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Transylvania Journal of Medicine and the Associ-
                  ate Sciences....Extra.
 I.  MR.  W.  P. NTf!TTOJ jfUftyy. P ^MPTTf FT

                             AND

       II. Dr. B. W.  DUDLEY'S  REPLY.

                                           c

Dr.  Short,                                      '        ^
         Dr. Sir, The enclosed manuscript was sent to me by its au-
thor with a request that I would present it  to the editors of the Me-
dical Journal for  publication in their next number, or at as early a pe-
riod as they can.  Should the publication be deemed inadmissible in
your paper, please return the manuscript to my son who will hand you
this note.
              I am with much respect your ob't serv't,

  Lexington, 28th January  1829? fi *  C^^C'?>\
                               LeX^^^Pd^^ya^th, 1829.
  Dr. Sir,                                — ^'
          The 5th number of the Transylvania Journal of Medicine
(For February 1829) has already  been  published;  consequentl  no
communication, now offered, can  appear in it.  In reference to the
manuscript, sent us for  publication by Mr. Nicholson, and yesterday
delivered to one of the editors  with your note, our engagements have
not yet afforded us an opportunity of examining it;  but as soon as we
have leisure to do so we will look over it, and then inform you whether
we deem it admissible or not.
               Respectfully 6?c. Your ob't serv'ts,
                                      The Editors
                         of the Transylvania Journal of Medicine &c.
  M.  T. Scott, Esq.
           1
 
a
                                   Lexington, February 5, 1829.
   Dr. Si*,
           We have how taken an opportunity of examining the man*
script which you placed in our hands a few days ago, and find its con-
tents to be essentially the same with that of a printed pamphlet, receiv-
ed a short time before through the post office.
   As the matter of this pamphlet relates mainly to a personal difference
which can  in nowise " promote the science of medicine,"  we cannot
allow it a place as a regular article in the Transylvania Journal.   But
inasmuch as Mr. Nicholson conceives himself aggrieved, through its
pages, by the essay of Dr. Dudley, and since  he has chosen to address
his publication to us, that all manner of justice may be done him, we
have determined to reprint his communication in an extra form.  This
will be accompanied by  an answer from  Dr. Dudley, and together they
shall be sent to all our subscribers, to the end that they and the public
at large may be enabled to judge  fairly  of the points at issue between
them.
                Respectfully &c. yours,
                                       The  Editors
    *r rr.  r,       -r,       of the Transylvania Journal of Medicine &c.
    M. T.  Scott, Esq. 
I.  Mr.  W.  V.  NICHOLSON'S  PAMPHLET.
BOTH  SIDES,
Extract from the Transylvania Journal  of Medicine and the Asso-
     ciate Science;,, Vol. I. No. 14,* November 1828—page 532.

          DUDLEY  ON  THE  BANDAGE.

   "It is rather a singular fact, that on a subsequent occasion, another
individual, who had been under my charge, for an injury done ihe head
of the fibula, some  time after leaving me,  became the patient of the
professional character, who had failed in the treatment of the case just
recited; and when  this  very simple case eventuated in the loss of the
limb, the patient was taught to ascribe that loss to his treatment, while
under my charge.
   The history of the case is as follows.  In attempting to mount his
horse, the patient was thrown with the inferior and outer part of the knee
on a piece of timber.   In  a few minutes I was called, and upon exami-
nation, the head of  the  fibula gave to my hand the sensation of an egg-
shell crushing between  the fingers; no other part of the limb received
the slightest injury.  The patient was in great pain, which was attribu-
ted in part to the mjnry  sustained by the peroneal nerve.  The bandage
was applied, extending from the toes until it passed the knee, notwith-
standing a variety of imprudences, committed by the patient, in rolling
in bed, in eating and drinking secretly, articles of the most  injurious
kind, whereby two severe attacks of fever were produced, and in inter-
rupting the dressings; yet about the twenty-second  day from the injury,
he was well  enough to leave me and go to the country.
  lie was not long in the country, before I was informed that he was
a^ain ill, and that his leg was swelled  and painful near the ankle.   The
individual who could  lend the weight  of his word  to propagate error
and do injustice,  in a case, the history of which affords sufficient evi-
dence in favour of the treatment instituted,  only exposes his own weak
ness and folly to the derision of the intelligent in the profession.

  * In the printed copy of Mr. Nicholson's pamphlet directed to the "Edito*
of the Transylvania Journal of Medicine, &c. Lex. Ky.» we find this note in
manuscript,—"The Ed. will:'lease return the MS. to Mr. Scott and insert irom
this W V \ "  Consequently we follow the printed pami hlet literacy,  ;tl-
thousrh it diners in 80i;<e resr-ects Iron, the Mo. copy, and contains some error?
in th* extract »irem enr Journal.—Eds. 
4
   Had the bandage been judiciously continued nfter leaving me, (Twill
here remark Hi.it the bandage was continued until the aaymylimb was
amputated; probably not  with  that judicious power in which it was
fir.t applied,) the patient might have been  the subject of fever  for
months in succession, from improper indulgence in eating and drinking,
without necessarily losing bis limb.  No hing can exceed the folly and
stupidity of the charge against the use of the bandage in that case;  the
more especially as the patient was well enough after two attacks of fever,
induced by imprudence, and the injury done his knee and the head of the
fibula,  to leave town in twenty-two days. It must be manifest  even
with  the tyro, that the evil effects of the bandage, when they do occur,
are speedily made known.  Swelling, inflammation, deep seated abscess
es, suppuration and sloughing, are incompatable with its direct action
on any  part.   Its tendency is immediately opposed to each of  these
states of the system.   The law whereby constitutional diseases are in-
clined to spend their force on parts rendered prematurely weak and  ex-
citable by violence or otherwise, seems to have escaped attention.
   It is from that law, a solution of the ease in  question, is to be drawn;
while from ignorance or neglect of it,  the patient ultimately lost his
limb.   By means of the bandage, I have been enabled to save  more
limbs, the removal of which had  been determined on by other physicians,
than all the cases of amputation together would amount to, in which I
had the least agency, either immediately or otherwise, for the last four-
teen years.
To the Editor of the Transylvania Journal of Medicine and the As-
                         sociate Sciences.
   Sir—On perusing one of the late numbers of your Journal,  I  per-
ceived several statements of cases therein, intended to illustrate the util-
ity of tight bandaging,  under the  signature of Dr. B. W. Dudley, the
professor of Surgery in the Transylvania University.
   The case which particularly arrested my attention, is the one that he
most fully dwells on,  in the 53? page of the  14th  number,  for Nov.
1828,  which is evidently intended  as a representation of my own case.
Presuming that your Journal was established to  promote the science of
medicine, to impart correct information to the student, and to enlighten
the community at large,  by publishing to the world ficts, and correcting
or exposing error \ I have therefore deemed it necessary to address you, in
answer to Dr. Dudley's statement of my case as alluded to above. Had he
confined himself to the ficts it actually presented, without descending to
the gratuitous task of commenting upon my habits attheexpeuse of trulh,
in violation of his duty us a professional man, and ar the sacrifice of the
ordinary courtesies of life, I should  not, at this late day. have trespassed 
5
Upon your attention, or claimed the public ear.  But, as he has thought
it to accord with h,s p-iiKiplos as a gentleman, and leputaticn ssa sur-
geon, to add insult to the injury he has already inflicted upon me, through
his culpable ignorance of the nature of the injury I had received, and
want of judgment in the treatment of my case, and seems disposed to
exculpate himself  from censure, by the heralding foith his good fame,
at the expense of my reputation, as well as  that of others, justice re-
quires that I should  arrest the current of erroneous impressions, which
it is too evidently the wish  of Dr. Dudley to  impose upon the public.
