243MEDICAL JURISPRUDENCE.-HYDROPATHIC QUACKERY.

"bined with sufficient opportunities of obtaining knowledge, tomake an accomplished physician or surgeon, fitted for the" higher duties of the profession. The loss we have sustained

" will not be easily supplied, either to the profession or to the" public." ,

Every one who had the pleasure of knowing the late Mr.ASTON KEY will join in this; and the remarks on the differ-ences, referred to with so much clearness, between medicaland surgical talents, and the talents of the bar and the senate,suggest some very painful reflections. Amongst the losses tothe profession by the death of eminent surgeons in this me-tropolis, within a comparatively short period, we have had torecord those of Liston, Samuel Cooper, Callaway,White, Mor-gan, Andrews-and now of ASTON KEY! This list, indeed,makes a very great hiatus in the present generation of maturesurgeons of the first rank.

Medical Jurisprudence.HYDROPATHIC QUACKERY. — ALLEGED DEATHFROM THE IMPRUDENT APPLICATION OF COLD

WATER.—INQUEST AND VERDICT.(FROM A CORRESPONDENT.)

ON Tuesday, the 19th of June last, an inquest was held onthe body of Dinah Toothill, at the Angel Inn, Keighley, be-fore TROMM; BROwN, Esq., Coroner. The first witness ex-amined was WILLIAM TOTHILL, husband of the deceased. Onbeing sworn, he said, " I am a woolcomber; the deceased DinahToothill, was my wife; she was twenty-four years of age; wehave been married about four years. A fortnight since, shewas so unwell as to leave off her work as a factory weaver,and from that time she has been confined to the house fromillness. On the Monday morning I went for a man calledPaul Sugden, who, about a year before, attended her when shewas ill, and we thought did her some good; he came to seeher soon afterwards; it was before breakfast time. I said tohim that I thought it was a similar illness to that she hadwhen he saw her before. After examining her, he said shehad got the typhus fever. She was then in bed. He orderedher to be laid in wet sheets, and he assisted in taking fromher bed a cotton sheet, which covered her, and he wetted itin a pail or bowl of water, and then wrapped it round her, andput two blankets round her on the top of the wet sheet. Inthis situation she lay in bed an hour or two; he then told herto get up out of the bed, and walk about. She got up anddressed herself, and he told her to walk out in the road. Shewalked out beyond the toll-bar, on the Halifax-road, (nearlyhalf a mile,) called on the way at a friend’s house, and gother tea; she did not return till near dark. I was presentwhen she went out, and I saw her return. In a short timeafter her return, Paul Sugden came; my wife was seated bythe fire; he told her she must go to bed; he had his own sheetwith him this time, and before she went to bed, he wetted itin a bowl of water, and then spread it on the bed, directedher to lay down upon it, and wrapped it close round her, andtwo blankets over it. She remained wrapped up for abouthalf an hour. He remained in the house all the time,and at intervals, directed her to drink cold water, which shedid. He felt at her now and then to see if she was sweating,but she did not sweat at all. At the end of the half hour, hetook off the blankets and sheets, and she stood naked on thefloor, and he directed her to be washed with cold water.He threw a fresh wetted sheet over her, and then he rubbedher back, and I rubbed her before, until she was quite dry.She then went to bed by his orders in dry blankets; he thenwent away, leaving orders that if she got too hot in the night, II was to pour cold water upon her head. In the course of thenight, she was worse, and very hot, so that twice I pouredwater on her head. On Tuesday morning, Sugden came to seeher between six and seven o’clock; he again put her through Ithe wet sheets, and afterwards washed her down and rubbed iher dry. At noon he came again, and she was got up from Iher bed, sheeted, washed down, and rubbed dry as before. IAt about four or five o’clock he came again, and she wassheeted, washed down, and rubbed dry, and put to bed. Be-tween seven and eight o’clock, she underwent the same treat-

