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LABOUR AFTER CRIMINAL ABORTION
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362 ’This is contained in the Philosophical Transactions for 1874, pp. 501-5, where he mentions cases in which the operative heat radiation originated from the faces of the experimenters. L am, Sir. vours faithfully. I : A. A. CAMPBELL SWINTON, F.R.S. Victoria-street, Westminster, August 9th, 1921 AN INSTRUMENT WHICH IS SET IN MOTION BY VISION. To the Editor of THE LANCET. SIR,-In reply to Dr. Ian D. Suttie’s letter in your issue of August 6th, the desirability of further work is obvious. My researches so far have been voluntary and unendowed, but there is a limit to one’s endurance, .at least on the financial side. Even Dr. Suttie must take this factor into account when complaining that I have not worked out yet all the variations of the eye .force in diseases, cataracts, &c. He probably has already realised that time given to research must be at the expense of any medical man who has a living to get in practice. The tone of the critical remarks of Dr. Suttie is in sharp contrast to the interested and modest observations by the leaders of science to whom I gave the demonstrations. My assistant and I were impressed of course by the natural power but penetrating acumen of these men upon the -numerous occasions that the effects were demonstrated before them. I hold no academic qualifications in physics and none are attached to Dr. Suttie’s letter, .but perhaps this was only his modesty. Referring to Fig. 2, I must suppose that Dr. Suttie has not yet had time to make merely a few thousand observations on a model of that type. If and when he has done so, he will find with pleasurable surprise that while applying all his will-power or psychic force, - or whatever it is, the condenser will not move, provided his vision is withheld. As a general principle I may remind him of the unwisdom of invoking a force as little known and as complex as psychology to explain something demonstrably due to a variation in a known (electrostatic) state. The force is reflect- able, though the slight loss of power at so many feet from the mirror had to be ignored in the reference I made (p. 223). His reference to cataracts as controls is surely a feeble suggestion, and I gave him the best illustration of a means of cutting off the force by closing of the eyes, referred to under the heading of controls. Dr. Suttie thinks my experiments have allowed me to outrun the appropriate amount of reflection. This may be so, as I have only been pondering them for four years, and it is one week since my work has reached him by means of THE LANCET. He may have heard me at the Congress giving more than once an amiable reminder to the questioners that when current electricity had just been found out it was unreasonable to expect us to be already driving the trams and telephones and lights by its power. Dr. Suttie’s closing remarks appear to group him amongst the earnest searchers after the truth. The qualifications for that position are the production ,of much hard work and the other sacrifices. After osuch efforts in our subject he may well take the matter further than I have, and then he will not be so troubled by anxieties as to what fraud or abuse it may suffer by charlatans or others, who are the equivalent of the weeds in every garden. These latter activities will thrive as long as human credulity - continues to like entertainment at least as much as instruction.-I am, Sir, yours faithfully, Beaumont-street, W., August 8th, 1921. C. RUSS. ’THE FÆCES IN ALIMENTARY DISORDERS. To the Editor of THE LANCET. SIR,- It is evident that in my article on this sub- ject in THE LANCET of July 2nd I have failed to make my meaning clear to Dr. Chalmers Watson. I expressed the view that, in routine examination of the faeces, a Gram-stained bacteriological film was of little help ; if, however, definite organisms, such as typhoid, were suspected, it was another matter. In that case (I left my readers to assume) the appropriate bacteriological methods were to be undertaken as a matter of course. I would assure Dr. Watson that my statement in regard to the small value of a Gram- stained film is based on experience in which the cooperation of both clinician and bacteriologist has been intimate ; but I welcome his insistence on the necessity for such cooperation. I shall be glad to learn the sort of conclusions which Dr. Watson himself is able to draw from Gram- stained films. Undoubtedly in some cases there are