• .1 ^, <3^ ^ IMAGE EVALUATION TEST TARGET (MT-3) /y ^>*. :^ M. O V , :%^>^ 1.0 I.I mm m22 2.0 14.0 u& \M IM 1^ < 6" ► Sdmces CorporaliGn ^ a>^- \ <^ ^. >^^1^ ^ ^.V^ ;\ 7J WIST MAIN STRUT WiaSTIR,N.Y. USM (716)*7:t-i303 '^ ' o r/it ,fi0 K^ 4* i^ ^ ^ <^ CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian Institute for Historical IMicroreproductions / Institut Canadian de microreproductions historiques Technical and Bibliographic Notaa/Notas tachniquat at bibliographlquaa T t( Tha Inatltuta haa attamptad to obtain tha boat original copy avallabia for filming, i^aturaa of thia copy which may ba bibllographicaily uniqua. which may altar any of tha imagaa in tha raproductlon, or which may aignif Icantly changa tha uauai mathod of filming, ara chackad balow. □ Colourad covara/ Couvartura da couiaur I I Covara damagad/ Couvartura andommagta □ Covara rattorad and/or iaminatad/ Couvartura raataurte at/ou pailiculte □ Covar titia miaaing/ La titra da couvartura manqua I I Colourad mapa/ D D D D Cartaa gtegraphiques an couiaur Colourad inic (i.a. othar than biua or biacic)/ Encra da couiaur (i.a. autra qua blaua ou noira) I — I Coloured piataa and/or iiluatrationa/ D Planchaa at/ou iiluatrationa an couiaur Bound with othar material/ RelM avac d'autrea documanta Tight binding may cauae shadowa or diatortion along interior margin/ La re liure aerrte peut cauaar da I'ombre ou de la diatortion la long de la marge IntArieure Blanic leavea added during reatoration may appear within tha text. 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T P o fi b tl si o fi si Ol Tl si Tl IM dl ei bi rii rs m Thia item ia filmed at the reduction ratio checked below/ Ce document eat film* au taux de rMuction indiqu* ci-deaaoua. 10X 14X 18X 22X 28X 30X y □ 12X 16X 20X a4X 28X 32X TtM copy fllm«d hcra has bMn raproducad thanks to ths gansroshy of: Library of tho Public Archivas of Canada L'axampiaira f limA fut raproduh grica i la gAnArositA da: La bibliothAqua das Archivss publiquas du Canada Tha imagas appoaring hara ara tha bast quality posslbia considaring tha condition and lagibllity of tha original copy and in kaaping with tha filming contract spacif Ications. Original coplas In printad papar covars a:.^ fllmad baglnning with tha front covar and anding on tha last paga with a printad or lllustratad Impras- sion, or tha back covar whan approprlata. All othar original coplas ara fllmad baglnning on tha first paga with a printad or illuftratad impras- sion, and anding on tha laat paga with a printad or lllustratad imprasslon. Tha last racordad frama on aach microflcha shall contain tha symbol — ^ (moaning "CON- TINUED"), or tha symbol V (moaning "END"), whichavar appllas. Lsa imagas auh^antas ont 4t4 raprodultas avac la plus grand soin. compta tanu da la condition at da la nattatA da l'axampiaira film*, at w conformM avac las conditions du contrat do fllmaga. Las axamplalras orlginaux dont la couvartura an paplar ast ImprimAa sont filmfo an commandant par la pramlar plat at an tarmlnant soit par la darnlAra paga qui comporta una amprainta d'Imprasslon ou d'liiustratlon, soit par la sacond plat, aalon la cas. Tous las autras axamplalras orlginaux sont filmAs an commandant par la pramlAra paga qui comporta una amprainta d'Imprasslon ou d'lllustration at an tarmlnant par la darniAra paga qui comporta una talia amprainta. Un das symbolas suK/ants apparattra sur la darniAra Imaga da chaqua microflcha, selon la cas: la symbols — ► signiflo "A 8UIVRE", la symbols Y signifia "FIN". Maps, platas, charts, ate, may ba fllmad at diffarant raduction ratios. Thosa too iarga to ba antlraly includad in ona axposura ara fllmad baglnning in tha uppar laft hand cornar, laft to right and top to bottom, as many framas as raquirad. Tha following diagrams llluitrata tha mathod: Las cartas, planchas, tablaaux, ate. pauvsnt Atra filmAs A das taux da reduction diff Arants. Lorsqua la documant ast trop grand pour Atra raprodult an un saul clichA, 11 aat filmA A partir da I'angla supArlaur gaucha, da gaucha A droita, at da haut an bas, an pranant la nombra d'Imagas nAcaasalra. Las diagrammas suivants illustrant la mAthoda. 1 2 3 1 2 3 4 5 6 ./ EEPORT (» 3RS. NELSON AND MACDONNELL, AND .,«,S' /: \\ :^ ZEPHIRIN PERRAULT, ESQ., ADVOCATE, OF THE QUEBEC, MARINE AND EMIGBANT HOSPITAL. ' % 1 \ ||)rint«b ba other of tl)e Cegialatine asoemblQ. QUEBEC J PRllTTBD BY JOHN LOYELL AT HIS STEASt PRHfTDTO ESTABUSHMENT, MOUNTAIN STAfiKT. 1853. mmmm m h ■'^ 4 EETURN To AN Address from the Legislative Assembly; of the 30th ultimo, for a Copy of the Report of Doctors Nelson and MacDonnell, and Zephirin Perrault, Esquire, Advocate, on the Quebec Marine and Emigrant Hospital, and of all Documents having reference to the Inquiry held by the said gentlemen concerni. g the said Institution. By Command, A. N. MORIN, Secretary. Secretary's Office, Quebec, 7th April, 1853. m To His Excellency the Bight Honorable James, Earl of Elgin and JSineardtne^ Knight of the Most Ancient and Most Noble Order of the Thistle^ Governor General of British North America^ Captain General and Governor in Chief in and over the Provinces of Canada^ Nova Scotia^ New Bnmsmck^ and the Island of Prince Edward f and Vice Admiral of ihe samCy ^c, ^c ^c. May it please Your Excellency : On the thirtieth day of October last, it pleased Tour Excellency to issue a Commission, under the provisions of an Act of the Legislature passed in the ninth year of Her Majesty's Reign, intituled, " An Act to empower Commissioners for ** enquiry into matters connected with the public business to take evidence on oath," nominating and appointing the undersigned, Wolfired Nelson and Robert L. Mc- Donnell, of Montreal, Physicians and Surgeons, mid Zephirin Perrault, of Kamou- raska. Advocate, to be Commissioners to inquire into the management of the Marine and Emigrant Hospital at Quebec, empowering them to summon before them any persons or witnesses, and to require them to give evidence on oath, orally or in writing, and to produce such documents and things as they the said Ccmmissioners, or any two of them, should deem requisite for the full investigation of the manage- ment of the said Marine and Emigrant Hospital. That in and by a letter bearing anterior date to the above-mentioned Commis- rion, namely, the eighteenth of October last, and offering the same for the acceptance of the undersigned, it was stated, that it was the wish of Your Excellency that the Commissioners should meet in Quebec on the second of November then next, when and where they would receive their Commission and instructions ; and further, that in and by the communication, enclosing therewith our appointment, dated the second of November, one thousand eigbt hundred and fifty-two, they were instructed to report specially upon the mututu charges or complaints of Dr. Douglas and the late Commissioners, and upon the subject referred to in Dr. Rowand's representation, herewith transmitted, and generally upon the internal mana^ment of the Hospital, with a view to suiocest a remedy to any abuses or irregularities which may be found A St to have heretofore existed therein, and to enable the Government to place the estab- lishment upon the most sativfactory footing in all respects. The Commissiiiners therefore most respcctUilly l)ca leave to Report, for the in- formation of Your Excellency, that, in obedience to Your Excellency's commands, they repaired to Ijuebcc at as early a period as ihcir professional avocaiions would permit. One of them, Dr. Nelson, presented himself at the Office of The Honorable The Provincial Secretary on the second of November, and Dr. McDonnell reached Quebec on the morning of the third of November. Mr. Perrault was prevented by important business from reaching Quebec before the thirteenth of November. Having received their Gonunission with tlie letter of Instructions, the two Medical Gommissioners proceeded at once to business, and immediately made ar- rangements for an apartment in which to hold their investigation, and through the politeness of The Honorable The Speaker of the Legislative Council, one of the Com- mittee rooms was placed at their disposal. They also engaged the services of a medical gentleman. Dr. Von IfHand, as Secretary, being ]>ersuadfcd, from the nature of the inquiry intrusted to them, that they could not proceed to their own satisfac- tion with ordinary writers, the more especially as the greater ]>art of the proceedings were to have reference to matters of a strictly medical character ; and tne Commis- sioners are happy to state that Dr. Von Ifflancrs assistance was most valuable and efficient, and that he rendered the duties of the inquiry less arduous, and materially contributed to its being brought to an early termination. The same day the Commissioners made their first inspection of the Marine and Emigrant Hospital, and examined its structure, internal economy, and domestic man^ement. The result of this and subsequent visits to the Instituti(m will be detailed in another part of this Report, as well as the suggestions humbly offered for the future management of the establishment. In the examination of the facts placed before them, the Commissioners beg to state that they dispelled from their minds all feelings of partiality ; and not being residents of Quebec, or interested in the issue beyond their desire to have justice done the aggrieved parties, and order and regularity once more established in the institution, they believe they have been free from those personal motives which it is difficult to render inoperative, when we are allied by relationship, social intercourse or community of interest, with parties standing in the position of the accused and the accusers m the present case. The Commissioners felt, therefore, that if the mode of inquiry instituted by them be unsatisfactory, and the suggestions they offer be valueless, the fault must be attributed to their want of ability, and not to their want of honesty, for, impressed with the great responsibility imposed upon them, they used their best exertions to conduct the investigation to the satisfaction of the Government and the credit of the public service. Whilst the public interest demanded a fair and searching examination of all the alleged abuses, there was likewise entrusted to the Commission the delicate task of guarding from undeserved reproach the professional and private reputation of a number of respectable practitioners, whose medical qualifications and characters for integrity, propriety and morality, were freely and extensively assailed, and careful attention to this part of the inquiry was rendered necessary, as well for the interests of the Hospital as in justice to the gentlemen whose characters were thus assailed, for it is hardly necessary to state that no charitable institution can occupy a high position in public estimation or public confidence whose officers are even suspected of conduct which (as will appear in the sequel) was so frequently and so Of>enIy attributed to some of those connected with the Marine and Emigrant Hospital. There was one feature in the present Investigi^tion peculiar to it, viz., that the 8Ame parties appear both as accusers and accused ; and the same chaises,— -derelic- tion of duty, connivance at abuses, and indifference to the interest of the estab- lishment, — are reciprocally charged against all concerned with the management of ^e Hospital. This unusual state of disorganisation has arisen from the want of a proper code of regulations exactly (Icflning the duties of the scvcrnl officers, and to a want of firmness in enforcing such rules as did exist, to which may he a(lded, as another and important cause ot disorganisation, the want of a Board of paid Com- missioners or Inspectors, whose duty it ought to have heen to visit the Institution regularly, to report to the Government at regular periods, to correct irregularities and redress grievances at their very outset, and not to have allowed them, from long duration and want of correction, to become established abuses. These observations apply more especially to the mutual charges of Dr. Douglas and the late Commissioners, which have unfortunately called for the interventi(m .of the Government, and the nature of which will be best understood by giving a short history of the causes which have led to this disagreement. It would ypnear, that for several years past a want of harmony so essential to the well-being ot an Institution like the Marine and Emigrant Hospital, has existed among the officers ; but, though occasionally manifesting itself previous to the year 1847, it then became so evident that both parties ceased to make any efforts at concealment ; and this discord and bad feeling have been increasing up to the present time. Notwithstanding such serious impediments to the proper discipline of the Hos- pital, t!ic care and attention bestowed upon the patients, the zeal and assiduity of the lay officers, and the advancing and well deserved reputation of the Medical Staff, served to counterbalance all drawbacks, and the Hospital attained a high position as an Ajylum for the sick and maimed, and a respectable reputation as a School of practical Surgery and Medicine. The first Commission .appointed to superintend the affairs of the Marine Hos- pital, was composed of Drs. Parent and Morrin, and Mr. Gowen ; — of these. Dr. Parent seldom acted. The feeble state of Mr. Gowen prevented him attending to his duties, whilst the active professicmal occupation of Dr. Morrin, the Chairman, interfered with his efficiency as a Commissioner, and he delegated to Dr. J3ouglas his power, having every confidrncc in that gentleman's zeal for the interest of the Hospital, and ability to manage for its general welfare and utility. That this confidence wa» not misplaced, is proved by the testimony of Dr. Painchaud, who states that he always deferred to the opinion of Dr. Douglas, and admitted his superior knowledge ot Hospital management and discipline ; and the Steward, Mr. Whelan, who resided in the establishment from its commencement to within a few years, declares that he always regarded Dr. Douglas as the very " heart *' and soul " of die establishment, and that it was to him complaints were referred, and by him abuses were checked. So long as matters were thus managed, so long as the Commissioners had their duties vicariously performed, so long as Dr. Douglas ruled supreme (to use the words of the late Commissioners), all went on well, and no c;)mplaints were made by Dr. Douglas, although several were made against him. Amongst these, was his overbearing conduct to the Under-officers of the Medical Department. In support of this statement, the evidence of Dr. Landry may be quoted, in which it is averred, that during the period he was Apothecary, he was frequently ill-treated {maltraiU) by Dr. Douglas ; although with a candour which stamps veracity upon his previous statement, he admits that, whilst performing the higher duties of House Surgeon, he was treated "kindly by that gentleman, and received marks of special attention from him. D.'. Painchaud also alludes to the treatment of his son by Dr. Douglas, during the tiiTiD that young gentleman act?d as House Surgeon, and which he assigns as one of the first causes of discord in the establishment. He says, in one part of his written document: — " Pa'nful as the task is to pourtray the ofttimes unpardonable " conduct of a professional brother, of a colleague and a friend of long standing, I ll^shall not shrinK. from my duty." 6 Dr. Painchaud alludes to the concord which existed during the first ten years, and to the threat held out hy Dr. Douglas, when Dr. Painchuud, Junior, was ap- " itment was un a pointed Ilousc Surgeon : — " It was not before 1846, and then on the iippoiutni ** of my son as IluuHe Surgeon, that our amicable and fraternal understanding " interrupted. Dr. J. D. was impressed with the idea that my son had played lii " trick in supplanting hisprof^g^, whom he had strongly recommended ; m^ collcagua " then remarked to me, * Yoiir son will not be three months in the Hospital : I will " * put him to the proof!' " To this threat Dr. Painchaud replied that, if nis scm were badly treated, he would protect him, not because he was his own son, but as he would any other House Surgeon. This remonstrance appears to have had no effect upon Dr. Douglas : — " He kept " his promise and his word in treating the young man tyrannically. He began by " questioning him every day, and in tne presence of the Students of the Hospital, " on the materia medir.a. His imperious tone had the effect of intimidating him, and " occasionally caused him to give erroneous answers. He made an official com- ** plaint to me. I remonstrated with my colleague on the injustice of his proceed- ** mg, and assured him that if the Commissioners refused to do justice in the case, I '* should make adirecl appeal to the Executive. The examinations ceased, but the " tyrannical treatment was not abated, taking only a different form. Dr. J. Douglas " deprived him of all moral influence by making him a subject of ridicule before the " patients and nurses, and by charging Whelan, the Steward, with a part of his ** duty, as the admission and discharge of patients." Df. Painchaud proceeds to state that, in 1847, a Methodist Minister entered as pupil of the Marine and Emigrant Hospital, and soon some of the duties of the House were assigned to him, and altercations took place between this gentleman and Dr. Painchaud's son, caused by Dr. Douglas having given the former orders to turn out the House Surgeon from his surgical wards; and, when an official inquiry was made into the matter. Dr. Douglas appeared to approve of the coniaict of this gentleman, and justify his proceedings. The Commissioners, though aware that, in 1847, owing to the great prevalence of typhus fever, and the diff.culty of procuring competent medical assistants, the discipline of most sanitary institutions necessarily became law artd was temporarily suspended, can hardly imagine a state of things which could justify a line of conduct like that assumed by Dr. Douglas. How is respect for an inferior officer to be main- tained, when his superior turns him into ridicule before his subordinates, sets at naught his authority, delegates to others the performance of his most important du- ties, and entrusts an inexperienced person with highest responsible duties of the surgical department ? If the House Surgeon was incapable, Dr. Douglas ought to have made known the circumstance to the Commissioners ; — if they heeded not his complaint, the Executive would have listened to it, and. have inquired into the matter. No amount of incapacity on the part of the House Surgeon, — no indifference on the Eart of the Commissioners, — no degree of superior qualification of a gentleman olding the position in the establishment which the party alluded to occupied, could warrant the conduct of Dr. Douglas towards the recognized officer of the II<)sj)ital — the permanent House Surgeon. When we recollect that the yonn^ gentleman was son of Dr. Douglas' oldest colleague, we can well conceive how difficult it was to preserve harmony and unanimity in the Institution, — how impossible for the visiting Physicians to act in unison as colleagues, or ever meet one another with the usud civility of ordinary acquaintances. That the animadversions upon the behavior of Dr. Douglas are not based upon the statements of Dr. Painchaud alone, is clear, from what Dr. Morrin mentions in his reply to sorr.e of the charges brought against him by Dr. Dongas. That gentle- man states that, "during the early years of the Commission, Dr. Douglas was one of " two paid visiting Physicians, and, as such, was allowed to reign suprme through^j " out tne Institution. No charges were then heard respecting its management, sav# I *' those which had reference to the well-known peculiarities of his temper and dispo- " sition, which were freqiiently the cause of bitter complaint." Tlie above extracts siiew the cause of niucli of tlic disagreement that for years past lius reigned in the Hospital ; and the Cotnmissioncrs would suggest that a great a nount, if nut all, of this bad feeling might have been averted, had Dr. Douglas' duty in the Hospital been strictly confined to his medical care of the sick. But when we find the Chairman of the Commissicm speaking of tlje visiting Physician as *' ruling supreme," and of his " Dictatorship," we nuist confess we can put no other construction upon these words, than that Dr. Douglas was allowed to use this authority because tne Commissioners delegated it to him. It is too late to charge an officer with the abuse of power, which we have shifled from our own shoulders to his. It is too late for Dr. Morrin to complain of Dr. Douglas' "Didator- *' shipf^ when he himself placed him in a position to act the Dictator. If Dr. Douglas, from his known peculiarity of temper and imperious conduct, abused the power entrusted to him, it was the fault of the Commissioners not to have kept him in check, and to have withdrawn the control of the establishment from his hands ; but though these facts were well known to the Commissioners, and though their Chair- man was frequently made acquainted with the " bitter complaints" they nccasioned, no attempt wai^ made to curb this misrule — no effort was made to confine Dr. Douglas* duly to its proper limits ; he was allowed to act as Chief Medical Officer and Chief Commissioner, combined offices, for which his infirmity of temper, to use a mild phrase, evidently rendered him unsuited. The Commissioners of this Inquiry cannot refrain from expressing their opinion that, had there been a regular paid Board of Commissioners, Visitors or Inspectors of the Institution, who were responsible for the performance of their duty, wno dared not to have delegated to the visiting Physician the onerous charge (,f such an im- portant establishment, they should not now hear of the visiting Physician being called the " heart and soul " of the establishment, to whom all complaints were to be referred, and by whom redress was to be granted ; nor should they hear of his " reigning supreme," of his being a "Dictator;" nor should they hear of " bitter " complaints," " tyranny " over inferior officers, and insulting and degrading treat- ment of the Medical Officers of the Hospital. Had such a Board been in existence, there would have been no necessity for the present investigation. We should have heard i>f no abuses, for they would have been arrested in their infancy ; no charges of dereliction of duty, for such would have been instantly detected ; no acrimonious vituperation, for such would have been uncalled for, and unnecessary. The Commissioners have now brought down to the year 1847, the history of these misunderstandings and disagreements, and they respectfully direct Your Excellency's attention to the documents contained in the Appendix, for the grounds upon which they base their statements. They are anxious to direct special attention to these documents, for in the course of their inquiry, it was endeavoured to date the origin of these misunder- standings from the appointment of the six visiting Physicians, in 1847. This attempt has been made, both by Dr. Douglas and some of his present and former colleagues, but Your Commissioners feel satisfied that this unfortunate state of feeling existed before, ana had its origin in Dr. Douglas' treatment of Dr. Painchaud's son, in 1846, before which period perfect good feeling appears to have existed between the two visiting Physicians, indeed, between Dr. Douglas and the Commissioners, if that body can be said to havie existed, or to have ever exercised its functions. In 1847, a new cause of discord came into operation, and now the bickerings and heart-burnings became more general and more universally known, not only to the officers of the Institution itself, but to the public ; and the press of the City acted upon from different quarters and by different oi)erations, dragged the alleged, as well as the real abuses before the public, and tended to injure materially both the respectability and the utliiity of the establishment in general estimation. 8 Br.i before entering upon llii'- part of the question, the Commissioners of Inquiry beg to direct attention to the following points : — Dr. Doufflas never having forniallv comphiined of the non -performance of duty on the part of the Murine Hospitrt! CMuniissioners, und jis these gentlemen never felt aggrieved by the dietutorsliip of Lr. Donu;hi8, and his assuming supreme reign, it is to be presumed, that neith • party cimsidcred that any cause of comphiint existed. Dr. Douglas assumed the fui.ctioiis of the Commissioners, and performed thcmi which these gentlemen appeared content. d to allow him to do, — thereby being relieved of much resnonsibihty. Dr. Douglas caimot, therefore, at this late period, complain of the ncdigoncc and apathy of tlie then Cjmunissioners, nor can they com- Elain without incrmunating themselves of his abuse of power which should never ave been placed in his hands. It is since 1847, that a real antagonism has existed between the Commissiim and the visiting Physician, and it is now the duty of the Commissioners of Enquiry to lay before lour JExcellcncy, what they believe to be the real cause of this discontent. On entering upon their investigation, the Commissioners determined to avoid a consideration ofall those charges upon which a decision of the Executive had already been given ; consequently many of those questions involving the character of the officers of the establishuK nt, which had already been settled by the previous Enquiry held by the late Coinmissioners and which are contained in a blue-book entitica "A Return, &c.," were not opened anew in the present investigation. By excluding all vagnc and imfoundcd hearsay evidence, anu by obliging the majority of the wit- nesses to furnish written as well os verbal statements, the Commissioners believe thev have protected their investigation from the charges of distorting evidence, and givmg a false coloring to testimony, imputed to the niquiry held by the late Com- missioners. As the Commissioners of Inqui.y are of opinion that Dr. Douglas' real hostility towards the late Commissioners, and their opposition to him, had its origin in the appointment of the six additional visiting Physicians in 1847, it is well to state the grounds of those strifes before considering the mutual charges of the Doctor and the Commissioners. In 1847, Canada was visited with a greater amount of immigration than in any other year, and along with it came Typhus fever, which was then racing all over Ireland. The duties of the two Medical Officers became suddenly in- creased, and they demanded additional assistance, and the Government yielding to their request appointed Drs. Fremont and Racey as their colleagues, but vnthout any salary. Here commenced the first real dissatisfaction amongst the im^eased medical staff. The newly appointed gentlemen complained of not being paid, and one of them, Dr. Fremont, soon retired, and Dr. Racey died of Typhus fever contracted in the discharge of his duty. Soon after this event, the Government appointed six additional Physicians, the nomination of whom was left to the Medical Officers of the Hospital. It would appear from the evidence laid before us, that Dr. Douglas expressed his disinclination to have associated with him some of those recommended by Dr. Painchaud, and proposed that six of the senior Medical practitionerL^ of Que- bec should be requested to accept the new appointments; but on applying to these gentlemen, they refused to act, as the (.overnmenl did not propose paying them for their services. Six other lames were then agreed upon ; and when requested to meet these gentlemen. Dr. Douglas expressed ignorance of their having been nominated, although he himself had given in the names of some of them. For confirmation of this statement the Commissioners refer to the letter of Dr. Pain- chaud in the Appendix (see p. 53). This pretended ignorance on the part of Dr. Douglas was not calculated to create a good feeling towards him on the part of the new Visiting Physicians ; and the rude manner in which they were received by Dr. Douglas, and the highly ofi'ensive terms in which he alluded to their pro- D( ne cu "P frsnionjil (niiiIifK'nlions, \v(^r«' cnlculntrd to cngcndf^r \ho worst frrling nnuMJgct lh«* senior (ind junior ln(•nlb^^^^ of the irirdical stafl". It would upprar tliiit I)r. Dou;j;l(is wished, hy mnliiiig rt^sisfaiu;*! in the liejrjnnini,', to prevent iiny of the newly-iippoinled riiysicinns taking uny part in the rnan.'igenient of the si.ii^ical ca^es, f(>r whose eaie and treninient lie eonsich'red hiiriselfas ah)ne f|tialifi('d. The position ihns assnrn<'d by Dr. Doiighis might to some extent ho rx- 'cused, wore we ignorant of the fact, that he himself had aided in tln' seleetion of the>e genilemeii, and if they were unfilled for the dniies of the office they wer<' ajjont to assume, it did not display on his part, n mailractiast strife is forgotten, and every effort made to uphold his professional qualifications, and protect his rcptUation against any unjust assaults that may l)cMluected against them. But in the instance now under consideration, we find a gentlcmati, at the head of a large pidilic Institution, entrusted by the (jlovernmcut of the country with the nomination of a number of practiticmers to be associated with himself in the per- formance of highly responsible duties, and who is so rctrardlcss of the trust reposed in him or so indifferent as to the manner in which it is discharged, as to nominate gentlemen whom he subsequently stated to be unqualified for those duties. Your Commissioners would wish to put this constrnctu)n upon Dr. Douglas' conduct, but a careful examination of the docmicnls laid before them, as well as an auitlysls of the evidence furnished by the witnesses examined by them, prevents them forming such an opinion. They cannot conceal from themselves the fact, that Dr. Douglas wished to retain to himself the whole of the surgical practice of the Hospital, and domineering over the newly appointed Physicians as he was accustomed to do over the Inferior officers of the estaulishipent in former years. They cannot allow this part of their report to be terminated, without directing Your Excellency's attention to the very insulting expressions made use of by Dr. Douglas at the first meeting of the increased Staff, to the words of which all the witnesses testify. He then stated to his new colleagues, that he would as soon let a "bull into a china shop, as allow one of " them into his surgical wards." No difference in professional standing, no supe- riority in experience, skill and learning, and no inequality of reputation, could warrant the use of such language — were all other causes of discontent removed, this reception of the newly appointed gentlemen, was quite sufficient to account for the cniarrels and heart-burnings that have since existed. It is no excuse for the use of such language, that Dr. Douglas was already at the head of the surgical part of the profession in Quebec, and that some of his col- leagues where as yet unknown to fame ; he should have recollected that no greater difference existed in their re pective relations, than between the senior Surgc(m of a European Hospital and his newly appointed colleague, and that it was not possi- ble to have selected from the profession of Quebec, six Surgeons of equal eminence with himself; moieover, he must have been aware that some of those who accented office did so for the sake of the surgical practice afforded by the Hospital, and which t'. 10 in lieu of pecuniary cmoUnnent, thev regard as the reward of their services, and he must have known that the duties of a Hospital Surgeon necessarily tend to make him more practically familiar with the treatment of important surji^ical diseases, and that it is for this object alone that many industrious and aspiriiig members of the profession seek II )spital employment. To have supposed that his colleagues would not aspire to distinction in this walk of practice, was to have supposed them either deficient in a laudalile ambition to advance themselves, or wanting in moral courage to resist liis uaurpalion, and that they would quietly have yielded to his dictation. Their opposition to his views, was followed by an appeal to the Government, and it was ruled, that the newly appointed Physicians were to be considered m every respect on equal terms with those already in charge of the Hospital, jmd that no distinction was to be nuvde in the surgical and medical practice except what waa agreed upon by the Staff amongst themselves. In these directions, the Executive was guided by the practice of the Montreal General Hospital, to the President of which application was made for information on the subject. THE MARINE AND EMIGRANT HOSPITAL, QUEBEC. A brief account of the present stale of the Marine and Emigrant Hospital seems not only desirable, but absolutely necessary, as pertaining in an especial manner to the duties that have devolved upon the Commissioners, who will con- sider themselves amply repaid, If only a small portion of advantage should result from their invest iga ion and suggestions; and they mu t be candid enough to admit that they do anticipate no small measure of good therefrom. Under any circumstances the Commissioners will enjoy the consoling reflec- tion that they have, to the utmost of their abilities, as professional men and as citizens, endeavored to acquit themselves faithfully and fearlessly, of the impor- tant trust confided to them. On the third of November last, they paid their first visit to the Hospital — a very large edifice, which cost, as they vere informed upwards of twenty-two thousand pounds. They were met by the House Surgeon, Dr. Lemieux, a highly intelligent young gentleman, who speaks English very fluently, and in a manner to fit him well for all the exigencies of his office. . The Apothecary's Shop, though small, was neat apd clean ; the officials were in good order and well labeled ; the shelves and drawers were tidy, and every thing at hand. There was quite an armory of splint? of every kind and form, and among them a goodly array of Dessault's long splints for the thigh. There was no great al^undance of Su^-gioal lustrnments, nor were they of very modern datt* ; they had not apparently been obtained at first hand, although it was said, they had cost as much as wouM have procured a complete s^t of the very best kind, yet such as they are, they can be used efficiently, and aris ifi good order. The Library is in a large room, and consists of 3 M volumes. The books, however, are not of very recent date, although, generally, the v'orks of standard authors ; they have been considerably used, and it would coasequently appear that they were not originally purchased for the Marine and Emigrant Hospital, as Ihere are few Students attending the Hospital to disturb or soil them ; and it is very properly forbidden to take any oat of the Institution. Whether procured at auction, or from the private library of some orthodox professional veteran, doe.s not satisfactorily appear, They will, neverlhelest;, form the nucleus of a good library. The whole edifice was examined, and every thinuf appfcarec'.