Monday Series: Inquest into A Surgical Procedure III

James Reid conducted the full autopsy in front of the other medical experts and at the inquest, made a “long general anatomical statement” about his findings to Wakley and the jury. The facts relative to the case revolved around the finding of bleedings: there scalp had more blood than usual and between the dura mater and inner membranes of the brain, there was a “thin layer of blood, about two or three teaspoonfuls, principally at the left and posterior part. Under the thin membranes or the brain, and in the small veins, were globules of air, which putrefaction might have produced.”

Upon vertically sawing the face to get a clear view of the Eustachian tube, the “tubes were found pervious,” and Reid found no damage to them. However, upon inspecting the ears, Reid found that while the right tympanum had no clear indications of injury, the left was “swollen, and there was a slight effusion of blood into it, forming a small clot,” but the bones presented no sign of disease or injury. Moreover, as an air douche was used with the catheterization, Reid found no evidence of an aneurysm or air in any other blood vessels. Reid concluded that the

rupture of a very small vessel, or disease itself, might have produced the blood found in the tympanum. Thinks it is possible to have been blown there by the instrument. The death might have been caused by apoplexy, to which the deceased may have been predisposed, as he was a stout, plethoric man.

However, Reid could not state what the cause of the apoplexy was.

Appearance of the dura mater From: Post-mortem pathology : a practical treatise for students and practitioners / By: Henry W. Cattell (J.B. Lippincott,London, 1905).

Appearance of the dura mater
From: Post-mortem pathology : a practical treatise for students and practitioners /
By: Henry W. Cattell
(J.B. Lippincott,London, 1905).

Liston, Savage, Lynn and Quain were all present as Reid conducted the autopsy. Although they all agreed upon the facts of the case and Reid’s autopsy report, they disagreed on the cause of death. Savage saw no difference on the quantity of blood effused on the brain, but claimed he observed disease in both ears (but did not specify what kind or to what extent). He attributed the primary cause of death to the injection of cold air from the air pump to the catheter and remarked that it appeared Hall might have been predisposed to some sort of nervous condition that contributed to his death. He also remarked that it was not clear whether the extravasated blood observed by Reid was extravasated during life, a statement that was echoed by Liston. According to Liston, it appeared Hall probably died during a fit of fainting, for it appeared that some spasm or other affliction of the heart was the cause of death. The men all agreed nothing precisely satisfactory could be derived for the cause of death due to the decomposed state of the body.

As per guidelines for coroner’s inquests, the jury was to view the body and judge their verdict on their observations as well as on the witness depositions and postmortem report. This raises specific questions about the value of medical witnessing, which Wakley argued was essential for a proper investigation. Yet the cause of death was only one aspect of the case—the other being, of course, whether blame should be assigned to the practitioners involved in the case. Wakley complained that although Hall died on Saturday morning, no notice of his death was sent by Dr. Turnbull or Mr. Lyon to the summoning officers of the district. Inspector Sampson Campbell of the East Division of Police even testified that he did not hear of the death until Sunday evening, after being told by a Mr. Bye (possibly Hall’s employer) that a death had occurred in Turnbull’s practice of rather suspicious circumstance sand he requested Campbell to investigate.

At the inquest, Wakley asked Turnbull and Lyon to provide some explanation of their conduct; Turnbull admitted the death occurred at his residence, but denied blame, remarking that he wasn’t aware of the death until three hours after it happened; Lyon, on the other hand, argued that Turnbull was perfectly aware of the circumstances and was in the next room attending to gentlemen, when Hall expired. The case also raised confusion, due to conflicting witness reports claiming that it was Hall himself who set the fourth and final charge instead of Lyon (who gave the first three) thus being responsibility for his own death.

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Latest Comments

  1. Sally Frampton says:

    I’m really enjoying your posts about this case Jaipreet! Fascinating stuff and raises lots on interesting questions about risk and responsibility in 19c surgery. Also great to read about about how Wakley undertook his investigations!

    Like

    • Jai Virdi says:

      Dear Sally, thank you for the lovely comments! I’m glad you’re enjoying the series–you’re right: it does raise a lot of questions and perspectives about risk & responsibility!
      Thanks for reading,
      Jai

      Like

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