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245 THE LANCET. LONDON: SATURDAY, SEPTEMBER 11, 1852. THE POSITION OF THE PROFESSION IN RESPECT TO CHOLERA. RASHNESS and timidity are proverbially the offspring of ignorance. Unhappily, the conduct of the Government and its officials, in all that relates to Asiatic Cholera, is an exemplification of this dangerous instability and its cause. We need not refer to previous vacillations; but before and after the advent of the cholera in 1849, it is well known that the Board of Health indulged in a great bravado respecting the non-contagious character of cholera. Greens and tarts were incontinently condemned, but the public were told to make free with laudanum and opiate confection; and as for contagion, the officials of the Board of Health carried in their pockets specimens from the dead bodies of those who died from cholera, to show their contempt of infec- I I tion. But before the pestilence left our shores, vegetables regained their character, laudanum was inhibited, and a lower tone was taken about contagion. At the present time, cholera is undoubtedly prevailing to a considerable extent in Russian Poland and in the eastern provinces of Prussia; but the accounts of the disease clearly show that its ravages diminish as it travels from Warsaw, in which neighbourhood it has been said to have been reproduced by the opening of the cholera burial-ground. This circum- stance, together with the facts that after the first great visita- tion, a partial outbreak occurred on the continent of Europe, which expended its force before it could reach this country, and that the weekly mortality of the metropolis is diminishing, particularly in the items of diarrhoea and summer cholera, should make the authorities chary of alarming the public. Yet we notice that the Board of Health has sent off its representa- tives to the scene of disease. The Privy Council, as will be observed from the subjoined order, have made provision for enforcing quarantine regulations, and placing all suspected ships under the yellow flag. (COPY.) Council Office, Whitehall, Sept. 2, 1852. "SiR,—ONIoIal information having been received by Her Majesty’s Government of the prevalence of Asiatic cholera in the Port of Dantzic and other places, I am directed by the Lords of Her Majesty’s Council to state to you,for the information of the commissioners of customs, the desire of their lordships that instructions should be given to the proper officers of customs, more particularly to those employed along the eastern coast, to examine very particularly the masters of vessels arriving from the Baltic and North Sea, as to the state of health of their passengers and crew, more especially with reference to cholera; and in the event of there being any person or persons on board actually suffering from cholera, or who had been suffering from that disease within the five days previous to the arrival of the vessel in port, the said officers should be further directed to detain any such vessel under a precautionary quarantine for such period as the medical officer employed to visit the sick may judge necessary for the security or preservation of the health of the community on shore. " I am further directed to state that the proposed quarantine being only a quarantine of observation, and established with the view of preventing the persons suffering by disease from communicating with the shore, it is not intended that any restraint should be placed upon persons on board in the enjoy- ment of good health, whether passengers or crew, who may be permitted to have the same free communication with the shore as if the yellow flag had not been hoisted. " am, Sir, your most obedient servant, (Signed,) C. C. GRETiLLE." Of course these proceedings have been taken without any reference to the opinions or counsels of the medical profession. As far as the Board of Health or the Government is concerned, medical science might as well cease to exist. The authorities seem to look on the College of Surgeons as the keepers of the Hunterian Museum, and to consider the production of a Latin oration once a year the chief function of the College of Physi- cians. It does not enter into the capacities of our rulers to con- sider that these bodies might be useful to the State, in devising the means proper to be taken while an epidemic is raging in countries not very far distant from our own island. An im- partial observer might wonder why it is that the public mind is at one time drugged by false assurances of security, and at another excited by unfounded alarm, while the great medical institutions of the nineteenth century are entirely unconr sulted by the rash persons who thus play with life and with death, with public confidence and with public terror. Our Colleges will ill perform their duty to themselves and the public if they do not remonstrate with the Government upon the course it seems bent upon pursuing. The College of Physicians possess the results of the Cholera Committee which formerly sat upon the subject; and in the face of a spirited collegiate protest, we do not believe the Government would dare to neglect the natural medical advisers of the country. That such a measure as the proposed quarantine should be enforced without consultation with the heads of the medical profession, is an outrage upon the members of a body which no ministry can afford to despise. . To surround any absurdity, however trifling or ridiculous, with an air of mystery, is to invest it with an attraction and charm apparently irresistible to the majority of mankind. , Credulity is the source of far more error than ignorance, and , when joined with superstition, is capable of holding the un- thinking portion of the human race in chains which it is vain , to endeavour to rend asunder by truth or common sense. The . follies and falsehoods of MESMER would have attracted but l little attention, at least in the present day, but for the pre- tended wonders of clairvoyance; while, had the homoeopaths followed in the ways of the ancients, and attempted the cure . of diseases by diet, without attributing absurd impossibilities l to infinitesimal doses of drugs, they would but have ex- ! perienced the treatment of those whose system they : copy, and long ere this must have sunk into that sea. F of forgotten absurdities, where so many systems of l quackery-quack medicine, quack divinity, quack patriotism, and impositions of all kinds and degree-already repose. The l number of educated people, even, who incur the responsibility r T and trouble of thinking for themselves, is indeed small; and we see nothing in the signs of the times to lead us to the con- 3 elusion that they are on the increase. These thoughts have r been suggested by the publicity which has been given to an r example of the old form of hysteria, not even dressed up in a > new garment, which has been going the round of the papers, i to the astonishment of many besides country bumpkins. The 1 facts of this " extraordinary case" may be thus stated:- y- - At Shottisham, in Suffolk, about thirteen miles from s Ipswich, there dwell Asaph Squirrell, his wife and family, B a girl named Elizabeth, the heroine of the tale, forming one of the latter. While a mere child, she gave evidence that she possessed a very superior mind. At ten she was placed under the care of Mr. Osborne, the village schoolmaster, who
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Page 1: THE LANCET

