LXIX.

THE AGE OF LIBEL.

"Discit enim citius meminitque libentius illud, "Quod quis deridet, quam quod probat." Horat. It is not a little remarkable, that the last four years have given origin to more libels in the medical press, and more law-suits in consequence thereof, than the whole pe riod of 60 years that preceded-namely, since the first introduction of medical periodical literature into this country! It is not our intention to trace the remote, the predisposing, or the proximate causes of this phenomenon. The fact is certain, that a kind of fermentation took place about the period in question, in the body politic of medicine, producing such intestine commotion, such warring of elements, such evolution of mephitic gases, as threatened a dissolution of all those bonds that held medical society together! We do not quite agree with those who attribute all this explosion of the worst passions of our nature to a single cause, or to a single individual. Deep and unseen operations are long going on in the bowels of the earth, before the dread convulsion rends the solid rock, opens the yawning chasm, and swallows the crashing city, with all its terror-stricken inhabitants. The fiery elements are long preparing for the conflict, before Etna's crater vomits forth the cloud of flame, or flood of boiling lava. In the treacherous calm, the quiescent atmosphere of the Antilles, when all Nature seems drooping into languid and safe repose-when not a vibration is perceptible in the leaves of the forest, nor a ripple on the bosom of the deep, the dread machinery of the TORNADO is in full play, unseen by human eye, unheard by human ear, until the very moment when the aerial torrent rushes from its hidden source, and sweeps into ruin every production of nature or art on the surface of earth and ocean. It is the same with the moral as

with the physical world. The seeds of discord and disaffection must long be sown in the minds of men, before the political incendiary can light the torch of civil war.

But to come nearer our subject. The distracted state of the profession-the unnatural division of its members into so many motley castes-its tri-corporate governance, if that be government where Jaws exist without power or will to enforce them, and powers are exercised without reason to sanction them-the abuses which crept into public institutions, if in

stitutions can be called public, which are not seldom worked by a secret junto, and sometimes converted to private emolument--institutions where the price of admission is not always the possession of talent, and where, according to the genius of our country, MERIT has a double meaning, viz. patronage, or wealth-but above all, ciety itself, split into three parties, where the divisions and jealousies of medical soit should be one and indivisible," (as far as its education and government are concerned)-without a HEAD to direct its energies-without a sympathies--without a soul to unite its interests these, and many other causes conspired to produce an æra that was singularly favourable to the evolution of all the angry passions of our nature, by the exposure of serious, the exaggeration of trivial, and the fabrication of imaginary grievances. But such exposures, exagge rations, and fabrications would have been deprived of more than half their zest. had and wafted on the pinions of ridicule :— they not been engrafted on personal satire,

HEART to cherish its

"There is a lust in man no power can tame, "Of loudly publishing his neighbour's shame; "On eagle's wings immortal scandals fly, "Whilst virtuous actions are but born, and die."

As hardly one in one hundred of the medical, or of any other profession, ever becomes conspicuous, whether by virtues or vices-talents or demerits; so, it requires but little insight into human nature to know, that, whoever can stigmatize, with any tolerable talent, these prominent characters, will offer a delectable treat to the "envy, hatred, and malice," of ninetynine" in the hundred. This is a law of human nature, which, no doubt, has some ultimate wise end or object-though, it is not very easy to find it out! He, however, who possesses a certain degree of callosity of nerve, and recklessness of future consequences, may turn this failing of mankind to some account! Those who consider themselves secure, enjoy the storm by which their neighbours are shipwrecked!

"Suave mari magno, turbantibus Equora ventis, "E terra magnum alterius spectare laborem."

