healths, "five fathom deep," the vicechairman was sharpening his scalpel for a dissection of the president. It is a remarkable fact, however, and may serve as a lesson to short-sighted mortals, that, on the very day when it was triumphantly proclaimed, "that opposition and competition were at an end," the new joint-stock company started into existence, to the utter dismay and discomfiture of the original monopolists. years of reform and repentance would hardly be sufficient to set the medical profession on a level with their neighbours, in point of polished manners and refined taste, for which they had hitherto obtained credit. The work of reformation was a Herculean task. The Augean stable was to be cleansed, and people were some time in determining on the stream that was to wash away the filth.* *We beg it may be distinctly understood that we do not identify the ostensible editor, or rather the Proprietor of the Lancet, with the real editors or writers in that publication. We have the best reasons for believing that Mr. Wakley is not the writer of those scurrilous, defamatory, and odious articles, which appear, and have so often appeared in that periodical. We believe they were and are penned by hireling editors, who, in betraying the confidence of their master, have injured the medical profession at large. The following portraits of two EX-EDITORS, drawn in the very last number of the Lancet, will explain our meaning. 64 "We are told, however, that Mr. "Guthrie intends to rely chiefly on the testimony of two individuals, whom we "do not hesitate to pronounce the most "ungrateful, and the most short-sighted scoundrels that ever disgraced their, or But, whatever may have been the origin of the DISSECTING COMPANY, it is certain that the appearance of this opposition to the phlebotomists excited a very strong sensation. Several very neat dissections and specimens of "morbid parts" were quickly forwarded to the new company; and men began to wonder why they had so long permitted an association of scandal-bearers to revel on their vitals, without retaliating in kind on their persecutors. The workings of the public mind were not unheeded by the OLD COMPANY of Phlebotomists-and the first measure which suggested itself to the DIRECTORS was, to lower the price of their ORDINARY -or rather to place a few supplemental covers on the table, containing various kinds of most suspicious viands, in order to induce their guests to continue customers. This was a doubtful expedient. It was like offering some additional messes of fat pork to a company of sea-sick passengers. In short, the medical profession now began to perceive, for the first time, that they had been taking great pains to place themselves in a false position, with regard to the public at large, and especially with regard to the other learned and liberal professions. It was no longer to be concealed, that the public felt disposed to question the taste of the medical faculty, and to compare them with a community of cannibals, who preyed on each · For the credit of human nature, we other, in open day, without the least sense hope that such monsters, whoever they of sin or shame! The consequences of be, have not existed, even as the hireling this revelry on human flesh were now writers of the Lancet! The above docuunequivocal. The manners of the medi- ment, however, shows in what light Mr. cal profession had retrograded four cen- Wakley holds those, whose bold, manly, turies, in the short space of four years! and independent writings have captivated On searching the records of their art, no a certain portion of medical society!! specimens of defamation could be dis- In helping to expose the delinquencies of covered, that might at all compete with such hirelings, Mr. Wakley will be guilty those exhibited by the Company of PALE of the blackest ingratitude, if he does not BOTOMISTS. It was evident that some hereafter call us-FRIENDS! 66 any other profession-men, whose mo"ral turpitude has gone immeasurably "beyond the ordinary course of human "crimes. Give us the opportunity, kind, "modest author, of publicly extracting "from these wretches a history of their 66 own infamy, and we will ever after call "thee FRIEND."-Lancet, 22d December, 1827. 1 meting e al artisshes wich, unfor- Sean sull exist. but, a arenes arty ear and as poliane ebullitions of Tetulle as a brit the best and HO2S rons wages of the human But as my aliuded to has been he not ment v good as well as evil. as a Corta palanx in the cause A ONE, F, et, liberality, scimes, uni in, wach will redeem the water & English medical profesnon. ud med a lustre on human nature tset. We are no observers of the signs aided by, the superiority of talent, extent of intermattor, and judicions industry of the competitors. Under such a system, the more numerous the candidates, the graster will be the exertion; and the humar ieliect will now be called upon for the display of its utmost energies. An enemy to all monopolies, we rejoice at the prospect which expands before the eye of philanthropy. In the intellectual contest, which has now spread to the medical profession, we should grieve at the extinction of any rival, however formidable and however inimical. In drawing the sword against every thing which tends to degrade the profession to which we are enthusiastically attached. we hold out the olive branch to every honorable competitor in the promotion of medical science and medical literature. 