245

THE LANCET.

LONDON: SATURDAY, SEPTEMBER 11, 1852.

THE POSITION OF THE PROFESSION IN RESPECT TO CHOLERA.

RASHNESS and timidity are proverbially the offspring ofignorance. Unhappily, the conduct of the Government andits officials, in all that relates to Asiatic Cholera, is an

exemplification of this dangerous instability and its cause.

We need not refer to previous vacillations; but before andafter the advent of the cholera in 1849, it is well known

that the Board of Health indulged in a great bravado

respecting the non-contagious character of cholera. Greens

and tarts were incontinently condemned, but the publicwere told to make free with laudanum and opiate confection;and as for contagion, the officials of the Board of Health

carried in their pockets specimens from the dead bodies ofthose who died from cholera, to show their contempt of infec- I Ition. But before the pestilence left our shores, vegetablesregained their character, laudanum was inhibited, and a lowertone was taken about contagion.At the present time, cholera is undoubtedly prevailing to a

considerable extent in Russian Poland and in the eastern

provinces of Prussia; but the accounts of the disease clearlyshow that its ravages diminish as it travels from Warsaw, inwhich neighbourhood it has been said to have been reproducedby the opening of the cholera burial-ground. This circum-

stance, together with the facts that after the first great visita-tion, a partial outbreak occurred on the continent of Europe,which expended its force before it could reach this country,and that the weekly mortality of the metropolis is diminishing,particularly in the items of diarrhoea and summer cholera,should make the authorities chary of alarming the public. Yetwe notice that the Board of Health has sent off its representa-tives to the scene of disease. The Privy Council, as will beobserved from the subjoined order, have made provision forenforcing quarantine regulations, and placing all suspectedships under the yellow flag.

(COPY.)Council Office, Whitehall, Sept. 2, 1852.

"SiR,—ONIoIal information having been received by HerMajesty’s Government of the prevalence of Asiatic cholera inthe Port of Dantzic and other places, I am directed by theLords of Her Majesty’s Council to state to you,for the informationof the commissioners of customs, the desire of their lordshipsthat instructions should be given to the proper officers of

customs, more particularly to those employed along the easterncoast, to examine very particularly the masters of vesselsarriving from the Baltic and North Sea, as to the state ofhealth of their passengers and crew, more especially withreference to cholera; and in the event of there being anyperson or persons on board actually suffering from cholera, orwho had been suffering from that disease within the five daysprevious to the arrival of the vessel in port, the said officersshould be further directed to detain any such vessel under aprecautionary quarantine for such period as the medical officeremployed to visit the sick may judge necessary for the securityor preservation of the health of the community on shore.

