£ ^ir/^iiiiiiin^ci^aeiin^iiiiiniiiiiiiiiiiiiiBiiiiiiFiini! A VINDICATION OF CHARACTER, AND AN EXAMINATION OF THE ACCUSATI CONTAINED IN DR. T. REVBURN'S Supplement tc tlje " St. Couts Ulebkal & Surgical 3arm -C F. KNOX, M. D. 4 'OFFICE OF THE ST. LOUIS " UNION." TO THE CITIZENS OF SAINT LOUIS. A decent self-respect and a proper regard for the opinions of the community seem to require some notice of gross attacks on private character, when publicly made, no matter how absurd they may be, or how contemptible the source from whence they come. Hence, I deem it proper to offer a brief statement of facts in relation to Dr. Reyburn's at- tacks upon me, in his " Supplement to the July number of the St. Louis Medical and Surgical Journal," recently published. Owing to the con- dition of my family, I did not read Dr. R.'s paper for several days after it was published; and for the same reason several more elapsed before I gave the matter any attention. This must be my apology for having neglected him so long. It is a matter of no small satisfaction to me that these charges, which have been, in a most base and cowardly manner, " secretly whispered," in dark corners, and by dastardly inuendoes, for six years, have, at last, been forced to assume an open and tangible shape, and the base-born brats are, at length, duly acknowledged by their legitimate parents. In my heart I cannot do less than wish them much joy of their hopeful progeny. With the main questions at issue between Drs. Reyburn and Adreon and Dr. White I have nothing to do. Dr. W. has shown himself fully competent to the management of his own affairs ; and, if it were other- wise, I have neither cause nor disposition to interfere. I neither have done, or shall do so, further than I deem proper to defend myself from unjust attacks. I shall proceed briefly to state, first, just what agency I have had in the somewhat famous case of Mrs. Dugan; and, second, to notice, in a proper way, some of the calumnies that have been heaped upon my head, therefor. 4 VINDICATION. On the 25th of April, 1840,1 was requested by Rev. Geo. C. Light to visit a poor member of his church, who was very ill and without medical attendance. He said that Dr. Adreon had been attending her, but had not visited her for two days—as he, (Mr. L.) supposed, be- cause he thought nothing could be done for her, and because she was unable to pay for his visits. Mr. L. said that he did not suppose the woman could be cured; but he thought that, as a matter of humanity, she ought to have the consolation of knowing that whatever could be done for her case was done. He said he had applied to his family phy- sician, Dr. White, and he declined to go, unless some other physician would accompany him: and that, as he had been well acquainted with me for several years, (during which we had been associated as members of the Executive Committee of the Mo. State Temperance Society) he wished me to attend. He said that he presumed Dr. A. did not expect her to live so long, or he might have visited her again. I advised him to see Dr. A., and request him to visit her again. He replied that she would not see him again at any rate — that she thought he had inflicted an irreparable injury upon her, and she would not have him visit her again. I asked him if he had informed Dr. A. of that fact. He replied, no: but that the desertion of the patient in such a critical state, for two days, rendered that unnecessary, as it amounted to an abandonment of the case. I thought so, too ; and told him I saw no impropriety in visit- ing the case; but that, as Dr. Adreon had, for a good while, been con- stantly slandering and abusing me, on all occasions, I had reason to be- lieve he would endeavor to misrepresent and injure me, if I had any thing to do with it: and, therefore, I wished him to procure some other person. But he insisted on my going, placing my refusal on the ground of inhumanity; and on receiving a written request to visit her, with Dr. White, I did so. Mr. Light is alive, and can be found, at least by a member of his own church, and can tell if I have misrepresented him. We visited the patient on the 25th of April, 1840. I examined her carefully, Dr. White standing by my side at the time. There was one clear, distinct opening into the bowel, its orifice about in the usual situation of " the right external abdominal ring," and running upward and backwards, in the usual direction of the inguinal canal, about an inch or an inch and a half; from which the matter usually found in the small intestines was discharging. There was no pus, or other admix- ture with the matter usually found in the bowels, and no other opening, sinuosity or swelling, except a very slight one around the edges of the VINDICATION. 5 orifice before mentioned, and no appearance of gangrene, or the exten- sive sloughing which it appears afterwards took place, from the testi- mony of witnesses for the defence on the trial. On questioning her as to this opening, she said it had been made by the lancet of her attending physician. I asked her when the tumor which had been lanced first appeared; she said about seven years be- fore ; that it had gradually enlarged since that time, and had given her much trouble ; that it was usually soft, and, by pressing upon it, it readily disappeared; but that, sometimes, it became hard and immov- able, and then she suffered intense pain with it ; that she had sometimes been obliged to call a physician to obtain relief. She said that the at- tack she then had came on as the others usually had done—• when she had been doing a " hard day's washing." I then told her, that as Dr. Adreon had been attending her, and was familiar with the history of the case, he could do better for her than any one else, and she had better send for him; that I had no doubt but he would attend her, if she did, and that it would be the best way for all concerned. Dr. White seconded my suggestion, but she replied — " No : he shall never come into the house