The Liverpool Standard and General Commercial Advertiser.
Liverpool, Merseyside, England, 1848-08-01 00:00:00

INVESTIGATION AT THE WORKHOUSE INTO
THE CHARGE PREFERRED AGAINST MR.
STEEL, HOUSE-SURGEON.

Yesterday, Mr. Austin, Assistant Poor-law Commis-
sioner, held an investigation at the workhouse into the
serious charge recently preferred by the Workhonse Com-
mittee against Mr. Steel, house-surgeon. It will be re-
collected that that charge was, in substance, to the effect,
that the medical ill-treatment of Mr. Steel had caused the
death of a female of the name of Ellen Ashworth. who had
been confined in the lock ward. The following mem-
bers of the Select Vestry were present :—Messrs. Brown,
Riding, Hodgson, Mellor, Abraham, Shakeshaft, Watson,
and Seward. Mr. Steel was in attendance, so also were
Dr. 'Brett, Dr. Burgess, and some other medical men.
Mr. Beaver, surgeon, of the Manchester Infirmary, assisted
the Commissioner in the medical points of the case.
Mr. Steel commenced by asking what was the charge
against him ? _ .

-Mr. Riding replied that he was perfectly ignorant of it
himself.

Commissioner.—T wrote to Mr. Hart some days ago,
and he sent me a copy of some documents, and another
copy of them I believe was sent to 111 r. Steel. The sub-
ject-matter of inquiry will be found in these documents.
Mr. Steel.—l should prefer to hear the case against me,
in• the first instance, and then to submit a statement of
my own. I should like to have a medical man present,
for, as this is a matter of the greatest possible importance
to me, I may, if unassi%ed by the gentleman in questibn,
overlook some important points.
Commissioner.—You may have him here if he is to
assist you. The point of the present inquiry is ascertain
facts.

A copy of the whole of the evidence taken before the
Workhouse Committee was here read.

Mr. Steel was assisted by Mr. M'Dougal, surgeon.
Mr. Steel said that before he offered any evidence in
his defence, he wished to observe that this was a matter of
importance to him, not only as it respected his appoint-
ment in the house, but his reputation as a medical man.
There were several gentlemen present who had already
condemned him. They conceived his treatment to be
improper, and they had recommended his dismissal. Now,
was it competent for them to take any part in this enquiry ?
It might be that they came:there with prejudiced minds,
and therefore they ought at once to see the necessity of
not interfering, and of remaining, if they remained at all,
as impartial and silent spectators.
Mr. Watson said that himself and his brother members
of the Select Vestry did not sit there to re-adjudicate upon
the case, but merely to see that the facts came fairly out.
Mr. Steel observed, that evidence against him was con-
tained in documents already read. These documents con-
tained depositions of several witnesses, among whom were
some of his colleagues. And with regard to their evidence
he had to say, that their statements ought to be taken
with caution, because they had one and all evinced decided
hostility against him. They were strongly interested in
condemning him, for having already told the workhouse
committee that his treatment was improper, they must
stand convicted of being wrong if he were now acquitted.
He had to charge these medical men with something very
serious. They had told the committee that his treatment
was unsafe and improper—that death had been caused by
that treatment, and yet they never once intimated to him
during the period of three weeks that it was ill-treatment.
It was their duty to him, as colleagues,—it was also their
duty to their fellow-creatures to have pointed out what
they considered improper in his practice. They ought-
also to have reported the case to the coroner, and for not
having done so they had rendered themselves liable to
judicial proceedings at the approaching assizes. The
case was one of syphilitic sore throat. There was an
ulcer of the phanguse, which was not sloughing, but
there was chronic ulceration. There was also consi-
derable induration of the soft lining at the back part
of the pharynx. The woman had suffered from this
disease for some years, and she had been in the Lock
hospital repeatedly. She had had strong nitrate acid
applied to her throat before. She had a disease of the
lungs, an embarrassment in breathing, and the usual
symptoms of a narrowing of the passages to the throat.
Her constitution was generally broken down • and all
these appearances were of importance with regard to the
history of the case. Now, his mode of treaJnent consisted
of a mercurial unction—the application of the acid of
nitrate of mercury to the pharynx. He did not intend
to apply this to the lungs, nor did he apprehend that
she had inspired any of it,—for this reason, that, if she did,
it would have immediately produced spasms.; and no spas-
modic effect had been produced. The first time he applied
it was the day after she came into the hospital—on a Sa-
turday. It produced pain at the time, of course, but she
derived so much benefit from the application that she said
if he did not use it again she would ask him to do so. He
used it again in the same manner on the following Mon-
day. There were no spasms up to this time. He then
visited the rest of his patients in the ward, and, as near as
he could judge, in about a quarter of an hour, the nurse
sent to say that the woman was very ill. He went imme-
diately and found her suffering acutely. Her countenance
was livid, and her respiration very seriously obstructed.
He at once determined to perform the operation of trach-
eotomy, and called in the assistance of Mr. Taylor, his
colleague, for that purpose, and by the time he was ready
to perform the operation Dr. Burgess and Mr. Leather
were both present. He performed the operation in the
manner directed by Mr. Ferguson in his Manual of Sur-
gery. On opening the trachea no relief was afforded—in
fact, the woman was in articulo mortis at the time, and,
she died before the operation was finished. Some blood
escaped into the trachea during the operation.
Mr. Beaver.—Was there any expiration. after you open-
ed the trachea