ment, the sheets this time being continued for an - hour.During the night, according to the directions he had given, Ipoured water on her head twice. The sheeting, washing, andrubbing were continued daily until Tuesday last, at noon, ex-cept that on Sunday, and after, he used water rather warm.Sugden attended daily, and directed the proceedings. Mywife grew weaker and weaker, and refused to submit to histreatment any longer. I then called in Mr. Milligan, surgeon,who continued to attend her until she died, on Sunday fore-noon. On the Sunday before Sugden was dismissed, he broughtwith him a man named Turner to see her, who directed warminstead of cold water to be used, and a bandage round her-body. On the Monday after, Sugden put my wife into what hecalled a sitz bath; the water was in a tub and slightly warm;she remained in it about a quarter of an hour. On the Sun-day after Turner had gone, he administered to my wife twoclysters of water rather warm; her bowels were confined at:’the time. On Monday, I saw marks upon the sheets indicating-that my wife was the subject of her monthly indisposition.JOHN MILLIGAN, surgeon, on being sworn, said: I was first-

called to see the deceased on Tuesday last, in the evening,She was in bed; complained of great pain in the head andbody; she answered questions coherently. I saw her next

morning early, and was perplexed with the symptoms, havinghad no intimation of the former treatment. On inquiry, Ilearned the nature of the remedies previously used; and also-that during their administration she had been labouring underher ordinary monthly indisposition; but after a short durationthe function became suspended. I attended her regularlytill last Sunday, when she died. I attribute her death to in--flammation of the coverings of the brain, the formation ofserum, and consequent apoplexy, which conditions were, irr-my opinion, induced by the imprudent application of coldwater.HANNAH BowLER, of Keighley,power-loom weaver, on bein

sworn, said: I am twenty-four years of age, unmarried. Ihave known the deceased intimately for a long time. A week-since yesterday I went to see her, about half-past two o’clock.She was in bed; she said she was very poorly indeed. I ad-vised her not to go into the wet sheets. Directly, PautSugden came in. He put his hands upon her breasts, andtook her out of bed, and stripped her quite naked, andwashed her with two bowls of water. She was sick beforehe had done; and she shrieked with pain, so that she mighthave been heard two or three hundred yards distant. Heput a small pot twice full of warm water into the cold water.It could not be very warm, as there was very little fire in therange to warm anything. On making the bed, I saw that-she was ill from her monthly indisposition. I went again inthe evening. Sugden was there. He again put her into thesheets. I did not tell him what I had observed; but he couldnot miss but see when he washed her all over, and the stainsran on the floor. ’

[Adjourned till next day (Wednesday, the 20th) at six.o’clock, to give time for a post-mortem examination.] .

Evidence at Adjoumment.-MARTHA Wenn, of Keighley,wife of Thomas Ward, on being sworn, said: I live near to,the deceased, and saw her frequently during her last illness.A week since last Friday night I was in when Sugden camein. I was washing up some pots. He asked how long Ishould be, and said, You must be quick, as I want you to-

go away; I am going to take her (meaning the patient) outof bed.’ I went away directly, and left Sugden and thehusband of the deceased in the house. She was then laid inbed, very poorly indeed. I saw her again a week since last.Monday morning. Sugden and her husband were in. She-was in bed. She was laid on wet sheets in the bed.JONATHAN ACKROYD ILLINGwORTH, of Bradford, surgeon,.

being sworn, said : I have to-day assisted Mr. Milligan inopening the body of the deceased. We opened the head: theappearances were, great congestion of the vessels of the mem-branes of the brain; great effusion into the ventricles and be-tween the convolutions of the brain of a serous fluid, in whichwere suspended straw-coloured flocculi. On opening the body,I observed inflammation of the interior of the bladder, extend-ing along the ureters to the kidneys, particularly the left;there were appearances of inflammation on the anterior sur-face of the womb; the rest of the organs in the body andchest were healthy. The cause of death was effusion of the-brain. It is my opinion, that if the periodic discharges weresuppressed by cold applications it would injuriously affect thesystem and might cause inflammation of the brain.Mr. Milligan’s former deposition being read over to him he-

says that it is correct, and that he concurs with Mr. Illing-

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worth as to the appearances on the post-mortem examination,and as to the cause of death.