Were his statement destined to be seen alone by :h< se to whom we are
both known,  or by those who could have an opportunity of infoiming
themselves rightly as to facts, I should have treated his production with
that contempt, which, from its malignity and falsehood, it so richly me-
rits; but as such is not the case, I must be indulged while I  rescue my
ch i racier from the insidious stab of one, who avails himself of official
station, to injure an  individual whom he, by his want of skill, has ren-
dered a cripple for life.
   To begin then with Dr. Dudley and his statement.   I am really at  a
loss to conjecture to whom he alludes when he says, that "I was taught
to ascribe the loss of my leg to  his treatment, by a professional charac-
ter,  into whose hands I fell subsequently to being under his charge."  In
his published history of my  case, he states, that "in attempting to mount
his horse, the patient was thrown on a piece of timber."  Now the fact
is,  that in attempting to mount the horse, my cloak caught, and I could
not  gain the stirrup, and in jumping off' 1 sprained  my leg,  as will ap-
pear in the sequel.   I fell on a grass plat; but as to the piece of timber
the  Doctor alludes to, if there, it must have been buried under ground,
as it was neither visible to the sight, nor tangible to the touch.  His no-
tice is the first intimation I ever had of it.  He then says, that  "upon
.examination  of the heud of the fbula, jt gave to his hand the sensation
of an  egg-shell crushing beneath his fingers; no other part of the limb
received  the  slightest lnjmy."  It certainly cannot have escaped  the
memory of Dr. Dudley, as  well as that of several other persons, who
were present when 1 met with the accident, that not more than ten min-
utes elapsed before he was present, and that after pulling off a tight boot,
and examining the limb, he observed it was only a sprain; but upon a
moreclose examination, he said both bones were broken about three in-
ches below the knee, and employed two gentlemen in holding the bro-
ken bones, while iie was preparing the bandages, which he applied in
the  following manner: he first  tore off five or six small bandages about
two and a half inches in width, and about two feet long; these he satu-
rated with whiskey, and bound over the knee; he next applied the long
roll bandage, (which was also saturated in spirits,) beginning at the lues
and extending upwards nearly  to the hip-joint.   Being thus bandaged
up like a harlequin and placed  upon  a bed,  but a  very short time h;td
elapsed  before  I felt  the most excruciating tortures, and observed to
those present, I could never sand it;  that the pain created by the blood
endeavouring to force its passage to the extremities of the injured leg, 
6
 Was beyond enduranee.  I felt the pain just above the knee joint, and in
 the tendons underneath the knee.
   My friends taking it for granted" that the Doctor ought to know best,
 notwithstanding  the  remonstrance of the Rev. George C. Light,  who
 wished to relieve me,  suffered me to remain in the situation I have de-
 scribed, until  I  became delirious, under the baneful effects of the tight
 bandaging.  While in this situation, I may have been guilty of the im-
 prudence of rolling in bed, as reported by Dr. D.f-but agreeable to the
 representation of my  friends, Dr. D. was sent for three different times
 during the first night; the first time he sent a message to this purport—
 that I must endeavour to bear the bandages, and that they ought not to
 be removed (I think) for two weeks.  To the second message  he return-
 ed a note, stating that he would not have the bandages removed for one
 hundred dollars, and that the cause of my extreme pain arose from the
 circumstance of the fracture extending into the knee joint, and that he
 could compare it to nothing else than egg-shells beat in a mortar.   The
 third time he was sent for, he came, and observed,  he was astonished I
 had no more philosophy.   Philosophy! Philosophy in  a man partially
 deranged  by tight bandaging, which prevented his blood from circulat-
 ing?   Had Job, with all his patient forbearance, been driven to mad-
 ness by the empericism of his physician, I question very much whether
 his philosophy would  have availed him much  more than mine did  me.
 In the morning of the second day, when he came to see me,Dr.D. loos-
 ened  the bandage to the knee joint, and, if I mistake not, it was reliev--
 ed again  the same day by  Dr. Webb, by the consent of Dr. D.   The
 bandaging from the knee  to the extremity of the foot, was  not removed
 for several days, and always reapplied as soon  as wet with spirits, as be-
 fore.   In  this situation I was kept for twenty-six days,  (Dr. D.  saya
 twenty-two.)   Whether the variety of imprudences as  ascribed to me
 by Dr. D., such as rolling in bed, &.c. arose during the first forty-eight
 hours, when labouring under delirium, brought on by his want of judg-
 ment, I know not; it  is, however, a pitiful subterfuge  for him to take
 shelter under such a flimsy covering,  from the well deserved  censure,
 consequent on his ignorant treatment of me.   The next items in his list
 of my imprudences, are his charges against me of eating and drinking
 secretly, articles of the most injurious kind.  This is evidently an after-
 thought, eminently worthy of one so skilled in surgery.   Is it not too
 ridiculous for serious  refutation, that an invalid, who was unable  io
 move from off his bed, could procure articles of food and drink secretly ?
 But if they were so secretly disposed of,  how  came the fact in the  pos-
 session of Dr. Dudley ?  Did he discover a knowledge of it by the same
 penetrating eyes that enabled him to discern the timber, on which his
 imagination so ingeniously broke my leg ?  He certainly should have
 explained the name, and quality of those injurious articles, in which I
 indulged,  as also how and by whom  he obtained his information.   By
 whom was 1 furnished with them? wherefore the necessity for secresy?
 I was  not in a situation to demand of me a resort to any such  means, to
gratify my appetite.  J bad  arrived at the age of maturity, and was sdr- 
7
rounded by those, whose hospitality, kindness and attention were «nly
equalled by their sympathy for my sufferings, and solicitude for my re-
lief—whose indulgence would have precluded the necessity of resorting
to secresy, to procure  either the  necessaries or luxuries I might  have
needed or desired.  Instead of its  being necessary to  practice covert
devices to procure articles of "a pernicious kind" to indulge in, it was
not an unfrequent, though a painful duty I had to perform in refusing
the numerous litttle messes provided by the generous thoughtfulness of
those, by whom it was my good fortune to be surrounded.   I say the
duty  was a painful one—it was truly so to me,  to be compelled  by a
sense of propriety, in obedience to the directions of my surgeon, to re-
ject the proffered kindnesses of those whose greatest pleasure it was
              " To bind up the wounded heart,
              And pillow the aching head."
   It  is well known that I neither ate nor  drank any thing out of the
common prescriptions  given by Dr.  Dudley, for my  guidance, without
consulting him, except in one or two instances, which I shall notice, du-
ring  the whole course of my  confinement, while under his charge.   J
recollect a few days after the accident occurred, of asking for a glass of
wine  sangaree,  which was  handed  me, though not secretly.  I had
scarcely tasted it before Dr. Dudley came in, and pointing to it, I asked
him whether it  was proper for me to drink it; and on his replying that
it was not, I desisted from doing so.   Again, about eight or ten  days
from  tliis period, I drank about a tumbler of cider without his consent;
but this was done openly and not secretly.  About the third week  after
I met with my accident, and after Dr. Dudley had pronounced that I
would soon be well, (although my leg was then as scaly as the back of a
fish, and smelt, as I was told, very offensively,)  I did, as he states, per-
haps  imprudently, eat  a  few oysters.   These are the only times that  I
recollect of having either ate or drank any thing out of the range of Dr.