what for clinical purposes may be called " stools of putrefaction," in others " stools of carbohydrate fermentation," each with their more or less typical bacterial flora ; but these conditions can be recog- nised without recourse to bacteriological investiga- tion. Sometimes these findings are linked up with some abnormal clinical condition, sometimes they are associated with apparently good health ; although, even when, for example, a " stool of putrefaction " is associated with the symptoms of so-called " intes- tinal toxsemia," the pathology of the condition is not at all clear. Undoubtedly the recognition of these types of stool gives useful indications for treat- ment, especially in the matter of diet. But to assume, as some clinicians appear to do, that the preponderance of a Gram-positive or Gram-negative flora has any special significance in that connexion seems to me to be at present quite unwarranted. I am. Sir. vours faithfullv. Liverpool, July 30th, 1921. ROBERT COOPE, M.D. THE OBJECTIVE STUDY OF THE NEUROSES. To the Editor of THE LANCET. SIR,-I am afraid that Dr. F. L. Golla has pushed the bottom out of his receptacle of interesting material in the last column of the report of his third Croonian lecture in your issue of August 6th. A woman tidies up immediately before childbirth because the probable date of it has been fixed, and because she knows that her chests of drawers will be looked over by others when she is in bed. His asking a midwife whether this tidying habit was common counts just nothing as a confirmatory procedure ; as well might a laboratory analyst ask his bottle-washer to decide whether such or such a result was right or no. Only when Dr. Golla writes, " We have here an instinct untainted by any possibility of mimicry, and since its existence is apparently unknown, free from any complication due to suggestion," does he seem to invite controversy, for the remainder of the lecture is extremely interesting and useful. What about most men and women tidying up before going to bed for operations of various kinds ? Are they fetching up the old nest-making instinct 2 I am, Sir, yours faithfully, HAYDN BROWN. Cavendish-square, W., August 5th, 1921. LABOUR AFTER CRIMINAL ABORTION. To the Editor of THE LANCET. SiR,-The following notes of a case may interest gynaecologists and also medical jurists. Some years ago a married woman, finding herself two months pregnant, endeavoured to procure abortion by taking pills. These failing, she went one morning and, presumably, visited an abortionist; later in the day she joined her husband, who was innocent of what was going on, and spent the afternoon shopping with him. It was not until late that evening that she was seized with pain, after giving herself a douche. The following day a doctor was sent for, who found her suffering from commencing peritonitis. The next day, 48 hours after the symptoms began, she was operated upon, when there was no sign of any wound in the vagina or cervix, but there was general peritonitis with pus in the pelvis. A perforating wound, large enough to
Transcript of LABOUR AFTER CRIMINAL ABORTION
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’This is contained in the Philosophical Transactionsfor 1874, pp. 501-5, where he mentions cases in whichthe operative heat radiation originated from the facesof the experimenters.
--
L am, Sir. vours faithfully. I :
A. A. CAMPBELL SWINTON, F.R.S.Victoria-street, Westminster, August 9th, 1921
AN INSTRUMENT WHICH IS SET IN MOTIONBY VISION.
To the Editor of THE LANCET.SIR,-In reply to Dr. Ian D. Suttie’s letter in your
issue of August 6th, the desirability of further workis obvious. My researches so far have been voluntaryand unendowed, but there is a limit to one’s endurance,.at least on the financial side. Even Dr. Suttie musttake this factor into account when complaining thatI have not worked out yet all the variations of the eye.force in diseases, cataracts, &c. He probably hasalready realised that time given to research must beat the expense of any medical man who has a livingto get in practice. The tone of the critical remarksof Dr. Suttie is in sharp contrast to the interested andmodest observations by the leaders of science towhom I gave the demonstrations. My assistant andI were impressed of course by the natural powerbut penetrating acumen of these men upon the-numerous occasions that the effects were demonstratedbefore them. I hold no academic qualifications inphysics and none are attached to Dr. Suttie’s letter,.but perhaps this was only his modesty.
