Monday Series: Inquest into a Surgical Procedure IV

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 Thomas 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.

Whether Wakely had enough of the bickering between Lyon and Turnbull, or whether it was too difficult and would have taken too much time to amass through the conflicting statements, it’s not clear why further investigation Lyon and Turnbull was not conducted. On the Friday morning, Wakley addressed the jury at “considerable length,” and after hearing all the medical evidence and viewing the body, the jury returned with a verdict of “Accidental Death, and cautioned “Dr. Turnbull not in future to allow his patients to use the instruments themselves.” Additionally, the warrant for the interment of Hall’s body was passed on to his friends. The verdict was perhaps not surprising considering the state of medical coronership during the period. As Ruth Richardson points out, there were no established coroner’s courts or public mortuaries by the time Wakley was elected to his position, and Wakley attempted to reform what was essentially a peripatetic post.

Immediately following the Hall verdict, Turnbull denounced any role in Hall’s death:

Much misapprehension has arisen from a recent occurrence which I deeply regret should have happened under my roof. I allude to the death of Joseph Hall, on whom an operation was performed by Mr. Lyon, a surgeon, formerly, but no longer, residing with me…With regard to that operation, I have only to repeat that I had nothing to do with it. I did not authorize it—I was not cognizant of it—nor was I made acquainted with the result until three hours had elapsed. With regard to the case of Mr. Wm. Whitbread, which had been referred in connection with the foregoing, I beg to say, that, to my knowledge, I never saw that individual, and certainly never performed on him any operation.”[1]

Shortly after, Lyon wrote to the editor of The Morning Chronicle, defending himself:

SIR—A letter appeared in your paper of this day by Dr. Turnbull, containing a number of imputations which I consider due to my own character to contradict. In the first place, I never resided with Dr. Turnbull. In the second, before I performed the operation upon Joseph Hall I told the doctor I was going to do so, and it met with his approbation; and in all cases of deafness I acted with his cogaizance and authority.[2]

According to witness depositions, Lyon and Turnbull also had different roles within the practice at Russell Square. Several witnesses stated that Lyon was responsible for operating upon the poor in one room, while Turnbull attended to the gentry in another room.

Moreover, Lyon defended himself against claims in periodicals stating that he was an “unqualified practitioner” who was “unskilled” in performing Eustachian tube catheterization. The London Medical Gazette, for instance, in publishing a summary of the Hall verdict, described Lyon as Turnbull’s assistant, “who operated on Hall, not being, we suppose, a medical practitioner.”[3] The statement apparently infuriated Lyon, who immediately requested the editor to print a correction stating that he was a member of the Royal College of Surgeons since 1823.[4] While Turnbull remained quiet in defending himself against accusations of quackery, particularly from Wright and Toynbee, Lyon almost demanded the profession acknowledge his skills as a practitioner. He wrote a letter to the editor of The Lancet, the same letter he also requested to be reprinted in the London Medical Gazette:

In some of the articles which have lately been published in your Journal respecting the unfortunate case of the late Joseph Hall, it has been assumed that the surgeon who injected the Eustachian tubes had not sufficient anatomical knowledge and skill to perform it, and thence a chain of reasoning has been attempted to account for the death. To show the fallacy of this mode of argument, I shall refer to two operations of great magnitude performed by me, and recorded in the “Medical Gazette”…These were cases of tumours situated directly upon, and in contact with, the common carotid arteries, both of which had a successful termination…The operation of injecting the Eustachian tubes is considered by aurists of eminence as one of the minor operations of surgery…I shall leave it to the profession to judge whether a surgeon capable of performing the operations above alluded to was not, also, capable of performing one of the easiest of the minor operations in surgery.[5]

Here, Lyon drew on the profession’s need to categorize surgical procedures according to their level of difficulty. But there was no established consensus on Eustachian tube catheterization, either on its use as a diagnostic or remedial agent, nor on the methods necessary to employ the procedure.

Turnbull eventually left London and headed to Edinburgh, where advertisements of his “miraculous cures” for deafness were placed under scrutiny. He eventually made his way to the United States, earning notoriety for his “cures.” Nothing much is known about what happened to Lyon. But debates among aurists and other medical practitioners about the merits of Eustachian tube catheterization as a remedy for deafness continued well into the 1850s.

 

end-


[1] London Medical Gazette 24 (July 1839), 576; The Morning Chronicle (8 July 1839).

[2] The Morning Chronicle (10 July 1839).

[3] “Death from Pumping Air into the Eustachian Tube,” London Medical Gazette, 24 (July 1839), 575.

[4] London Medical Gazette 24 ( July 1839): 575-576.

[5] T. Lyon, “Operations by Mr. T. Lyon,” The Lancet 32 (August 1839): 734-735; “Note from Mr. Lyon,” London Medical Gazette 24 (August 1839): 736.

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