which has disgraced our age and country, when the venerable BABINGTON left a sick bed to raise his voice against the said system? To those well-intentioned friends who think we ought not to sully our pages with the mention of the Lancet and its advocates, the Wakleys, Lamberts, and Haslams of the day, we recommend a perusal of the epigraph which we have affixed to this article. We believe, however, that there is now but little need of our assistance. The professional spirit and good sense of Englishmen, when once roused, require no fuel to support the flame, and we shall now probably take leave of the LANCET FOR EVER!

A review of our whole conduct, during a five years' contest with the organ of professional defamation, harrows not up a single unpleasant reflection. We denounced it in its progress-we defied it in its zenith-but we shall spare it in its FALL.

XVII.

MEDICAL JUSTICE AND LIBERALITY-NEW

PATHOLOGICAL PHENOMENON.

The spirit of the FREE PRESS has now given ample proofs of its existence in every direction-and liberalism, as it is miscalled, shews itselfin its true colours-freedom from every sentiment of truth, candour, or justice! These remarks will be amply illustrated by a late Coroner's inquest on two children who died of scarlatina, in the parish of St. James's, Westminster. They had been attended by Mr. Davis, of King Street, St. James's, and Mr. Duchez, of Air Street, Piccadilly. The latter gentleman served his apprenticeship with Mr. Alcock, and had, in the parish work-house, a long and extensive opportunity of seeing and treating both measles and scarlatina. On these complaints he read a very able paper in the Westminster Medical Society, during the present session. Merriman was ultimately called in, in the cases under consideration, and approved of the treatment pursued by Mr. Duchez and Mr. Davis. But, from what cause we shall not pretend to say, the parents of the children were excited against the two first medical attendants, and Mr. Healey, Mr. Tuson, and Mr. Dermott, were requested to examine the bodies of the children anatomically,

Dr.

in order to ascertain whether proper medicines had been administered! "The opinons of these gentlemen were, that, had proper remedies been applied, the lives of these these children might have been saved." [Times Newspaper, 27th Dec.] Dr. Merriman, who saw the children during lifewho had communication with Mr. Duchez, and consequently who was made acquainted with the treatment-did not object to the means employed-and did not consider that the children died of improper treatment.

Now we call upon the anatomical investigators, in this case, to inform their brethren by what means, and upon what pathological principle, they were able to ascertain that, had improper remedies been employed, these children would not have died of scarlatina. What will foreign nations say to the medical profession of this country, when they see such monstrous instances of absurdity and cruelty proceed from surgeons when employed in the solemn act of juridical investigation! If the report in the TIMES be correct, then we say that it is absolutely impossible for the anatomical witnesses to support or to excuse the illiberality-not to say injustice of their report. Was there ever such an idea broached before, as that the scalpel will detect the non-application of proper medicines!!! If indeed Mr. Dùchez had administered a dose of arsenic and poisoned the little patients, at once, then anatomy and chemistry might have proved that improper medicines had been given by which the children came by their death. But for anatomy to be appealed to, for the purpose of proving that proper medicines had not been administered, and that had they been exhibited, life would have been saved, exceeds all credibility, and can only be explained by the dreadful state of public and private feeling universally diffused among the members of a once liberal and respectable profession!

Were

Surely these transactions will open the eyes of the three corporate bodies, and induce them to unite in an application to parliament for one strong and uniform system of government in medical society. there such a head, with legal powers to enforce proper regulations, and punish by expulsion, those who broke the laws of decorum and medical ethics, the profession would soon assume a new and a better aspect. Till such a measure is adopted-till such powers are sought, obtained, and exercised, the spirit of illiberality and sensoriousness, will, we fear, continue-and the medical profession, in this country, will be an object of wonder over every civilized nation on earth.

P. S. We have been informed by a friend, after the above was written, that Mr. Dermott publicly declared that he had signed the anatomical report without reading it; and that he disapproved of the said report, when his attention was called to the illiberal and unjust principles involved in it. If this be the case, Mr. Dermott should show who was the framer of the report, in order that professional indignation may be directed towards him. This inquest may teach Mr. Dermott a lesson, not to affix his signature again to any document teuding to calumniate a brother-practitioner, without being very sure of the grounds on which the document is framed. This negligence, in itself, is highly censurable.

XVIII.

PROFESSIONAL OR UNPROFESSIONAL? THAT IS THE QUESTION!