Dudley's general prescriptions.  It is perfectly within my remembrance,
that after I had eaten those oysters of which I have just  spoken, upon
Dr. Dudley's being informed of it, that he said they were the most inju-
rious  things I could have eaten,  and that a person present observed to
him, "Doctor, when I was so ill, you recommended them to me." "Yes,"
was his  reply,  "but those that  I recommended to you, were cured  in
their  own liquor"  He was then informed  that those I had eaten  were
also cured in  their own liquor, and not with vinegar.   After this expla-
nation, he admitted they were innocent.  Notwithstanding this admis-
sion,  in his desperation, like a drowning man catching at straws, he has
continued to harp upon this oyster business.  I feel satisfied, after this
candid detail of facts, that the intelligent part of the community will
conclude, that the reason assigned  by Dr. Dudley as the cause of his
failure, is no less impotent than unjust, and but serves to expose   " his
weakness and folly to the derision of the enlightened in the profession." I
recollect but once of having any considerable increase of fever,except what
was induced by the cause already assigned, while under Dr. Dudley's care,
when  at my request he  gave me a dose of medicine.   This was  some 
                                8

time after the "egg-shell fracture" iook place.   I am the more certain
of i his circums aice, because of my having asked him if the medicine
was not calomel, and observing to him that I was in the habit of taking
from fifteen to eighteen grains.   His reply is distinctly within my recol-
lection; it was, "if ten grains would not have the  desired effect, fifty
would not."
  I shall now notice the journey I performed,  which, as  the Doctor
says,  was about the 22d day, but  which, in fact, was on the 26tli day.
He says, "nothing can exceed the folly and st upidity of the charge against
the use of the bandage in my case, the more especially as  the patient
was well enough after  two attacks of fever induced by imprudence, and
the mjury done his knee, and the head of  hi* fibula* to leave  town in
twenty-two days."   Here the Doctor is  at points  with himself,  tie
certainly must have forgotten that in giving a history of the case, at the
commencement, he says, no other part of the limb received the slightest
injury except the head of the fibula,  which was like the crash of egg-.
shells; but when he recites my journey, performed on  the 22d day, in
order to impress the public with the idea that the case was a very despe-
rate one, (which, unfortunately for me, was made so by his mismanage-
ment,) and that consequently the case  was bordering on the miraculous,
he recollected of a sudden that the knee was injured.
  Now in all human probability,  if the Doctor had written another par-
agraph, he might have recoUected the circumstance of his giving two
gentlemen the trouble of holding two bones, which he represented as
being broken, whilst  he was preparing and applying the bandages.  It
is unfortunate for the success of  the Doctor, (hat he is not able to con-
tinue this delusion, as  with the aid of  those two  bones, which  were ne-:
ver broken, except in his imagination, he might be able to make out a
tolerably specious  case.  Facts,   however,  stand too strongly arrayed
against him, and he has been compelled to yield to circumstances.  Ow-
ing to his wreiched misapprehension of the nature and extent of the in-
jury I had received, and barbarous application of the bandages, the flesh
sloughed off,  and exposed  the  bones to  view, when  it was discoveied
that  there was not the slightest crack perceptible—no evidence of bro-
ken bones.
  This can be established by some of the most eminent physicians, as
well as by several  respeciable  gen'.lemen in and  around  Lexingion.
Thus driven to the wall, the Doctor has very prudently dropt the broken
bones, conscious that so flagrani. a mis.ake would be received as a proof
of his defective judgmem, and as a reflection upon his skill as a surgeon.
  A more gross misconception of the character of  an injury,  I think F
might venture to assert, is not to  be found in the books; nor neve; did
any individual suffer more through stupidity than I have done; for, by
what other name  shall 1 designate that condition of the mind, which
m stakes a simple sprain, for an injuty of the complicated kind, as ascri-
bed to mine by Dr. Dudley?   I  will return so my case.  The day suc-
ceeding 'he one on which 1 me with  the accident,  Dr. Webb, as before
premised, come to see me, and observed that if the bandage remained in 
9
its then situation much longer, I must cither lose my limb or my life;
and if 1 nusiakenoi, it was at his suggestion the bandage \v..s loosened
the firsi time to the knee, by Dr. Dudley.  About the second week, my
friends, finding my situation growing worse, culled in another physician,
Dr. Pindell, in consultation with Dr. Dudley, to whom Dr. D. represent-
ed the "broken bone*" and the "egg-hhett fracture,"  observing to him
that he should not like to remove the bandages.   Dr. Pindell did not
insist upon their being removed, but replied that he should have prefer-
ed putting my leg in a box, and advised the application of warm vinegar,
which was poured over the bandages, with the approbation, as I presume,
of Dr. Dudley.   After this. Dr. P. made two different appointments to
meet him in consultation, but Dr. D. both times failed to make his ap-
pearance, which occasioned Dr. P. to desist from visiting me,  and I ne-
ver saw him again until after my removal from Lexington.
   After a day or two, Dr. Dudley stopped the application of  the vine-
gar, observing it was of no use; that  the application  of the  bandages
was all that was necessary;  and that the reason why most of the physi-
cians were so averse to using them, was because they did not know how
to apply them.   That they were like a set of old dray horses, (I think
he said,) that could not be got out of the old beaten track.   If I am not
egregiously mistaken,  he also stated that the  old  fashioned  mode  of
using splints in cases of fracture  was entirely abandoned, being super-
seded by the application of the bandage, by the first surgeons in Europe.
   My limb, in a very short time after this, became very offensive, and
Dr. Dudley will recollect, he was asked the cause.  What he attributed
it to, I was not informed until some time after my removal to the coun-
try',   whither he was not  invited, his services not being desirable.  It
must, I think, be obvious to all, that  mortified pride has driven him to
the unenviable task of accounting by  means of slander  and falsehood,
for consequences arising from his own mal-treatment of me, and hence
springs his charges of  the secret use of articles of a pernicious tenden-
cy, wliich he has so uncharitably trumpeted  forth to the public against
me.
   It  may be proper to remark in this place, that whilst under  the direct
tion of Drs. Pindell, Satterwhite and Webb, my course of diet vas  al-
tered, and instead of restricting me, they gave me stomachics to increase
my appetite.  This they deemed necessary to  counteract the ill  effects
which were likely to result to my general system from the copious diS'
charges of my leg,  it  being their opinion that if my  appetite failed, I
could not survive many days.   I would here ask, is it probable  that a
little wine sangaree, a tumbler of cider, and a few oysters, used during
a period of twenty-six days, could have produced such unhappy resul sf
If so, what could have produced that  scrofula appearance and  purple
ppoiS, before I either drank the cider or tasted the oysters.   Suiely it
was not barely taking a mouthful  of wine sangaree to wet my lips,  and
mois'en a parched throat.   No, the cause is to be traced to the applica-
tion of the  bandage, and to that alone, notwithstanding "the law where-
by constitutional diseases seem to have escaped attention, and the four-
                     2 
10
teen years experience" (of Dr. Dudley,) in the application cf tight ban-
dages.
   But to proceed; knowing I was trespassing upon the generous hos-
pitality where I was then unavoidably confined, I  was anxious, as well
as my more interested friends, to remove to the country, and Dr. Dudley
must surely recollect being questioned as to the propriety of the meas-
ure; if he does not, I perfectly lcmember his answer, which was, that I
had better remain a few days longer, that I would  soon be well enough.
I waited patiently several days, in hopes well enough would arrive;  but
instead of getting belter, I evidently grew worse.   Dr.  Webb  at  lust
insisted upon my removal,  stating he could not, with propriety,  inter-
fere while I remained under Dr. Dudley's charge; and without consult-
ing him, I was removed to the distance of two and a half miles from
town.  Dr. Dudley would fain have the public believe that when remo-
ved to the country, my leg was nearly well,  than which nothing can be
farther from the fact. 1 will describe the manner of my removal, from
which it will  be perceived that I was as low as I well could be.   Dr.
Webb  removed me in a  carriage,  on the bottom of which a  bed  was
placed.  I was taken from the chamber in which 1 was confined,  and
carried to the carriage, and carefully laid on the bed provided for my re-
ception.  Thus situated, I was conveyed by slow  travelling to the resi-
dence of M. T. Scott, Esqr. lifted out of the carriage, and carried to a
bed previously prepared  for me.
