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CORNELL UNIVERSITY LIBRARY 
 
 924 104 224 534 
 
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ANSWEE 
 
 DK. A. RUPPANER, 
 
 AVITII A REVIEW AND CRITICISM ON HIS RECENT REPORT OF A 
 
 CASE OF 
 
 LAEYMO-TRACHEOTOMY, 
 
 mCLUDINQ ALL THE ATTESTED FACTS REGARDING 
 
 THE REGENT PARTRIDGE POISONING CASE 
 
 AT THE FIFTH AVENUE HOTEL. 
 
 BY 
 LEWIS A. SAYEE, M. D., 
 
 PK0FE8S0R OP OKTHOPEDIC SITRGERT. BELLE VUE HOSPITAL MEDICAL COLLEGE, SUUGEON AT 
 EBLLEVUE AND CHARITT HOSPITAL, ETC.. ETC. 
 
 NEW YORK: 
 D. APPLE TON & COMPANY, 
 
 90, 92 & 94 GRAND STREET. 
 1870. 
 
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CORNELL UNIVERSITY. 
 
 THE 
 THE GIFT OF 
 
 ROSWELL P. FLOWER 
 
 FOR THE USE OF 
 
 THE N. Y. STATE VETERINARY COLLEGE. 
 
 1897 
 
 THE DR. JOHN BUSTEED COLLECTION. 
 
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ANSWER 
 
 DR. A. RUPPANER, 
 
 WITH A REVIEW AND CRITICISM ON HIS RECENT REPORT OF A 
 
 CASE OF 
 
 LARYMO-TRACHEOTOMY, 
 
 INGLUDING ALL TEE ATTESTED FACTS REQARBING 
 
 TEE REGENT PARTRIDGE POISONING CASE 
 
 AT TEE FIFTE AVENUE EOTEL. 
 
 BY 
 
 LEWIS A. SAYRE, M. D., ^ 
 
 PKOFESi^OR OF ORTHOEEEDIC 30KGERT BELLETITE HOSPITAL MEDICAL COLLEGE, 3UKGE0S" AT 
 BELLETtJE AND CHAEITY HOSPITAL, ETC., ETC. 
 
 NEW YORK: 
 
 D. APPLETON & COMPANY, 
 
 90, 92 & 94 GRAND STREET. 
 
 1870. 
 
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To the President and, Memlers of the American Medical 
 Association, and the Medical Profession. 
 
 Gentlemen : As one of the Vice-Presidents of this Asso- 
 ciation, and Chairman of its Committee on Ethics, my char- 
 acter should be above reproach, or at least capable of with- 
 standing the strictest professional scrutiny. 
 
 Within a few weeks past a pamphlet has been published, 
 and very extensively circulated among the profession and the 
 public — including the daily and weekly press, and the public 
 libraries of the country — by A. Ruppaner, M. D., who adds to 
 his name " member of the American Medical Association." 
 
 In this pamphlet I am accused of the most gross violation 
 of the code of ethics ; which charges, if true, should certainly 
 remove me in disgrace from my present position as one of the 
 officers of this Association. It is due to me — it is due to the 
 Association — that these charges should be investigated by im- 
 partial and disinterested parties, and reported upon to this 
 convention, as to their truthfulness or falsity. 
 
 I therefore very respectfully but most earnestly request 
 that the subject be referred to some new Committee on Ethics, 
 or to a special committee to be appointed by the chair, with 
 instructions to report to this convention, at the earliest prac- 
 ticable moment. 
 
 All of which is most respectfully submitted. 
 
 Lewis A. Sayee, H. D. 
 
 Chairman Comm,ittee on Ethics. 
 May 3, 1870. 
 
 This petition was referred to the Committee on Ethics, of 
 which Dr. Stille, of Philadelphia, was chairman — Drs. Davis, 
 
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of Chicago ; Askew, of Delaware ; Keller, of Kentucky ; and 
 Dr. Woodward, of tlie Army, composing the committee. 
 
 The committee, having their time so occupied with the 
 contesting delegates from the District of Columbia that they 
 could not investigate the subject, and as Dr. Ruppaner was 
 not present, returned the paper, with the request that it be 
 referred to the local Medical Society of New York, for ad- 
 judication. 
 
 Dr. Murphy, of Ohio, stated that, as the slander was made 
 by a man who, in the same pamphlet in which he published the 
 slander, had confessed that he had before published two false- 
 hoods, he was therefore unworthy of credence, and could do 
 my professional character no harm. Dr. Maddox, of Mary- 
 land, then moved that the whole subject be laid upon the 
 table. 
 
 Having learned subsequently that Dr. Ruppaner was a 
 member of the New York County Medical Society, Dr. 
 Hibbard, of Indiana, moved to take it from the table, and 
 refer it to the New York County Medical Society, which 
 was done. 
 
 I have, therefore, in accordance with this resolution, pre- 
 pared the following narrative of facts, and present it to the 
 New York County Medical Society for their official action — 
 and publish the same for the information of the profession- 
 and the public : 
 
 In the March number of the New York Medical Joue- 
 NAL, 1870, I published a review of Dr. Ruppaner's article 
 upon " Laryngo-Tracheotomy," published in the January 
 number of the same journal, for the reason that, in one of the 
 cases published by Dr. Ruppaner, he claimed to have per- 
 formed an operation which I performed myself, and stated 
 that, in the " opening of the trachea and inserting the tube, no 
 untoward circumstance occurred," whereas the haemorrhage 
 and the insufflation of the blood were so great as to endanger 
 
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life for some minutes ; and, therefore, it became my duty, in 
 justice to science, and to the profession, to correct tliis errone- 
 ous statement. So far as his claiming to have performed the 
 operation alone was considered (which was false), I should 
 have paid no attention to it had he given a correct account of 
 the operation itself, and the hnemorrhage that occurred at the 
 time the trachea was opened. 
 
 This latter accident was aggravated very materially from 
 the fact that no suitable instruments were at hand to retain 
 the trachea open, in order to insert the tube, which by its pres- 
 ence and pressure might have prevented the haemorrhage; and, 
 as this point is not emphatically dwelt upon by our authorities 
 upon the operation as distinctly as it should be, I deemed it 
 'my duty to di^aw attention to the fact, in order that operators 
 in future might le especially upon their guard at this par- 
 ticular point in the operation, which is in fact the only point 
 of danger iu it, namely, the invaginating of the incision, from 
 the excessive desire to obtain air by a man who is suffocating ; 
 and at the instant the opening is made the inspirations are so 
 strong that, unless you are prepared to retract the opening by 
 proper instruments, there is great danger of immediate suffoca- 
 tion. It was to draw the attention of the profession to this 
 particular point that I made my review of Dr. Ruppaner's 
 paper. 
 
 The doctor, it seems, cannot understand a professional criti- 
 cism in any other sense than that of personal and pecuniary 
 advantage, for he has replied to it, and states that the question 
 will reduce itself simply to this : " Were you intentionally in- 
 jured in my report ; have I tried to correct my error % " I 
 never claimed to be either intentionally or unintentionally 
 injured. It was science and truth that were injured, not my- 
 self personally. I had no personal interest in the matter. 
 
 The doctor, in his review, now states that he always con- 
 sidered that the tumor was malignant, and denies having told 
 me that it was not malignant. I repeat my assertion that he 
 informed me that he had made microscopic examination of 
 the pieces of the tumor, and ascertained them to be non- 
 malignant ; and, in proof of this assertion, I refer to his treat- 
 ment, which he had pursued for months, that he Relieved at 
 
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that time that it was non-malignant ; for I cannot believe Mm 
 so ignorant of all the well-established principles of treatment 
 as to think that he would assume to treat a cancer successfully 
 by constantly tormenting it with irritants and escharotics. 
 The very plan therefore, which he had been pursuing for some 
 months, is an evidence conclusive that at that time he consid- 
 ered it non-malignant. I also refer to the second letter of Mrs. 
 Bigelow, in which she states that the doctor positively as- 
 sured her husband that it was not Tnaligncmt. Viewing it 
 myself as non-malignant at the time, accepting his description, 
 I suggested its removal ; whereas, if I had deemed it malignant, 
 I should have simply suggested tracheotomy as a means of 
 temporaiy relief. In my review, I state, I heard nothing from 
 it further until I received a telegram at Long Branch, which 
 telegram I simply quoted from memory, stating, " the captain 
 is dying, come iminediately, he must be operated upon at 
 once. A. Euppanee." 
 
 The exact telegram, as the doctor states, copied from the 
 books of the telegraph-office, is : 
 
 De. L. a. Satee, Mansion House, Long Branch : " Come immediately, 
 Bigelow must be operated upon at once." 
 
 Now, mark — the simple addition of " the captain is dying " 
 is the difference between the two, and it is remarkable that, 
 having been made simply from memory, it should be so ac- 
 curate as it is. 
 
 The fact that he was dying, and made therefore the neces- 
 sity for the operation, may possibly account for my mistake 
 in adding that conclusion to the telegram, I had no copy of 
 the telegram, it was merely one from memory. 
 
 The doctor states that after the first consultation we had 
 several conversations about it, and that I expressed a great de- 
 sire to see it. That is true ; it was a case of professional inter- 
 est, and I was very anxious to see him perform the operation. 
 But he states that I had been engaged to perform the opera- 
 tion—had agreed to do it ; that he had so told the captain, 
 and also Mrs. Bigelow, on the very day of the operation, and 
 their friends. If that is true, so much greater the crime of 
 his wilfully stating that he had done it himself. I most un- 
 
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hesitatingly state that, so tar as I am concerned, he never re^ 
 quested me to perform the operation until a few moments be- 
 fore it was done ; and, so far as the falsehood of his statement 
 in regard to Mrs. Bigelow and the captain, I refer to the 
 letter of Mrs. Bigelow, and to the published report of Dr. 
 Euppaner in the January number, as marked by Captain 
 Bigelow himself before his death ; and more especially to that 
 part of Mrs. Bigelow's letter where she states that the cap- 
 tain himself " ma/rked these untrwthsP 
 
 As another proof that I certainly did not expect to per- 
 form the operation, is the fact that I went to it without any 
 instruments whatever, except my ordinary pocket-case, which 
 I always carry, and, but a few moments before the operation 
 accidentally meeting Dr. Vance, informed him that Dr. Eup- 
 paner was going to perform the operation of laryngo-tracheot- 
 omy, and asked him if he wished to see it ; that if he did, I 
 would see if I could get him an invitation, and went and ob- 
 tained from Dr. Euppaner permission to invite him. If I were 
 to have performed the operation myself, I certainly would 
 have felt at liberty to invite Dr. Vance, or anybody else whom 
 I liked ; and most certainly, if I were going to perform so seri- 
 ous an operation as tracheotomy, and the removal of a tumor 
 from within the larynx, I should have taken a proper number 
 of assistants with me. I again repeat that the first idea I had 
 that I was expected to perform the operation was, when Dr. 
 Euppaner made the suggestion to me to perform it for him, 
 a very few moments before it was done. His statement that 
 I said, " Just let me know, as we progress with the operation, 
 what you wish done, and I will do it," I pronounce as most 
 unqualifiedly false. 
 
