1
618 From inquiries which I have made since, it appears certain that the child was submersed for at least five minutes, as he had to be extricated from the mud in the bottom of the pond by means of a ladder. I remain, Sir, your obedient servant, . RICHARD ELLIS, L.R.C.S. Edin. Bishops-Auckland, Durham, June, 1857. RICHARD ELLIS. L.R.C.S. Edin. THE SECRET PROCEEDINGS AT THE MIDDLESEX HOSPITAL. To the Editor of THE LANCET. SIR,—The students of the Middlesex Hospital ought to feel grateful for your able ad just remarks upon the contemptible - cancer mystery. But have they not suffered themselves to be implicated in it? Suppose a few men who had paid to.wit- ness the surgical practice of the hospital had quietly followed Dr. Fell into the cancer wards, and, if requested to withdraw, had firmly and respectfully stated their determination to re- main unless ejected, would the affair have proceeded ? I emphatically answer, No! This, like many other self-incumbent ,duties, would certainly not be of pleasant performance, but the sympathy and approbation of every student in London would have amply rewarded it. Moreover, I firmly believe that there is only one of the surgical staff who would, not at heart have admired such.,% step. That individual who has been permitted by his,quiet senior and junior colleagues to thrust himself into a prominence due neither to his status nor performances, might have encountered them with his gloomy scowl, and treated them with more than his habitual con- temptuous taciturnity, but, as this would involve no great educational loss, they m.;ght well have afforded to smile at it. , I remain, Sir, your obedient servant, June, 1857. ’ A FORMER MIDDLESEX PUPIL. , ’-’ To the Editor of THE LANCET. ’ : SIR,- With reference to the alleged mismanagement, at the I Middlesex hlospital, I am not aware that anything has yet been heard on the other side,,and I therefore trust that, with I an Englishman’s love of fair play, you will honour this letter with insertion. E‘" - . :.> .,’, :,’... i Itnust, in limine, take exception to the very unfair manner in’which you have handled this vexed question of "secret re- medies. " Until within the last week the ’’columns of THE LANCET have been made brilliant by fierce and virulent ".’leaders," based on nothing sounder than mere assertion and rough guesswork., , Ex-parte. statements have been received with the warmth only due to’i,’eracious facts; and the public, if they take ashy interest in the matter at all, must have been pretty well bewildered as to the true state.of things, by the ,clamour and unnecessary clinking of the tin kettles and keys of medical journalship If, Sir, before descending to almost personal abuse, you had Sone’the surgeons of our’hospital the justice to inquire whether their conduct was not’ influenced by something more noble than mere love of notoriety or contempt of public opinion, you would have found no difficulty, I am sure, in allaying the feverish symptoms which have since so dis- tressed you. Our lecturers have simply done their duty. Acting in strict compliance with a clause in the will of the .greatest benefactor to our hospital, which enjoined every exer-’ tion in fillding.some means whereby the misery of cancer might be alleviated, they invited Dr. Fell to explain hishew mode of treatment. He, on his part, consented to do so, but only on the condition that he ’should be allowed the entire control of a certain number of cases, and protection for six months, while he wrote a book (as, he hadevery right to do)’ for his own private profit, and the advantage of the profession at large. There was no secrecy whatever in the matter. The surgeons knew from the very’first what ’was the formula of his 6,pplica- tinn; they became his clinical clerks and dressers’; and as the students knew that good faith must be sustained on both sides, they felt perfectly satisfied with what the surgical staff were doing, and refrained while going through the wards from inter- fering with the cancer patients. In this I can see no hardship nor ground for complaint. Every surgeon has a right to forbid his pupils handling a ’case of fracture if thereby unnecessary pain is caused. We walk the wards for instruction, and to be- come acquainted with the aspect of disease; not for the mere gratification of unfeeling curiosity. We have nothing to do with experimental