   So much for Dr. Dudley's Flemish account of my being well enough
about the twenty-second  day, to leave him and go to the country.  The
day after my removal, after I had somewhat recovered from the fatigue
of this wonderful journey, Dr. Webb removed the bandages, when it
was discovered that there were several purple spots, and one black one,
about three or four inches below the knee, on the outer part of the leg,
from which a copious stream of the most offensive matter immediately
issued, nearly filling a quart vessel.  As soon as it had stopped running,
Dr. Webb went to Lexington for Dr. Pindell, who again attended me
as a consulting physician.   In a short period after this, every muscle in
my leg began to decay, and finally rotted oft";  my heel and part of the
toes sloughed off.  It was the opinion of the respectable physicians who
attended me,  as well as that of other intelligent persons who witnessed
my sufferings, that the whole was ascribable  to the improper application
of t.he bandages, and that during the first forty-eight hours.
   In all probability, had the sprain, for it was nothing more, been left
to nature, she would have perfotmed a cure in a few weeks; but it wits
my misfortune to call to my aid a votary of tighl bandages, who, to grat-
ify  m unhallowed  pride of opinion, has compelled meio  wear a  wood-
en leg "«.v a monument of bad xurgtry."  The f c\ is, that if Dr. Dud-
ley was to put the same piessure upon an uninjured leg, that he did up-
on my sprained one, the  same  disastrous  results would no doubt be
produced.
   Again, Dr Dudley attributes my sufferings and loss of limb  to the
interruptions of the bondages or dressings while under his care.   This 
11
is the more strange,  as he acknowledged to M. T. Scott, Esq. that du-
ring that time, the bandages were never removed but by himself, except
once partially, and then by his directions.  The Doctor is not, however,
over scrupulous in framing excuses; for upon another occasion, in de-
spite of the facts  I  have detailed, he asserted that if I had remained
three days longer under his care,  I would have  got well.  If there hud
been the slighest ground for such an assertion, how is it possible that
the  inflammation, deep seated abscesses, suppuration, and sloughing,
that  immediately  followed my translation from Lexington, could have
taken place.   It will not be contended that this instantaneous change  s
attributable to the effects of the country air; if not, what was the cause?
Nothing more nor less than Dr. Dudley's tight bandages.  The excuse
which I have just exposed, calls to my mind a conversation which he had
with the same gentleman, in reference to the application of his bandages.
He  gravely contended that if he had the strengh sufficient to exert a
force equal to the  power of ten horses in  their application, it would be
impossible to injure a limb, provided the bandages were wrapped regu-
larly.   I  merely mention this to convince the public how carefully the
Doctor is to outrage decency and common sense, rather than his  favorite
hobby should not be sustained.  Every one who knows any thing about
the matter, must know that such a force  applied to a limb, would grind
it in good earnest to an egg-.skell su\>slniice;  it would be better  for the
Doctor to be candid  for once, plead guilty, and abandon his leg-destroy-
ing bandages; for unless he does, should he have  many cases, he will
have much to answer for; for each one will have cause  to bear testimo-
ny against him.  The Doctor really seems to have set out with a deteimU
nation to run a tilt  after dilemmas,  as will appear from the foUowmg.
He says, "He (I) was not long in the country before I (he) was informed
that he was again ill, and that his (my) leg was swelled and painful near
the ankle."
   Now it so  happened that my illness had not intennitted.  But  why
should he particulatise the pain as being "near the ankle?"  The  fact
is, there wer« many other parts of the leg which caused me infinitely
more suffering and pain.   To me it seems somewhat singular, that the
Doctor's information should be so precise at this remote period as to en-
able him to locale the seat of pain; for on reference to a note written by
him only 11 months after the accident occurred, he  affects to have  for-
gotten bolh me and my case.
   Noi withstanding all Dr. Dudley has said to the contrary, it is an unde-
niable fact, which  can he substantial od by several distinguished gen:le~-
men of the faculty, that my leg was in a state of mortification when my
friends remcved me from under his care,  extending from 4 or 5 inches
above the knee to  the end of my ioes.   To the skill of the physicians
who attended me, after my removal, together with the unceasing alien
tion of my friends, am i indebted for my recoveiy.   To Dr. Webb, who
scateely ever  left my bed side during a period of five months; to Drs.
Pindell and .Satterwhue, ('he two latter attended in consuliaiion,) lowe
a debt of gratitude, I tear 1 never shall  repay. 
12
  In about five months after my accident, my situation being considered
extremely precarious, Dr. Scott of Chiliicothe, (now of Lexington) was
written for; but having unfortunately met with an  accident the day be-
fore his intended departure with a view of visiting me, he was prevented
from coming, and 1 of availing myself of his services at the time.
  In the month of June following, Dr. Webb being anxious of return-
ing to Ohio, by the advice of Dr. Scott, and the approbation of Dr. Pin-
dell, who were consulted upon the occasion, I was removed to Chillico-
the, a distance of 150 miles.   It was considered by my physicians,  that
in my low and doubtful condition, a change of air might be serviceable
to me.  At the period of which I am now speaking, five months after the
accident, notwithstanding the Doctor, in his report, alleges I was "well
enough" to leave him and^o to the country about the 22d day, I was so
reduced that my back and  hip bones had come through the skin, and I
was wholly unable to help myself.  I was so low that it was found  ne-
cessary to fix the bed on wliich I was laid, on a springy board in the car-
riage; I was lifted in and out as occasion required.   Mrs. N. and a ser-
vant, besides the driver, accompanied me in the carriage, to render such
assist-ince as might be  requisite, and Dr. Webb and his brother accom-
panied on horseback.  On my arrival at Chiliicothe, Dr. Scott examin-
ed my leg, and then pronounced it as his opinion, that it would never be
of much service to me; but that  after it should have been healed, I
would be  the better able to judge, and if it should be necessary then to
have it taken off, I would be in a better situation to undergo the opera-
tion.  In  about four weeks from my arrival in Chiliicothe, I had so far
n covered as to be able to  set up, and occasionally to walk with the aid
of crutches, and a stirrup suspended from my neck, so as to support my
skeleton of a leg.   In the month of August following, by the advice of
Dr. Scott, I returned to Kentucky to avoid the autumnal fever which had
prevailed for one or two years in Chiliicothe.
  In the month of November, I had so Lr regained my strength, as to be
able to leave Kentucky for Baltimore, my leg being supported on a pil-
low in the carriage.
  Thus after  eleven months of the most intense suffering, I was ena-
bled once more to reach my home,  with a mutilated limb, produced
from the want of skill  and judgment  in my medical attendant at the
commencement of the case.
  On my arrival in Baltimore, Dr. Buckler, who is my  family physician,
©ailed to seeine, and on examining my leg,  said it did not appear  (hat
any bones had been broken, but that it would never be of any use to me,
and advised amputation; at this period my leg was nothing but skin and
bone, there being  nothing  left but the"ariery to nourish it, the  little
flesh and muscles it used  to have, having rotted off.
  At Dr. Buckler's request, Ds. Davidge and Jamison, were called on
hi consultation.  On examination, the latter  gentleman coincided in
opinion with Dr. B. and recommended  amputation;  the former agreed
as to the firs- point, but recommended  amputation lo be deferred°for a
time to see the eiiect the efforts of nature might produce.  Desirous, if 
13
possible, of saving my  limb, T awaited the operations oP nature until
the 24:hof April foil' wing, when uespainng of ucivery, en 'hut dsy
the amputation was performed by Dr. Buckler find Dr.   lbson, uid-ui
the presence of Dr. Lyon, now demonstrator of anatomy in the medi-
cal college of thisciiy, Dr. Keerl who  is now in Europe pursuing his
studies, and Drs. Coskery, C ddwell, Pearce and Handy; those gentle-
men, who dissected and examined the limb after it had been taken off,
told me there was no sign  of fracture that  they could discover. Thus
ends the history of the case of the "broken bones," the "egg-shell crash,
and the injured knee," after seventeen  months of the most excruciating
torture.  It is unreasonable to presume for a moment, that effects so ex
traordinary could have proceeded from a simple sprain, unless superin-
duced by improper treatment.   To Dr. Dudley's want of judgment and
tight bandages, I am indebted for all my suffering and the loss of my
limb.