That the LANCET (We speak merely of the Journal, without reference to the secret or ostensible writers in it) did avail itself, without scruple, of the public appetite for scandal, and supply the demand to an amount hitherto unexampled in medical literature, no one will be hardy enough to deny. Personal satire (would

that we were unauthorised to term it defamation) became the order of the day; and the age of LIBEL commenced-an IRON AGE, that will form no gratifying epoch in the history of British medicine! That resistance and re-action should be called forth, is not to be wondered at; and that many who were disinclined to conflicts in the war of words, should have been drawn into the vortex, from feelings of resentment, or for the purpose of self-defence, might be easily proved. We do not urge it as any extenuation of our own sins of commission, that men of the most peaceable dispositions, may be induced, by the irritation of the moment, to use libellous language, which, without such irritation, they would never think of employing. But this is a very different thing from the new system of literary warfare, in which the provocation and the libel are fired from the same cannon-and that indiscriminately, at every prominent object, save and except a small coterie of favoured individuals, who are always exempted from the failings of humanity! If retaliation is attempted, the LAW is instantly flown to by the LIBELLER-but if the law be invoked to shield the libelled individual, the injury is aggravated by the plea of justification; or, should that be impracticable, by the denouncement of unceasing persecution for daring to resist! Such a system of literary despotism, cruelty, and proscription, was never before witnessed in any age, or in any country! The GOOD which it effects, is no counter-balance to the heartless profligacy-the dereliction of all generous principle-the estrangement of every social feeling-the annihilation of all friendly confidence, which inevitably result among the members of the profession itself. -To which ought to be added, the degradation and contempt into which medical society must fall in the eyes of the world at large, by the perpetual exposure of these calumnious combats among its members.-Should such a system continue for a few years longer (which we hope will not be the case) it is impossible not to foresee, that the profession will be deprived of all respectability, and deserted by all respectable people.

We have been led into the foregoing reflections, by a transaction which has occurred and been judicially disposed of within the year just closed; but which will be referred to by succeeding generations, with mingled sensations of horror, and we hope of pridehorror at the brutality of the times in which we live--pride, that such an iron-age has passed away!

"Quid nos dura refugimus "Etas? Quid intactum nefasti "Reliquimus? Hor.

One

A young gentleman has the misfortune to be the Nephew of one of the greatest surgeons of Europe-to be educated in the best possible manner-to spend many years in the Hospital, so long the theatre of his Uncle's fame-to become a teacher of anatomy, an expert operator, and, in due time, and not before the mature age of 30 years, to be appointed one of the surgeons of the said hospital. In short, there is but one thing against him-he has given offence to the editor, or sub-editor of a medical journal, and consequently, to all the editor's hirelings. of these hirelings has long attended the operations of the surgeon, and long witnessed his adroitness and surgical knowledge. But these are either passed over, or faintly noticed. At length, one of those untoward occurrences, which, in the dark and difficult operation of lithotomy, have happened in all ages, and baffled the dexterity of the boldest surgeons that ever took gorget in hand-an occurrence that kept John Hunter an hour and a quarter in greater agonies than was his patient on the table-one of these untoward occurrences, we say, which no penetration could foresee, no dexterity avert-befel the junior surgeon, and protracted a case of lithotomy to 50 minutes duration. Every spectator who had one drop of the milk of human kindness in his composition-whose heart had not, by some strange mistake of nature, been cast in the mould of the hyena, instead of that of man -whose soul the beams of heavenly mercy, or even human philanthropy had ever warmed, would have sympathised with the operator, whose feelings might have been overpowered, whose nerves might have become unstrung, whose hand might have become tremulous-or, whose judgment might have become obscured.

But what was the conduct of some halfdozen of marble-hearted, or rather heartless spectators, on this occasion? To deny the difficulties of this operation-to distort the efforts made to overcome them-to exaggerate the sufferings of the patient-to malign the expressions, and oppugn the procedure of the operator!

We drop the pen, ashamed (for the first time) of that profession to which we have been attached-ardently attached, for nearly half a century! The following trial will contrast the refulgent and dark portions of the medical character, in this country;-and will tell to foreign nations, that we are, indeed, that strange medley, of which we used to upbraid our neighbours, the FRENCH:a mixture of the tiger and monkey--with, thank God, some remains of the generous and noble LION!

COOPER v. WAKLEY.

This cause, which was specially appointed for this morning (Dec. 12,) excited the most intense interest. Long before the sitting of the Court, at half-past nine o'clock, the different avenues leading into the court were so crowded, that there was scarely any possibility of forcing a passage. It was with the utmost difficulty, with the most active assistance of constables and the officers of the court, that counsel, jury, and witnesses could obtain an entrance. Almost every hospital surgeon and eminent practitioner in London was present, besides an immense number of students.