" I am further directed to state that the proposed quarantinebeing only a quarantine of observation, and established with

the view of preventing the persons suffering by disease fromcommunicating with the shore, it is not intended that anyrestraint should be placed upon persons on board in the enjoy-ment of good health, whether passengers or crew, who may bepermitted to have the same free communication with the shoreas if the yellow flag had not been hoisted.

" am, Sir, your most obedient servant,(Signed,) C. C. GRETiLLE."

Of course these proceedings have been taken without anyreference to the opinions or counsels of the medical profession.As far as the Board of Health or the Government is concerned,medical science might as well cease to exist. The authoritiesseem to look on the College of Surgeons as the keepers of theHunterian Museum, and to consider the production of a Latinoration once a year the chief function of the College of Physi-cians. It does not enter into the capacities of our rulers to con-sider that these bodies might be useful to the State, in devisingthe means proper to be taken while an epidemic is raging incountries not very far distant from our own island. An im-

partial observer might wonder why it is that the public mindis at one time drugged by false assurances of security, and atanother excited by unfounded alarm, while the great medicalinstitutions of the nineteenth century are entirely unconrsulted by the rash persons who thus play with life and withdeath, with public confidence and with public terror.Our Colleges will ill perform their duty to themselves and

the public if they do not remonstrate with the Governmentupon the course it seems bent upon pursuing. The College of

Physicians possess the results of the Cholera Committee whichformerly sat upon the subject; and in the face of a spiritedcollegiate protest, we do not believe the Government woulddare to neglect the natural medical advisers of the country.That such a measure as the proposed quarantine should beenforced without consultation with the heads of the medical

profession, is an outrage upon the members of a bodywhich no ministry can afford to despise.

.

’ To surround any absurdity, however trifling or ridiculous,with an air of mystery, is to invest it with an attraction andcharm apparently irresistible to the majority of mankind.

, Credulity is the source of far more error than ignorance, and, when joined with superstition, is capable of holding the un-’

thinking portion of the human race in chains which it is vain, to endeavour to rend asunder by truth or common sense. The.

follies and falsehoods of MESMER would have attracted butl little attention, at least in the present day, but for the pre-

tended wonders of clairvoyance; while, had the homoeopathsfollowed in the ways of the ancients, and attempted the cure

. of diseases by diet, without attributing absurd impossibilities

l to infinitesimal doses of drugs, they would but have ex-! perienced the treatment of those whose system they:

copy, and long ere this must have sunk into that sea.

F of forgotten absurdities, where so many systems ofl quackery-quack medicine, quack divinity, quack patriotism,and impositions of all kinds and degree-already repose. Thel number of educated people, even, who incur the responsibilityr T

and trouble of thinking for themselves, is indeed small; andwe see nothing in the signs of the times to lead us to the con-

3 elusion that they are on the increase. These thoughts haver

been suggested by the publicity which has been given to anr example of the old form of hysteria, not even dressed up in a

> new garment, which has been going the round of the papers,

i to the astonishment of many besides country bumpkins. The1 facts of this " extraordinary case" may be thus stated:-y-- At Shottisham, in Suffolk, about thirteen miles froms Ipswich, there dwell Asaph Squirrell, his wife and family,B a girl named Elizabeth, the heroine of the tale, forming one

of the latter. While a mere child, she gave evidence thatshe possessed a very superior mind. At ten she was placedunder the care of Mr. Osborne, the village schoolmaster, who

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246 TIIE SUFFOLK IMPOSTURE.