-lo be in its pro- per place The wards were closely inspected and were passably tidy. All the bedsteads are of iron, and are stnmg ; but the interstices, between the cross-bars or hoops, were too large, thereby allowing the bed tick to be forced throuifh, causing it to wear the sooner, and the bed to be less comlortabie. The bidding was snificient, snug and clean. Although the ventilation is most defec- tive, still there was no unpleasant odour perceptible in the few wards that were occupied, for as at this season of the year the navigation is nearly closed, the number of inniates is consequently small. There was, however, one ward in which the smell was excessively bad, and this was a ward which had been placed at the disposal of a physician who had announced in the public prints that he was in possession of an infallible cure for the Cholera! There was a stove in active operation ! The windows and doors were kept most carefully closed, and the natural ci^nsequenee was, that patients and attendants were immersed in an atmosphere, which froni its heat and closeness constituted the best medicine possible for imparting mcreased impetus and virulence to a disfirder whii;h apart from its own malignity, requires a cool, fresh, and pure atmosphere. So oftensive was the smell, that the nurses were advised to remove the chimney board, and to keep the door ajar. A sug- gesiion of a similar nature, it was afterwards understood, had been deemed an inlerlerence with the treatment, and invoked as one cause of the failure of all the cures that were to have been wrought ThisCholel-a aflfair has been alluded to in a former part of this Report, and it is to be hoped, that no similar event will ever oecnragam in any public institution. The Surgical Wards, certainly, presented to the medical men a far more pleasinaf appearance. Order and method prevailed, and while there were no cases of particular importance, yet, were the Commissioners struck with the large numl)er of fractures under treatment, and especially of the lower extremities: the proportion of such injuries is far greater in this Hospital, than is any other certainly in this Province. This is to be attributed to the fieqnency of accidents occasioned in loadinij timber. They all seemed to be doing well : the ban- daging was very neat, the splints well applied, and the whole reflected much credit on Dr. [.emieux. In fairness to Dr. Douglas, whose demeanor towards his fellow practitioners has so often been painfully alluded to by the (Commis- sioners, they have pleasure in admitting that he has spoken of Dr. Lemieux in a most favorable and gentlemanly manner, in his capacity of House Surgeon. The whole interior had a gloomy appearance, arisin.g from the dull colour of the paint on the walls. It may be here observed, that paint is by no means the most economical, or most eligible application for effect, and certainly not in a sanitary point of view ; it may be also remarked, that a preparation of liuje and salt, with or without a small portion of plaster or size, colored to suit the taste, (the pure white or bluish cast is far preferable) would impart a lively aspect to the whole interior of the buiiding. This should be applied twice a year, or once at the very leasi, and that should be in the month of April, so that all might be ready for the arrival of the shipping. By this application, all (Exhalations with which the walls might have been impregnated, would be completely destroyed, and a Iresh and sweet state of the atmosphere be imparted to the wliole edifice. To continue this digression, the floors of such Institution should be in the first instance, well saturated with double h:)iled linseed oil, and this should be' repeated every second year ; each subsequent coaling would require a sradlerquantity of oil, than the previous one, and ultimately the flooring would become impervious to any thing that might fall on it, and" thus all foul effluvia would be prevented. By these several means, the sanitary condition of the Hospital would be effectually sustained, provided always that recourse be had to some more efficient method for ventila- 12 tion, f jr, without a full supply of external air, it would be vain to expect any lodging plaee to be healthy or a fit receptacle for the sick. The Commissioners were at a loss lo conceive to what purpose one of the aparlineiilsi, a dark room, was devoted ; on inquiry, however, they were informed that it was in this dark room that the clothes of the sick were deposited, on thejt entering the Hospital, redolent as they were, with perspiration, filth, and often times with vermin, without being aired or washed. In this abomiiiable and filthy state, they were "rolled up and labelled," and there lefi to fester (real furinites from which, on the sliglest cause, pestilence might be generated and spiead through the whole Institution) until the owners should claim them on leaving the Hospital.' • , Now the Commissioners miist be permitted to state that they regret, as they sincerely do, tliat such an unpardonable oversight should be all owed lo e." ist, which could scarcely Iwve been expected, in an establishment exclusively devoted to sanitary purposes. They must, nevertheless, state, that there is a Rule enjoining : " That the " Stewards shall receive the clothing of the patients, catalogue and ticket them, *' and have such of them washed as may seem to require it;" but on examina- tion it appeared that they " rever seemed to require washing !" The rule should have been imperative : "■ That all the clothing should be " aired, washed, dried and pressed, and then ticketed. &c." This not being the case, a very unpleasant odour of perspiration and other offensive smells were apparent on opening the door of this dark chamber. The fact is repeatedly alluded to by authors, and corroborated by daily observations, that (as stated by Griscorh in his work on this subject) ; " Scarcely " any thing tends more to pollute the air than the accunmlation of old rags and "old clothes, imbned with every species of filth, and covered with vermin. "They constitute the lurking places of those contagious fevers that occasionally "devastate the neiglibourhood of houses in which these wares art; kept." The distribution of the rooms appear to be tolerably well adapted for the f)urposes intended, and the whole Hospital might not be found exceedingly de- ectivp, h.id not the means of ventilation, of such paramount importance in the construction of dwellings for mankind, been totally disregarded, the want of which, particularly when combined with other important items of mismanage- ment, may tend to very disastrous results, and even to a high rate of mortality. Of uU the instances of faulty and inconvenient distribution which have ever come under the notice of the Commissioners, that of the cellar or basement story, was found to be the worst. The kitchen is situated here and is of far too con- tracte'd dimensions, to "leet all the purposes of so important a department in an Hospital, it being only 6 feet 7 inches in height, and with but two small win- dows of four panes of glass each, 10 « 11 or 10 by li inches. There are no means for the escape of the large volumes of steam continually arising from the boiling caldrons. The flooiing is very bad, and is raised only a few inches from the soil beneath, and during high water, the planks forming the floor are lifted and are almost afloat, thereby rendering it very wet and always damp. It is a most gloomy apartment, and not at all adapted for cooking. It is as damp, repnisive in appearance, and as defective from the want of pure air, as it IS possible for any person lo imagine, or be devised. Y .,' « 1 "^ ri — ' .»«...^i, «,uv» ^vtiipi«rtuij 1U111I9IICU Willi Ull lUC utensils and conveniences required for culinary pul-poses. Then should follow in succession separate store-rooms for all kinds of victuals, fuel, materials for cleanmg and lighting, and various other articles necessary for so large an Institu- Id The cellars are all on this flat, and are equally as wet and d;iinj) as the kitchen, rcquirini? planks to be laid down on the earth for .!.e purpose of a psuh- way, without which those having business there would sink shoe-deep in mu(J. The water-closets are located in the souili end of the buildin/, one on each flat to gain access to which the sick have to pass through the paniry, where the women are almost constantly at work, and cannot but hear the flatus and noiso made during defecation, as the seats are within a few feet of them, and only separated from their washing place by a thin half glass door and wooden parti- tion. In addition to this, the cess pipes are often obstructed in summer and constantly during winter, as no steps have ever been taken to guard against iheir freezing ; besides which the sewers are always full. The result of this want of precaution is, that the privies are useless half the year, and during the summer, emit a very foul stench ; in winter the few sick remaining in the Hospital, and wh( have sufficient strength, are obliged to go down stairs, and cross the yard, to find a place where they can obey the calls of nature ! The others have recourse to the night-buckets, a filthy and highly improper expedient, and which means should be taken to avoid. Dr. Douglas assured the Commissioners, that of late years in particular, the Hospital had become quite unhealthy, the basement story always abounding in bad smelis, of so deleterious a nature as sensibly to affect the health of ihe siek to such a degree, that he has frequently been under the necessity of transferring those of his patients labouring under wounds and ulcers to an upper story, who when sufficiently strong were sent abroad for exercise and air. Nor is it to be wondered at, when \hv. attention is directed to the facts above staled, having reference to the cess-pipes and sewers. The ex halations from similar ones when opened, have in many well recorded instances, caused instant death. This infectious air is exceedingly expansive as well as penetrating, and is rapidly absorbed by the soil, not only to be given out again, to the air above ground, but also to be inconstant operation ; thus it occurs, that the pestilential vapour is incessantly at work, and as no possible remedy can correct it, there is no safety but in total abandonment of the locality. It is true that the putrescent mass will ultimately decay, and by evaporation the earth at last discharges itself of all the mephitic gas it had imbibed, but that can only be achieved by time, and the complete abandonment of the site. A recent writer has most correctly remarked : " That it has been found " impossible to divest water once contaminated by human excreta^ of \u noxious " principles," in another place the same popular author uses these words, very severe but, it must be admitted, too true : " It is hard to conceive the depravity " of sentiment which tolerates the presence, the contact even, of human egesta '^ which makes no effort to avoid or remove the most loathsome excrementitious " matter." Although this extensive edifice is comparatively new, having been con- structed and established for the reception of sick Mariners and Emigrants, in the year 1835, it has already the appearance of decay, and will ere long require greut repairs ; and should no measures be adopted to prevent the water from pursuing its course from the roof into the stone work, and through the window sills, the plasteriQg will be destroyed, for it is already much injured, the whole masonry work in bad condition, and the massive walls will crumble and fall, in consequence of the water freezing between the stones. There are neither spouts nor gutters attkched to the building, but in place of these and apparently for ornament, there is a moulding, projecting nearly 16 inches from the walls, about a foot below the eaves. On this ornamental projection the rain falls, a part of the water penetrates behind this contrivance, into the stone work, the rest is pro- jected over the moulding, and with the slightest wind is blown and spread over the whole external surface of the building, thereby destroying the mortar on the 14 outside ; and by continually falling on the window ledges, works its way under them and injures the plastering within, as already stated. The Commissioners wcvld suggest, that the inconvenience alluded to, might be eflectually remedied, by carrying the eaves five or six feet further out ; this pro- jection would throw off' the water to such a distance as to prevent it wetting the walls, except occasionally during violent gusts of wind. It might be made omar mental and even useful, by being lined underneath with boards in a circular form, and painted white. This would reflect much light, and give an appearance of airiness to the building, while it would withhold the direct action of the gun's rays in hot weather, and thus render the whole Hospital cooler and more pleasant. In winter it would lend, not only to keep off'lhe cold in some degree, but also in a great measure ward off* the snow ; prevent its collecting about the windows, and diminish the force of wintry blasts. This addition would cost comparatively but a small sum, certainly nothing in comparison to the advantages to be de- rived from it. Some plan of the same description might be adopted in the construction of all similar buildings; a short gutter only would be required to keep the droppings of the roof from falling over the door-ways. The Commissioners remarked that a long, low, wooden building about one ' hundred feet from the Hospital, constructed in the first instance for a shed and wood-house, was being vamped up at considerable expense, for the purpose of being converted into a Cholera or Fever Ward ; certainly a very necessary and proper appendage to a large Hospital. It is to be regretted, however, that though designed to.be but a temporary structure, a little more regard had not been paid to its sanitary state. The sills of the building, although on a stone foundation, were but a few inches above the ground ; at trifling cost, the whole edifice might have been raised a couple of feet, by which means the floors would have been higher from the earth, and less exposed to the exhalations and vapours that arc always given out from low, damp and shaded places. These could have been effectually carried off* through small apertures in the wall. But even a far greater error has been committed in the interior of this building, which is not over seven . feet high, and is ii^tended to accommodate a large number of sick. There is not one single opening for ventilation in the whole of the Imc and flat ceiling; and how the bad air is to go out, and the good air is to get in, surpasses the philosophy of ihe Commissioners ; and yet, there was a means of effecting this, as simple and efficacious as advisable, which could have beezi resorted to at little cost. Be- tween the ceiling, wh^ch is of boards, aad the floor above, there is a space of nearly a foot, caused by the intermediate beams ; it would have been the most easy thing possible to have made openings between each beam, (for the whole frame-work is of thick planks) and in each side of the building opposite to each other of from twelve to fifteen inches broad and four or five inches high, in which a small blind could have been put, thus would a thorough draught be obtained through and through between the floors, and if there were a certain number of per- forations made in the ceiling, the fetid and buoyant air would readily issue, and be carried off* by the transient current of fresh air from the outside, and a pait of which, unquestionably, would pass down by its specific gravity, while the hot air from its levity would rush upwards, hence, a double current would be in constant operation by the escape of the air between the floors. Registers could have been easily placed in all these small ventilators, to moderate the draught as might be required. For want of some trifling mechanism of this kind the most frightful consequences might ensue, from the air becoming infected as much from its de- terioration in the process of breathing, as from the poisonous emanations from the bodies of the sick which are constantly exhaled ; and who, in truth, would suffer even less than their attendants and physicians, lying as they would, low on their beds, while those walking about would have their heads a|id breathing apparatai 15 always immersed in this pepliferous effluvium, and if is such, seeing that there would be more than one deleterious agent always at work. The author already quoted in reference to sanitary matters, uses these words, which are applicable to Canada quite as much as to England or elsewhere. : " Society, from ba^e to apex, has yet to be indoctrinated with the true principles ** of the reciprocal relations between vital functions and physical elements." And when treating on the subject of pure air and adequate ventilation, he makes the following remarks, which, it may l^e said, are of universal application ; ** Almost ** without exception, in all structural arrangements, there is no plan, every "builder builds as to him seems best;" and in another place we find these words, the truth of which is so palpable, and they are so judicious, that it would be a happy circumstance if Architects and Engineers, nay, if everybody was to acquire some practical knowledge of the animal economy. ** Architects and • " Builders seem to have been profoundly ignorant of the physiological fact, that " man carries a pair of lungs beneath his ribs, fitted only to inspire oxygen and " nitrogen in their purity." The able author might have extended his remarks a little further, and have stated, that besides these uses of the lungs in breathing and in the formation of blood, they also possessed the faculty of ridding the body of one of the most dele- terious principles in nature, and which is abundantly formed in the system, and if not duly eliminated, would prove fatal ere long; this mephilic gas is one well known under the name of carbonic acid gas, and is destructive to life when col- lected in any quantity, and where it constitutes the whole atmosphere of the place, causes death as instantaneously as would a thunderbolt. This Hospital, under the best attempts at improvement, can -never be made wholesome, or freed from noisome smells arising from the lowness of the ground, which at high water is but a few feet, and often only a few inches above the river: as the drains have little or no declivity, they therefore can very imperfectly empty themselves of their contents; and what is still worse, thiey are more or less in a constant state of agitation, than which nothing tends more to cause them to give out vast volumes of putrescent gas; for by the alternate rising and falling of the tide, the pestiferous mass they contain, is driven backwards and forwaids repeatedly every day. This locality can never become perfectly healthy, even if the contatni nation above pointed out did not exist, the atmosphere being malarious from the great extent of low lands, and especially from the marshes which surround it on almost every side : it will, therefore, always be exposed to unhealthy emanations. It is furthermore most inconveniently situated, and not very easy of access. The Com- missioners, therefore, conceive themselves warranted from the above facts, most respecltiiily but strenuously to recommend that, instead of building up the wing for which the foundation has long been laid, no further outlay be made for this purpose than the exigencies of the moment actually require ; but that the best possible bargain should be made to get rid of the prepnt building, which n^ight easily be converted into use as a storehouse, and the premises being sufficiently extensive, into a Lumber or Timber Depot for the numerous ship yards in the vicinity ; and, further, that a new Hospital should be erected with the least pos- sible delay in a more elevated or dryer , and therefore more salubrious position and one which would be more easy of access. It has been said, that not a few persons conversant with this establishment have expressed their opinion that it would be a fortunate circumstance if it were burnt down, rather than be continued as an Hospital for the relief of the sick, who only become worse by a soioum in so pestiferous an atmosphere. It may not be deemed irrelevant in connection with this subject, to suggest that there Aiould be stationed at some convenient point, at or near the Port (perhaps the best would be at the Custom House,) half a dozen or more pairs of i 1 16 "ftearcra" for the purpose of conveying iho sick and maimed to the Hospital; nothing; being more injurious lo iho sicit themselves nor more horrifying to a me- dical man, than to seo a poor fellow with a broken thigh or other limb carried on men's shoulders a couple of miles — '.he extremity dangling and the fractured end of th* bonis coushmtly grating against each othc. and lacerating the tender flesh, thus rendering the injury infinitely worse than it was originally. This cruel and revolting spectacle has been witnessed al Quebec; it should be eflec- tually guarded against, and means should be provided, and oare taken to convey the unfortunatiisuiriTcrs in a stat'i of comparative e ise and comfort to the Asylum which humanity has prepared for his recf^ption and relief. The subjoined extracts from two valuable little works lately published, the one in England anJ the other in ^few York, on the ventilation of buildings seem, far from being out of place, to be loudly called for — that the oversights so inva- riably committed in the construction of our public buildings may, lor the future, be avoided, whithout which all measures, however ample, complicated and expen- sive, must prove abortive in all that relates 'o sanitary purposes. Dr. Jo'.m H. Griscom in his work on the uses and abuses of air, at page 156, states as follows : — a, ^ " The r.newal of the air is not so light a matter as is supposed. To effect " it, a simple communication is not sutiicient, a mere contact ol the external and " interoal air. It is necessary that one or more currents exist to multiply that con- " tact and cause the pure air to prevade that which is vitiated." And Charles Toinlinson, in his Rudimentary Treatise on warming and venti- lating, says, at pan>es 256, 257 and 258. First, " Tlie proper supply of fresh air is denied to the great mass of the po- " pulalion, because builders who ought to be perfectly acquainted with these " things, loo often neglect to study the natural laws which Chemists and Physio- " logists have placed on a sure basis." And again : " When the great masses of the population become fully alive to the necessity of abundant supplies of wholesome air within doors, then and " not till then will they also become alive to other sanitary measures; then will " every house be properly supplied with pure toaler^ efficient sewerage and special " means for letting out foul air and admitting fresh ; then shall we ceai4e to bury " our dead in the midst of the living ; then will cattle markets, slaughter-houses, " and all noxious trades, manufacturer and occupations be removed to a greater "distance from dwelling houses; then shall we have Boards of public health " filled by competent men, and endowed with adequate powers ; then will vested « rights in injurious abuses yield to public opinion, and the health and well-being " of the population will be of paramount interest." Further remarks on the condition and economy of the Marine and Emi* grant Hospital at Quebec. The Commissioners observed, with surprise, that the practice of smoking was indulged in by nearly all the male patients. In one ward every patient had his pipe and tobacco. Without alluding to the danger of nre incurred by allow- ing patients lying in bed to indulge in this habit, it may in certain cases be inju- rious to some of the patients and ofTenaive to others ; whilst a tidy and neat appearance of the ward can hardly be maintained. The bad condition of the water-closets, generally, has already been noticed, but this was particularly the case in the one connected with the syphilitic ward— which was so completely out of repair that the venereal patients were obliged to go out to the privies at some distance from the building It is needless to remark upon the dan^r incurred by those patients, many of them in a state of salivation and obliged to leave their 99^ warm bed and warm ward to resort to a pr:vy, in the inclement season, during which the Commissioners visited the Hospital, when snow, sleet and rain were daily falling. , The appearance of the servants was not as clean and respectable as could have been desired, and indeed there is little about the establishment to encourage decency of attire and self respect on the part of the servants and nurses. When the Commissioners visited the kitchen, the servants were at their dinner, and instead of \..e cleanliness, order and regularity to be expected at the meals of the servants of such an Institution, disorder and discomiort were observed. The table at which they were silting was composed of a few boards nailed together and laid across a couple of uprights ; there was no table cloth, the portion of each servant seemed to have been helped out to him separately, and some were eating in one direction and some in another. The apartment was very dirty. Adjoining this room (the kitchen) was the one appropriated for the division and distribution of the diet for the different wards ; the boards upon which the meat had been divided and cut up, was in any thing but a clean con- dition, and drew from the Commissioners, remarks to that enect. In one part of the chamber was a bedstead and bedding, and articles of female dress were strewed about in different directions. These, it appeared, belonged to the cook, for whose occupation of the apart- ment, which was iatended for another purpose, and which, it is manifest, should not have been converted into a dormitory, no better excuse could be given than that she found it more convenient to sleep there than in her own room, as it was nearer to her work. Had the room been in a tidy and clean state, it might have excited less sur- prise ; but it was in a state of great disorder, and very badly ventilated. The Commissioners would remark, that Hospital servants, like those in pri- vate families, soon throw aside the decencies of life, when they do not see a re- spect for them observed by their employers ; and the slovenly attire and habits of those of the Marine Hospital admit of some excuse, when we know that so few comforts have been provided for them, and which could have been procured at so little expense. In the future management of this Charity, the Commissioners trust that those to whom its interests are confided will pay attention to this matter, and see that a proper room be provided for the servants to take their meals in, and that such cheap comforts as a clean table cloth, tumblers, knives and forks, be procured ; and that each servant be obliged to keep himself or herself clean and respectably dressed, and observe the decorum and propriety of conduct at their meals, required from similar persons when in private service. There can be no doubt that, by making the position of servants in the Hos- pital comfortable and respectable, a better class of domestics will be procured ; but, as at present managed, few servants who could be engaged elsewhere would be likely to enter its employment. The Commissioners noticed, with astonishment, the absence of aU proper means for the washing and bathing of the sick, an oversight on the part of the Visiting Physicians not easily to be accounted £c)r, in consequence of which the Commissioners deem themselves called upon to make some brief suggestions on the subject. A metallic bathing tub, one of cast irotiy the cheapest and the best, should be placed at the extremity of each corridor, with a moveable screen in front. The water, when not used, would not require very frequent changing, as the iron would prevent its sipeedy decomposition. The contents of these tubs could also be used ibr sprinkling the f)oor, be at hand in the event of fire, and the constant and gradual evaporation of the water would tend to restore and mamtain in the atmosphere of the place its due hygrometic condition. !■« «■ 18 It may not be irrelevant to recommend that a small portable fire-engine should be placed in every corridor ; it would also serve for the purpose of sprinkling the fioers. Evidence of Doctor Douglas and the other Visiting Physicians of the Hospital. Dr. Douglas having appeared before the Commissioners on the 6th November, 1862, in compliance with their request, gave an account of the commencement of the abuses which have since existcfd in the Marine and Emigrant Hospital. He states that, at one time, the Hospital had got into the hands of one family, one member of which was a Commissioner, another Visiting Physican, a third was House Sur- geon (son of the Visiting Physician), and a fourth, a nephew of the same Visiting Physician, was Medical Officer to the fever sheds. AH these gentlemen were receiving Government pay. He also stated that, in the year 1847, the Hospital became completely demoraliaed. A great difficulty was experienced in procuring nu'-jes for the fever patients, and at last it was found impossible to get respectable women to volunteer for this service. The Commissioners were then obliged to avail themselves of the services of several female prisoners, at the time confined in the Quebec Gaol, who were granted a free pardon on condition of tlieir acting as nurses in the fever sheds. These women being of immoral character, intro- duced every species of vice into the Hospital, and the morale of the Institution became thus contaminated, and it has not yet recovered from it. • He states that he frequently complained on this score to the Chairman, Dr. Morrin, and pointed out the evil which would certainly follow the employment of such characters in the Hospital ; but that no attention was paid to his remon- strancps. He also stated that much of the mismanagement of the Hospital was caused by the appointment, in 1847, of a new Board of Commissioners, not one of whom, except the Chairman, Dr. Morrin, was in the least aciuainted with the discipline of an Hospital, and that they took no pains to become acquainted with it. He likewise mentioned as another cause of disorder, the appointment by the Govern- ment of six additional Visiting Physicians, some of whom were, in his opinion, unfit to perform the duties imposed upon them. At first he refused to hand over the surgical wards to some of them, but stated his willingness to allow Dr. Blan- chet to take charge of his wards, but objected to allow some of the others. One of these gentlemen happened to mention, that he had accepted office principally for the opportunities thus afforded of *' learning surgery ;" whereupon Dr. Douglas remarked that, in his opinion, the gentleman ought to have learned surgery elsewhere, and should be prepared to practice it at the Hospital when he accepted office. Dr. Douglas objected to giving up his surgical wards, because he had not received any comjnands, either from the Executive or the Commissioners, to do so. The newly-appointed Physicians applied to Government for information re- specting the position they were to occupy in the Hospital ; and, in reply, Mr. Provincial Secretary Daly informed them that they were to be placed on ihe same footing as Drs. Douglas and Painchaud, except that they were not to receive any salary : that there was to be no distinction between the surgical and medical practice, except what might be agreed upon amongst the medical staff themselves. Dr. Douglas declares that owing to this order, the reputation of the Hospital has been seriously injured, that operations have been attempted by unqualified Surgeons who were incapable of completing them. That in one particular instance, the operator wished to extirpate a portion of diseased rib, and contrary to his advice, commenced the operation, became confused, lost his presence of 19 ine He m- on, )ver an' mind, and that finally the patient was removed to bed without the operation being completed. The same Surgeon on another occasion had to perform Tenotomy (one of the simplest operations,) and " stuck fast " in the middle of the opera- tion. On another occasion, a man was allowed to remain three days labouring under a strangulated Hernia ; the Surgeon not affording him any relief when he, Dr. Douglas, was called io see the patient, he returned the Hernia by the Taxis without any trouble, but it was too late, inflammation of the peritoneum had already set in, and Ihe man died. Dr. Douglas mentioned some cases of badly set fractures, which he was obliged to break over again, and set in the proper manner, so as to insure the future use of the limb to the patif.nt. Dr. Douglas stated that the character of the llospitul became so much injured by the practice of some of the newly appointed Visiting Physicians, that patients used to leave the Hospital sooner than allow some of them to operate upon them. He particularly alluded to two cases, in one of which it was neces- sary to amput te a linger, *in the other a toe; these patients left the Hospital sooner than allow the attending Surgeon to operate upon them. These cases occurred soon after the " rib case." These patients did not subsequently app'y to Dr. Douglas to perform the operations Dr. Douglas stated that there is no written rule for calling consultations in urgent or dangerous cases ; nor is there any rule obliging a Surgeon to abide by the decision of the majority of his colleagues when their opinion is adverse to the performance of an operation. Drs. Blanchet and Nault, two of the newly appointed Visiting Physicians, resigned because they were not to be remunerated for their services. Dr. Douglas then gave a very high character of Dr. Lemieux, the present House Surgeon, he had always found him at his post, he took excellent care of the patients, and *^ gave him every satisfaction." He complained of the incapa- city of the present Apothecary, who though a studentof only three months' stand- ing, was appointed by the late Commissioners to that important office. He is not aware if the young gentleman is related to any of the late Commissioners, nor can he tell if the vacancy in the office was duly announced to the Medical Students of Quebec. Dr. Douglas disclaimed any connection with Dr. Marsden, and averred that he had nothing to do, either directly or indirectly with that gentleman's charges against the management of the Marine and Emigrant Hospital, and that he had no desire to have him summoned as a witness on his behalf; that Dr. Marsden was a gentleman whose testimony would be more injurious to his friends than his enemies : that he was very excitable and apt to be carried away by his feelings. He said, he (Dr. D.,) had made his charges against the late Commission, advisedly, and had other witnesses to substantiate his statement. With reference to the expulsion of Dr. Marsden from the Marine and Emi- grant Hospital, he stated that there was a rule in the Hospital, that no Physicians should enter the Wards, except in the presence of the Attending Physician, or during the hours of visit ; and that such a rule was not made to act expressly against Dr. Marsden, but that the House Surgeon had his attention directed to it, that he might make the same known to Dr. Marsden. Dr. Douglas appeared again before the Commissioners on ili^ 8tb of Novem- ber, 1852, and furnished them with his reply to the letter of the tate Commis- sioners in answer to his own, of the 17th July, 1851. He expressed his satisfaction with the manner in which the present Com- missioners were conducting their enquiry, inasmuch as they were giving each party a fair and impartial hearing. In the course of a desultory conversation which then ensued. Dr. Douglas complained of the bad situation of the Hospital, the want of purr air, and the I J d . verv unliralthy condilion of the syphilitic wards, thnt hittcrly he had experienced difficulty in healing the venereal sores, and in some instances, was oblige to remove patients to the upper wards, where they quicitly gel well ; in other instances he was obliged to discharge the patients from the Hospital altogether, giving them medicines to take in their own lodgings; they rapidly got well, although their diseases were quite intractable whilst in Hospital, which the Doc- tor attributed to the bad foul air surrounding the Hospital. During the interviews between Dr. Douglas and the Commissioners, that gentleman made other charges against the Officers of the Institution. He stated that some of the Sailors, inmates of the Hospital, had been robbed of their money, and that the money had been divided between the present House Surgeon and some of the Nurses, and the late Steward, Mr. Cutter. That in one parti- cular case, a cheque of Mr. Deane's, the President of the Board of Trade, haJ been cashed, and when the owner was about dying, he made a will distributing this money amongst the Officers of the Hospital above named. That the will was made in such an irregular manner, and the circumstances of the case were so peculiar that three Notaries to whom application was made to draw up the will refused to do so, as such a transaction was discreditable to a charitable institution. Dr. Douglas also referred to the case of a Sailor named Mcintosh whose money was stolen from him by one of the Nurses. The Commissioners having discovered, that with the exception of this one case. Dr. Douglas could not specify any instance where a similar disposition of a patient's effects had been made, and as this very case had been thoroughly enquired into, and the accused parties acquitted by the decision of Your Excel- lency, the Commissioners did not conceive that they were called upon to re-inves- tigate the matter ; and for the same reason they objected to enquire into certain charges of immorality brought forward again by Dr. Douglas against the Officers of the Institution, which upon examination were found to be the identical charges already preferred by Dr. Douglas against the same Officers, and upon which Your Excellency had already adjudicated. Dr, Douglas repeated the same com- plaints that he had before preferred against the late Commissioners of neglecting to attend to the requisitions of the medical staff, for the necessaries of the Hos- pital, whereupon the Commissioners suggested to him the propriety of putling these complaints in writing as part of the charges he stated he was prepared to advance against the late Commissioners. All these complaiilts are incorporated in the letter of Dr. Douglas, dated 6th November, 1852, to which attention will be directed when the mutual charges of the Commissioners against Dr. Douglas, and Dr. Douglas against the late Commissioners will be under consideration. Dr. Douglas also preferred charges against Dr. Painchaud, of indecency in the style of his lectures to the Students of the Hospital. He said that these lec- tures were illustrated largely by indelicate and even obscene anecdotes and allu- sions to the diseases of certain patients of Dr. Painchaud, that he felt it is duty to prevent his own Students from attending them, and consequently prohibited them doing so. Dr. Douglas related some particulars in support of the state- ments he now made to which the Commissioners do not think it necessary further to allude. At present the Commissioners of Enquiry would direct Your Excellency's attention to the statements of the other medical officers of the Hospital, for having beard Dr. Douglas' complaints of his colleagues, and listened to his charges against them, ot incapacity, &c., they considered it but right and proper that these latter gentlemen should be heard, not only in their own defence, but that they should be allowed an opportunity of stating what reasons they might have for being dissatisfied with the conduct of Dr. Douglas, and what causes he may have given, which have led to the destruction of the peace of the Hospital and tbe good feeling which ought to exist amongst its medical staff. 