“The man returned home that day, and remained a week when he came again to me. I called upon Mr. Webber and mentioned the ease of the poor man who had been to me, and handed to him the two notes I received from Mrs. Shirley on the subject. Mr. Webber said he was exceedingly anxious to see the practice of Homæopathy, and if my remedies failed in removing the stone, he would be very glad to operate on the man, if I would allow him. Accordingly on the morning of the man’s arrival to stop in Norwich, which was Wednesday, the 11th February, Mr. Webber accompanied me to his (Swann’s) lodgings, at Nurse Phillips’. We sent the man up to his room, and desired him to prepare himself—Mr. Webber, myself, and the Nurse followed soon after. I then attempted to introduce my sound into the man’s bladder—the one I had used before; on this occasion I found the instrument from being cold, seemed to be grasped by the uretha; I ordered the nurse to bring some warm water, with which I warmed another instrument and passed it through. Upon Mr. Webber calling the attention of the jury to this expression, Dr. Bell said ‘I introduced it with the greatest facility.’ I immediately felt a stone, and I then passed the instrument to Mr. Webber, who said he felt it also. He withdrew the instrument, and upon my solemn oath, not a particle of blood or sign of blood followed. After the lapse of a minute or two, Mr. Webber drew an instrument of a large size from his pocket and introduced it, and he also injected some hot water. (Mr. Webber here exclaimed ‘hot water.’) On my oath, gentlemen, not hot water, but scalding water. Directly after this instrument was withdrawn, the man left the house. On my next visit, it was reported to me by the man and the nurse, that he had been parting with a good deal of blood, and I prescribed accordingly—I never introduced any instrument after that. Every visit that I made afterwards, I found that the man became more and more dissatisfied—he said he was anxious to leave me and Mr. Webber and go home, and the nurse declared that Mr. Webber had injured the man by the injection. Finding that he did not improve—that his nervous system was becoming more irritable, I called on Mr. Webber the following Wednesday morning, who observed I had done evil in bringing the man to that woman’s house, and we went and visited him.
“The days on which Mr. Webber saw him with me, were the 11th, the 18th, and the last time, the 22nd of February. On these occasions, Mr. Webber spoke to me respecting my treatment, and that was the reason why the man’s confidence in me was removed—but this was not all—on the evening of Sunday, the 22nd, Mr. Webber visited the man when I was not with him; after doing so, he sent me a note, and here it is:—
Dear Sir,
Having since I parted from you, been again summoned to the neighbourhood of Crook’s Place, I took the opportunity of giving Swann another look, I saw no ground for altering the opinion I openly expressed to you at our meeting; nor will I suffer the real issue in the case, the security and welfare of the patient, to be prejudiced by irreconcileable and strange disclosures which have been made, reflecting most unfairly and ungenerously upon me, considering the candour and frankness I have shown towards you, but to which I shall not now further allude, the real object of this note, being in my estimation of far more importance than professional differences; therefore, let me again beg of you to lose no further time in pursuing those measures, of which you at our first meeting expressed yourself as “sceptical or doubtful,” but at once to adopt more energetic means for the relief of the sufferer.
Understand me, I do not mean for a moment to assert that the inflammation which you agreed existed, may not abate or be determined without the application of the leeches, &c., but surely the known sequelœ of neglected opportunity, such as ulceration, &c. ought to be thought of, and if possible, to be averted—they being as effects quite as mischievous in the end, as the cause—the inflammation itself; the only difference that I ever observed, being that the one destroys quicker than the other, but both as certainly.
The patient begged of me to write to Mrs. Shirley, and state the facts of the case, and I cannot deny his request; but I will “nothing extenuate or aught set down in malice.”
As you have admitted to me, that you occasionally give half-grain doses of opium and of quinine (allopathic doses,) as “homæopathic to disease” (?) excuse my ignorance, you will I apprehend, have no difficulty in carrying out sound constitutional treatment, with local means, in the case in point.
I am, Sir, yours in much haste,
W. WEBBER.
St. Giles’, Sunday, Feb. 22nd, 1852.