remedies, but have only to look to the agencies of well-assured medicines and tried modes of treat- A FORMER MIDDLESEX PUPIL. ment, and to their ultimate results. If we could not appeal to precedents met with in our studentship, our career as practi- tioners hereafter would be that of quacks and empirics, and hence the advisability of the surgeons privately satisfying themselves of the efficacy of a remedy ere imparting it to us. From this it will be seen how inconsistent with facts are several points in your last leading article. It is simply an error to suppose that the publication of Dr. Fell’s book was hastened by anything said in THE LANCET. It was well known that the work would appear at the expiration of the period agreed upon, and it did. It was equally well known that chloride of zinc would most probably be the caustic employed, but in a way very different to that generally in use; and although it has been sought to be proved that his new mode is the revival of an old one, it has not been shown that it is not the most successful and the most permanent in its good effects. In 1852, Dr. Patteson offered to sell to the governors of the Middlesex his cure for cancer, hampered with the condition that it should not be made public; hence its rejection. Surely their consistency compelled them, in the case of Dr. Fell, to comply with his demands, and to admit that what he has pro- mised to do he has not failed to perform. I am, Sir, yours obediently, Middlesex Hospital, June, 1857. A STUDENT., # The surgeons of the Middlesex Hospital will have little reason to thank their zealous but somewhat intemperate advo- cate. He admits all that we have charged against them. He admits that they entered into a secret compact for one persons private pecuniary advantage; that they sanctioned and abetted the trial of a secret remedy in a public hospital; that they became the "clinical clerks and dressers" of an adventurer. What stronger condemnation could they receive ? It is scarcely necessary to say that the will of the benevolent Whitbread does not enjoin the resort to secret remedies, nor is it true that the " period agreed upon" for the publication of the book and the nostrum has even yet expired.-ED. L. SPONTANEOUS CURE OF PSOAS ABSCESS. To. the Editor of THE LANCET. SIR,-In your " Clinical Records," on the 7th of March, you notice the probable cure of lumbar abscess from spontaneous causes. I venture to trouble you. with the two following cases :- . A patient of mine, some years ago, suffered from lumbar abscess. After a long corfinement, a bit of dead bone, about the size of a horse-bean, came away almost immediately, the discharge became less, and he perfectly recovered. He is now alive and well. There is a preparation in the Museum, at St. George’s Hos- pital, which perfectly explains how this may happen, A small bit of necrosed bone is surrounded by carious bone in the lum- bar vertebræ; but there was no aperture of sufficient size to permit its escape : had there been, this case also might pro- bably have been added to the list of spontaneous cure of lumbar abscess. A case was related to me by Dr. Sylvester, of Taunton, in which, in consequence of caries of the lumbar vertebrae, he was obliged to open an abscess in three distinct places-in the back, and each groin. The patient, a young man, per- fectly recovered, married, and has a family of healthy children. I remain, Sir, your obedient servant, Bath, June, 1857. STEPHEN SPRANGER, M.R.C.S. STEPHEN SPRANGER, M.R.C.S. PROCESS FOR THE DETECTION OF IODIDE IN AQUEOUS SOLUTIONS. To the Editor of THE LANCET. , , SIR,-I send you an account of the process I employ for the detection of small quantities of free iodine in aqueous solutions. The method has not, to my knowledge, been pointed out by anyone but myself, I should therefore feel obliged if you would allow your journal to be the medium for giving it publicity. , If water (or almost any aqueous fluid) holding free iodine in -solution is agitated in a glass tube for a few seconds with a small quantity of chloroform, and then left to itself, the chloro- I form, when it subsides, will be found to have acquired a beau- tiful violet colour (more or less intense, according to the quan- tity of iodine present), which is due to its holding in solution all the iodine which the liquid contained. This. test is. highly