Referring to Fig. 2, I must suppose that Dr. Suttiehas not yet had time to make merely a few thousandobservations on a model of that type. If and whenhe has done so, he will find with pleasurable surprisethat while applying all his will-power or psychic force,- or whatever it is, the condenser will not move,provided his vision is withheld. As a general principleI may remind him of the unwisdom of invoking aforce as little known and as complex as psychologyto explain something demonstrably due to a variationin a known (electrostatic) state. The force is reflect-able, though the slight loss of power at so many feetfrom the mirror had to be ignored in the referenceI made (p. 223). His reference to cataracts as controlsis surely a feeble suggestion, and I gave him the bestillustration of a means of cutting off the force by closingof the eyes, referred to under the heading of controls.
Dr. Suttie thinks my experiments have allowed meto outrun the appropriate amount of reflection. Thismay be so, as I have only been pondering them forfour years, and it is one week since my work hasreached him by means of THE LANCET. He mayhave heard me at the Congress giving more than oncean amiable reminder to the questioners that whencurrent electricity had just been found out it wasunreasonable to expect us to be already driving thetrams and telephones and lights by its power.Dr. Suttie’s closing remarks appear to group himamongst the earnest searchers after the truth. Thequalifications for that position are the production,of much hard work and the other sacrifices. Afterosuch efforts in our subject he may well take thematter further than I have, and then he will not beso troubled by anxieties as to what fraud or abuse itmay suffer by charlatans or others, who are theequivalent of the weeds in every garden. Theselatter activities will thrive as long as human credulity- continues to like entertainment at least as much asinstruction.-I am, Sir, yours faithfully,
Beaumont-street, W., August 8th, 1921. C. RUSS.
’THE FÆCES IN ALIMENTARY DISORDERS.
To the Editor of THE LANCET.SIR,- It is evident that in my article on this sub-
ject in THE LANCET of July 2nd I have failed to makemy meaning clear to Dr. Chalmers Watson. I
expressed the view that, in routine examination ofthe faeces, a Gram-stained bacteriological film was of
little help ; if, however, definite organisms, such astyphoid, were suspected, it was another matter. Inthat case (I left my readers to assume) the appropriatebacteriological methods were to be undertaken as amatter of course. I would assure Dr. Watson thatmy statement in regard to the small value of a Gram-stained film is based on experience in which thecooperation of both clinician and bacteriologist hasbeen intimate ; but I welcome his insistence on thenecessity for such cooperation.
I shall be glad to learn the sort of conclusionswhich Dr. Watson himself is able to draw from Gram-stained films. Undoubtedly in some cases there arewhat for clinical purposes may be called " stools ofputrefaction," in others " stools of carbohydratefermentation," each with their more or less typicalbacterial flora ; but these conditions can be recog-nised without recourse to bacteriological investiga-tion. Sometimes these findings are linked up withsome abnormal clinical condition, sometimes theyare associated with apparently good health ; although,even when, for example, a " stool of putrefaction
"
is associated with the symptoms of so-called " intes-tinal toxsemia," the pathology of the condition isnot at all clear. Undoubtedly the recognition ofthese types of stool gives useful indications for treat-ment, especially in the matter of diet. But toassume, as some clinicians appear to do, that thepreponderance of a Gram-positive or Gram-negativeflora has any special significance in that connexionseems to me to be at present quite unwarranted.
I am. Sir. vours faithfullv.Liverpool, July 30th, 1921. ROBERT COOPE, M.D.
THE OBJECTIVE STUDY OF THE NEUROSES.To the Editor of THE LANCET.
SIR,-I am afraid that Dr. F. L. Golla has pushedthe bottom out of his receptacle of interesting materialin the last column of the report of his third Croonianlecture in your issue of August 6th. A womantidies up immediately before childbirth because theprobable date of it has been fixed, and because sheknows that her chests of drawers will be looked overby others when she is in bed. His asking a midwifewhether this tidying habit was common counts justnothing as a confirmatory procedure ; as well mighta laboratory analyst ask his bottle-washer to decidewhether such or such a result was right or no. Onlywhen Dr. Golla writes, " We have here an instinctuntainted by any possibility of mimicry, and sinceits existence is apparently unknown, free from anycomplication due to suggestion," does he seem toinvite controversy, for the remainder of the lectureis extremely interesting and useful.What about most men and women tidying up before
going to bed for operations of various kinds ? Are
they fetching up the old nest-making instinct 2I am, Sir, yours faithfully,
HAYDN BROWN.Cavendish-square, W., August 5th, 1921.