 The doctor lays great stress upon my regarding this as an 
 operation of magnitude. I am aware of the simplicity of 
 simple tracheotomy, and, probably having performed it as 
 many times as Dr. Euppaner, am fully competent to judge of 
 its magnitude or simplicity ; but, when tracheotomy is com- 
 menced with an idea of being extended to the removal of an 
 intra-laryngeal tumor, and is complicated by the necessity of 
 puncturing through a vascular tumor before you reach the air 
 passage (see Dr. Cheever's letter), it is an entirely different 
 
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operation from simple tracheotomy, and its magnitude will 
 be properly recognized by every competent sm-geon. 
 
 1267 "Washington Steeet, Boston, ) 
 April 10, 18T0. 5 
 
 Deae Doctoe: 
 
 I gladly embrace the opportunity to send you, throngli our mutual 
 friend. Dr. Brown, a brief account of the later hours and autopsy of your 
 patient, Captain Bigelow. I attended him from January 1st to March 26th, 
 when he died. The tumor had then attained the size of a duck's-egg, and 
 projected so much externally that it constantly pushed out the tube, which 
 had to be lengthened from one-qnarter to one-half an inch every three 
 weeks. The last tube he wore was three and a half inches long. A week 
 before death, sloughing began and soon destroyed the tumor down to a 
 level with the skin. He did not die of suffocation, as he had feared, but 
 of exhaustion, consequent on mal-nutrition, diarrhoea, and hfemorrhages. 
 The autopsy was made twenty-seven hours post mortem. Dr. Ellis was 
 present. The tumor surrounded the larynx, and had pushed forward the 
 hyoid group of muscles. Externally, it nearly touched the sternum. In- 
 ternally, it extended down very slightly beyond the cricoid cartilage. It 
 did not pass beyond the third ring of the trachea. The tube was fhrough 
 the lower edge of the tumor, between the cricoid and third or fourth rings 
 of the trachea. The trachea was intensely congested, but clear. The tu- 
 mor had sloughed inside and out. It blocked the glottis, the vocal chords 
 being covered and much altered. The ventricle of the larynx was invaded. 
 The tumor had sloughed through into the pharynx on the right side. The 
 epiglottis and tongue and throat were free. 
 
 Pieces of the tumor were submitted to two microscopists, who pro- 
 nounced it cancerous. The specimen is preserved in the cabinet of the 
 Boston City Hospital. Very truly yours, « 
 
 David "W. Oheevee. 
 Dr. Sayre. 
 
 Tbe doctor again asserts that " two tenaculums were on 
 hand, and Dr. Dudley asserts that one of them was too weak." 
 I again affirm that this weak tenaculum, to which Dr. Dudley 
 refers, was the one taken from my pocket-case, which was not 
 therefore present at the operation, except in my pocket, re- 
 quiring some time to be obtained before it could be used ; and 
 the proof of it is the fact that Dr. Dudley in his letter states 
 that he " used the open ring from the handle of my scissors 
 out of my pocket-case to retract the opening, after finding 
 that this tenaculum was too weak." How could Dr. Dudley 
 have obtained the hook from the scissors of my pocket-case, 
 unless I had previously removed it from my pocket? 
 
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9 
 
 The doctor acknowledges that he neglected to refer to the 
 hsemorrhage which occurred, but states that in the original 
 draft of his report he wrote : " Xo untoward event happened 
 when the incision was made and the canula introduced, except 
 some hoemorrhage, the una/voidable result of the vascularity 
 of the tumorP The latter part of this sentence, he says, by 
 some unfortunate mishap, he neglected to copy in the manu- 
 script for the press. This, which is really the only important 
 'part of the whole operation, to he neglected, is certainly most 
 extraordinary. It is like the playing of Hamlet, and, on the 
 particular evening of the play, Hamlet is entirely left out. 
 
 The doctor next finds fault with my corresponding with 
 his patient, and says : " Shortly after the operation, I became 
 aware that you were working up my case." After havii^ 
 published that he performed the operation, and now stating 
 that I did it, and that he and Bigelow expected me to do it, 
 I am at a loss to understand how he can call it his case. 
 Having performed the operation myself, I certainly had the 
 professional right to claim the operation as my own, and the 
 professional right to watch and keep an interest in it. But 
 his statement that I corresponded with his patient is not true, 
 as will be seen by reference to Mrs. Bigelow's second letter, 
 with the single exception of writing him a respectful answer, 
 to a very long communication which I received from him, 
 most of which I had copied and sent to the doctor, and from 
 which I think he obtained his first ideas of its malignant 
 character, and in which letter the captain refers to the doctor's 
 want of honor, which letter I have not published in full ; but 
 do now respectfully refer to the committee his letter on that 
 subject. 
 
 {Mrs. BigelovPa First Letter.') 
 
 92 Shawmut Avenue, Bobton, April 19, 1870. 
 De. L. a. Sathe — 
 
 Dbak Sie : I have just received a note from Dr. Obeever with your let- 
 ters to him of the 15th enclosed, in wliioh you say " you have written to 
 me at New Braintree, but have not received any answer.'' I have not re- 
 ceived the letters, therefore the cause of my silence. I will write you the 
 desired information as soon as I am able. When Dr. Euppaner's report 
 appeared in the New Yoek Medical Journal, Captain Bigelow read it and 
 
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10 
 
 ma/rhed the wnt'ruths in it, and I have loaned it to a medical friend, and 
 ■when I get it again I will write yoa our experience with, and regard for, 
 Dr. Enppaner, which is not aa pleasant as we hoped it might he, when we 
 first made his acquaintance. I should be pleased to hear from you before 
 I leave here, which will be one week from next Friday. If there is any 
 thing particular Which you wish to know I shall be glad to give you all 
 the information I can. With grateful remembrance, I am, 
 
 Yours respectfully, 
 
 JlTLIA E. BlGELOW, 
 
 As I intended ptesenting the whole controversy to the 
 American Medical Association for adjudication — which was 
 to meet in Washington on the 3d of May — 1 wrote to her to 
 forward me the copy of the Medical Jotjenal above referred 
 to, and received the following reply : 
 
 (Mrs. Bigelow's Second Letter.) 
 
 MiLBUET, Mass., Monday, 3 p. si., May 2, 1870. 
 De. L. a. Sayee— 
 
 Dbae Sie : I have just received your letter of April 28th, forwarded 
 from Boston. I hasten to answer, and fear you will not receive it in time 
 to do you any good. 
 
 After you were called by Dr. Kuppaner to examine Captain Bigelow's 
 throat the first time, Captain Bigelow asked Dr. Kuppaner, what you 
 meant by asking if it was malignant, not quite understanding the term. 
 
 Dr. Kuppaner explained, and said positively that it was not malignant, 
 but never gave him to understand really what it was, only that it appeared 
 like what is called a cauliflower growth. You were called the second 
 time in consultation, and, after you were gone. Dr. Kuppaner says : " That 
 man" (speaking of you) "is one of the best surgeons in the city, and if there 
 is an operation to be performed on your throat, Bigelow, I shall call him 
 to assist in doing it." I was present and heard him say it. That was just 
 before we went to Norfolk, Virginia, 
 
 "We spoke of you to our friends, and they all spoke in the highest 
 terms of your skill as a surgeon, and we were quite at ease in oar minds 
 afterward. On our arrival in New York, August 13th, Captain Bigelow 
 called on Dr. Kuppaner (Dr. Parish from Portsmouth, Virginia, was with 
 Mm, having accompanied us to New York, as it was not considered safe 
 for me to come alone with him), and was told that something must be done 
 immediately, and that he would send for you, and the time was set on 
 Monday, twelve o'clock, August 16, 1869. 
 
 Dr. Kuppaner got vexed at what Captain Bigelow said to him, Satur- 
 day morning before the operation, about something our Boston friends 
 had said about him (Dr. Kuppaner), and in the evening sent for me to call 
 
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11 
 
 at liis office, as he desired to talk with me. I went, and he then told me 
 after what the captain said to him that morning, concerning our Boston 
 friends' opinion of him : Tie should never touch a hnife to Captain Bigelow's 
 throat; that he wished to ^rop'the whole affair and case, just where it 
 was, and we might get who we liked, and our Boston friends might man- 
 age the whole business to please themselves. 
 
 Not knowing the man as well as I do now, I hardly knew what to say, 
 but finally told him something must be done for Captain Bigelow, and if 
 he chose to drop the case somebody would be called, he could not live as 
 he was but a very short time. Then Dr. Euppaner said to me : " But if it 
 js your wish I should go on, and do for the captain, I will, but I will on 
 no account whatever put a knife to his throat." 
 
 I told him, from what I had heard of your skill, I was satisfied to have 
 you perform the operation, and he said he would be then at our rooms at 
 the time set, and assist you, as he had already sent for you, to come from 
 Long Branch. 
 
 "We saw notliing more of him until he came in, instruments in hand, at 
 the time set on Monday. Our friends, Mr. Hobart, and Mr. Worthley, 
 remained in the room, but were told by Dr. Euppaner to go out. They 
 did not, as they afterward said, they " did not wish to leave Captain 
 Bigelow alone, without a friend near him." Dr. Parish and Dr. Martin 
 were present all the time, and both stayed a few days with us after the 
 operation. Dr. Euppaner did not dress the throat once. He assisted in 
 removing the tapes, the first time. I did it myself as long as he lived. 
 
 We questioned Dr. Euppaner about the operation, and all we could get 
 from him was : " Captain, you behaved splendid, every thing was all right, 
 and in a few days you go home, to your country place, in Massachusetts, 
 and wait until I send for you, and we will then see what can be done about 
 removing that thing in your throat, for you will then be stronger, and 
 better able to bear it than you are now, it is useless to make another at- 
 tempt riglit away." He never answered our questions satisfactorily to 
 any of us {Captain Bigelow, myself, and our sister Mrs. Harding), and 
 about that time Dr. Euppaner left the city, and was very anxious to have 
 us go as soon as he did, but we did not choose to leave Uew York until 
 we knew something about the operation. You had not called on us since 
 the operation, and knowing that you used the knife, and did the most of 
 the work, we ventured to call upon you at your office, and ask you for the 
 particulars of the operation, which you kindly gave, and manifested sur- 
 prise at our not knowing any thing about it from Dr. Euppaner. 
 
 You never wrote to Captain Bigelow, except in reply to his letter. 
 
 Dr. Euppaner claimed that he assisted you in the operation. He al- 
 ways told Captain Bigelow that the tumor was not malignant. I cannot 
 send you the report that Captain Bigelow marked, as it is in my trunk, 
 which lies at the railroad station at West Brookfleld. 
 
 I left Boston last Friday, and stopped here over the Sabbath, on my 
 way to my home in New Braintree, Massachusetts. 
 
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12 
 
 I intended writing yon as soon as I arrived there, as I was not able 
 before I left Boston, being very weak and nervous, for I took the entire 
 care of my husband night and day, while he was spared to me. 
 
 In the report Dr. Euppaner says he put down a concealed hnife, and 
 cut into the tumor. He never did it. He showed the instrument to Cap- 
 tain Bigelow, and said he would like to try that. 
 