21 The C()mtni^*sliotl(;r8 regret exceedingly lo find sueli unanimity displayed in describing Dr. Dougliis' trealmrnt of his collcugues, oh nervades the tcHlimony of ull thcHc gentlemen : ihey have all been aggrieved by him ; Ihey have all smtirted under the slights he has cast upon them ; th(;y had all felt that their reputations had been injured by his unkind and unjust aspersions; they have nil murmured, but siraiitre to say, they have all smbmitled to these ac^ts of o|)presRion, indeed it may be said of cruelty, without ottering resistance, with one single exception, that of Dr. Rowand, who not only maintained his position in the Hospital, but openly challenged on two occosions Dr. Douglas' assumption of infallibility, and proved that that gentleman was, like all medical men, liable to err, and that on two very important occasions, his errors were near leading to irreparable mischief. Dr. Rowand did more, he openly complained to the pre- sent Commissioners of Dr. Douglas' neglecting to consult his colleagues, before proceeding to operations, and openly charged him with the blunders he committed in the cases just referred to. With the exception of these two instances, the Commissioners have not been able to ascertain any in which the present col- leagues of Dr. Douglas have remonstrated against the conduct of which they now so unanimously complain ; nor, do the Commissioners find any other instances recorded, where Dr. Douglas himself has been brought to task, or his acts examined with the same searching scrutiny, as he was accustomed to employ in the examination of those of his colleagues. The Commissioners cannot allow themselves to believe that Dr. Douglas is different from all other medical men and that he has never made mistakes of omission or commission in his hospital practice. To suppose such exemption from error, would be absurd, for, until medicine can rank as an exact science, errors will be committed, and there is little doubt that a captious enquirer, searching for materials to form a charge against Dr. Douglas, could find plenty of evidence where perhaps the Doctor least expected it ; a knowledge of our great liability to error, and of the care constantly exer- cised by the scientific and conscientious practitioner to avoid it, should have made a practitioner of Dr. Douglas' experience and acknowledged abilities more lenient towards his junior brethren, and perhaps a kind suggestion, or ad- vice delicately communicated, might, even in the instances to which he alludes, have averted the mi.schief of which he complains. Indeed, the Commissioners were so impressed with that idea, that they asked Dr. Douglas if he did not con- sider it his duty to assist his less experienced colleagues with his advice, and occasionally to urge them to abandon operations they were about to commence, and plans of treatment they were pur^uing, in which courses Dr. Douglas might have considered them in error. To this enquiry he replied, that he did not consider that his directions, as received from the Government, authorized him to interfere in the least in the afifairs of his colleagues, that when asked his opinion, he gave it, but, that it was not always followed ; he allowed them to follow their own courses, without any active opposition from him. The Commissioners would again draw attention to the confusion and absence of system created by the want of rules regulating the conduct of the Medical Officers in cases requiring consultation. Consultations at the Marine and Emigrant Hospital seem to have been little better than solemn farces. The staff were summoned, their opinions given, and the operator proceeded, in many cases, to carry out his original intentions regardless of the opinions of the majority of those present. Cut bono such consultations } Were opinions asked, that respect for them was to be manifested by going in direct opposition to them } Yet, such has often been the practice faom 1847 up to the present tinje. The Commissioners hope that the important feature in hospital discipline of holding regular consultations will occupy a prominent place in the future man- 22 agemcnt of the Hoftpital, nnd thry believe thot thcroby \ho ropiitntion of tbo Honpitnl will bo greatly incrensed, and what \» of mon* conwcjiuMKu?, ilu; safrty, care and judicious managciiiont of the paticntH will bo mon> efl'ectually (Uirried out, and the cause of suHorins; humanity be matorlally bcnoHled. Dr. Douglas again appeared before the Commission, and requested that Dr. Fremont, Mr. Patrick Whelan and Mrs. Whelan, Buckley, the Sexton, and Mr. Dean, President of the Board of Trade, should bo summoned to attend, as he be- lieved they could each give evidence in support of the statements made in the letters of 17th July, 1861, and 8ih November, 1862. Letters were accordingly addressed to these parties. Mr. Whelan and his wife, and Mr. Buckley attended at the hours specified, but Dr. Fremont did not make his appearance before the Commission, but furnished them with a written document containing his evidence. Mr. Dean did not attend, nor did he direct any written statement to the Com- missioners, or even acknowledge the receipt of their letter. Mr. Dean's conduct is the more strange, ns he exhibited, on one occasion, a great desire for an enquiry into the affairs of the Hospital, and did not display any great reluctance in bringing forward charges which he shrunk apparently from substantiating when an opportunity presented for his doing so As the testimony of Mr. and Mrs. Whelan and that of Mr. Uuckloy refers to the charges against the Commissioners, and not against the Medical OfKcers, its examination will for the present be omitted. The Commissioners summoned Drs. Painchaud, Nault, Sewell, Hall, Robi- taille, Jackson and Lemieux, to give their opinions concerning the causes of dis- content in the Hospital, and these gentlemen were requested to state whence they believed the evil to originate, and how it could be best remedied. The Commissioners did not summon Dr. Rowaud on this part of the enquiry, for as he already appeared as an accuser against Dr. Douglas, they did not con- sider that his testimony was called for. The evidence is given in the order in which it was taken. The striking similarity in the testimony of the witnesses is very remarkable, and must con- vince the most sceptical, of the truth of the assertions contained in the diflerent depositions. Letter from Doctor Pamchaud to Commissioners of Enquiry, {TrariBlation.) Gentlemen, — You have been so obliging as to permit me to state in writing what I know in reference to the state of the Marine and Emigrant Hospital, since I have been one of the Visiting Physicians, directing my remarks particu- larly to what has passed in it since 1847. Painful as the task is to pourtray the ofttimes unpardonable conduct of a professional brother, of a colleague and a friend of long standing, I shall not shrink from my duty, but act in obedience to your requisition. I regiet that the time does not permit me to select my phrases, but I have thought fit to give a faithful and succinct account, without attending to the sounding of my sentences. I was appointed Visiting Physician of the Marine Hospital jointly with Dr. James Douglas and on the same day. The first ten or eleven years passed in the most perfect peace and harmony, for the excellent reason, that I allowed my colleague to do as he pleased. I was un ler the impression that I was indebted to him for my new appoiut- ment, and that he had in a manner obliged Lord Gosford to place me in the Hospital. I considered him then, and I still consider him to be the most skilful Surgeon in North America. I thought that he was belter qualified than myself 23 to govern an Hospital, and I loft tho government to him. I oIwayH acted with him, Higned everything with him, and joined with hint in his accusations^ often at my own rink and peril. In the affair witfi Dr. Andrews, the House Surgeon, Dr. J. D. drew mo into action of damages, perHonally for £10,000. The suit histed 18 iiuhiths, was dismissed for informality, and I came off, with a loss of my share of tho costs. Not till 1S4G, on the appointment of my son as House Surgeon, were our good understanding and amicable feelings interrupted. Dr. J. D. was convinced that my son had used unfair means (played hlra a trick) to supplant Dr. McGrath whom he favoured, and had strongly recom- mended. My colleague then observed to mo, " your son will not be three months in *' the Hospital. I will put him to the proof." *' Why should ho not remain long *' in it," 1 replied, " provided ho does his duty ? Can you intend to treat him " unfairly? If so, I gjve you notice that I shall support him, not as being my " son, but as I would support any other House Surgeon." I explained to him as a friend, that my son was only desirous of improving himself in Surgery, under his auspices, for a couple ol years, and intended to devote himself as a Surgeon-missionary to the relief of the Indians at Vancouver's Island ; that tho young man, strongly reconnnended by his professors at Paris, had been equally so, by all the most nspectable practitioners in Quebec ; and that he was not unpro* vided for'; that with me he had a situation upon which he might enter forthwith, and very much to his advantage, with the prospect of succeeding me. This made no Impression on my colleague. He kept his promise and his word that he would exercise his tyranny on the young man. He com- menced by questioning him every day, in presence of all the pupils in the Hospital, on materia medica. His imperious tone intimidated him, and some- times caused him to answer erroneously. He complained to me in my official capacity. I remonstrated with my colleague on his unjust conduct, and assured him that, if the Commissioners did not do justice in the case, I should make di- rect application to the Executive. The examinations ceased, but the tyranny was none the less continued in another form. Dr J. D. deprived him of all moral influence, by making him an object of ridicule before the patients and the nurses, and by charging Whelan, the Steward, with a part of his duty, as admissions and discharges. In the spring of 1847, a Methodist Minister, Mr. Selly, offered himself as a pupil at the Hospital. He came strongly recommended by one of the Members of this Honorable body of Commissioners, Dr. W. Nelson. I received him as well as I was able, and asrurcd him that my son would do everything in his power to make his time pas-!i usefully and pleasantly in the Hospital. I also ad- vised him to visit my colleague. This he had already done; and he told me moreover, that he had taken him under his protection. Several days after, Mr. Selly assumed towards the House Surgeon an inso- lent and rude demeanor. Dr. J. D. addressed himself, in his visits, only to Ijim, and he made up his prescriptions. Towards the end of the month of May, the . Hospital filled rapidly with cases of typhus fever; tho House Surgeon was scarcely competent to do the whole duty of filling up the tickets of admission, and afterv.'aWs entering them in the large book. The Commissioners allowed him an assistant, a writer, at a dollar per day. Dr, J. D. had Mr. Selly ap- pointed. At the end of a week the new writer threw pen and ink aside, and went to work to prescribe for the patients in the Hospital. He lived at that time with his wife at the Little River; generally arrived between 8 and 9 o'clock, and went away between 3 and i. h'j 24 In order to shew his contettipl for me, this Mr. Selly used to call out on my anival at the Hospital, '' John, or Thomas, bring the tray ; I am going to make my visit !" I thought it right to make a strong remonstrance to my coUeagae on this occasion. He made answer that Mr. Selly was a man of talents, that he had confidence in him, and that he made himself answerable for his acts. Subsequently, my colleague entrusted to him his principal surgery, No. 16, with orders to prevent all persons from going near the patients ; the House Sur- geon on going to make his usual visit, was brutally turned out, and the watch- chain which he wore round his neck was broken ; next morning he complained to me, in my official capacity. I referred the complaint to my colleagues who were, at that time, Messrs. ^Douglas, Racey and F'lomont. Mr. Selly was called, and being questioned by Dr. J. Douglas as to whether he had really acted in that manner, boldly answered in the amr-native, and declared that he had acted according to orders. Dr. J. Douglas then made use of these unfeeling words " you served him well." An enquiry took place, but came to nothing ; the Commisoion of the day was literally Dr. Morrin. Mr. Gowan attending to nothing but the building, and Dr. Parent being too sick to act. Mr. Selly was moreover charged with the mi::or operations which he per- formed in the Dispensary, shutting out the House Surgeon and some Canadian Students, who made a complaint to the Commissioners, which came to nothing. They even obtained no answer: yet. Dr. J. Douglas had cognizance of the complaint for he enquired of Mr. Lemieux, one of the pupils, whether he was not at the head of the complainants. The latter replied that he was. The Dr. observed to him in my presence, " You shall remember me," and he kept his word. At the contest for the office of apothecary. Dr. Douglas' pupil was proved to be very far inferior to Mr. Lemieux, but Dr. J. Douglas found means to get Mr. Martin appointed, because he had longer to contin^jc his medical studies. 1 think that Dr. J. Douglas has always owed Lemieux a grudge for it, and that h§ still owes him one. Mr. Martin was installed as apothecary," and was soon converted into an instrument of torture against the House Surgeon. He nailed up the door of com- munication between the apartments of the latter and the Dispensary. A com- plaint 3 the Commissioners came to nothing. The House Surgeon then made application to the Executive, and a new body of Commissioners were appointed and a formal enquiiy set on fool. Whelan, the Steward, and Mr. Martin were dismissed. A final effort of Dr. J. Douglas was the represeniing of the House Surgeon as of a feeble constitution, as being always in ill-health, and that he. Dr. J. Douglas, could no longer answer for the safely of his patients. The answer of the Executive was prompt and brief. The House Surgeon was to resign, and the Commissioners were to send in the name of the person whom they recom- mended to fill the vacancy. Th^ House Surgeon had, however, still leave to offer any remarks which he migh I havo to make, through the Commissioners. The House Surgeon humbly replied that he would submit to the will of the Governor General, that he would send in his resignation, but that at the same time he defied Dr. J. Douglas to prove that he had been a single hour absent from his duty, with the exception of two attacks of Typhus Fever contracted in the Hospital. Dr. J. D. thought he had gained the victory ? He gave it out through the Hospital, that there was no longer a House Surgeon ; that he had been disgraced. He was much surprised to learn by the next post that the Government had given orders that the enquiry should close. The House Surgeon remained another year in the Hospital, and resigned in order to return to France, when he was appointed to a French Government vessel freighted with settlers for California. 25 My colleague was very much displeased with the new Commissioners ; he could no longer dictate as before; but His Excellency's determination to add six new visiting Physicians to the Hospital displeased him still more, and he resisted the Government accordingly, and obstructed .ne in the execution of the duty assigned to me. On the 21st July, 1847, I wrote to the Provincial Secretary that the Physi- cians of Quebec would receive with joyful approbation His Excellency's ofiler, and that the whole difficulty lay in the selection. Dr. J. D. wrote likewise on the 22nd of the same month, that the measure was impracticable, and could not be brought to work beneficially. The selection was made by Dr. J. D. and his associate, the late Dr. Race^. I objected, but in vain, to the omission of the senior members of the , profession who had accepted, in order to substitute a junior, namely Dr. Hall. I was in the minority and he was appointed. Dr. J. D. received his new colleagues veiy coolly, and endeavoured to inti- midate them in respect of their position, giving them to understand that they were only temporary, that in all likelihood they would be ordered to the sheds. The six new Physicians then applied to the Executive, who gave them a satis- factory answer. The second time they appeared at the Hospital in order to organize them- selves. Dr. J. D. objected to make an arrangement with them. " I require no " assistance," he remarked, " 1 did not ask for you and I would as soon see a " bull in a china shop, as see you enter my surgery." Some time afterwards, three of the new Visiting Physicians, Drs. Sewell, Blanchet and Nault resigned. Since that period Dr. J. D. has seemed to me to be desirous of bringing the Hospital into discredit : he has allowed operations to be performed which did no honor to it, and that by his peculiar proteg4 Dr. Hall, without giving him a word of advice. From time to time indeed, he would say to him " an- " other slice, Dr. Hall, another slice." He endeavoured to scatter dissension between the Visiting Physicians and the Commissioners while the Board of Trade assailed the whole establishment; and what makes me believe that Dr. J. D. moved the springs of these fvents, is, that he predicted the proceeding of the Board of Trade three weeks beforehand : and we recognized in Mr. Dean's communication the very words and expres- sions which Dr. J. D. made, use of in our presence. The contempt of Dr. J. D. for his new colleagues has been evident for several years. He allowed me to be maltreated in a Court of Justice by Dr. Marsdon, whom we (Dr. J. D. and I) ha '. banished from the Hospital by an order given verbally to the officers in consequence of a reprehensible action. Dr. Marsdeii produced in Court a letter from Dr. J. D., the substance of which was " that he had never given such an order in writing." By this equivo- cation, he saved himself from the imputation of a falsehood, and by it he indirectly fixed the stigma upon me. Dr. liowand was likewise maltreated in Court by Dr. J. D., and in a man- ner still r.iore cruel, as also more than once in the Hospital in my presence. Recently he displayed contempt for his three colleagues, who are not on terms with him; Drs. Rowand, Jackson (his brother-in-law), and myself, by introducing, without consulting us, a method of treating Cholera^ derived from Mr. Chaperon, a country practitioner, although th's method had been contemned by respectable practitioners in Quebec. A month afterwards, when Dr. J. D. perceived that the method of treatment was absurd, and that he would probably be censured for it, he called on us all three " to know whether he should discontinue the said Dr. Chaperon's plan of " trer tment." I was absent from that meeting, and purposely so, because I was already aware of its intention. Dr. Rowand replied, in my opinion very justly, 26 " that as Dr. J. D. had commenced the treatment without asking our opinion, he " would act with equal propriety in discontinuing it without requiring our per- "■ mission." There will never be peace in the Hospital unless Dr. J. D. should be sole and undisputed Master — never will there be sympathy between him and the Visiting Physicians. The whole humbly submitted to your consideration. Gentlemen of the Special Commission, By your respectful Servant, (Signed,) JOS. PAINCHAUD, One of the Senior Practitioners at the Marine [lospital. Evichnces of Drs. Jewell and NauU, Dr. J. A. Sewell appeared and stated that he had some aversion to continu- ing as Visiting Physician to the Marine and Emigrant Hospital from : 1st. non- payment ; 2ndly. want of equality, as far as regarded his position in the Hospital with Drs. Painchaud and Douglas ; and Srdly. the apparent want of readiness on ihe part of Dr. Douglas to render his assistance in surgical operations. That Dr. r-)uglasdid not show any regard to the Visiting Physicians, and instead of requesting the assistance of his colleagues in surgical operations, he usually obtained the assistance of Dr. Fr6mont, or others, not connected with the Marine Hospital. Drs. Sewell and Nault, conjointly are of opinion, that neither harmony nor cordiality car? exist in the institution, so long as Dr. Douglas treats his colleagues as he has done. Dr. Sewell states, that while acting in the Hospital, he soon after his nomi- nation, perceived that neither harmony nor good undei.4landing could exist therein, while Dr. Douglas assumed to himself so much undue authority. Dr. Nault stales, that ho only performed duties in the Marine Hospital, f / a few weeks, and says that the same reasons assigned by Dr. Sewell for retiring from the Hospital, besides \hzA of being employed as Inspecting Physician of the Port, caused him to discontinue his attendance. When Dr. Douglas was remonstrated with, for using the language he had, in alluding to the new Visiting Physicians and particularly that of as soon see- ing a bull in a China shop, as the performance of duties, by the present Visiting Physicians, he Dr. Douglas, replied, that he had merely alluded to Dr. Jackson. Drs. Sewell and Nar't state that Dr. Douglas frequently operated on Sundays, during the hours in which Divine Service was being performed in the different cimrches of the City, implving that, by operating on such days. Dr. Douglas would not have the attendance of his colleagues. Sunday is not the day appointed for operations, one week-day, generally Tuesday, having been set apart for per- forming operations. : :.- (Signed,) JAS. A. SEWELL, ^.. ........ ..,.^. ..:' ..........:,....._v.v-,.-.-.-.' ■^.-. . J. Z. NAULT. - Evidence of Dr. J. L. Hall. Dr. Hall states that, since his appointment, having always considered the Visiting Physicians and the Commissioners as gentlemen, he always met them with perfect confidence and a desire of performing his duties honestly and con- scientiously, and he was also under the impression that the same feeling existed amoDg the other Visiting Physicians. 27 That he was always treated by his colleagues with altention and considera- tion, and that they (his colleagues) evinced a desire to advance the interests* of the pupils and the welfare of Ihe institution. He also thinks that there always appeared a desire on the part of his colleagues to shew him (Dr. Hall) every con- sicleration when professionally employed. That he has been more intimate, and on a more friendly and kindly footing with Dr. Douglas than with any other member of the profession : so much so, indeed, that his house is, he believes, the only one which Dr. Douglas visits, and takes tea, &c., with him, and that he (Dr. H.) does the same thing reciprocally: that of visiting his (Dr. D's,) house, and taking tea with him and his family. That he had always depended upon his own resources, and that through his professional exertions alone he had acquired property. That lately, from some remarks which have been made, not by the Visiting Physicians but by others out of the Hospital, he had felt a want of confidence (diffidence^ in performing operations, which he had a consciousness of being able and competent to perform well and neatly. In alluding to the case of caries of the Rib^ and for which he operated, he states that, before commencing the operation, although agreed upon by Dr. D., he (Dr. D.) observed that it was a bad case and not fit for him (Dr. II.) to begin to operate with, and one that was better adapted for him (Dr. D.) lo perform upon ; and, in connexion therewith, he states that Dr. Douglas had no conception that the disease was so extensive. That he has felt embarrassed more than once, when performing operations, by the presence of persons who were unfriendly to him, and who would misre- present his manner of operating. He does not allude', in this observation, to any of his colleagues. Dr. Hall states that Dr. Douglas has, in some instances, called in Dr. Fremont, when performing operations, at the Hospital. On the question being put to him, (Dr. Hall) whether he did not think this practice a slight intended to the Visiting Physicians, he objected to reply to the question. He states that the observatioi; made by Dr. Douglas on the appointment of the new Visiting Physicians, viz : iliat he would as soon see " a bull in a china " shop as the newly appointed Visiting Physicians in the H"' 'tal," caused some dissatisfaction among the Visiting Physicians. He states that Dr. Douglas was in the habit of consulting his colleagues in professional cases, and also that Dr. Douglas was in the habit of calling in his colleagues in consultation, previous to an operation, and, on a recent case, he declined to operate, though prepared to perform it, on Dr. Rowand's disapproving of it, as Dr. R. said the case was susceptible of cure without operation. He also states that in cases when operations are to be performed, he Dr. D. waits for his colleagues to the time appointed for operating; but, if they are not present, he at once performs the operation without waiting. That Dr. Douglas has performed operations on Sundays, but it is his belief that it was at the end of the summer and to send the sailors home before the close of the navigation ; and that he has also an indistinct recollection of his (Dr. D.) having performed operations on Sundays, during the winter season, when the above reasons did not exist for operating. , , (Signed,) JOHN L. HALL. Evidence of Dr. Robitaille. Dr. Robitaille states that he is one of the Visiting Physicians of the Marine and Emigrant Hospital since 1847, the period of the new appointments. S8 Shortly after their nomination, the Visiting Physicians assembled at Dr. Parent's on the subject of dividing Iheir duties in the Hospital. Dr. Parent recommended the division into Departments and fixing the period of attendance, quarterly. He (Dr. Robitaille) was rather averse to being connected with Dr. Douglas, but on some explanation taking place. Dr. D. said he would make things veiy easy to him. Some time after, in the Hospital, and when speaking of the qualifications of the Visiting Physicians, Dr. Douglas observed, that " he would as soon see a " bull in a china shop as the Visiting Physicians in the Surgical Wards," he, (Dr. D.) applied the words generally and the expressions were certainly very painful to the feelings of the gentlemen present. On Dr. Robitaille being questioned on the authority assumed by Dr. Douglas in the Hospital, as also his (Dr. D.'s) expressing himself disparagingly of his col- leagues. He (Dr. R.) was silent, but he relates the case of a sailor having the humerus fractured — there was a callus {d4p6t) formed. He had 'seen cases muoh worse than the one in question, and notwithstanding that the case was of a nature not to require it, he (Dr. II.) felt greatly pained to see Dr. Douglas break anew the bone, and place the arm on the fracture apparatus, and without consulting the Medical attendant u: der whose case he was. He, Dr. Robitaille, is in the habit of calling Dr. Douglas in dangerous medi- cal cases, and when attending at the same time with Dr. D., but that he has never himself bf-en called in consultation in any important medical case' occur- ring in the Hospital, nor in any surgical case. That their being in attendance at the same time, he does not think that there is any necessity of calling a consul- tation on medical cases. That when Dr. Douglas has some important operation to perform in the Hospital, he is assisted generally by professional men not connected with the Hospital. Dr. Fremont is generally the gentleman assisting with his (Dr. D.'s) own pupils. He has never seen Dr. Douglas assisted by his own colleagues. When surgical operations are performed by his colleagues. Dr. D. gives his opinion on being requested to do so, and now and then is present at the operations. Dr. Douglas has, to the best of his recollection, attended to the consultations when required. He has no recollection that Dr. D., in capital operations, per- formed them before or after the time appointed. That he has no recollection that Dr. Douglas has performed capital operations on Sundays. That, in one case, a patient being placed on the operation table to be operated upon, it was a capital operation, a case of diseased rib, Dr. Douglas was pre- sent, at some distance from the table, and seemed to take no interest whatever in the operation He, Dr. Douglas, however, observed to the operator, that, " when " an operator is desirous of seeing the nature or character of the disease, he should " at once make sufficient incision thereto." He made these remarks at the ter- mination of the operation, and not at the beginning. He was surprised that he Dr. D. took so little interest in the operation. Dr. Douglas, he thinks, might have done more to create harmony in the Hospital than he has done. (Signed,) OLIVIER ROBITAILLE. Dr. Jackson being absent from Quebec, the following questions were proposed to him in writing, to which he has given written ansvtrers hereto annexed. 1. State the ' abstance of conversation which took place at the first meeting of the newly appUnted Visiting Physicians? Q9 2. To whom did the expressions " Bull in a china shop" apply? 3. Did you not feel insulted at being thus received ? 4. Have you always had the assistance of Dr. Douglas in your cases which required consultation? 5. Does Dr. Douglas attend the consultations regularly, and does he give his opinion of the propriety of the operation, and lend his aid to the operator? 6. Docs not Dr. Douglas bring professional gentlemen not connected with the Hospital totissisthim at his own operations? 7. Is not this practice calculated to cast a slight upon the Medical SlafF of the Hospital, and to lower them in public estimation ? 8. is it the custom to call consultations in serious medical cases ? 9. Have you had occasion to complain of Dr. Douglas ' ving treated yon in a manner calculated to lower you in public estimation, i . J to diminish the confidence of your Hospital patients ? 10. Will you state the particular instances to which you have alluded? •• 11. Have you heard Dr. Douglas speaking disparagingly of the Visiting Physicians, before the House Surgeon, stewards, pupils, &c., or patients of the Hospital ? 12. What do you know of the case of Lawson? - - 13. When you took charge of Lawson, did you believe he had been under the care of Dr. Douglas ? 14. Is it the rule of the Hospital, that the Surgeon who commences his quar- ter, takes the cases (bad and good) of the Surgeon who has terminated his quarter. *' * 15. Does not Dr. Douglas leave bad cases to his successors? 16. Did you know of Dr. Douglas having on any former occasion refused to take the management of a bad case left in Hospital by his predecessor? 17. Will you state your connection with the treatment of Cholera by Dr. Chaperon ? 18. Did you throw any obstacles in his way whilst investigating the result of his plan of treatment? • i . . * - 19. What are the real causes of want of harmony and union in the Hospital ? 20. How would you propose putting a termination to this slate of affairs ? ' 21. Does Dr. Douglas call his colleagues in consultation in his surgical cases? '^' ■" ■'^■' ''':■'' 21. Or does Dr. Douglas seem to conduct himself towards his fellow Physicians as if they were on a par with him ; or does he decide on the treat- ment or the operations that he may deem necessary and only state when he is to operate? -'-■-■,. :-,•..■■ ..- ...■■■-'■' .-, Answers to the questions put by the Commission of Enquiry into the affairs of the Marine Hospital ? 1. At the first meeting of the newly appointed Visiting Physicians, Dr. Douglas refused to give up charge of the Surgical cases ; he slated that he had asked for no assistance, and required none, thil iie would sconer see a Bull enter a China shop than some of the newly appointed Visiting Physicians enter his Surgical wards. 2. I cannot say exactly to whom the expression applied. : 8. As a matter of course, the reception was not a very flattering one, and we appealed to His Excellency the Governor General. 4. I remember one case in which Dr. Douglas refused to attend in consulta* tion, giving for reason that he had not been regularly notified. 5. Tuesday of each week is appointed as consultation day. The consulta- tions are not regularly attended. It is customary when an important case 80 happens, to notify the Visiting Physician in writing, stating the time appointed for the consultation, the nature of the case, &c. I have had occasion to find fault with the manner in which Dr. Douglas gave his opinion? at consuUaiions. He has frequently stated that he was prevented by his instructions from interfer- ing at operations. 6. It is within my recollection that Dr. D. brought medical men not con- nected with the Hospital to assist him at his operations. 7. I certainly did think that it was a slight, cast upon his colleagues. 8. It is not customary to call consultations in medical cases, except they b« of an unusual nature. 9. I have had occasion to complain of the manner in which Dr. D. treated some of my cases, and spoke of others, as it had a tendency to lower me in the estimation of the patients of the Hospital. 10. The instances aliudied to were, a case of fracture of the patella, a case of fracture of the arm, and one of fracture of the thigh in a child ; they happened in the summer of 1848. 11. I do not remember, with the exceptions mentioned, any particular occasion upon which Dr. D. spoke disiparagingly of his colleagues ; but Dr. D. is in the habit of joking, and some one of the Visiting Physicians may have been occasionally the subjects of his jokes. 12. I know very little of Lawson's case; I saw him occasionally when he was first brought to Hospital, he came under my charge about eight or ten days before his death ; he was then in a hopeless state. 13. When I took charge of Lawson, I received him at the hands of Dr. Rowand. I was under the impression that he had been under Dr. Douglas' care, he. Dr. Rowand having stated as much. 14. It has always been a rule with me to take charge of all cases good or bad ; at the commencement of a quartei, there is, however, a rule established amongst ourselves to the effect that any Visiting Physicians having an interesting case may retain it at the end of his quarter should he think fit so to do. 15. Dr. D. leaves his cases to his successors such as they are, good, bad and indifi'erent. 