To Dr. Bell.
“This shows that Mr. Webber went in my absence and talked to the man. I had told him to leave Swann in my hands, but instead of that, he visited him in my absence. Up to that night, the nurse had invariably told me that it was the injection which had injured him, but after that, Mr. Webber and the nurse seemed to have set him against my treatment. On Tuesday, the 24th, when I visited him, he would have nothing to do either with me or my medicine, and the nurse suggested that I should send for another medical man.
“On Wednesday morning, the nurse came to me, and asked me to see him early. I went immediately to him, and found him labouring under a paroxysm of the stone. He declined to receive any medicine from me. The nurse then suggested that Mr. Webber should attend him—I was much surprised at this, as previously she had always abused Mr. Webber. I asked the man if he wished Mr. Webber to see him, and he replied that he did. About nine o’clock the same morning, I wrote to Mr. Webber, stating that the man refused to use my medicine, and that he wished to see him. Mr. Webber sent me a note, stating that the wife of Swann had just been, and requested that he would take charge of her husband’s case, which he had promised to do. The man after this remained five weeks in Norwich, during which I had nothing to do with him.”
The coroner commenced ordering strangers and witnesses to withdraw, previous to his summing up, when Mr. Webber asked the coroner why he had been summoned, and insisted on his right to be heard, after the palpably incorrect statements which Dr. Bell had been allowed to make—the coroner replied that he did not consider it was necessary for Mr. Webber to give evidence at all. [46] The foreman of the jury, (Mr. Coleman) said “He thought it would be no more than right, that as Dr. Bell had made a statement, Mr. Webber should be allowed to make a statement also;” this opinion his brother jurors coincided in, and much against the inclination openly expressed, and the significence of great and frequent impatience of the coroner during the time occupied in the delivery of the evidence. Mr. Webber, after being sworn, deposed as follows:
I am a M.R.C.S., Eng., residing in Norwich. I received a note from Dr. Bell on the morning of the 11th of February, who asked at what time I could see a patient of his who had been sent by a lady, to be placed under his care, to which I returned an answer, and agreeably to arrangement, Dr. Bell called on me, and proceeding on our way to Mrs. Phillips’, in Union Place, he said he believed the patient, Wm. Swann had a stone in his bladder. That Mr. John Coleby of North Walsham had examined him, but had not found one, and he therefore wished to be satisfied that he was correct in the opinion he had formed. That he intended to treat him homæopathically, and that if the man should not be relieved by his treatment, about which he was “sceptical,” (“as he had had no experience in this disease”)—he would then hand him over to me to be operated upon, as he believed I was fond of operating in such cases—I told him I had no fondness for cutting up anybody, but, that when operations came in my way, and they were necessary, I never hesitated to perform them. He said he was not in the habit himself of operating in such cases. I agreed to go and examine the case, stating at the same time that I would have nothing to do with the treatment he proposed. That if his system proved to be a sound one, I should not hesitate to proclaim it as a great boon to suffering humanity, but that if it should prove to be otherwise, he might rest assured I should expose it.
Arriving at Nurse Phillips’, I there saw Swann, who was a man about five feet, nine or ten inches in height, in tolerably fair plight, no emaciation, no evidence of extensive organic disease going on, nothing beyond a slight wearing from the irritation which generally accompanies stone in the bladder, and with nothing in his appearance to interdict an operation after a week or two preparation, nor to exclude the benefits of opportune and proper treatment.
