622

band, on going into her room, was alarmedon finding her asleep in so unusual a posi-tion, with her breathing inaudible. The

swellings of the limbs continued rapidly todecrease, aided by the use of oil-silk stock-ings, though the uneasiness in the region ofthe heart, with occasional palpitation, con-

tinued. From this time the patient lerogres-sively improved, and became able to walkdown stairs, and engage in some of thelighter concerns of her family. She discon-tinued the use of her former medicines,taking only an occasional aperient, and at herown discretion. Dr. Ayre did not see herfor several weeks, and I paid her only anoccasional visit. At length an accidentalcold which she took, renewed her cough anddifficulty of breathing, and the other unfa-vourable symptoms, when Dr. Ayre wasagain consulted. But the patient havingresisted his order, as she had done mineseveral days before, to be again cupped, sherapidly became worse, and expired suddenlythe following night. The examination ofthe body the next day exhibited the appear-ances expected. There were traces of for-mer and long-continued inflammation ; theheart was extremely softened, the muscularfibres being torn or divided by the slightesteffort. The aorta at its junction with theheart was greatly ossified, and a small sacwas formed from it, constituting an incipientaneurism. There were two pints of water ineach cavity of the chest, and an unusual quan-tity in the pericardium, which, as well as

the other serous tissues of the chest, weregreatly thickened, and united by preterna-tural adhesions. The lungs were sound, butwashed with a serous effusion.From the foregoing statement of facts we

may, I think, assume with Dr. Ayre, thatthese effusions into the chest are the effectsof inflammation, and that the urgent symp-toms in the above case were not so much

depending upon the actual disease, as uponthe effusion which resulted from it ; andthat, therefore, besides using the means toremove the effused fluid, we must apply our-selves to remove also the inflammationwhich causes it, and that the above case,like the one you published last week fromDr. Ayre’s work, proves that even in theworst cases we need not despair of success.

I am, Sir, your obedient servant,EDWARD VVHITE,

Surgeon-Apothecary.Red Lion Street, Holborn,

12th July, 1830.

EDWARD WHITE,Surgeon-Apothecary.

OPERATIONS AT THE DERBY INFIRM ARY.

To the Editor of THE LANCET.SIR,—I hoped that the next time I had to

address you on the government and the

conduct of the medical officers of the DerbvInfirmary, it would have been in my powerto have eulogised their new rules and regu-latious, as well as to have acknowledged aradical reform iii the medical and suricaldepartments. But in this, Sir, I am disap.pointed, and I fear, judging by recent cir-cumstances, that the day of congratulationis far distant. A revision of the old lawstook place, or rather a new code was enact-ed, during the early part of March last, withall probable chance of improvement. Suchndeed were the alterations, that on viewingthem as a whole, they might have been con-sidered good, and likely to he productive ofgeneral utility, though, I confess, if eachrule were subjected to scrutiny, reasonableobjections might be raised ; for my presentobject, I shall content myself by singlingout one of the faulty rules, to illustrate thenecessity of a speedy remedy.Appended to Kule 7, page 10, of the reo

gulations of the Infirmary, will be seen thefollowing note :-

" It being desirable that the Infirmaryshould be a means of promoting professionalscience to the greatest extent consistentwith the benefit of the patient, and good re-gulation of the house ; the governors thinkit proper to express their wish, that themedical men of the town may be permittedto see operations, when not attended withinconvenience."

This recommendation was proposed bythe committee who met to revise the laws,in consequence of an united appeal from thesurgeons of the town. Prior to the introduc-tion of the note, the medical officers had beenin the habit of consulting their whims andvagaries as to who should, and who shouldnot, witnESS either their practice or theiradroitness with the knife ; and so far had

they carried their pleasure, that on one me-morable occasion, the senior surgeon (Mr.Godwin), with the greatest sany froid, or-dered Mr. Huggins, a Derby practitioner,out of the operating theatre. At other timesthis gentleman has operated privately mthe wards ; at least, he has had only thesanction and countenance of his apprenticesat the time. Such was the deplorable stateof the surgical department when Expositortook upon himself the task of pointing out tothe world, through your Journal, the effectofMr. Godwin’s lordly will, as hkewise hisrevolting system of 11 liole-and-cornersur-gery." Since the present code of laws cameinto action, the governors have believedthat no obstacles would be thrown in theway of the town-surgeons witnessing theoperations. Such indeed were my own

anticipations ; but to-day, for the first time,my hopes were defeated. An operation wasfixed for this morning at eleven o’clock, and,as customary, I went up with the full in-

