Various

“ It is quite obvious that if the jury had believed one syllable of the evidence of Wakley's witnesses, they must have given the verdict in his favour. In a case like this, where one individual only, and he the plaintiff, can be fully aware of the difficulties which had to be overcome, it is almost impossible to bring evidence into a court of justice capable of satisfying the minds of twelve unprofessional men. ”

“ Is that the mode in which your poor patients are to be treated?—that young and inexperienced men are to be placed there to learn their profession—not to know it before they get there, but are to go there to learn it—and learn it upon whom?—upon individuals who are as much entitled to the best and most scientific practice of surgery as any nobleman in this land. ”

“ There are the same objections to considering mere redness as equivalent to inflammation here as in the pericardium, or in any other part of the body: here, as elsewhere, in one case it may be the condition out of which inflammation is to spring; while in another it may not be destined to give origin to any change in the structure of the part beyond itself, and may itself constitute the whole disease. ”

“ It should seem, indeed, according to the ordinary course of things, that disease does not begin in the lining of the right cavities of the heart, until it has already advanced to an extreme degree in the left.
The internal lining of the heart, as well as of the arteries, is often found to have become of a red colour. This redness, so well known to all who are accustomed to examine dead bodies, used to be regarded as a mere stain imparted to it by the colouring matter of the blood after death. ”

“ And as rupture of the membrane seldom occurs in more than one situation at a time, the heart of the same individual seldom presents more than one excrescence of this kind: and as the aortic valves are the parts most liable to rupture, it is there that this single excrescence is most frequently found; not that rupture may not take place elsewhere. I once saw a single chorda tendinea ruptured; and a single fungous excrescence of considerable size hanging from it into the cavity of the left ventricle. ”

“ Is it thus that knowledge is to be advanced, the dignity of our profession to be maintained, its benefits enlarged, and its usefulness transmitted? Is it thus that the young men are to be taught how to acquire an unworthy and discreditable notoriety ”

“ At present I would only remark that they are often found conjoined with actual disease in other structures of the heart, such as osseous or cartilaginous thickening of internal lining, adhesion of the pericardium, and ossification of the coronary arteries, to which they owe their origin; and, moreover, that they are often found where the heart is otherwise perfectly sound in texture, and where their cause must be sought in other parts of the body.
The heart is liable to undergo a simple dilatation of its cavities without either thickening or attenuation of its muscular substance. ”

“ The muscular substance is less red than natural; its proper fibrous texture less distinguishable; but there is still the appearance of muscle shrunk and withered, as if from an insufficient supply of nourishment. It may be called atrophia of the heart.
Conjoined with augmentation, as well as with diminution of strength and bulk in the walls of the heart, there is almost always an increase in the capacity of its cavities; and in whichsoever part of the heart the walls are thus augmented or diminished, it is the cavity appertaining to the same part which undergoes the increase of capacity. ”

“ Dilatation of any cavity of the heart, with thickening of its walls, is called active dilatation; and dilatation of any cavity, with attenuation, is called passive [14] .
Active dilatation may appertain to every cavity of the heart simultaneously; and so may passive dilatation. But such occurrences are very rare: for one cavity being naturally more liable to this species of dilatation, and another to that, it most frequently happens that specimens of both conditions are found in the different cavities of the same heart.
The left ventricle is much more liable to active dilatation than the right ”

“ But great thickening may take place in the situation of the valves, from deposition of cartilage, without any unevenness of their surface or alteration of their shape; and under these circumstances the membrane itself you may expect to find hitherto exempt from disease [4] .
Osseous depositions are always, I believe, originally formed beneath, or exterior to, the membrane, both in the heart and in the arteries. There are two circumstances especially worthy of remark in this process of ossification: sometimes it is a pure and unmixed process: bone is formed, and nothing else. ”

“ When, during life, one tissue is separated from another, as the periosteum from the bone, or the cuticle from the skin, or the mutual cohesion between different tissues is sensibly weakened, we find it to be owing to the intervention of serous fluid which does not belong to their healthy state; and this, together with increased vascularity, or redness and heat, and pain, is enough to bespeak the presence of inflammation. ”

“ Not one word has escaped the lips of the counsel on that subject—not one word from the mouth of one of the witnesses. No, gentlemen, they are hospital surgeons themselves, and they know too well what the practices of our hospitals are, and the sufferings patients are in the habit of enduring at their hands, to feel for this man, or for any other man placed in a similar situation!" Canting hypocrite! this from the man who in the very case before us published his account of the patient's sufferings in the form of a drama, mingled with low and scurrilous gibes. ”

“ The appendix of the left auricle is a situation in which they are apt to occur, and they are generally accompanied by an extensively diseased condition of the lining membrane. These coagula, from their laminated texture, and from the intimacy of their union with the internal lining, seem to be essentially different from polypi of the heart. They appear to be connected with a process of disease in the membrane, and to have obtained their union with it long before the death of the patient. ”

“ All these conditions cannot remain after death. Hence, if we desire to form positive opinions concerning much which is unfolded by dissection, we must supply the defect by analogy. Thus, whenever, in any part of the heart or arteries, the cohesion between the internal membrane and the subjacent structure is manifestly lessened, and the membrane is unusually red at that part, we may regard these appearances as the vestiges of inflammation, without thinking that we go too far in so regarding them. ”