Mr. Steel.—Very slight—it was a mere bubble. He
made a post mortem the following day, in the presence of
his colleagues, Dr. Burgess, Dr. Lee, Mr. Taylor, and
Mr. Leather, but it did not appear that any of these gen-
tlemen had witnessed the whole of that examination.
The appearances were—a hardened state of the soft parts
lining the pharynx, induration and thickening of all the
upper parts of the throat, the epiglottis partially destroyed,
and the lungs much congested. The pharynx showed un-
mistakeable symptoms of long standing disease. He could
scarcely account for the destruction of the epiglottis,
unless it were the result of the ulceration which had
cicatrised. There was a dema about the glottis, ulceration
about the trachea, and an effusion of blood traceable
some way into the lungs. He had no doubt that a deal
of blood flowed into the trachea after death. During the
interval that he was out of the ward, the deceased had
gone to a kettle and drank some boiling water out of it,
and this drink had very probably caused the de ma of the
glottis. Now, he had evidence, documentary and other-
wise, to establish the propriety of his treatment, for the
application of nitrate of mercury by Wallis and Collett.
He would prove this by a letter he had received from Dr.
Samuel Cooper of London..
Commissioner.—We do not think it necessary to go,
into a justification of the treatment you recommended,
the object being to get at the main facts.
Mr. Steel.—But, sir; my colleagues have alleged that
my treatment was unsafe and improper, and that it was
not recommended by any authority they had ever heard of.
Commissioner.—When we ascertain the facts, the Poor-
law Commissioners will come to a proper conclusion upon
them. _ _ _