16. I do not now remember any former occasion on which Dr. D. refused to take the management of a bad case left in Hospital by his predecessors. 17.1 had nothing whatever to do with the treatment of cases by Dr. Chaperon ; he took charge of the patients at a time when I was off duty, with, as I under- stood at the time, the sanction of the medical men in charge, and the approval of the Commissioners. 18. 1 did not interfere in the least, or throw any obstacles in the way : I used to go to the Hospital occasionally to see the result of the treatment, but understanding, as I have said before, that he was there under authority, I looked on and said nothing. 19. In my opinion, the want of harmony in the staff of the Hospital is due to three different causes : in the first place it is too numerous and composed of mat lis difllering in their way of thinking and acting, with different views on me«, '1 and surgical matters. Secondly, a feud or antagonism has existed be- twefci. e two senior Visiting Physicians for several years past, which has com- pletely destroyed all esprit de corps and caused many of the jars that we have to complain of at the present time. And thirdly, that part of the staff is paid, and the remainder not, thereby creating an invidious distinction. 20. I would propose that the staff be reduced in number to four, that the two senior Visiting Physicians be made consulting Physicians, to attend on all occa- sions as such when requested to do so by the Visiting Physicians and subject to be called on active duty whenever the number of patients in Hospital shall exceed one hundred, or in case of sickness or absence of the Visiting Physician. That misi\ ai '; II ^1 ihe two Visiting Physicians be placed on permanent duly, as I consider the plan of changing every three months faulty, ana that all parties be equally paid. This plan I have every reason to think should work well. 21. Dr. Douglas does occasionally call his colleagues in consultation on his surgical cases, and notifies them in cases requiring operation. (Signed,) ALFRED JACKSON, L. R. C. Dr. E. Lemieux^ House Surgeon states : — That whenever appointments were made for a meeting of the Visiting Phy- sicians for the performance of a surgical operation, it is within his knowledge that when Dr. Douglas arrived before his time appointed, he would proceed at once to the operation without waiting for the arrival of his colleagues, and would also, although arriving himself after the time proceed to the operation, notwithstand- ing the absence of his colleagues, and without consulting those present, and in surgical cases generally, he, Dr. Douglas very seldom regarded the advice of his colleagues. He also states, that Dr. Douglas has often spoken in very disparaging terms of his colleagues in the presence and hearing of the patients and students, and such was the severity of the language employed by Dr. Douglas, that he. Dr. Lemieux declares, that if he had been a patient himself, he would' never have allowed any of the Visiting Physicians to continue their attendance upon him. That furthermore, it is his, Dr. Lemieux's opinion, that so long as so much arrogance on the part of Dr. Douglas is allowed, there cannot exist any harmony or good feeling among the Visiting Physicians of the Hospital. Truly taken, (Signed,) A. VON IFFLAND. 9th November, 1852, It having been represented to the Commissioners thai Dr. Landry, formerly House Surgeon of the Hospital, could give information calculated to aid the en- quiry, he was accordingly requested to appear before the Commission. Having complied with their request, he gave the following evidence, which the Commis- sioners have much pleasure in laying before Your Excellency, as it proves that though Dr. Landry has had good reason to be dissatisfied with Dr. Douglas, yet his sense of justice would not allow him to detract in the least from that gentle- man's merits. The Commissioners are pleased at being able to adduce this testimony, as it served to disabuse their minds of an impression they had received from the various reports that reached their ears, as well as from printed statements, one of which was laid formally before the Executive, which attributed to Dr. Douglas an overbearing and indeed an unjustifiable fondness for operating, and a disre- gard of other methods of treatments, as well as neglect of the medical cases in- trusted to his care. These imputations so injurious to the character of a Surgeon are removed by ihe evidence of Dr. Landry, who had ample opportunity of form- ing a correct opinion on this subject from the length of time he was resident in the Hospital, during which period all the operations were performed by Dr. Douglas, and much of the medical treatment of the patients devolved upon him. Dr. Landry appeared in conformity to the request of the Commissioners, No- yember 10th. He was examined by the commission on the presumed co-operation of Dr. Douglas with the Sexton, Patrick Buckley, and more particularly whether on •ay occasion or occasions two bodies had been coffined and buried together. 32 l«;i That on one occasion he recollected that two bodies had been buried together in the same coffin ; one Protestant and one Catholic. The information which Dr. Landry afforded was, however, obtained by his having visited the burial ground. Dr. Landry stated, that he believed Dr. Douglas had objected to the new appointments of the six Visiting Physicians, and had not approved of their nomi- nation, and in reference to these appointments had used the expression that they were no more fitted to perform their duties than a hull in a china shop ; he likened the admission of the new Visiting Physicians into the Hospital to that of letting a bull into a china shop. Dr. Landry stated that he believed Dr. Douglas intended these improper observations to apply to all the six Visiting Physicians appointed. Dr. Douglas, however, evinced a disposition to divide the surgical wards. Dr. Landry considered Dr. Douglas as the Chief of the Hospital, because Dr. Parent was very feeble, Mr. Gowan a very indolent man, and Dr. Morrin took very little interest in the matters connected with the Hospital. Dr. Landry then entered into an account of his two perioils of residence in the Marine Hospital. During the first period he had been Apothecary, and during that period he had been badly treated {nudtraiMj) by Dr. Douglas, which was in the years 1837, 1838 and 1839. During the sepond period as House Surgeon, in the years 1844, 1845 and 1846, he had been well treated by Dr. Douglas. Dr. Landry gave several instances to prove that he had been badly treated during the time he had been Apothecary to the Institution, and also enumerated instances when he had been well treated by Dr. Douglas. In allusion to the assumption that Dr. Douglas had not visited the Hospi- tal daily during the winter. Dr. Landry stated that it was because the cases did not require daily visits, but that he did so whenever dangerous cases were in the Hospital ; his impression is that Dr. Douglas look great interest in the Hospital nd in the recovery of his patients. That it is within his recollection that Dr. Douglas had said to a patient of Dr. Jackson, who had a badly united fracture, " crooked," when asked by the man. What shall I do? "Go show yourself for a penny a head, and you will " make your fortune." This was said before the class of students of the Hospital, and with an intention apparently of casting reflection upon Dr. Jackson. Dr. Landry thinks that Dr. Douglas had been exceedingly successful in his treatment of patients, and happy in his treatment of accidents. Dr. Douglas is averse to primary operations in the class of accidents that present themselves at the Marine and Emigrant Hospital, and was desirous of giving nature an oppor- tunity of some weeks of effecting a cure, as he has often said that it will be time enough to perform the operations. Dr. Douglas objected to the appointment of the six Visiting Physicians. It is also his. Dr. Landry's impression, that in naming the six Visiting Physicians^ Dr. Douglas had selected those who were less likely to dispute with him the surgical supremacy of the Hospital. He believes that Dr. Douglas knew the inefficiency of Dr. Hall for the surgical practice of the Hospital, and that he did not conceal his opinion of Dr. Hall's want of capacity for the duties of the surgi- cal practice from the members of the Profession, although he had recommended that gentleman with the other five Visiting Physicians. He believes that the practice of Dr. Douglas in cases other than those of accidents was equally cau- tious, and he does not recollect any instance where a fondness for operating induced him to resort to operations, " il ne faisait pas des operations sans n^ces- " 8it6." Dr. Douglas took an equal interest in the medical care of surgical diseases. He never undertook an operation without reasonable prospect of success. He never operated from mere fondness of operating. In painful operations Dr. 33 time lians. Douglas did nol exhibit any marked indinbrcncc to the sufTcrings of his patients, but used to t lUe unnecessary pains. Yet it appeared that in amputations he did not divide tlie ^oft parts. Dr. Douglas never treated the patients with cruelty^ and his attention to patients wlio did not require operations or active surgical treatment was e(|ually regular. He prescribed lor tiiem when requisite, and examined them daily. His after treatment was always judicious, as well as in all cases upon which he had operated. , • Mutual Charges of Dr. Douglas and the Commissioners. From the evidence laid before the Commission of Enquiry, it appears that from time to time Dr. Douglas made verbal complaints to the Chairman of the late Commission of the Hospital of certain abuses alleged to exist in the Hospital ; but as these charges were irregularly preferred, and as he carefully avoided put- ting them in writing, so as to bring them formally under the notice of the Board of Management, he cannot now complain, with any degree of justice, of attention not having beien paid to his remonstrances. At last he addressed a letter to the Executive, in answer to one from Mr. Assistant Secretary Parent. In this letter, dated July 17th, 1851, Dr. Douglas states that the accusations urged by the Com- missioners, in their Report to Government, that he had had communication with the Board of Trade, and had instigated Mr. Dean to make his complaint against the management of the Hospital, is unfounded. He distinctly states, that he never had any communication with a Member of that Board, knowing him to be such, " with the exception of Mr. Dean." He denies that he ever calumniated the Commissioners, and states that, in the previous enquiry they distorted evidence in some instances, and sup- pressed it in others, so as to mislead His Excellency the Governor General. He. also states, that the Commissioners are culpable of a dereliction of duty in not having attended to the applications of the Visiting Physicians; and that on two occasions he himself had formally called upon the Chairman, in November, 1850, and stated to him that great irregularities and abuses existed in the Hospital, and which demanded an immediate investigation by the Commissioners ; and furthermore. Dr. D. avers that he requested the Secretary, M. Casault, to call a meeting of the Commissioners to hear his (Dr. D's.) statement regarding these Irregularities, but that no meeting was called, Mr. Casault stating that he had no power to call a meeting. Dr. Douglas then requested to be notified of the first regular meeting of the Commissioners, but his request was not attended to, and he has not since had an opportunity of laying his complaijits before that body. Dr. Douglas says, that he is aware conversions have been made in the Hos pital, and that such conversions might have been prevented by adherence to a rule formerly existing, which provided lor the separation of the Protestant from the Catholic patients. Dr. Douglas states, that though aware from hearsay^ that two bodies had frequently been buried in the same coffin, yet, as he had no positive proof of the matter, he refrained from making it a subject of complaint to the Com- missioners, but that as positive proof was subsequently furnished him of this practice having been pursued in owe particular instance, he did mention the cir- cumstance to Dr. Morrin, the Chairman. He also charges the Commissioners with a systematic neglect of the commu- nications made to them by the Visiting Physicians, for "on no occasion did they " answer, verbally or in writing, any one of the repeated requests and compla'nts " of the Visiting Physicians." He charges them with exhibiting in the enquiry they held into the aflairs of the Hospital, an anxiety to " screen the parlies (guilty,) " and to escape themselves from a dilemma in which their dereliction of duty and " management of a valuable Institution had placed them." 34 f As a proof of what he Btalcs, Dr. DouglaH refers to the fuet, that at the mo- ment he was writing, a suit was pending in the Court;^, in roferenee to dittgrucc- ful scenes that had been recently enacted in the Female Wards of the IIo?ded ; and " two days later, the Board of Trade also addressed complaints to Government (p. " 138 and following B.B.) Three of the Visting Physicians have subsequently denied " the charges, and said that they had been ' honiemement indnits en erreur'' by Dr. " Douglas, (p. 65 and following B B.) The Board of Trade must then also have licen " led into error ; and by w^hom ? Is it by the three Visiting Physicians who w Ith- " drew their signature i ? Is it by the two, who acknowledged, during an investlga- " tion, that they knew nothing going on wrong? (p. 185 and 186, B. B. ;) or is it sign Don- their and (P: niea Dr. »een ,ith- tiga- is it 39 " by the one who had already, for the same purpose, shanefully led his confreres " into error? The facts speak for themselves." Now compare the several abstracts respectively marked, l^o. 1, 2, 3, 4, 5 and 6, and annexed to this letter, and we leave it to you to state, if our conviction was well groimded or not. Further, if you add to that, what was known by many of us, that is : that a member of the Board of Trade had acknowledged that they had got all their information from Dr. Douglas, to whom they were referred bv Archibald Campbell, Esq., and that the same Mr. Campbell had solicited a gentleman from this City to write to Mr. Leslie, the then Provincial Secretary, about those abuses, and moreover, that long before those com- plaints of the Visitmg Physicians and the Board of Trade, there were rumours that an investigation would take place on the management of the Marine Hospital ; the name of Mr. Bristow was connected with those rumour.'. Dr. Douglas alludes again to the fact of monies having been divided between the Officers and Servants of the Hospital. It is not true that we refused to take the evidence which was tendered to us in relation to that matter ; none whatever was ever offered but what was given by Dr. Douglas himself, during the investigation on Mr. Cutter's conduct (p. 49, B. B.) We were then inquiring into the conduct of the Steward. The Nurse incriminated had been dismissed froin the Hosjutal, and Dr. Lemicux was identified with one case only, (same page.). It was the first time that those accusations were brought againsi the Steward. We took the evidence of Dr. Douglas as he dictated himself; he did not suggest the name of any other witness who could substantiate the fact, which, moreover, was then admitted by both House Surgeon and the Steward, the former promising to explain the whole matter and circumstances, which he did, on the 13thof Jany., .1851, (p. 58 and following B. B.) We transmitted that explanation to Government, and stated ()). 17) : " The answe.'S " given by Dr. Lemieux are so satisfactory as to render it unnecessary for the Com- ^' missioners to make further enquiries, unless directed to do so by Government." To that, ( jvernment, in answer to a letter from the Board of Trade stated in a letter, copy of which was transmitted to us (p. 143, B. B.) " With regard to the case of *' the will made by a seaman, referred to in a letter, that case having formed part of *' the previous investigation mentioned in my letter of the 15th February, was satis- " factorily explained and repoited upon to His Excellency." After Government had pronounced itself satisfied with the explanations which were given, were we to investigate de novo into the matter ; ana to what end ? We again copy our letter of the 30th August, 1851 : " That Dr. Douglas unjustly attacked the Commissioners, that ha has calum- *'niated them, that he has shamefully traduced them to Government, is proved "by the answers made by the Commissioners on the 31st March, 1851, (p. 99, '' fi. B.,) to the complaints addressed to the Executive by L-is. Douglas (p. 70, B. B.) " Hall and Jackson, and by the letters in which Drs. Painchaud, Rowand and Robitaille " (30th January and 3rd February, 1851, p. 65, 66, 67, B. B..) informed His " Excellency that they had been " honfeiisement induiia en erreur^^ by Dr Douglas, *' who by that means had caused them to complain of abuses and grievances which " did not exist, and more so by the letter which forms the subject of this answer, " (the letter of Dr. Douglas of the 17th July, 1851,") and we may also add now, by the letter which forms the subject of this present answer. We Leg yon to take notice of the admission of Dr. Douglas, that he refused to put his complaints and communications about the Hospital in writing, and we deny that it was our duty to call him before n-i to know if he had any communications or con)plaints to make to us about the wants or management of the Hospital. We could not call him before us unless there was something officially laid before the Board. Dr. Douglas as well as all other Visiting Physicians or Officers of the Hos- pital should have communicated to us 'offirially his remarks, complaints or sugges- tions on the v/arts or management of the Institution, and then we would have acted upon them^ To maintain the contrary, is much as to say, that each meeting of 40 i i ai\ the 'Board oua;ht to have been a Court of Enquiry, where all the Officers and Ser- vants of the Hospital should have been called to be questioned on all the wants of the Hospital and its manngenicnt, a thing surely most absurd and impracticable. Was it not, we ask, the duty of each Officer and Servant of the Hospital who knew of any thing going on wrong within it, officially to call the attention of the Com- missioners to it? This was provided for by the rules and regulations for the guid- ance of the Visiting Physicians of which there is an abstract, p. 125-126 of the Blue Book, which rule w!is well understood and acted upon by Dr. Douglas himself for years previous. Were those Reports required by the rules to be made to Members of the Commission when they were met in the Street and likely to forget what had been ommunicatedlo them? Or were they to be made by the complainant in his official capacity? And why not, if they were true and well founded, submit them in writing ? Why attempt to draw back from the responsibility of his office ? But even in the absence of that rule, would it not be the imperative duty of the Visiting Physicians to inform the Commissioners of all that was wanting or improper in the Hospital. They had tj visit the Hospital daily, at which visits it was their duty to remedy the abuses and provide for the immediate wants of the Hospital ; and when they thought that it did exceed their poweri; they should have reported to the Com- missioners who would immediately have acted, remedied abuses and provided for the wants. This had not been done either by Dr. Douglas or any of his colleagues, and yet they complained that " their repeated requisitions and their claims on the '' attention of the Commissioners have been disregarded," (p. 65, B. B.). The reasons assigned by Dr. Douglas for not having made his communications official and in writing, is such as to do no credit to his judgment and good faith. If he felt that he could not fizlfJ the duties of his office of paid Physician, without ex- posing himself to ' w suits ana disagreements which he did not like to submit him- self to, he should nave resigned it ; all that story about a similar case which occurcd in 1838, is a pitiful afterthought which is not likely to avail him. A sL.ndcr cither verbal or written is equally actionable ; but a written communication to his Superior Officers about things v»hich he was obliged to communicate to them by the duties of his office, and the rules of the Institution, did not expose him to damaijcs. If the contrary were the case, who would give his evidence before your Board or any other Board ; but Dr. Douglas shews by his letter of the 17th July, 1851, which he lately published in the newspapers of this City, with comments of his own, by his former attacks, charges and accusations against us, and by the letter which is the subject of this ancwer, that his duty was not so imperative on him as his frantic desire to attack, calumniate and injure; all his hesitation, all his fear of prosecution had then vanished; he was not even stopped by the obstacles that truth and honesty threw in his way, and he resolved to duplic'ty, (and even perhaps the word false- hood Avould not be too severe) to accuse us, and to induce his brother practitioners to join him in his slanderous attacks against us and the InPtitution. Both Dr. Lcmicux and Mr. Casault will probably have to testify l)cf()re your Board of the truth to their narration of Dr. Douglas' intervicAv with Mr. Casault. The oliject of those intcrvicAvswe imagine, though wc know not their purport, it will be to those gentlemen to state if it was other than what they stated to us, (p. 113, 127 and 128, B. B.) namely, the want of knives and forks. As to the conversations with the ChairiTinn, Dr. Morrin, Dr. Douglas was inva- riably requested by that gentleman to put his complaints in writing, and address the Commission officially. Why did he refuse to do so? Will he allege his ridiculous fear of prosecution when they related to the bad quality of the meat and the want of knives and forks for the patients or other similar objects ? Could cf)mmui;icat ions of that kind expose him to an action for slander ? But even when the conduct of the officers was "he subject of his communication, if his reason not to write, was tuat assigned by him, why did he not write officially to the Commission, stating that here were abuses in the Hospital which he did not like to disch)se in a letter, but 41 which lie would mal^c ihcm aware of if called before the Board? In that case the blame should have remained with lis ; as it is, it remains altopiethcr with him. We refer to tliu evidence of Dr. Dcuglas, (p. 49, of the Blue Book), to estab- lish that ho never stated to us on that occassion referred to by him, that tliere were other al)nscs about which he wished to be heard. He comj)lains tliat he had not been called before us to state what these reuses were; but why did he not mention them at tliat time ? lie had been called to that meeting ; there he was in the pre- sence of those Commissioners whom he refused to address in wrilin;^- ; what then closed his mouth ? Why did he remain silent on those abuses? Why did he give such short answers to all questions which were put to him by ourselves, tlie House Surgeon and the Steward ? Had he not there that opportunity which he had sought for so long ? This would more than sufficiently prove that Dr. Douglas had then no complaints to prefer, no abuses to complain of, and tha^ he was actuated by some other motive 'han the welfare of the Hc^pital when he complained to Government. This would tend to prove a want of goocl faith in the reasons by him assigned for not having addressed us in writing. Of conversions we kenw nothing. No complaints of the sort ever reached us, (see last paragraph of p. 147 and 148, B. B.) As to the " rule" mentioned by Dr. Douglas, for the classification of Protestants and Catholics in the Hospital, we per- sist saying that it has never been put into eflfcct, (though never cancelled and Still force,) as may be ascertained by reference to the accompanying letters of Dr. 1 iiiuchaud and Mr. Whelan. It was lef*^ with the Visiting Physicians to put into force, and we repeat that if it has not been followed, the blame should fall on those gentle- men, who are solely charged with the classification of the diseases and patients. We do not think necessary to dwell on that point, speaking, as we do, to gentlemen conversant with the rules and government of institutions of the same kind, and pro- ducing, as we also do, a letter signed by Dr. Douglas himself, which fully bears out the truth of our assertions, and leave with the Visiting Physicians the responsibility of having not carried out the rule into eflFect. You will, moreover, ascertain from all the patients and servants that have ever been in the Hospital, that the Ministers of all religious denominations arc admitted iu the Hospital, and that they are always indiscriminately sent for nhcn asked by a patient. If those gentlcuicn did not think it proper to attend regularly the patients belonging ic their denominations, surely neither the Hospital nor its Managers are to be bla ■. u '". r their absence. We further state that a room in the Hospital has been set apaii - . . : ppropriated as a place of worship for the Protestants. As t ) ij* rments, the rules of the establishment, (see those for the guidance of the Stew.. ■< ,) and the investigation on the House Surgeon's conduct, sufficiently prove that the fault in tliat case remained with the then Steward, Mr. Cutter, (see p. 171, 200, 207 and 208, B. B.) We leave it to Dr. Douglas to explain how that fact came to his knowledge. It mu3t cither be before die interment or after. If it was before the inlcrnient, as we already said, why did he not ])revcnt it? If after, how did he get that knowledge? We are well founded in stating- that in that case, he must have acquired that knowledge by the graves having been opened after burial : and we leave it with you to say, if he could acquire it otherwise. He was, as h;' i ' :ges, informed of the fact by the grave-digger, who complaint d to him that he w..' f ''^eated by the cffieers of the Hospital. But, how could that man know that two h(xb^^ were inclosed in a coffin of ordinary sizn ? Why did he mention the facts to Dr. Douglas before addressing himself to the Commissioners. The answer to those quest' >ns is too plain to be inserted here. We do, however, beg to state that we are informed that Dr. Landry could give you important information in relation to that part of our letter. We have no words to qualify Dr. Douglas' bad faiUi and the hideous effrontery of thf^ abuse which his letter to "the address of D •. Morrin contains on that subject, when Dr. Douglas himself told that gentleman, that he had iu his possession tho head of the alleged " runaway negro." # mm 42 We cannot but quote Dr. Douglas' own words, speaking of the letter which was addressed to the Government by the Visiting Thysicians, on the 27th January, 1851, (p. 6o, B. B.) he says, " their joint letter ivas intended to shield them from a " charge of net/kct of duty.'''* It is cstiibiished (p. 87 and 88, B. B.) thai the meeting was called at the request of Dr. Douglas, that (p. 88 and 89) he framed the letter which was signed by him first and by the others after some hesitation. It is also established (p. 66, 67) that three of tliose gentlemen denied the charge, and accused Dr. Douglas of having " shamefully led them into error," to induce them to sign it. Dr. Ilall's own words during a subsequent investigation were (p. 185 B. B.) " If I had per- " ceived any thing going on wrong in the Hospital more than I have stated above, " I should have taken notice of it officially." And Dr. Jackson in answer to the same questions which had been put to Dr. Hall, namely, if he had heard any com- plaints a jrainst the Hospital or knew of any thing going on wrong in the establish- ment, said (p. 186 B. B:) " While I was on duty at the Hospital, I heard of no " compLiints, excepting about potatoes. I spoke to the Steward, who told me they " were of the best that he could get in the market ; some of the patients also c()m- " plained to me of the quantity of the i^lc'es of the diet, but not of the quality. " I again addressed myself to the Steward, > i )ld me that the diet prescribed was " given ; and it is not an uncommon thing ^ i upon half, low or spoon diets, to " complain, ])articularly mariners." From all this from Dr. Douglas' own admission, he became the accuser, not en account of the interest he took in the Hospital, but so as not to become the accused, he knew that the mismanagement, improprieties of conduct, malpractices and all the disorders which had been proved during the investigation on Mr. Cut- ter's conduct, which was then over, could be attributed to his own neglect of duty, to the want of information by the Visiting Physicians to the Commissioners. He knew that if the Visiting Physicians had made their visits as they should have done, and inquired not only into the health of the patients, but into their wants, into the way and manner they were attended and treated, into their food and their comforts, he knew that {a) " If they had been particularly observant of the gen- " eral good conduct of all persons attached to the Hospital, and if they had reported " to the Commissioners any irregularity of conduct, or violations of the Hospital " regulations," all that had then been proved could not have taken place, that it would have been prevented or stopped in time. He knew that he could be blamed for all those disorders, and then he thinks of directing public attention by accusing the Commissioners ; he thinks of carrying into effect a plan long thought of and by which he would get rid of the Commissioners and obtain the appointment of others, who, according to his wishes, would be led by his ideas and suggestions. By disclosing the abuses, by accusing the Commission and charging its management, he would bo looked at as the proper person to remedy the abuses. The advice of a man who had so much at heart the interest and good management of the Hospi- tal would necessarily be asked and taken, in the formation of a new Commission. And then again he could rule and command as sole master. He had already laid the foundation of his attacks by the joint letter of the Visiting Physicians, addressed to the Commissioners on the 14th December, 1850 (p. 72) by the conversations he had with the President and the Secretary. The time was come to act. Injurious and calumnious reports are spread against the Institution and its employes, which we traced to Dr. Douglas. At his request a meeting of the Visiting Physicians is called, and at that meeting a letter prepared and drafted by him, is signed and transmitted to the Government. The Board of Trade instructed through him and his agents address complaints to Government agairjt the Hospital and its manage- ment and officers. A man of public notoriety is set to work. Everything was so (a) 6th Eule for the guidance of the Visiting PhysiciauB p. 116, B. B. we 4d not IS ious Inch ns is and and age- is so well coiiccrtctl, so well managed, so well prepared, so well conducted, that he was sure of success, when three of his confreres guided by honortible principles publicly acknowledged to Government diat their complaints were unfounded, and that they had been led into error. The rcs^ult of your investigation will prove this to be the whole story ; these appear to be Dr. Douglas' motives and object. Dr. Doui^las states that our investigation on Dr. Leniicux's conduct was intended to screen the guilty parties. We boldly refer to that investigation. The number of witnesses examined, their position, the actual or previous connection of many of them with the Hospital, sufficiently show that we aesired to know the truth and to do justice to the Hospital, We defy any one to name any of the present or former Officers and Servants of the Hospital and even of the Ministers of Religion who had been connected with it whom we did not call before us for the purpose of examining them. Dr. Douglas' assertions in that respect are as false as they are malicious. We call on him not to make more unscrupulous and untrue assertions, but to mention and to state tiie evidence which we did not call, and more so, that we refused to hear when offered As to the testimony of Drs. Hall and Jackson, we call your attention to the part of it which we copy above, to show whether we gave it a meaning which was not intended by them. They were made to see by Dr. Douglas that their evidence was a contradiction, and gave the lie to the letters which he has got them to sign, and rather than oppose him, they admit that they finlUfied ihcmsekes (these are Dr. Douglas' own expressions, letterof the 17th July, 1851) by saying that which they did not mean. We would like Dr. Hall to say what he meant by these words, " If I had perceived any thing going on wrong in the Hospital more than I have " stated above, (bad tea and bad soup,) I should have taken notice of it officially." (p. 183.) . With respect to the disgraceful scenes which took place in the female wards of the Hospital, Dr. Douglas, in his letter of the 17th July, 1851 stated: "A letter " from the Visiting Physician in charge, dated 5th instant, and demanding instruc- " tions from the Commissioners, has, like all other demands on their attention been " disregarded and unanswered." In answer to that charge we said in our letter of the SOth August, 1851, that Dr. Douglas should have left to Dr. Painchaud the care of saving if the Commissioners had not done all that could be expected from them. Now in his letter of the 6th ins cant to you. Dr. Douglas says, that he was not then making allusion to the letter of Dr. Painchaud, but to one addressed to the Commis- sioners on the same subject by Dr. Jackson. That letter of Dr. Jackson, which was also signed by Dr. Rowand was received by the Secretary on the 18th July, (as may be seen by the indorsement on the back of it) though dated the 16tn, submitted on the 18th to the Board, who assembled that day, and answered on the 19th, as may be ascertained by the annexed copy of the correspondence. Dr. Painchaud's letter was dated the 5th, and it was clear from their respective dates, that Dr. Douglas made allusion to that letter and not to Dr. Jackson's letter, which was dated the IGth ; that taken aback, he says what he must have known to be incorrect. Could the delay of one day between the receipt of Dr. Rowand and Jackson's letter, and the letter and the answer thereto be thought too long, and condemned? And even supposing that three days elapsed between the receipt and the answer, could that be thought too long a delay, when we had to be assembed, and meet to decide on the answer ? Was not the passage above described of the letter of Dr. Douglas, a false, shameful and dishonest attack upon us ? It was more. At the time Dr. Douglas wrote his letter, Drs. Rowand and Jackson had received an answer to their joint letter of the 16th. Dr. Douglas knew it, audit was for the purpose of bringing against us that false and malicious attack, that he antedated his letter, and mentioned it to be the 17th July, 1851, when it must have been written after the 21st of that month, date of two letters from Drs. Hall and Jackson which he commented on, in his own of the 17th. ' ' L 44 ML An order had been given to Dr. Douf^las in the presence of Dr. Lniuhy not to admit Di'. Marsden into the Hospital ; that gentleman having been iiilbnued by Dr. Douglas as he subsequently said, ;iL a trial before the Police Court, tliat tlicre was no such rule, introduced hiinscif into the Ilospital to test the fact, and there caused most disgraceful scenes. That was the purport of ihat note of Dr. Douglas, which Dr. Landry will ])rovc to be incorrect, ii not to cause trouble and dillicukies in the Hospital ? And after such conduct on his part, he is bold enougli to allude to those scenes and to attack us in respect to them. We did not say that Dr. Douglas ought to visist every day during the whole year round, but during the term of his attendance, that is during six months ; and we complained that dui'ing that time he was not in the habit of visiting regularly, and at the regular hours fixed by the Rules. The truth of that assertion is borne out by