It is usual when a consulting surgeon is called in, to allow him to perform the manipulation, but in this case Dr. Bell himself passed the sound—I stood by while he attempted to pass it, which in my opinion was of a very objectionable form, and such a one as he would be likely to experience difficulty in introducing, and not calculated to detect the stone when in. On passing it down to the commencement of membranous portion of the urethra, he came to the check which I had anticipated; he then made forcible attempts to pass the instrument, despite my advice not to do so, conveyed in the words “Oh do not use force; pray do not use force—force will do no good, you will do harm.” That instrument was withdrawn, but not until force had been used. Another and smaller instrument was tried by him, when the nurse suggested that he had better use some warm water, as she thought the instrument might be cold, and she brought some. A further attempt was made to pass the instrument, and more force was applied, and Swann cried out “Oh! sir, you have hurt me, it has gone somewhere, I think it has gone wrong,” of which, I myself, entertained no doubt. The instrument was then partially withdrawn, and I seeing where the difficulty existed, recommended that this sound (producing it [49]) should be passed instead, for it had never fallen to my lot to see such unskilful manipulation as was exhibited by Dr. Bell, whose hand shook considerably at the time. He then turned the instrument and effected an entrance into the bladder. He said he felt the stone, and requested me to take the instrument, I did so, and felt a grating, but not being satisfied, I requested him to withdraw his instrument and I would introduce mine. I have no doubt that the urethra had been lacerated, for on his withdrawing his instrument, blood dropped on my boot. I do not say there was any great quantity, nor was it likely there would be, because it became extravasated; therefore, I adopted my usual plan in such cases, which was to introduce an instrument as large as the passage. I passed the instrument into the bladder and struck the stone, and I believe the sound was audible to the nurse, who is accustomed to such cases. Dr. Bell not being satisfied, on this, I withdrew the sound, and proceeded to inject into the bladder tepid water, as no surgeon in his senses would do what Dr. Bell states I did—use hot water, and if he would, he could not, for the patient would not let him. I then handed the instrument to Dr. Bell and turned the stop cock, allowing water to run out, so that the stone might fall on the end of it which it did, and was heard distinctly by those present, and Dr. Bell having assured me he felt it distinctly, it was withdrawn. During the progress of the examination, I asked the man whether he felt any serious pain, and he said, “I hope you have done, for I am getting very faint.” As he was very deaf, I put the question to him again, and asked him, did the last instrument hurt you? and he said “No; the last instrument did not hurt me.” All this was done openly. Dr. Bell said he was going to treat the man homæopathically; I said “he might do as he pleased, he might humbug the patient, but that he should not humbug me, and I would have nothing to do with such treatment.” Dr. Bell then mixed some medicine in some water in a tumbler glass; it did not readily dissolve, and he called for another tumbler, and in order to dissolve it, he poured the contents of one tumbler into another several times, and in the process, spilled one half of it. Thus showing how important these medicines are in their integrity. It was arranged that if the man was not benefitted at the end of a month, he should pass into my hands to be operated upon. I remarked to him that that time would afford no criterion of the value of his treatment, as patients had what is called fits of the stone, and if the fit went off, he would take the credit of curing the man, when in fact he had done no such thing. Dr. Bell states that I saw the man on Wednesday, the 18th, but that is not correct, as on that day I was called to and attended a patient in Cambridgeshire. On the following Sunday, (the 22nd,) he came to me and asked me if I had seen the man again, I replied certainly not—he asked me if I would come and look at him, because said he, “my treatment does not appear to succeed with him, I have no great confidence in its success.” I went with him to nurse Phillips’, and never in my life did I behold a man so changed—his condition was that of a man suffering under acute inflammation. I immediately turned up the bed clothes, or rather the sheet, and placing my hand lightly on the body, I was about to examine the state of the bladder, when he shrieked violently, saying “Oh! take away your hand, sir—I cannot bear it—you will kill me!” I had used no pressure. I then turned round and said, “Dr. Bell, how comes this about? Why the man has got inflammation of his bladder, what have you been doing?” The man was rather deaf, but he caught the last words, and looking at Dr. Bell, said “you have done it; you have given me poison.” Dr. Bell remarked, “I have merely given him nux, [52] because his bowels were confined.” I then said “there is no time to be lost; I fear the man will die; you had better put on leeches, as soon as you can, and have recourse to fomentation, and