The report of the ordinary and resident medical officers and the annual report of the Inspector and Director, of the Public Hospital, for 1864, with the reply of the ordinary medical officers thereto : the letter of Alexander Fiddes ... and his correspondence with the governor, and the executive committee on the subject of his resignation and retirement from the Hospital : the letter of L.Q. Bowerbank ... in reply to Dr. Fiddes, and Dr. Fiddes' reply to same : also, the evidence adduced at the coroner's inquest, held on Richard Bailey, lately an inmate of the Public Hospital.

Kingston Public Hospital (Jamaica)

Date:: 1865

Credit: The report of the ordinary and resident medical officers and the annual report of the Inspector and Director, of the Public Hospital, for 1864, with the reply of the ordinary medical officers thereto : the letter of Alexander Fiddes ... and his correspondence with the governor, and the executive committee on the subject of his resignation and retirement from the Hospital : the letter of L.Q. Bowerbank ... in reply to Dr. Fiddes, and Dr. Fiddes' reply to same : also, the evidence adduced at the coroner's inquest, held on Richard Bailey, lately an inmate of the Public Hospital. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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m tne bladder. The Jury retired for an hour, and on their re-assembling, the following I further evidence was taken :— Charles Campbell, Esq., Doctor of Medicine, and Fellow of the Royal Col- lege of Surgeons of Edinburgh, sworn ] was present at the post mortem ex. animation on the body of the deceased, and I have heard the details of his treat- ment, whilst in the hospital, as also a great deal of the evidence on the inquiry I shall first state : those post mortem appearances which appeared to bear upon the death of the deceased. The heart was diseased, its right cavities dilated and attenuated to such an extent, as to have made it unable to bear any serious disease. The right lung was collapsed, atrophied and bound down to the walls of the chest by„ old adhesions ; both kidneys were in an advanced stage of granular degeneration, their pelves contained pus. In the cortical structure of the right kidney, there were several small cysts filled with pus The ureters were somewhat dilated ; the bladder bore the usual evidences of chronic inflammation. In the perinjeum, there was an incised wound an inch- and-a-half in length, the edges of which presented an unhealthy ash-coloured appearance, indicating a low vital action, and showing that the constitution had been unequal to the usual healthy reparative action. The scrotum was somewhat swollen, the cuticle in front was abraded, and the skin exposed, was of the appearance of washed leather. The cellular tissue of the scrotum was infiltrated with turbid serous fluid. There was to my mind, no evidence what- ever of urinary infiltration. There was no smell of urine; the alviolar tissue was not disorganised or broken down, as must have been the case in urinary infiltration.. The conditions necessary to add to it, did not exist; there ■was no obstruction to the free exit of the urine, as the perinseal incision was clear and free. It was a contingency not to be anticipated from such an operation: in proof of which I may mention, that of many hundred cases of the externa! division of stricture in the perinseum—an operation almost identical to this— that have been recorded, not a single case of urinary infiltration has occurred. Mr. Syme, the originator of the operation, says that “ it never occurs withou division of the deep facise of the perinseum,” which certainly did not take plao$ in this case. I dwell particularly on my belief in the non-occurrence of infiltra- tion of urine ; as some of the witnesses have ascribed death in this case to that pathological, state. I have seen exactly the same appearances, which were found in Bailey’s scrotum, in a case of renal dropsy, where no operation ha< been made.—The only other appearance whieh I wish to notice is, that the parotid glands were enlarged and were infiltrated with pus. From a carefo consideration of everything I have heard of this case, I am of opinion, tha death was produced from seuremic poisoning depending on the diseased condi- tion of the kidneys. I consider that the condition of the cellular tissue of th scrotum, which has been noticed, was the result of the constitutional state the deceased, and not the cause of the symptoms of which he is said to hate died.. I cannot account, in any way, for the accident which happened. I am of opinion, that with properly constructed forceps, the broken piece of instru- | ment might have been removed. A great deal has been said of the possibility of removing a foreign body in that situation, by ordinary polypus forceps. I ] believe myself the thing to be impossible ; I never saw in Jamaica, until Mon| day last, instruments that I think could have done it—The ordinary dressing forceps are two inches too short to reach the body in that position, even if of the necessary length, such as these (forceps produced); it is impossible to dilate the blades, to a sufficient extent to admit a No. 2 catheter without doing injury ■ the hands to the channel of the urethra, especially its orifice. I consider » necessary in forceps for the urethra, that the handles must be constructed so «t to cross each other, similar to the plate now shewn (plate exhibited). Any on? who has attempted to use the ordinary polypus forceps in the urethra, mutt have experienced the difficulties which I mention. Mr. Syme, no mean author- ity on these subjects, says: “Forceps are used with hardly any advantage from the difficulty of extending their blades in the case of foreign body in the ure- thra.” It was stated in evidence, that urethral forceps were not to be procured. .Dr. Fiddes says, that they might have been had at the stores of the Army and

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