“ If it be a sound surgical maxim that, in strangulated hernia, the patient's safety depends upon an early operation, it is also a maxim no less sound, that where the evidence and symptoms of strangulation are imperfect, or dubious, the benefit of the doubt should be given to the operation, and it should be performed: for it is better that buboes should be laid open, or inflamed sacs cut into, twenty, aye, fifty times in succession, than that in one case a man should be suffered to die with strangulation of the intestine unrelieved. ”

“ It is most commonly found around scales and spiculæ of bone, and under such circumstances as to leave no doubt that the bone itself has furnished the source of irritation from which it springs. The ulceration commences from the very border of the bony scale, as if it was a process of nature for detaching it, and to a considerable distance around the ulceration the membrane is reddened, and easily detached from the subjacent structure. Where there are several distinct scales of bone, it is not uncommon to find a circle of ulceration around each of them. ”

“ Had there been any thing particular in the formation of the pubes, would they not have cut out the man's bone as well as the bladder?" It is probably impossible for any but medical men to appreciate fully the impudent imposition—the fraud of this statement,—this knavish artifice to mislead the jury. No attempt was made in any part of Mr. Cooper's case to show that there was such malformation, or that the stone was in the position which Mr. Wakley demonstrated it could not occupy—thus answering an argument which had never been advanced. ”

“ It is remarkable how curiously disease is apt to limit itself to the spaces just pointed out. Of the fibrous circle between the auricle and ventricle, of the valves which originate from it, and of the tendinous cords which connect the valves with the carneæ columnæ, there will not be the smallest space free from disease ”

“ Dr. Locock never saw a case where laceration occurred in the early months of pregnancy. Dr. L. remembered the particulars of a case where the uterus was lacerated in the fourth month, and the ovum escaped into the cavity of the abdomen, and the symptoms of pregnancy were exceedingly strong. Dr. Locock almost doubted whether Mr. Jewel's was an instance of pregnancy at all, for frequently women enjoying sexual intercourse have enlarged abdomens, and many of the other symptoms of pregnancy, which a few doses of purgative medicine will remove. ”

“ Where, in cartilaginous depositions, the lining of the heart has become puckered and uneven on its surface, and the valves shortened and altered in their shape, the membrane itself participates in the disease, and is generally incapable of being separated from the subjacent structure. ”

“ Patey, who was called to the chair, stated the object of the meeting; but as his speech was rather long, and contained nothing of the least interest, we omit it.]
Mr. Waller, in proposing the first resolution, adverted to the terms of the advertisement, and remarked that the question for them was not whether they would support [135] Cooper against Wakley, or Wakley against Cooper; but whether they would have a free medical press or not— (cheers) . Every body must admit that there was only one medical publication that was entitled to be considered free—only one that dared to tell the truth. ”

“ On the forehead, about an inch above the nasal process of the frontal bone, was a cut an inch and a half in length, extending obliquely downwards from the right side; through this a triangular fracture was felt, the base of which was in the direction of the external wound, and the apex pointing downwards; the fractured portion of the bone was slightly depressed; the bones of the nose were also fractured, and there was great discharge of blood from the nostrils. One third, or nearly, of the upper lip was cut off, and a good deal of blood had been lost from the labial artery ”

“ The healthy heart is always more or [121] less marked upon its external surface with streaks of white, and this appearance results from the deposition of fat in the cellular texture, which unites the serous covering with the subjacent muscular structure. It is found principally where the venæ cavæ unite to form the right auricle; also at the base of the ventricles, and along the line which marks the boundary between the two, and around the origin of the great blood-vessels as they emerge from the heart. ”

“ Humbug, to be successful, ought not to be very open to detection; alleged abuses ought not to be of a kind which every man can satisfy himself are entirely without foundation; and he who professes disinterested motives ought not to begin by raising a subscription for himself. We offer these few hints to Wakley, in hopes they may be of use to him in his new career ”

“ But when fat is deposited in more than these situations, and in more than the natural quantity, it is not so much added to the healthy substance of the heart, as existing at its expense and detriment, and the muscular structure is that which especially suffers. ”

“ Have arts and sciences, which are asserted of old to soften the manners and temper the violence of our nature, produced no such fruits amongst us? Is serious, and perhaps irremediable injury, to be inflicted on reputation ”

“ On some occasions the internal membrane of the heart and arteries, wherever it exhibits the appearance described, will allow itself to be peeled off from the subjacent structure with the least possible force ”

“ The deep dark tinge shews that the muscular substance is unnaturally loaded with blood; whereas the absence of colour shews that it is destitute of its natural quantity. These different appearances do, in fact, belong to different stages of the same disease. ”

“ Jewel saw her, examination detected nothing unusual in the os uteri, and the symptoms she presents are these. The abdomen is about the size of a woman's in the sixth or seventh month of pregnancy, the enlargement being general. Her general health is much disturbed: she complains of pain in the left hypogastric region, particularly when the abdomen is compressed by the hand or stays—and she also complains of weight in the abdomen, especially on leaning forwards. The woman herself has a strong prepossession that "something is to come away," or that she might be relieved by an operation. ”

“ I have met with it most frequently, and to the largest extent, in subjects whose previous disease has produced a constant and habitual impediment to the transmission of blood through the heart and through the lungs, and that impediment has gone on increasing to the hour of their death ”

“ Mark also the following—"Give such a verdict as shall satisfy the poor—as will shew that men are not to go into offices of this sort where the poor are to be killed, and that they shall not be at liberty to wade and ride through blood up to their necks to eminence in their profession. ”