   In about six weeks after the operation was performed, I walked to my
office, distance probably  a quarter of a mile—so much for a skilful
surgeon.  In the month of November following, I mounted a wooden
leg, and have visited Kentucky three times since then; during the last
summer and fall, 1 spent the most of my time in and around Lexington,
and never heard a word of my case, until the day  previous to my  leav-
ing Lexington, when I was informed it was preparing for the press.  A
few days after my return here from Kentucky, I received a copy of his
publication through the medium of the post office.  To me it is inex-
plicable what  fatuity could have beset Dr. Dudley, after an elapse of
four years, to publish my case;  much less can 1 account for the worse
than savage pleasure he seems to indulge  in, while unprovokedly as-
saying me.   Had Dr. Dudley stopped after giving his imaginary state-
ment of my case, erroneous as that was, I should have permitted him to
have enjoyed his laurels undisturbed; but as he lias calumniated me, and
called my morals m question, I have felt myself  bound to expose the
g.  ssness of his professional  errors, and to  throw back the foul asper-
sions upon my reputation, as unworthy of  me, and becoming only him,
in whose malevolent heart it was nurtured.  In a word, 1 defy him and
the miserable beings whom he has employed, or those  who gratuitously
.lent their aid, to propagate the charge of eating and drinking to excess
against me, to  substantiate it, by the evidence of a solitary individual
entitled to credit in the estimation of  honourable men.
   In conclusion, 1 will appeal to the  public, and ask  them, admitting
for argument sake, that Dr. Dudley's representation of my case wascor-
 rec', which I deny—I say 1 ask them,  1 ask the intelligent of the medi-
 cal profession,  whether under the  circumstances of  the case he has
 m ide out, he was justified in the application of  tight wet bandages?  I
ask them did they ever see, hear, or read of such treatment, except by
 D  . Benjamin W. Dudley, in  a  case of egg-shell fracture, in Europe,
Asia, Africa  or America?  And whether  it succeeded?   I have done
 with the Doctor.
                             I am the public's  ob't serv't,
                                          W. P. NICHOLSON. 
14
                  CERTIFICATES.

  The following is in answer to a letter I addressed to Dr. Buckler some
time after my limb had been amputated.
                           COPT.
  Dear Sir—In answer to your note of the 24th, in which you desire
to know "if I could discover any appearance of fracture in the bones
of your amputated limb, more particularly of the head of the fibula
and kneecap," I state, for your satisfaction, that no trace of such inju-
ry was discoverable in either of these bones, nor could I perceive any
sign by which I could infer that the larger bone of the leg or tibia had
been fractured.
                      Respectfully, &c.
    May, 30th, 1826.                        J. BUCKLER.
  My object  in procuring the annexed certificates is merely to show
that Dr. Dudley was entirely  mistaken in the nature or extent of the
injury I received.

  We, the undersigned, were present at the amputation of Mr. Nichol-
son's limb, and have again  examined it this day, and do not perceive
any signs of fracture.           Signed,
                                 S. H. LYON, M. D.
                                 S. H. CALDWELL, M. D.
                                 W.  D. COSKERY, M. D.
  Witness, W. A. Schjeffer.
    Baltimore, Jan. 9th, 1829.
  We have examined  the bones of a leg, handed to us by Mr. Nichol-
son, ;md do not perceive any evidence of fracture in either of them; and
die head pf the fibula  appears perfect.
             Signed,    C.EOR  E S. GIBSON, M. D.
                       MAXWELL McDOWELI,M. D
                       MICHAEL D1FFENDERFFER, M D
                       JOSHUA I. COHEN, M. D.
                       GEOR  E FRICK, M. D.
                       WILLIAM DONALDSON, M. D
  We have examined the bones  of a leg, which was handed to us by
Mr. iNicholson, and particularly the head of the fibula, and do not per-
ceive any evidence of fracture.
                Signed,    JOHN J. McKENZIE, M D
                          S. B1RCKHEAD, M. D.
                          ALEXANDER CLENDINEN, M D
                          ASHTON ALEXANDER, M D
                          SAMUEl BAKER, M.D.
                          W. FISCHER, M. D. 
15
  I do "hereby certify, that I buried Mr. Nicholson's limb, and at his re-
quest took it up again the other day, cleaned it, and gave it to him, and
that the limb now before me is the same one.
         Witness my hand, this 9th of Jan. 1829.
                   JOHN C. BROWN, Sexton of Christ Church.

State of Maryland, City of Baltimore, sc.
   On the 9th of January,  1829, before me, the subscriber, a justice of
the peace for the said city, personally appeared John C. Brown, Sexton
of Christ Church, in said city, and made oath on the Holy Evangely of
Almighty God, that the several facts contained and set forth in the above
certificate, are respectively true as they therein stand stated.
   Sworn and subscribed before me the day and year first written.
                                          W.  A. SCHJ1FFER.
  I certifiy that I was present when  John C. Brown buried Mr. Nichol-
son's limb, and also when he took it up again, and that the limb now
exhibited is the same one.
  Witness, W. A. Sch.effek.                W. T. PEACHEY.
       Baltimore, 9th January, 1829*
  "I was called, and upon examination, the head of the fibula gave to
my hand the sensation of an egg-shell crushing between the fingers.
No other part of the limb received the slightest injury."
                                       Dr. Dudley's Statement. 
II.  Dr.  B.  W. DUDLEY'S REPLY.
  A man who has lost a limb through folly is sufficiently punished for
his indiscretion; and the public, in the exercise of charity, turns m in-
dulgent ear, when an effort is made to prove that he  is not the author
of his own  misfortune.
  Mr. Nicholson is given  to understand that  I feel no disposition to
render  his  case worse than it really is; on the contrary,  I am quite
willing to concede to him all the benefit of  the argument, that he was in
a sate of derangement not only for the first two days, as stated by him-
self, but that he remained so during the whole period of his confinement
under my charge.   In this concession there is quite as much charity
shown to Mr. N. as there is justice done those who have urged  him to
the commission of an  outrage upon truth and virtue in his slanderous
publication. Had the same pains been taken to conciliate, that  have
been to poison  his feelings against me,  Mr. Nicholson  might now be
numbered among my friends.  Reasons, however, existed  among those
who directed his  opinions and  fixed his prejudices, for turning both
against me.
  Not many weeks after he was withdrawn from  my charge and  was
carried to the country, there were so many falsehoods and slanders cir-
culated to my  injury,  that I wrote a letter to M. T. Scott, one of the
brothers-in-law at whose house Mr. Nicholson then was, and threatened
to hy the  whole case before the public.   By reading the pamphlet of
Mr. Nicholson, I am possessed of additional  and  satisfactory  reasons
for  believing, that his brothers-in-law committed the first outrage on cor-
rect behaviour, and  that  to their interference he is especially indebted
for  his irreparable misfortune;  since according to his own admission, his
brother-in-law, Dr. Webb, (who  at  that time was scarcely familiarised
wiih 'he initials of the profession, and who could not approach me in
the light of a physician,)  old him only the day after the injury, "that if
the bandage remained  in its then situation much longer, I must either
lose my limb or my life."  From that time the series of imprudences
commenced, as well in relation to improper meddling with the limb, as
to indulgences of appetite.
  During the absence  of Mr. Nicholson from this state, and while un-
der the charge of  mother brothei-in law, 1),. Scoi:, then of Chiliicothe.
