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REPORT OF THE MEDICAL DEFENCE UNION, LIMITED

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794 REPORT OF THE MEDICAL DEFENCE UNION, LIMITED. .of the case was as follows :—"I removed the whole of the fractured bone, which was comminuted ; one small portion ’had penetrated the dura mater..Me has been treated just .a.s the former patient was and has not had a bad symptom since." The case was immediately recognised as one that had been reported in THE LANCET of the previous quarter as having a fatal termination through abscess of the left - frontal lobe of the brain, and Wakley appended the account ofthe post-mortem which he had printed at the time as L note to Tyrrell’s account of the case. Upon this undoubtedly libellous article an action was brought against the Editor of THE LANCET and damages of £2000 were claimed. The case of Tyrrell versus Wakley came on for hearing .on Feb. 25th, 1824, before Lord Chief Justice Best (afterwards Lord Wynford) and a special jury. Mr. Serjeant Vaughan and Mr. Serjeant Adams appeared for the plaintiff, and Mr. Brougham (afterwards Lord Brougham) and Mr. FitzRoy Kelly (afterwards Sir. F. Kelly) for the defendant. Mr. Serjeant Vaughan, in his opening speech, referred to the deplorable state of friction between Wakley and certain of the hospital surgeons, and attempted to show that the publication of the libel was the direct and malicious outcome of Wakley’s exclusion from St. Thomas’s Hospital by Mr. Tyrrell and his colleagues. He justified that exclusion by saying that Wakley had made ill use of the privilege enjoyed by old students at St. Thomas’s Hospital of being free of the wards and lecture-rooms of the institution after they had completed their medical curriculum ; that false state- ments had been made by him in his paper ; and that it had therefore been thought proper by the authorities to exclude him from the hospital. Mr. Tyrrell was one of those who put his name to the paper by which Wakley was ,excluded in May, 1824 ; and from that date a series of libels - on Mr. Tyrrell could be traced to THE LANCET, ending with the one now specifically complained of, which made a most direct and bitter attack on his character. The damages were laid at .E2000, which counsel did not consider excessive having an eye to the scurrilous nature of the article and the wide circulation of the paper in which it ’appeared. Mr. Tyrrell was held up to the public in a paper whose known - circulation was over four thousand as a man who had been in the habit of publishing false statements to the world, by which it bad been imposed upon, and of attempting to raise a spurious reputation on the supposed success of his practice by publishing his unsuccessful cases without adding to his accounts their luckless terminations. The imputations were not merely of a want of talent-not merely of erorrs .of the head, but of the worst vices of the heart. Mr. Tyrrell was practically called in the article in question a thief of another’s labours and a mendacious boaster. One part of Serjeant Vaughan’s speech certainly carried weight, and that was where he dealt with Wakley’s property in the lectures. Mr. Tyrrell could not be said to have stolen from Wakley what Wakley had never legally owned-and the question of Wakley’s right in these lectures was very doubtful. Some sort of right in them had been given him by Sir Astley Cooper, but how much was an open question. Moreover, as the Abernethy case was at this very time being - considered in another court under the rather notorious circumstances already detailed, everyone felt that the - question of copyright in lectures was in an unsettled -condition and that an accusation of gross literary dis- honesty founded upon any assumed settlement of that .question did not at the time come very well from Wakley. When Serjeant Vaugban said that the lectures were