 He put the forceps down but once, but did not succeed in removing any 
 thing, but made the tumor bleed profusely. He applied what he called 
 "hell-fire," Vienna paste. 
 
 I was with Captain Bigelow ; he appeared more nervous than I had ever 
 seen him before, and what we both did for him brought his breath back 
 again, but he was never as well after it. 
 
 On receipt of your letter to-day, I was son*y that I had not taken tlie 
 reports with me, and then I could have sent them to you ; but as it is now, 
 I do not think I can possibly get this letter to you in Washington in time, 
 and shall send it to your house in New York. 
 
 Captain Bigelow lost all confidenAie in Dr. Euppaner, and I can safely 
 say he has not a very good reputation in Boston, and what he says of you 
 will not injure you in the estimation of the Boston friends, and Captain 
 Bigelow always felt that, through your skill, his life was saved. He lived 
 to settle all his worldly affairs, and to prepare his mind for a final separa- 
 tion from those he so fondly loved, and to be fully reconciled to God's will, 
 for " His will, not ours, be done." I will give you the address of some of 
 our friends who were present at the time of the operation, and if you like 
 to communicate with them you can do so. George H. "Worthley, care 
 Cyrus Wakefield, Esq., Boston, Mass. ; Dr. S. E. Martin, North Brookfield, 
 Mass. : Dr. James Parish, Portsmouth, Va., and Joseph Hobart, Esq., 189 
 Broadway, New York City. 
 
 Eegretting that I did not receive your letter in time for the answer to 
 reach yon while in Washington, and hoping that this matter may be set- 
 tled to your satisfaction, 
 
 I remain yours, gratefully and respectfully, 
 
 Julia E. Bioelow. 
 By E. W. Peieoe. 
 
 I did not receive the promised pampUet until a few days 
 since, when her friend called and left it .with the following 
 letter : 
 
 {Mrs. Bigelow'' s Third Letter.) 
 
 \ 
 
 New Beaintbeb, Mass., 
 Dn. L. A. Savee — 
 
 Tuesday, May 17, 1870. 
 
 Deae Sie : I wrote you from Milbury two weeks ago, but was not able 
 to send you the Medical Jouesal, containing the report of my husband's 
 case, as I did not have it with me. 
 
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13 
 
 Yesterday nn acquaintance from New York called to see me, and, say- 
 ing he sliould return there this week, I asked him if he would take the 
 book to you for your perusal. He very kindly said he would do so, and 
 you will there see the untruths marlced ly Captain Bigelowh own hand, 
 and judge something what his feelings were toward Dr. Euppaner. I 
 would like the book returned to me, as I desire to keep it for reference, for 
 he marked it for me at my request. I have all the correspondence between 
 Dr. Euppaner and Captain Bigelow, which, if necessary, you can have at 
 any time. I do not think that what Dr. Euppaner can say about you will 
 injure you in Boston, but he has not raised himself at all there, since these 
 reports appeared, for I have never heard a word spoken in his favor, and 
 he is well Jmown there. 
 
 I shall be glad to hear that the affair is settled satisfactorily to yourself. 
 
 Trusting that it will be, I remain, yours respectfully, 
 
 Julia E. Bigelow. 
 
 The side notes in small print are copies of Captain Bige- 
 low's notes on tlie report, and the italicized sentences refer to 
 what he considered untrue. 
 
 Case III. — La/rge Tnalignant tumor, involving the infraglottic 
 space and trachea ; cough, dyspnoea, aphonia, danger of 
 suffocation, attempt at extirpation / laryngo-tracheotomy. 
 
 Mr. B , of B , Mass., aged about thirty-six or forty, sea-captain, 
 
 was sent to me for examination by his physician. Dr. Swan, of the Astor 
 House, New York. 
 
 HisTOET. — Has always enjoyed good health, for a man subject to the ex- 
 posures and hardships of his calling. Three years ago he was sbipwrecked. 
 In oonsaquenoe of several days of extreme exposure and 
 
 hardships in the endeavor to save ship and cargo, his H^ye l"'?i> ?«<=- 
 
 '■ 1 termg, with loss 
 
 health became impaired, manifested by the advent of of voice most of 
 
 , T .11 /. . k Di. T ■ the time, since 
 
 cough and occasional loss of voice. After shorter or November, 1863 ; 
 
 longer periods, sometimes with, sometimes without treat- ^^^6^1868''^°" 
 ment, he recovered hisvoice, though each renewed attack 
 left its traces behind ; its quality became more and more impaired. Al- 
 though he placed himself again under treatment, the hoarseness increased, 
 till most of the time he could only speak with a whisper. 
 
 In tills condition Captain B. presented himself at my office, March 23, 
 1869, for examination. 
 
 CoNBiTioiir. — Body well developed and finely proportioned ; chest large 
 and movements regular ; breathing vesicular ; no developed disease ; heart 
 normal. The external region of the larynx presented nothing abnormal ; 
 slight pressure on either side, or upon the anterior surface, caused no par- 
 ticular pain. Pharyngeal mucous membrane moderately congested; no 
 effusion ; no evidence of recent or old ulcerations. Inspiration easily 
 
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14 
 
 audible, accompanied by a peculiar shrill sound. Voice gone ; able to 
 whisper only. General health good ; appetite fair ; sleeps well. 
 
 LABTNaoscopio ExAMii^ATioiT. — Epiglottis depressed posteriorly, so as 
 to hide from sight one-third of the contour of the supraglottic space ; its 
 free border and apex show traces of recent ulceration; anterior surface 
 slightly inflamed ; posterior surface much more so. Owing to the depressed 
 and irritated condition of the epiglottis, some days elapsed before a com- 
 plete view of the interior of the larynx could be obtained. These obstacles 
 removed, the ary-epiglottic folds, ventricles, and false vocal cords, were 
 found to be congested. The right vocal cord presented a dirty-gray color, 
 yet normal in its action. The left vocal cord, on the contrary, remained 
 stationary, held back by a grayish red-looking mass attached to its lower 
 surface. During the act of expiration, when told to pronounce the letter 
 (l, or to shout, or to laugh, the free border of this mass, smooth, thin, 
 readily moving to and fro, was clearly seen to project forward and upward 
 into the free space of the glottis, obliterating it almost entirely. Upon 
 inspiration, this same part of the growth, the base of which was clearly 
 attached to the left wall of the trachea, would sink back again into the 
 space below, leaving the free space in the glottis larger than during expi- 
 ration. The vibratory motion of this part of tlie growth might fitly be 
 compared to the opening and shutting of a valve. 
 
 Fig. 4 (see plate) represents the glottis during the act of expiration witli 
 that portion of the growth exposed to view, as I demonstrated it to nume- 
 rous medical gentlemen on different occasions at my office — among them 
 Drs. Swan, Sayre, Dunster, Dudley, Cooper, Kinney. 
 
 Diagnosis. — From the first I was inclined to regard this growth as 
 iiery dangerous in character and malignant in type. Appearance, rapidity 
 of growth, position, symptoms, all were against the case. Still I hoped to 
 ie able to arrest the disease in its progress upward, ty removing with 
 instruments portions of it, and l>y local applications to heep its growth in 
 checTc. My great fear was its downward progress — its descent into the 
 trachea — and then already suggested the possible necessity of the operation 
 of tracheo-la/ryngotomy . 
 
 Subsequent results still more confirmed my apprehension. Whenever 
 an instrument was brought in contact with the mass in situ, it bled readily 
 — profusely at times. Pieces of the size of a large pin's head were re- 
 moved with the forceps, and also coughed up at intervals by the patient, 
 followed always by hemorrhage. Much may have been expectorated, as 
 often the sputa were tinged considerably with blood. 
 
 The portions, after being removed or expectorated, when examined, 
 were of a lobular, cauliflower appearance, of a soft, lardaceons consistency, 
 and of a grayish-red color. Examined under the microscope, these lobules 
 were found to consist of cancer-cells, varying in type, some being oval, 
 some round, others globular, with distinct nuclei, in some two, and more in 
 others. 
 
 Considering, then, these specific characteristics described with the rest 
 of the symptoms collectively— pain, tendency to haemorrhage, color, con- 
 
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15 
 
 ^Utencp, form, and rapidity of growth — the carcinomatous nature of the 
 tumor was established teyond a doubt. 
 
 Peognosis. — Unfavorable. 
 
 Tkeatmbnt. — To remove as much a« possible of the growth, per mas 
 naturales, thereby relieving the aphonia and dyspnoea, and later, if neces- 
 sary, and as seemed most probable, to have recourse to laryngo-trache- 
 otomy, should the growth encroach too rapidly upon the free space of the 
 trachea. 
 
 After a week's practice with the mirrors, the irritability of the fauces 
 was in a great measure overcome, and I had no trouble to demonstrate the 
 neoplasm to my medical friends. 
 
 I touehed the larynx daily with Lugol's solution, bringing the brush 
 directly to bear upon the mass, which, after a short time, seemed to con- 
 tract under its use. Captain B. began to speak louder, and to breathe 
 freer, nor was there any pain in swallowing at that time. Dr. Swan, who 
 saw the patient from the first, was also of opinion that the tumor grew 
 smaller and the voice more powerful. This latter fact was apparent to all 
 of the captain's friends. 
 
 During a temporary absence of the patient the good accomplishted was 
 nearly lost. Then I decided to use the forceps to remove what I could of 
 the growth. My efforts in that direction were, however, arrested by the 
 profuse bleeding that followed each time small lobules icere torn away. 
 I next resorted to decision of the part in situ. Several incisions were 
 made at the favorable moment with the catheter-shaped, covered lancet of 
 Tobold. Hemorrhage followed ; the next day the part in. Ata. showed signs 
 of suppuration. The result of this operation was gratifying, as the patient, 
 after a few days, when the result of the incision became evident, gained 
 again in voice, and his breathing was much relieved. 
 
 Fig. 5 {see plate) represents the larynx with the tumor in situ in the 
 glottis, after the operation of decision. 
 
 StiU another relapse followed, accompanied by considerable difficulty in 
 swallowing. I became more and more satisfied that, although I was op- 
 posing the enemy with considerable success in its progress above, the 
 disease was, at the same moment, rapidly encroaching upon the trachea. 
 This truth was still more forcibly brought home to me by the appearance, 
 ia the latter part of July, of an enlargement in the left side of the trachea, 
 increased sensibility upon pressure, greater difficulty in swallowing, and 
 a feeling, when lying down, as if something loose was hanging from its 
 attachment on the left to the right side. Pain in the left ear, dizziness in 
 the head, increased paroxysms of coughing, and profuse expectoration, were 
 now added. No wonder the captain became at times alarmed about him- 
 sel£ I now had recourse to the application of chromic 
 acid, followed by some relief, at least, of the distressing or "heTa^re^" as 
 symptoms. Business called him repeatedly to Norfolk, gff^'^®'' "; '^''t 
 Virginia, in June, July, and August, though he paid me ly cost life .on the 
 visits from time to time. Owing to the increased gravity 
 
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16 
 
 of tlie case, I laid before Mm the necessity of an operation (extra-laryn- 
 geal, but could not get his consent at the time. 
 