theCth answer of Dr. Landry (p. 121 of the B. B.) and the 14th answer of Dr Lemieux (p. IIG, B. B.) and also by a letter of Dr. Painchaud (p. 83, B. B.) He never gave the iutbrmation that we had a right to expect from him ; ho spread slanderous reports against the institution, and did his utmost to discredit it in public opinion. During the investigation, and more so during that on Mr. Cutter's con- duct there was scarcely a day that passed without some rumours of the m( st serious character about scenes that had happened in the Hospital the previous day, which we always traced to Dr. Douglas. Amongst others, we heard one day that a trust- worthy man, whom we had hired as porter during Mr. Cutter's suspension was reported to have gone during the night to the female ward and tried to introduce himselt into the bed of a blind woman. An immediate inquiry proved it to be false, and traced it to Dr. Douglas. Another day the same man was reported to be an habitual drunkard, who was always drunk in the Hospital. This again was traced to Dr. Douglas. On another occasion we heard complaints that a young gentleman acting asApoi -ecary could not understand one word of the English language. After ex- amination we found that he was quite familiar with that lang-'ige, and again Dr. Douglas was the author of that report. There would be no end to this letter if we were to notice all the instances of that kind in the conduct of Dr. Douglas. It on may judge by yourselves of what a person would be capable who couUl have antedated his letter to charge us with negle vvho so mueli feared prosecution for damages, but who nevertheless slandered right and left. He could not with safety address to the Commissioners a written communication on the management of the Hospital, but he could with im])unity spread false and calumnious reports against the Hospital and its Officers and Employes, namely by his published letter of the 17th July, 1851. Dr. Douglas always did his utmost to render to us the management of the Hospital not only disagreeable", arduous and difficult, but almost impossible. He advised and counselled those whose con- duct was the most to be blamed, and specially Mr. Cutter, during the investigation on his conduct. In one word, we always found him creating obstacles and raising difficulties in the management of the Hospital. And we do not hesitate to say that the same state of things will last as long as Dr. Douglas is allowed to have any con- nection with the Marine Hospital. He is at war with every one in the Institution with the exception of the Visiting Physicians, and of those one is united with him through fear of his power to do harm (p. 80, B. B..) and the other li-jm motives best known to himself. We did not assert what we are still ready to prove and maintain, that before our appointment Dr. Douglas commanded in the Hospital as sole master (p. 122, 6th answer of Dr. Landry,) that he was allowed to have i lorc influence tlian the Commissioners over all the persons connected with the Hospital, that he carried and did all he wished without control or opposition. ^ As soon as other Visiting Physicians were appointed against his wishes and advice, as soon as he understood that we would take the responsibility of our office it 45 and control llic government of the Hospital nnd the conduct of its Oflicers, he began to throw obstacles in the way and has constantly done so dnrinp;our]a(lminifltrattion. Wc beg to add in conclusion that, though we do not admit llic ri!j;ht of Govern- ment to submit us to a trial after wc ceased to be in otticc, and particularly after having by unjust and unaccountable trratment forced four of us to resign, still we owe it to oui-sclves to ii'cet your en(iuiry, in order that the public may sec tiiat wc do not dread an investigaticm into our conduct, and that if we did resign before it took place, it was not to avoid submitting to it. We have the nonor to be, (Jcntlemen, Your most obedient servants, (Signed,) JOS. MORRIN, RlCni). J. ALLEYN, F. X. PARADIS, J. J. NESBITT, T. KELLY. (Dr. Morrin desires to state that all the letters addressed to Government by the other Commissioners since his resignation, were sent without his concurrence, and even without his knowledge. He haf? not since then anything to do with the manaKcment of the Hospital. efore 122 the land Abstracts from Correspondence , ^c. No. 1. " That the patients were in want of absolute necessaries; that some " of them were obliged to eat with their fingers for want of sufficient number of " knives and forks." — Conversation of Dr. Douglas with the Secretary, Sth No- vember, 1850, p. 113, B.B. " Yet it is asserted that the provision made in the Hospital for sick and " disabled seamen is of the most wretched description ; even in the article of " food, the quantity as well as the quality is often deficient, and such as it is, thoy " have it served to them like dogs, with scarce a knife or fork for 150 patients." —Letter Board of Trade, 29th January, 1851, p. 128, B.B. " Among other things in support of these facts, it was stated to him, that " 160 patients then in the wards fed themselves with their fingers, as there was " not a single pair of knives and forks in all in Hospital." — Letter Dr. Douglas, Hall Sf Jackson, on 21th February, 1851, p. 70, B.B. No. 2. " The statement made in my letter as to the defective provision made " for sick and disabled seamen in the way of food or otherwise, is fully borne " out by the records of the Hospital, and will be corroborated by the Visiting " Physicians."— Le«er of Board of Trade, 5rd March, 1851, p. 137. *" The soup was not soU|j; it was dirty water. The beef was very bad ; it " was not fair beef. I stated the same day, to the Chairman of the Commissioners, " that the materials furnished to the Hospital were of inferior quality, and gave " just grounds of complaint, by which the patients suffered, and the character of " the Hospital was damaged. — Evidence of Dr. Douglas in the investigation on Mr. Cutter^ s conduct, p. 49, B.B. No. 3. " That if the " (speaking of Dr. Lemieux and Dr. Beaubien) " had been guilty of the irregularities and malpractices attributed to " them, it was only what might have been expected from young men under their " peculiar circuri.'stances, placed as they were in an institution, unchecked, irre- " sponsible, and neglected by the Commissioners,^^— Letter of Dr. Douglas^ nth July, 1851. 46 m t'lii m ♦' There was no intention to inclnde the Commissioners or Visiting Physi- " cians under thiit designation, or to implicate them in the abuses complained, *' any further than these abuses may be touiid to have arisen from a neglect of " duty on their part. ''^ — Letter of the Board of Trade, p. 136. No. 4. " It is most desirable that Mis Excellency the Governor General should " appoint a Commission, entirely unconnected with the present management of the " Marine Hospital, to inquire into its whole condition, &c., &c., &c., and for " organizing a system under which such abuses will be less likely to recur." — Letter Board of Trade, 29M January, 1851, p. 130. " I now trust to His Excellency's sense of Justice, and to his expressed " anxiety for the welfare of so important an Institution, that he will be phmsed to " cause such inquiry to be made, &c., &c., as will place the Hospital itself on such " a footing of usefulness and respectability as it ought to possess, and as it did " possess some years ago." — Letter Dr. Douglas, llth July, 1851. " Nor do they ask His Excellency to condemn, punish, or even try the " parties implicated. All they ask for is, that a full investigation into the conduct " of those parties be instituted and carried on, on the spot, by a competent triljnnal " above all suspicion of partiality or prejudice." — Letter Board of Trade, 3rd March, 1851, p. 136. No. 5. " With the particular views which the Roman Catholic Church " entertains of the efficacy of certain rites and ceremonials before death, it is to " be expected that its clergy should consider it to be a paramount duty to make " as many conversions as possible." — Letter of Dr. Douglas, llth July, 1851. " The last moments of the patients are often disturbed and embilteretl by " ignorant, though perhaps well-meant efforts, to convert them to the Roman " Catholic idiXXh:'— Letter Board of Trade, 29lh January, 1851, p. 130. No. 6. " Rumours have been for some time afloat, seriously reflecting on the ** general management of the Quebec Marine Hospital." " These rumours have lately assumed such a shape and consistency, that the " Council of the Board of Trade have deemed it their duty lo ascertain, as far as ". possible, the truth or falsehood of them. This they have done, and, after ob- " taining all the information in their power from parties on whose knowledge and ** accuracy they could rely, they regret being able to come to no other conclusion " than that there is a great reason to fear that neither the property, the morals, nor " religion, &c., &c., &c." " It is also, in the apprehension of the Council, a very serious evil, that " while the services of one of the most accomplished Surgeons in Quebec are " actually paid for by the Institution, an arrangement has been sanctioned by the *' Government, by which his talents and experience are only available to the ** patients for a small portion of the year." — Letter from Board of Trade, 29th January, 1851, p. 128 ^ 130, B.B. "The Council, although urged from various quarters (a) to bring these " rumours under the notice of Government, refused to do so until they were per- *' fectly satisfied that they were sufficiently well founded to warrant them in " calling for an investigation." — Letter Board of Trade, 3rd March, 1851, p. 135. More citations would be a trespass on time, and a mere copy of the Blue Book. . . Marine and Emigrant Hospital, Quebec, 25th August, 1851. Sir, — In reply to your letter of the 19th instant, received this moment, I hasten to reply. I am asked, " whether at any time there had been a rule ir the (a) Arohibald Campbell, Esquire, and the Rev. Dr. Oook.'-Note of the Commiiriimert. 47 yj " Hospilnl, directing Protestant pnticntH to be placed in separate wards, and " attended by Protestant nurses, and to state if it has ever been enlbreed, and " when, and how long; and also to state when and for wlint reason this rule " ceased to be persevered in ; also, if there has been any other rule respj'cting " the classification of Protestants or Catholics, to state what it was, when and *' how long it was enforced, and when and for what reason it cea-ed to bo " enforced." I have the honor to inform you. Sir, that I have no recollection or experience of any such rule being either established or acted upon in the Marine Hospital, but I recollect that the subject had been merely spoken about ar.d suggested by different parties, (particularly in 184T,) but never was carried into "fleet in any manner. • I have the honor to be, Sir, Your obedient servant, (Signed,) P. WHELAN, Steward Marine and Emigrant Hospital, N. Casault, Esquire, S. T. Marine and Emigrant Hospital, Quebec. ( Translation.) Marine Hospital, Quebec, 25/A ^M07/s/, 185 L Sir, — In answer to your note dated 19th August, requesting me on behalf of the Commissioners of the Marine Hospital, to inform them whether there ever existed in the Hospital a regulation for the classification of Catholics and Pro- testants, and to state at the same time when, and why, and by whose orders such regulation ceased to be in force, I have the honor to state to you, for the informa- tion of the Commissioners, that no regulation has existed in the Hospital for the classification of Catholics and Protestants other than that which still exists ; that is to say, that a card is affixed to the head of each bed, on which are written the name, the country, and the religion of the patient. In 1847, the Chairman of the former Commission communicated to us the wish of the Lord Bishop of Montreal relative to the classification of the patients ^. in the Hospital. He was desirous that Protestants and Catholics, should be ' placed in different wards. The Chairman requested us, at the same time, to state to the Commissioners whether this classification would occasion inconve- ^ nience or additional expense. My two colleagues. Dr. James Douglas and Dr. John Racey were favorably inclined towards his Lordship's plan ; for my part, I thought differently, and did not consider the plan a feasible one, especially at certain seasons of the year, but as I did not wish to throw in the way any obstacles which might prevent the plan from having a fair trial, I signed with my colleagues, and there the matter ended. I have, &c., (Signed,) N. Casault, Esq., Secretary, M. H. Q. JOS. PAINCHAUD, Vis. Phys., M. H. Q. t 48 - Quebec, 13/// S/'jj/cm&rr, 1847. Gkntlkmk?;,— Wo have the honor to Qcl, inclosing one from His Lordship the Bisliop of Montreal ; and in answer we beg h-ave to inform you, tliat there will bo at present no dillienlly or addi- tional expense in placing Catholic and Protcslant patients in separate wards. We will accordingly adopt measures to carry your wishes into eU'ect, and will report to you wdienever the number of patients in Ilospilul is so small as to require a change in this mode of classifying them. Wc have the lynor to be, Gentlemen, Your obedient servants, (Signed,) JOS. PAINCIIAUD, J. DOUGLAS, J NO. RACEY. To the Commissioners, M. & E. Hospital. it (Translation.) Quebec, 5th July^ 1851. Sir, — I am under the disagreeable necessity of requesting that you will inform the Commissioners of the Marine Hospital, that this morning, Dr. Wm. Marsdeu renewed his attempt to intrude into the wards, and that I considered it my duty to cause him to be put out ; this I was compelled to do twice. I respeclfuUy request that the Commissioners will take immediate steps to prevent the repose and tranquillity of the patients being interrupted. I have the honor to be. Sir, Your most humble and obedient servant, < ^i; (Signed,) JOS. PAINCHAUD. N. Casault, Esqr- Sec. Com. M & E. H. ill Quebec, 16/Ao//m/j/, I85L To the Commissioners of the M. & E. Hospital. GE^TLEMEN, — We are under the impression that our colleague Dr. Pain- chaud has made an official report to you of what took place at the Hospital on the fourth and fifth instant concerning the peace of the Establishment, and the tranquility of the patients, which were seriously interfered with ty the obtrusive visits of Dr. Marsden. Our colleague has been prosecuted in damages for having caused Dr. Marsden to be turned out of the Hospital, and we legret having to add that he is still waiting for the protection he has demanded from you, and even (a) an answer to his two letters. As it is possible we may be placed in the (a) Tbia is incorrect. I, as Secretary, wrote to Dr. Painchaud on the fourth, (Signed,) N. CASAUL'l', S. T. C. of M. 49 8«mo silualion as our colleague, and not wishing to enter in any lawsuits, and incur costs on account of the Hospital, we beg respectfully that you may'take this ail'air into your serious consideration. We have the honor to be, Gentlemen Your roost obedient servant, (Signed,) A. JACKSON, A. ROWAN D. Quebec, 22nd Ifavembcr, 1852. Gentlemen, — Having appended my signature to the preceding letter, I deem it my duty to state that before doing so 1 expressed to my colleagues my regret that it should have been considered expedient to adopt therein a tone anci expression which, however much they may be justified by the general course pursued by Dr. Douglius in relation to this matter, as well as by the language of his tetter of the 6th instant, are nevertheless in my opinion much better avotded. This objection, T wish it to be perfectly understood, has reference only to the tone, and not to the sub.^tance of the letter (in which I entirely concur) and applies equally to the Commissioners* letter of the 30th August, 1851, which has called forth Dr. Douglas in terms per- fectly characteristic of that gentleman, though not such as I have any desire or inten- tion to imitate. Further than expressing my dissent in the above particular, I should not have considered myself called upon to add any remarks of my own to those of the Com- missioners, were it not that Dr. Douglas' letter to which the above is intended as a reply, gives a prominence to my name which it becomes less the duty of the Com- missioners as a body than mine as an individual member to notice. There are but two points in Dr. Douglas' letter upon which I feel myself per- sonally called upon to touch, and these I shall dispose of as briefly as possible. In the first place, as reiards the frequency with which Dr. Douglas asserts he brought under my notice, as Chairman, the irregularities practised in the Hospital and my unwillingness to institute the required investigation, I am not at all surprised at the pertinacity with which Dr. Douglas adheres to any assertion that he has once made, whether it be founded in truth or like the present, the offspring of his own imagination. I am perfectly aware that Dr. Douglas was (and has bt^n ever since the cessation of his dictatorship in the Marine Hospital) in the constant habit of finding fault with every thing connected with that Institution, and moreover that on many irrevalent occasions when I was present, he would persist in bringing the suliject under discussion and making vague, rambling and general charges against its management, which always appeared to me to be the result of personal pique and not the genuine expression of friendly zeal for the interests of the Institution against which they were directed. These incidental conversations, which took place most frequently at the Quebec Lunatic Asylum in the presence of Dr. Fremont, when met on the business of that Institution, and also occasionally in he streets, consti- tute the twenty occ isions to which he alludes and which he would lead the public to believe were so mf.'^iy proper official communications addressed to me as Chairman, instead of being a» they were, vague and intangible general complaints. I here distinctly and emphatically repeat that on two occasions only did Dr. Douglas make the Hospital grievances the suoject of a special visit, and my reply on those as on other similar occasions was, that he should address the Commissioners in writing oflficially and that his complaints should receive immediate attention. This course was so plain and reasonable, so simple and so safe, that it is surprising that so small «3T M a sacrifice of time am'. convenience could Imve prevented its immcdiute adoj)tion by any one pretending to entertain a sincere desire for the redress of llie cvda com- plained of. I need not remind any «me who has ever had the misfortune to differ in opinion with Dr. Doughu), that verbal eonvcr!mmi8- sioners. Dr. Douglas had informed her that the investigation of the affair of the Hospital was going on, but did not enter into partieulars, or say that she was to be called as an evidenee. Mr. Neviiys {the Steward) Evidence. Mr. Neville was examined by the Commissioners of Enquiry on different occa- sions, as to whether he knew of any impropriety going on in the Hospital, and he invaria!)ly declared that he was not aware of any instances of the kind. He offered a suggestion which the Commissioners think sliould be acted upon, viz : — that mcJe nurses should be employed in the male wards, particularly in the venereal wards, the inmates of which are generally sailors. As he very ])r()j)crly remarked, no women, however virtuous, can long remain in attendance upon patients labouring under a disease of such a nature, and having to perform services offensive to modesty, V ithout having her morals, or at least her delicacy of feeling, seriously endangered. It seems strange that this circinnstance has been up to the present totally neglected, for as the Hospital has always had a male nurse in some of the siu'gical wards, it would have been no innovation to have appointed one to that ward, which, more than any other, required one. Patrick Buckley appeared before the Commission and declared under oath, that lie bv-'lievcd he was in his twenty-ninth or tliirtielh year, and that he was and had been Sexion to the Marine and Emigrant Hospital burial-ground for six years. That in the summer of two years ago and during the prevalence of sickness, a black man and a white girf of seven or eight years of age were placed in the same cofttn for interment. That from the weight of the cofBn, he suspected that there was tnore than one body in the eollin, he was therefore, from so suspecting, induced to raise the cover of the coffin wiih his spade, and found the two bodies. That he went to Dr. Morrin at the request of Dr. James Douglas, but he would give hlra no satisfaction, and told him to go to Mr. Paradis (one of the Commis- sioners) ; that he went to Mr. Paradis, but that gentleman said he would not believe such talk unless he saw it himself, and that he would go after him to examine the case, but which be did not do. That next day when he went to cover the bodies he found them missing; in explaining he said, that there was no earth in the coffin the evening previous, brt iliat on the next morning he found that some earth had been thrown upon the coffin. That on a second exaniination when he had raised the lid of the coffin, he discovered that the head of the black man had been taken away, and that next day when he \/ent for the purpose of. interring the .coffin, he discovered that the bodies had also been taken away and the coffin empty. That he is positive that bodies several times before those of the black man and the girl have been taken away, and even since that period. That he has never assisted in abstracting or procuring bodies for any dissect- ing room in the City of Quebec or Montreal, before the black man and the young girl had been taken away, nor since, and that he never entered into any agree- ment with any person or persons to furnish them with bodies ; nor has he ever absented himself for the purpose of allowing bodies to be taken away for dissec- tion, or other purposes, during the lime he had been employed as Sexton to the burial-ground of the Marine and Emigrant Hospital. That some time after discovering that two bodies had been placed into one coffin, he went to Dr. Lemieux and complained, that he was cheated by doing so ; upon so complaining Dr. Lemieux placpd his hand upon the collar of his coat and ordered him out, remarking at the lime he was doing so, not to make any further false reports about the Hospital. > -y i i (1 t' That he has seven shillings and six pence for opening a grave and burying, and that wlien out of employment he is employed on the farm of Dr. James Douglas. That he has never been requested by Dr. Douglas to furnish him with bodies, nor by persons in the professional service of that gentleman. That he has never in any instance, nor has any of his family ever given notice to any medical gentleman or medical pupil that they could easily obtain bodies from the burial-ground of the Marine and Emigrant Hospital. And that indepen- dently of being employed as Sexton to the burial-ground, he is employed by Dr. James Douglas, in the summer sdason, and he is much more, and I»e would say, more generally employed as labourer by Dr. James Douglas than by any other person in the company. his PATRICK X BUCKLEY. mark 1^ it '! ' m (J*..' Case of William Lawson. Mutual charges of Drs. Roivand and Douglas. William Lawson was admitted into the Surgical Ward of the Marine Hospital on the 22nd June, 1851, which was then under my care. He had a gun shot wound in tlje left diigh. Upon examination, four or five lacerated wounds were observed on the posterior aspect and about the middle of the thigh, whicli were scattered over a surface of five or six inches. Two or three of these had perforated through and through and emerged on the inner side. A shot which had not quite penetrated through the limb was felt under the skin and removed, and ani)ther was shortly after found in the poultice which had been used. These shot were about the size and weight of swan shot. They differ from it only in their form which was square, which accounted for the lacerated appearance of the wounds. The femur was fractured in the middle. It did not possess any of the characters of a commi- nuted fracture. But on the contr.ry, a doubt was entertained by me and my colleague, Dr. A. Jackson (who being at the time at the Hospital, I had requested to see the case with me) whether the bone might not have been broken by the superincumbent weight of the body, after it had been splintered and thus weakened by the shot. There was very little hemorrhage from the wounds. We agreed to leave the limb in the long splint, which had been very properly applied by the House Surgeon previous to our arrival at the Hospital. The House Surgeon, at my request, called a general consultation of the Visit- ing Physicians on the following day, and to the best of my recollection, Dr. Douglas was there, and like the others, appeared to entertain a hope of the man's ultimate recovery without the loss of his limb. Li a few days, notwithstanding cooling applications and low diet, great turefaction foUovvedfrom inflammation, and it became imperatively necessary to loosen the bandages and relax the extension of the lim!). This step was quickly followed by considerable shortening. As soon as the subsidence of the inflammation would ])ermit, an attempt was made to correct this shortening ; but the suffering and irritation it gave rise to, compelled the aband;)nment of further attempts. I continued to employ the long splint as it did not appaar to hurt the patient m any way, and it enabled the nurse to apply poultices constantly on the posterior aspect of the thigh where the greater number of tho wounds were situated, and from which there was a constant discharge of pus. My treatniont was strictly antiplilogistic until the subsidence of all inflammatory symptoms, when every effort was made to support the constitution by a generous .diet and tho us3 of wine. The man's appetite became very good, and he was in excellent spirits, having no doubts as to his ultimate recovery. I have frequently Is were •li were rforated ot quite 10 r was e about ich was femur commi- uid my ucsted :»y the ikcned cod to by the cooling and it nsion of \s soon lade to m polled int as it o apply number of pus. matory enerous found him laughing with his fellow patients and enjoying his pipe. The woimds looked healthy. Those on the front were cicatrizing juid those behind had become clean and healthy from the removal of the sloughs. Two wounds which lay close together on the posterior aspect had bee. me converted into a common one from the sloughing away of the septum which divided them. Through an opening thus made, the upper end of the fractured femur was seen overlapping the lower upon its outer side. About an inch of bone was exposed, and it had a pearly appearance, as if deprived of vitality. This bone did not stick out or project through the wound, as Dr. Douglas asserted in the Court House. It lay in a straight line with the lower end of the femur, and was placed upon its outer side. From the time I observed this exposed bone, I was of opinion and frequently expressed it to the patient and students who followed my visits, that exfoliation would take place, when rapid recovery would follow. In this condition, 1 left my patient on the 15th of Auguat, my term of attendance having expired. I was informed on the following day, by the House Surgeon, that Dr. Douglas had taken charge of my wards, and at his very first visit had seen Lawson, commented upon the shortening of the limb, to the students who followed him, as if it had been caused by my limit. About a fort- night after this, he ordered the long splint to be removed and the double inclined plane to be used in its stead, countermanded the wine which the patient had been taking and ordered porter. The nurse who attended this j)aticnt during the whole lime he remained at the Hospital, thinking Dr. Douglas had charge of this case as well as of the other cases in the same ward, frequently exposed the leg for his inspection, when Dr. Douglas ordered him to go on with the poultices. At length, the patient becoming despondent, ho begged Dr. Douglas to cut off his leg to save ■c; his life. He was answered no, that it would do. During the period of three months that Dr. Douglas attended the Hospital, I never visited or prescribed for or in any way interfered with Lawson, as I looked upon him as Dr. Douglas's patient. I was never informed, either by Dr. Doudas or the House Surgeon, that he was not attended to. In fact, it was only afler Iiis death, and when the case was likely to become the subject of criminal prosecution, that 1 learned for the first time, that Dr. Douglas intended to disown having had anything to do with the case. The patient again came under my care on the 15th November, at the expira- tion of Dr. Douglas' quarter. I found him in a hopeless condition, he was pale and greatly emaciated, with a bad cough anddiarrhoea. The wounded limb was much enlarged fi-om the groin to the knee and was permanently flattened by the double inclined plane. The form of the shaft of the femur could be distinctly iraced upon the posterior surface. About three inches of bone was now exposed. The discharge from the wound was thin and watery. My colleague, Dr. Jackson, saw him with me about this time, and we were both of opinion that tubercular disease had fairly commenced. We concluded so from the man's naturally delicate and ciToininate conformation, and the severe cough under which he was laboring. The appearances so very unfavorable, indicated approaching dissolution, so that I considered ampu- tation at this time an act of unnecessary cruelty, and rejected the idea. At the beginning of January, 1852, I was succeeded in my charr to Lx; in IiIm hands and lie wtadd |);iy to ii tlic attention it ^tle attention to the patient. He must certainly have known that the case was serious, and though at first the patient was not absolutely in danger, nevertheless his rase required skilful treatment, and a conscientious Physician would have devoted to it his best science. I am of opinion that amputa- tion ought to have been performed in September as soon as it was perceivcc' that the patient's health began to suffer from the irritation caused ly the pain and by the abundant and constant discharge of matter from the wound. I say that had amputation then been performed in September, it would have given the patient a last chance of recovery, while omitting it, he could not pos- sibly live. I am. Sir, Your obedient servant, i,i (Signed,) Dr. J. T. C. BEAUBIEN. g one My Dear, Hall, — "Was a consultation of the Visiting Physicians called on Lawson shortly after his admission into the Hospital ? Did you see the case, and what was your opinion of it? Under whose charge was Lawson after 15th August, and until nearly the middle of September ? 70 \i>t' 11- Did not Dr. Rowand, about that time, ask j^oii occasionally to see Lawson, saying it was not worth his while to go so far to visit one case ? Quebec, November 15th, 1852. Yours, very truly, (Signed,) J. DOUGLAS. My Dear Sir,— The following are my answers to your questions ; 1st. In conjunction with Dr. Jackson, I saw Lawson shortly after his admission into Hospital, at Dr. Rowand's request. 2nd. I saw the case which I considered a bad one. 3rd. Dr. Rowand. 4th. Yes. Yours, truly, (Signed,) JOHN L. HALL. Quebec, 16th November, 1852. Dr. Rowand never stated to me that he would take charge of Lawson after the commencement of Dr. Douglas' term, but the proposal was made anterior to the comn -incement of Dr. Douglas* quarter. (Signed,) CHS. LEMIEUX, House Surgeon. Marine and Emigrant Hospital, Quebec, 22nd November, 1852. Extract from the Prescription Book of the Marine and Kmigrafit Hospital. Dr. Douglas removed the long splint, on the fourth September, 1851, in Lawson's case and substituted to it, on the same day, the double inclined plane. (Signed,) Marire and Emigrant Hospital, Quebec, 22nd November, 1852. CHS. LEMIEUX, House Surgeon. It affords me much pleasure to express the very fiivorable opinion which I en- tertain of Dr. Rowand's talents and ncqiiirenients, t liave been well acquuiiUed with him during his residence here, and have always remarked his diligence in the acquisition of professional knowlcdfjie. I believe that he is now in every respect prepared to enter upon practice witli credit to himself and benefit to his patients and beg to offer my earnest recommendation of his claims for employment whether in a public or private capacity. (Signed,) JAMES SYME, , ; Professor of Clinical Surgery, '' ''."".■'. in thcUnivcrsitv ofEiinburgh. Edinburgh, 24th February, 1844. 71 a ■ Edinburgh University, I have llic pleasure of knowing; Dr. Rowarul — I believe biin to be tboioiighly well ethieatcil and truslworiby piactllioner. His ediieatioii lias bicn most elabo- rate, and his oppoi tunitics of ae(|uiriiig professional knowled^^e unusually great. (Signed,) HENRY SIMPSON, ' Professor of Midwifery. cry. Observation.'} on the case of William Lawson. The Commissioners have entered upon the consideration of the case of that unfortunate man, William Lawson, with much regret, and feel themselves compelled, after diligent investigation, not to approve of many of the steps taken in the pre- mises, steps, they are constrained to say, that in all probability would not have been taken had a better spirit prevailed among some of the staff of the Hospital. It is quite enough to make a running conmientary on the whole matter. The age and habits of Lawson are not mentioned — rather an important omission in a medical point of view. This man received a gun shot wound in the middle of the left thigh, which fractured the bone, but apparently with little comminution, on the night of the 21st of June, 1851, while perpetrating a nefarious act. The next morning he was taken to the Marine and Emigrant Hospital, and fell under the care of Dr. Rowand, the Physician of the quarter ; Dr. R. states that he called a consulta- tion, this Dr. Douglas denies ; others of the faculty state that it was the fact, whilst others declare they knew nothing about it. However, Dr. R. came to the conclu- sion, a perfectly correct one, not to perf)rrn " primary" amputation, but to test the recuperative powers of the constitution ; and this conclusicm of Dr. R's. harmonized with the general practice of the Hospital, which was opposed to primary amputationa in serious ajci;lents. Dr. Douglas himself bein2: favo''u!)le to that line of treatment, and constantly in tho habit of f)llowin;^ it and inculcating it upon others. The trea'.nient ado{)tjd seems to Ikivc been quite judicious up to the 1 5 ih of August, wlicn the Dr's term of attendance for that period expii'ed, and Dr. Douglas assumed the charge of the " Surgical " word, and asserts that he was told that Liwson was to remain under Dr. R's. care : a desire of this kind, it appears clearly, was mani- fested by Dr. R., but he did not in fact coutinue the attendance, stating that "it *' was not worth his while to go such a distance to see one patient." It is mentioned that for a few days no one visited Lawson; not long after, however, Dr. Douglas very prop:)rly re narking thit tlie man was not there to be abandoned, prescribed, and removed the long splint, substituted one in the form of one inclined ])lane, and ordered porter in the place of wine, which had been directed to be taken by Dr. R. After this he appears to have prescribed for this man, as for the other patients, in is " ward " as is proved by reference to the Prescription Book of the Hospital ; and still Dr. D, persists in asserting that Lawson was not his patient. Yet he ac- knowledges to have invited Dr. Fremont, who was not coimected with the Hospital, to see him. Now, lliis circnmstanno alone is sufficient to establish one of iho two points, either ihrit L. was Dr. D's. patient, or if not, that he was .