Mr. Steel.—They object also to the way in which I
performed the operation of tracheotomy. But I can show,
by quotations from the best works on surgery. that I per-
formed the operation in the proper manner. They say I
commenced the incision too low ; but, if anything,. I com-
menced it too high, instead of too low.
Mr. Beaver.—We want a plain history of the facts of
the case, and of the point at which you commenced the
incision.
Mr. Abraham here observed, that the present charge
had not been preferred against Mr. Steel by any of his
colleagues. The Workhouse Committee first heard of it
out of doors.
Mary Smith was the first witness called. She said :—I
live at 18, Upper Gloucester-street, and knew the de-
ceased Ellen Ashworth. She had had a sore throat for
the last three years. I was in the lock-ward of the work-
house, as a patient, when she was there also as a patient.
I recollect Mr. Steel applying something to her throat
twice—first on a Sunday morning, and last on a Monday
morning. She was in great agony after the first applica-
tion, and said she would never have it used again. On the
Sunday afternoon she got quite relieved, and said that if
Mr. Steel did not apply it again she would ask him to do
so. After the first application she was in great pain ; the
water was running out of her mouth, and she seemed to be
near choking. She asked me, after the second application,
for a smoke of a pipe ; I lighted it, but she pushed it back,
saying she would have a drink first. I told her not, lest
it should wash the stuff down her throat. She then went
to a kettle, poured some water into a dish, and drank it.
The water had boiled ; it was hot water—too hot to drink.
It could not be a quarter of an hour from the time of Mr.
Steel's application until she appeared to bein pain. When
Mr. Steel first applied the stuff she was in bed. She then
put her shawl and boots on, went into the yard, remained
there about two or three minutes, and, on her return,
asked for some drink. While I went to the cupboard for
some buttermilk, she ran to the kettle, and drank the hot
water. She then said, "I am choking," and she desired
the nurse to send for the doctor. She was worse after
drinking the water than she had been before. The caustic
caused agony after both applications.
By Mr Whitby.—Mrs. Staveley, publican, of White-
ell:l)e), will tell yotithat for years the deceased was hoarse,
and that she had a continual choking sensation in the
throat.
Ellen Grayson called.—l have been nurse in the Lock
Ward for ten years. I knew the deceased Ellen Ash-
worth. She was seven times in the Lock Ward. Her
throat has been diseased for the last six or seven years.
She had never
.had any strong application to the throat
until this last time. I saw Mr. Steel apply the cau,stic-cra
Monday. He did not remain in the ward more than rive
minutes after. In about five or ten minutes after I sent
for him. The following day (Tuesday), Mr. Leather said
nothing to me about this case. I left the Look Ward,
and was put in confinement.
Mr. Steel.—Did any of the medical gentlemen con-
nected with the house give you any money since this case
occurred?
Commissioner.—What has the giving of her money to
do with our inquiry ?
Mr. Steel.—To show the animus of my colleagues, and
to destroy the credibility of this witness.
Commissioner.--. 4 do not see that thet evidence can be
taken.
Dr. Gee wished to offer an observation ; but
The Commissioner stopped him, and said the case must
proceed. He did not feel disposed to go into the matter
adverted to by Mr. Steel, at least for the present.
Mr. Abraham wished Mr. Steel to be at liberty to bring
out every fact that he considered desirable.
The Commissioner again declined to go into the money
part of the question.
Dr. Gee said he should decline to give any, evidence
to-day, in consequence of the scandalous imputation which
Mr: Steel had just endeavoured to cast upon his medical
colleagues in the house.

THE LIVERPOOL STANDARD.

Mr. Hodgson wished the Commissioner to act with
strict impartiality, and to prevent charges from being
made, if he would not permit those charges to be an-
swered.

Mr. Brown wished the Commissioner to understand
that the dismissal of Mr. Steel was not simply recom-
mended because of his improper treatment in the case of
Ellen Ashworth—that there were two other cases against
him as well as the one in question, upon which that re-
commendation was founded.

The Commissioner read a letter from the Select Vestry
to the Poor-law Commissioners which caused the present
inquiry to be held, and said that as the case of Ellen Ash-
worth alone was mentioned in that letter, he did not feel
himself at liberty to travel out of the record.
Examination continued.—l never saw Mr. Steel attend
to his patients otherwise than with the greatest care and
humanity. After Ellen Ashworth died, Mr. Steel gave
me a strong glass of whiskey, which completely overcame
me. I was then accused of being drunk, and removed
from the Lock ward. Mr. Steel never gave me a glass of
whiskey before. He gave it to me on the day Ashworth
died, and he spoke to me about her, but what he said I
cannot recollect. He washed his hands in some water
taken from the kettle after he had administered the second
caustic application to the deceased. The deceased drank out
of that kettle, but the water was then only milk warm,
and she drank some milk after it. The Governor and Mr.
Steele were both present, on a late occasion, when the
former said to me, " Would a pomid take you to Scot-
land." He did not induce me to leave for Scotland, but
he certainlly asked me the foregoing question. Before
Mr. Steel gave me the whiskey, he asked me whether any
of the medical men had been asking me about the case of
the deceased, and I said not. I know that the water with
which Mr. Steel washed his hands was not hot, because,
had it been so, it would have scalded him.
Dr. Gee.—Spasms would come on almost immediately
after the application of the nitrate to the glottis.
Dr. Burgess.--I believe there was an inspiration after
the opening of Cie trachea. I know there were two or
three expirations, for I was present at the time.
Mr. Leather denied that there was any dema of the
glottis.
Dr. Gee said that the caustic applied in the present case
was one of the most powerful known. He did not think
that a powerful caustic ought to have been applied.
Mr. Beaver.—That is matter- of opinion.
Dr. Gee, in reply to Mr. Abraham, said he believed the
death in this case was caused by the application, and that
the account of appearances in the post mortem examina-
tion, as given by Mr. Steel, was not correct.
To Mr. Steel THe also believed that there was no
flaggellina during life. He had never seen acid of nitrate
of mercury used to the throat. The swallowing of hot
water would cause irritation of the throat. He believed
that there was not an ulcer in the pharynx.
Mr. Abraham informed the Commissioner that a state-
ment of the case had been submitted to various medical
authorities and that their answer had been received. He
wished to know whether these answers would be received.

