them to relieve the coroner by deciding forthemselves. He is after all but a recordingofficer of the court, in which we shall here-after see that he will be treated with respector otherwise according to his clarms. The

country may depend upon it that this sort ofbusiness will henceforward be transacted inanother way, whether we have lawyers ormedical men in the situation of coroner.

The remarks upon the subject alluded toin the- concluding paragraph of my formerpaper will be transmitted on a future occa-sion. As they do not bear so directly on thepresent emergency as the foregoing, therewill be no inconvenience in reserving them.

MEDICAL CORONERS.

937

To the Editor of THE LANCET.SIR,-As I deem the interests of society

deeply involved in the question agitated re-lative to the legal and medical qualificationsof the coroner, I beg to submit the followingsketch of an inquest, the circumstances thatled to it, and the final legal proceedings.As it is neither my intention to reflect on

any one, nor to chum ctedit to myself, I shallavoid as much as I can all particulars thatmay identify the parties-you, Mr. Editor,being entrusted with my name and addressas a guarantee of the correctness of thestatement. A man, who had been occa-

sionally afflicted with rheumatism, andwhose constitution was not good, having in-dulged for several hours one very cold win-ter afternoon, till late at night, in drinking,first ale, and then spirits, till he was intox-icated, received in an affray, short) afteron his way home, several stabs, such as a

small penknife could innict; but only tno openetrated through the cutis-one throughthe lower margin of the pectoralis major,and the other penetrated diagonally upwardsthrough the pectoral muscles, glancing overthe fourth rib, and plunging against thethird rib, and wounding the pleura costalis,but ttot penetrating it; after this the manwalked about half a mile, and laid thegreater part of the night on a stone floor,and the next day an apothecary saw himand dressed him. I found the wound on themargin of the pectoralis healed, but that onthe breast was filled with a dossil of tow,with a poultice applied over it; it had notthe slightest perceptible iniiammation ; yetthe whole of my attention, by the patient,the apothecary, and attendant, was directedto this spot as the source of every pain andailment. After much minute and tediouscross examination, I ascertained that thearms had swelled and become so painful,

that he could not move them ; this was at-

tributed to wounds received on the back ofthe right arm and in the left to bleeding.The orifice had suppurated, but phlebitisbad not taken place ; the right arm had notbeen wounded, and the whole affection was,clearly, acute rheumatism. Some time priorto tins investigation, these symptoms ofacute rheumatism had, rather suddenly, verymuch abated, and subsequently, paiu in thechest, dyspnoea, and cough, had come on,and continued extremely harassing, not-

! withstanding some saline aperients thatwere frequently administered. It seems thatneither bleeding nor blistering was thoughtexpedient ! When I first visited the patient,effusion had taken place ; " he had purplelips, hectic flush, coliiquativo sweats, a

gurgling rattle in the bronchise, perceptibleto the ear and to the hand placed on thechest; respiration 42 in a minute, and pulse110, elastic, round, compressible to a thread-like feel." Ile rallied under a more appro-priate and more vigorous treatment for twodays; he then sank, and died the fourth

day after I first saw him, and twenty-fivedays after the infliction of the wound.The thorax was opened, and all its viscera

and membranes exhibited traces of the ex-istence of excessive inflammation; the pe-ricardium was nearly full of chocolate-co-loured serous fluid, with flakes of pus andcoagulable lymph floating in it.Now, Sir, 1 inferted that the chief cause

of this man’s death was mflammatory rheu-matism ; a metastasis having taken placefrom the arm to the viscera and membranesin the thorax, and that this fever had beeninduced by excess in drinking and subse-quent exposure to extreme cold ; at the sametime I admitted that the wound might haveexerted some influence in determining theinflammation to that particutar spot. Thecoroner, who I need not say was not a medi-cal man, frequently interrupted me, declaringhe did not thiuk my medical opinion hadany-thing to do with the inquiry ! And asthe evidence of the other medical man wentto assert, that the wound in the muscularportions of the pectoralis and intercostalcaused the death, the criminal was commit-ted under the coroner’s warrant, chargedwith murder. At the assizes, the grandjury did me more honour than I receivedfrom the coroner; they examined me veryminutelc, and listened in a very patient andgentlemanly manner to all I had to say,paint’ully objecting to me the conflictingopinion of the other medical man. I believe,however, on my evidence, the bill was ig-nored by the grand jury, and some informal-ity being discovered in the other part of thecoroner’s proceedings, the proceedings werequashed, and the man was discharged. Now,Mr. Editor, bad you been the coroner, or

938

any one like you, my opinions would havereceived as high an estimate from the coro-ner as from the grand jury ; the man wouldhave been committed for the minor offenceand substantial justice would have beendone.