^nilly of a great broach of Medical Etiquette, in calling another Physician to see his colleague's patient, and one not attached to the Hospital. Even admitting what Dr. D. pertinaciously insists upon, that L. was not his patient, still he cannot but admit that L was in his ward, and if he really was without att'^ndance, on the sctore of common humanity alone, but more particu- larly as the Senior Medical Oiiicer of the Iasti:uiion, and likewise a paid officer, : t 72 as well as for llio credit of tlio Hospital, with wlioro ropnlntioii lie was iiiliinalcly allied, lie sihould liiive summoned lii.s cunfrtres^ the Vi,suing Pliy-^iciaiis, if not in deference to their opinion, at leuf^t, to set himself rii!;lH in the eyes of every body ; the move so, as Ik^ was awan* that wlietlier recovery or death eii; imhI, the case woidd come before the penal trilniiials of the Counlry. However this tnay be, no Physician saw L. but 13r. 1)., rind it has come out in evidence, that the unfortunate man begi^ed of Dr. 1). at one time to atn|,ulate his limb, but the Dr.'s rejoinder was, that " it would do," from which eN|)ieys;un it was natural for L. to infer that he would recover and save his leg; bat at a later period, he told the man " the time for operation was past." After beini!;ov(«rlinee moiilhs in Dr. D.'s ward, he again fell under the care of Dr. Ilowand. Dr. R. says, " he " considered amputation at this time an act of crnelty." Now, to say the h^ast, the case was most miserably managed, and while Dr. R. \\as perl'eclly justified in giving nature full scoi)e, to try her restorative powers in the fust instance, he does not stand justified in not calling all the Physicians of the Hospital togeiher, that some decision might have been arrived at ; and while it is very true, that it is not always just or prudent to give an opinion in any serious case without a personal examination of it, the Commissioners are forced to come to the c:m- clusion, that there was still a tolerably fair chance of saving the utmi's life by the loss of the limb. The symptoms of hectic fever were certainly very promi- nent, but there was ample cause for all the disturbance, without attributing it to " Tubercular disease." The constant irritation, together with the exhausting suppuration, were quite sufficient to aceoiuit, with considerable certainty, for all the mischief that was apparent, the whole was entirely synip'oniatic ; ilie renioval of the cause in all human prol)abiliiy, would at once have arrested all the excite- ment, and even the "severe cough and diarrhoea," if the cough did not result from disease of the lungs, of which the stelhesoope would 1 ave liven sit sfactovy f)roof; and the examination after death has shewn that there was little or no esion of the lungs. Nor must it be forgotten, that L. died G7 days after Dr R. resumed the charge of the ward. But whilst the Commissioners conceive it to be their duty as medical practitioners of some experience, thus to reficct u|:on Dr. R. for not giving L. the only chance left him for his life, they are compelled more strongly still to disapprove of Dr. D. not using his reputed determination, when there was Jiot only all reasonable hope of saving ilie man's life, but when it would appear, it was imperative upon him to have performed "secondary" amputat'on. Nature had had ample opportunity to try her powers. The le was yet much vigor, and the man was desirous of submitting to the loss of his limb to save his life. And while the Commissioners are unwilling to believe the insinuations promulgated, that there was some malignant passion at work, and efllbrts made to ruin a rival, or injure one at least disliked, the man was allowed to perish ; but while this discreditable imputation is r(?pndiated witii the utmost indignation by the Commissioners, they are bound ui lairness lo state, that it is their decided impression, that if a better lei^ling an;l more cordiality had existed between Drs. Douglas and Row nl, in all p obib.lity WilliaiTi Lawson would this day be alive, at least, so far as regard his injury, or the amputation. As a surgical matter, this case is full of interest and importance to the Medical Profession, but this is not the place to treat it as such, and the Commissioners, though wishing to he as concise on this subject as possible, deemed tliemselves called upon to make the above statement, and from the facts above cited, together with those that have been dtJtailed elsewhere, no doubt can longer be entertained of the step that should have been adopted. The only one to prevent such tragi- •^al occurrences as the above being repealed, as well as for the establishing con- c »rd, unanimity and a proper professional feeling in a situation, where every one is expected most zealously to co-operate with the other, for the honor of the Profession, and for the well being and safiMy of the unfortunate individuals con- .fided to them as Christain men and Physicians. 73 When it is rocollcntpd tlint ihis.nnfortnnale man siirvivod llio injury 214 days, the prpsnniplioii is that the nnsrhicr was not so groat hut as to alloKl very reasonable hopes of a eure. The f'rst 66 days were in ist projx'rly (h'voted to ascrrlainintj what the eonstitnl ion eonld eli'ec;!, hut Ihis prol)aiion;iiy state was nearly exhausted ; and how L. eonld have remained 91 (lays under Dr. Douglas' dady inspection without that gentleman deeiding upon iIk^ adopiion of some other steeps, is |iainl'ul to rellect upon. It was during the first part, more particu- larly, of this loiur period, that a very fair chance of success might have been anti- cipated to result from an operation, and even during the third period, the propriety ot a ro;-!:)vt to tlie Knife seems manifested, seeing that death must have been the inevitable consi.'(|uence if the limb were not removed ; it is difficult to be reconciled (o the omis^ (m of it even at that time, calling to mind the circumstances of his living 67 days after IJr. Rowand took charge of him for the second time. The Commissioners are very far indeed from wishing to cast any improper censure on either of these gentlemen, but they have a solemn duty to acquaint tlKUusclvea of, and which they are bound to do, with all du(; caution and circumspection, but still without f(;ar or favor, and in obedience to their instructions and to the dictates of their consciences. ( Further remarks on this case. The evidence adduced by Dr. Rowand, viz: that of Dr. Beaubien, who was at th(! lime of Lawson's sojourn in the Hospital, acting as Apothecary, that of Dr. Lemieux and .Tohn Iltilslrip^ the orderly, all go to esiahlish the fact that Dr. Douglas did take charge of the patient, and that he j)r('seribed for him is beyond question, proved by reference to the book of the Hospital. It is useless then for Viv. Dougla:? to attempt to exoneiate himself from any implication in the case; by the rules of "die Hospital he could not have refused a bad case, and he often left them to others, on his own term of duty being finished. It is true that he has brought forward llie evidence of Drs. Hall and Jackson, to show that no regular consultation was held on the case of Lawson, and it is not unlikely that on this point Dr. Rowan:! may be in error, for as it ajipears Drs. Hall and Jackson saw the case at the time, the impression may have been left on his mind that others had done so likewise. The statement concerning the morbid condition of the limb, is different from that given by Dr. D., whose account is borne out by the House Surgeon. It is too late for Dr. Douglas to charge Dr. Rowand with ignorance of the principles of his profession, when we recollect that Dr. Douglas took thai gentleman into partnership some years ago, and introduced him as a competent Surgeon to the public of Quebec ; but Dr. Rowand is fortunate in being able to bring forward the certificates of such celebrated men as Syme and Simpson of Edinburgh, to prove his qualifications, and may with confidence refer to his standing in the j)rolession of Quebec, to repel the malicious, indeed it may be said, libellous attack on his professional reputation, contained in Dr. Douglas' remarks on his account of Lawson's case. In these remarks Dr. Douglas has unfortunately again betrayed the unhappy spirit which seems to pervade all his actions when coming in contact with his colleagues; he not only displays a want of respect for their attainments, but a total disregard for the ordinary cour- tesy of professional life, and complete indifiU'rence for their feelings, and it can well be conceived that his every day behaviour is, when he can pen such language in the calm retirements of his study, and when he is well aware it must come- before the Profession and before the public. But he has been rather forgetful of recent events, in charging Dr. Rowand with ignorance of the "principles of " Surgery," for it is in evidence before the Commission, that Dr. Rowand has charged Dr. Douglas with having set about commencing an operation of a very 51 ii I 74 ■eriou8 nature, (castration) without calling a consullalioii, and that at his, Dr. Rowand's remonstrance, the operation was stopped, and the man cured by other means. This surely displayed a greater amount of knowledge than is usually possessed by " a sUideiit of .hree months standinj^ !" Did it not di.spluy, on that point at least, a greater amount of practical knowledge, than was at that time possessed by Dr. I'ou^jlas himself who has always stood sentry over the errors, real or supposed, of his colleagues, and dragi!;(;d them before the gaze ot the Pro- fession and the oflicers and inmates of the Hospital, to their serious injury and annoyance. The Commissioners of Enquiry, after a careful examination of all the evi- dence before them, adopt the conclusions drawn by Dr. Rowand, except the fourth one, which refers to the consultation said to have been held, of which Dr. Rowand has not furnished satisfactory evidence ; under these circumstances they mnst strongly condemn the means taken by Dr. Douglas to get out of a dilemma, which would have placed his name in a disadvantageous light before the public, had he not taken the steps he did to screen himself, and heap obloquy upon a brother practitioner and one of his own colleagues, and which measures did for a time prove successful, and served the end for which they were adopted, but which now that the real facts of the case have been inquired into, contribute largely to his own discredit and discomfiture. 1' fir k nK The case of Monsieur Ic Docteur Chaperon . . It would appear that for some months previous to the outbreak of cholera last summ 'r, in Quebec, a Dr. Chaperon haJ been eulogisin:^ some p:'ouliar treatment of his own for which he claimed a superiority over the remedies usually employed by the profession. He was invited by Dr. Douglas to test his remedy in the Marine Hospital. Dr. Douglas having obtained the necessary permission from Dr. James Sewcll, the recently appointed Chairman of the Hos- pital, and with the concurrence of his colleagues Drs. Hall and Rol)itaille, placed some wards at the disposal of Dr. Chaperon. Every facility was given him to carry out his plan of treatment, and after some time it was ascertained that the average of success was less by Dr. Chaperon's plan than by that previously employed. Dr. Douglas now convened the staff of the Hospital, and wished them to join him in some plan to get rid of Dr. Chaperon, but one of those present, Dr. Rowand very properly remarked, that as Dr, Douglas had not consulted the staff of the Hospital for Dr. Chaperon's introduction, he might tak'' upon himself the responsibility of his dismissal. It was ultimately agreed that Dr. Chaperon should be written to, to relinquish his attendance; and after some dclny, he did so on the 2."jlh of October. As the Commissioners cannot conceive what right Dr. Douglas and his col- leagues had to place sixty individuals entrusted to their charge, in the hands of a Strang 'r to the Hospital, to be made the subjects of experiment on a grand seale, in order to test what Dr. Douglas himself style a '■'■ nostrum,'''' they cannot conceive with what justice Dr. Chaperon can complain of the abrupt termination put to his experiments, seeing that not one of his promises had been fulfilled, as will he hereafter shewn. That all parties consenting to Dr. Chaperon's admission are to blame for making a charitable Institution, supported by public funds, a scene for testing the value of a nostrum there can be little doubt, and the Commissioners catmot but express t.ieir astonishment that gentlemen of education, entrusted with the care of ignorant patients who had no idea that they would be made the subjects of experiment, would have so far forgotten their duty to these unfortunate 75 creatures, as to allow sixty of them, afllicted with a dreadful disease, to be Ireatcd with a remedy with whose properties, chemical or .medicinal they were at the time ignorant. If every one pretending to have an infallible cure for certain diseases, should obtain admission to our public Institutions, where would the mischief end ? If such remculies are to be tested, let them be tried on persons who give their consent to their being employed in their own cases, not upon the poor, ignorant and afllicted inmates of an Hospital, who are under the impression that in rsort- in^ to it for relief, they are sure to be treated with the greatest skill, care and judgment. Patrick Neville, Steward, Marine and Emigrant Hospital, appears — he states : — That he is at present the Steward of the Marine and Emigrant Hospital. That on the introduction of Dr. Chaperon into the Hos|)i«al for curing cholera, he Patrick Neville, observed to him. Dr. Chaperon, that he was prepared to place at all times, at his disposal, anything which might facilitate the objects he had in view. (Signed,) P. NEVILLE. Suggestions for the Future Management of the Marine and Emigrant Hospital. The Commissioners of Enquiry, before ofFering any suggestions for the fnture management of the liospital, would beg respectfully to direct the attention of His Excellency to the present anomalous state of its constitution. Five; Commission- ers are appointed by Government, and, like the former Commission the present has only one medical member. Itdoesnot appear what peculiar fitness these laygentle- men, no doubt in all other point 9 most respectable, possess for the performnncc of their functions for which it is but n.'asonable to suppose, they had not prepared them- selves until appoinli'd. These gentlemen are not paid, and residing at a great dis- tance from the Hospital, and having their own affairs to attend to, may become indiflerent tothe management of the Institution, or, as on the former occasion, dele- gale to others their powers. The Chairman is in every respect qualified for his post, but two of the Commissioners of Enquiry being themselves medical men, know well what demands are made upon the time of their brother practitioners, and are well satisfied that even the zealous and active gentleman at present at the head of the cstablishmrnt, will acquire, and ought to be furnished with competent and responsible colleagues. There arc six Visiting Physicians, who are declared by the Government to be on the same equality, to have control over the surgical and medical cases in equal degree, to have no power of interference the one with the other, and though two of ihem have been in otKce since the opening of the pret^ent Instilnticn, there is no other distinetion belwecn them iind their recently appointed colleagues, than the very invidious one of the former beinjj renmnerated for their services while the latter have to perform ihe same duty for nothing. It is true that amongst themselves the Visiting Physicians are in the halnt of styling Dr. Douglas the "Senior Physician," but to this distinct'on he is not strictly entitled ; it does not confer any extra |)rivileges, nor does it involve the performance of any extra or special duties, or impose upon that gentleman any responsibility not shared by his colleagues; yet the Comtnlssioiiers call Dr. Fainchaud the Senior Physician, because he is considered the doyen or oldest member of the Statl". In this apparently simple matter, want of uniformity is perceptible. it II i Tlip Visitin'^' Pliysiciiins bcirii,' lrrosponHil)lo lo tln^ CoTnnii^isioiicrfi, iind only ncrounlnMc for llicir coiiduril to llif (Jovciniiiciil, lias a Iciulcncy to lead to al)iis('9 which arc didiciilt of r(Mnce estahlishnient pecnliar in its economy, heing snpported lioni two dillercnt somccs, and Jiccotnmodaiing two v(>ry opj)Of!iite classes of inmates, are very apt to disregard, or at least, not pay the necessary respect to orders and snggeslions coming from persons they suppose incapable; of giving advic r on snch subjects. In most ether Hos[)itals, even where the Medical SiaJl'is under the control of Trustees or Managers, the selection of the House; Surgeon and tin; A|)()tlicc;iry is left to their jndgmenf, or what is tantamount to the same thing, the examina- fion of the; candidates is left to them, and their recommendation of the best (|uaH- fied candidate is followed by his selection to the Dflice. But in the present instance the flouse Surgeon is appointed by the Executive, without re'fercnce to the OiiTunissioners or tlie Visiting Physicians (sou letter of Mr. Casanit in Appen- dix) and consequently it is fair to presume, that he who can command the grt^atest amount of political influence may be appointed, to the prejndiee of him who is best qnalified. This OHlcer not being subject to removal eiihcr by the Visiting Physicians or the Coinmissioners, is to a certain extent independent of thern, and the Kxe(!Utive must be applied to for his removal for improper c 'net or neglect of duty. It can well be supn;)S!'d that many acts (!ven deserving i censure may be overlooked in prcrerenre to appealing to so distant and formal'a tribunal. 'I'he Ap:)th:'cary is appointed by the Commissioners after due advertisement of the a[)|>ointment beui? vacant, but it does not appear that the Visiting Physi- cians are even consulted in the luatler. Yet this Officer is entrusted with the compormdingof the presciiptions and the superintendence of their administra- tion ; and although he may be incapable of the first part of his duty and indif- fer.nl about the seeonri, tlu! Visiting Physicians have really no control over him. Nordo the Commissioners thittk it even necessary in all cases to consult the Medical Stall' about the substitution of one person for another in the higher post of House Surg(;oii, as tlu>y themselves admit in reference to the appointment of Dr. Godbout during the illne?!? of Dr. Lemieux. The appo:nt;rient of the Steward and Matron also rests in the hands of the Executive ; and the same objection applies with equal force to this mode of appointment, as to that of the House Surgeon. Misconduct must arrive at a high pitch, before even the most querulous will think fit to bring the matter before Government. It must beat once evident that it is difficult to conduct an establishment of the kind wiih order and regularity in which the different Officers are so independent of each other, and little astonishment need be expressed that in the Marine Hos- pital some abuses have crept in, which the public prints acted upon by secret maligners have so much exaggerated and distorted. The Visiting Physicians, and not the Commissioners, are competent to judge of the ability of the Apothecary, Steward, &c. ; and coming in contact with them nearly dally, atTords them opportunities which the Coinmissioners cannot possess of knowing how to judge of them. They are the servants of the Visiting Physicians, who have a deep personal and professional interest in the due per- formance of their duties, hence they should have the sole control. But ill other respects this Institution is peculiar; two Physicians are paid, four others not paid. The House Surgeon (inferior in rank and responsibilities to the paid Physicians) has a salary greater than they receive. He gets per annum, £125 : £30 for alimentary allowance, rooms, with coals and candles. IS will of the judge t with cannot isiting paid, bilities t'ts per andles. 77 The two Senior Pliyrtieians gel JClOO a year. TIm^ Steward, lower u'^riin lliau the House Sm^coii, gels u s:iiary alinoNt i'(|iial Id liim lor (liiticn (('rhiiiily If-'a rc'sponsiMe anil ardnons, wliiUl llie Malron, wliox- oliici! ^lu)lJlll \tc {•uiLsulcrcd ne;irly on an ('(iinil looting willi lliat ol' the Slewaril, is paid very liiih' ii)om( ijiun tho cotninon nurses, and not more than is paii ; but a less scrupulous man might be appointed, and us the Instiiution may not always have* so honest and consi-ientious a 'I'leasurer, it is not imprudent to provide against an abuse so likely to occur and so dillicult to deti'ct. The Conmiissioners of Encpiiry have now pointed out for Your Excellency's information, the more prominent features in the Conslitutic^n of die Jlospiial, which they believe mar its working and interfere with its successrul manag(MTient, and as they are firmly (onvinced that a perpetuation of the same must inevitahly lead to similar eonseijuenccs, th(!y would humbly sugg(!st that the following alterations in the management of the Hospital be adopted, if it be, as they are well aware it is, the wish of tla^ GovernmiMii that order and regularity should prevail in its ecout)my, and that it should again oeciij)y a resj)ectablo position in public estimation and command the confidence of the community. The Commissioners of Eiajuiry woidd stron,dy but respcctiully recommend ihat the following organisation be adopted. They have carefully relleclcd upon the measures they now propose, and are convinced that a considerable change in the Constitution is absolutely required for the proper working of the Institu- tion. They beg leave therefore to propose — 1°. That the management of the Hospital shall henceforth be under the control of three " TVui-^ees," who arc to he designated by that term. Of the Trustees, The Chairman of the Trustees should be a Medical Practitioner; one, tlio Chief Emigrant Agent; and the other, the President of the Hoard of Trade for the tiaie being. These Trustees should each be paid the sum of fifty pounds currency yearly. They should hold a meeting in the Board room of the Hospital, at a icgularly appointed hour, once every week both dufing sunnner and winter. When prevented from attendance, payment for the period of their absence to be d^-dncted tiom their yearly allowance, and no cause, save illness, to be consld ed as satisflietcjry excuse for absence, in arrest of the aforesaid dedncrion from the yearly salary. 1 hey should sign their names in a book to be kept for that purpose, as well as the hour of their \v 78 I'- I: w arrival at llii' Ilospita), oti those days iipoti \vhicli a Doard is hold. It should be thoir (hity to sinifiintond the whole inaiia{j;enient of the Hospital, to alteiid to coin- pluitits ot itiipi'opei' eoixhiet, to eorreet abiisey, and, when such occiir, to ])oint out to the njeinl)ers of the Medieal FaeiiUy, throutth the (Jhaiinuin of that body, any condiiet reiiMirinjx explanation or eorreetion on tl>e part of any one of its inend)erH. They should recpiirc fioin all parties making serious eharges n}/;ainstoratt'eelinjf any of the olHeers of the Institution, that sueh charges he putm writing, and transmitted to the Chairman of th* Hoard of Trustees; and iliey should also observe the sume rule themselves when adtlrcssing the medieal staff on any point eomieeted with the conduet or iialioii of lypliiis ft-vcr in 1817, liavini( visited (liosnc! Isle, in his eap::eity of Coinmissioner, in coiiipuny with ihat |[,'enilenian, has slroii!,'ly reroinTneiuh'd his appoiiilinent to hiscoMeagiu-N, and they now hiirnhly sni;gesl lliat ihal {ijenth'nian'ji .seiviet's Le solicited for ihc Hospital as Trustee. It also allbrds thn Comrnissionrrs pleasure to express their liuuibh' opinion, that a belter selection for Medical ('iKiinnan could not have l)ren made than that of the present highly respectable practitioner whom the (ioveriunent have so wisely placed in that position. the the hort utlcs, ust be jn the ously. ration Com- The ■cs not nd its in the Agent Trade [lected whom ict, or ospital easons th the tfully cation n to 77ic Sdcrctari/ and Trcatnurr, 2 ® . The Secretary and Treasurer nuist be a Medical man appointed by Gov- ernment, but subject to removal for inellieieucy or i)ad conduct, at the siiijf^estionor prayer of the Trustees. Ilis salary should be J[JI00 currency per annuiii, at least. lie shonKl be oblii^ed to visit the Hospital not less frequently than twice a wec^k, besides havini^ the power of doinj^ so at any otiier time and at all hours. At his ordinary visits, ho shall enquire and examine into the condition of the difl'erent wards, and make? an entry in his minute book of the condition of the wards, their state of cleanliness, ventilation, the conduct of the olficcrs, &c. This Report is to be laid before tin; I3oard of Trustees at the weekly meeting. lie should act as Secretary to the Trustees, take notes of their proceediujfjs and enter them in the minute book, conduct the correspondence of the Trustees, give notice of extraordinary meetings, and summon the Trustees on any emergency not admitting delay until the usual period of the weekly meeting. He is to prepare a quarterly Hcporl of the Hospital to be laid before the Trustees, which is to include the morbility and mortality of the Hospital, its state of discipline, its requirements, its expenses, (in detail,) and its actual state of funds. He shall examine and check the Steward's accounts. He shall visit the dead house occasionally, and take care that decency and order are observed in preparing the bodies for interment. He shall sign all the cheques along with the Chairman, and produce, at each quarterly meeting, vouchers for the disburse- ments he may have made on account of the Hospital. All requisitions from the MedicalSlaflare to be addressed to him and by him laid before the Trustees. Once appointed, he must consider himself as under the control of the Trustees. He is not on any account to undertake the duties of any of the Medical Oflicers of the Institution, or to interfere in the least, either actively or otherwise, with the medi cal management of the patients, nor is he to express, either in their presence or in that of the other officers or servants of theesfablishment, any opinion concerning the nature or treatment of the diseases ; but should he observe anything which, in his opinion as a medical man, would require correction or interference, he is to make known the same to the Chairman of the Trustees at his earliest convenience. It is not inteuded to prevent the Secretary from offering his opinion when requested to do so, by one of the Visiting Physicians, about any case in the Hos- pital, or any plan of treatment under discussion, and if any sudden emergency should occur whilst he is on his duty in the Hospital, or if any patients who have received accidents should be admitted, he may if requested to do so, assist with his advice the House Surgeon or Apothecary in the treatment of the case until the Visiting Physician shall arrive, after which he is not further to interfere in the management of the case. • As complaints have, from time to time, been made of the quality of the pro^ visions and of the manner in which they are cooked and served up, the Secretary 80 will 1)0 cxpeclocl lo niiikc his visils (VcqiKTilly al the meal, times of the patients, and fatisly himsiH' thai the diet i»: good, measiin.'d out ac(ordingto the; llospilal scale and properly coolxed. lli? will eiUer in his ^vcekly n^ports the result of those examinations nnd lake fare lo hring under the notice of the Trustees any circumstances requirini^' Iheir interference. Lk t *.i' i.. Pi !€ JVie Vtsiiiitg PJujalcians. There should be Tour Visiting I'hysieians who ought to be Graduates of some University or College in the lirilish Dominions, LieenliaU^s or Memberrf of a College of Physicians or Surgeons of Great Hritain or Ireland or other in the British Dominions, oi at least three yearn atfimling^ and : hey should tnoreover be i. possession of the License to practise granted by this Province. They should receive a yearly salary of £100 currency. Tli(^ Commissioners would beg tu explain in this place their reasons for re- comm(;a(ling this allowance : — 1st. 1ft is in evidence that some of the most experienced practitioners in Quebec were offered the situation of Visiting Physician and refused iheir ser- vices, on the grounds that tiny were not to receive any remuneration. 2nd. It is also in evidence that Dr. Blanchet, (whom even Dr. Douglas did not object lo) Dr. Kewell, the present (chairman and Dr. Nault, a respectable praciiijoner, allege as a reason for resigning^ the want of emolument. 3rd. Dr. J)ouglas and oilier members of the !\ledical Stall' have declared, that the fact of some of them being paid, and olliers not paid has led to an in- vidions distinction among them, and has also been the cause of many of the disturbances ihat have ccMisliluted one of the subjects of the preseni invesiigation. 4ili, It has been represented that the present Visiting Physicians are not likely to coniinue their services unless paid. Now, if ihey resign in a body, ihc llospilal will have logo through a prol)atio'iary |)eriod of disord(M"and \v..t\\ oldis- cipline, before any staff of in-coming Physicians shall have had lime to become familiar wilh rios[)ital managemenl and Hospital routine, and the Insiituiion losing llic advantage it now possesses in having Medical attendants familiar with its working, might be thrown back into the very condition from which it is the ooject of the Executive at this moment to rescue it. 5:h. Unlike many other Hospitals, the one under consideration docs not hold out the prospect of tnj/iVfc/ rewaru to the Visiting Physicians. It is frecjuented by persons who do not become residents of Quebec, and who having no friends in that Cily, do not assist in establishing the fame of the practitioner wdio may have most skilfully cured a serious malady, or performed a most dillicull opera- tion ; and as few- students frequent the Hospital, the judgment of the Phy- sicians, and the skiii *.•. the Surgeon, are not through them made known in the community. Hence the attendant in this Hospital has few of ihe incentives to exertion that stimulate the Physicians of other Hospitals, ard not deriving any advantage indirect!.)/ i'com his post, he is apt to become indifl'erenl in llu; manner of performing some of his duties, and iiregnlai in the pi riods of his attendance, for ihougli it has already been explained that some allowance is to be made for want of punctuality much inconvenience necessarily attends a too great disregard for it. Il is only necessary to point lo the manni'- in wdiich the Hospital Uecords have been kept to illustrate the species oi neglect alluded to. Gth. The salary of £100 a year would se(;ure for the Hospital the services of the bes« talent and skill in Quebec, and thus the paternal solicitude evinced by the Government would be satisfied, and the community cease lo regard the Institu- tion with tlie feelings of rancour .so frequently displayed and »;) oIUui expressed in tlie public prints; although it must be acknowledged, however, that many of )t hold it-ntcd •ie;nds f) may i)|)cra- IM.y- lin llio vcs to l^' liny aiiiKT ■e, for want nJ lor .'CO rch ices of i;)ok." In the event of '.h^ir not being able to attend punctually at the appointed hour f)r visiting the Hospital, they should name the cause of the irregidarity, which may be orient professional avo^Mtions and injporlant private business, &(.'. This book should be examined by the Trustees at s:a ed periods, and should any of the Visiting Phy>i:>ians exhibit a tnarked disregard for punctuality, he should be admor.ished by the Cliairman, th.it su;h irregularity ii calcidated to cause confusion in the routine of the Hospital, and give rise lo adililional trouble, and will not be tolerated. The Visitin:^ Phvsieiaus slioidd consider the hour appointed for a <:onsulta- tion as the most iinpo'iiant en'^agenient for that day, and nothing short of the most urgent demand on their lim,'! uud alleuiion should prevent ihcm keeping it. »3T 82 The House Surgeon and Aitufhecari/. This Officer fihonld be appointed by the Exrciitivn, after tlio rcenmiTirnda- tion of the Triistt^es and the Visiting Phy-^icians. If the Hospital is to prosper, care tnust be taken that efficient Oifieer.s be appointed, an'' rules of the Hospital, need not be alluded to further. The Mttlnm. The Commissioners are of opinon that this Office has never ^/^'/n considered by the authorities ol the Hospil.ll as ifnportf'nt as it really is, and invAlving as much respcnsibilit}' as it ought to do. liny would respeetlully remaik tliat a peison entrusted with a supervision of a number il servants in a large public charily, having the care of linen and other mattcMS, should receive a salary inHch hgher than that of an oidinary servant; yet in the present instance tl.e cllowan^e to the Mation is only £18 eurr.ncy, per annum. 'I'he Commissioners would Leg to suggeM dial the Matron bhould thenccioith receive a salary of >£lO, with boLrd and lodging at the expense of the Hospital, the same as the Steward. T! e Commissioners need hardly point out that mat y abuses likely to cccur Jn such a large Institution, will be avoided by boaiding the difli rent officers at its expen>e. 'i'hough lliey have every c» nfidence in the honesty of the present Steward and Matron, speculation may be |)rae'ised by tlieir successors, at;d it in'r'y be exin mely dilFicnlt to prove the oflt nders guidy. All i.diucmenls to piher iiom die ptovisions of the Hospital, will be prevrntcd by ihe plaaiiovv humbly rt commended. (C i( £75 lored n^ as liat a public salaiy e tie loners ry of ■IS llie ccciir •vxs at icM'nt ir;tl it nts to I aokV 83 The Commissioners wojld sns^gest ihal after the resignation or removal of the present Steward and Matron, these odiecrs should not be man and wife, un- less some very spt^cial advantage to the IIt)S))it!il is thertl)y to be obtained, for these oiIi;-ers should serve as a ehcek upon each oilier, a proteclioa against abuses, lost by the appointment of a married couple. The Nurses and other Strvnnts. The Nnrses (male and f«'male) should be hired by the Trustees, but if found ineompcienl by the Medical Stall' for the perforuiiuice of their important and ar- duous duties they should be dismissed. Their wages will of course vary, »nd its amoiiifl should be regulated by the Trustees. A servant who has been onjo dismissed lo! bad conduct, should on no ae(!ount be aL^aiii employed, uidess ih -re were the v<'ry best reasons for thinking that he was truly repentant, and wu dd not odend agiin, — and they should be made to understand that they are to ob 'y the lawful commands of the lh)use Surgeon, A|)olhecary, Sieward and Matro.), as implicitly as if the servants of these several parlies. The MeJical Records of the Marine and Emigrant Hospital. In the commencement of this Report it wns stated that much irregnlaritj nr-tse from the want of a good coile of rules, and from neglect of cnforriug those which MJre.uJy exisled. A sti iking in>^tance of the truth of this slateiucnt is fur- nished in I«;e careless, impeifett and slovenly manner in which liia Hospital Ilecoids have been kept. The .'louse Surg ons are not to blame so much for this neglect of duty,, as the Visiting Physicians. The House Surgeo i is hand- .somely paid for his services, and nolwilhsianding that occasionally his diUies miy be ouiTous, yet the Commissioners are satisfied thai even durin » the most ])psy period of tlu; year, he could have entered in detail in the C ise Books, nil cases of an interesting or extraordinaiy nature. It was the daly of tho Visiiing Physicians to direct the House Surgeon to note such eases, and more- over they ought t) have assisted him in his labor, so as to transmit t a their suc- cessors the medical history of tlu; Institution, to have |)'aeed befort^ the stndi'nis ihj re.;ulis of the practice of 'he Hospital, whii;h would have served as models to guide tliem eiUering prac'ic' !'«emselves, and s(Tve as guides in thtt piactice of case Likinq^ a most imporlaii: department of Clinical Institutions la order to illuslral** this branch of their enquiry, it may be useful tocpiote from the regulations the rules defining the duties of the House burgeon in these matters, and t'rom the examination made of the books laid before the; (Commission, it will be obsi^rved how the rules were neglected. The Table ofoperitioas hereto appended gives the ruml)er and variety of the operations performed during the last seven years. Coiiiravy to what the professioa has been led to believe, these have neither been numerous nor very important; very lew of them have even becMi capital operations. The cases present the com- mon run of surgical practice, and fail coujpletely in upiiolding the character which the eslal)lisl.m(>nt was said to possess above all others in the Province, as a Sur^^i- cal Ilosp tal ; it is in fact more useful as a Medical than a Surgical Hospital, and icquires that the Medical attendants be equally able as Physicians and Surgeons. " He shall enter in detail in the Case Book all cases ol an inlereslingorextra- " ordin uy nature, givin » as complete a history of the disease from the commence- " ment a.s can be obtained, with the treatmt'iit ii) Ho'^pital and the result; in " every instance making the record as complete aj possible," — Bylaw 26. — (For the guidance of the lluuse Surgeon.) 