the sooner the better,” when Dr. Bell remarked “Can we not go some where else and talk?” I said “No, sir, whatever I do every body is welcome to see and hear, I will be a party to nothing in the dark, and I will tell you, unless you stop this inflammation soon, it will soon stop the man.” Dr. Bell said “that he would not take a drop of blood from the man, and he mentioned the names of several persons who, he said, knew the cause of inflammation, and that it could be stopped without it.” Being called into that neighbourhood on the evening of the same day to attend a patient of my own; and being anxious about the poor fellow, I called again at Mrs. Phillips’, but did not see the deceased. The nurse said that she had used fomentation, but the man was in great pain; I asked if Dr. Bell was there, and on her replying that he was not, I said I would write to him, (and hence the letter which Dr. Bell has thought proper to produce in his defence.) I then took my leave—Dr. Bell continued to attend him, on the Monday and Tuesday, and on the Wednesday, I received a note from him, asking me when I could attend, but I did not immediately answer it, as I saw his motive for writing in such a way. After this, Swann’s wife called upon me and I did attend, and I found the man discharging mucous from every mucous surface. Mr. Crickmay who happened to be in my house at the time went with me, and also saw the deceased, and he enquired as to the remedies that had been adopted; we both thought the man was sinking—his pulse was almost imperceptible at the wrist—his eye was vacant—the surface of his skin was clammy, and there were other indications of that general decline of power which frequently precedes death. I naturally inquired what the man had been taking, but before the nurse could answer, he said “he has been giving me more poison, I know it was arsenic, because I have mixed arsenic and lime with wheat, and know the smell and taste too.” This is the condition I found him in—I prescribed for him, directing such treatment as I conceived to be required to meet the exigencies of the case. He continued much in the same state for four or five days, the principal symptoms being diarrhoea, and a discharge of a small quantity of urine, mixed with bloody mucous and pus, which he had great difficulty in voiding. He then rallied somewhat, but relapsed in a day or two, and fearing the threatened result, and being influenced by the remarks being made out of doors, which were loud and condemnatory of the treatment the man had received from Dr. Bell, I thought it necessary to call in Mr. Gibson, a medical man, with whom I was not intimate. On the evening on which Mr. Gibson saw the man, he supported him while I drew off his water, and after Mr. Gibson had examined him, he came to the same conclusion as myself, that abscesses were forming in the neck of the bladder, and in the tissues connecting that organ with the adjacent structures. Mr. Gibson said that he had nothing to suggest in addition to my treatment. He saw the man the next day, and he said there was evidence of abscesses having burst, both in the rectum and in the urethra, for a great deal of pus had escaped. For a few days the man rallied again, but we had no hope for him at that time; and those who understand these cases, will tell you, that when abscesses form, as the result of injury and irritation in structures adjacent to the bladder and its connections, they will, by a continuous irritation in the absence of controul, lead to the perpetuation or encroachment of similar action in similar tissues, as for instance, an abscess in the capsule of the kidney, which has been attested to by Mr. John Coleby as the proximate cause of death. [55] From that time however, the man gradually progressed, and thanks to good watching, good nursing, and a generous diet, he recovered sufficiently to be removed home, not with my consent, but from frequent importunities I submitted to his going home, and he having improved, to a certain extent, I told him that he was at liberty to please himself, as to the future; he could either be under Mr. Coleby’s care, or he might return to me, and he went home on the 30th of March. I heard no more of him for a fortnight, when he sent word to me he was going on well, and that he hoped to return to undergo the operation. From the cause before mentioned, and possibly owing to the less nutritious diet, another abscess formed—after this, it appears the vital powers began to sink.”
Dr. Bell declined cross-examining Mr. Webber, and no other evidence being called, the room was then cleared of strangers and witnesses, and the jury proceeded to consider their verdict; after deliberating about 20 minutes, the foreman returned the following verdict:—“That William Swann died from an abscess in the capsule of the left bladder,” but on the suggestion of Mr. Crickmay, the coroner substituted the word “kidney” for “bladder,” remarking that, that was what the jury intended. One of the jury said that the foreman had not given the verdict exactly as agreed upon; and the foreman then added the words “and we are of opinion that deceased’s death was accelerated by improper treatment.” [56] Mr. Crickmay said, by whom do you consider improper treatment was used? The coroner observed “as for that, you and the public are to form your own judgment.”