Mr. M. T. Scott procured of me my biU aguiust Mr.  Nicholson,  with 
17
the intention, as T thought, of paying it off.   But in the October fol-
U >vn-, after the reiurn of Mr. Nicholson fiom under the charge of Dr.
Sci> , he addressed me the following note.
   "To Dr. B. W. Dudley:  Sir, I propose leaving this country in iho
course of two or three weeks for the eastward, Baltimore, if my situa-
tion permits.  As it is not my intention to pay you unless compelled by
law I have thought it thus proper to inform you of my contemplated
journey in order that you  may take such steps as may be deemed mosr
adviseable.     Your  serv't.                 Wm. P. Nicholson."

   To this note I returned the following answer:
"Mr. W.P.Nicholson:
             Sir, 1 received your note this morning in which you ap-
prise me of your determination to go to the eastward, and that you wdl
not pay my bill which your brother-in-law (M. T. Scott) got of me some
six months ago, unless compelled by law.
   A legal process before  one of our justices of tlte peace, wherein a
Kentucky  doctor is  plaintiff and  a Baltimore merchant  defendant,
would be truly a novel scene.  There are two orders in society  against
whom I never prefer a claim for professional services,  and you are cer-
tainly at liberty  to rank yourself in my estimation, with either of these.
Since you have chosen to recall your case to my recollection in  the un-
civil style of your letter,  I have now  to add, that I apprehend 1 pity your
folly as much, as you.can love your money, or lament your misfortune.
                 Respectfully,                  B.  W. Dudley."
   What agency the brothers-in-law of Chiliicothe had in causing Mr.
Nicholson to write  me the foregoing note, immediately after his return
from that place, the history of the case will tell.   But inasmuch as Dr.
Scott could not have forgotten a case of fractured leg under his  charge,
followed after some time by fistulous abscesses, in which he could not
effect a cure; and since he must be apprized that I succeeded in that case
in a short time by the use of the  bandage, I had some claims on him to
become the advocate of the practice, and to reconcile his brother-in-law,
Mr. Nicholson, to what I had done.
   Mr. M. T. Scott  has played a-part in this business not at all calcula-
ted to show his love for consistency, or his regard for disinterested pis-
tice.   Regrets expressed to one gentleman at the injurious  reports m
circulation, while currency is given them  when in conversation with an-
other; threats or surmises of personal danger, prostration of character,
law-suits, and answers in print to my notice of his brother-in-law's c se
in the  journal, arc  held  out at one time;  while  at others it appears he
would like to approach me as a friend and beg me to desist, except that
he  was forbidden by  some unknown cause of anger on my part.   Mr,
Scott cannot be  ignorant of  the source of my humble opinion of hun.
   But I  have other  reasons for believing that  Mr. Nicholson has  been
goaded on by the bad feelings of his friends in lexing'on to make  he
lote unwarrantable attack upon mo.   Although  Mr. Nicholson speaks
                  3 
13
of having perused the number ef the Journal containing my communi-
cation at which he has taken such offence, I do not believe he has ever
seen that number, and  that he has based his pamphlet on an incorrect
m muscript copy of that part of it, relaling to his own case only.   Oth-
erwise I cannot conceive why he should have addressed his publication
to";he Editor" of the Transylvania Journal,  when  it bore  on its title-
page the names of two gentlemen as  Editors; how he could have mis-
taken 4 for 14 ;n allusion to the  number of that work from which the
extract is taken;  how he could have copied prematurely for preternatu-
rally; immediately for immediate; how he could have thrown two sen-
lences into one, by placing a comma where he found  a full point;  or
have made detached  paragraphs  in his copy, where there were none in
my essay; thus  perverting  the meaning and making nonsense  of  it.
These errors do not savour of the mercantile accuracy of a man of busi-
ness,  and  it is quite certain that no printer would have made them from
u printed copy.  They speak for themselves.
  Mr. Nicholson himself complains, after so long a period has elapsed
since he sustained the injury, that 1  should now unfeelingly throw his
case into  print,  and attempt to. injure his moral character.   Thus far
Mr. Nicholson has enjoyed all the privileges  of a one-sided story, told
by himself and friends.   From Baltimore, Philadelphia, and New-York,
enquiries have been  made of me concerning his famous case.  Even
now I would  suffer him to enjoy all the benefit of  his pamphlet, and
would be silent, except for  the array of professional  names,  under the
weight of whose authority, he no doubt expects to repose  in quiet, and
to enjoy the satisfaction of witnessing my humiliation.  This circum-
stance gives his communication an importance in  the public eye which
it otherwise would not  possess,  and seems to demand from me  some
observations in reply.  1 therefore proceed to a plain statement of facts
and a few  remarks thereon.
   Besides the various  articles of drink and diet taken to Mr. Nichol-
son's sick room, consisting of brandy, wine, porter,cider, oysters, cheese,
and crackers, his plate was supplied at the table, to an extent that start-
led those who observed it, with all the luxury and substantials of  a pro-
fusely spread board;  nor did this satisfy the cravings of his appetite;
for, as Mr. Beatty informed me, he was in the habit of ordering one dish
to be set  aside for his benefit between  meals; to wit, the back bone of
the hog, cold  chine being his favorite meat.  Even his brother-in-law
was heard to express his disapprobation of his excesses.
  It is by no moans gratifying to me  to make this exposition, nor would
I m any other circumstances than those of vindicating myself under the
charge of falsehood.  Mr. N. might have been satisfied that I could not
made  this  complaint except on proper advisement.   It is not my cis om
to be  kept in  ignorance of the drinks and diet of my patient nor  to
ma;:e  my enquiries of any but those most competent to give me correct
inhumation.
  From the family where he was confined I received my information,
and that family recollect my remarks upon his indiscretions, when 1 ob-' 
                                 19
 served that Mr. Nicholson was a patient admirably calculated to dis>
 grace liis attending surgeon—language that could not have fallenfu.m
 me, had it not been elicited by communications respecting his repealed
 improprieties.  Why in the concluding part of his address he should
 again  allude to this  subject in the  following  condemnatory strain is
 truly matter of astonishment.  "1 defy him and the miserable beings
 whom he has employed, or those who gratuitously lent their aid, to pr  -
 pagate the charge of eating and drinking to excess against me, to substan-
 tiate it. by the evidence of a solitary individual entitled to credit in the
 estimation of honourable men."  I had been willing to concede to Mr.
  Nicholson the advantages of being raised a gentleman; but how shocking
 the contrast.   After meeting with his accident he was received into the
 house of a friend, and Uiere assiduously and tenderly nursed; and be-
 cause, on account of the warm solicitude felt  for his comfort and his
. speedy recovery, daily communications were made me respecting his ha-
 bits, the better to enable me to exert a proper control upon his conduct as
  my patient, he has by one sweeping denunciation included those who
 were pleased to extend to him the most generous hospitality. Surely there
 could be no inducement on the part of the family  to misstate fac s:
  nor has there been any inclination on my part to use them improperly.
 But as it is possible that Mr. Nicholson may ask for names notwithstand
 ing I have given him the source of my  information; for his satisfaction
  I will  refer him to Dr. Stephens R. Beatty of  Washington county Ma-
  ryland, and to Mr. Charlton Beatty  of Kentucky, the latter of whom
  resided in the family at the period- of N's confinement, and the former
  received his information  from  the family twelve months ago.  The re-
  sult of an  application to these  gentlemen,  provided Mr. N. has  any
  sense  of justice left him, would be to urge him to some atonement for
  the outrage he has committed on truth and gratitude.
    I shall not stop to argue the point with Mr.  Nicholson  about his fal-
 ling on a piece of timber, which as he says was neither "tangible to the
  touch nor visible to the eye".   The only information I had on the subr
 ject was second hand.