soon perceived that his pupil was possessed of great naturalability. She was attentive to her studies, and while otherswere at play, she would be closely engaged in poring over thebooks that composed Mr. Osborne’s library. Having a religiousturn of mind, she read upon all theological points. She alsomade herself acquainted with the English poets, with history,with parts of botany, and with phonography. In June, 1850,at the age of twelve, she left the school from illness, occa-sioned, it is said, by too close attention to lier studies. Herillness assumed the shape of a spinal affection, for which shehad the best medical advice, and was subsequently sent to theEast Suffolk Hospital, in Ipswich, where she remained aboutsix weeks. She then returned home, became worse, andlock-jaw set in, depriving her, as it was alleged, of the powerof swallowing. She lived on suction, milk being poured downher throat; but the quantities were so small that her deathwas daily expected. She, however, to the astonishment ofher friends and the villagers, continued to live on, although itwas said she did not take a morsel of solid food. At Mid-summer, 1851, she recovered from her lock-jaw, but it wasalleged that she had previously been seized with blindnessand deafness. The way in which she had lived began to betalked of, and some excitement was occasioned among thegossips of the neighbouring villages. But about this time the

writings and speeches of the child occasioned considerableinterest, which was heightened by the assertion that she stillate no food. Persons living in the locality came to visit her,and found the patient in a humble apartment, supported onher bed by pillows, with a countenance which most of themcalled " angelic." Although it was alleged she could not see,her eyes remained opened, and but little defect could beobserved in them. Her visitors were assured that for nearlytwo years not a particle of solid food had passed her lips; andthat for the last three months neither food nor drink of anykind had been taken. These statements were confirmed byher parents. The girl’s statement regarding herself andher alleged peculiar condition was, that she had seen a visionof angels, one of which number had consented to become herom,t..,nt. "Ul’nò",nt, ...nli lYl1",rnj..n-

Some gentlemen in Ipswich, who had become deeply inter-ested in the case, at length felt that it was quite time somesystematic effort should be made to test these statements totheir fullest extent, and judged that an eight days’ trial wouldsettle the matter as to whether or not she partook of any kindof nourishment. Accordingly, two women of good characterwere selected, at the earnest entreat ofthefather ofthe girl, whowere instructed to keep watch over her for eight days andeight nights, it being an instruction that the room should neverbe left without one of them being present. Three weeks sincethey commenced their task, receiving their instructions froma medical man, and at the end of eight days returned to

Ipswich, declaring that the child had not had anything to itslips during the whole term, and that they were thoroughlyconvinced it was a genuine case. This, however, did not

fully satisfy the gentlemen alluded to. The thing was nowuniversally talked of in these localities, and it was determined ’,to spare no pains to test it to the utmost. They formed them-selves into a committee of eight persons, and drew up regula-tions for their guidance; one was, that for eight days andnights she should never be left unwatched; and another was,that each gentleman on guard should make a written entry ofthe events that occurred every hour, and that he should signhis name to it. (The report of this committee has not, as yet,been published.) On Saturday, August 21st, this watch comemenced, and went on without the slightest thing to exciteany suspicion, excepting a little restlessness, until the eveningof the following Thursday, when Messrs. Pitcairn and Burton(bookseller) were relieved by the Revs. Webb and Whitby.The former gentleman had long been a sceptic in the matter,and on entering the room thought he discovered an unpleasantsmell. He left for an hour’s walk, leaving Mr. Whitby incharge. The father then entered, and complained of the wantof faith which the watchers in charge manifested, and thensuggested that they should seek the blessing of God. He im-mediately knelt down and prayed with great apparent earnest-ness and solemnity, and at considerable length. Mr. Whitbywas close to the bed, and during the prayer noticed some agi-tation of the clothes, and fancied that something was offend-ing his olfactory senses. When Mr. Webb returned, Afr.Whitby mentioned his suspicions, and as the nose of theformer gentleman again convinced him that something waswrong, he insisted that the bed should be searched. Twonurses, who were also present, proceeded to make the examination, and they reported that all was right-not a suspicious Ithing had been found. Mr. Webb not being satisfied, and 1

feeling the delicacy of his position, went to the clergyman’shouse, and secured the assistance of a medical gentleman whowas staying with him. The circumstances were stated to the