 August 13, 1869. — Captain B. arrived by steamer from Norfolk, in 
 company of Dr. Parish, late surgeon on the staff of General Lee. Dyspnoea, 
 cough, paroxysms of strangulation, and inability to swallow food, had be- 
 come so alarming that the doctor had to accompany the captain. Ooante- 
 nance livid, hands cold, pulse weak, nervous system prostrated, expression 
 anxious : such was his condition. 
 
 August 16. — Opebatioh of LAKYNoo-TEAeHBOTOMT. — My friend, Br. 
 L. Sayre, who liad seen, at my request, the patient at a former consulta- 
 tion, consented to divide with me the responsibility and to aid me with Ms 
 experience and sJcill in performing the operation, so as to give me free 
 scope for observing the course, position, extent, and nature of the tumor, 
 and to direct such a course as the progress of the operation might demand. 
 I bad also the valuable assistance of Drs. Dudley, Parish, Swan, Zolnow- 
 ski, and several others. 
 
 It had been decided upon to perform, first, tracheotomy, so as to give 
 the akeady much-exhausted patient an opportunity to breathe freer; then 
 to divide the thyroid and cricoid cartilages in the median line in order to 
 reach the tumor, and to extirpate if possible, if not the whole, at least 
 part of it. "When the larynx and part of the trachea were exposed to view, 
 after careful dissection of the adjacent parts, the trachea, as far down as the 
 sixth ring, was found to be enlarged, principally on the left side, though 
 the enlargement extended across the median line about half an inch. To 
 the touch this enlargement was rather hard and immovable. None of ns 
 had anticipated that the growth had progressed to such an extent into the 
 air-passage below. The chances for a successful termination of the opera- 
 tion had nearly vanished. To attempt to remove the tumor in the then 
 exhausted condition of the patient, coupled with the additional danger in- 
 volved on account of the extent of the disease and the parts affected, would 
 have been foolhardiness. Division of the cricoid cartilage and first ring of 
 the trachea and so much of the mass lying below as was necessary to get 
 the canula into the trachea, was at once determined upon. This would 
 rescue the patient, at least from immediate danger of suffocation, afford 
 him a chance to recuperate his strength, and perhaps admit, 
 drowmno-'^with ^'^ some future time, of a supplementary operation. No 
 ^'°°^- untoward event happened when the inciMon was made and 
 
 Never attended ^^'•^ canula introduced. When the effect of the ancesthetic 
 and was always ^"^ passed away, the patient, though much exhausted, 
 troubled about breathed easier, and fellinto a slumber. When I visited 
 Bwallowmg. T.. . ., ■ 1 I ■, 
 
 htm in the evening he was a changed man. 
 
 The next day, August Vj, he exhibited some symptoms of pneumonia, 
 which yielded, however, to treatment in twenty-four hours. Mucus and 
 blood were discharged from the canula, hit the wound caused little or no 
 2Min. The process of eating and drinhing, at first a little difficult, soon 
 became perfectly easy. On the fifth day the stitches were removed. There 
 
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17 
 
 was some soreness and discharge around tJie canula. The greater force of 
 the left larger division of the tumor twisted the canula somewhat toward 
 the right. Oq the sistti day the patient sat up, and could attend himself 
 to the cleaning of the tahe, eat with comfort, and move about. A laryn- 
 gosoopic examination showed the growth distinctly, grayish-red in color, 
 nearly closing the glottis. He spoke, of course, only in a whisper ; cquld 
 not articulate the first word, or make other than a hissing sound. 
 
 The progress now made from day to day was surprising. He lost that 
 anxious look, relished his food, and slept well. He could breathe easier 
 and take a deeper breath than he had done for years. August 25, being 
 obliged to visit a patient in Montreal, I saw Captain Bigelow for the last 
 time. He also made preparations to return home the nest day. Before 
 leaving, he called upon Dr. Sayre, who cauterized the wound, as it had be- 
 come irritable. 
 
 From a letter received from this patient, dated September 9, 1869, I 
 made the following extracts: "I endured the journey from New York to 
 this place remarkably well, but was considerably fatigued and troubled 
 with the dust ; have been gaining ever since I came here. Have walked 
 and rode, and am becoming expert in the arts of eating and drinking, both 
 of which I do now without putting my finger on the tube or otherwise 
 closing it. The wound in the throat is healing full as well as could be 
 expected." 
 
 Nothing has been elicited from the captain since the 
 above date, till a short time since I came in possession of &iyj.|"'"' '" ^^' 
 the foUowing statement of his case, brought down to the 
 date of writing: 
 
 " When I first got home, I improved in strength and general health 
 very rapidly for eight or ten days — but continued to cough a good deal — 
 raising much mucus, varying from clear white to yellow, often streaked 
 with blood — frequently a good deal of blood, as I had ever since the opera- 
 tion. Scabs formed below the tube, which I would several times each day 
 cough up with more or less diflSculty, and this has continued to the present 
 time. At first, had fom- or five of them each twenty-four hours — raising 
 them always with severe coughing and more or less blood, in quantities 
 from two tablespoonfuls down to occasionally a very minute quantity. The 
 scabs sometimes are so large and hard, and get stuck so fast, that, even with 
 small ixxbe removed, I have been many times nearly strangled. Lately, 
 however, they have been much reduced in size, more irregular, and healthy 
 in appearance. 
 
 "For two or three weeks my cough, though very frequent through tlie 
 day, was mucli worse at night ; and as I could not cough alone, I was com- 
 pelled to have my wife up to assist me, sometimes twenty times per night. 
 As this was wearing us both out, I began to take, on going to bed, twenty 
 to twenty-five drops McMunn's Elixir, and this opiate immediately gave 
 me quiet sleep and rest free from coughing. To relieve my cough and 
 pains, and give me quiet sleep, I have continued this to the present time. 
 
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18 
 
 I have had considerable bronchitis, and Lad one bad cold— just now I have 
 no cold, and less bronchitis. Still I cough up a good deal of mucus and 
 blood. Some- of this blood we know must come from the trachea helow 
 the tube. Some of it we also know comes from the tumor aiove the tube — 
 as, when it has a bleeding-turn, we can see it dripping in through the hole 
 in upper part of the tube. When I left New York, as you saw, suppuration 
 was going on inside and oozing out around the tube — this continued and 
 increased, so it was difficult to keep my throat tolerably clean until middle 
 of September, when it ceased. While active it had much odor, as also had 
 my mouth, when held open, though kept as clean as possible. We had 
 great hopes that this suppuration would work a favorable change, but it 
 stopped almost in a day. The tumor had previously somewhat enlarged, 
 but now it grew faster in size, and got very hard, all around the tube, 
 especially above and on left side. I had a good deal of soreness around 
 the tube — and as this hardness and swelling increased, so also did the pain. 
 My left ear began to ache severely and almost constantly, as before the 
 operation. 
 
 " Immediately around the tube, a ridge or swelling formed, harder than 
 any other part. During all this time proud flesh had never ceased to grow, 
 since the first that you cauterized in your office. We had continued to- 
 cauterize it — but as fast as it was killed in one place it appeared in another ; 
 this fungus gradually changed in appearance, cauterizing became painful — 
 burning, smarting pains lasted often for hours after the application — the 
 pains of each thorough dressing and cleaning of my throat morning and 
 evening were exquisite. Still this fungus was pronounced ' proud flesh ' 
 and cauterized. At last Dr. Martin (our family physician, whom you may 
 remember as present at the operation) applied a paste, which he thought 
 would have different and better effect than caustic — but two applications 
 were made, as the swelhng around the tube increased— the ri(^e above 
 named was forced up into quite a hilloch, through which the tube ap- 
 peared, and was forced far away to the right side of its original position. 
 During these painful days and weeks, the changes from day to day were 
 remarkable. At last this ' eidob,' from an angry red, grew purple, then 
 black, and at one morning's dressing my wife removed the whole of it 
 without difficulty — a dead, rotten mass of decayed flesh — and it left a trench 
 around the tube, about three-eighths of an inch wide and deep, and not a 
 bit of proud flesh was to be seen ; but on the left side, close against the tube, 
 was a darh, roiigh, warty growth, as large as a full-sized pea, and larger — 
 looking ugly enough. It had no attachment to the flesh beside it, as it and 
 the flesh could be pressed apart easily. While the flesh adjacent was ex- 
 quisitely sensitive to the touch, this 'growth' had no sensitiveness at aU, 
 but could be pressed with the point of a knife, without any feeling, though 
 it was easily provoked to bleeding. There can be no doubt but what this 
 is a part of the original tumor which has forced itself out of the windpipe 
 and tlirough to the surface, beside the tube. From that time till a week 
 since (about eleven days) my wife used morning and evening to take away 
 
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19 
 
 portions of tliis matter, which would ' slough ' off the tumor. As this 
 diminished, suppuration began again; the swelling all around the tube — or 
 rather the great tumor in the traohea — which was so large and swollen 
 and hard before, became greatly reduced, and, when the ' sloughing off' 
 ceased, suppuration became more active, with very offensive odor ; this has 
 gradually decreased, till now the suppuration is but slight, and the ' trench ' 
 around the tube, that for a time was a ghastly sight, is now nearly healed 
 up ; but next the tube the tumor has extended, and at present it can be 
 seen two-thirds the way around the tube, and the original tumor inside the 
 trachea has so enlarged and expanded it, that it appears now more than 
 twice as large as at the time of operation, and is almost as hard as a stone. 
 Coughing and bleeding continue as before, much blood comes from the 
 tumor, and considerable comes from the lower trachea, if not from the 
 bronchial passages. I cannot believe that the tumor has extended below 
 the tube yet — but certainly there is more difficulty in breathing, that is, 
 even when free from scabs and mucus. I do not inflate my lungs as freely 
 or as easily as I did five or six weeks ago, and breathing generally is not 
 as easy. 
 
 " This may be owing to irritation and inflammation about the inner 
 end of the tube, making the passage smaller, or it may be the growth of 
 the tumor, encroaching on the passage into the tube — or something else 
 beyond my ken may occasion it; I cannot and dare not even guess what it 
 is! During the time the above-named 'ridge 'was forming, and even 
 until the subsequent 'trench' was nearly healed, I had almost continually 
 sharp, stinging, darting pains around the tabe —not extending far from the 
 tube, but all radiating from that as a centre — sometimes the hole in which 
 the tube is inserted would feel as if filled with a red-hot iron or live coal, 
 so intense would be the pain ; at other times the pain was less, and more 
 as if it was filled Vfith. & chestnut-lur ; at other times the stinging, burn- 
 ing, darting pains would follow each other in quick succession, appearing 
 to me, especially when asleep, like so many irregular shots fired from one 
 centre, but mostly to the left side — all this time the pain was most exquisite 
 while the throat was being cleaned and dressed, and, soon after the first 
 application of warm water with a soft camel's-hair brush, it would inva- 
 riably become so severe that I could scarcely endure it. 
 