    It is strange logic urged by Mr.  Nicholson that because he  was of
 mature age, therefore no secrecy on the subject of his'diet could be sus-
 pected.  He ought to know, however, that there are old as  well as young
 children; and  that notwithstanding  his maturity  in years, he acted to
  the life, the part of a spoiled child.
    In the fourth page of his pamphlet Mr X. observes that I told him
  on the third week after he received  his injury, that he would soon be
 well; when at the same time, as he  goes on to state, "his leg was  scaly
  as a fish's back," and, as  he was told, smelt  offensively; while in the
 seventh page he stales, that on  the day after  going to the country hie
 leg discharged nearly a   quart  of offensive matter.  Now the  writer
 might know that "scales" like those on the back of a fish do not occur
  during inflammation: that they are the consequence of a partially nour-
  ished  integument,  under  the influence of pressure  by  the baml.'.oe;
  tfhileon the contrary, the formation of neaily a quart of mailer wo id
  be attended  by a tarnid stafo of th^  limb Rod a. smooth distended ?K-m; 
20
a condition of things  incompatible with the treatment pursued, as ther-
facts in the case show.
  I do not know how  to answer the hotchpotch served up on the l.i:h
page* of the pamphlet, but were 1 to claim the privilege there conceded
to me, of having "dropt the broken bones", by which I suppose Mr.
Nicholson means that 1 ceased  to contend that  the  fibula had been
fractured; it would place him in the ridiculous attitude of one engaged
to prove by  a variety of certificates, what I had  gratuitously admit-
ted; while the dilemma of a false  accusation necessarily awaits him,
Bm  altogether  1 think this  pamphlet proves,  to the credit of Mr.
Nicholson, that  he has not been schooled to  misrepresentation, other-
wise he would have learned to protect a false statement  by a thicker-
mantle.
  I am willing to concede quite as much  on the subject of the consul-
tation as will answer the purposes of making out the tale of Mr. N.
Not recollecting particulars, 1 can only add, that 1 had not time at that
season of the year, it  being during the medical session, to bestow any
attentions not absolutely required of me.
   it must, however, appear quite ludicrous among professional men that
'Mr. Nicholson should  represent me as contending that  the bandage
had superceded  the use of splints with the first  surgeons "in Fiiirope."
It is a practice which  1 have pursued and inculcated  in opposition to
 that of Europe for more than ten years.
   In the seventh page,* Mr.  Nicholson observes that  matter was dis-
charged frcm iiis leg "the day after" he retired to the country, and "in
 a short period after this, every muscle in  my leg began to decay, ; ud
 finally rotted off; my heel and pait of the toes sloughed oft."  Anu u-
 g;;in,  "It was the opinion of the respectable physicians who attended
 me, as well as that of other intelligent persons, who witnessed my suf-
ferings, that the whole was aseribable to the improper application of \ue
 bandages, and that during the first forty-eight hours."   Compare Oie
 above  with the following from the eighth page. "Notwithstanding all Dr.
 Dudley has said to the contrary, it is an undeniable fact, which can oe
 substantiated by several distinguished gentlemen of the faculty, that my
 leg was in a state of mortification when my friends removed me from un-
 der his care, extending from 4 or 5 inches above the knee to the ena of
 my tees."   The contrast of these extracts, extorts from me the conces
 >ion that Mr. Nicholson must  have been in a state of  derangement du-
 ring his confinement  in Lexington, and  that he has written under the
 influence of menial alienation.   Let us  put  all together  and see how
 it seads.  Matter was discharged the day afier leaving town; in a short
 time (he does not say how long) every muscle began to decay and final-
 ly rotted  off, notwithstanding  mortification from  above the knee to the
 toes took place before leaving town, and consequently long before  he
 muscles began to decay.  The application of the bandage during the
 fiiSt two days after  the injury produced consequences that did not show
  ♦Therrfrrorices apply to the  ; anirhlet as originally printed, and not t?
Ojcrepriut, which varies in the paging from the original.—Eds. 
21
ihemselvt s until twenty days or moie elapsed; and yet every body knowi
tint  iiu circulation of a part being cut oil" will pioduce  mortification
in eight and  forty hours,  as in the application of ligalures upon  tu-
mours, and in fractures where theciiculation is destroyed.   Lastly ihat
the leg was mortified  before leaving town, as can be proved by those
who only saw it sometime after going to the country.
   In regard to various other small  items contained in Mr. Nicholson's
publication, 1 decline  to make any  reply, and have now only to nouce
the certificates appended to the pamphlet.
   The pert tyro may vociferate, the ignoramus may dogmatise, but it is
expected of  the man  of true merit, that he  will examine  cautiously,
deliberately,  thoroughly;  and  that he  will  not hazard an opinion while
any  source of information upon the subject before him, remains unex-
plored.   1 do not propose to prefer any claims to the liberality of my
professional brethren, and I waive, so far as regards myself, on this oc-
casion, all considerations  of etiquette usually observed in  their in ;er-
course with each other.   To no one of the gentlemen who have signed
the certificates, am I personally known; nor have I ever had the slight-
est connexion with either, in any shape, except with those of them who
belong to the medical faculty of the University of Maryland; and who
(without my  solicitation) concurred in  unanimously recommending me
to the Trustees, by  whom 1 was unanimously elected to  the chair of
surgery in that Institution. This transaction took place eighteen months
ago, and consequently more  than two years after the case  of Mr.  Ni-
cholson was  familiarly known  in Baltimore,
   If the conduct of  these gentlemen be  taken as a precedent, then I
would ask of them, Who in society is  safe?  Certificates to prove mat-
ters  of science, wherein the cause  of knowledge and the advantage of
humanity is the object, are admissible where truth is in jeopardy.   But
in ne case before us, no such apology can be offered.   An  individual,
no;  belonging  to the profession, applies to a  number of physicians for
signatures to a certificate wearing  mischief on its face;  and I hazard
the  assertion, that  no gentleman, whose name is on the pamphlet, can
pronounce himself superior to attack with a similar weapon.   Howev-
er submissive his patient,  under all the injunctions imposed upon him,
the physician is yet liable, from numerous causes, to mortification and
defeat: and is he, after the exercise of skill and assiduity, to be subject-
ed to the painful task of vindicating himself against the certificates of
his brethren, which charge him with misconception and error, and this
too, not for the cause  of science,  but  for the gratification of the worst
feelings  of our nature?  Establish this principle, and what  becomes of
knowledge, and science,  and manly  worth?   By one fell sweep, each
and all will be hurled from their elevated  stations in the estimation of
men, while they will  be replaced by every  thing that is abject, ignoble,
and disgusting.   Once  recognise the principle,  and the gentlemen
themselves would soon give place to ignorance and presumption, to im-
pudence and folly.   Galhleo was made to renounce his opinious in Phi-
losophy  by   n impious decree; Harvey struggled foi a long time against
the  ignorance and prejudice of the age in which he lived before he tii 
sw
limphed in the great discovery of the circulation of the blood; and in
this enlightened age, when a Western surgeon proposes what he believes
to be an improved mode of treating various surgical  diseases, sixteen
practitioners of Baltimore enter their  caveat in certificates calculated
to suppress all effort at improvement,  and  he  is held up to society as
unworthy of confidence or patronage.  As an American some sympa-
thy might  have  been anticipated in behalf of his ardor and persever-
ance; as a colloborator in the cause of that science, the object of which
is ihe advancement of human happiness, the subject alone should fur-
nish him with protection and defence,  from all those who love the sci-
ence of medicine as a department of  knowledge, who pursue the prac
tice  with a view to fame and independence, or who are actuated by the
warm and more elevated principles of the philanthropist.  The natural
tendency of certificates of the character in question is to repress inves-
tigation, to chill the expansive powers of the inteUect,  and  to encour-
age servile  and  irrational imitation.  Who  will be found so hardy as to
dep nt from the beaten track, when  he feels that he is ever liable to be
certified out of his reputation by his professional brethren?   Will he
not choose to let his patient  suffer rather than  suffer  himself? None
but the reckless would encounter the consequences of such conduct.