84 " Tlicy will take caro that iho doscriplion of the appcaiancos after doalh bo ** recorded in the Modieal Register of Cases, as a coiielus'on U.) the individual ** case." — By-litw 2. — (For the guidance of the Visiting Physicians.) Tlie above By laws clearly provide for the eslablishnnenl and maintenance of the book \vhic;h should conl.iiu an accurate detail of t'le history, symptoms, ircat- "nent aiil re.snlis of treatment of eveiy cas^e of disease "ofan interesting or extra- " ordinary natnre," admitted into the Hospital ; and to which should l,ead(led,a detailed statement of appearances revealed by post mortem examintition, wht n- ever any such case termina'cd fatally, and it were possible to obtiiin snch cxaminaii(n. A ](si(n c« rerally. lusies.d, however, of strictly observing the n*(piiremeiit oi the Uy-laws, by k('e.|)ing owe complete Jfrglstrr of cases, three scptnate and vrri/ iwp(rfecl l-noks have i;ecn maintained by the Hospital Snrgeon and Siafi" of Visiting Physicians: — 1st. "Case Book of the Marine Hospital." 2nd " Post Mortem liook" 3id " List of "operations.". The incompleten(\ssof th j Case Book mtiy be readily tipprecialed by the mere mention of the fact, that i' corlains ih<* recoids of nineteen cases only, all of which were entered durins; the ije.ar 1848. But five out of the nineteen have the mime of the disease allixed to th.^rn, and the remainder are so meagre in details, that the natnre of the malady in mtiny cases must l;e exceedingly problemtilical toihe reader. The numerous glaring errors orthographical as well as .grammatical, are disgraceful '^i the pages of a McfHcal " Case; Book." Two of the cases menlioned in this book terminated fatally. An autopsy was held on one, and the particul.irs inserted in the book kept for that pur|)ose. '1 he " Post Mon-'in ^* Book" (ontains the details o{ fourteen cadaveric examinations during tli(^ v;;ar 18*8, o{ snien made during the year 1851, and of eif^ht during the year 185ii : — iwenly-mi)e in all. During the years 1819 and 1850 either then^ must Inive been TiO aut()psi<>s ntade, or the House Surgeon must have neglected to enter them in 'detail in the Book "and the Visiting Physicians must have omitted U) take caro (hat the description of the appL?rances after death were recorded." The compara- tive number t/f |;ost mortems is exceedingly small during th(; years 1851 and 1852. Acco (ling to the Hospital Returns there occurred 265 de.iths, while as menlioned til ove, ox\\y fifteen autopsies were mnde during the same period. As the cases sttind in this book, they are practically of little or no impoitanr-e, for with the exception of two, there is no accompanyiiig history of th(j disease and its trfatintrnt. The I'ollowing is a Table of th^ '' List of operations." H- *; Name of I'at^ nt. Ainabl? 'R'.ircr , Eftward B 1 .... James M 'Nid.'r . George M N ;;Iii . James Me Til' I .. , Jamtt Th >!ri; son Jo'in .MiDo..i:d . Amable li • ii e.- . Wit. Woodliouse. •George Green .... Date of operation. Name of operation. Name of Operator. I{(Blilt. 1813. Marcdi 27 ^'nrch 29 ^'arfh2l M..y 2 M.yr 8 iM y 1.') uuy 1!) May 18 .tune 8 Arnpiitntion of riglit leg liomnvai of left Melalar.=us ... Oislocation into t'l'' Axilla ... Vmpiitit on oftlie 'rhumb ... Ds'oeatiou into the Axilla ... A iiriitation of lo^ on righlfDOI Hydiocete of llie Cord Anij uta*.ion of .Metatarsal B nrs of itfi r)ot Ambulation of phalamgcs of f,)Ot Not given. Not given. Not ■fivci). Dr. Douglas. I .• giv(n. N )t g ve 1. Not g.ven. Natg'.vc.i. N)t g^et. Nut gi\ ei:. Not given. Not g;vrn. Kedu ed. Not giM n. licduLfd. 1 Not {jiven. J June li'istulu in ano Mode 1 .A n, of 1 F,,, operation. 1 .1 .'i n. \ Nat given. 85 List of Operations. — (Oontintied,) Nam;? of Put e i!. Date ol' operation. Samiir'l Sivan Jaine.s U ),s.s James Fil/.|>atrick ... Mich. W lie Louis Bmi'iri ('tiarl(-"s B.iuvii Cliarli's Koacli ,rifl< K 'lly James M.IMiorson ... C'las C iait.6 David Wlieian Andr.'W n.iinlloii Kiaiu' s !i i.:y»'s ... .l.)Iin i'. Ml ,vi'u ,. R.'llj. F;,i:iClS Jam.'* l>,)!(b 1,1 F»*n. Ke\ il!i. V.cv-i 'I'.iiho.! au JLiij. F.a.cis ... . ~ \V,i-!,,. Isaac ^ici.o Is Na.ocMa \\.',u\.:l- Jmii MaiM'v ... . .1.1S. Mj|t|cli('s:i-|' ^'•'^•i'la.ii Jt..) Ju 10 .'}» I.sai; IVpjnlilay Wm. R )')ert J'ln (io i.lhaii IIiisjli t'.irii|)I)ell — Ht-sit.T — PiMSOll — i aly , — I.'itv — S'iniili Tlio-'. II )'>iii 0.1 M uy I'liwer L >i.i>a T.i.b.iiiU Will. Tiiy Tli.s. K..VC Jiihii W.llu,;p ..... ., Jamo.-* Wc^ilaii.l Jo'iii M I shall , Micfi Winkle M ell. I>,niiliy J.)S;'|.li L ii iiL- T:kk. 0,1 M/ Martin Uon'tli J.)sc|)li lv')l:ins . ,,. ., VVlll. ()' CUM Jo!l:l K.' t ,' ... Joseph D.'Liin Luke Sani-on John N •wiiian — DnlPy J tlin Ni'WMKin Cath. K 'liy IVlor 'I'lviu: I'olOllI .■.-.,11(1 J lly Jii'y Au;;. Au^. Au.;. Sept. Oct. Oct. iNov. Nov. 181'}. May 18 ay .May May May 18 27 5 22 2.) 1;» 8 10 8 9 21 2.) 31 31 Name of operation. Removal of 2 tumours Aiii|nitalioM of <|ieat toe Stiiibi.smusof ri;iht eye Hydroeeie I D.slopiition of Tomlo Achilles. Removal cf Anal Kxcreseefiie lilind Kisluiu Amputation of riijht lej; Aiii| u'aliori of lelt arm Removal of ii Polypus Ununited fracture of Hu.iierus Name of Operator. .Not ;;iven .Au^. An;. .\ u J. A 11 :. Air,'. All,'. An.:. S.'i.t. Spt. S-pt. S-p'. Oct. Oct. Oet. O.t. .5 1 1 22 2/ 2') 27 27 2» 22 1 ) 3) 'J !) !) 7 \mputation of leij For Phimosis Amputation of ureal toe Amputatiiin of linger Am; u'fttion ol finger .\nipulation of linijer ... Ampu'ation of linirer Ampu'aiion of eight toes ...... Ampuia'ion of great to,> Ri'inoval of portion of tl.u.nl). Amjuitat.on of great toi- Par.ieeiitejis abdominis For Pliimos;s .. . Aiiiiu'ition of great ton .'\rnpiratioii of IO' .\iii|iu!atio;i of three tojs Am, u'atioii of fiiig -r \iii|araiion of fin^;!r I..i!lii>liiniv Removal ofcaneer on li[) }■ Not given. iv'iinvil of 'IV'sliel.! ' 1' ^Itila in ano |lly>lio,ele I Uydioeele I Fi» til, I in ano I Anip'iit.itioii of lingT Not given .■ Catarac t .Amputation of 'iifht leg ... ., Sliuiiixnlaled olirijii ; Hernia . f/nrii eofih" fi'inora! artel y I'a:iieeri'(.s s abdominis Renio\al ol tu iiour .* nipiilation of arm ISHv. Ap/il I April l(j A pi. I 2o Airil ^• Apr I 27 Apr' ,'7 May 7 Mav \: >y Vhiy Not v v\H». ni| n'alion ol lue iii| 11 at on ol anil .. . . ii|-iil.rioM nf (he t'lig'l . inpn'alioii bi'lovv l< Mij 11 alioil ol' (ii;g •la of hand . Ulj ll',|tio«' of flOifMS il u lib of ii>>ht liiiiid . . eiiiox ill Ol eaiK-er of I p III iii.itioii !,(■ I'm ■ lo.'s . tri|'ii?a'iim of linger .... i"j ii'iition ot liii,!/er ... Ml; u'al.on at Ii e il: ifli . It; iral "U ol ^.1 at 'o.' . Ill; ii'at o I of ne ii| u a'ion of liiijjor ... . ; I •fi r.esul Mode of operation. y .\jt given, i }■ \ol given. ;! Ii 86 List of Oj)orati()ns. — (Coutinved.) B Nauic of Patient. Thos. WilUniTis . And. Cummins , .Artr.ur honiiliuc , Phil.Gli&&on .... Not givrn Hujffi Wilton .... Iticli. Ilnrris Wm. I elaney .... Nat. Ilumphiy .. Stanley .Miks .... Eliz. Koxlurgh Mm. Tiiylor ... Wm, E\ans , Kirh. D 1 1 y .., John Wilson ... Gro. Tooke Join ijiiiit'lt ... Wm. Gil(8 Iviibplt KoiiSTS... Luke Pamson ... J^'artin Joyre Wm. C uorai) Janus l]ii(.'an Joliij Aici i. on.. .. Joliii Crosiwl aile ThoF. l.avicouiit .. I'tlir .Moiiiii Thos. McNnmnra . Drnis O'Horn Adam IM f A"1o lie I.ii\o"p .... John Sen ii.-c Edward CiiiKn .... Geo. !)rl.ii| oUo Chris /^ikiM Chs. KcMniu Jame." Ihiti.s Jani4'S Day Chh-. Frm^n 'J'linf;. l'a\ ulKiri Lawn 1 ( (• Kiiri.fiiy . llci.iy Paiiy Jami's luiiLctt .Toht' Fnin ] trn JiirtK ."> I.( she .. Joiiii McL'diiilil Date operation. 1846. Not given .liily il .Fuly .'illy .lul/ •luly .lul 9 13 l.'J 14 a/ Ko N imc of opeiatior. £:i\ Name of Operator. }-Not II II 147. Jiinv. 6 .liiiy. 21 F} Oct. (J IP48. Ftby. 3 given. Fcliy. FclV. .May Miiy ,IUMP An;,'. S.,t. s..,,t. Oct. Oct. 4 (J ■M) 17 18 12 2.") 2 10 2:) 2.') Jl Pil. O'MhH y... Allu-IWaid .. Cull. ( ase Mat. ToiLliiison Oft, ( ct. Nov. Dr.-. [y if^4;). .May 24 Mny 25 ^'av '.!) VI uy •* May 2(1 .Tunc « Amputation of finger ........ Aiii) Mtalion of linucr Kcuioval of (anfpf of lip .An I nial'on ol jitrcat toe For riiimo.>ii8 r\ni| utafion ol great toe .. .. .Ani| u'ation of finger Ciitiiract I\'• : i.^nii u'ntio!) oftoi' .. ,\ mi ii'a'irii ol l'o;h less JAiDi nation ol idc^i of lolt loo! I Anil n'iiiii n of fi L;rr Aln| Ilia! (Ill ol Icj; Fi.-'ii'a n ai o .. l''ni(';tirc ol aim flydiocclc .^iuiiii;iiliilfd luTiiia I.'en o'. Ill . (■ hcriioilioidal tu- niriirs Ani| n alop of fi^cpr .All I II at on of 1 1 ulan.\ '''i;'n'a in iii o lu n;ov a! (;l ll.M.riir (-Not given. ^*n^;^ i o r«'lli'licr ... Dan Aiclv( ritu.'y 01 vjr Thomison ... June 11 A 11^'. 8 Nov. I Nov 3 IPSO ^ Fcbv. 2f) NiNliTatinii into ll c axilla .. Am) ii'al'on of | halanx Ani) niiMii II of tuo phalanges I it-loiiil nil of or.i' I. tad of Ihian r i.« forwards AiTju'a ion of pl.alanx .\iii| iitiiiicn of J halanx Anij I'talion of toe Anrjju'alion at the thit^h Removal of rnrt of lower jaw (•;)(-ia'iiiii of Tt'iioioniy .... Amputation of leg. Dr. Doiir:1as. Dr .lackfon Dr. Jackson. Dr. Uohita lie Dr. Doiiyii;.s. Dr. Doii(.Has. Dr. D. n-ias. No' civrn. Dr. Rohitiiille Dr, Hohitaille Dr. Rohilaillf Dr. Hall. Drs. JaekFon and Douglas. Dr. Hall. Dr. Hall. Dr. .Tacl>on. Dr. .'act .son. Dr. Hall. Dr Jarl .'Oil. Dr. liov. ar.d. Dr. Doiiirln.e. Or. Ha!!. Dr. DotiglaF. Re.sult. Mode of operation. ■Not given. J- Not given. Rrdnrrd. Not iri^cr^ Not given. Uoc'u'cd. > Ni'i !;i\rn. ) 1) '-ll llic.^amc day. Not ^'ivrn. Nolyixen. No; I'ivcn. %7 List of Operations. — {Continurd.) Name of I'aticn' Wm FTiiTson .... Oliver Tiio ripson JdIiii ^tepi eisoii . I.''.'ii(l Mi-K riiiisli C»th. Ciinoll .... jVl iry H iiu'-.(-y . Tliotn IS l{ii-li , ... H'^iny VV.i!;iier .. K'limi Syl\;i ... . Du ii'in Tuy'or .. David Speiu'e 3t\\n VVys,^ Joliii S-.'ii'h Ilu'.:li T if»>T)') July IJ Xanm of iipnration. Amputation of phalanx Vmru'atinn ol'l.'fi Icj Xinpiiiiiiio'i ol p'inlarix... Am Hitation o( fiiii^cr \r'ilic!»l pupil ,\nn:'U*atioii of riiiht le)» .^mpiifaton of firr:j»'f .\tnputa'ioii of thumb Kc'rop un Kxc's'oii of Pptiis Am; u'ation of tin \'ri:>ii'iiti')ii of riirht I .'g .... •) >i'.n Mtioii of' n into Urethra fr s^r'.c ture.-* D.-. Doiigla.s. D.-. J ickson. J.ick.ion. J icksoii. II 1 1. llill Dr. D,jii^!a3. Dr. Dou;:las. Dr. Jackson. \)\\ J icknori. Dr. J.ickson. Dr. Jackson. Ju'y 2.3 A'nrmUsfioT of twT fiiig(?is .., Am'u'ation of tw > phaliinge.s, Did'i-at'on of hip joint A'li, u'ation of two plialangi;.s, \iir)u'aM'oii of two pliaian^ri's iDr. Jnck.son il'lVactiin^ofm il-iinited bones! Dr. .lack.son Ampiititioti of (ingcr |Dr. Jackson \'n;Hratio:i of two pha'angcs. Dr. .lacksoti \iii;ii*atioM iif tw.) phalanges. Dr. Jack-.o:i Virirutiif'on of firiirer Dr. Jackson llenioval of 5 cncys'c.l tu- mours of eyelid .StraLi.'^nius ' Not given. Mode of operation. Rcduc 'd. '.Not given. It 'duccd. > Not given. Dr. llowand Dr. Jackson. • \' )t given. Til? f()ro:r:>*n^ tal)l(> oonlnin^ llu* Rocnrd.^of 16? op;'ratio:is pprforme:! during thr' ycirs 13 H -1 j-lO- l;-H -19->'J-51 and 53. Not ono entry is ntadt; in llie *' Lisl " lor ili;» y;' ir I -j U. M my c* xscs arc rocnrdod wilh marked brevity, !«noh a^: " Atn;) It ition of rii^Iil Ic:^ of PaM'icIv Kelly." "The left arm of Jatncs MePlu-rsm wis iim )n'a'(!,l." " Dn'lV w.is operated for strm'^nlated Hernia, " after three d iy>5 s!r mjfal itiori." " George Tooke, seaman, from the 'Geiitoo' " h:i 1 W\s x\'t'\\ eve e\iirp lied in c;)n3eqiienee of Fungus." — " A Polypus removed " fn)!n Clis.' C.'iiilr'-," &e., &c. The (I ite of ih(^ operation is not given in ihivtv one eases. The niine of the operator has be(;a omitted s;ixty-f.)ur times, and the name of the p ilieni onee. The residt of thtf op'^ration has been nolieed seven times; six out of the seven wen? re liietions of disLicated b ):ies, and ihe seventh was a record, that the pilient " died ihe, satne d ly." Tile in )Je of operation \h not mentioned in any one instance. 88 w w All that can be learned from the " List of oprrntlons" is simply this: one hnndnul and sixty two operations of various kinds have been performed during the period of nine years. 1851, Disea*)ps nsnally exiiibitinjj a low rato of inortalily : — Rhcnmntismus 100 Gastrndynia 1 Febricuhi 51 Febris Intermit 11 Dyl!lpep^«ia 3 Diarrhcea 37 Cyiianehc Tonsillaris 1 Diseases of the Skin 20 Rubeola 18 Epilepsia 1 Hystt ria 1 Neuralgia 2 Insanity 1 Otitis 1 Spermatorrhoea 1 Arnenorrhcea 1 Preimaney 18 Hcemorrhoidcs 1 F>ysipela!« 5 Siibinxalio 2 ConlUHitMis 74 1851. Diseases usually cxhibitinf^ a high or medium rale of mortality : — Fever 311 Indammation of the Lungs 55 ** of the Liver 5 « ■ of the Bowels 13 •* of the Heart 5 Gastritis 2 Dysentery £3 Variola 26 Apoplexia 1 Congestion of the Brain 3 S<^orbutus 2 Delirium Tremens 3 Paralysis 4 Nephritis 1 Cholera 162 Dropsy 4 Scrofula 3 Tyiripanilis 1 Phthisis 4 Cancer Lahii 1 Necrosis 2 Hernia 4 Gangrena Spon!an«'a I Concussion of the Brain 2 Fraci ores WoumLv; 17 Caries Max ll I one , Periostitis Catarrhus Vesica) . . . 20; Diseases of llic Eyes G95 1 1 • «••••••• I • •••■• ••• O Burns and Scalds G Frost Bite 3 Stiiitiures 3 Indamujation of Testicles 13 >ypliilis 112 Dislocations 2 Abscesses 105 Ulccis 30 035 1852. • ■ 1852. Diseases usually cNliibiting n high oi { Diseases u>-MialIy cxhibillng a low rale medium rale of morlaLiy: — i of mortaliiy :— Fever 144 i '?heumati.-mus 89 Indamrnalion (;f ilie Lungs Gi' Febricula 02 Phrenilis of ihe Liver of th(! Bowels.. . of the Heart. . .. 5' Feb. Intermittens 9| !)ijirrh 3 13 112 2 105 30 G35 rate 1852. Diseases nsimlly fxliihit'ng a high or medium rale of moitulity : — Scorbutus 2 Delirium Tremens I Paralysis 2 Cholera 121 Serofula 3 Morbus Coxarius 1 Phthisis 4 Wounds 27 Necrosis 1 Concussion of Hrain 2 Fractures 24 Dropsy 2 476 1832. Diseases usiinlly exliibitin;]' a low rate of morti I ly : — Insanity 1 Mania 1 OtorMuea 1 Piyalism 1 I Iwmori hoi Jes 3 Pregnancy 27 Eiysipelas 5 I'eitussis 2 Asthma 1 Catarrhus Vesica) 1 A bscessus 76 Subluxalio 2 Contusions 85 Periost itis 1 Diseases of the Eyes 15 Burns and Scalds 10 Frost Bile 9 Siriclures ^ 5 Hydrocele 4 Fist, in ano 1 Diseases of Ankle Joint 1 Innammation of 're>li(.;lcs 10 Syphilis Ill DislocaiioMs 3 Ulcers 34 col M'jrhillff (nil Mor.'dli'i/ vf the Quchec M iriiieawl Er.nijrdut JIjsihiuI ThD C )nir^?i;)-i-:-s of E:r|niry \\.\vvai f'lHv exiiiiia.nl th.^ RjMini of a:l nissiona, dischivr^Ds an.l djitlis, ia th? M.irinean.l Eaiioraiit IlaspiUil, far the y.ars l^^ol arid 1852. w.Tc surp.i.s.vl t;) (i v.l s:> great a ratio of mortality, aad in order to ascertain if thore were a ay a:\'i LaKal circimstx aces occnrriny; in th^su years to accoant for the fa:;t, thjy p:-acvi"e 1 fro::) the lT:)u.so Snr^rpon thc'llctnriis f)r \\v: last five years. They also p.-ocavo 1 tVoai t!ic Records of the; M.in rcaUkMicral Ilosnilal, t!ic R:>]>.)rts, f )r the c oriv'so ) a lia.;- five years.^ in order to camparc llieai wiia these f;on the Marine and EiTii iraiit II )spital. They ave divl I >.l lae diseases nan d ia l!ie Uetin-n f.-om the Qn?')-^.- TI )sj)i;al into twodasscs, lu-cause a great jiortion (.f ilicni arc larolyArA*/ (!i''22 1 2:nring precisely under the same fornis of disease, the mortality has been twice as •rrcatat the Marine Hospital as it has been at the Montreal (Jeneral Hospital. And if the years when diseases of a particularly fatal character, as typluis and cholera, be compared, we fiid that the same ratio (in round nu:n!)ers) is main- tain. >d. Thus, iii 1817, the year wlien typh\H fever rai;ed, wo find that into the Monireal G.'ucral Hosj)itaI 2001 patienis were admitted, the majority of whom were afflicted with typhus; the number of deaths amounted to 2G3, or in the proportion of 1 to 7. ^0. Dm-Jn^ the same year, the number of admissions into the Marine Hospital was 4973, of wlioni 1227 died, ^Ivin^ a proportion of 1 to 4.05, nearly doul)le that of the Montreal lnstitutii)n. If we examine the Returns for 1810, the year of c'.iolera, we obtain nearly the same results. Thus there were admitted into the Marine and Emi:j;rant IInsj);lal in the year 1849, 1493 patients, of whom 263 died, chiving a mortality of I to i\oOO. During the same year there were aduiitted into the Montreal General llospi- lal 871 patienis, of whom 79 died, or in the proportion of I to 1 1. Jhil when compared with the Iletunis of Si, PalrieU's IIosj)i:al, the difTer- cnce is still more striking The nninl)er(if admissions into the St. Patrick's Hospital from .August 16lh, 1852, when the Hospital was opened in the present building, to Februaiy 1st, lb5J, was 331, deaths — 18, or in the proportion of 1 lo 18.33. ' 91 II Is triio t!int in llw I illcr Iiittiliilion llicn* urt^ '2 ) bc-N ocriipicd liy p 'ti-'rils lalionriiis; under Oplilliliiiic (li^f;is'««, l)iii ihcn uw iim m'\iiy <>r iiicic I <•|>ital. There must be some reason for this unusual m >r'aliiy. If it depends upon the unhealthy situation of the Hospital, that cause s'lonld bo removed by changing the lo-ati* n. ' ' it (h'pends upon the medical treatim nt of the paiifMiis, the iirUtcr should be in icd into, and the usual 1re;i1iri« ni ado; led; nnd this Institution -liould be c(Miip:i with that of oilier estalj'iishiiieiit.-:. There is loo g:eat a difremuu', and ibat d , rene*.' I. >; Ik ca too well maiked !)o;h during seasons of Iii le siekncss, ;.!i I ilic:.\\(.\. S:):iie articles, such as arrowroot, s(>em to l;e oideied by lh(? Physician-! rathertoD ti<\]neally, an I in too large (|iiafiliiies lo be coitss^ent with due economy. To rmtiy of the patients this article of diet is pre-eiited for the first tim;> wh -n in the lb' w'tal ; nn I we know, from our own experi: nee of Hospital Hianagemei:l, that m niy oiIkm* ariicles of nmch less exp-n-c would be equally useful to the sick, and more palatable to ihein. (Jn th;s and a lew oiIt(>r poinls, the (JomftMs>y.e in a state of exciteine.il an I fever tlic whole day ; for it is pi'rhaps unaeeessavy io |;oinl out, that increase in the rapidity of tl:e' circulation ensues, upon \\.v. inludiuticn of food into the stomach, and continues dm ing the process of digestion ; but, Lesidcs being injurious to the patients themselves and deslruclive to regidarily. in <.ne of the most im))ortant t)f Hospital economies — the dietary — it is injuriOr:s to the funds of the Hospital. It is a fact w«dl known tothose who have had experience in Hospitals, particularly those in this conntiy, that many persons of l;izy, nulolent liabils, or who are unprovideil f)r, make excaises for remaining in Ilospiiai long offer they are cured, and they will very reluctantly U-ave that Institution wheic the diet list is a veiy generous one. '1 hoc jiersons are in the (•oll^taaI habit oithi'r of fi.'ignin^ disease, or of g'ving ex;igg(,'ral(Ml acecamls of ilio^e tl.ey uro really afllieted with, and find in j; the IIosj)iial a comfortahle residence, and its d.et go.id an I even more ample than they li;ive Leen aeeustonu'd lo, and moreover oblain.Nl gratis, they freciMcnlly m;magc! to deceivu the medical ai:en;!:int, i.nd cd\e"onl a eonsiderat)le term of residence, to the great prejudice of the Hospital interest, and to the inj uy of other p.atients who m:iy be in want of a be*! in the Insliiutioa. Tii" (/'onunissioni'is are [vrsaaded that the diet sc.de ol iIk; Marino Ho. cxtiat nrc t) be given on full, liilf or low diofs, except Wine, Porter or Spiiita- Uicac t^ b«; giviii wht-n leiiuiiud, ia cmlorniity with cxiHtiiig lleguliitiipardized by the *ent moment. The necessity for this rule is obvious. 5th. No officer of the Institution should have any interest direct or indirect with the parties supplying provisions and other aili(rles to the In.«tiluiion, and such ailicles as may be required for the edifice itself, such as wood, srone, (in and other articles employed in building and for repairs, should not be purchased under any circum.stances from officers of the Ho.xpital. These remaiks may appear unnecessary, when wc recollect ibc parties now recommended for 95 1 ; oflTicc* ; l)nt iIk' liij«lo"y of public institutions in Caniula and (jIsowIktc, shows that prccunlion on ihis subject in not nllogelher useless, and thai i'! K i 9S cine and medical comforts of all the sick admitted to the Hospital, did not exceed X200, while the pay and allowances of the staH' of military, commissioned and non-commissioned officers, employed in superintending the disbursements and keeping the accounts, exceeded considerably the amount expemled. This does not, of course, include the sums paid in hire of steamer, salary of Medical Officers, Hospital nurses and boatmen, all of which being fixed and established by the Executive Government, previous to the commencement of the season, require no supervision or control. Mijny other advantages besides those of an economical naJure would accrue from the appointment of such officer; the class of patienis admitted to both institu- tions is the same, and the Chief Agent of Emigrants, Mr. Buchanan, has repre- sented the convenience in many instances of transferring sick Emigrants or those falling ill to the Grosse Isle Hospitals, particularly those who have already num- bers of their family detained In the Quarantine Hospitals. Again, there are constantly happening cases of sickness or injuries, neither of which can be treated with safely in Hospitals devoted solely to the reception of contagious diseases, and who might be transferred to the Marine and Emigrant Hospital, Quebec. A Commissioner having superintendence over both Institutions would facilitate many such arrangements. (Signed,) Quebec, November 10th, 1853. GEO. DOUGLAS, M. D., Medical Superintendent. Although not coming within the scope of their duty, the Commissioners, take the liberty of laying before the Government the foregoing document sent to them by Dr. George Douglas, the Medical Superintendent of the Quarantine Establishment at Grosse Isle. It affords an additional argument for the necessity of a Sanitary Board, whose duty it would be to superintend, not merely the Quarantine Hospital, and that at Quebec as suggested by him, but all the Public Hospitals and Charitable Institutions of the Country, supported by or receiving assistance from Govern- ment. Until some such Board be formed, the Establishment at Grosse Isle will cost more for military services than is enough to pay " for the diet, medicine and *' medical comforts of the sick." There will every now and then be a necessity for a Commission of Enquiry into abuses, alleged or proved, to exist in Penitentiaries, Gaols, Hospitals, &c. In addition, whenever there is an outbreak of pestilence the " Central Board of Health" will have to be formed, the Medical Members of which will not readily give their services, so valuable to their own patients on these occasions, without payment — nor can the Government expect them to do so. The history of all Public Institutions proves, that it is much more easy and economical to prevent abuses than to correct them. The Government have acted wisely in applying this doctine to one of their most important Institutions — the Provincial Penitentiary — but it should be appHed to all establishments supported by Government, and it would cost the Countiy less to establish such a Board of Control, as is now alluded to, than to pay for the several Commissions to be employed in examining into the affairs of different Public Institutions. The foregoing remarks are, with the greatest respect, submitted for the con* sideration of the Executive, and the importance of the subject it is hoped will be considered sufficient apology for their introduction into this Report. The whole respectfully submitted. (Signed,) Montreal, February 2ad, 185S. WD. NELSON, M. D. ROBERT MacDONNELL, M. D. Z. FERRAULT. 99 LIST OF PAPERS. Letters and other Documents composing the Appendix to the Report of the Com- missioners appointed to enquire into the mana^rment of the Marine and Kmigrant Hospital^ Quebec. No. 1. Copy of letter from Dr. J. Crawford to S. Gerran!, Esquire, President of the Montreal General Hospital, dated lltli January, 1848. 2. Ur. Painchaud's proposal for election of Visiting Physicians. 3. Copy of Provincial Secretary's Letter, dated 17th July, 1847. 4. Circular addressed by Visiting Physicians M. and E. liosi)itjd to Medical Prac- titioners of Quebec, dated 22nd July, 1847. 5. Letter from Dr. Painchaud to Dr. Douglas, relating to appointment of six Visit- ing Physicians, dated 5th January, 1848. 6. Dr. Douglas' Letter to Provincial Secretary. 7. Dr. Marsden's Letter to Dr. Douglas, dated 5th July, 1851. 8. Dr. Douglas' reply thereto, of same date. 9. Provincial Secretary's Letter to Dr. Douglas, dated 4th July, 1851. 10. Dr. James Douglas' Letter, complaining of the conduct of the Commissioners, addressed to Provincial Secretary, dated 17th July, 1861. 11. Letter from Provincial Secretary to N. Casault, Escj., Secretary to the Marine and Emigrant Hospital, Quebec, dated 5th August, 1851. 12. Reply of the Commissioners to the Letter of Dr. Douglas, dated 30th August, 1851. 13. Letter from P. Whelan, Stewart of the Marine and Emigrant Hospital, to N. Casault, Esq., Secretary and Treasurer, dated 25th August, 1851. 14. Letter from the Secretary of the Marine and Emigrant Hospital to the Honorable Provincial Secretary, dated 4th Sept., 1851. 15. Letter from Dr. Painchaud to the Secretary of the Marine and Emigrant Hos- pital, dated 25th August, 1851. 16. Letter from Secretary of the Marine and Emigrant Hospital to Honorable Pro- vincial Secrr^tary, dated 18-19th August, 1852. 17. Letter from Honorable Provincial Secretary to the Secretary of the Marine and Emigrant Hospital, dated 21st August, 1852. 18. Letter from the Commissioners of the Marine and Emigrant Hospital to the Honorable Provincial Secretary, dated 24-25th August, 1852. 19. Letter from Dr. Fremont to Dr. J. Douglas, dated 9th November, 1852. 20. Letter from H. Gowen, Esq., to Dr. J. Douglas, dated 9th November, 1852. 21. Letter from Dr. Lemieux in the case of Lawson, dated 12th November, 1852. 22. Copy of Minutes of Post Mortem examination of William Lawson, who died in the Marine and Emigrant Hospital on the 21st January, 1852. 23. Dr. Robitaille's Letter relating to Lawson's case, dated 20th November, 1862. 24. Dr. Jackson's Letter to Dr. J. Douglas, referring to case of Lawson, dated 17th November, 1852. 25. Letter from Dr. Douglas to Dr. Hall, referring to case of Lawson, dated 15th November, 1852. 26. Dr. Hall's Letter to Dr. Douglas, relative to case of Lawson, dated 2l8t July, 1851. 27. Petition of Dr. L. F. Chaperon to His Excellency the Governor General. 28. Statement of Expenditure on account of the Marine and Emigrant Hospital for years 1849, 1850 and 1851. 29. Return of all patients admitted into the Marine and Emigrant Hospital from 1st January to 31st December, 1851. 30. Return of all patients admitted into the Marme and Emigrant Hospital from 1st January to 27th November, 1852. 100 ArPENDIX. jLcttcrfrom. Dr. J. Crawford to S. (werrardj Esquire, Prrsidnit of the Mmitrcol General Hospital, dated 1 Uh Januart/, 1848. Sir, — In reply to your enquiry with respect to the manner the duties of Montreal General Hospital are conducted, I beg to say, that the Physicians who are now twelve in number, are elected by the Governors of the Iiistilution, and by arrangement between themselves, they attend by two at a time for two months, during which period they have the entire management of the sick, each taking charge of one half of the Wards, and receiving patients alternately by weeks into their own portion of the wards. During their periods of attendiince, they have the aid and advice of their colleagues in consultation, if required, but are not interfered with. There is no distinction made between medical and surgical cases, unless it be by private arrangement. (Signed,) J. CRAWFORD, M.D., Physician to the Montreal General Hospital. (No. 2.) Dr. Painchaud's proposal to appoint six Visiting Physicians, dated Quebec, 21st July, 1847. The following is the scheme which Dr Painchaud would adopt in conformity with the desire of His Excellency, conveyed in the letter of the Provincial Secre- tary, dated the 17th instant : Should Messrs. Douglas & Racey desire th adoption of another, they will be good enouph to communicate it to Dr. P., otherwise the present scheme will be carried out. (Signed,) J. PAINCHAUD, Visiting Physician, Q. M. H, Messrs. Douglas & Racey, Physicians, Q. M. H. (No. 3.) Official Letter dated Secretary's Office. MoNTRBAL, VI th July, 1847. Sir, — I have the honor to convey to your fellow Visiting Physicians of the Marine and Emigrant Hospital, the Governor General's desire that you should make it known to the Faculty of Quebec, that you are authorized to select six Physicians to assist you in your duties, but on the distinct understanding that services so rendered will not entitle them to any remuneration, as His Excellency cannot but believe, that many members of the Faculty will be ready to avail themselves of the professional advantage which the practice of such an Hospital will afl'ord them. His Excellency understands that at Montreal, the Physicians are anxious to afford their gratuitous services in the General Hospital, solely for the professional advantage to be gained thereby, and there exists in the Hospital practijce at Quebec a superior advantage over that at Montreal. I have, &c. (Signed,) D. DALY, Secretary. 101 Circular Latter adilnssrd hj Visithv^ Phi/sichnis to I j( fiat I J'rftr- titioHcrs of Quehcc on the sul^Jcct of nomlnutlny six other V'isitimj J*/t//.sieians, (fated 2'2n(l Jul//, 1847. (Trans/fit ion.) GENTr.KMK.v, It hcliii^tlie (If.sir(M)f IlisT'lxocllciicy llic; (lovfrnorCJoncialtonfld six to tlu! iimiilxT ol' ilu; Visirni<«; PliysitMiiiisoC ilu' Miiriiu; Ilospilal, iiiid in order tlicrcto, Mis lOxecllciury luvvini^ aiUliori/iHl us to select six members of tlic prolcssion in Qiieliee, we would retpiest of you to inform us in writint^, wlielli'ir you would accept the said olHce of Visiting Physician to the Murine Hospital. We have the honor to be, Gentlemen, Your very obedient servants, (Signed) JOSEPH PAINCHAND, JAMES DOUGLAS, To the Quebec JOHN R^CEY, Practitioners. Visiting Physicians lo the Marine Hospital. (No. 5.) Letter from Dr. Painchnud to Dr. Domjlas relating to appointment of Six Visiting Phf/sicians, dated 5th January, 1848. ( Translation.) My Dear Doctor, — Your pretending ignorance is very unfortunate. What ! After having, with me, appointed Visiting Physicians who have all accepted, you now ask me who they are? I have added this time the word " Surgeon" to the words " Visiting Physicians" to make the newly appointed Visitors clearly understand, that this general style of designating the Visiting Physicians and Surgeons, in ollicial and other commu- nications only by the short term of Visiting Physicians, is applied to those parties appointed to attend and prescribe without exception tlironglioiit tin; whole Hospital. I am aware that some of these gentlemen are under the impression that reference will to-day be made to this subject, and that an altemj)t will be made to separate the department of Surgery from that of Medicine, that is to say, that there shall be a Visiting Surgeon, and that the others shall be Visiting Physicians, an arrangement never intended by Government, as I have been informed at the Government Offices. I shall require the official communication of the Commissioners. Send it back if you please before noon. Ever yours, (Signed,) JOSEPH PAINCHAUD. (No. 6.) Letter from Dr. Douglas to the Hon. D. Dalg, Provincial Secrefarg. Sm, — Dr. Painchaud has given me communication of your Letter, authoriz- ing him with Dr. Racey and myself to appoint six Visiting Physicians to assist us in our duties in the Hospital, without remuneration. Dr. Painchaud is under the impression that these six gentlemen so to be appointed will form psirt of the permanent Medical Staff of the Hospital. Dr. Racey and I dilfer on the interpretation of your letter. !Sir, in the Hospital we require no assistance ; the duties just now are arduous, but even without a successor to Dr. Fremont, we can perform them. The sheds, 102 liowc'vor, pross loo lioavily on our liiiip, and wo liitve latterly liccn in liopo that one additional nu'difid man, with pny, 2()s. per dirm, wonld have hvvn appoititrd by the Connriissioncrs, to assist us. This is all we nMinirt* at first, and all \vc will likely ro(|nire iliis sea-on. The medical men, wliem yu 'uithorize us to appoint, will, I doubt not, oljject to do duty in the sh^-ds, as not Ibrminf,' part ol' the Hospital. The members of the profession here of hi.<,her standing', and who woidd be of advantage to the Hospital will not, I am s.itisfied, aceept under present cireum- stances, and an addition of six of die junior members of the profession would be worse than useless. In fact, this Hospital would not work ; nine Physicians loan Hospital such as the Marine Hospital, is at present out of all proportion to its size and wants. Some time since, the charter of a medical school, in coimection with the Hospital was granted by the Legislature, and it was contem])lated by the Faculty to recommend to His Excellency the appointment of the gentlemen who could be the Lecturers. The present plan would seriously impede this very desirable object, and would exclude Drs. Blanehet, Morriii, Rowley, Nault, Sewell, Jackson and odiers. There will be no difficulty in finding a Medical man of good standing to fill up the situation vacated by Dr. Parent. It is, however, necessary at present, and 1 would respectfully recommend that under existing circumstances, that ap- pointment be deferred until next winter when with likelihood the Medical School will be authorised. I am authorized by Drs. Morrin & Parent to state, that they entirely concur in the remarks I have here submitted to you. I will endeavour to induce Dr. P. to suspend any action in the appointment of the six additional "Visiting Physicians, until I bear from you, that it is His Excellency's pleasure, that such appointments be made, and that the Visiting Physicians so to be appointed, form part of the present medical staff' of the Hospital. (Signed,) J. DOUGLAS. (No. 7.) Letter from Dr. Wm. Marsden to Dr. Douglas dated 6fhJu1t/, 1851. Sir, — Will you inform me whether, during your long and valual)le connec- tion with the Marine and Emigrant Hospital, any rule or law existt d prohibiting medical gentlemen from attending the Hospital, during the regular medical visit hour, or whether in point of fact any medical gentleman was ever refused ad- mission at any of these limes to your knowledge. (Signed,) W. MARSDEN, M. D. No. 8. Bejjhj cfDr. Douglas to the above, dated bfh Jul/, 1851. No medical gentleman has ever been refused admission to the wards of the Marine Hospital during the regular limes of visit, and I am not aw.r that any rule existed prohibiting medical practitioners from attending the p:^.ace of the Hospital at these times. I am. Sir, (Signed,) JAS. DOUGLAS. 103 (No. 9.) 