while I live. He has ruined me ; and then, because I had no money to pay for his visits, he has left me to die; and I will never have him, if I have no physician" — or words to that effect. She then entreated us to attend her and do what we could for her. She asked me whether I thought it possible for her to recover. I told her that persons had recovered in a similar situation, but that it was not at all likely the opening in her side could be healed : that the question of her living with it depended very much upon what part of the bowel was connected with the opening, and whether the en- tire contents were passed by the opening or not; and encouraged her to hope that, as part of the contents of the bowel, only, were discharged by the opening in her side, she might recover. We then made such prescriptions as the case seemed to require, promised to call in the morning, and left her. And this is all I ever had to do with Mary Dugan's case. The next morning, before I visited her, I was informed that Dr. Adreon had re- turned to the care of her, and I did not go, and have seen her but twice since, and that recently. Immediately after the above mentioned occurrences, reports were in- dustriously circulated that I had, with others, improperly interfered in the case, endeavored to wrest it from Dr. Adreon, and the like. Dr. A, called on me with a witness, and I frankly told him all the facts, so far 6 VINDICATION. as my agency in the matter was concerned; and I understood him to be satisfied with my motives, though he said I had been misled as to the facts. As that question was one of veracity between Rev. Mr. Light and Dr. Adreon, and I knew them both well, I had no hesitation in form- ing my opinion. Dr. A.'s course towards me for some time previous would have fully justified me in withholding any explanation from him ; but I had nothing to conceal from friend or foe, and was willing both should " see my hand." Notwithstanding this, his abuse of me did not cease. The town was full of it, and special pains were taken to preju- dice, as far as possible,, all physicians newly arrived in the city, against me. This was never regarded by me, further than to give my distinct and positive denial to every charge of the kind that was ever made in my hearing, and send my defiance to its authors, to attempt to sustain it, if they dared. In this way things progressed for about three years, when Dr. Rey- burn, in March, 1843, after there was the strongest reason to believe that the body of Mrs. Dugan had become thoroughly commingled with its mother earth, read before the Mo. Medical Society (of which I was a member) a paper, from which, to avoid the possible charge of unfair- ness, misquotation, or garbling, I take the following long extract; only altered by putting a few passages in italics, from the form in which it was published by Dr. Reyburn, in ilThe St. Louis Medical and Surgical Journal," for May, 1846, pp. 553 and 554:— <:'On the 20th of April Mrs. D. again sent for me; she was com- plaining of violent pain in the right inguinal region, and a large abscess had gathered there, involving, to a great extent, the surrounding parts in its inflammation. She had aeen suffering for the two previous days. I ordered an emollient poultice to be applied to the groin. Next day continued the poulticing, and gave a cathartic which operated on the bowels. She did not appear to suffer in any other way except from the inflammation in the groin. She continued in this way, using poul- tices and an occasional cathartic, up to the 21th, at which time the an- terior walls of the abscess had become very thin and of a bluish appearance, perforated at several points, with small openings through which oozed a thin sanious discharge; the groin was in a state ap- proaching to sphacelus, very much resembling the condition of a car- buncle. Fluctuation was perceptible in the depending portion of the abscess, and a puncture was there made, from which a quantity of well- digested pus was discharged. There was also some fetid gas emitted, which I thought came from the bowels. That evening some faecal matter passed through the openings in the groin, together with thin sa- nies and fetid gas. There was now a disordered condition of the bowels, the stools being thin and frequent. In a few days the abscess degene- VINDICATION. 7 rated into a foul, ill-conditioned ulcer; sloughing of soft parts from the groin took place, and a fermenting poultice was applied. To improve, the patient's habit of body, port wine, quinine and a nourishing diet was ordered.' " Dr. A. continued in quiet attendance on Mrs. D. until 29th or 30///; April, looking forward with reasonable hopes to a favorable termination of her case, notwithstanding its serious and almost anomalous character. Having every confidence that the treatment adopted was that which had been clearly indicated by circumstances, and was the only course that gave a chance of recovery to the patient, he felt that, in case her death did occur, he was fully acquitted of any charge of neglect, error or ig- norance. He had been supported in his treatment by the advice and assistance of several able practitioners, and never for a moment dreamed of any interference of the kind which now occurred. " Unfortunately for the character of the medical profession, there exists in every latitude some practitioners who set all the laws of pro- fessional ethics at defiance. Some in our own city are of that class, who resolve to attain practice at any cost, whether of professional principle or a brother's character, it matters not; they are willing to make any sacrifice ; and the end, with them, sanctifies unholy means. They cal- culate their own success by others' downfall, and by means of detrac- tion will sap the reputation of a professional brother, with the hope of building up a practice on his ruin. If a difficult case occur, ivhich, after its progress, they wisely discover the way in which it should have been treated, the