The Sun.
London, England, 1865-07-11 00:00:00

SPIRIT OP THE PUBLIC JOURNALS.

TIMES.—The mysteries of medical etiquette have
seldom been more unfavourably exposed to public
criticism than during the late trial of Dr. Pritchard.
It will be remembered that Mrs. Pritchard was
visited during her illness by no less than three me-
dical men, at the request, or at least with the full
approbation, of the prisoner. One of them does not
appear to have observed anything to arouse his
suspicions ; another was so far " puzzled" that he
thought it right to communicate with the lady's
brother; but the third, Dr. James Paterson, divined
from the first the true cause of her sufferings.
Being called in on the 24th of February to attend
Mrs. Taylor, the mother of Mrs. Pritchard, he was
at once struck and startled by the appearance of the
latter. Nothing can be more explicit than his own
language in the witness-box. " I must say I could
not banish from my mind the conviction that her
symptoms betokened that she was under the de-
pressing influence of antimony." On the 2d of
March, after her mother's death, he saw her again,
and not only was his former impression confirmed,
but he " prescribed for her accordingly." On the
7th of March he attended her for the last time,
and we infer from the vivid description which he
gave of her condition at that time that his former
surmises must have ripened into moral certainty.
In short, he was virtually in possession of this
terrible secret for three weeks, and yet kept it to
himself. He prescribed certain things, and then felt
that his duty was done. " The etiquette of the pro-
fession" restrained him from inquiring further, even
as to the effect of his own medicines. He did not
venture to whisper his suspicions to Dr. Pritchard
himself, for " it would not have been a very safe
matter to have done." And so the poor woman
was poisoned by slow degrees, we may say, in the
presence of a witness. That witness, however, was
no accomplice of the murderer, but tongue-tied
under the duress, not of bodily terror, but of pro-
' fessional etiquette. The remarks of the Lord Justice
Clerk on this extraordinary piece of moral obliquity
deserve to be recorded. The counsel for the prisoner
had dexterously endeavoured to represent Dr.
Paterson as actuated by a strong animus against
the prisoner, and thereby to discredit his own state-
ment that on first seeing Mrs. Pritchard the idea
of poison was forced upon him. After disposing of
this suggestion the Lord Justice Clerk proceeded :
" He said distinctly, in answer to a question I put
to him, that what he intended to state in the wit-
ness-box was that he was in the decided impression,
when he saw Mrs. Pritchard on this occasion, that
somebody was then practising upon her with poison.
Now, he thought it consistent with his professional
duty, and I must also add with his duty as a citizen
of this country, to keep that opinion to himself ;
and in that I cannot say that I concur. I care
not for professional etiquette—for professional
rule. There is a rule of life, and a consideration
which is higher than rule, and that is the
duty which every citizen of this country, which
every right-minded man owes to his neigh-
bour to prevent the destruction of human life,
and in that duty I cannot see but that Dr. Paterson
failed." Few of our readers will be disposed to
think these observations unduly severe upon the in-
dividual concerned. The conflicting relations of
professional men towards each other and towards
the public have often been discussed, but we never
heard of any theory which would justify such reticence
as Dr. Paterson practised and avowed. There are
many situations in which a doctor may reasonably
doubt what he ought to do, but a situation in which
he has reason to believe that a brother practitioner
is poisoning his wife is assuredly not one of them.
Much, of course, must depend on the strength of
the belief, and something on the nature of its
grounds ; but here nothing was wanting to render
the path of duty clear. Not only was the conjecture
of February 24 strengthened in a high degree by the
visit of March 2, but in the interval Dr. Paterson
had been requested by the Registrar to certify the
cause of Mrs. Taylor's death, and had positively re-
fused to do so, stating in writing that it was " cer-
tainly sudden, unexpected, and to me mysterious,"
and referring the officer to Dr. Pritchard. So far his
conduct was that of a man who felt his responsibi-
lity, and we are glad to notice that even his notions
of professional etiquette do not cover the signature of
a false certificate ; but then his caution on this
point makes the rest of his conduct the more inde-
fensible. Unfortunately this conduct, though it
transgressed the furthest line of veniality yet traced
by medical casuists, is not so wholly unlike what is
done every day by respectable medical men as we
could desire. Most of those who have been long in
the doctor's hands must have become conscious of
certain sentiments and traditions which are not
dictated by the interests of the patient. The use of
some particular remedy is discouraged because, how-
ever successful, it is unprofessional, and savours too
much of some obnoxious " quackery." A physician
called in to give a second opinion does not like to
change the method of treatment too abruptly, lest
he should damage the credit of the family apothe-
cary, whom he knows to have mistaken the case.