After

At half-past nine o'clock the defendant appeared in person on the floor of the court. Mr. Brougham and Mr. Kelly, his counsel, were also present. Sir James Scarlett, Mr. F. Pollock, Mr. Scarlett, and Mr. Platt, were counsel for the plaintiff. Only six special jurymen answered to their names. some hesitation Sir James Scarlett prayed a tales. The talesmen were then called into the box, but before they were all sworn, three of the special jurymen, who had been previously called and did not answer, made their appearance and were sworn. Three talesmen were then added to the jury, and, after several of the special jurymen had been fined for non-attendance, the jury were sworn.

On the bench we noticed Sir Astley Cooper, (the uncle of the plaintiff,) Mr. Brodie, and Mr. Green. Dr. Roget sat to the left of Sir James Scarlett, within the bar.

The defendant, on coming into Court, brought with him a cast of a man in the position in which a patient is tied, when undergoing the operation of lithotomy. He had also a pelvis and case of instruments, such as were used on the occasion. He applied to Lord Tenterden to be accommodated with a table; but his Lordship stated, that in consequence of the pressure at the doors, it was impossible for him to have his wish complied with at present. A table was afterwards brought in.

Mr. SCARLETT opened the pleadings. The declaration charged the defendant with having published a certain false, scandalous, and malicious libel, imputing to the plaintiff, Mr. Bransby Cooper, the unskilful performance of an operation of lithotomy, which took place at Guy's Hospital in March last. The defendant had pleaded several special pleas of justification, setting forth the matter charged as libellous, and averring that the whole of it was true.

The alleged libel was contained in Nos. 239 and 240 of a weekly publication called the Lancet, and was in the following words:-

"We should be guilty of injustice towards the singularly-gifted operator, as well as to our numerous readers, if we were to omit a full, true, and particular account' of this case. It will, doubtless, be useful to the country draff' to learn how things are managed by one of the privileged order-a hospital surgeon-nephew and surgeon, and surgeon because he is 'nephew.'

"The performance of this tragedy was nearly as follows:

"Act 1. The patient.† a labouring man from the county of Sussex, thick set. ruddy and healthy in appearance, and 53 years of age, was placed on the operating table, at a few minutes past one o'clock, on Tuesday the 13th. The only one of the surgical staff present, besides the operator, was Mr. Callaway. The ceremony of binding the patient we need not detail; the straight staff was introduced, and was held by Mr. Callaway. The first incision, through the integuments, appeared to be freely and fairly made; and, after a little dissection, the point of the knife was fixed (apparently) in the groove of the staff, which was now taken hold of, and the knife carried onwards-somewhere. A small quantity of fluid followed the withdrawal of the knife; the forceps were now handed over, and for some time attempted to be introduced, but without effect. I must enlarge the opening,' said the operator, 'give me my uncle's knife;' this instrument was given, and a cut was made with it, without the staff being re-introduced. The forceps were again used, but as unsuccessfully as before; they were pushed onwards to a considerable distance, and with no small degree of force. Its a very deep perineum,' exclaimed the operator. I can't reach the bladder with my finger.'

Act 2. The staff re-introduced, and a cutting gorget passed along it-various forceps employed: a blunt gorget-a scoop-sounds and stays introduced at the opening in the perineum I really can't conceive the difficulty-Hush! Hush! Don't you hear the stone!'- Dodd, (turning to the DeGive me monstrator,) have you a long finger?

another instrument-Now 1 have it! Good God! I can hear the stone when I pass the souud from the opening, but the forceps won't touch it-O dear! O dear!

"Such were the hurried exclamations of the operator. Every now and then there was a cry of Hush! which was succeeded by the stillness of death, broken only by the horrible squash, squash. of the forceps in the perineum. Oh! let it gopray let it keep in,' was the constant cry of the poor man.

"This act lasted upwards of half an hour; the former upwards of 20 minutes. The stone was eventually laid hold of, and never shall we forget the triumphant manner in which the Assistant Surgeon raised his arm and flourished the forceps over his head, with the stone in their grasp. The oper

rator turned to the students and said, I really can't conceive the cause of the difficulty.' The patient being upon the table, bound, while the operator was explaining.