undoubtedly Sir Astley Cooper’s, and that he must be .allowed to do whatever he liked with them and that lie therefore was within his right in employing his nephew, Mr. Tyrrell, to publish certain of them in a book with a view to correct the inaccuracies present in the reports which had appeared in THE LANCET he made a point and it was the only one he really did make. With regard to the imputation that Mr. Tyrrell had wilfully suppressed the fatal termination of the case of Thomas Denman, counsel contended that it was a gross libel. The account of the case in the book, of which the libel was in some sort a review, expressly only dealt with the condition of the patient up to a certain date, and when the man died later the fact was noted in a slip of errata pasted into all the copies. Mr. Serjeant Vaughan called witnesses, who proved Wakley’s responsibility for whatever appeared in THE LANCET. The printer of the book testified to the fact that a correction which had to be pasted into each copy of the book was made at the earliest possible opportunity, though he could not swear that every copy of the book that went out from his establishment was so treated. No evidence whatever was adduced that the alleged errors in THE LANCET reports, owing to which Mr. Tyrrell had been invited to publish a corrected edition of the lectures, ever existed. Not a single slip or flaw in them was ever alluded to by any witness, though the statement that Mr. Tyrrell’s assistance in the publication of the volume had been invoked as a corrective to Wakley’s inaccuracies had been much insisted upon in counsel’s opening speech. (To be continued.) REPORT OF THE MEDICAL DEFENCE UNION, LIMITED. WE have already reported the proceedings of the annual meeting of this Union. We have now to notice its annual report. We can only congratulate the executive on a really splendid amount of success. The addition of new members is 252, bringing the total up to 3537, and the total guarantee fund up to .&5212. The number of cases of members requiring aid, advice, or assistance has been over 1000. It throws an unpleasant light on the risks of our profession that nearly one in three of its members seems to be exposed to attacks needing skilled defence. The schedule of cases given in abstract is a most interesting and instructive piece of medico-legal reading. Very satisfactory is the demonstra- tion which the schedule aifords of the ability of this Union to meet almost every form of attack that can be devised by an unprincipled libeller. The success of the defensive action of the Union in the courts, and generally before the courts are reached, is almost monotonous, and suggests not only the ability of the executive, but the flimsy nature of the charges that are brought against the profession. The report should be circulated throughout the profession. We greatly doubt the expediency of the absorption of the Union by the British Medical Association. This would be an ignoble end of a body which has so much individuality and of which the profession has shown so much appre- ciation. We doubt whether this would be good for either of the bodies, though it is easy to see that a few leading members of each think so. One effect of such a fusion would be to necessitate the resignation by members of the General Medical Council of the membership of the British Medical Association. They could not continue to be members of a body that would then be practically a prose- cuting body. The General Medical Council is severely handled in this report, often with some good reason ; but it is scarcely likely that the British Medical Association would like to lose from its membership those who are also members of the General Medical Council. This, however, is a matter that must be decided by the respective bodies. Two other
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Page 1: REPORT OF THE MEDICAL DEFENCE UNION, LIMITED