 " This has lately gradually diminished, till now I have none of the pains 
 mentioned, and but little tenderness about the parts when under cleansing 
 treatment, and I should here say that, through the most painful period 
 mentioned, there were intervals of comparative comfort and relief, but they 
 were short and irregular. The tendency to left earache has been almost 
 constant for nearly a month past — much of the time it is dull, and not very 
 hard ; but it has paroxysms of very severe aching pain in left ear — doubt- 
 less caused by inflammation and enlargement of the throat, affecting the 
 nerve in some way that you understand, but I do not. "When the earache 
 comes on quick and sharp, it has frequently, within the last ten or twelve 
 days, been accompanied with aching of all the teeth on left apper jaw — but 
 
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20 
 
 this has never lasted raoi'e than fifteen or twenty luinutes at a time. Ec&- 
 piration, as I hare said, is not as-free as it was a few weeks since. I have 
 to he careful to avoid the cold air, as it goes so directly to my lungs that 
 the effect is had ; when the weather is warm I walk or ride out, but at 
 other times I keep the house pretty closely, with rooms kept warm with 
 wood-fires, and fresh water steaming to moisten the atmosphere. I do not 
 feel as strong, nor can I endure the exertion I could a few weeks ago, and 
 my appetite, which was then strong and hearty, is now poor and variable. 
 The above account needs no comment. The rapid progress of the 
 growth foretells also the sequel. 
 
 HesuTnS. — For six years the patient was suffering and 
 constantly getting worse, yet Ms true condition remained un- 
 told nntil he was subjected by myself to a laryngoseopic ex- 
 amination. This much the captain used to grant, that for the 
 first time he had been told what ailed him : and I think also 
 my diagnosis and prognosis were correct. What might have 
 been the result, had the disease been discovered in its incipient 
 stage and treated accordingly, cannot now be told. It may, 
 however, be asserted, that if the disease, as subsequent results 
 have shown, was malignant, it would not have been arrested 
 or eradicated. Still, could not its progress have been retarded, 
 and thereby the patient's life prolonged ? 
 
 Again, local interference through the mouth accomplished 
 all that reasonably can be claimed for it in a case of this na- 
 ture. It gave the patient comfort — it helped to prolong his 
 life. 
 
 TJie operation of the tracheo-laryngotomy, had it heen per- 
 formed earlier, to which Captain £., however, 7)iost strenu- 
 ously objected, as well as his friends, might have resulted in 
 great good. Undertaken, as it was, at the very latest tnoment, 
 under conditions of great danger, it still was a success, and 
 accomplished all we had a right to expect. 
 
 As to the doctor's statements of the thanks, gratitude, and 
 confidence of the captain in him, I refer simply to the widow's 
 letters, and the marked copy of the doctor's report in the cap- 
 tain's own handwriting. I would draw especial attention to 
 another sentence in the doctor's reply, in which he confesses 
 that he had written the report with the intention of conveying 
 
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21 
 
 tTie idea that he performed the operation, but, when carefully 
 read, could only he interpreted that 1 could have done it, but 
 that he did not punctuate his sentences too correctly, so as to 
 parse grammatically that "I" instead of "himself" had per- 
 formed the operation ; and in the very next sentence he states : 
 " Upon reading, however, that rather, I should think, com- 
 plimentary than disparaging sentence, your injured sense of 
 justice is aroused, you swear vengeance, and, presto, you ad- 
 dressed questions in wiiting to the gentlemen who were my 
 guests, not yours, at the operation," thereby inferring that it 
 was his operation, and certainly contradicting his previous 
 expression that it was my operation. I leave it to the doctor 
 to explain this discrepancy. 
 
 The doctor now states that he wished to make the amende 
 honorable, and ^vrote me the following note : 
 
 SL, 1 
 k. M. ) 
 
 Fifth Aventje Hotel, 
 New Yoek, December 31, 1869, 11 a. 
 Mt dear Doctoe : 
 
 I regret to learn, from a mutual friend of ours, that yon feel yourself 
 aggrieved, inasmuch as thati had not done you justice in my report of Cap- 
 tain Bigelow's case. 
 
 Allow me here, tlierefore, to state that, when I wrote the report of my 
 ease, I had not the remotest intention to claim for myself what credit, in 
 my case, really belongs to you. I trust you have known me long enough 
 to know that I am not willing to compromise the good opinion and fame 
 of a professional friend in a few printed lines. I disavow any sinister mo- 
 tives in toto. 
 
 If there is any doubt as to who performed the operation, I shall be hap- 
 py to clear up that doubt in a supplementary note to the Jottenal, as well 
 as in reference to the hteraorrhage, which fact, I acknowledge, I overlooked 
 in my report. 
 
 I am not willing that the dear old year should pass away, and the new 
 one come in, without my addressing you, in the sincere hope of a satisfac- 
 tory solution of the difference. 
 
 Witli the compliments of the season, I remain very truly yours, 
 
 A. Etrpi'ANBE, M. D. 
 Dr. L. A. Sayre, Fifth Avenue. 
 
 " This letter," he states, " Avritten in a most kindly spirit, 
 for an honest purpose, you never condescended to answer," and 
 finds great fault because I have not quoted the whole letter in 
 
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my first report, but only sentences of it. In looting over my 
 manuscript, I find that asterisks are placed at the proper posi- 
 tions showing the parts of the letter left out, but which were 
 neglected to be inserted by the printer ; but compare the two 
 letters as quoted, and you will find that they are perfectly cor- 
 rect so far as quoted. 
 
 The doctor finds fault that I have not replied to his letter. 
 No gentleman could reply to a letter from one who confessed 
 that he had published a falsehood until he had as publicly 
 corrected his error as he had publicly committed it. His let- 
 ter to me individually, containing the statement that he had 
 no sinister motives, was of no moment. His statement had 
 been made to the public, and it was to the public, through the 
 same source that he had propagated the falsehood, that he 
 should have made the correction, and not to me individually ; 
 and the fact of answering his letter at all until this correc- 
 tion had been made, would have been an admission that Z con- 
 sidered him a gentleman, which, as & publisher of falsehoods, 
 of course was impossible. As to the fifty operations of a simi- 
 ilar sort in which Dr. Zolnowski assisted during the space of 
 a year and a half, I have nothing to state, except that in my 
 opinion it is a much larger nmhber of cases than even Dr. 
 Kuppaner, who makes a specialty of diseases of the throat, has 
 performed in the same space of time. 
 
 The fact is, that Dr. Euppaner never intended to correct 
 his error in the Medical Johenal, as is apparent from the fol- 
 lowing letter from Dr. Eeuben A. Yance. And it shows, also, 
 the animus of the doctor, and that he had been dwelling on 
 this subject for nearly two years — without ever speaking to me 
 about it — on the contrary, all this time pretending to be my 
 greatest friend. The doctor being near my office, and very 
 convenient of access, I had called at his office on two separate 
 occasions, when suffering from a slight laryngitis, and he ap- 
 plied a' solution of iodine to my throat very satisfactorily, and 
 I felt grateful to him for his attention ; sent him quite a num- 
 ber of patients ; was instrumental in helping him to get up a 
 dispensary for the treatment of throat-diseases, and my name 
 is published as one of the incorporators and trustees of this in- 
 stitution. 
 
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23 
 
 So far, therefore, as the influence of my nanae may go, I 
 am responsible to the community for indorsing and recom- 
 mending him to public patronage. This was done at a time 
 when I had coniidence both in his capacity and integrity. 
 
 But discovering his deficiency in both of these essential 
 qualifications, and that he had hired a building, opened the 
 institution, obtained money from the city and private individ- 
 uals for its support, and publicly advertised its existence by 
 distributing circulars announcing himself as physician, along 
 with the names of the other medical officers of the institution, 
 without any hnowledge or consent of the Board of Trustees 
 — in fact, the Trustees had never teen called together at this 
 time, and there was no organization of the Boa/i^d of Trustees 
 for some weeks after this public advertisement of the opening of 
 the institution, of which he was the self appointed physician — 
 and as the Board of Trustees were the only legally authorized 
 persons to make appointments, or direct the management of the 
 institution, I looked upon this action of Dr. Buppaner as a 
 fraud, and, to absolve myself from any responsibility in the de- 
 ception, narrated these facts in my first review of his case. 
 But the editor of the Medical Jouenal advised its erasure, as 
 it was irrelevant and personal matter. 
 
 I therefore here repeat these facts, in order to absolve my- 
 self before the community from any responsibility for his presr 
 ent official position in the itfew York Dispensary for the Treat- 
 ment of Diseases of the Throat. 
 
 A few days after I had operated upon Captain Bigelow, I 
 met Dr. Euppaner in front of the Fifth Avenue Hotel, and he 
 then told me that the " Boston doctors were opposed to the 
 operation," and said they had told Captain Bigelow " those 
 New York doctors would cut his throat and kill him ... In 
 fact I thought he would die myself, but I thought he had better 
 die on your hands tham, on mine.'" This remark was made 
 with a strange, sardonic laugh, and so surprised me that I 
 scarcely knew what to reply to it, as I could hardly under- 
 stand its meaning. Yiewed, however, in the light which is 
 thrown upon Dr. Euppaner's feelings toward me by Dr. 
 Yance's letter, this remark has a very significant meaning in- 
 deed. 
 
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2i 
 
 .1 
 
 144 EA.8T TwEJTTr-SECOND SxEEET, 
 
 New Yoek Oitt, June 1, 1870, 
 
 Di{. Lewis A. Satbe, 285 Fifth Avenue — 
 
 Deae Sir : In reply to yours of May 27th, I have to state that, early in 
 January of the present year, Dr. Euppaner called at this office to see mo 
 in regard to the case of Captain Bigelow, I having been present at the 
 operation performed upon that gentleman in August, 1869. During the 
 course of the conversation, I urged Dr. Euppaner to correct the phraseology 
 of his report published in the New Yoek Medical Jouenal of January, 
 1870, so that there could be no misapprehension as to who performed the 
 operation, and thus obviate the threatened difficulty. This he declined to 
 do, saying that, as you had injured hira, on a prior occasion, you would 
 not dare to have any trouble with him about the present case, as you knew 
 it was in his power to expose what he designated as your falsehoods about 
 the poisoning cases at the Fifth Avenue Hotel. 
 
 There was nothing in our interview that partook of the nature of a pri- 
 vate conversation, Dr. Euppaner expressly disclaiming any such interpre- 
 tation of his communication. Yours truly, 
 
 Eeuben a. Vance. 
 
 I will now leave the case of Captain Bigelow, and refer to the 
 particular chargSs which I have to make against Dr. Kuppa- 
 ner for unprofessional conduct in his reference to what he 
 styles " The great poisoaing case, by partridges, at the Fifth 
 Avenue Hotel," which occurred on the 15th of February, 1868. 
 