I am, Sir,Yours very faithfully,

MEDICUS.MEDICUS.August 30th, 1830.

P.S. I have failed to find the " entréedes cavites du cerveau of M. Magendie ;I shall feel very much obliged to any onefor directions which will enable me to

find it.

REPLY TO SOME REMARKS MADE ON THE

REPORT OF

DR. ALEXANDER THOMSON at the late In-quest on Miss Cashin.

To the Editor of THE LANCET.SIR,-In the last Number of one of the

monthly medical Journals, I was sorry tofind some animadversions upon Dr. Alex.Thomson, and upon the report delivered byhim to the jury, which so carefully investi-gated the cause of Miss Cashin’s death. Tothese 1 beg to.offer a few words in reply.I agree with the writer of the article that

the Doctor presents " a good example," &c.,

but my assent to the truth of the observa-tion is dictated by a different view of thecause. He is, in my opinion, most decided-ly a good example, and if such au examplewere generally imitated, we should not bedisgusted so often as we are with the unin-telligible slip-slop and unredeemed non-

sense, uttered by medical men, upon occa-sions of judiciary investigation.

I hardly apprehend that the Doctor is

exactly " a tyro in medicine," for I remem-ber being present, many years ago, whenhe eloquently and learnedly took a conspi-cuous part in a discussion at the Medico-

Chirurgical Society ; and I have ever sinceentertained a high respect for his talentsand acquirements. I believe he has, in theintetim, been sedulously and successfullyengaged in applying the first of these ad-vantages to the improvement of the other.But I take it for granted, that the writerdoes not know him personally, and, fromcertain facts which have recently trans-

pired, you may possibly conceive him to benovus, if notjuvenis, in the profession.

Fault is found with his report, upon thefollowing general grounds; into particularsit is neither requisite nor possible for me toenter :-1. That he ought to have had nohesitation about the eschar being the cause

of death ; 2dly. That the examination of thebrain and spine was unheard of as themeans of discovering the cause of death-appending to this remark the surmise, thatthe cause of death, from several circum.stances specified, mirhtbe looked for in thebrain with utter hopelessness of success;Sdly. That the Court was puzzled hy histechnical description of every organ in thebodv ; 4thly. That the body was disinterredwithout the slightest necessity ; 5thly. Thatthere is not a well-informed man in the pro.fession who would not declare the sloughingto be the cause of death; 6thly. That noman acquainted with the effects of local audconstitutional irritation, would hesitate amoment in forming an opinion on the causeof death in this unfortunate case; 7thtv.That it is a principle in judicial medicine,that medical men should be as intelligibleand as conclusive as possible; 8thly. Thatthey should avoid all unnecessary displays oftechnicality and " rigmarole."Such are the charges quoted in the order

in which they appear, and I proceed to cou-sider them seriatim :-

1. It is observed that the existence of theeschar was proved by one of the most scien-

tific and eminent surgeons of London. Noone will question the claims of the gentle-man alluded to ; but it is not always themost eminent practitioner who forms thebest medical witness. I record this as a

principle in judiciary or forensic medicine,and could very easily quote practical illus-trations in support of it; but of some ofthese the writer is or ought to be well

enough aware already. Thomson acted upona knowledge of the importance of the occa-siou, and of the rules which, in similar cir-cumstances, ought to direct our conduct.He was quite right in hesitating before pro-nouncing ct positive opinion in a matter ofsuch moment. It is also to be observed, thatthe surgeon alluded to had finished all that

part of the investigation which devoted

upon him; whereas the gentleman who hasreceived (without incurring) the censure

of the critic, was at the time yet engagedin pursuing his.

2. I should have expected (t teacher ofmedical jurisprudence to have bestowedcommendation, instead of disapprobation,concerning the second article animadvertedupon ; but 1 am compelled to take him as Ifind him. So far is the course of examiiia-tion instituted by Dr. Thomson from bein" unheard of," that no other is observed bythe best medical jurists. All the cavitiesmust be examined before any necrotomistcan swear to the real cause of death. For,although he may not find traces of a positivenature, the result of such a careful and mi-nute inspection will enable him to denythe existence of a vaiiety of causes which