623

tention of seeing it; but when on the eve ofpresenting myself at the theatre, I re-

ceived a message from Mr. Godwin, by thebouse-apottlecary, informing me that mycompanv might be dispensed with." I im-mediatelv inquired personally of Mr. God-wtn, whether he was incapacitated hy mypresence from performing those duties [hisoftice required of him, for if so, I wouldsacrifice my desires for the benefit of the

patient. He hesitated, but at last openly con-fessed that it would be " inconvenient" forhim to proceed in my presence, and that ifI remained in the room he should postponehis operation for a more convenient season.Of course, by the foregoing rule, I wasbound to leave, as my company was " at-tended with inconvenience ;" and I did so,after stating to Mr. Godwin that it was incompliance with the rules of the house.This renewal of illiberality will, I trust,

be a lesson to all future committees who un-dertake the thankless and arduous duty offiaming laws, to consider beforehand forwhom they are legislating. Had they doneso in the present case, the absurd introduc-tion of the loop-hole " inconvenience "

would never have taken place. It behoves

the governors, therefore, at their first meet-ing, to amend the above rule by the omissionof, " When not attended with inconve-nience ;" if not, it will bear the semblanceof hypocrisy, for, without doubt, the notewas made with the laudable intention ofbenefitting both the institution and the me-dical profession, and it becomes their dutyto arrest that which is clearly found to beineffective. If such a course be not pur-sued, governors may again expect to hear oftheir senior surgeon practising " hole-and.corner surgery ;" of his again transfixingthe iris in the operation of cataract—of hisagain removing a healthy testicle as a curefor hydrocele-of his again operating for anincarcerated femoral hernia, without eitheropening the sac or dividing the stricture.

By the admission of the town practitioners,a guarantee is obtained that the publicwill be protected, and without it I feel as-sured, little benefit will attend the unfortu-nate sick who fall under the charge of Mr.Godwin.

I have just heard that Mr. Godwin, byway of acquitting himself for the conduct ofwhich I have complained, asserts that hewill not permit any individuals but hisfriends to be present during his exhibitionof manual dexterity. This is, indeed, ridi-culous. Does Cooper or Lawrence, or anyother surgeon of well-known merit, before hecommences an operation, ask of the gazingthrong, whether they are his friends or hisenemies ! Do they degrade themselves bysdmtttmg this man and rejecting that’! No,no; men of talent pursue a more enlightened

path ; they like to meet their enemies inthe field, that the public eye may have anopportunity of appreciating or censuring.What, then, shall we say of this conduct ina man of inferior attainments-in a man

who has proved himself incompetent for theduties of his office ?

I am, Sir,Your very obedient servant,

HENRY F. GISBORNF.. M.IL.C.S.Green Lane, Derby, July 10, 1830.

UNIVERSITY OF LONDON.

A Pupil of this Institution has forwardedto us the following statements in reply tothe animadversions made by Dr. Birkbeck -at the last meeting of the proprietors of theLondon University, on the acquirementsand conduct of Mr. Eisdell, one of the pupilswith whom the expression of dissatisfactionon the subject of Professor Pattison’s lec-tures originated :-In the first place (the writer observes),

it is not true that this student is ignorunt ;for, he cairied off the gold medal in Dr.Grant’s Class of Comparative Anatomy, frompupils who had hitherto surpassed him, andfrom all those who had received the highesthonours in the various classes of anatomy;it would be idle to attempt to show that noman can be a good comparative anatomist,who is not well acquainted with the struc-ture and arrangement of the human body. Ihave myself heard Dr. Grant state publicly,that Mr. Eisdell distinguished himself aboveMr. Phillips and Mr. Blackmore (our twobest anatomists) chiefly by his accurateviews regarding the anatomy of the deve-lopment of organs,—the highest grade in thescience, and that, indeed, which has been thesource of the fame ofCuvier, Blainville, andMeckel.

Secondly ; There is not one of Mr. Eis-dell’s fellow-pupils who has not the highestrespect and esteem for him, and it is theintention of at least one half of the class, tocome forward to present Mr. Eisdell withsome token of their respect for his talents,and their admiration of the independent andnoble spirit which led him, without consult-ing any one of them, to come forward andvindicate the credit of the school, by inform-ing the Council of the slovenly and imper·fect character of the anatomical lectures.There is, moreover, none of the professorsunder whom Mr. Eisdell has studied, savingProfessor Pattison, who has not declaredhimself pleased with the acquaintance ofthat Gentleman, and confident of his supe-rior acquirements.

Thirdly; Mr. Eisdell’s charge has beencalled an " ignorant accusation." lllr. Eis-dell’s charge is not founded in ignorance.

HENRY F. GISBORNE, M.R.C.S.