THE SECRET PROCEEDINGS AT THE MIDDLESEX HOSPITAL

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Page 1: THE SECRET PROCEEDINGS AT THE MIDDLESEX HOSPITAL

618

From inquiries which I have made since, it appears certainthat the child was submersed for at least five minutes, as hehad to be extricated from the mud in the bottom of the pondby means of a ladder.

I remain, Sir, your obedient servant,. RICHARD ELLIS, L.R.C.S. Edin.

Bishops-Auckland, Durham, June, 1857.RICHARD ELLIS. L.R.C.S. Edin.

THE

SECRET PROCEEDINGS AT THE MIDDLESEXHOSPITAL.

To the Editor of THE LANCET.

SIR,—The students of the Middlesex Hospital ought to feelgrateful for your able ad just remarks upon the contemptible- cancer mystery. But have they not suffered themselves to beimplicated in it? Suppose a few men who had paid to.wit-ness the surgical practice of the hospital had quietly followedDr. Fell into the cancer wards, and, if requested to withdraw,had firmly and respectfully stated their determination to re-main unless ejected, would the affair have proceeded ? I

emphatically answer, No! This, like many other self-incumbent,duties, would certainly not be of pleasant performance, butthe sympathy and approbation of every student in Londonwould have amply rewarded it. Moreover, I firmly believethat there is only one of the surgical staff who would, not atheart have admired such.,% step. That individual who hasbeen permitted by his,quiet senior and junior colleagues tothrust himself into a prominence due neither to his status norperformances, might have encountered them with his gloomyscowl, and treated them with more than his habitual con-temptuous taciturnity, but, as this would involve no greateducational loss, they m.;ght well have afforded to smile at it., I remain, Sir, your obedient servant,June, 1857. ’ A FORMER MIDDLESEX PUPIL. ,

’-’ ’

’ To the Editor of THE LANCET. ’: SIR,- With reference to the alleged mismanagement, at the I

Middlesex hlospital, I am not aware that anything has yet been heard on the other side,,and I therefore trust that, with Ian Englishman’s love of fair play, you will honour this letter with insertion. E‘" - . :.> .,’, ’

:,’... i

Itnust, in limine, take exception to the very unfair mannerin’which you have handled this vexed question of "secret re- medies. " Until within the last week the ’’columns of THELANCET have been made brilliant by fierce and virulent".’leaders," based on nothing sounder than mere assertion andrough guesswork., , Ex-parte. statements have been receivedwith the warmth only due to’i,’eracious facts; and the public,if they take ashy interest in the matter at all, must have beenpretty well bewildered as to the true state.of things, by the,clamour and unnecessary clinking of the tin kettles and keysof medical journalship If, Sir, before descending to almostpersonal abuse, you had Sone’the surgeons of our’hospital thejustice to inquire whether their conduct was not’ influenced bysomething more noble than mere love of notoriety or contemptof public opinion, you would have found no difficulty, I am sure,in allaying the feverish symptoms which have since so dis-tressed you. Our lecturers have simply done their duty.Acting in strict compliance with a clause in the will of the.greatest benefactor to our hospital, which enjoined every exer-’tion in fillding.some means whereby the misery of cancer mightbe alleviated, they invited Dr. Fell to explain hishew mode oftreatment. He, on his part, consented to do so, but only onthe condition that he ’should be allowed the entire control of acertain number of cases, and protection for six months, whilehe wrote a book (as, he hadevery right to do)’ for his ownprivate profit, and the advantage of the profession at large.There was no secrecy whatever in the matter. The surgeonsknew from the very’first what ’was the formula of his 6,pplica-tinn; they became his clinical clerks and dressers’; and as thestudents knew that good faith must be sustained on both sides,they felt perfectly satisfied with what the surgical staff weredoing, and refrained while going through the wards from inter-fering with the cancer patients. In this I can see no hardshipnor ground for complaint. Every surgeon has a right to forbidhis pupils handling a ’case of fracture if thereby unnecessarypain is caused. We walk the wards for instruction, and to be-come acquainted with the aspect of disease; not for the meregratification of unfeeling curiosity. We have nothing to do with experimental remedies, but have only to look to the agencies of well-assured medicines and tried modes of treat-