practitioner in attendance must endure the ordeal of their censoriousness. This case of Mrs. D.'s was too favorable an op- portunity for men of such character to permit escaping. It might, as they thought, prove fun to them though death to others. It could be used to blast the reputation of those, who, through superior merit, stood between them and a practice. Gloating over a presumed error in the di- agnosis of the case, they proceeded to doom to destruction those whose benevolence had been taxed in its attendance. Some personal ill-will towards these physicians gave zest to their charitable efforts. A volun- teer deputation of these doctors visited the patient, and as gratuitouslv gave her their opinions. " It's a hernia," says one—''the Dr. has cut a gut," was the refined expression of another — "take a dose of castor oil," says a third, " and you will see it pass through the opening in the groin and not by the natural passage." The volunteer consultation doomed the patient to certain death; she never would have another natural passage by the bowels, and one of them kindly asked her per- mission to hold a post mortem on her mangled remains. But, alas ! for these expectants — it proved to be no hernia, the oil operated per vies naturales; and the case, in its sequel, contradicted all they had advanced. From opinions expressed freely and publicly, on the merits of Mrs. D.'s case, great excitement was created throughout the city—the treat- ment of it was discussed in mysterious whispers at the street corners, — lawyers were predetermining the exact degree of manslaughter it involved; and the propriety of immediately calling the attention of the *1 VINDICATION. grand jury to it, was hinted at, for fear the medical attendants would run away. Anonymous letters were sent to the physicians, requiring a free confession of the exact position each one had occupied in produc- ing the unfortunate result of the case, and explanations were demanded of them from every quarter : so industrious, indeed, had been the detractors, that the case was known every where and spoken of by every one. The reputation of the physicians " hung suspended by a single hair " on the recovery of a case, of which they could not have the entire control. The mind of the patient xuas kept in continual alarm by the croak- ing of these, birds of ill-omen who were to batten upon her carcass. A benevolent society, which assisted in her maintenance, was thrown into terrific commotion by the circumstances growing out of her case ; and even the minister who attended her joined in the public clamor, and at- tempted to interfere to the detriment of the practitioner first called in. The volunteer party attempted to wrest the patient from the original attend- ants, for the purpose, it may be presumed, of assuring to them a favor- able termination. As an inducement to the patient to change her phy- sicians, it was promised, that if Dr. A. and his co-laborers were dis- charged, ten or twelve other physicians should visit her every day, so that she would have a better chance for life with the attendance of the many, than of a few. Dr. A. had been so harrassed in the case, by this unwarrantable interference, that he voluntarily offered to decline any further attendance; but at this the patient became greatly alarmed, and wept, declaring her unbounded confidence in his skill, and begged him to continue his attendance." Here is a statement that Dr. Adreon had a patient— a certain " Mrs. D."—with certain symptoms, to which he applied certain treatment: that certain very wicked and unprincipled and ungentlemanly physi- cians had tried to rob him of her, circulated slanders about him, &c, as fully set forth in the above extract. No clue was given as to who the patient was, who were the very mean physicians described, or any thing else connected with the matter. I had no means of judging as to whether allusion was made to me, but by the description of the case. I watched carefully, during the reading of the paper, for something that would enable me, from my knowledge of the case and attending circumstances, to determine that I was attacked, as it had been " whis- pered " I was to be that evening, that I might denounce the slander and the slanderers, as they deserved. But there was not a word said that applied to me —not a word by which I could suspect that I was alluded to ; and I never should have had such a suspicion, but for the " myste- rious whisperings" about town, when I was not present, which assert- ed the fact. Of course I could only do as I had done before — deny the fact whenever it was stated in my hearing, and demand the proof. VINDICATION. 9 With that I was centent to rest, so long as no one dared to make an open and specific charge. Thus the matter rested, till the famous trial. Then Dr. Reyburn tells us, he was forced by "subpcena duces tecum" (which a friend, who understands Latin, and who compassionates my "unfortuate case," in not being so well "educated" as Dr. Reyburn says he is, tells me means —bring it with you) to bring his immortal document before the court. In the course of the trial, it appeared in evidence that Drs. White, Henry, Trudeau and myself had visited the case. Between us, therefore, were to be divided the very interesting encomiums contained in the above extract; for Dr. Reyburn, had avowed, when on the stand, that the article referrred to the case which I had visited — and it was the first authentic knowledge of the fact I ever had. By the first con- venient opportunity, I pronounced " all such charges and insinuations, so far as I am concerned, and so far as my knowledge extends, utterly and basely false :" and I added, for reasons which 1 will presently show, " the circumstances do not permit me to doubt they were known to be so, when made." That denial was published in the St. Louis Medical and Surgical Journal,'''' for July, 1846; and in connexion with it was published a mass of testimony perfectly overwhelming, substantiating its