   But let us turn to the merits of the particular case in  question.  In
the fourth number of the Transylvania Journal of Medicine &,c. Mr,
Nicholson's injury is alluded to as one in which upon examination,  the
head of the fibula gave to my hand the sensation of egg-shells crushed
between the fingers.  According to Mr. Nicholson's account, the limb
was amputated, seventeen months after  the injury was received, by his
physician Dr. Buckler, who gave a certificate a few days after that time,
stating that he could perceive no evidence of fracture.  Nearly three
years after the amputation, viz.   9th January  1829, the leg was taken
from the grave and inspected by fifteen  other physicians, all of whom
concur in sentiment that there was no  fracture.
   The question now presents itself, have those gentlemen examined the
bone cautiously, deliberately, and thoroughly?   I answer the question,
and affirm without putting any thing at hazard—they have  not.
   The principle is admitted by all physiologists,  that the bones as well
as all thesoft parts of the body are constantly under  the influence of the
two active  systems, the secreting  and the  absorbing orders of vessels.
Interesting exemplifications of these facts are presented in  observations
upon the bone which has been fractured, as  well as in other  instances,
where no violence has been done.  In the ordinary mode of  dressing
fractured bones, while there is an enlargement after recoveiy at the site
©f the fracture, there is also a material difference in  its internal organi-
zation.   At the point of union of a recent  fracture,  there is  more vas-
cularity than elsewhere.   As nature progresses in her work of renova-
vationby secretion and absorpiion, solidity  takes the place of a spongy'
texture, and increased magnitude gives way  to symmetrical form. Bones
that have been uregularly set, and  which present rough points near the
su:face after union, are rounded off by  the action of the absorben's in a
ffew months* so as to present one uniform smooth surface.   Hence a dif- 
S3
ficulty,  and in many instances an impossibility of pointing out the seat
of a former fracture, by a bare examination of the superficies of a bone.
When fractures are managed by the skilful application of the bandage,
the tendency of which goes to suppress all tumefaction and inflamma-
tion in the soft parts, the increased difficulty of ascertaining, by a  sub-
sequent examination, the seat of fracture, must be palpable to the most
superficial thinker; nor is it possible to decide this question with cer-
tainty, by any examination of the superficies of the bone, where the
fragments have been placed fairly in apposition.   The facility of retain-
ing the  head of the fibula in its place by the bandage, could scarcely be
doubted by the most skeptical.   There is no one point of the osseous
system more accessible to the controlling influence of the bandage than
the head of the fibula: hence the facility of effecting reunion with the
preservation of the natural aspect of the bone.
   But without any design to derogate from the anatomical acumen of
the gentlemen who have placed their names to the certificates, it is pro-
per for me to  make a remark on the difficulty of deciding upon the na-
tural form and appearances  of the head of the fibula.  Without  regard
to the size of  the individual, it is large or small, flat or protuberant, pro-
tected by  the tibia or  standing in relief by its side; while it is completely
shielded by tendinous matter inserted into it, and dense fasciae and eel
hilar substance surrounding it.  Hence a fracture, even  with a change
of its natural form, would  most easily escape detection  after  reunion;
while it would be impossible to decide upon it in cases where, by the in-
fluence of the bandage or otherwise, no deformity supervened.   To re*
cognize an insulated head taken from this bone, would puzzle most phy-
sicians.
   From the language of the certificates, the reader is at  liberty to infer
that they  were signed by the gentlemen after a bare inspection of the
external appearances of the bone.  I have already stated that in cases
where the fragments of a fractured bone are replaced in  perfect apposi
tion, and retained there by means of the bandage, no superficial appear-
ances remain permanently,  whereby  to detect the site of the original
fiacture." But I am warranted by facts to go much farther.  Neither the
superficies, nor the interior organization of a bone, will betray any marks
of fracture, provided  the fragments are perfectly adjusted to each other,
and  secured there by the aid  of a bandage..  Such a bone examined
one or two years after the injury is sustained, will be so perfectly  natu-
ral in all its exterior manifestations, and so uniform in its interior or-
ganization, as to elude the most scrutinizing  investigation:  nor  will  a
bone, less judiciously set, present at all times the external marks indi-
cating the site of the fracture.  On the contrary, even where considera-
ble deformity is manifest in a bone recently fractured, every observing
surgeon has seen such deformity gradually disappear, while the super-
ficies of the bone when subsequently examined, will often be found void
of all appearance of previous injury.   Many causes, of constitutional
as well as of local origin, conduce to  change the external aspect of  a
bone much more than fractures, while any abrupt change in the general
 direction of the bone is a manifestation equally equivocal in character
 with others mentioned. 
24
   In order to delect the seat of a previous fracture, we are instructed by
 those of exalted standing, and of unquestioned skill and atti.inmen.s, io
 m ike a section of the bone in question.   Where the interior confe ma-
 tion presents a regular continuity of fibrous structure, it  is impossible
 to make any discovery.   On the contrary, if  the regular fibrous texture
 be interrupted throughout the diameter of the bone, this is admitted as
 proof of fracture.  In cases wherein the appearances upon making a
 section of the bone are not conclusive in character, a facility of arriving
 at truth is secured, by extracting all the animal jelly, thus leaving the
 part to be examined in an insulated state.   But  while this process ena-
 bles the inquirer to delect  those  cases of fracture only,  which occur
 about the middle of the bone, and wherein they are not properly placed
 and retained in apposition during the process of reunion, it proves radi-
 cally defective in all others.
   All the articulating extremities constitute so many exceptions to the
 mode of ascertaining the site of a fracture by the interior manifesta-
 tions;  and probably no one bone is better calculated to exemplify he
 principle, or to prove the position, than the head of the fibula.  This, ■ s
 well is  other extremities of articulating bones, is constituted of a mass
 of cellular net-work bearing no analogy to the rectilineal fibrous c< i.-
 forniition of the middle of the same,  and other bones.   The imen 1
 organization undergoes no permanent change as a consequence of f c-
 ture, while the  superficies as well as the deeper seated parts, by re.s; n
 of a larger amount of circulation, are  susceptible of a more speedy re-
 turn to  their natural appearances.  We decline to make any observations
 on  the  changes produced upon  a soft bone from  being buried several
 yea-s in a grave yard.
   Thus it is obvious, that were it made to appear that the bone had been
 divided, and then deprived of all animal jelly,  preparatory to a more cau-
 tious and satisfactory examination, those  gentlemen would not have
been prepared to  offer an  opinion  worthy of influencing the opinions
 of intelligent men.  A  blow upon the  head of the bone might enlarge
it,  the  preternatural contractions of the muscle inserted into.it, might
deform it; but these would be very  equivocal manifestations when the
 bone came to be examined,  in reference to the existence of a  previous
fracture.  It therefore palpably appears, that no evidence of a conclusive
character can be set forth, seventeen months after  the injury, however
cautious, deliberate,  and thorough the examination might have been.
   I am  well aware that certificates are often given without due conside-
ration, and that they are frequently rendered subservient to purposes not
anticipated; and therefore have been disclaimed by their authors.   In-
asmuch as  the physicians who have given countenance to ihe abuse of
Mr. Nicholson are unknown to me, and have never had any  just caise
to lend  the weight of their names to a publication of slander agains; ine,
I ..m left in suspense as to the course which they may esteem due to
themselves, and to the profession, of winch some  of  them aie d'sim
guisiied, and all responsible meml.eis.            B. W.  DUDLEY.
  Lexington, Kentucky, Feb. 1, 1829.