A FORMER MIDDLESEX PUPIL.

ment, and to their ultimate results. If we could not appeal toprecedents met with in our studentship, our career as practi-tioners hereafter would be that of quacks and empirics, andhence the advisability of the surgeons privately satisfyingthemselves of the efficacy of a remedy ere imparting it to us.From this it will be seen how inconsistent with facts are

several points in your last leading article. It is simply anerror to suppose that the publication of Dr. Fell’s book washastened by anything said in THE LANCET. It was well knownthat the work would appear at the expiration of the periodagreed upon, and it did. It was equally well known thatchloride of zinc would most probably be the caustic employed,but in a way very different to that generally in use; andalthough it has been sought to be proved that his new mode isthe revival of an old one, it has not been shown that it is notthe most successful and the most permanent in its good effects.In 1852, Dr. Patteson offered to sell to the governors of theMiddlesex his cure for cancer, hampered with the conditionthat it should not be made public; hence its rejection. Surelytheir consistency compelled them, in the case of Dr. Fell, tocomply with his demands, and to admit that what he has pro-mised to do he has not failed to perform.

I am, Sir, yours obediently,Middlesex Hospital, June, 1857. A STUDENT.,

# The surgeons of the Middlesex Hospital will have littlereason to thank their zealous but somewhat intemperate advo-cate. He admits all that we have charged against them. Headmits that they entered into a secret compact for one personsprivate pecuniary advantage; that they sanctioned and abettedthe trial of a secret remedy in a public hospital; that theybecame the "clinical clerks and dressers" of an adventurer.What stronger condemnation could they receive ? It is scarcelynecessary to say that the will of the benevolent Whitbread doesnot enjoin the resort to secret remedies, nor is it true that the" period agreed upon" for the publication of the book and thenostrum has even yet expired.-ED. L.

SPONTANEOUS CURE OF PSOAS ABSCESS.To. the Editor of THE LANCET.

SIR,-In your " Clinical Records," on the 7th of March, younotice the probable cure of lumbar abscess from spontaneouscauses. I venture to trouble you. with the two followingcases :- .

A patient of mine, some years ago, suffered from lumbarabscess. After a long corfinement, a bit of dead bone, aboutthe size of a horse-bean, came away almost immediately, thedischarge became less, and he perfectly recovered. He is nowalive and well. There is a preparation in the Museum, at St. George’s Hos-

pital, which perfectly explains how this may happen, A smallbit of necrosed bone is surrounded by carious bone in the lum-bar vertebræ; but there was no aperture of sufficient size topermit its escape : had there been, this case also might pro-bably have been added to the list of spontaneous cure of lumbarabscess.A case was related to me by Dr. Sylvester, of Taunton, in

which, in consequence of caries of the lumbar vertebrae, hewas obliged to open an abscess in three distinct places-inthe back, and each groin. The patient, a young man, per-fectly recovered, married, and has a family of healthy children.

I remain, Sir, your obedient servant, ’

Bath, June, 1857. STEPHEN SPRANGER, M.R.C.S.STEPHEN SPRANGER, M.R.C.S.

PROCESS FOR THE DETECTION OF IODIDEIN AQUEOUS SOLUTIONS.

To the Editor of THE LANCET. , ,

SIR,-I send you an account of the process I employ for thedetection of small quantities of free iodine in aqueous solutions.The method has not, to my knowledge, been pointed out byanyone but myself, I should therefore feel obliged if you wouldallow your journal to be the medium for giving it publicity.

, If water (or almost any aqueous fluid) holding free iodine in

-solution is agitated in a glass tube for a few seconds with asmall quantity of chloroform, and then left to itself, the chloro-I form, when it subsides, will be found to have acquired a beau-tiful violet colour (more or less intense, according to the quan-tity of iodine present), which is due to its holding in solutionall the iodine which the liquid contained. This. test is. highly