truth. I believe that every person who is a competent witness in the case — that is, who knows any thing about my conduct in the matter—has there testified that my conduct was proper. Rev. Mr. Light is not here, but his note, requesting me to go, is sufficient evidence of his opinion of the propriety of my visit. The testimony of Rev. Jos. Tabor and of Mrs. Waddingham, who was present during my visit, gives the lie direct to all these charges, as against all the physicians alleged to have interfered with Dr. A.'s patient. Drs. White, Henry and Trudeau deny all the charges, so far as themselves concerned, or as their knowledge extends. The poor patient, herself, who certainly ought to know, declares on oath, that she employed us to attend her, and that no abuse of the physicians who had been in attendance was uttered by any of us, while visiting her; and every witness who is cognizant of the facts testifies unqualifiedly, that in visiting and while visiting Mrs. Dugan, my conduct was perfectly correct and proper — such as became a gentleman and a physician — even if he had possessed all the advan- tages of birth, early association and professional education, which con- spire to cause T. Reyburn, M.D.,so to tower above the ordinary spirits of his age and profession — himself being the judge. 2 10 VINDICATION. That all the allegations of Dr. Adreon, endorsed and promulgated by Dr. Reyburn, were utterly disproved by Dr. White, no disinterested person, with a capacity above that of a lobster, will for a moment doubt. Dr. Reyburn had then his option: finding he had been deceived — made a "cat's paw"—been induced to give currency to falsehoods —he had to choose between acknowledging his error and apologizing for it, like a man of honor and truth; or of re-affirming and persisting in it. I specially left him that option, in my note, which carefully abstained. while it denounced the falsehood as it deserved, from charging it on Dr. Reyburn. I said it was " in an article read by him." But that article was all founded on the authority of Dr. Adreon, and much of it in his own words. The whole article left Dr. R. at liberty to acknowledge his error and atone for it. He made his election ; and that was to stand by and re-affirm all that he had before said, and which had been fully and unanswerably shown to be false, by about thirty witnesses. And by what system is he to proceed ? By none of those, gentle reader, laid down "by the schools," in which he boasts so much profi- ciency. Oh, no ; that would be too tame a process for so exalted a ge- nius as his. He hits upon a plan that would never have occurred to a ]ess — or more—mighty mind than his own. He leaves out, in his answer, the main individual charged in the indictment, and introduces him as a witness. Shades of Blackstone, Hale, Story and all other small fry! stand back abashed at your own insignificance ! Here is a new principle developed in the law of evidence, that never entered your poor heads! No! It was reserved for the high-born, highly-associated, highly-educated and highly-talented (in his own opinion —and who else should know sovvell) T. Reyburn, M.D., to discover this new and im- portant principle in the law of evidence — that the original author of a slander is the most suitable witness to prove its truth! Were Dr. Adreon a (' competent" witness, I would oheerfully allow his testimony to go before my judges, and leave all who know him to decide between him, on one side, and all others who know any thing about the matter, on the other. But Dr. Adreon is not "competent" as a witness in this case:—1st. Because he is the individual mainly inte- rested on one side — he is the main author of the original attack. Dr. Reyburn and others merely repeat what he has told them. But, 2nd and more especially, because, from the very nature of the case, he can have no personal knowledge of the matter. What does he charge ? That I visited his patient, endeavored to cause her to discharge him and employ me, used abusive language respecting him, told the patient and Vindication. ji others that he had practised unskilfully upon her, &c, &c, &c, etc.< etc., etc.: all the charges are of this character. Now, will any man, with a capacity above that of an idiot, believe, for a moment, that I ever did either of those things in the presence and with the personal cogni- zance of Dr. Adreon, Dr. Reyburn or Dr. Beaumont ? Such a prepos- terous idea is not even broached by my accusers, with all their " poetic license," and, if it were, would only make them ten-fold more the laughing-stock of the community than even the immortal discovery of a way to prove falsehoods, by making their main, original author a witness. No. It is self-evident, that, if* Dr. Adreon ever had any ground for his accusations*, he must have"1 witnesses to the assertions he has made. He has not, yet, brought forward one; and I confidently believe he can not. I am authorized to state, that it is not for want of effort to procure testimony that he has failed to do so; but, in one instance, at least, he (to use a proverb that will, I fear, shock the refined sensibility and pure taste of Dr. Reyburn) " came back with a flea in his ear." He found the witness did not recollect his facts : and, knowing the charges against me all to be false, I have too much confidence in the in- tegrity of my fellow men, to believe any witness — any "competent wit- ness" — can be found to testify to their truth. If one can be found, why has he not been produced ? Dr. Reyburn informs us, that Dr. Adreon attended Mrs. Dugan " for a space of three months after 'theun- warrantable interference' of myself and others in the case;" and Dr. Adreon's detail of the case, states that he had attended it nearly a month before. He, of course, knew well all the members of the family, and all the neighbors in attendance — in short, all persons who could have any knowledge of the facts charged were well known to him ; and were there any witnesses to the