Smiles and compliments are exchanged during con-
sultations at the bedside, when the sequel proves
that a difference of opinion, involving a question of
life and death, really existed between the doctors.
These are familiar instances of what we mean, and
they indicate the existence of an unwritten code
governing the medical profession, of which a sense
of duty to the patient is not the only principle.
No doubt this very sense of duty may often
give rise to much perplexity. A patient must
often be protected from his own fears ; the truth
must always be told him, but not always the whole
truth ; and the question whether he should be
made aware of his real danger, where it would be
aggravated by disclosure, is one that must for ever
remain open. But these are difficulties of a dif-
ferent kind, since they turn upon a regard for the
patient's welfare, and on that alone. The motives
which lead medical men to back each other up
and conceal, if possible, the errors of their fellow-
craftsmen, belong to a class by themselves. They
are motives which operate, more or less, in all pro-
fessions, and spring from an honourable feeling of
loyalty towards those whose trials we have shared
and can appreciate. There is an instinct of weak-
ness in all bodies which possess a special character ;
a clergyman is apt to remonstrate when a brother-
clerk is called a parson ; barristers do not like to
hear even solicitors abused, except by themselves ;
and no true soldier will allow before strangers that
a regiment which he often runs down in the mess-
room actually turned its back to the enemy. There
is no profession in which this instinct is stronger
than it is among medical men. Their science is far
from being exact, their art is little more than empi-
rical, there are powerful heresies to combat, and a
dangerous spirit of scepticism abroad ; they stand
together, therefore, like one man. Nor would it be
fair to deny that the public benefits, in some re-
spects, by the esprit de corps thus created. Like the
etiquette of the Bar, medical etiquette fosters akind
of honour which is a safeguard against baseness.
Still it is often carried much too far, and operates,
in the same way as official routine, in crushing indi-
vidual conscientiousness. To allow a life to be lost
lest undue discredit should be brought on the faculty
resembles the cruel bonhomnzie of the Scotchman
who saw his next neighbour sink back in a fit at
the supper table, but gave no alarm, for fear he
should spoil good company.
POST.—It should be fully understood beforehand
that the return of an anti-Liberal majority to Par-
liament signifies a great deal more than the mere
negation of progress. Her Majesty's Opposition
has been hitherto compelled, by the force of cir-
cumstances over which it has had no control, to
confine itself to the negative function of opposing
the good measures introduced by the Government.
True it is that when those measures have been car-
ried against the efforts of the Opposition, that body
has been wise enough in its generation to make a
virtue of necessity and accept the legislation thus
forced upon it. It has even gone the length of de-
claring that such legislation must be regarded as an
accomplished fact ; indeed, as part and parcel of
the institutions of the country which it is the first
principle of its creed to uphold. This, we would
beg leave to point out in passing, is an exceedingly
elastic and convenient creed. To oppose every
good measure while its success is at all uncertain,
and, when it is carried, to declare it is part of the
institutions of the country, and that your aim
above all things is to uphold the institutions of
the country exactly as they are, is convenient in
a variety of ways. It does not commit you to
support any other good and liberal measure for the
future. You are only concerned with the past.
The past is an accomplished fact. You are for
supporting the institutions of the country as they
are and keeping them as they are. Woe be to those
who add to or take from the great book of the con-
stitutibn. But the book of the constitution is just
just what you find it at any given time. There was .
a time when it included rotten boroughs ; there was
a time when it included protection. Rotten boroughs