surgeon, who determined on instituting a further search inpresence only of the two nurses. For some time their effortshad no result, but at length a hundle was discovered betweenthe child’s arm and body, which one of the nurses immediatelylaid hold of. The girl, as it is alleged, instantly called out," You must not touch that."-" But I must have it," said thewoman.-" But," said the deaf child, "you shan’t have it."—"I will have it," exclaimed the nurse, and away went thebundle, the child, with great resignation, saying," Well, if youwill, you must." The surgeon undid the parcel, and found itto consist of about a score of napkins, bits of linen, &c., which,it is said, had been recently used. These were spread outupon the counterpane, and the parents and the two watcherswere summoned in to gaze upon the not very fragrant dis-covery. Of course the utmost consternation was depicted onthe faces of the parents. The mother immediately accusedthe child of deceiving her, but was properly stopped by theremark that this part of the imposition could not have beencarried through without her agency. The father seemed inan agony of distress, and solemnly protested that he was en-tirely ignorant that the napkins were there, and that, so faras he knew, neither morsel nor drop had passed the child’slips for sixteen weeks. Messrs. Webb and Whitby, themedical gentlemen, and the nurses, immediately left thecottage, and all, with the exception of the surgeon, walked onto Woodbridge, feeling Indignant at the imposition that hadbeen practised. It is important, however, to notice that duringSaturday, Sunday, Monday, Tuesday, Wednesday, and Thurs-day, she had had no food or drink, neither was any food foundin the bedding. After the discovery, the girl folded her hands,and, looking to heaven (for it is fully believed that she has theuse of her sight), said, " I commit myself to the care of myguardian angel, and know that God will take care of me."When her father left for Ipswich, she exclairned," Never fear,father, I shall weather the storm—’twi)I all end well." Weunderstand that her parents and herself still stoutly assert thatshe has taken no kind of nourishment for sixteen weeks, andthat each of the three is most anxious for a further trial, whichshall extend over fourteen days.

The common sense of our readers must not be insulted bycomments upon this gross, not to say blasphemous imposi-tion, which it has pleased so many miracle-mongers to fosterand encourage, and which appears, through their notice andattention, to have gone to such a disgusting length. We feelno more called upon to describe the mode in which this

hysterical girl procured nourishment while being watched-for nourishment she most assuredly had-than to explain thesleight-of-hand of M. ROBIN, or the tricks of any other adroit

conjuror. It may be instructive, however, to put the case uponrecord, if only for the purpose of adding another example tothe host that might be adduced to prove the credulity of thepresent " enlightened" age.

ANOTHER portion of Dr. WEBSTER’s report on foreignasylums having recently appeared, we think it right to

bring before the profession one or two additional pointswhich seem interesting. The institutions embraced in that

gentleman’s present narrative are Stephansfeld and Illnau,situated in the great valley of the Rhine; but although theformer establishment is French, and the latter, strictly speak-ing, belongs to Germany, both may be considered very similarin essential features. Alsace and Baden, although havingdifferent governments, have inhabitants that greatly re-semble each other, as well in race and physical con-

formation, as in religion, language, and social condi-

tion. The two asylums just mentioned having been onlyrecently constructed, they are naturally of a very superiordescription, consisting of a large central structure, which con-tains the chapel, as also official residences, and from whence

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247FRENCH LUNATIC ASYLUMS.-MR. FARR AND THE INCOME TAX.

the various dormitories, with their appropriate court-yards,branch off on each side. Ilence, unlike many public asylumsin England, instead of being one large building, (howeverpleasing such elevations may appear to spectators from with-out, nevertheless the comfort of residents is frequentlysacrificed to architectural display,) St6pliat)sfeld and Illnaucomprise a congeries of distinct houses with separ<lte enclosures,which, besides constituting better accommodation, possessnumerous important advantages, when contrasted with themost palatial erections of the former description.

Parallel in respect of structure, it is also remarkable howmuch the two institutions resembled each other with refer-

ence to actual population, number of admissions, cures, anddeaths; indeed, in almost every peculiarity, excepting thereported amount of personal restraint-the camisole being muchmore frequently employed in the German than in the Frenchasylum-only one patient being partially confined by a strait-waistcoat at Stephansfeld; and even that was chiefly to pre-vent this lunatic from deranging the dressings applied to oneof his legs, recently broken; whereas, against this solitaryexample, it appears eight patients were then suffering frompersonal confinement nt the Illnau establishment. These