 In reply to this I would state, and as will be seen by Mr. 
 Suit's, Grimes's, Guthrie's, "Willmarth's, and other letters, that 
 for many years I had been Mr. Suit's family physician ; that 
 a messenger came to rae on the evening in question at about 
 six o'clock, just as I was sitting down to dinner, requesting 
 me to see Mr. Suit immediately / that on going to the door 
 to ascertain whether it was a case that required immediate at- 
 tention or could be postponed until after my dinner, the mes- 
 senger informed me that " Mr. Suit and his friend had been on 
 a lark and were at the hotel pretty drunk," when I replied, 
 " That being the case, he could wait until I had got my dinner," 
 and told him I would be down as soon after dinner as possible. 
 In a very few minutes after, another messenger, Thomas Wise- 
 man, arrived, requesting me to go in haste (whose letter stat- 
 ing the facts will be found attached to this report). He 
 also stated that Mr. Suit was pretty drunk, and that I had 
 better come as soon as possible. I immediately went with 
 
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25 
 
 this messenger to the hotel, and found Mr. Suit and his friend 
 both there sick, and two or three gentlemen in the room. 
 Upon asking Mr. Suit what was the matter, he stated that he 
 did not know ; when I asked him how long he had been sick, 
 he stated " Only a few minutes ; a little while ago, coming 
 through the reading-room, my legs all went to pieces, and some 
 fellow there reading a paper said it was a pity to see such a 
 handsome fellow as I was set up that way ; I replied to him, 
 I thought I was pretty well set down." This remark giving 
 no evidence of drunkenness, caused me to smile, and after ask- 
 ing him a few more questions I said to him, " I do not think 
 you are drunk, Suit ; " he replied that he did not think he was 
 himself. Upon asking him to get up and let me see what 
 was the matter, he said he could not, and upon his making the 
 effort apparently fainted and fell backward, and I sent to the 
 bar-room and got some brandy to restore him. The bar-keeper 
 remembers very well having sent it in a very few minutes 
 after my arrival, and will testify to that fact. Finding that 
 his pupils were immensely dilated, his pulse very weak and 
 feeble, and when in the erect posture almost ceased, and yet 
 his intellect was clear, I stated to Mr. Suit that he did not 
 seem to be drunk at all, but acted as if he had been poisoned ; 
 he replied that it must be the whiskey, that he knew what 
 whiskey was made of, and, thinking that he was correct, I re- 
 plied to him that I guessed he was right ; some gentleman pres- 
 ent, whose name I do not now remember," stated that I must be 
 mistaken about the whiskey, that he had drunk as much as 
 either Suit or Grimes, and wanted to know if I thought he was 
 drunk or poisoned ; I told him, no ; he seemed to be all right, 
 and asked him what was the real ti'uth about the whole story ; 
 what had they eaten and drunk, and to let me know what had 
 passed the whole day. He stated that] they returned in the 
 New Haven cars from Canada too late for lunch and too early 
 for dinner, and had gone to the St. James's Hotel to get din- 
 ner ; he had eaten of something which I have now forgotten, 
 but that fche other two men made their dinner of par- 
 tridges ; and Suit stated that he had eaten twice of the par- 
 
 ' I have since learaed that the gentleman referred to was Mi'. Frank 
 Turk, of Washington City, whose letter will be found annexed. 
 
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26 
 
 tridges, and the balance that was left Grimes finished, and 
 when they came to dessert Mr. Grimes complained of feeling 
 very faint, that he never felt so faint in all his life, and felt as 
 if he wanted a drink of brandy ; Mr. Suit remarked that he felt 
 exactly the same way, and would like to take a drink too ; the 
 other gentleman who was telling me the story began to laugh, 
 and said it' was rather novel for two fellows to eat themselves 
 faint ; that it was the first time that he had ever seen such a 
 thing in his life ; that upon getting up to get a drink, or else 
 ordering it, I have forgotten precisely which, they got so much 
 worse that they hurried to the front door and got into a car- - 
 riage which stood in front of the hotel, and drove immediately 
 to the Fifth Avenue Hotel on the Twenty-third-Street side. 
 In getting into the carriage Mr. Grimes fell down and vom- 
 ited very freely. Upon arriving at the hotel they mustered 
 up all their courage and strength, and succeeded in walking 
 as far as the reading-room, where they both fell down almost 
 at the same time and in a similar way, and were carried into 
 the room. I was then sent for immediately, as will be seen 
 by referring to Mr. Hasimer's letter, the clerk in the book- 
 store, who assisted in carrying Mr. Suit into the room, and 
 also to Mr. Suit's and Mr. Turk's letters. 
 
 Viewing the case with the evidences before me : three men 
 having drunk of the same wines and whiskey, in nearly equal 
 quantities, but eating of different food, and the two men who 
 had eaten of the partridges being very sick, and the one who 
 had eaten the most partridge being the sickest of the two, but 
 the same kind of sickness, I naturally inferred that the sick- 
 ness by poison was due to the partridge which they had eaten, 
 and so stated to them. Mr. Turk replied that he thought I 
 was correct — as the birds could get nothing to eat in deep 
 snow, except from the laurel-berries, which were poisonous. 
 Mr. Grimes was very much exhausted and very faint, and had 
 vomited very freely, and was still vomiting. Mr. Suit not 
 having vomited so freely, and still complaining of sickness at 
 his stomach, I caused him to drink large quantities of water 
 for the purpose of distending his stomach, and by mechanical 
 distention excite muscular contraction, and so cleanse him 
 from whatever it contained. 
 
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27 
 
 After having done this, still finding him with a feeble 
 pulse, and dilated pupils, I feared that whatever jjoison he 
 had taken had been absorbed into the system, and I so stated 
 to him, and that I would go into the drug-store and ascertain 
 what was the proper remedy to give him, which I did ; and 
 stating, in Messrs. Caswell & Mack's drug-store, that the two 
 gentlemen were poisoned from the eating of the partridges, 
 some person in the store said it was the poison of the laurel- 
 berry ; that the birds were compelled to feed on them on ac- 
 count of the depth of the snow ; and when I asked him what 
 was the antidote he stated he did not know, and requested one 
 of the clerks to get out the book, either Christison on Poisons, 
 or "Wood and Bache's Dispensatory ; and we were reading over 
 tliis book in order to ascertain the proper remedy to be admin- 
 istered, when Dr. Euppaner came into the drug-store, which 
 I think was the first time I had ever seen him; he intro- 
 duced himself to me as Di*. Euppaner, and informed me that 
 he had seen two of my patients that evening who were " very 
 sick, very sick indeed, in fact they were pretty tight, doctor." 
 I told him I did not think they were drunk, I thought they 
 were poisoned from eating partridges, and I was trying to hunt 
 up a remedy for them ; he said they were poisoned with the 
 bad whiskey we had in this country, " Pretty bad whiskey, 
 doctor." I again informed him I thought they were poisoned 
 from eating the partridges, and the gentleman who was hunt- 
 ing over for the remedy which he wanted had succeeded in 
 finding it, and he hastily prepared it and put it up for me, 
 which I took to their room, not having written any prescrip- 
 tion for it. 
 
 I requested Dr. Euppaner to come baclf to the room with 
 me and see them ; he refused, stating that he merely lived in 
 the hotel, that he was very glad to have been able to do any 
 thing for me, very happy to do any thing of the kind, but they 
 were my patients, and he declined to do any thing further. I 
 asked him to go in as matter of curiosity, as it was a very 
 interesting case, which he did, and after having given them 
 the medicine, which they continued to take for a couple of 
 days afterward, I requested him, as he lived in the hotel, to 
 come in and see them frequently, as I had to go home to my 
 
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28 
 
 dinner and attend to my office business ; that I would be back 
 again at ten o'clock and see them again with him, which I 
 did. So far as the statement made in the Sunday News, I 
 never knew any thing of it until I read it in Dr. Euppaner's 
 report. I have since ascertained that it was written by a gen- 
 tleman of the name of Pittman, whose letter, which is here- 
 unto annexed, will explain fully that I knew nothing at all 
 about it. I received from Mr. Roosevelt, the gentleman who 
 ' has published a book on the birds and fishes of the State of 
 New York, a very respectful communication, asking for infor- 
 mation in regard to the case, which I replied to, and which 
 is copied in Dr. Euppaner's report precisely as I wrote it, but, 
 as will be seen by his letter hereto annexed, was not written 
 for the purpose of publication, although I think it our duty to 
 thus disseminate useful information to the people, to protect 
 them against an unsuspected danger. 
 
 Coleman House, New Yoek, April 28, 1870. 
 To De. Lewis A. Satee — 
 
 Dbae Sie : My attention has been called to a pamphlet, purporting to 
 have been written by one A. Euppaner, M. D., in which he published an 
 article written by me on the well-known partridge-poisoning case that 
 occurred at the Fifth Avenue Hotel, February, 1868, and which appeared 
 in the columns of the Sunday News, on the 1st of March, 1868. In com- 
 menting on this article, Ruppaner intimates that it was written and pub- 
 lished with your knowledge and consent. 
 
 In justice to you I beg to say, most emphatically, that it was not writ- 
 ten or publisbed with your knowledge or consent ; and I do not know that 
 you ever saw it in the News. I am certain I neither directed your atten- 
 tion to it, nor sent you a copy of the paper. I heard of the case the night 
 it occurred, and having met Mr. Suit some time previous, in company 
 with Hon. Benjamin Wood, I took an interest in the matter, and ascer- 
 tained the facts from authentic sources, and so published them, believing 
 the public to be as much interested in such a case as the medical fraternity. 
 
 Had Dr. Euppaner taken some pains to have ascertained my knowledge 
 about the " great master of surgery and wonderful decoction that mys- 
 teriously kills poison," he would have been spared the labor of his unjust 
 comments, and his ungenerous attack on your professional reputation. 
 With great respect, yours truly, 
 
 Thomas W. Pittman. 
 
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29 
 
 New York Oommissionees ol? Fisheries : 
 
 Horatio Seymour, Utica, 
 
 George G. Cooper, Eocliester, 
 
 EoBEET B. EoosBTELT, New Yoi'k, 
 
 32 Beehman Street. 
 Dr. Lewis A. Sayre — 
 
 My dear Sir : I regi-et to hear that any 'complaint has been made 
 against you, conoerning the publication of a letter which you wrote to me 
 some years ago in reference to the danger of eating partridges (ruffed 
 grouse) out of season. 
 
 I had written several works on sporting matters, and had mentioned 
 the fact that the flesh of these birds occasionally became poisonous in con- 
 sequence of tlieir feeding on laurel-berries. 
 
 This assertion of mine had been disputed, when the effect of the game 
 laws was under discussion, and I, hearing that you had a case in point, 
 wrote to yon, asking you for an account of it. You kindly sent me the 
 answer, which I, without thinking it could possibly be misconstrued, pub- 
 lished, the matter being one of serious public concern, and about which 
 there seemed to be some doubt. 
 
 The first time I saw you after such publication, you complained to me 
 of what I had done, and said that you had not intended your letter for use 
 in the paper, but merely meant it for my own information. 
 
 I was quite surprised at this, as I knew of no professional rule on tlie 
 subject requiring a matter of such vital importance to the public to be 
 kept secret. I hope that the medical fraternity do not desire to keep the 
 people in ignorance of danger, that they may have the pleasure of curing 
 them, after they shall have unwittingly poisoned themselves. 
 
 In any event, if there is any one to blame, it is myself, through my un- 
 intentional error. 
 
 In justice to you, I will be happy to substantiate this statement in any 
 manner that you may desire. Yours, very respectfully, 
 
 (Signed) Kobert B. Roosevelt. 
 
