arrange the same."

_Mr. Rogers_ seconded the resolution, and it was carried unanimously.

The members of the committee were then named, and power given to them to add to their number.--The chairman then vacated his office, and the meeting separated.--_Morning Chronicle, Wednesday._

In the course of the evening, the conduct of one of the speakers gave for a short time an amusing turn to the discussion, which for a great part had appeared to many extremely dry and tedious. The gentleman in question, (not a medical man), in order to show the opinion he had entertained of the object of the meeting, proposed to read for the audience a letter which he himself had written to the chairman of the committee, asking permission to attend. He began, but he had scarcely got through a few words when he declared he was not able to make out his own writing, and requested the chairman to assist him. The chairman made the attempt, but was not more successful. Another gentleman then undertook the task, but with no better effect. The audience received each unsuccessful effort with loud laughter, which so much annoyed the writer that he took back the letter, and again tried to go through with it, but not being able to make it out, he proposed to read for the meeting two letters which he wrote on the same subject to the editor of a Sunday paper. (Loud laughter followed this proposition, which was increased, when, on an attempt to read one of them, he had no more success than before.) The gentleman, after complaining of the want of courtesy in the meeting, resumed his seat, declaring that he would give the letters to the reporters.--_Times, Wednesday._

HOSPITAL REPORTS.

GLASGOW ROYAL INFIRMARY.

_Injuries of the Head._