truth of the charges, it would be easy for him to produce therm I, on the contrary, scarcely know any of them ; and my conduct has been proved correct and proper, almost without any agency of mine. I must now proceed to notice in detail some of the new charges made against me in Dr. Reyburn's " Supplement." Many of the false state- ments respecting me, contained in it, are of so frivolous a character, and so unimportant to the issue, so far ,as I am concerned, that I shall pass them unnoticed. Others, however, require a little showing of "the other side." On page 10 of his " Supplement," Dr. Reyburn says — " If I have done injustice to Dr. Knox, he must ascribe it to the equivocal position in which he placed himself voluntarily, and to my impression, not lightly 12 VINDICATION. founded, that, under the circumstances, he is not above acting as has been implied." Nowr, here is a precious confession! Dr. Reyburn, forsooth, is " un- der the impression" that I am " not above acting" so ; and, forthwith, he "implies" that I did so act! and then immediately he makes the assertion that I did ! ! When he comes to " make a clean breast of it,'* and all the rest concerned in making these charges do the same, it will be found that none of them rest on a more solid basis than " impres- sions" and " implications." And, as to ascribing my share of the " injustice" to having placed myself in an "equivocal position" — though Dr. Reyburn says I " must" — I can do no such thing. No. It is simply because my position is unequivocal, that I am made the recipient of this vile abuse. Drs. Henry and Trudeau were not so situated as to be obliged to say more than to simply deny having used or heard any improper language, or done or seen any improper thing; and there was no special malice or hate to be gratified by pursuing them. It was, too, no doubt, thought advisable to attack as few as possible, inasmuch as it now had to be open work. While it was all thrusting in the dark, and no one knew who was stabbed but those who had the benefit of the " secret whisperings," there was no scruple to include us all; but, now, those gentlemen are exonerated, and the whole dose is bestowed on myself and one other — in exactly what proportions, I am not able to determine, as the applica- tion is, sometimes, rather " equivocal." They even come pretty near the honor (see page 26 of Dr. ReybUrn's "Supplement") of being claimed as friend*, by the original author of the accusations against them. But even this seems to have been an afterthought, and the pas- sages applying to more than two of us were not all erased. When Dr. Adreon speaks of " White and his associates," I would like to know, if he does not " mean to reflect upon Drs. Henry or Trudeau," for how many he takes me ? It is in proof that only those gentlemen, Dr. White and myself visited the case. Really, I feel almost compensated for having failed to secure Dr. Reyburn's good opinion, by so high a compliment from one who uses him as his supple tool. But, seriously, this only shows that course to have been an afterthought: and the same appears from the fact, that Dr. Beaumont hurls his charges indiscrimi- nately against a whole bevy of us. He, doubtless, had not been informed of the change in the plan of attack. And why, if they saw cause to withdraw their charges as against a part of those accused, why not, like honest men, withdraw them as to the rest? True, Drs. Henry and VINDICATION. 13 Trudeau were fully proved clear of all the charges that had been made ; but the very same evidence that proved them clear, just in the same degree, and to just the same extent, proved all the charges false as to every person against whom they were directed. By what system of logic, I Would like to know, is the testimony, applied in the same words to us all, made to satisfy these redoubtable champions of medical eti- quette and guardians of medical " manners and morals," that two of us are innocent of all the charges, and other two guilty of all ? But, enough. The absurdity of the thing is too glaring : malice prepense is the only explanation. Dr. R. continues : — " Furthermore, I was led to this conclusion, as were others, by his silence, when the paper was read before the Medi- cal Society. Had he spoken at that time, he would have been met by a discussion of the then recent occurrences ; the circumstances of his conduct would have been made known; his peers would have been his judges ; and, if not convicted, my insinuations must have been repelled* By avoiding, as he has done, the proper opportunities for defence, he laid himself open to the implication, that he dare not then discuss this censure." There are several points in this extract to which I would desire spe- cial attention: and — 1st. When I desire any light from Dr. Reyburn, as to the " proper" time, or the "proper" course 'to protect my personal honor, I shall, most assuredly, call on him for it; and, I hope, with a becoming regard for his transcendant fitness to impart it. If the whole community do not find that out, it will never, hereafter, be his fault. 2d. Here is another " implication" that I am guilty of these charges, because I did not at once assume that they applied to me; while, in the same breath, it is " implied" that Dr. White is guilty of them, because (as is asserted repeatedly) he did appropriate them to himself. This reminds me of the man who was determined to whip his wife, at any rate : — He came home, and, hanging his hat on a chair, ordered her to knock it on to the floor: if she complied, he whipped her for knocking his hat down: if she did not, he whipped her for disobedience. 