RE

[Mr. Wakley's Report of the Trial.] Mr. Lambert has been turned out of two Societies for an "UNPROFESSIONAL PORT," and we are now to call the attention of our surgical brethren to a REPORT by Mr. Lambert's Master-the "REPORT of the TRIAL Mr. Wakley is constantly calling upon the SURGEONS, and especially the GENERAL PRACTITIONERS of England, to rally round his standard, as their leader and representative in the "ENSUING AUTUMN. Now we request that they will carefully inspect the FRONTISPIECE and plates of the REPORT in question, for there they will see, veluti in speculo, an emanation from the great mind of their self-appointed leader and teacher. A human figure (which Wakley could never have seen) with agonised features and manacled limbs-with a gash, (or rather gulf) reaching from near the pubes to the os coccygis, and measuring in length the distance between the sternum and chin, while the neck is on the stretch!!—such a figure is presented to the SURGEONS and GENERAL PRACTITIONERS of England, to teach them how to operate for lithotomy!! In compliment to the learning of his surgical readers, Mr. Wakley has prefixed a glossary to his work, in which, among many other highly important pieces of intelligence, he gives them to know that-the abdomen" means the "belly,'-that calculus signifies" the stone found in the bladder;" (of course it is not a calculus till it is found there)-that integuments mean skin-that the subclavian artery is

"a vessel which passes under the collarbone"-that the "urethra is the canal through which the urine escapes from the bladder"-and to crown the monument of surgical literature, that "the umbilicus is the navel." Mr. Wakley seems to have been taken with a fit of unbounded generosity towards his surgical readers. He has gone to the expense of lithographing a whole ARMAMENTUM LITHOTOMICUM, by means of which the country-surgeons will be able to learn the names of nine instruments employed in cutting for the stone. To each figure the name of the instrument is affixed, and in order to impress these names on his readers' memories, they are again given in a distinct list. Now, if this profusion of information poured out upon the surgical profession for the trifling sum of four shillings. does not bind them in chains of gratitude to the HERO of REFORM," we know not what will!

66

But we must be serious upon this point. We appeal to every surgeon in England, who takes the trouble to examine Mr. Wakley's book, whether it is not even more UNPROFESSIONAL" than the "Report" for which Lambert has been degraded. It is evidently designed, not to convey any surgical information to his brethren; but to create a horror of surgery among the vulgar. To exhibit a cast of the unfortunate patient in a Court of Justice was bad enough. To expose such a figure as that which graces the Report, to the idle gaze of the millions who pass along the Strand, is the most disgraceful act (professionally speaking) that ever surgeon did! We ask Mr. Wakley-we ask his medical brethren, if this be an honourable, manly, and surgeon-like mode of vindicating his own conduct, and impugning that of Mr. Cooper, or is it a mean, dastardly, vindictive, and coarse device, calculated to excite the angry feelings of the ignorant mob against a brother-practitioner? Let Mr. W.-let the profession itself answer these questions!! Human ingenuity never devised a procedure better adapted to engender disgust against the whole profession of surgery, and horrify the non-professional public than that which is adopted in this REPORT, and practically enforced at 210, in the Strand. If Mr. Wakley or his adherents believe that they can throw odium on part of the profession, without injuring the whole, they allow their passions to obscure their reaIf a publication were to start in the law, for the purpose of representing the judges and barristers as a set of knaves,

son.

and argued that, by so doing, it would induce a belief that all attornies were honest men, what would be thought of the intellects of the editor? Yet such precisely are the tactics of Mr. Wakley and his associates. By representing HOSPITAL SURGEONS as ignorant and clumsy, the public, he tells us, must naturally draw the inference that all other surgeons are learned and dexterous-Q. E. D!! If the Brodies, the Guthries, the Bells, the Coopers, the Travers, and the Stanleys, who have a wide range of hospital experience for their assistance, be incapable of conducting capital operations, it follows, from Mr. Wakley's logic, that the Lamberts, the Lees, the Clapham's and the Gilberts, are the men to whom the public are to look for high operative surgery! Would any other than Wakley draw this conclusion, unless he were an inmate of Bedlam, or had recently made his escape thence?

If Mr. Wakley were as busily engaged in practising his profession, as in traducing its most distinguished members, he would long since have learnt that the greatest difficulty which medical men encounter in their intercourse with the public, is this very distrust (unjust and ungenerous as it is) of their exertions, which he labours, day and night, to augment. Practitioners know, to their sorrow, that whenever a case goes not on smoothly, quickly, and favourably, (cito, tute, ac jucunde,) the patient begins to suspect the skill of the medical attendant; and, not unfrequently casts reflections on his professional character! We ask the surgeon or the physician (for we need not ask Mr. Wakley, who seems to know or care nothing about the matter) whether this district of the private practitioner's knowledge is to be lessened by representing almost the whole of the heads of the profession as stupid, ignorant, and knavish? The answer is obvious. The distrust would be increased tenfold, if such a preposterous belief could be generally infused into the minds of the public. We fearlessly maintain, then, that Mr. Wakley's writings are not merely unprofessional, but that they are ANTI-PROFESSIONAL, and tend, in every way, to depress the whole medical character of the country. As to the FRONTISPIECE to the "REPORT of the TRIAL," we solemnly and publicly denounce it as a disgrace to the age in which we live-as a stigma on the science we profess-as a blot on the surgical annals of the country which gave it birth! The frontispiece in, and the canvas placard over, the shop-window of Mr. Wakley, may make the ignorant stare, but cannot

fail to make the sensible grieve! They afford, at once, the signal and the proof that he has ceased to appeal to the PROFESSION-not indeed before it has begun to turn a deaf ear to him-and has addressed himself to the mob, whose passions and prejudices he may yet turn to some account. His lithographs and paragraphs may pass among the vulgar for SURGERY, but they must be considered as VULGARITY among surgeons.