Mr. Beaver replied that the iietClifficslty ;vasio;;;;-
tairr the symptoms during life, and that with reference to
these symptoms there appeared upon the present occasion
to be very conflicting evidence.
Ellen Graham cailed recollect the deceased, and I
also recollect Mr. Steel applying something to her throat
on the morning of her death. In about five or ten mi-
nutes afterwards she complained of pain. There was no
peculiarity in her breathing ;. and after having drank the
hot water she said that she was dying—that she was
chokin. There was no troop.
_ _ _

Mr. Taylor, surgeon, said that he did not observe any
inspiration. There was no disease of the lungs, nor was
there any appearance of slough, There was ulceration
at the back part of the mouth. He was not aware of the
application of nitrate of mercury to the throat. He
should not have applied it, and he thought the applica-
tion had caused the death.

Mr. Leather, surgeon, said that upon the trarhestornic
operation Mr. Steel, had, in his opinion, commenced the
incision too low down. The incision was commenced
about an inch above the sternum.

Mr. Beaver.—There has been no evidence to prove that
the operation had anything to do with producing the
result.

Mr. Leather thought the application had caused the
death.

Mr. Beaver complained again of the difficulty in the
present case of ascertaining the appearance preceding the
death.

Mr. Hodgson thought there could be no difficulty
about it. Here was a woman who was comparatively
speaking well, who had eaten her breakfast heartily, and
in a quarter of an hour after she was dead.
Mr. Steel.—But have yoga never heard of eases of
sudden death ?

Mr. Hodgson.—Yes; I have.. Two persons died in this
house, whom. you had seen,.. but for whom you,never
prescribed..
Mr. Steel.—l am here to defend myself in the present
case, and am ready to defend myself in the others at the
proper time.

- Mr. Hodgson here read the letters of Sir PhilipCtamp-
ton, Dr. Brett, Dr. Kaye, Dr..Bransby Cooper, Dr. In-
man, an& Dr. Alfred Taylor; in which they generally), if
not all, said that the death was caused by asphyxia. and
condemned the use of nitrate of mercury in cases of
syphilitic sore throat.

Mr. Steel read letters from Dr. Cooper, Mr. Car-
michael, of Dublin, and Mr. L. Parker, of Birmingham,
to the effect that the nitrate of mercury was justifiable
treatment under the circumstances mentioned to • those
gentlemen.
Mr. Beaver thought that Mr. Ferguson's work on
Tracheotomy was a most dangerous one for the faculty
to follow.
Mr. Hodgson was of a similar opinion.

Mr. Steel-tendered the Rev. Drummond Anderson, the
chaplain of the house, as a witness, to prove that he had
ever attended to his patients with the utmost care and
humanity.
The Commissioner thought evidence of this- nature
foreign to the inquiry ; and
Mr. Beaver having intimated that sufficient evidence
had now been received, the inquiry terminated shortly
after three o'clock.
The whole of the evidence will now be submitted to
the- Poor-law Commissioners, and their repert may be
expected in the course of a short time.

LATEST INTELLIGENCE.
(BY EXPRESS.)

Private letters from Milan, dated the 26th instant,
make the Austrians to• have lost 16.000 men in prisoners,
and 7000 in killed and wounded; and a hope is ex.
pressed here that such may be the fact, as it may be the
cause of a break up of the army, and an earlier return to
a state of public order.

MONEY MARKET-YESTERDAY.

The political advices from Italy have commanded much at-
tention in the moneyed circles this morning. The information
from Dublin still exercises the chief influence in the stock and
money markets, and the Dublin intelligence of last night being
favourable, everything down to that period remaining tranquil,
we have hnd very little fluctuation in the funds. Consols
opened at 80 to 2; from this they receded per cent., namely
to 861 (sellers), but soon rallied to the opening value of 86/ to
2. Exchequer Bills, 335. to 37a. prem.
It was settling-day in the foreign funds and in railway shares.
Spanish Three per Cents., 2U to Five per Cents., 11 to 2.
Portuguese, 18 to 19. Mexican, 17i to 2, Dutch Two-and-a-
Half per Cents., 43 to 4.