"The man was put to bed much exhausted, but rallied a few hours afterwards, and leeches were applied, in consequence of tenderness of the abdomen. He passed a restless night, was in great pain, and was bled from the arm on the following morning. Leeches were applied in the afternoon, and about seven o'clock in the evening, death ended the poor fellow's sufferings, about 29 hours after the operation

"EXAMINATION OF THE BODY. "There was a very large and sloughy wound observable in the perineum, and the scrotum was exceedingly dark coloured, from ecchymosis. The finger could be passed to the prostate without difficulty, which was not deeply situate; indeed, it was the declared opinion of Dr. Hodgkin and Mr. Key, that the man had not a deep perineum.' The celJular issue throughout the pelvis was easily lacerable, and this was especially the case with the portion between the bladder and the rectum, admitting of the passage of the Singer with great facility, and to a considerable distance. There was a tolerably fair lateral section of the prostate and neck of the bladder The giand itself was larger than natural, and the por ion which is designated the third lobe, presented a singular appearance, being of the size of the tip of the little finger, and forming a kind of valve at the neck of the bladder; part of this third lobe had a dark-coloured appearance, and it seemed as if some substance had been resting upon it. The bladder itself presented nothing remarkable.

The peritoneum lining he abdominal parietes was highly vascular, and there was a slight quantity of turbid serum in the cavity of the abdomen. The kidneys had a mottied appearance throughout their cortical substance.

There are two or three points in this case to which we beg particular attention; first, the statement of Mr. B. Cooper, at the time of the operation, that he could not reach the bladder with his finger,' as contrasted with the fact of the bladder being very readily reached in the post-mortem examination; the man not having a deep perineum. Secondly, the circumstance of the finger passing with facility, between the bladder and rectum to a great depth, as considered in connexion with another declaration of Mr. Cooper, that he could not feel the stone with the forceps, until the time of its extraction, although a sound, passed into the bladder downwards, from the penis, struck upon the stone; as was the case also, on one or two occasions, when a staff was passed at the perineal opening.

"The surface of the calculus was rather larger than the disc of a shilling, flat, oval-shaped, and apparently consisting of lithic acid."

A long discussion arose, as to which party was to open the case; Sir James Scarlett contending that as some of the affirmative issues, were thrown on the plaintiff, who was to prove his own skill, he had a right to begin; and the defendant, on the other hand, insisting that as he had charged the plaintiff with unskilfulness, and was to prove the truth of his pleas, he ought to proceed with his case before that of the plaintiff's was gone into. In support of his argument,

which was of some length, he cited various authorities.

Lord TENTERDEN observed, that as the decision in this case might be quoted hereafter

as a precedent, he would take the opinion of his learned brothers who were sitting in the Bail Court upon the question. His Lordship then retired, and on his return in about five minutes, stated his opinion to be (in which the other judges concurred) that the defendant had a right to begin. The plaintiff, as a surgeon, was to be supposed to be a skilful person until the contrary were shown, and therefore there was no necessity for him in the first instance to go into evidence to establish that fact; and as the defendant had pleaded the truth of the matter which imputed unskilfulness to the plaintiff, it was incumbent on him, in the outset, to prove the truth of his allegations.

Sir J. SCARLETT trusted, as that was the decision of the Court, that whatever the termination of this case might be, he should be at liberty to examine the plaintiff's witnesses. It might happen that the defendant's case would fall to pieces, and then he (Sir J. Scarlett) should insist that his evidence ought to be heard for the purpose of proving that the operation had been performed with the utmost skill. He should ask, on behalf of the plaintiff, a gentleman of high honour, and who was greatly esteemed, both in and out of his profession, that he might have an opportunity of showing that the calumny which had been attempted to be fastened upon him was without foundation. He mentioned this now, in order that, in the event of the defendant failing to prove the whole of his pleas of justification, it might not be said that the plaintiff had no right to go into evidence in vindication of his professional character.

Lord TENTERDEN did not think it necessary for him to give an opinion upon that point at present.

The defendant then suggested that the witnesses on both sides should withdraw.

Sir J. SCARLETT had no objection to the withdrawal of those witnesses who spoke to facts, but those who were to give opinions he considered it essential and necessary that they should remain in court.

The defendant said, as he could not at that moment make a separation of the witnesses who were to speak to facts, and those who were to give opinions, he would not insist on the withdrawal of any of them. They might remain, if the Court pleased.