41. PHLEBITIS. ne mes-we know nothing of the sprags that actuate men's mind's, or we are night in prognosticating that the year 1828 w exhibit a display of talent,knowLelge, and high-minded probity, which [Dr. Forbes. Med. Chir. Trans. Vol. XIII. wall drive into the abyss of despair, if not fabiirion, the host of MALIGNERS of the medical character, which have so long revelled in the abuse of a power which they vainly thought to be absolute, unlimited, and unassailable, Part II.j The second part of volume thirteen of the above transactions has recently appeared, and a volume is now to be published regularly every six months. A year Whether or not we have uniformly, or two ago, the LANCET, that oracle of and hitherto almost singly resisted this truth, proclaimed to the world that the diabolical tyranny, it is for our readers to Medico-Chirurgical Society was on its bear witness. We have now numerous death-bed. This oracular prediction is allies in the work of stemming the tor- fulfilled, in the way that all its other rent of demoralization; but the most pow- prognostications are verified—as, for exerful of all, is, without doubt, the reaction ample, the pupillary insurrection at Barof the public mind itself. This is so evi- tholomew's Hospital. A considerable dent to the JUNTO, that some of its mem- number of members and visiters are obbers, with that instinctive sagacity which liged to go away frequently from the characterizes a very small quadruped- meetings of the Society, for want of room, the RAT, are backing out of the company, and the list of its members is rapidly inwith all possible haste. The point of creasing. So much for the moral influtheir instrument indeed is broken offence of the JUNTO'S JOURNAL. or rather it is completely worn out by its own venesectionary mal-practicesthose who used to shrink in alarm, the weapon was unsheathed, now to laugh it to scorn. In fine, as we that the taste f abuse is rapidl for public favo The patient was a young man of 26 years, conceived to be labouring under pulmonary consumption, accompanied by -"swelling of both ankles." The swelling of the right ankle, however, gradually subsided, while that of the left extended upwards and increased, attended with pain about the ankle and calf of the leg, knee, ham, groin, and lower part of the abdomen. With these symptoms, the whole limb became hotter than the other, and tender on pressure. Dr. Forbes saw the patient for the first time on the 31st October, a week before his death. He was then in the last state of pulmonary consumption. The limb was double the size of the other," and every where it pitted on pressure." The colour of the skin was whiter than natural, and presented the exact resemblance of "common anasarca. The subcutaneous veins above the ankle were distinctly marked, and distended with blood. Died on the 8th November, The dissection was performed by Mr. Grainger, The saphena major and its branches were greatly distended,and filled with coagulated blood, but their coats were not diseased. The cellular tissue. of the whole limb was infiltrated with a limpid fluid, and the lymphatic glands in the groin where rather enlarged. The femoral vein was filled with coagulated blood. "The dissection was continued so as to expose the left iliac veins. The trunk of the external and common iliac vessels was found even more distended than the femoral vein. The common iliac vein had an unnatural colour, approaching to a greenish hue; and it seemed as large as the inferior cava. The distension of this vessel suddenly terminated at that part where it is united with the right common iliac vein. The left internal iliac vein was filled with blood for about two inches of its course, and the rest of it appeared natural. "The femoral and iliac veins on the right side were nearly empty, and quite healthy in their appearance, forming a strong contrast, when compared with the gorged and distended state of the veins on the left side. "On laying open the upper part of and common iliac veins, they were found the femoral vein, as well as the external filled with a coagulum. of much firmer consistence than is usually met with in healthy veins; and had much of the fibrous appearance of the blood which is found contained in aneurismal sacs. On separating this coagulum, a thin but distinct membraneous layer was seen adherent to the internal coat of the vein, and it required some force to separate them. The femoral vein, which was examined as far found in the same condition," 296. down the limb as the triceps muscle, was We perfectly agree with Dr. Forbes that the morbid appearances in this case were very similar to those which have been described by Dr. Davis in his paper on phlegmatia dolens-but on that very account we maintain that this was not a case of phlegmatia dolens, but one of phlebitis. In a former number we have taken such pains to disprove Dr. Davis's theory, that we need not recur to the subject again. If phlegmatia dolens depended on inflammation of the inguinal and iliac veins, three-fourths of the pa tients would die-whereas death does not take place in one case in the hundred where that disease is exquisitely marked. This fact would be sufficient to disprove the identity-but there are numerous other reasons for refusing acquiescence in Dr. Davis's views. 42. EXTRA-UTERINE PREGNANCY. Mr. Norman, of Bath, has related an interesting case of this kind, in the last vol. of the Med. Chir. Transactions-and the more so, on account of its termination. Eight months before the date of report, the female, aged 41, had become very ill, with palpitation, difficulty of breathing, frequent sickness and vomiting. It was then the catamenia were interrupted. At three months from this cessation, a rounded tumour was felt in the left ilac region, about the size of a fist. She could not lie on her right side, and all her distressing symptoms were on the increase. At five months from last menstruation, she felt the motions of the child, which gradually became stronger, until all doubt of pregnancy was at an end. Her breathing became more difficult, and she was often unable to lie down at night. At the end of eight months, (14th October) Mr. N. was summoned. She had been suddenly seized with symptoms indicative of failure in the action of the heart, and her dissolution seemed impending. Large doses of opium restored the heart's action and a few days passed before any thing was done. On the 13th October, she was again seized with a paroxysm, and again she was relieved by laudanum, &c. It was determined to induce labour, as she was now supposed to be in the ninth month; but, on examination, the os uteri could not be discovered. The form of the child's head was distinctly felt, covered by an intervening substance, as thick as the parietes of the uterus. Through this an incision was made, about two inches in extent; but still the os uteri could not be found. Some fluid escaped, and the scalp of the child's head could be felt. She became easier, and remained so through the night and next day. In the evening, she