It amounts to this, that Professor Pattisonis so negligent in the delivery of his lectures,that if he be a scientific anatomist, the

pupils are unable to discover it. That theProfessor neglects to link together any ofthe numerous facts which he crowds uponthe notice of his pupils, by a judiciousarrangement, or by physiological remarkst’lat he, in fact, makes no refel ence what-ever to regional, functional, developmental,or comparative anatomy. Nut to descendto minutiae, these are :;rave, serious, andimportant charges, neither, frivolous, vexa-tious, nor ignorant. Nor are the.se chargessupported by Mr. Eisdell alone, but byseventeen of his fellow-pupils; in fact, byevery one of the gold-medalists, and by allthe men who have distinguished themselves.Indeed, Professor Pattison’s inadequacy hasbeen the theme of conversation during thelong and tedious session ; the benches ofhis class-room have been deserted, andsometim?s only two men have come to hisexaminations. Are these prool’s of the truthof Mr. Eisdell’s charge, or of its ignorance ?Had Mr. Eisdell not been out of town,

I should have left him to himself to answerthis attack, made while he was absent. Asit is, I close my letter by stating that evenProfessor Pattison’s favourite pupil andgold-medalist, has signed the allegation ofthe Professor’s ignorance.

A LOVER OF TRUTH ANDPUPIL OF THE LONDON UNIVERSITY.

624

BOOK FOR REVIEW.

An Inquiry as to the expediency of aCounty Asylum for Pauper Lunatics. Se-cond Edition. By W. Palmer, D.D., a

Magistrate for the Counties of Devon andSomerset. Exeter : Trewman and Co. 1830.pp.36.

TO CORRESPONDENTS.

Prior -. The facts are sufficient;the motives do not concern us.A Surgeon. Undoubtedly. The society

must fail. It bear3 too much of the aspectof a " hole-and-corner" birth to receive the

support of the influential mernbars of the

profession. It is a curious way of increas-

ing " respectability," to descend from thetitle of surgeon to that of general practi-tioner. A conveyancer, in older to elevatethe general character of his calling. wouldscarcely assume the appellation oi pick-pocket. It is all fudge, and the most activeknow the least. Prepare to support theLONDON COLLEGE OF MEDICINE. Successis certain. Benighted influence no longer

thrives at Court. HAL may be active, bitthe FORD is no longer considered to beeither safe or sound.F We are not aware that there are any

" lectures on midwifery delivered to fe-

males; hut we believe that women are

practically instructed in that department ofthe profession, by the experienced matronof the Lying-in Institution in the old CityRoad.Dr. Burton denies that he solicited for

the situation of ale-conner.Justus. A true bill was found bv the

grand jury ; but the matter has been hushedup. Who quoted the catechism, in orderto obtain the expulsion of a deserving mem.ber of the profession 1 How feels the oldman now’’ Is he another Roman father ?

Botany however is a science, and of courseit was not " unprofessional" to cultivate therape plant. -

Expositor. In due time. His conducthas been foolish, if not vicious.No DuB. Dr. Macmichael was registrar

to the College in Pall Mall Kast, and lie isnow private secretary to Sir Henry Halford.Dr. Hawkins is clerk to Dr. Macmichael.The carpet-shop is in Holborn, and the pro.prietor disclaitiis the letters of ’4 Medicus,"because they are so exceedingly ptosy, il.logical, and illiterate. At the hospital abouttwelve, and at Lord ————’s about four.The Princess’s carriage arrives every mnrn-ing from Kensington at about eight o’clock.A Parent. We are not sufficiently well

acquamted with the school kept by Dr.Paris’s mother, in Bishopsgate Street, to

recommend it, but we have heard that it isconducted upon very high moral principles.The crime of plagiarism is held in greatabhorrence.

Zeta. If such a contradiction had beenreceived by us, it would have been pub-lished.

Reformer. We do not think that Bedfordcould be made available for the purpose.The electors there, are, generally speaking,men of spirit and character, but their localinterests are too strong to allow them to healtogether independent. With regard toLord John Russell, a more miserable crea.ture, in the shape of a reformer, iieverinoredupon the face of this earth. He can talkabout giving liberty to the Greeks, and atthe same time work night and day to depriveEnglishmen, aye, and his neighbourstoo, ofpopular rights and privileges which thev badenjoyed from time immemorial. The billwhich he brought into, and smusgled through,parliament for the government of St. Giles’and St. George’s, Bloomsbury, would have

been a disgrace to a Caligula.ERRATUM.—In the review of Mr. King’s

Translation of Cloquet, page 581, col. 2,lite 51, for " parcoumes" read parcournes,