809

and we must in justice to the editor say,they display, in a very complete manner,the multiplied anatomical relations, and thenumerous causes of danger, which attendthis difficult and complex operation,-anoperation, however, which lithotrity is in

many instances, though by no means in all,happily superseding. The whole are faithfulcopies of nature, and are excellently en-graved on steel by Johnstone.

SHEFFIELD GENERAL HOSPITAL.

AMPUTATfON ABOVE THE KNEE—HÆMOR-

RHAGE—AND AMPUTATION AGAIN ! 1

-

-, a young man, set. 22, was ad-mitted an in-patient February 3, 1832, withdisease of the knee-joint. Ordered " milk-diet." A consultation was called on the7th, when the medical officers examined thepatient and decided upon the necessity ofan operation, which was performed on

Thursday the 9th. The length of time oc-cupied in taking off the limb was eightminutes, and the patient having been re-moved from the tab!e at the expiration ofthirty-three miuutes, was carried to bed andDut unon low diet.

On Sunday the 12th, a small quantity ofblood oozed through the dressings, and onthe evening of Wednesday the 15th haemor-rhage ensued to such an extent that the

house-apothecary thought it prudent to sendfor the operator, who arrived at the hospi-tal a little after ten o’clock p.M. The dress-

ings being removed and the stump opened,the bleeding vessel or vessels, either fromtheir retraction, from the impaired visionof the operator and of the house-apothecary,or from some other unknown cause, escapedtheir notice. A red-hot iron was now hadrecourse to, which was alternately thrustinto the abductor muscles of the thighbv these two gentlemen, being the partwhence the blood oozed. Failing, after re-peated attempts, to arrest the haemorrhage,the cavity was next plugged with lint dippedin turpentine; the vessels being in thismanner compressed, the patient was put tobed after having suffered nearly three hourstorture.On the 1Gth milk, diet and broth were

ordered, and the patient began to feelsomewhat stronger, although a slight hae-morrhage was still going on. On the 22ndthe ligature of the femoral artery came away,and oft the morning of the 23d bleeding en-sued to a considerable extent. The other

surgeons of the hospital happening to be atthat time in the house were desired to give

’then-opinions on the case. The stumpbeing bared f,r tbeir inspection, and thecoagulum removed, it was ascertained thatthe blood issued from an artery of consider.able size situated amongst the abductors ina cavity of between three and four inchesdepth from the extrtmity of the stump, pro-duced by the ’ natural retract;on of the

muscles ;" * the end of the os femoris wasprotruding about an inch beyond the integu-ments ; this, combined with the deep situa-tion of the artery, the profuse hæmorrhage,and the debilitated state of the patient, most

likely induced the surgeons to determineupon a second operation. Accordingly thepatient was again brought into the operatingtheatre to receive the benefit of the consul.tation, and if 1 shall not be occupying yourvaluable columns with too long a detail, Iwill simply relate the particulars of thesecond amputation.The stages of the operation were as foI-

lows :—The patient being placed upon thetable, the femoral artery was compressed atthe groin, and the circular incision madethrough the integuments at two separatecuts (with thp amputating knife), about twoinches above that made at the last amputa-tion. The operator commenced dissectingback the integuments with the common

scalpel. This stage of the operation occu-pying nine minutes, the integuments werethen reflected, and a portion of the tensorvaginæ femoris, which had been raisedwith them, was cut off, and a :etractor ap-plied, consisting of half’ a yard of nari-owrolter. The next stage, viz. dividing the

muscles, was commenced by thrusting intothe abductors the same little scalpel whichhad been used for reflecting the integu-, ments, but having made several ineffectualplunges for the purpose of getting down tothe bone, the junior surgeon, who had pre-viously been at a distance from the scene,now advanced, and informed his colleaguethat he thought the amputating knife was amuch more proper instrument for dividingthe muscles ; the operator relinquished thescalpel for the knife, and succeeded, afterstrenuous efforts, in cutting down to thebone, which was next sawn through ; thisstage occupied four minutes ; three minutesand a half were then devoted to shaping theextremity of the stump, i. e. cutting awayany lumps of muscle that did not imme-diately retract, leaving the bone uncoveredby anything save periosteum, for an inchand a half,-sixteen minutes and a half hav-ing now elapsed from the commencementof the operation. The bone was now sawnthrough. The arteries were next secured,and the integuments drawn together, the

* Did not the action of the red-Lot iron assist inexcavating this tunnel ? P

810

edges resting upon the extremity of thebone. The stump was then dressed withpla ter, lirtt, three or four piedgets of tow,and ro lers sufficient to keep the parts toge-ther, and the patient was removed from thetable after a lalrse of forty-three minutesfrom the commencement of the first inci-sion.