 Let US now compare the statement of this poisoning case, 
 as published by Dr. Euppaner, and the facts as testified to by 
 a number of credible witnesses. 
 
 Dr. Euppaner, in his pamphlet, says, " February 15, 1868, 
 hetweenfour and jive o'clock (the italics are mine), I was has- 
 tily summoned fi-om my office to room H, on the same floor 
 of the hotel as my own, where I found two gentlemen, lying 
 each on a bed, surrounded by a few gentlemen, friends of the 
 patients — one the father-in-law of one of the sufferers," etc. 
 This latter gentleman referred to is Mr. Willmarth, the father- 
 in-law of Mr. Suit. By referring to the annexed letter of 
 
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 Charles Ledworth, tlie usher at the dining-room of the Fifth 
 Avenue Hotel, it will be seen that Mr. Willmarth was at din- 
 ner at the time Mr. Suit was brought into room H, and it 
 must therefore have been after half-past five o'clock, as the 
 room is not opened until that hour. It is highly probable 
 that it was nearer six, as the regular boarders of an hotel are 
 not apt to rush into the dining-room the moment the doors 
 are opened. 
 
 PiFTH Avenue Hotel, May 2, 1870. 
 
 A little after six o'clock, on Saturday, February 15, 1866, one of tlie hall- 
 boys came after me and wished me to call Mr. Willmarth out from the din- 
 ner-table, stating that his son-in-law, Mr. Suit, was down-stairs very sick, 
 and wanted him to come at once. 
 
 I always open the dinner-door at five and a half o'clock. 
 
 Ohables Ledwoeth, Usher. 
 
 The doctor made a hurried examination of the patients, 
 and says : 
 
 " Satisfied that no time was to be lost — my diagnosis being 
 poisoning by hydrocyanic acid — I ordered the by-standers to 
 apply friction, with speed and force, so as to keep up the cir- 
 culation, and to produce warmth. Ordered hot fomentations 
 to the bowels ; sent a servant for mustard and warm water, 
 and, in the mean while, rushed to Caswell & Mack's drug-store, 
 where, not having time to prescribe, I had handed to me, with 
 the utmost dispatch, some muriate of ammonia and sesquichlo- 
 ride of iron, rushed back, prepared and administered the anti- 
 dote in the presence of the by-standers. Immediately after, I 
 prepared myself the emetic of mustard and warm water, ad- 
 ministered it in large quantities, got powerful action therefrom 
 soon; kept this action well up by additional doses of the 
 same emetic. Later I gave an active purgative, which acted 
 promptly and powerfully, and thus, after some three hours 
 (the italics are mine) of hard, very hard work — thanks to the 
 kind and humane assistance of the friends present — I had, un- 
 der Providence, the great satisfaction to see my two patients 
 out of danger. These were indeed three hours of intense sus- 
 pense, of the result of which any medical man might justly 
 feel proud." 
 
 By referring to the letters of Mr. Suit, Henderson, Turk, 
 
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31 
 
 and Hasimer, it will be seen that I was sent for immediately 
 after Mr. Suit was carried into room H, and, by referring to 
 tbe letter of "Wm. Henderson, it will be seen that he took the 
 recipe from Dr. Kuppaner and got the medicine from the drug- 
 store, and took it back to him. 
 
 Fifth ATENtrE Hotel, April 9, 18T0. 
 Dr. Lewis A. Satke — 
 
 Dear Sie : I am the clerk of the "book-stand in the reading-room of tlie 
 Fifth Avenue Hotel, and saw Mr. Snit and his friend fall down in the room 
 some two years ago, at the time they were poisoned. 
 
 The evening papers were just coming in at the time, about half-past 
 five or six o'clock, when two gentlemen fell very suddenly on the floor in 
 front of the book-stand. 
 
 I ran out and helped one of the gentlemen to room H, back of the bar- 
 room. 
 
 Dr. Rnppaner was immediately called to see them, but Mr. Suit said, 
 " I want Dr. Sayre ; he is my doctor." Dr. Ruppaner replied : " Oh, I will 
 fix you all right in a little while; you are in no danger — a little tight, my 
 boy, a little tight ; but, if you want Dr. Sayre, you had better send for him ; " 
 and a messenger was immediately sent for you. John B. Hasimee. 
 
 New Yoek, April 29, 1870. 
 
 Dr. L. A. Satee — 
 
 Deae Sie : I have read the pamphlet of Dr. Euppatier's, and particu- 
 larly that part relating to Messrs. Suit and Grimes's case of poisoning at 
 the St. James's Hotel about two years ago. 
 
 I was employed at the Fifth Avenue Hotel at that time, and was in at- 
 tendance on the sick men from the time they were brought to the house 
 until they recovered. Dr. Ruppaner was in attendance on the men imme- 
 diately after they were taken ill, and I heard him say they were suffering 
 from the efiects of drink. 
 
 A messenger was sent for you, and, as you did not come immediately, 
 Mr. Suit sent me to hurry you up ; you came, I think, about sis o'clock in 
 the evening, and, after some conversation with the sick men, you said they 
 were not drunk, but poisoned. Mr. Suit said : " It must be that bad whis- 
 key, I know what whiskey is made of," and you said you guessed he was 
 right. Some other gentleman ' standing by said : " Doctor, it cannot be the 
 whiskey, as I drank as much as they did, and I am not drunk." Tou said he 
 was all right, and asked hhn all they had to eat and drink that day. He said 
 they had diued at St. James's Hotel, and that the sick men had eaten par- 
 tridge, the sickest man having eaten the largest quantity. 
 
 ' Turk, lawyer in Washington. 
 
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32 
 
 You made one of them drink a large quantity of water, and vomit, and 
 went to the drug-store and returned in company with Dr. Euppaner. 
 
 You were with the sick men some time later that night. 
 
 I was almost continually in the room with the sick men, and do not be- 
 lieve they got any medicine until you came, and I am sure Dr. Euppaner 
 said drink caused their sickness. On that night, and on several occasions 
 afterward, both Mr. Suit and Mr. Grimes told me they thought Dr. Eup- 
 paner knew very little about their case. 
 
 Yours, very respectfully, 
 
 Thomas Wiseman, 448 Fourth Avenue. 
 
 150 West 28th Sbeet, April 2T, 1870. 
 
 I was hall-boy at the Fifth Avenue Hotel in 1868, at the time Mr. Suit 
 and Mr. Grimes were poisoned, and was called on to answer the bell of 
 room letter H, as near as I can recollect about 6 o'clock or between 6 and 
 7 o'clock. When I got there, Dr. Euppaner wanted me to go to the apothe- 
 cary store for some medicine. 
 
 He gave me a paper, which I took to the drug-store of Oaswell & 
 Mack, and they gave me a bottle, which I took back to the room and gave 
 to Dr. Euppaner. 
 
 Wm. Hendbrsoit. 
 
 The doctor's treatment, as above described by himself, is 
 certainly most remarkable. He says that he " prepared and 
 administered the antidote in the presence of the by-standers. 
 I'lnmediately (the italics are mine) after I prepared, myself, 
 the emetic of mustard and warm water, administered it in 
 large quantities, got powerful action therefrom soon ; kept 
 this action well up by additional doses of the same emetic." 
 
 The poison had already been absorbed into the system ; 
 and what good could be expected from an antidote, if it was 
 vomited out of the stomach immediately after it had been put 
 in, I am unable to see. Comment on this part of the doctor's 
 treatment seems to me imnecessary. 
 
 "After over three hours of friction, vomiting, purging, 
 taking of antidotes, hot applications, and any amount of anxi- 
 ety all around, the patients were quite comfortable, warm, 
 pulse lower and fuller, and an inclination on their part to con- 
 verse, manifest." 
 
 " At this stage of the case, Mr. S. said to me : ' Doctor, 
 what ails me, anyhow % ' ' You were poisoned, by eating those 
 partridges,' I replied. ' Oh, no ; I know it was that vile whis- 
 
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33 
 
 key we were drinking that did the work,' rejoined Mr. S. 
 ' Sorry for your whiskey, then,' was my reply. 
 
 " Mr. S., still continuing to doubt, asked me : ' Do you 
 know Dr. Sayre ? ' I replied affirmatively. ' Have you any 
 objection to. my sending for him, to see whether he thinks as 
 you do, for he has attended me before when I was sick ? ' ' Not 
 at all,' was my answer ; ' I shall be glad to have Dr. Sayre 
 see you.' 
 
 "A messenger was immediately dispatched. During his 
 absence, I was called to see another patient up-stairs. When 
 I returned to the room where my patients were, I was told 
 that you (Dr. Sayre) had been there, and gone into the apoth- 
 ecary-store. Following you there, I met you." 
 
 " All of 7ny prescriptions can ie found entered at CaswelVs, 
 in their books, corresponding to the dates, number of room, 
 and patients in question. But I have taken the trouble care- 
 fully to look for your prescriptions, particularly the antidote, 
 but there is not one of yours to be found in the prescription- 
 book of that period ! Very singular, indeed ! Perhaps you 
 sent out for the medicines, as more handy than to get them 
 right in the house ! Is this, too, a question of veracity between 
 you and me ? " 
 
 This certainly is a question of veracity between us, and by 
 referring to the letter of Mr. Willmarth, and the certificate of 
 Drs. Jordan, ITewman, Katzenbach, and Storer, it will at once 
 be seen who is entitled to belief. I request especial attention 
 to the postscript of Mr. Willmarth's letter : 
 
 New Yoek, April 13, 1870. 
 Dbae Sib : We have carefully examined the prescription-books of Cas- 
 well & Mack, for the date of February 15, 1868, and find two prescriptions 
 of Dr. Euppaner's on that day. The copies are herewith enclosed, but we 
 do not find any prescription, or the trace of one, containing iron and am- 
 monia. Respectfully, etc., 
 
 W. 0. JoEDAN, M. D., 304 Madison Avenue, 
 "W. H. Katzenbach, Esq., 225 East Thirty-first Street, 
 KoBEET Newman, M. D., 107 West Forty-fifth Street, 
 HoEATio E. Stoeee, M. D., Boston, May 1, 1870. 
 To De. L. a. Satee, Thirtieth Street and Fifth Avenue. . 
 
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34 
 
 5. Bismuth subnit. 3j, 
 lufus. gent. CO. | iss, 
 Aq. menth. pip. | ss. 
 111. S. A teaspoonful every half hour till relieved. — Euppanee. 
 
 5 . Pil triplex, No. xii, 
 
 Two pills night aud morning. 
 
 5. Sodfe bicarb., 3ij. — EuiPPAK-Eii. 
 
 Home Insueance OoMPAmr, ) 
 OflBoe, 135 Broadway. j 
 IfEw YoBK, April 25, 1870. 
 De. Lewis A. Sayee — 
 
 Deae Sie : In response to certain inquiries in your note of tlie 16th 
 inst., I wiU say: 
 
 1. That when you were called to Mr. Suit at the time he was poisoned, 
 at the Fifth Avenue Hotel, while I should hardly feel willing to testify that 
 Dr. Euppaner was not iu the room at the time of your arrival, I think he 
 was not. Indeed, I am quite positive that he was not. 
 