facts show clearly the non-restraint system of treatingmaniacs has not yet made so much progress on the east, as onthe west bank of the Rhine. Indeed, when subsequentlyalluding to the " Irrenthurm" of Vienna, which constitutesthe old lunatic asylum of the Austrian capital, Dr. Webstersays, when he visited that receptacle for the insane, someyears previously, it was the very worst he had ever inspected,"many of the inmates being bound by chains, and howling in"dens, more like wild animals in cages than Christian men;whilst numbers had almost nothing but straw for their cover-"ing." Such harrowing details demonstrate the necessityof improvement; although it is gratifying to hear, on thesame authority, that a new lunatic asylum has been recentlybuilt in Vienna, at an expense of .t:80,OOO, which is now

considered one of the best-conducted institutions throughoutGermany.The recent political excitement, like other important

popular movements which intensely occupy public attention,seems to have produced marked impressions upon the mindsof large classes of people in France. In proof of this influence,Dr. WEBSTER, mentions that several imaginary Prefets, self-

styled representatives in the Legislature, and other fictitioushigh personages, who had lost their senses during the laterevolutionary proceedings, were recognised amongst the

inmates of different public asylums. At one institution,there recently existed three maniacs, who believed them-

selves to be Louis NAPOLEONS, and consequently all Presidentsof the Republic; whilst at another establishment, a fourthvisionary Louis NAPOLEON was also under treatment. Various

candidates for the presidential chair, or seats in the legislativeassembly, were likewise noticed at some of the asylums in-

spected, each of these afflicted fellow-creatures being insaneupon particular subjects. Such results are, however, analogousto previous experience, since, at the period of the Crusadesand great Reformation, as during the first French Republicand subsequent wars in Italy, and on the Rhine, insanity veryfrequently prevailed. Again, when the Emperor NAPOLEONupset dynasties, and overran Europe with his victorious

armies imaginary kings, princes, and ideal great men, were

numerous in the lunatic asylums of France and GermanyThese facts are not only instructive, but they also indicatethat wherever the population of any country become intensel

I excited by predominant ideas, especially amongst individual:predisposed to mental disease, and otherwise of weak nervousorganization, similar influences will occasion such very powerfueffects, as even sometimes to cause a species of mental epidemic in certain communities.THE " obsequies of the late Duke of HAMILTON" have, as the

newspapers inform us, been recently " performed." Under-

takers are happy in their phraseology, and verily they doconvert the last pomp of this world into a

" performance."We have, however, a reasonable objection to their involvingmedical personages in their mortuary melodramas, and we are

sorry to see they have been permitted to use up Mr.

PETTIGREW on this occasion to a considerable extent. The

newspapers tell us that the mortal remains of the " lamented

deceased" were, shortly after death, " embalmed by Mr.PETTIGREW;" and we are further told that the Duke had a

fancy to be entombed in a " sarcophagus" purloined from thePyramids, and supposed to have been the coffin of some prin-cess of the house of PHARAOH. A venerable, if non-illustrious

nobleman, might be excused for this snobbery, but we aresorry to see Mr. PETTIGREW as one of the chief

" performers"of the ceremony of entombing a defunct Duke, whose vanityextended even beyond the grave. The penny-a-liners blazonit forth, that after the funeral ceremony, " the workmen," headed by Mr. PETTIGREW, the embalmer, and Mr. BRYCE," the architect, then took possession of the chapel, when the" coffia was opened, and the body placed in the sarcophagus,"&c. &c. Now we do insist that Mr. PETTIGREW should have a.

little care for the respectability of the profession, when hethus mountebanks it so gloriously at the closing pomp of adead Duke. The Court medical men have, no doubt, to do theRoyal embalming, but they have the good sense to let as littleas possible be said about it. Mr. PETTIGREW has performedthe feat of unfolding sundry mummies for the edification ofthe curious in these matters; perhaps he is ambitious of

making mummies for future PETTIGREWS to unfold, or it maybe that when he inclosed the fourth Duke of HAMILTON in the

sarcophagus of the Egyptian princess, the cunning wight wasproposing an archaeological conundrum to some future Dr.DRYASDUST. As lookers-on, we can only regret when medicalmen of otherwise estimable repute fall into such mistakes.

The Income tax seems to have met with its master in Mr.