3d. As to my not daring then to discuss this subject, my friends know that I was most anxious for an opportunity to do so. I expressed freely and often my desire that my "secret" accusers would say openly, something, by which I might be able to know that I was attacked, thatl might meet it then — though the " occurrences " were not so very much more " recent" than when at last brought out. "The then recent oc- 14 VINDICATION. currences" were "then" about three years old. But, I have already shown that the description of the case did not enable me to decide that it was a case of which I had any knowledge. And now, as I am forced into it by gross charges, founded on " implications'' drawn from " im- pressions," I must go one step further, and show that the whole article, now that the case to which it applies is identified, is a tissue of false- hoods. It was not for me to say so, while I knew nothing about it ; for I do not charge gross delinquency on the strength of " impressions" and " implications" founded thereon. Hence, when Dr. Adreon said he had such a ca^e as was described, it was not for me to deny it; for how could I know he had not ? But, when I am to be convicted of gross charges, because I did not respond to an attack made onsomebody, which is now asserted to have been me, it becomes my duty to show the utter falsehood of the whole story. I here, inasmuch as Dr. R. has " proved " Mrs. Dugan guilty of " perjury," by a reference to his own testimony before the Court, (See page 6 of his ''Supplement,") hope he will excuse me for alluding to a fact proved by myself, in conjunction with two other witnesses. It was proved by the testimony of Dr. White and myself, and the note of Rev. Mr. Light, that the only visit I made Mrs.D., in 1840, was made on the 25th April. I had personal knowledge, by the appearance of the edges of the opening, that the cut could not have been made less than about three days previous to that time. But what does the report say ? Why, that the tumor was opened on "the 27th." I never visited or saw Mrs. Dugan, in 1840, after the 25th day of April; yet the charge of " interference" is on the " '29th or 30th April." Rather considerate in giving two days for it, as it increased the probability of hitting the right one. I also knew, from the appearance of the skin around the opening, that there had been no " perforations," and no " state approach- ing to sphacelus," previous to my visit. That such symptoms may have appeared afterwards, as described by the consulting physicians, and indicated by her present aspearance, I do not say. I make no assertions, but of things that I know. In what the falsehood consisted and just what the truth would be, cannot, probably, be ascertained. The con- sulting physician, on the trial, could not speak of dates, as he had no written memoranda to guide him. The only writings to be relied on, are, it seems, Mr. Light's note and Dr. Adreon's case-look. Here, then, I had personal knowledge that the most striking and fun- damental points in the whole case were utter falsehoods — on the sup- position that, as is now proved, it related to Mrs. Dugan. The dates, VINDICATION. 15 even, are five or six days from the truth, as to the two most important points in their charges. And yet, it is pretended that this is a true ac- count of Mary Dugan's case, from notes taken at the bedside, and there- fore not liable to error, through failure of the memory ! Mr. Ligrhi's note is very serviceable in that respect. // shows what day we were called to visit her ; and it was proved in Court by Dr. White and my- self that we visited her on that day, and that I saw her on no other day in that year. And when I thus knew the main features to be false, I was prepared to believe others so, on the testimony of other people.. For instance, Mrs. Dugan and the other persons in the room when I made my visit, told me there was a profuse discharge of the contents of the bowels, immediately on the introduction of the Doctor's lancet. Dr, Adreon says there was a discharge of " well digested pus," " also sone foetid gas" — and "that evening some fcecal matter passed through the openings in the groin." Mrs. Dugan had then, certainly, no moth e for deception. She was telling us facts on which we were to base our pre- scriptions for her, and it was for her interest that we should have them stated correctly. She appeared to have no hope of living but a short time, and would not be likely, in such circumstances, to make false statements. All these facts, with many more like them, would have been forth- coming, when this precious document was read before the Medical So- ciety, had its veracious authors possessed the manliness to avow what they have been at length forced to do- It was, no doubt, far from their imaginations then, that ihey would ever be obliged openly to avow against whom their malignant slanders were directed. That they hoped I would assume them, I have no doubt; for they would then have had one., slight ground for an " implication" against me. Now, they have nothing but " impressions." But that was enough to enable them to go about town and charge that I was guilty of all this baseness, and had been charged with it to my face, and dared not reply. I had too little regard for them or their influence to pay any attention to their abuse, till they chose to print it: then, with all due deference to Dr. Reyburn's " superior merit," I concluded it was the " proper" time for me to speak. When he expected me to speak before, he evidently thought me as "green" as he now thinks me uncivilized. As for the "superior merit" of Drs. Adreon and Reyburn " standing between me and a prac- tice." that is an idea that would never have occurred to me, if he had not suggested it — any more than would the fact of his having published some very severe " sarcasms." 