had another paroxysm of dyspnoea, on recovering from which, it was agreed to open the child's head, as it was far out of the reach of the forceps or vectis. The head was opened, and the brain extractd, as was afterwards the body of the child. No placenta presented, or could be felt. A hard solid tumour was found on the left side of the abdomen. It was now considered that the case was one of extrauterine conception, and that 'the opening had been made through the vagina and peritoneum. On the second day, symptoms of peritoneal inflammation came on, and she soon died. On dissection, the small intestines were found much inflamed, as well as the peritoneum. The placenta was found attached to the right ligamentum latumthe funis was torn away about two inches from the placenta-the part divided in the operation was discovered to be the posterior portion of the vagina-the os uteri was situated above the pubes, as in retroversio uterus. The uterus itself was thickened and hard, and its cavity was lined with a well-defined tunica decidua. the heart was flaccid--the ventricles thin, and containing no blood. Mr. Norman thinks that, could the placenta have been extracted, and bad there not been disease of the uterus, the recovery of the patient was not improbable It appears to us, that the patient had disease of the heart, (passive aneurism) which would have soon terminated her existence. 43. DURATION OF PREGNANCY: In a paper in the recently-published volume of the Medico-Chirurgical Transactions, Dr. Merriman has given some tables calculated to assist in throwing light on the mean duration of utero-gestation. We say the mean duration, for we have no doubt that Nature, in this, as in many other instances, deviates occasionally, and to a considerable extent, from her own general laws. Of the births of 114 mature children, calculated from, but not including, the day on which the catamenia were last distinguishable, 3 happened in the 37th week-13 in the 38th week-14 in the 39th week-33 in the 40th week-22 in the 41st week-15 in the 42d week-10 in the 43d week-and 4 in the 44th week. From this table, our author thinks it fair to infer, that conception is effected soon after the catamenial period has intermitted, rather than immediately before the expected return of that period. A knowledge of this fact, he says, is useful on many occasions, and is of paramount importance, by enabling the accoucheur to fix upon the proper time for inducing premature labour in cases of deformed pelvis. Our experienced author has seen a very few cases where the period of delivery (calculated from the last appearance of the catamenia) exceeded 44 weeks, or 308 days; and of these few anomalous cases, he has given some details in the paper above mentioned. Medicina Forensica. I. THE COLLEGE OF PHYSICIANS. "Perituræ parcite Charta." If the College or its partizans think that we have been too severe in our comments, or too extravagant in our demands for reformation, we beg they will calmly peruse the following document, drawn up and presented to the College 30 years ago, by 14 as eminent physicians as that Institution can boast of. In this remonstrance, petition, or whatever else it may be called, will be seen most of the leading principles for which we contend; and happy would it have been for the College, if it had hearkened to the reasonable request of the Licentiates thirty years ago, instead of having recourse to measures which we shall be compelled reluctantly to portray in our next number, should no appearances of better feelings be developed in the interim. "To_the President and Fellows of the College of Physicians of London: "GENTLEMEN, "WE, whose names are subscribed, licentiates of the college of physicians of London, conceiving ourselves unjustly deprived of those professional honours and privileges to which we are entitled, and persuaded that every physician of irreproachable character and of competent learning has a legal right to be admitted a fellow of the college, submit to your dispassionate consideration the following grounds of this conviction. "In the beginning of the sixteenth century, when learning had made but little progress in this country, and medicine was chiefly practised by ignorant empirics, the physicians of London were incorporated into a college or community, by a charter from Henry VIII. The object of the grant, as declared by the charter, was to provide for the safety of the subjects of the realm, by restraining the VOL. VIII, No. 15. audacity of those wicked men, who practise medicine more from avaricious motives than from any good intention, to the great injury of the illiterate and credulous multitude. With this view, partly in imitation of well regulated states in Italy and many other countries, and partly in compliance with the prayer of John Chambre, Thomas Linacre, Fernando de Victoria, the king's physicians, of Nicholas Halsewell, John Francis, and Robert Yaxley, physicians, and of Cardinal Wolsey, a perpetual college of discreet and learned men was established, consisting of the above-named six physicians, and all other men of the same faculty, residing in London. The members of this body were authorised to exercise their profession in London and its neighbourhood, and at the same time, were strictly required to prevent every other person from practising medicine, either in that city or within seven miles round it, unless he had been admitted to do this by the college; and in order that this injunction might be carried fully into effect, they were invested with powers to punish the disobedient. "It is evident then, that neither the graduates of Oxford and Cambridge, nor those of any other university, were to derive any partial advantages from the charter; but on the contrary, that all discreet and learned physicians, residing in London at the time it was granted, were indiscriminately admissible into the college, and that the perpetuity of the body was to be preserved by the reception of every physician of the same description, who should ever practise medicine in Londor, or its vicinity, and should claim to be a member. Can it be supposed, that Henry VIII. while he declared that the good of his subjects at large was the object of his grant, in reality meant to 31 |