8k('ukta uy's Okkhk, ToKo.NTo, .Inly 4thj 1H5I. Sir,— Willi reference to the eorrespondenee wliieli liiis jilreiidy tiikeri place between the Government and the Visitiiii^ Physicians ol the Mnrine and Krni- graiit llospittd at Qiiebe<', an also with the (Quebec Hoard of Triide, in relation to certain chari^cs brou^dit by thone Hodies nfjfainst the iidininistration and man- agement of that Institution, I have the honor to state that a llep<)rt of a full in- vestigation made by the Commissioners has been received by His Kxcellency the Governor General. As your ccnduct in connection with the above mentioned charges is severely censure(l and condemned by the Commissioners, His Excellency before taking final action upon their Report, has commanchul me to transmit to you a copy of these charges, in order to atlorfl you an opportunity of giving such explanations as you may deem proper to otFer to any parts thereof which a|>pear to allecl your conduct. I am at the same time commanded to draw your special attention to that portion of the Report which states that "there cannot bo any good understantling, " mutual assistance, or harmony between J)r. Douglas and the Commissioners, and that prompt measures on the part of His Excellencry are necessary to do away with a state of things so much the more dangerous, as the season of navi- gation is connnenccd, and as the active co-operation of all the oiiicers of the Institution will be promptly and unavoidably inditij)ensable." I have, &c., (Signed,) J. LESLIE, Secretary. Dr. Douglas, Quebec. (No. 10.) » jDr. James Douylas Letter (omphihihiij of the cnidiict of the Con , ,n issioners. QuEHEC, Mill Jnly^ 1851. Sir, — I have the honor to acknowledge receipt of your communication of the 4lh instant, inclosing copy of a Heport of Counnissioncrs of the Marine Hospital. The papers, throngli mistake, were transmitted to Grossc Isle, and only reached me yesterday. In conformity with Ilis Excellency's desire |that I should furnish him with any remarks or explanations on the Commissioners' Report, I beg very respectfully to reply that I know nothing whatever of the aflidiivits transmitted to the Commissioners by Dr. VV". Marsdcn. I have had no coiDmunication with Dr. Marsden on this matter, directly or indirectly. I have not seen the allidavits, and I do not know the parties who made tliem. With regard to the correspondence with the Board of Trade with which the Commissioners have been pleased to identify me, I beg to assure you that 1. am not tlio S'^cretary to that Body. I have nol now or never had any correspondence or connexion wi"h the Board either verliaiiy or in writing. I do not know the rnemhers I n(!ver conversed with anyone of thorn on the alVairs of the ]Ios])ital, knowing him to be a member of the Board, with the single exception of Mr. Dean, whom I know very slightly ; he called on me during the period \yhen the affairs of the Hospital were the subject of newsi)aper discussion, to inquire about some transactions •relative to the monies of the patients, and to the diet and I! •|.-rt 104 treatment of the seamen in the Hospital. F have since ihon twice met Mr. Dean and conversed with him, bnt the subject of ti)e Hospital, or of its attaches, was not alluded to. I am charged bv the Commissioners willi havlnij unjustly attacked and calumnialed them; liiis slatenicnt is utterly without foundation, and injustice lo me. 1 hope they will be prepared to state when, wluMe and to whom I ever spoke (lisvesp'^cllully of tlH'm,iis my chnvacler and moliv^ s as Visiting' Physician have been jjupiiL^ncd by the Co i.inissioners. I consider it a matter of strict justice to myself to submit fully and faiily to His Excellency the state and man- agement of the Hospital, since the a[)pointment of the oresent Commissioners. These gentlemen, in their Report, have made certain assertions on matters, in which they could have taken, but did not take, any evidence whatever. On other matters, vitally afTectingthe interests of the Hospital, they carefully avoided calling such evidence as would have elicited the truth. To some of the evidence taken they have given a meaning not intended by the witnesses, but tending to mislead His Excellency, as to the state and efficiency of the Hospital, under their management. This Report, moreover, wants the signature of the President of the Board, and of the only individual in the Commission who fully understands its management, and knows the wants and requirements of an Hospital. As to the moral conduct of the employes, it is a matter more immediately under the guardianship of the Commissioners; it is, however, the duty of the Visiting Physicians, should they see or suspect anything amiss, to call the attention of the Commissioners to it ; and it is obviously their duty to lose no time in instituting an enquiry. In November last I twice waited formally on the Chair- man, and stated to him that great irregularities and abuses existed in the Hospital, and which demanded an immediate investigation by the Commissioners. ! also waited personally on Mr. Cazeau, the Secretary, and stated to him that I had a communication to make to the Commissioners on the state and conduct of the Hospital, and beg that he would aflbrd me an occasion of doing so. He informed me that he had not power to call the Commissioners together. I then requested to be notified of their first meeting, to be aflbrded an opportunity of being heard. This opportunity has not been all'orded to me ; no enquiry has yet been made into these irregu'arities and abuses, and 1 have not been even asked by the Commissioners to state what they were. With respect to conversions, although as Visiting Physician, I have no!hing to do with the religious belief of the patients ; I am aware that conversions, so called, have been effected. With the particular views which the Roman Catholic Church entertains of the efficacy of certain rights and ceremonials before death, it is to be expected that its clergy should consider it to be a paramount duty to effect as many conversions as possible. It is, however, the business of the Pro- testant Clergy to look after their own flocks, and to take such steps as will pre- vent any undue or unfair influence being exerted upon them. A few weeks be- fore the appointment of the present Commissioners, a rule was made, directing Pro- testant patients to be placed in separate wards, and attended by Protestant nurses. This rule was made on tl>e complaint of the Lord Bishop of Montreal — that Pro- testant |)atients were improperly interfered with. I do not know why this reason- able and proper rule has not been persevered ».:, as it certainly would have obviated the present difficulties about interferinir about the religious belief of the patients. " With respect to the interments, I had heard that at different times two " bodies had been buried in the same coffin. As, however, that had been a " matter of hearsay, I did not consider it to be my duly lo inlbrin the Commls- " sioners until the fact came to my personal knowledge." I then infcrmed the Chairman of the Commissioners, that two bodies had been buried together, under circumstances the most revolting. This is neiiher the, first nor the second 105 time the character of the Hospital has suiTcred by such malpractice ; two years ago they were the subject of enquiry in Court. This particular aftUir yet remains to be enquired into. The Commissioners, in their Report, have not stated all they know on ilie subject. They refer to the evidence of Messrs. Godbout and Pelle- tier as altdcJiea of llie Hos()ital, and whose names I now hear for the first time. With respccl to that partof tiie Ile|)()it, refcrriii!^ to the vvidence of Drs. .Jackson and Hall, their note will prove that their testimony has been nio^t improj)erly travestied, and that they have not stultified themselves by ollicialiy stating a fact one day, and being induced to deny it the next. In their Report tlie Commis- sioners slate that " they consider it useless to repeat here the answer given by " them to complaints of Visiting Physicians." This tends to mislead His Excel- lency, by conveying an impression that they did answer the repeated complaints of Visiting Physicians. On no occasion did they answer, either verbally or in writing any one of the repeated requests and complaints of the Visiting Physi- cians. Even the confession of faith by the Commissioners tends to mislead His Excellency. Captain Alleyn ought to have remained silent on this matter, or to have stated that his associations and feelings were altogether Catholic, and that he attended exclusively the Catholic Church. From the time of the Report — from the refusal to receive evidence tendered to them — from the very improper color to evidence taken — from the anxiety to avoid subjects unfavorable to, and dwell on' matters favorable to those whose conduct was the subject of enquiry, I am compelled to express my conviction that in this investigation the Commissioners were anxious to screen the parties and to escape themselves, fn^m a dilemma in which their dereliction of duty and mismanage- ment of a valuable Institution had placed them. However estimable and capable the Commissioners may have been in private life, an enquiry into the state and conduct of the Hospital during the past two years will satisfy His Excellency of their utter vnfilm v to manage so important a trust. On this day suits are pending, and a Bill is bi fore the Grand Jury, con- nected with most disgraceful scenes which took place in the female wards of the Hospital. And a letter from the Visiting Physician in charge, dated 5th instant, and demanding instructions from the Commissioners, has, like all other demands on their attention, been disregarded and unanswered. My own conduct as Visiting Physician will bear the strictest examination. As Visiting Physician, I have invariably identified myself with the interest of the Hospital, and have done my duty uninfluenced by fear or favor for any one. The only, instance in which I feel I have erred was in not earlic! submitting the state and condition of the Hospital to His Excellency. I now beg leave most respectfully, but most distinctly, to assure His Excel- lency that the charges and insinuations against me as a Visiting Physician, con- tained in the Commissioner's Report, are utterly without foundation, and not based on one tittle of evidence. Of Jane Hamilton, whose name has been in my opinion most injudiciously associated with the House Surgeon, I know nothing whatever, my duties being confinfd to a different flat of the Hospital. I have many months ago, inmy examination of Mr. Cutter's case, stated to the Commis- sioners themselves, at a full Board, that of Mr. Beaubien's conduct in the Hospital 1 knew little. That Dr. Lemieux had proved hjmself to be a capital House Surgeon, and that if the twain had been guilty of the irregularities and mal- practice attributed to them, it was only what m ght have been expected from young men under their peculiar circumstances, placed as they were in an institu- tion unchecked, irresponsible anl neglected by Commissioners. I now trust to His Excellency's sense of jnstice, and to his expressed anxiety for the welfare of so important an Institution, that he will be pleased to cause such enquiry to be made as will afford me an opportunity of vindicating my character, so unjustly aspersed, and what is of far more consequence, as will place '\ 106 m the Hospital itself on such a footing of nsofnlness and respeclablity as it ought to possess, and as it did possess some years ago. I have the honor to be, Sir, Your most obedient servant, (Signed,) J. DOUGLAS. The Honorable James Leslie, Provincial Secretary. (No. 11.) Sechktary's Office, Toronto, bth August^ 1851. Gentlemen, — I have the honor to enclose to you by coitimand of His Excel- lency the Governor General, for such remarks as you may see fit to make thereon, the accompanying copy of a letter received from Dr. Douglas, with reference to the Report of ihe investigation made by you into the state and management of the Marine and Emigrant Hospital. I have &c., The Commissioners of the Marine and Emigrant Hospital, Quebec, To N. Casault, Esquire, Secretary. (Signed,) J. LESLIE, Secretary. (No. 12.) Reply of the Commissioners to the Tstter of Dr. Douglas. Marine Hospital^ Quebec, ^Oth August, 1852. Sir, — We have the honor to acknowledge the receipt of your letter of the 5th instant, which accompanies the copy of a letter from Dr. James Douglas, relative to the Report made upon the conduct of the House Surgeon, the Apothe- cary and one of the Nurses of the Marine Hospital, and which you addressed to us by order of His Excellency for such remarks as we might think proper. A reply to all that is said by Dr. Douglas is to be found both in the answers before given by us to the complaints of three of the Visiting Physicians of the Hospital, and in the investigation concerning Mr. Cutter and that concerning the House Surgeon and those who were accused with him. The Commissioners never pretended to say that Dr. Douglas was Secretary to the Board of Trade, but that he was the secret agent who caused that body to act. And this conviction which was generally felt, was more specially founded upon the letters of the Board of Trade of the 29th January and 3rd March last, and upon those of the Visiting Physicians of the 27th January and 27th February last, which bear so striking a resemblance not only in the complaints which are ab- solutely the same but even in certain parts of the phraseology itself. That Dr. James Douglas unjustly attacked the Commissioners, that he has calumniated them, that he has shamelessly trriduccd them to Government is proved by the answers made by the Commissioners on the 31st March last to the complaints addressed to the Executive by Drs. Douglas. Hall and Jackson, and by the letters in which Drs. Painchaud, Rowand and Robitaille, (30th January and 3rd February, 1850,) inform His Excellency that they had been " honteusemenC 107 " induits en errcKr"*^ by Dr. Douglas, who by that means had caused tlicm to com- plain of abuses and grievances which did not exist ; and also, lately, by the letter which forms the subject of this answer. Though the Commissioners availed themselves of the opportunity afforded them during the last investigation to enquire into the truth of some of the com- plaints preferred against the Hospital, yet the enquiry was not made into the mii'iagement of the Institution, but into the conduct of some oflicers and servants who were accused and incriminated. And upon referring to the letter addressed by you, on the 21st March last, to the Board of Trade, a copy of which was addressed to the Commissioners, His Excellency will perceive that in confining their investigation to that subject only, the Commissioners took the same view of the matter as Government did. As to the absence of the signature of the President of the Commission, it is •imply due to that gentleman being absent from Quebec when the Report was sent up. And had it not been that the Report was asked for by a telegraphic despatch, and that they were informed by one of his household that he would not be back before ten or twelve days, the other members of the Commission would probably have awaited his return, so as to procure his approbation in addressing to His Excellency a document of such importance. The Commissioners have already had occasion to inform His Excellency in their letter of the 31st March last, that Dr. Douglas always refused to put in writing, and officially submit to the Commission his remarks upon the pretended abuses of which, at two ditferent times, and in the course of conversations, he spoke to the President of the Commission ; and also that the conversation with the Secretary spoken of by Dr. Douglas had only reference to some knives and forks which he said the Hospital wanted. It remains now with them to show, as they will presently, the object of those conversations. The Commissioners never denied that conversions to the Roman Catholic Religion took place in the Hospital, but they formally denied that any of the officers or persons employed in the Institution ever took part in, or encouraged it. As to the rule spoken of by Dr. Douglas, the want of rooms, and the increase of expenses which the enforcing of such a rule would cause, render it impossible ; and it has never existed, as may be ascertained by reference to the accompanying letters of Dr. Painchaud and Mr. Whelan. The ^lan mentioned by Dr. Douglas, having been suggested by the Lord Bishop of Montreal, the then Commissioners left it with the Visiting Physician to carry it into eileet, if possible and practicable. If it has not been followed, the blame should fall on these latter gentlemen, who are solely charged with the classification of the diseases and patients. As to the interments, the rules of the Establishment and the investigation upon the House Surgeon's conduct, sufficiently prove that the fault in that case remained with the then Steward, Mr. Cutter, whoin His Excellency has since thought proper to dismiss from his office. The Commissioners can only assure His Excellency that it has not since occurred. Dr. Douglas states that the fact of two bodies being buried in one coffin came to his personal knowledge : but how did it come to his knowledge? If it was before interment, why did he not prevent it ? If it is by opening the graves in the Burial Ground of an Institution of which he is an officer, who is the more to be blamed, the ollicer who put two bodies in one coffin, or the one who opened the graves? In that lalier case the Commissioners would not be surprised at his obstinate refusal to address the Commission officially, but would be very much surprised at his alhuiing 1o a fact of a similar nature which happened two years ago, and which was laid at the time before Government. During the absence of Mr. Beaubien, caused by illness, Mr. Godbout and Mr. Pelletier, both at difierent times fulfilled the duties of Apothecary, the one 108 from the 30th of September until the micMle of November, 1849, nnd the other from the end ol June to the end of July, 1850, as established by the evifh'nee of those two «»entlemen in the investigation on Dr. Leinienx's oonduet. The Com- missioners did nt)l think that for the tcmiuirary snbsiitiition of these genllemen in his phiee, llu!y were bound to consult tlie Visiting Physieians. As \o that part of tlie Rej)ort rehiting to the ti'sliniony of the Visiting Pliysi- eians, and parlieularly that of Drs. Hall and Jackson, the Commissioners beg to refer again to tlu; answers of these gentlemen as dictated by themselves during the absence of the Secretary, Mr. Casault, to his partner Mr. Langlois, and to which they appended their signatures afier having read them. If they are susceptible of any other construction than the one put upon them by the Com- missioners, in the Report in question, they will cknowledge they had the inten- tion of misleading His Excellency, but if on the contrary their answers are formal and direct, it must of necessity be acknowledged that they were misled into the complaints they were made to sign. The Commissioners did not answer the complaints made to them by the Visiting Physicians, for the simple reason that they never addressed them any complaints, and that the only letter which they received, in December, 1850, re- quired no answer, having merely reference to a rule, which had long existed and which had then for the first time been found fault with, and the wants of the Hospital for the ensuing spring. The first was immediately attended to, and tne latter in due time as already mentioned by the Commissioners, in their letter of the 31st March, 1851. It is true that what they did answer was not com- plaints, but unjust and calumnious attacks addressed against them to the Govern- ment by three of the Visiting Physicians, under the guidance and directions of Dr. Douglas, one of them, as is proved by the document forwarded to His Excel- lency by Dr. Painchaud. It must appear more than strange that Dr. Douglas should try to imjjose upon Captain Alleyn, religious convictions which this gentleman has declared not to be his; and it would not have merited an answer, were it not that Captain Alleyn was desirous of stating that he belongs to the Protestant Religion, which he be- lieves not to be inconsistent with the religious faith of his children, and the respect and friendship he feels for certain Ministers of the Roman Catholic Church The Commissioners have not shewn favor nor protection to any person, not more to Dr. Lemieux than, to Mr. Cutter They were only desirous of shewing justice. They have heard and they caused to come before them for the purpose of examination, all those persons whom they thought likely to be able to give them any information upon the conduct of those officers of the Institution who were accused. They rejected hearsaj" evidence, as a species of proof unjust towards the accused and unfit to enable to come at the truth. The evidence before Gov- ernment, and more particularly the Report on t\m investigation concerning Mr. Cutter, sulficienlly prove that the Commissioners did not " screen" the guilty party so as to conceal their own mismanagement. Dr. Douglas should have left to the person who had a right to complain the duty of doing so; he should have left to the gMitleman who had been insulted by Dr. Marsden ; he should have left to the person whose orders were slighted, who was ignominiously dragged before Courts of Justice for having done his duty, and expelled from the Hospital a person who caused disturbances and dis- graceful scenes in the female wards of the Hospital ; in one word he should have left to Dr. Painchaud the care of saying, if tlie conduct of the Commissioners on that occasion was condemnable, and if ihey did not do all that could be expecied from them. Dr. Douglas is the last who should have alluded to those disgraceful scenes, after ha ing as he did, informed Dr. Marsden, by a letter produced by that gentleman in a Court of Justice, that there was no rule or order forbidding him an admittance, though he had himself given an order to that ellecl in the 109 preseiico of Dr. Landry. Above all, Dr. Dongla;^ should have given to his lotler a date which was not that upon which must have been written (as may be ascer- tained by reference to the date of the letters of Drs. Hall and Jackson, upon which he comments, his being dated the I7lh and theirs the 21st) to state that theCom- misyioners had not yet answered Dr. Painchaud's letter on that subject. The Commissioners would wish to believe Dr. Douglas ; they would, for his sake, that all he alleges having said about Dr. Lemieux and Dr. Bcaubien in the investigations concerning Mr. Cutter, should have been really mentioned. They feel desirous that the Visiting Physicians and Dr. Douglas, who should visit the Hospital every day and make a Heport to the Commissioners of all improprieties of conduct there, had warned them of those mal-practices and irregularities. Every one would then have done his duty. Mr. Cutler would not then have committed all the disorders of which he has been proved guilty, and Dr. Douglas would not have " shamefully led his confreres into error," spread calumnious reports con- cerning the Hospital, and excited the public against the Institution. Dr. Douglas in speaking of the manner in which he has discharged his duties as Visiting Physician, of the manner in which the Hospital was conducted when he commanded there as sole master, when almost every body in it was his creature, and when all was done accoding to his will, obliges the Commissioners once more to repeat that he has not discharged his duties, and that he has always tried to render the task imposed upon them difficult and arduous. The Commis- sioners pray His Excellency to refer to the letter addressed by Dr. Douglas to the Provincial Secretary after the nomination of the other Visiting Physicians. From that time which was previous to the appointment of the present Commission, he has not only shewn a want of good will, but he has not given the assistance which was of right to be expected from him in the management of the Hospital. The Commissioners feel themselves under the necessity of stating what is already established in their answers to the charges of three Visiting Physicians, that Dr. Douglas did not make his visits regularly, and did not give the information upon the abuses and wants of the Hospital, which the rules of the establisfiment and his office of paid Visiting Physician required, more particularly, from him. The Commissioners may in justice be led to suppose that the complaints which Dr. Douglas states had been made by him in the course of conversation with the President, and which he formerly refused to put down in writing and address officially to the Commission were the consequent effects of a plan formed before hand, and were necessarily to precede the complaints of the Visiting Phy- sicians and of the Board of Trade. For why obstinately refuse to put his com- plaints down in writing ? And why when his quarter had begun on the fifteenth of August and was to finish on the fifteenth of November, wait till that last month before addressing the President of the Commission.' Dr. Douglas took charge of the Hospital at a time when there were a great number of patients, and after having suffered to go on during nearly three months, the alleged abuses, impro- prieties, dereliction of duty and mal-practices, which must have come to his knowledge, if he did his duty, he comes when his time of attendance is nearly over, when the number of patients is considerably diminished, and then, for the first time, complains of the quality of the diet and of the want of knives and forks for the patients ; for to that alone were his verbal communications confined . About one month after December, 1850, at a time when there were but very few patients in the Hospital, and while the Commissioners were engaged in the investigation on Mr. Cutter, Dr. Douglas gets the other Visiting Physicians to sign a letter informing the Commission that a certain rule for the admission of the friends of the patients had lately led to abuses, and that the Hospital wanted bedsteads, bid- ding and clothing. Without having addressed any other communcation to the Commissioners for more than eighteen months previous, Dr. Douglas gets again the Visiting Physicians to complain to Government, on the 27th January following, !' i I 1 1- • I' I R 1 110 that their repeated requisitions and their claims on the attention of the Commis- sioners had equally been disregarded ; and two days later the Board of Trade also addressed complaints to Government. Three of the Visiting Physicians have subsequently denied the charges a*^ \ said that they had been " honteusemctU " induits en erreur " by Dr. Douglas. The Board of Trade must then also have been led into error ; and by whom ? Is it by three Visiting Physicians who withdrew their signatures? Is it by the two others who acknowledged dur- ing investigation that they knew of nothing going wrong? or is it by the one who had already for the same purpose " shamefully led his confreres into error ?" The facts speaks for themselves, and must convince His Excellency of the dispositions and intentions of Dr. Douglas and of the truth of his assertions. W^e have the honor to be, Sir, Your most obedient servants, (Signed,) t( iC (( iC The Hon. J. Leslie, Provincial Secretary. JOS. MORRIN, RICHD. J. ALLEYN, J. J. NESBITT, F. X. PARADIS, T. KELLY. N. CA<»Aur.T, S.T.C.M.E.H. (No. 13.) Marine and Emigrant Hospital, Quebec, 25th August^ 1851. Sir, — In reply to your letter of the 19th instant, received this moment, I hasten to reply. I am asked, " whether at any time there has been a rule in the " Hospital, directing Protestant patients to be placed in separate wards, and at- " tended by Protestant nurses, and to state if it has ever been enforced, and when " and how long ; and also, to state when and for what reason this rule ceased to " be persevered in ; also, if there has been any other rule respecting the classifi- " cation of Protestants or Catholics, to state what it was, when and how long it " was enforced, and when and for what reason it ceased to be enforced ?" I have the honor to inform you. Sir, that I have no recollection or experience of any such rule being either established or acted upon in the Marine Hospital ; but I recollect that the subject had been merely spoken about and suggested by different parties (particularly in 1847) but never was carried into etfect in any manner. I have the honor to be, Sir, Your obedient servant, (Signed,) P. WHELAN, Steward M. & £. H. N. Casault, Esqr., . , , * ,. S. T. M. E. Hospital, ;•■.;/■' Quebec. * , , :* ■-• ' -' < -.v Ill T (No. 14.) {Translation.) Marine Hospital, QuFBEc, Ath Srpf ember, 1852. Sir, — I have just discovered that I have omitted lo annex to the papers I had the honor to transmit to you yesterday, the aceompanying letter from Dr. Pain- chaud, whi 'i is referred to in the letter of the Commissioners. 1 have the honor to be, Sir, Your very obedient servant, (Signed,) N. CASAULT, S. T. M. & E. H. The Hon. James Leslie, Provincial Secretary. (No. 16.) {Translation.) Quebec, libth August, 1851. Sir, — In answer to your letter bearing date the 19th instant, requesting me on the part of the Commissioners of the Marine Hospital, to inform them as to whether any regulation was ever in force with respect to the classification of Catholics and Protestants, and also to state at what period and for what reason, and upon who? e order this rule was observed, I have the honor to inform you for the information of the Commissioners, that no other rule has ever existed with respect to the classification of Catholics and Protestants than that at present ob- served, that is to say, that a ticket is affixed to the head of each bed upon which are inscribed the name, country and religious faith of the patient. In 1847 the President of the former Commission expressed to us the desire of His Lordship the Bishop of Montreal, with respect to the classification of the patients in the Hospital, that the Protestants and Catholics should be placed in separate wards ; the President requested us at the same time to inform the Commis- sioners whether this classification occasioned any inconvenience or addi- tional expense. My two colleagues, Drs. James Douglas and John Racey, were desirous of returning a favorable answer to the scheme of His Lordship ; for myself I was of a contrary opinion ; I did not think the thing practicable, and more particularly at certain seasons of the year ; but in order to offer no opposition to a trial of the plan, I signed with my colleagues, and there the matter dropped. I have the honor to be, Sir, Your very humble and obedient servant, (Signed,) JOS. PAINCHAUD, V. P. Q. M. H. N. Casault, Esquire, S. M. E. H., Quebec. (No. 16.) Marine Hospital, Quebec, 18-1 9om the 15th August to the 4th September, the patient was not seen by any of the Visiting Physicians. It was at this dale that Dr. Douglas, during his visit, asked me who was attending the patient. I answered him that nobody had seen him but myself, and that I had continued the same treatment prescribed by Dr. Rowand at the termination of the quarter. Dr. Douglas then replied, " I do not care who has charge of tho patient, but at " all events something must be done for him." He then completely and carefully examined the limb, ordered the long splint to be removed, as being now useless, because the patient could not endure any extension, and desired me to place the patient upon a double inclined plane, continuing the cataplasm and wine. From this time I considered the patient as under his care ; for every day, at his visit, he stopped at his bed as at the others, which he had not done for three weeks pre- vious, that is since the commencement of his quarter. On the 8th September, the patient complained to Dr. Douglas that he was tired of wine ; he then pre- scribed porter, which was continued for a very long time. On the 16th, a ban- dage was applied to the limb, allowing a space between the folds for the escape of matter. A liniment was also prescribed on the same day for pains of which he complained in other parts of his body. On the 21st October the Dr. prescribed for Diarrhoea; Rhaeicomp. gr. ij., Doveri gr. ij., tei die. On the 18th October, Tr. Camphorae comp. drachm i. h. s. 116 On tho 26th Ocfobrr, Rhn;! comp. gr. Ij., Doverl gr. ij., tor dio. Tho palii'iit coMliniu'd to be under Dr. DoiigluH' care till ihi; 8th November, 1852, when I took very 111. During all this time I do not n-eollfcit tliat Dr. Douglas ever proposed amputation of the limb to the patient, but I distinctly recollect that the Do(ior in speak irig of the patient, said rj'peatedly before me, ** I am afraid it is j,'oint» to be u bad speculation." The general health of Law- son was PulFering nuich, he was now atid lln-n exposed to diarrhoia, his appetite diminished, blc|)t little, and was reduced to a considerable deii;ree of emaciation. From the 8th November I ceased to have any communication with the Hospital, till the beginning of January, when I found the patient in a state that announced a speedy dissolution. He was then utuler the (!are of Dr. Rowand till the 6th or 8th of January, nt which time Dr. Jackson took charge of Lawson till his death, which occurred on the 21st January, 1852. Post mortem next day. (Signed,) C. E. LEMIEUX, House Surgeon, M. & E. Hospital, M. & E. H. Quebec, 12th Nov., 1852. No. 22. Post mortem examination of William jMtvson^ who died in the Marine and Emigrant Hospital on the 2lst JantiarT/^ 1851. ' ' The cranium being opened the brain was found healthy. A few tubercles Were found at the apex of the left lung, and slight adhesions were seen between the lungs and parietes of the chest. The heart was soft and pale. The abdomen was opened and all the viscera presented nothing more than a great paleness. The thigh, being examined, was found 2 J inches shorter than the sound one, the two ends of the bone overlapping each other laterally, the upper end being situated at the outer side. There was no union. The fracture was oblique and a very small piece of bone was detached from the upper extremity. There could be no fissures seen in either of the extremity of the bones. They were exposed at the back part of the thigh, through an opening an inch and a half long. Two of the former openings made by the shot behind being confounded in one. All the wounds in front, with the exception of one, were cicatrized. The soft parts were all condensed and presented a kind of cartilaginous apf }iarance. Nothing whatever was interposed between the two extremities of the bone. The sciatic nerve was injured a little higher up than the fracture. (Signed,) C. E. LEMIEUX, M. and E. Hospital, House Surgeon. Quebec, 12th Nov., 1852. No. 23. '* . • (lyanslatton.) . ■ , --^ \^ ' • • Quebec, 20th November, 1862. I)r, ttohitaiiys letter in Lawson^s ca^e. Sir, — In reply to your enquiry, dated 20th instant, I have to slate that to the best of my recollection, no consultation was held by the Visiting Physicians, touching Lawson's case. I have the honor to be, i.^ ,: T r Siir, Your very obedient servant.. (Signed,) O. L. ROBITAILLE. J. Douglas, Esquire, M. D. nr No. 24. Lf.tter of Dr. Jackson^ rtfcn'Wf/ to vase of Law.fon. QuEnix, \^t^ Nov., 1852. My Dfau Sib. — Yon nsk mo in your noto of yrntcrd!'" wlirihcr a cotiMilta- tion wiis culled on Liuvson's (mi«>churgpi>. Deaths 1837 18.18 933 627 961 1398 1452 853 6110 9-22 1348 1407 70 27 39 .50 45 1842 1843 1149 1109 940 1414 1714 1079 1057 919 13.2 1625 70 52 1839 1844 21 1841) J8I5 4a 1841 . . .. 1846 89 Jos. Puinchaud, Esq., Vis. Phy. M. &F C. E. LEMIEUX, House Surgeon, M. & E. If. ^1. (Translation.) Bemarks on the Heport of \ 84:7. The patients were placed in the sheds so soon as a part of ihem weitt completed, but as at first the roof was only composed of boards, not tongaed and grooved, it became necessary, at the approach of a storm, hurriedly tD remove all the patients into the Hospital. The whole building was filled, and! indeed over-crowded ; the Chapel, Commissioner's Room, a part of the Hoaae SargeonV quarters, the passages, staircases, garrets, and even the cellarn i it 'was literally necessaiy to make great strides to avoid ^treading upon the slek, W^i 'f ~muix.'M.m!m!^mmmmmmmmmmmmmilttltfi 124 the servants themitelves took sick, and it was found impossible to replace them, and still more so to increase their numt)er, insomuch that the patients could not always procure drink. This state of things lasted several weeks. Two of the Visiting Physicians fell victims to the typhus fever, and another (the undersigned) Darrowly escaped following them to the tomb. Is it now surprising that so great a number of patients should have fallen victims iu 1847 ? Where in America or in Europe, will an Hospital be found, placed in similar difficulties. Can (he number of deaths which took place in the sheds with any justice be considered M an appreciation of the practice of the Visiting Physicians of the Marine Hospital .' Has the number of the deaths, which occurred at Point St. Charles, been> included in the Report of the Montreal General Hospital ? Indeed, one of the Commissioners and Visiting Physicians of the Montreal General Hospital would not so willingly have submitted to such a thing ! and nevertheless, a per- fect analogy exists between the sheds at Montreal and those at Quebec. • .iA.;r (Signed,) JOSEPH PAINCHAUD, V. P. M. &E. H. ! i". * u ^ass QUBBBO: — PRINTED BT JOHN LOVELL, AT HIS STEAM PRINTING ESTABLISHMENT. . _ , . ■ t. Jl^} J ',•...- k ■I »J ) » .. -'J^Jrn ■ ^V'^:■^ 'i Oiii ^ : 1^ •.'■■■: ■:}. ■■'■- . rt . ..^ «,.,*JJ^.~flfc-n«--' ^ *...-. ■*»>«« ^..y-^. V V-' Vk.Ai'>;--*»* .,*.;.,-« U:'.^t ■ ^. ,...-■..,-> .'.!rJi.,^»«-_.j*..y--'rtv'*' ■*■• ,.,;.,^ -.-^..^ '-■ :_-' 'V, ■■' ' '' 'A*i ./■; .-,;-/;>.. - .,-.» ( \ '.^h^' '^t , f ,-'<.. .f;;;-;■;„,^/. r^j *' i-i ^; ' '■■ * il, ;,' ; '/^:t'^ "' ' ''■ C';: '■:-' "•'■ '■ . i r i f. (^ USu-4: , and ways titlng ;ned) great lea or n the iered arine arles, me of spital I per- H. IT.