16 VINDICATION. Dr. Reyburn proceeds: "The letter of Dr. Knox will be taken by all readers, with due allowance for the bitter, intolerant and abusive spirit of the man. His temper forbids him fair judgment, and oppor- tunities have probably been wanting for the cultivation of gentlemanly courtesy. Such infirmity and misfortune may excite pity, but cannot raise anger. He conveys his contradiction, I believe, in his ordinary style of discussion, and in as gentlemanly terms as he is acquainted with." I have copied the above extract that I may have it ever before my mind; for, keeping both my own deficiences and the bright example of those who are kind enough to point them out in view, there may be some hope of improvement. Truly I may say, " Who am I, and what is my father's house,' that I should be" brought in contact with such ge- nius and refinement as are combined in Dr. Reyburn ? I must confess that, as to education — as an old clergyman said to a young one who inquired as to his religious enjoyment and experiences — " I have none to boast of;" and, as most of the little medical education I have was picked up in those out-of-the-way-places, Boston and Philadelphia, it is not to be expected I should know much of the ways of the refined world, in which it has been the happy privilege of Dr. Reyburn to move. I have, however, one consolation. I was taught to tell the truth ; and, live or die, to adhere to it; and, such is the force of early habit and early instructions, that I have — and this is not the first or only time — done so, when trouble might have been avoided by a different course. Dr. Reyburn may find, in the end, in spite of his " superior merits," supe- rior talents, and superior education, that truth will be too strong, even for him. It is but fair, too, that all I have ever said in this matter should be judged of, somewhat, by my ordinary "spirit" and "temper," as ob- served by all who are well acquainted with me. I accept of that test; because, though it prove hard, it is fair. I would not like, however, to stand the test, if I am to be judged by those, who, like Dr. Reyburn, have moved in so different a circle, that they scarcely more than " know me by sight," and form their judgments on " impressions*' made on their minds by the falsehoods of my bitter enemies. And, while I am upon this subject, I am reminded of one suggestion, that may be of some service even to Dr. Reyburn, if he will accept it from so humble a source. He seems to have been at much trouble, for the last month or two — constantly talking, writing and printing — to get the public to understand that he has been the author of certain VINDICATION. 17 '• sarcasms." The knowledge of the fact, that there arc many persons, like myself, deficient in some of his accomplishments, would seem to render it important that this difficulty should be avoided, and the com- munity spared the loss of his valuable time. I have heard of an old preacher, who was observed, invariably, to shed tears, about five minutes before the close of his sermon. His peo- ple never could imagine the reason, as there was nothing to excite a similar affection in them. But, in due time, the old man died, and the mystery was explained. Near the close of every sermon was inserted thus —" [cry here]." Now, with all due deference and humility, I would suggest that, when Dr. Reyburn oext proposes to publish a "sar- casm," he insert immediately before it, ]£§== [sarcasm here] —then his wit will be at once appreciated by common people, and he will be spared another month's labor in proclaiming it. Were I to enumerate and refute all the false statements concerning me, in Dr. Reyburn's " Supplement," I should be obliged to fill as many pages as that does: for my name is scarcely mentioned without a falsehood, directly asserted or " implied," in connexion with it. But I think I have noticed the most important ones, and so as to enable my readers to correct, for themselves, the " impression" sought to be made by the rest. They are mostly of too trifling a character to demand any notice. Of this stamp is the charge, (see p. 11) that, " At the time Dr. Henry was invited to see the case, in 1840, Dr. Simmons was also invited by both Drs. White and Knox ; but Dr. Simmons being cognizant of the circumstances, then, as afterwards, indignantly spurned such equivocal conduct, and showed the strong sense of decorum that befits the profes- sional gentleman." Now, were this true, I would have not the slightest objection to ac- knowledge it; for there is nothing charged but what it was perfectly proper for Dr. White or me to do. But, in the first place, I never asked Dr. Simmons to visit Mrs. Dugan : and, in the second place, when Dr. White, — very properly — asked him on the evening of the 25th, to see her, he promised to do so, and it was arranged that he should go the next morning — and I have his authority for the asser- tion. He did not go, it is true ; and for the same reason that I did not: because we found that the original attendants had returned to the care of the case. It is due to Dr. S., that I should state, too, that he is of opinion that this statement of Dr. Reyburn may have been made througli a mistake. That is a matter of opinion; and each one will judge for o 18 VINDICATION. Of the same eharaeter i. ft. •• implieation," en page 3rd, that 1 had a diffe ent opinion from Dr. White, as te the previous h.story and er.gmal nature of the ease. No disinterested person eould draw sueh an " implication" from my testimony. A!ain, on page 18, « That it was so immediately apphed to those for whom it was intended, is due to themselves, for truth alone could give sharpness to the sarcasm-fact alone could give edge to h,> censure, Now it is self-evident that none could know any thing about the facts, but those acquainted with and concerned in the case All others must have received their " impressions" from what they heard about it; and I confidently believe that no person ever applied the " sarcasms of Dr Adreon and his « confrere" to me, but in consequence of their secret whisperings." „ But enough. I will not pursue the disgusting detail further To call on Drs. Adreon and Reyburn for proof, after all they have said has been publicly proved false, and they have only met that proof by their own assertion that it is "built on perjury," would be as vain, as " Calling spirits from the vasty deep." They seem to feel deeply their "unfortunate" situation, in having no proof at all to