794 REPORT OF THE MEDICAL DEFENCE UNION, LIMITED.

.of the case was as follows :—"I removed the whole of thefractured bone, which was comminuted ; one small portion’had penetrated the dura mater..Me has been treated just.a.s the former patient was and has not had a bad symptomsince." The case was immediately recognised as one thathad been reported in THE LANCET of the previous quarteras having a fatal termination through abscess of the left- frontal lobe of the brain, and Wakley appended the accountofthe post-mortem which he had printed at the time as Lnote to Tyrrell’s account of the case.

Upon this undoubtedly libellous article an action was

brought against the Editor of THE LANCET and damages of£2000 were claimed.

The case of Tyrrell versus Wakley came on for hearing.on Feb. 25th, 1824, before Lord Chief Justice Best

(afterwards Lord Wynford) and a special jury. Mr.

Serjeant Vaughan and Mr. Serjeant Adams appearedfor the plaintiff, and Mr. Brougham (afterwards Lord

Brougham) and Mr. FitzRoy Kelly (afterwards Sir. F. Kelly)for the defendant. Mr. Serjeant Vaughan, in his openingspeech, referred to the deplorable state of friction betweenWakley and certain of the hospital surgeons, and

attempted to show that the publication of the libelwas the direct and malicious outcome of Wakley’sexclusion from St. Thomas’s Hospital by Mr. Tyrrell andhis colleagues. He justified that exclusion by saying thatWakley had made ill use of the privilege enjoyed by oldstudents at St. Thomas’s Hospital of being free of the

wards and lecture-rooms of the institution after they hadcompleted their medical curriculum ; that false state-

ments had been made by him in his paper ; and that

it had therefore been thought proper by the authorities toexclude him from the hospital. Mr. Tyrrell was one of thosewho put his name to the paper by which Wakley was,excluded in May, 1824 ; and from that date a series of libels- on Mr. Tyrrell could be traced to THE LANCET, ending withthe one now specifically complained of, which made a mostdirect and bitter attack on his character. The damages werelaid at .E2000, which counsel did not consider excessive

having an eye to the scurrilous nature of the article andthe wide circulation of the paper in which it ’appeared.Mr. Tyrrell was held up to the public in a paper whose known- circulation was over four thousand as a man who had been inthe habit of publishing false statements to the world, bywhich it bad been imposed upon, and of attempting toraise a spurious reputation on the supposed success of hispractice by publishing his unsuccessful cases without addingto his accounts their luckless terminations. The imputationswere not merely of a want of talent-not merely of erorrs.of the head, but of the worst vices of the heart. Mr. Tyrrellwas practically called in the article in question a thief ofanother’s labours and a mendacious boaster.One part of Serjeant Vaughan’s speech certainly carried

weight, and that was where he dealt with Wakley’s propertyin the lectures. Mr. Tyrrell could not be said to have stolenfrom Wakley what Wakley had never legally owned-andthe question of Wakley’s right in these lectures was verydoubtful. Some sort of right in them had been given him bySir Astley Cooper, but how much was an open question.Moreover, as the Abernethy case was at this very time being- considered in another court under the rather notoriouscircumstances already detailed, everyone felt that the

- question of copyright in lectures was in an unsettled

-condition and that an accusation of gross literary dis-

honesty founded upon any assumed settlement of that

.question did not at the time come very well from Wakley.When Serjeant Vaugban said that the lectures were

undoubtedly Sir Astley Cooper’s, and that he must be

.allowed to do whatever he liked with them and that lie

therefore was within his right in employing his nephew,

Mr. Tyrrell, to publish certain of them in a book with a viewto correct the inaccuracies present in the reports which hadappeared in THE LANCET he made a point and it was theonly one he really did make. With regard to the imputationthat Mr. Tyrrell had wilfully suppressed the fatal terminationof the case of Thomas Denman, counsel contended that itwas a gross libel. The account of the case in the book, ofwhich the libel was in some sort a review, expressly onlydealt with the condition of the patient up to a certain date,and when the man died later the fact was noted in a slip oferrata pasted into all the copies.Mr. Serjeant Vaughan called witnesses, who proved

Wakley’s responsibility for whatever appeared in THE

LANCET. The printer of the book testified to the fact thata correction which had to be pasted into each copy of thebook was made at the earliest possible opportunity, thoughhe could not swear that every copy of the book that wentout from his establishment was so treated. No evidencewhatever was adduced that the alleged errors in THELANCET reports, owing to which Mr. Tyrrell had been invitedto publish a corrected edition of the lectures, ever existed.Not a single slip or flaw in them was ever alluded to by anywitness, though the statement that Mr. Tyrrell’s assistancein the publication of the volume had been invoked as acorrective to Wakley’s inaccuracies had been much insistedupon in counsel’s opening speech.

(To be continued.)

REPORT OF THE MEDICAL DEFENCE

UNION, LIMITED.

WE have already reported the proceedings of the annualmeeting of this Union. We have now to notice its annual

report. We can only congratulate the executive on a reallysplendid amount of success. The addition of new membersis 252, bringing the total up to 3537, and the total guaranteefund up to .&5212. The number of cases of members

requiring aid, advice, or assistance has been over 1000. It

throws an unpleasant light on the risks of our professionthat nearly one in three of its members seems to be exposedto attacks needing skilled defence. The schedule of cases

given in abstract is a most interesting and instructive pieceof medico-legal reading. Very satisfactory is the demonstra-tion which the schedule aifords of the ability of this Unionto meet almost every form of attack that can be devised