The defendant then addressed the jury. They had already heard from the learned gentleman who had opened the pleadings, that this was an action instituted against him (the defendant,) the editor and proprietor of the Lancet, for an alleged libel of and upon the professional character of the plaintiff. It was stated in the declaration that he had

published a report of a "supposed" operation at Guy's Hospital, falsely and maliciously, and it was inferred from the declaration that no such operation was performed in that institution; and that what he had published was nothing more nor less than gross calumny. Guy's Hospital, as the jury must be aware, was an institution of very great importance, not only as an institution of charity, but one from which it was expected that there should emanate the first principles of his (the defendant's) profession, practised in the very first and best manner. It had attached to it an extensive medical school. It had lectures there, and a very large attendance of students. The practice which the students witnessed in the institution was necessarily carried by them to the most distant parts of the kingdom. Hence it was of the utmost importance to the public welfare that the practice there inculcated should be calculated to promote the interests of the public, and alleviate, as far as it was possible, the sufferings and miseries of mankind. Guy's Hospital was founded solely by one individual, Thomas Guy, in the year 1722 or 1724, and he at that period left to the Institution a sum equivalent to 200,000l. consequently the funds of the Institution, from the increase that had taken place in point of value, were immense. Of course it became of great consequence that these funds should be appropriated in the best mannerthat individuals of the greatest possible skill should be elected to fill its situations, both medical and surgical, and it was not fair that those offices should be filled in any other manner than what was consonant with the intention of the founder and would be of the greatest benefit to the public. The plaintiff, Mr. Bransby Cooper, was one of the persons who had been elected to fill the office of surgeon, and in the duties of his situation he performed the operation which was published in No. 339 of the Lancet. That journal was projected by him (the defendant,) and was first published in 1823. He considered that by publishing the lectures delivered in public institutions, he should be able to place in contrast the theories of the different individuals in the lecture-room, and the practice in the wards of the hospital; and this he thought was of immense importance, for, by so doing, the lecturers were stimulated to a greater exercise of their duty, as their opinions were laid before the public, who had an opportunity of seeing what those opinions were, and, at the same time, of seeing whether the practice used in the wards was a practice of neglect or attention. The publication of lectures had led to a good deal of discussion in the courts of law. The publication of hospital reports had led to

great benefits, as regarded the public, who had thus the advantages of the opinions of hospital surgeons; and they had to endure the scrutiny of the public, and could not hack and halve the individuals with impunity. He was of course under the necessity of employing a great number of reporters, who were in the practice of taking notes of the cases admitted, and carefully registering all the points connected with them. The reporters he had employed, as far as he had been capable of judging, were men of the most honourable character, and had fulfilled their duty in a very accurate and conscientious manner. The reports furnished by them he was of course compelled to rely on, as all editors were, for their correctness. They were transmitted to him regularly from the various institutions. The report of this operation was sent to him by a gentleman of very high character, a gentleman whom he should call into the witness-box to-day, and who would himself state that he witnessed this operation, and that the report which he furnished was in every respect correct. He (the defendant) would assert this openly before the Court, and he challenged every inquiry-every strict and scrutinizing investigation-into the reporter's character. He had heard, indeed, that attempts would be made to cast some imputation upon the young man, but he defied calumny, and courted scrutiny. When the report was transmitted, as he found it one of an extraordinary character, and as it referred to circumstances of a still more extraordinary character, he paused before he inserted it. He did not publish it in the first number of the Lancet which appeared after it occurred, but waited till the period of publishing a second one arrived. When the report was first brought to him, it contained some statements against the operator rather harsher than those which it now contained. The reporter considered it his duty to characterize such an operation by the strongest terms of reproach; and he stated, on his honour, before the report was published, that it was correct in every particular. Upon that assurance, therefore, he (the defendant) considered that he had no other course to pursue in his public character than to present it to the public, whatever the consequences might be. Having made a few alterations in it with regard to the expressions he had mentioned, and introduced the phrases, "nephew and surgeon, and surgeon because he is nephew," he inserted it word for word as he had received it. He should prove these facts, and had little fear of his case "falling to pieces," as his learned opponent had stated. He believed the learned gentleman would have ample reason for producing all his witnesses,