offer: and, as the best and only substitute they could produce, they have succeeded, at length, in procuring one endorser. To him my respects must be briefly paid, and I shall have done. Dr. Beaumont says, (see page 27 of the Supplement) that he " was invited by Dr. Adreon to see Mary Dugan, at the time of the most complete development of her disease, a few days after he, as her attend- ing physician, had punctured the tumor and abscess in the right inguinal region." This first visit of Dr. Beaumont must, in all probability, have been after the one made by Dr. White and myself; for that is proved to have been made about three days after the operation; and it is proved that no physician visited her for at least two days before our visit. Both these facts were fully proven in Dr. White's publication, and are susceptible of any amount of proof that the most fastidious may desire. The presumption is, then, strong, that Dr. Beaumont had never heard of Mary Dugan when Dr. White and myself visited her. At any rate, he can no more be a witness, as to the charges against us, than Dr. Adreon ; for he could never have had any personal knowledge of such facts as they have charged against us. It is a moral impossi- bility, too strong for the belief of any man, that we would have ever done one of the things charged in the presence of Dr. Beaumont, a»y VINDICATION. 19 more than in the presence of Dr. Adreon. Hence, I say, he is the endorser of Dr. Adreon's statements, and not a witness to them, at all. The matter now stands in the shape of a regular draft on public credulity, drawn by Dr. Adreon to the order of Dr. Reyburn, accepted by him, publicly protested and proved base and worthless ; and then, to give it currency again, endorsed by Dr. Beaumont, in the following manner : (See page 28, of the " Supplement"):— " He (Dr. Adreon) continued his usual attendance on her, I believe, and I neither saw nor heard any more of the case for several days when absurd rumors and reports had been put in circulation, and Drs. White, Trudeau, Knox, Light, Tabor, &c, had obtruded themselves upon Dr. Adreon's patient, interfered with his course of practice, gratuitously given their opinions of his mistaken viev/s and erroneous treatment of her complaint, alarming the patient, and created a panic in the neighbor- hood, about Dr. Adreon having ' punctured a hernia and cut an intes- tine,' and made proposals to wrest Mrs. Dugan from his charge." He, also, on page 27, fully endorses every thing said in the " report " of Drs. Adreon and Reyburn, and specially affirms all the abusive epithets there used, and quoted near the commencement of this sketch, and which arc now all applied to Dr. White and myself, by its original authors, to have been " strictly correct and particularly merited " by us : and that, while it is self-evident he could have no personal knowledge of one of those facts. Now " Drs. White, Trudeau, Light, Tabor, &c," can speak for themselves. So far as Dr. Beaumont's accusations against them are concerned, I have nothing to say. But, as to the " Knox" part of these charges, they are not a whit the less "■ utterly and basely false," than they were before Dr. Beaumont endorsed them. That Dr. Beaumont and Dr. Reyburn may have believed these charges, at one time, I think quite likely. That they have been assured they were true, I have no doubt. But, when they have been publicly proved false, they should have strong reasons to induce them to persist in that opinion. And, now, as Dr. Beaumont is supposed to have some capital in the way of character, veracity, &c, and has chosen to assert absolutely and unqual- ifiedly, on his own responsibility, that I am guilty of all those infamous charges, he will not think me unreasonable in requiring him to prove them. Every man, who publishes gross charges against another, expects to be held to that responsibility, or treated as beneath the notice of all honorable men. I give him his choice of three propositions : viz.— 1st. Ho prove what he has asserted: which I know he cannot do. 20 VINDICATION. 2d. To acknowledge he has been mistaken, and withdraw the gross accusations he has made against, me : which, if he be an honorable and truthful man, he will do. Or, 3d. To stand, in the face of this community, with the brand of a wil- ful, deliberate, and false calumniator, in letters of living light, upon his brow : which, if he fail to do one of the others, he shall do. I cannot forbear, before. I close, giving one more paragraph from Dr. Beaumont's certificate, that my readers may have the opportunity of seeing the style of composition that finds favor with the fastidious taste of Dr. Reyburn. Perhaps some of them will be able to invent a new grammar-tree, with branches crooked enough to hang up all his " parts of speech." If so, I would advise him, next, to try his hand on " squaring the circle;" for I think he might well hope to obtain the 100,000 pounds, now waiting in London, for the man who first does that. My learned friend, before alluded to, and who is something of a literary man, as well as a Latin scholar, tells me that it reminds him very much of the style of the celebrated Dr. Chalmers — particularly the length of the periods — though he admits that, in other respects, the resemblance is not so striking: — " SI. Louis, August 10/A, 1846. " Dr. Thomas Reyburn. " Dear Sir, — In reply to yours of 31st ult., waving as much as pos- sible all feelings of participation, interest or prejudice, I may be sup- posed to have entertained from the forced association into which I have been drawn in the controversy with Mary Dugan and others, I am con- strained, by a strict sense of duty to myself, to you, to community in general, and to the medical profession in particular, to say, that in my view, your " Report" upon' Mary Dugan's case, as published in the St. Louis Medical and Surgical Journal, and read before the Court in the trial of said case, &c, &c, was perfectly correct and candid, and com- patible