(Mr. Turner, surgeon, was here called in. It is necessaryto state that Mr. Turner is a professed hydropathist, and thathe at present practises on the principles of hydropathy atKeighley.)DAVID TURNER, of Keighley, surgeon, on being sworn,

said: a week since last Sunday I saw the deceased, by thedesire of Paul Sugden and her husband. I directed that thewater should be changed from cold to tepid; I did this be-cause I considered cold applications improper. I saw the de-ceased again on the Monday morning after with Paul Sugden;I was not told that clysters had been administered; appearedmuch the same as on Sunday; I did not perceive any dan-gerous symptoms.In summing-up, the Coroner said that in the whole course

of his experience he had never met with a more flagrantcase than the one under consideration. He could notimagine any proceeding more repulsive to the feelingsand more insulting to the delicacy of a woman than thatof being taken out of bed and stripped naked by a man;and this being repeated five times a day, made the circum-stance doubly gross. He then instituted a comparison betweenthe case of the deceased and that of Miss Catherine Coshen.The latter was a patient of the notorious St. John Long, whoby friction and the use of stimulating liquids to the back in-duced inflammation, terminating in sloughing, exfoliation ofthe spinal bones, and subsequent death. The friends of thelady brought an action against the quack, which. was triedtwice. In both trials he was found guilty, the judges decidingthat " an illegal practitioner exposing the person of a femalefor the purpose of applying his remedies was guilty of acommon assault; and if death followed upon the administra-tion of the remedies he was guilty of manslaughter." He (theCoroner) in conclusion mentioned these facts, as they pointedout the law on the subject in a manner not to be misunder-stood. It was for the jury to consider the whole of the evi-dence, and frame their verdict accordingly.

After a few minutes’ conference the jury returned a verdictOf Died by the visitation of God."

Correspondence.

THE PATHOLOGY AND TREATMENT OF CHOLERA.—ACTION OF THE KIDNEYS AND SKIN.

.. Audi alteram partem."

To the Editor of THE LANCET.

Sis,ŁHaving submitted the following observations on thesubject of cholera, and an epidemic which I purpose callingby the title of choleroid fever, to some of the members of themedical profession, on whose judgment I place much reliance,and having met with their approval, I am induced to requestthe insertion of them in your widely circulated periodical, Ishould you deem them worthy the notice of your readers.My time has been too much occupied to allow me opportu-nities to peruse a fiftieth part of what has been published onthe subject of cholera, and I cannot be aware of many opinions,some of which may have a similar bearing to those containedin this paper, and am not desirous to deprive others of thecredit due to them. For many weeks past, an epidemic hasextensively prevailed in this neighbourhood, and although themedical men have returned very few cases of Asiatic cholera,(possibly from a desire to prevent unnecessary alarm in thepublic mind,) I feel assured, from observation here, and at St.Bartholomew’s Hospital, where the disease has assumed sofatal a character, that this disease is identical with the Asiaticcholera, and capable of becoming, under unfavourable circum-stances, equally fatal if removed to some less-favoured district.Although the cases here have been most numerous, from theircomparative mildness the deaths have not exceeded four, as Iam informed, up to the present time. It will not, I hope, besupposed that it is desired to claim for myself great skill inthe treatment of cholera, but with all the advantages possessedby our hospitals, supported by the ablest physicians, the prac-tice is so various and varying, that it becomes to those seekinga guide rather "an ignis fatuus" than "a polar star;"-indeed,demonstrating the public opinion that " the profession are atsea in the matter." This statement is so often made, that it istime the confidence of the people obtained re-assurance, so thatmedical men may be regarded as comprehending the develop-ment nature, and best treatment of this fearful scourge. I hope