 2. I remember distinctly that you made, or rather continued, Mr. 
 Suit's vomiting by administering very large quantities of warm water after 
 your arrival ; and — 
 
 3. Please bear in mind that I do not retract nor amend the statement 
 made to Dr. Euppaner, that in my opinion the lives of both Mr. Suit and 
 Mr. Grimes were saved by him prior to your arrival, and while I knew that 
 he had prescribed for them I did not so inform you (at least I have no recol- 
 lection of doing so), neither did I know of what the prescription consisted. 
 
 Very truly yours, etc., 
 
 A. F. Willmaeth. 
 P. S. — It is proper for me to add that Dr. Euppaner informed me a few 
 weeks since that the prescription referred to might be found on the books 
 of Caswell, Mack & Co., giving number of room, etc., and that to my knowl- 
 edge you had previously been Mr. Suit's family physician. A. P. W. 
 
 Washington, D. C, May 4, 1870. 
 De. L. a. Satee — 
 
 Deae Sie : In answer to your verbal request as to my knowledge of a 
 
 case of poisoning which occurred at the Fifth Avenue Hotel, ¥ew York 
 
 City, on the 15th of February, 1868, I have to say that Mr. S. T. Suit 
 
 and Mr. Grimes, with myself, on that day, took lunch together at the St. 
 
 James's Hotel, those gentlemen partaking of a partridge, of which they 
 
 ate heartily, and soon after complained of feeling unwell. I advised their 
 
 taking a drink of whiskey, which was the only liquor they took during the 
 
 day. I soon after left them, and went to the reading-room of the Fifth 
 
 Avenue Hotel, where they soon after made their appearance seriously ill 
 
 and complaining that they had been poisoned ; they were carried to a room 
 
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 on tlie same floor, and, learning that a Dr. Euppaner liadj an office in the 
 house, I called him in to render such aid as they might require. Mr. Suit 
 was desirous that Dr. Sayre should he called in, and I dispatched one or 
 more messengers for him ; until his arrival. Dr. Euppaner devoted himself 
 to the care of both gentlemen. Dr. Sayre arrived about one hour after they 
 were taken. Dr. Euppaner having just then left the room, the impression 
 seemed prevalent that the gentlemen were under the influence of liquor; 
 but I iaformed Dr. Sayre, as I had already done Dr. Euppaner, that they had 
 evidently been poisoned by eating the partridge. I think Dr. Sayre imme- 
 diately recognized the fact, and treated them accordingly — administering 
 various remedies and large quantities of water. I should fix the hour 4-J- 
 to 5 o'clock, and that of Dr. Sayre's arrival from 5-J- to 6 p. m. 
 
 Mr. Suit was unwilling to believe that he had been poisoned by eating 
 the bird, but insisted that it was the drink of whiskey he had taken, in- 
 timating that there might be parties interested in getting rid of him, and if 
 I knew as much about the way whiskey was made as he did, I would 
 know it vras that'that caused the trouble. 
 
 Truly yours, 
 
 Feank Tube. 
 
 Grand Hoteb, May 25, 1870. 
 De. Lewis A. Sayre — 
 
 Dear Sir : In answer to your note of April 16th, I will state that I am 
 positive that, when you were called in to see Messrs. Suit and Grimes, at 
 the Fifth Avenue Hotel, at the time they were poisoned. Dr. Euppaner 
 was not in the room at the time of your arrival, nor did I hear any one 
 inform yon that he had been there. 
 
 Tou did administer large quantities of warm water to Mx. Suit, which 
 caused him to vomit very freely. I wish to state further, that I find from 
 Dr. Euppaner'a pamphlet that I used the term antidote in my note to him. 
 Not being a medical man, I am, of course, not competent to judge whether 
 his prescription was an antidote to the poison or not, and should, therefore, 
 have nsed the word remedy instead of antidote. 
 
 Very respectfully, your friend, 
 
 L. T. GUTHEIB. 
 
 Silver Hill, May 2, 18T0. 
 Dr. Lewis A. Sayre — 
 
 Dear Sir: In reply to your note of the 16th of April, I distinctly re- 
 member of Mr. S. T. Suit ordering some one to send for you immediately 
 after we were carried in room H, in the Fifth Avenue Hotel. I also re- 
 member of him having sent a second time, seeming very anxious to see you, 
 said you had been his physician before. Prior to your arrival. Dr. Eup- 
 paner had been in to see us. I do not remember that he, Dr. Euppaner, 
 told me, before I saw yon, that we had been poisoned by eating partridge 
 or any thing else. 
 
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36 
 
 I remember of taking some brandy, Tvith something else in the shape of 
 medicine, ordered by Dr. Ruppaner. On your arrival I do not remember 
 of Dr. Ruppaner being in the room at the time. I remember of you saying, 
 as I had vomited freely, I needed no emetic at the time, but you went directly 
 to work on Mr. Suit with cold water. I think he must have drunk four or 
 five pitchers of water, and threw it up as fast as his stomach would fill ; you 
 said, if there was any portion of the poison left in his stomach, you wished 
 to fill it so full with water as to fill up all the cracks and take the puckers 
 out of it. 
 
 I know Suit protested against taking any more water, and said he could 
 not possibly get any more in him ; you said he could drink a quart more, 
 and he did do it ; some one remarked to Suit he was pretty well set up. 
 Suit remarked he was pretty well s'et down. This remai-k was made in the 
 hall, and, when this was repeated to you, you, Sayre, said, " That don't talk 
 much like a drunken man," and said, "Suit, I don't believe you are drunk 
 anyhow ; I believe you are poisoned." 
 
 I remember of your talking with some gentlemen in the room, and was 
 asking what we had been eating ; you soon found out we bad been eating 
 partridge, and, as I understood, you came to the conclusion the partridge 
 was poisoned. I do not remember of telling you, or hearing any one else 
 tell you, that Dr. Ruppaner had been to see us before you came ; I do re- 
 member of you both being in the room at the same time. 
 
 Very respectfully, your friend, 
 
 R. G. Geimes. 
 
 Silver Hill, Peince Geoege's Corin'T, Maetlakd, ) 
 
 April 30, 1870. j 
 
 My dear De. ; Yours of the 19th, directed to me at Louisville, Ky., 
 reached me yesterday, in which you ask the following questions: "Was 
 Dr. Ruppaner in the' room at the time of my arrival ? " I answer, he was 
 not. " Did I give you an emetic of warm water before I went into the 
 drug-store 3 " I am under the impression you did. " Did you tell me that 
 Dr. Ruppaner had already prescribed for you before I brought him in with 
 me from the drug-store? " In answer to which I wish to say my memory 
 was very much affected, being, at the time, on the point of death. But, as 
 well as I can remember, I think your prescription of warm water was the 
 first I took, which was given in the absence of Dr. Ruppaner, who had 
 left the room for the drug-store. I believe I have answered all your ques- 
 tions ; now I wish to add a word or two regarding the letter I gave Dr. 
 Ruppaner. He called on me several times at the Pifth Avenue Hotel, and 
 asked me for a letter giving the facts in the poisoning case. I refused at 
 first, and at the same time stated my reasons, which were, that I did not 
 wish to be mixed up in any newspaper controversy. He then pledged his 
 honor as a gentleman that the letter should not be used in print, or in any 
 other way. without my knowledge and consent. He also stated he wanted 
 tlie letter to show some friends who were interested in the case. 
 
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 I have known Di'. Euppaner several years, having boarded with him in 
 
 the Fifth Avenue Hotel two or three years. He would be about the last 
 
 doctor in New York I would caU to my bedside if I thought my life was 
 
 in danger. "When I was poisoned and found myself fast approaching death, 
 
 I thought any doctor was better than none ; therefore, I had him called in, 
 
 but at the same time dispatched two or three waiters for you. When you 
 
 entered the room, I was satisfied iny life would be saved. 
 
 Yours, very re&iiectfully, 
 
 S. T. Suit. 
 To De. Lewis A. Sayee, New York. 
 
 The following was on a slip of papei^ and was enclosed 
 with the preceding letter : 
 
 My deak Feiend : I very much regret having given Dr. Euppaner the 
 letter I did. He has proven himself unworthy of the confidence of any 
 gentleman, and I shall tell him so when I see him. I have given you a 
 plain statement of facts as I remember them ; if you can better the letter, 
 let me know, and I shall do all I can to place you where you belong, and 
 to let the public know what I think of Dr. Euppaner. .. . . 
 
 As ever, your friend', 
 
 S. T. Suit. 
 
 In referring to this subject in my introductory lecture 
 at Eellevue Hospital, and about which the doctor makes such 
 strong comment, it was done for the purpose of impressing 
 upon the students the necessity of a knowledge of all the dif- 
 ferent departments of our profession. In both of these cases, 
 the lecture and the letter, I did not refer to Dr. Euppaner, for 
 the simple reason that / fcnew nothing of his having miy 
 ideas, or of his having prescribed, for these patients previous 
 to my being Galled to see them. Mr. Suit was one of my old 
 patients ; two hurried messengers coming within a very few 
 minutes of each other, and almost immediately, as proved 
 by their testimony, and by his letter after his having been 
 taken sick, upon my arrival I found no doctor present; was not 
 informed that any doctor had been there, either by him or any 
 of his friends / and I, therefore, had not the remotest idea that 
 Dr. Euppaner, or any other physician, had seen the patients 
 previous to my arrival ; and the Urst knowledge that I had 
 that Dr. Euppaner had seen them was by his informing me 
 of the fact when he met me in the drug-store, where he says 
 he went and found me. In that conversation he informed me 
 
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 that he considered them drunk, or suffering from the effects 
 of liquor ; and consequently, on my referring to the partridge 
 poisoning case, I had no more idea that the doctor had any 
 thing to do with the treatment of them as a case of poisoning, 
 than I had of the name of the servant who called me to at- 
 tend them, and therefore did not refer to his name, as it did 
 not occur to me that it had any claim to mention. 
 
 For two, years past, since this occurrence, Dr. Euppaner 
 has seen me frequently, and has never spoken of the subject, 
 or even referred to it in a single instance ; on the contrary, I 
 have letters in which he refers to me with the highest consid- 
 eration and, warmest friendship, and according to his own pub- 
 lished account, insisted to Captain Bigelow and his friends 
 that I should be the surgeon to perform the operation upon 
 him, although other surgeons were mentioned and preferred ; 
 and it is the most extraordinary thing, that, if he felt that I 
 had done him this great injustice and wrong, he should have 
 been so warm an admirer, so distinguished a friend, and should 
 have attempted to force upon Captain Bigelow a person whom 
 he now confesses to have held for two years in such contempt, 
 and from whom he had suffered such great professional injiury. 
 There are many more points on which I could have dwelt 
 in answer to Dr. Euppaner's pamphlet, but, as I have dis- 
 tinctly proved his entii'e want of veracity in the Bigelow case, 
 and his malicious and wilfal professional injustice in the poi- 
 soning case, I have not thought it advisable to prolong this 
 answer. 
 
 Lewis A. Satee, M. D. 
 Jnne 1, 1870. 
 
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