WILLIAM FARR. We are proud that this monster iniquityshould have met its thorough exposure at the hands of amedical man. There is, however, some justice in this, sinceno profession is more hardly dealt with in the working of thisincubus than the medical. We trust we may promise Mr.FARR the support of the medical profession in his exertions,and when Parliament meets we will do our utmost that a

large number of petitions from medical men against the in-come tax, as it now stands, shall be presented. We

will take care to remind them of it at the proper time,and we cannot suppose that medical practitioners are so deadto abstract right, and to their own pecuniary interests, as not

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248

to petition the legislature when there is a certainty of gettingrid of this crying evil by a little judicious exertion. Mr.

FARB stands forward as a champion in a good cause, and it

shall go hard but he be ably seconded.

Correspondence.

OCCLUSION OF THE OS UTERI.[NOTE FROM DR. HIGHMORE.]

"Audi alteram partem."

To the Editor of THE LANCET.

SiR,-In your publication of August 21st, you did me thefavour to insert a paper illustrative of a peculiar and not veryfrequently occurring difficulty which may arise in obstetric prac-tice ; peculiar, as the two gentlemen who have noticed the paperdiffer materially in their opinion of its cause ; infrequent, as oneof the same authorities states that he has only met with onesimilar case during an attendance upon upwards of 2000 midwiferypatients, a statement in consonance with one made by Dr.Sheppard, (vide THE LANCET, vol. i. 1851, p. 638.)

It has before been noticed (I think at one of the meetings ofthe Medico-Chirurgical Society) that a peculiar acerbity appearsto attend all discussions on matters puerperal, a fact sufficientlyillustrated on the publication of Dr. Sheppard’s somewhat analo-gous case; but in putting forth a brief and plain statement ofthe facts of an uncommon and interesting case, I hardly expectedto subject myself to the sneering personalities of your <xMOM!/7KOtMcorresponde-itt, 11 An Accoucheur," whom I shall not further con-descend to notice, but proceed to point out in what particularsthe case varies from those detailed by Mr. Hendry and Dr. Whit-worth-viz., that the patient had arrived at the full term of gesta-tion ; that the vagina was so relaxed as to oppose no difficulty tothe fullest and most perfect examination, which was furtherfavoured by the great subsidence of the uterus during the pains,which latter, from their commencement to the patient’s delivery,never ceased; the retention of the placenta and its peculiar con-dition ; and lastly, the state of the patient’s health previous tomarriage.

Mr. Hendry considers the os uteri not to have been developed;but why ? Dr. Whitworth is of opinion that anteversion existed,but had such been the case, it would have been impossible not tohave detected it, the state of the parts being so favourable forthis object. Several analogous cases have been put on record,one by Dr. Fairbrother, (THE LANCET, vol. i. 1851, p. 694;)another by Dr. Roe, (THE LANCET, vol. i. 1851, p. 569;) but athird more especially, by Dr. Henry Bennett, in his work on" Uterine Inflammation," p. 224 ; in two of which, as in mine,patience was rewarded by success, although my patient’s ex-hausted state and rapid pulse, at half-past four o’clock, renderedit a question how much longer the case could be safely left with-out interference.

I am, Sir, your obedient servant,Bradford, Wilts, Sept. 1852. N. J. HiGHMOBE, M.D.N. J. HIGHMORE, M.D.

[NOTE FROM MR. HENDRY.]To the Editor if THE LANCET.

SiR,-Perhaps few subjects are more calculated to create con- ’,troversy than the communications relative to the transient sup-position of the existence of occlusion of the os uteri, inserted inthe pages of THE LANCET of the 21st and 28th ultimo;nevertheless, I am not a little surprised that Dr. Whitworth, ofSt. Agnes, near Truro, should, in a more recent insertion, haveyielded to so hasty an impulse of imagination, so widely remotefrom the real question at issue, or so discourteous to the due

vigilance and discrimination of the parties first intruding them-selves to public attention.