by an unprincipled libeller. The success of the defensive

action of the Union in the courts, and generally before thecourts are reached, is almost monotonous, and suggests notonly the ability of the executive, but the flimsy natureof the charges that are brought against the profession. The

report should be circulated throughout the profession. We

greatly doubt the expediency of the absorption of the Unionby the British Medical Association. This would be an

ignoble end of a body which has so much individualityand of which the profession has shown so much appre-ciation. We doubt whether this would be good for eitherof the bodies, though it is easy to see that a few leadingmembers of each think so. One effect of such a fusionwould be to necessitate the resignation by members ofthe General Medical Council of the membership of theBritish Medical Association. They could not continue to bemembers of a body that would then be practically a prose-cuting body. The General Medical Council is severelyhandled in this report, often with some good reason ; but itis scarcely likely that the British Medical Association wouldlike to lose from its membership those who are also membersof the General Medical Council. This, however, is a matterthat must be decided by the respective bodies. Two other

Page 2: REPORT OF THE MEDICAL DEFENCE UNION, LIMITED

795THE NEW PHOTOGRAPHY.

points in the report are very satisfactory-the promising stageof the negotiations for union with the London and CountiesMedical Protection Society and the continually lower

expenditure of the Union notwithstanding an ever-increasingamount of work. Outsiders as well as members will admit Ithe wisdom of the appointment of Dr. Bateman as generalsecretary and the mere justice of giving him as salary B315a year. He has worked well for the Union, and it would beunreasonable to expect him to continue his energy in itsservice without some such recognition.

THE NEW PHOTOGRAPHY.

WE are enabled this week to lay before our readers some Iillustrations which show very well the applications of IRoentgen’s rays to surgery. Figs. 1 and 2 are from

prints taken by Dr. McKenzie Davidson of Aberdeen. In

Fig. 1 a needle had been driven into a patient’s hand,entering at the ball of the thumb, some ten months previouslyto her consulting a medical man. Ever since she hadhad more or less pain in the palm of the hand. Theneedle had broken on entering, for a part of it was

found sticking in the table at which the patienthad been working. Hence, presumably, there would bebut one piece in the hand. The print, however, shows

1"IG. 1.

very distinctly that the needle must have broken afterentering the hand, for there are two pieces lying on the ulnarside of the first metacarpal bone. This case is of greatutility, for anyone on extracting the first piece would hardly

have suspected the presence of another. and no-one could,have foreseen the exact state of things. z i

Fig. 2 shows a small revolver bullet lying against themetacarpal bone of the f orefin ger of a boy who had shot him-self a few days previously. When seen by Dr. Davidson theposition of the bullet could not be determined owing to

FiG. 2.

oedema. The bullet had entered near the point where it waseventually found, but on probing the wound the probe passedeasily down an apparent track to the styloid process of theulna. Eventually the position of the bullet was easily deter-mined by the new method and it was extracted without diffi-

culty. Dr. Davidson has used the method in three othercases. In two of them the patients were suffering fromneedles in the hands, and the third case was one of a revolver-shot, also in the hand.

Fig. 3 shows the hand of a patient photographed int THE LANCET laboratory. The little nnger has been

amputated, and the whole hand is much distorted byarthritis. The print is interesting as opening up possibilitiesfor deciding on surgical procedure in talipes, for it shows,that a good view can be obtained of a distorted extremity-even when it cannot be closely applied to the plate.

Fig. 4 is a very good illustration of a normal ankle-joint.The photograph was taken by Mr. Swinton, and for leave to

reproduce it we are indebted to the Swan Electric Engraving-Company.We have made various t.yia;4 to obtain a photograph

of the human vertebral column. but up to the presentwe have not succeeded. We have, however, taken a

very good photograph through the body of a monkey(dead), into whose kidney W3 had previously insertedla uric acid calculus. The spinal column and ribsshow with great clearness, so does the calculus, although,

’ judging by its position, it must have escaped from the. kidney. It is right to add that the monkey having been.


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