An eighteenth-century medical hearing and the first observation of tropical phagedaena.

Scarcely a week passes in Western countries without the media regaling their citizens with accounts of yet another lawsuit (whether compensational or penal) against a physician whose professional incompetence, ignorance, or negligence has seriously impaired a patient's health or has even cost a life. The substantial increase in the frequency of such court cases since the 1950s may appear to be indicative of democratization and the growing self-assertion of once hierarchically-subjugated masses. Such cases serve the good of a great many people involved, even if their real ins-and-outs remain largely obscure to the public, journalism being intrinsically beset with a lack of specific medical knowledge and with the daily pressure to provide the latest news. Are these lawsuits, medico-legal conflicts, and hearings really a new feature of modern times? Ofcourse they are not. The first liability and compensation acts passed in England and Germany around the 1870s rapidly generated a whole industry of lawsuits. As the next pages attempt to show, the unruly Dutch set a precedent for doctors' hearings at least a century earlier. The case we came across in Jakarta's National Archive is, to our knowledge, the first of its kind in this respect. We disregard for the moment the intercollegial conflict aired in 1750, as narrated by Titsingh: the Titsingh case was altogether different, for it related to the admittance of barbers and Jews to the Amsterdam surgeons' guild, along with the usurpation ofexamination fees; it was, moreover, a case which remained "in the family".45 The following pages show that an avant-la-lettre case from the past harbours more than meets the eye. In addition to reconstructing the case, we have tried to examine the endemic disease that lay at its roots and, in retrospect, to pose a satisfactory diagnosis of what the patients really must have been suffering from.