Ordinary talent, acquirement, and experience, may at all timesamply distinguish cases of retroversion, anteversion, or version ofwhatever kind, instanced by Dr. Whitworth. A digital explora-tion with the utmost facility recognises that resistance occa-sioned through vaginal duplication of its membranous sur-

face on the one hand, or otherwise, a more extended area, insome other direction, id est, that configuration and distributionof the vaginal cavity and parietes, which cannot fail to provethe existence of some uterine malposition, especially when cor-roborated by some not unusual vesical irritation or incapacity,some protraction of labour, or by some certain progressive deve-lopment of the os internum with the advance of labour, thus I

rendering unequivocal the case in hand, or superseding all neces-sity for undue importance to any apparent anomaly.

In the cases recorded on the 21st and 28th ult., no mentionwhatever is made of any emergence of the os uteri, from eitherbefore or behind, in the least to warrant Dr. Highmore’s untimelyassumption. Other intelligences are abroad, as well as in thevicinity of Truro, well versed in uterine phenomena, thus seekingfor more matured explications of the anomalies presented thanwhich hitherto have injudiciously emanated therefrom.

I am, Sir, your obliged servant,Hull, Sept. 6, 1852. WILLIAM HENDRY, M.R.C.S. &C.WILLIAM HENDRY, M.R.C.S. &c.

THE MEDICAL PROFESSION AND THE LIFEASSURANCE OFFICES.

To t7te Editor of THE LANCET.

SiB,&mdash;About three months since, I received a communica-tion from one of those liberal Assurance Offices whichdecline paying a reasonable fee for "services rendered." Now,no sane person can for a moment doubt that when a medicalman of standing and respectability is called upon to give hisprofessional opinion (the principal source of his means of ex-istence) upon any professional subject, it is only fair and justthat he should, to use commercial phraseology, "be paid forwork and labour done." My answer to the agent of theoffice was to the following effect:" Pay me my legitimatefee, and you shall have the benefit of my professional advice;this alone is my stock in trade,’ and if done out of this, why theGazette ‘looms in the future;"’ but "No," says the sapientofficial, " we pay our own medical officer." I reply: " Then toyour own medical officer must you appeal." The office did so,and trusted to his judgment; he was, however, little consciousthat the applicant had a lurking disease of the brain, whichhad caused frequent severe epileptic attacks; it is, however,but justice to say, that no medical man who had not been longand intimately acquainted with his constitution, would belikely, from a cursory examination, to have detected the exist-ence of any cerebral affection. I need hardly say, that if Ihad been called upon to answer the queries sent to me, Ishould have felt morally bound to have afforded this im-portant information.The sequel is soon told; and I trust it will be another warn-

ing to those stultified Societies which persevere in theirstupid determination to neglect your reiterated remonstranceand advice. On the faith of the judgment of their "ownmedical officer," the Company grant an insurance of 1000,and death ensues within two months of the date of the policy.

Verily, " Quem Deus vult perdere, prius dementat."Verbum sat! !

I remain, yours truly,Liverpool, Sept., 1852. FREDERICK CRIPPS.

** The utility of this communication would have beenmuch enhanced if the name of the offending office had beenpublished by our correspondent.-ED. L.

FREDERICK CRIPPS.

MARISCHAL COLLEGE, ABERDEEN.To the Editor of THE LANCET.

SiR,&mdash;I protest against the injustice you have done me in yournumber of Saturday, the 4th instant. On the previous MondayI had sent to you for publication in THE LANCET a letter, re-questing you to state your reasons for your "maturely con-sidered" and published opinion, that the medical degrees grantedby Marischal College were valueless as legal qualifications, andpledging myself to answer those reasons. My letter must havebeen delivered, in regular course of post, at your office on Tues-day. Your number of Saturday, published I am aware on Fridayafternoon, contains new attacks upon Marischal College, newreproaches upon the members responsible for the administrationof the University affairs, including myself by name, as unwillingto answer your attacks on the rights of the University, but doesnot contain my letter, nor a word to hint to your readers thatthis letter challenges you to come out with your 11 maturely con-sidered" reasons, and a pledge that they would then be answered.You yourself had said, " If we are wrong, it is for the authoritiesof Marischal College to set us right." Could any of the personsthus alluded to by you adopt any course more natural than toreply-Give me the opportunity of trying to set you right, byfirst stating the grounds of your opinion? All the new matter ofattack upon us could have been written and printed after my

letter was in your hands, in time for publication on Friday after-


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