In examining the above narrative of facts,the mind of the reader is of course preparedfor the result, namely, the death of thewretched suifcrer, which took place on thesame evening.

WESTMINSTER HOSPITAL.

CLANDESTINE REMOVAL OF THE BODY OFA PATIENT.

To the Editor of THE LANCET.

SIR,—The following particulars of an

occurrence at the Westminster Hospital,showing up some of the " secrets of theprison house,"-may not be uninteresting toyour readers, particularly at a time whenthe feelings of the public are so aroused atthe modes resorted to for supplying theschools of anatomy with subjects.A patient, of the name of Anne Young,

having died in the hospital about the1st inst. was removed therefrom on Fridaythe Srd inst. in a very clandestine manner.

Application was made on Saturday the 4thby a man of the name of Abel Meads,whose rectitude of conduct is generally es-teemed, and who had some knowledge ofthe deceased young woman, to stay theinterment of the body, till he had in-formed the friends of the deceased, wholive in Sussex ; when, to his astonishment,he was told that the body had been takenaway the day before. He addressed him-self to Mr. Edwards, the apothecary,who immediately called Mr. Th omas, thehous,-surgeon, into the room with himselfand Abel Mead, when the following con-versation took plact :-

’

11l1-. Edwards.—" Pray, Mr. Thomas,where is the body of Anne Young ?"Mr. Thomas.— " I do not know—I believe

it was fetched away by her brother."Mr. Edwards.—" Do you not ktiow where

it was taken to!"Mr. Thomas.—" No.’’Mead then put the following interroga-

tories to Mr. Thomas :-‘ Pray, Sir, haveyou got the order for the delivery of thebody ?" Mr. Thomas. " No, 1 burnt it! !"-Mead. " Pray, Sir, is it cu-tomary to

destroy sueh vouchers 1" Mr. Thomas

(hesitatingly). " No, not generally ; but1 burnt it."—Mead. " By whom was the

arder signed?" Mr. Thomas. " I believe

’by John Young, Rosemary Lane!!!—Mead then departed much surprised and

disappointed.However, thinking all was not " quite

correct," he wrote a letter to the weeklyboard (Thursday), 9th inst., when, to theirhonour, they immediately summoned AbelMead before them, and closely examinedhim, as also the officers of the hospital.The development astounded them, producinga perfect Babel. Sir Anthony Carlisle waschairman, and said that he would not havethe odium of the affair attached to him for

twenty thousand pounds, and said in Mead’spresence that he had had suspicions of irre-gularities for some time, but that the pre-sent investigation should prevent a repe.tition of them.

For the information of the public, as wellas for the refreshing of Mr. Thomas’s me-

mory. I present an abstract of the facts :-On Friday evening, in the absence of the

porter, the body was taken away in a cart

by two men dresst d in black, to an ana-

tomical school in Windmill Street, whoteone of the surgeons of the hospital is inthe habit of lecturing. Here the body wasseen by several subordinate officers of the

hospital, who found it there during theirsearch, accompanied by a respectable youngman unattached to the hospital.

This is not the only case that could beshown up, as the Board expressed them-selves that such doings had been carried onfor some length of time.-I am, Sir, mostrespectfully, your obedient servant,

W. M.

[In thanking our correspondent formakingthis exposure of a very serious outrageupon the feelings of the poor inmates ofthe hospital, we cannot withhold our ap-probation of the straightforward conductof the gentlemen composing the " WecklyHoatd." The poor have a just right to ex-pect that their persons, while alive, andtheir bodies when dead, shall receive fromthe officers and servants of every public in-stitution equal care, and as decent atten-

tion, as the lives and remains of the mostwealthy people in the kingdom. If thebodies of patients who die in our charita.ble medical institutions, may be removedfor dissection without any previous inquiryinto the causes of death, without any in-

spection by relatives or friends, or withoutbeing exposed to the view of such medicalmen as may be in the habit of visiting thehospitals, we can only say, that such a

practice will hold out the strongest induce-ment to the commission of every species ofmal-practice, and, if tolerated, will lead to arepetition of those murderous experimentswhich were even in course of procedure before