XIX.

SURGICAL REFORM.

When the last sheet of our last number was actually passing through the press, we saw the account of the meeting, at the Freemasons' Tavern, of certain SURGICAL REFORMERS, with the curious string of resolutions then passed. One of the resolutions was moved by Mr. Hensley, and at the moment of reading the account in the newspapers, we thought we recollected a name somewhat similar over the door of a chemist's shop in the neighbourhood of the Yorkshire Stingo, and we had not time to make the necessary inquiry. By this mistake, we became the unintentional means of drawing odium, or the suspicion of it, on M. HENSLEIGH, a most respectable surgeon, residing in Gloucester Place, New Road. This gentleman did not attend the said meeting, and he therefore wrote us a very indignant letter, in contradiction to our statement concerning him, for insertion in our next number. Having learnt from Mr. Craddock that we were in error respecting Mr. Hensleigh, we dispatched a letter to that gentleman apologising for the allusion to his name, and assuring him that we would correct the mistake through the most public channels. This letter having been received by Mr. Hensleigh, while his own was in transitu to us, changed the whole affair, and convinced him that the error was quite unintentional on our part. The insertion of Mr. Hensleigh's letter then became unnecessary, and we take this opportunity of freeing Mr. H. from all odium attached to the supposed attendance at the above-mentioned meeting, as well as to express our regret at the mode in which the allusion to his name was made in our own columns.

We have been requested by Mr. HENSLEY of Great James Street, Bedford Row, to state that he was not the individual who moved the resolution! In all probability the name was fictitious.

XX.

ON THE SIGNS OF PULMONARY TUBER

CLES.

One of the best, if not the very best papers in the first Number of the "MIDLAND REPORTER," bears the above titleand is professed to be by one of the Editors. It bears intrinsic marks of its pa. rent, who has turned out to be Dr. Hastings. After some appropriate introductory remarks, the author lays before us the old method of diagnosis, as applied to tubercular consumption, by the heads of our profession, in order to prove that the said methods were inadequate, and inferior to those which modern investigation has brought to light.

"OLD METHOD OF DIAGNOSIS.

"Tuberculous Consumption has always been considered a very insidious disease, and often makes considerable progress before any important affection is supposed to exist. The cough, at the commencement, is hardly so considerable as to claim notice; while the extenuated habit and loss of strength, with which it is attended, are often ascribed to other causes. But there is always some presumption that these are the incipient state of the Tuberculous Phthisis, when they take place between the age of fifteen and twenty-five, and are found to continue for some time, notwithstanding the use of those means which are in general successful in Catarrh. But the symptoms mentioned above, always give strong suspicion of Tuberculous Phthisis, when they occur with those who are of that fair complexion and delicate make, which is very common with such as are of a scrofulous constitution.

"There is also reason for suspecting Tuberculous Phthisis, where the symptoms above-mentioned have begun without any obvious exciting cause; such as injuries to the breast; where the pain, when it does take place, is not fixed to any particular spot; when dyspnoea does not occur, or, if occurring, is only distressing upon motion of, or any considerable exertion on the part of, the patient.

"But above all marks, the Tuberculous Phthisis is characterized by the peculiarity of the cough, which takes place both at its commencement and during its course.

The cough which attends the Tuberculous, is, as has already been said, of the short tickling kind, denominated a Tussicula. For a long time it seems to proceed from some accidental irritation, and is at tended either with no expectoration, or merely with the expectoration of a small quantity of mucus Where a more copious expectoration does happen, it is neither viscid mucus, nor purulent matter mixed with mucus. The matter expectorated is often clear and limpid, with a reddish tint; and is rather a bloody sanies than even ill-conditioned pus."

Such are the rules laid down by the late Dr. Duncan, who has been far more precise and correct than any of our countrymen on this point. Yet every physician must be well aware how very fre quently the whole of the foregoing signs are absent, with the exception of emaciation. The first of the following cases, which we shall much abridge, will be found interesting in several points of view, besides affording an illustration of the remark just made.

Case 1. W. M. aged 24 years, of pale complexion, was received into the WORCESTER INFIRMARY, on the 22d May, 1819. Complained of faintness, difficulty of breathing on making any exertion, giddiness, but very little cough. He had no expectoration-Pulse 106, and weaktongue clean-bowels costive-considerable emaciation. Had been ill 13 weeks. The disease commenced with sickness and vomiting, which continued more or less up to the time of admission. Blister to the epigastrium-saline aperients. During the next six days he rather improved; but the sickness and vomiting continued. This last affection remained obstinate till bis death and he never exhibited any symptom of hectic fever till the last.

"Dissection.-The Membrane lining, the healthy. There was no fluid effused in the Epiglottis, Larynx, and Trachea, was quite

Bronchial Cells, and the Mucous Membrane lining them, had a perfectly natural appearance. The pleura, covering the superior Lobe of each Lung, was adhering to the Costal Pleura, but in every other part of the Thorax, this Membrane was healthy; the adhesions were evidently not of recent formation The Parenchymatous structure of the Lungs was much