hereby to direct the attention of some of the many observant andscientific members of the medical profession to thissubject,whohave time and opportunity for inquiry at command; believingthat a general, intelligible, and effectual mode of treatmentmay be adopted,-not that I consider any plan, however dili-gently pursued, will be always successful; for many cases areso rapid in their progress, from their first marked symptom,that there is not time for the satisfactory employment of reomedies; and many others so neglected at the commencementas to offer no chance of succour. The strongest desire toalleviate the sufferings from this disease is manifested byevery member of our profession, and on liberality I dependfor the reception of these suggestions. An exposition of anyerror here fallen into will not be regretted. Assuming thatcholera originates from an unusual electric condition of the

earth and atmosphere, aided by improper diet, as well as bylocal and constitutional causes, whereby the most importantfunctions of the human frame are deranged, and in some casesaltogether suspended, I conclude that the disease is not pro-duced alone by the entrance of a poison into the system, butis developed by the non-elimination of those poisonous prin-ciples which ordinarily are carried out of the body, as theproper secretions of the kidneys, liver, and skin, added to adeficient formation of carbonic acid in the capillaries gene-rally, and the lessened evolution of this acid from the lungs.Hence the circulation of urea in the blood, as well as those

principles which should be got rid of in the bile and perspi-ration, and from the lungs, induce Nature to endeavour torelieve the system, usually by vomiting and purging; by whichmeans the patient is too frequently brought into a state ofhopeless collapse and death, owing to the large drain of theserum and salts of the blood, and the detention of thosematters which act as the poisons on the system. HereNature destroys the patient in her efforts to save, which toooften occurs in other diseases. The electric condition of theatmosphere has been felt, and acknowledged to have been;:peculiar for some time; and this I suppose to act directly indisturbing the healthy ftmctions of the ganglionic system,which presides over secretion and assimilation, and has an;intimate connexion with the cerebro-spinal system, and mayaccount for the cramps in various parts of the body and ex-tremities. It is commonly and almost universally thepractice to administer rice in this disease; a farinaceousdiet, frequently; more or less of brandy, water, ice, andother articles not containing nitrogen; and the early useof meat is found to excite a relapse of the fever, pro-bably from its tendency to the formation of urea-a substancehaving forty-six per cent. of nitrogen, with which the systemis already overcharged. From these deductions I propose totreat it by establishing, by all means in our power, even in thestage of apparently hopeless collapse, the several importantfimctions of the kidneys, liver, skin, and capillaries, especiallyby diluents; small doses of saline diuretics; by mercury com-bined with opium, to affect the gums; by rubefacients overthe chest and abdomen; and by the hot-air bath, to the pro-duction of copious perspiration.The administration of chloroform, ether, and other remedies.

to relieve cramps, I had rather leave to the discretion of themedical attendant, as auxiliaries, the purging being consideredas a symptom to be prevented as early as possible by an aro-matic chalk mixture with opium, or by starch enemata withlaudanum. In cases of choleroid fever it is often found requi-site to relieve costiveness by gentle and warm aperients.The reappearance of the urine, bile, perspiration, accom-

panied by warmth, will be always considered as symptoms ofimprovement, giving the hope of recovery. The importanceof the subject, and the universal interest felt by the professionand public, afford the best excuse for the length of these re-marks, and by their merits they will stand or fall to theground. Apologizing for this trespass on your time,

I am, Sir, yours respectfully.R. L. HAYNES, M.R.C.S.L.

ON MR. BERINGTON’S NEW EQUIPMENT FORINFANTRY SOLDIERS.

To the Editor of THE LANCET.SIR,—I read with much satisfaction, in the last volume of

THE LANCET, Mr. Berington’s description of his inventions,and his exposures, showing that those who are now investedwith the charge are the last persons who should have controlover soldiers’ equipment. All I can say is, that they areignorant of the effects of the present knapsack and loadedpouch borne by our infantry soldiers. You, Sir, must be