LABOUR AFTER CRIMINAL ABORTION.To the Editor of THE LANCET.
SiR,-The following notes of a case may interestgynaecologists and also medical jurists. Some yearsago a married woman, finding herself two monthspregnant, endeavoured to procure abortion by takingpills. These failing, she went one morning and,presumably, visited an abortionist; later in the dayshe joined her husband, who was innocent of what wasgoing on, and spent the afternoon shopping with him.It was not until late that evening that she was seizedwith pain, after giving herself a douche. The followingday a doctor was sent for, who found her sufferingfrom commencing peritonitis. The next day, 48 hoursafter the symptoms began, she was operated upon,when there was no sign of any wound in the vaginaor cervix, but there was general peritonitis with pusin the pelvis. A perforating wound, large enough to
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admit the tip of the little finger, was visible in thefundus of the uterus. The edges of the wound weresloughing. The patient’s condition next day wasapparently so hopeless that an attempt was madeto obtain her dying deposition. She obstinatelyrefused, however, to admit that any illegal operationhad been done on her. With even greater obstinacyshe refused to die, and after a long illness recovered.She had been told that her illness must have
destroyed any chance of her ever having children.About a year later she informed her doctor that shewas again pregnant. Considering the damagedcondition of her abdominal wall and the probabilityof adhesions, it seemed inevitable that labour would bedifficult and that trouble might arise in the thirdstage of labour. Her confinement took place in duecourse, labour being easy and quick and the -puer-perium normal in every respect. To the obstetricianthe case is an interesting illustration of the capacityof the uterus for recovery, and of the danger of fore-telling a difficult confinement. To the medicaljurist the case is important as the woman seems tohave spent an afternoon shopping after perforation ofthe uterus with a weapon, however caused. In thelaw courts recently an eminent specialist stated inevidence that such a thing would be impossible,and, apparently, that definite expert pronouncementhad an important bearing with the judge and jury.The case narrated above, therefore, also illustratesthe danger of stating in a court of law that anythingin medicine is impossible.To any medical man interested in the case from
the point of view of medical jurisprudence furtherdetails will be supplied. ’
1 am, tir, yours laitniuiiy,July 31st, 1921. X.X.X.
PRIVATE AND PANEL PRACTITIONERS.
To the Editor of THE LANCET.
SiR,—In the last paragraph under Public HealthServices in your issue of August 6th, you statethat " technically an insurance practitioner isentitled to charge a fee to the patient of anotherpractitioner " who comes to the former for treatmentin preference to his own " panel doctor," but you goon to say that " any practice of this sort would tendto be seriously prejudicial to the medical service forthe insured." Why and how thus prejudicial ? Thepanel doctor for whom the person has in the firstcase " signed on " for gets his capitation fee legiti-mately, though he does nothing for it, the second paneldoctor gets his fee from the patient willing to pay it,and the insurance funds are saved the expense ofmedicine or anything ordered by the second doctor,for as the patient is a "
private "
one the secondpanel doctor either supplies it or sends his patientto a chemist with a prescription-presumably not tobe supplied at the cost of the insurance finances. Andthe patient gets his satisfaction by consulting themedical man he wishes to consult. The patient can,of course, transfer to the practitioner he desires toattend him, but until he does so I do not understandhow such a proceeding can be so terribly prejudicialto the medical service for the insured.
I am not and have never been on the panel listand I hope I shall never be compelled to put my nameon it, but I am brought into contact daily with manypanel practitioners and I am interested in questionsconcerning panel practice.
i am, sir, yours taittituiiy,August 6th, 1921. NON-PANEL.
AN APPEAL FROM THE RUSSIAN RED CROSS.To the Editor of THE LANCET.
SiR,—As a Russian practising in this countrypermit me to associate myself with the stirring appealmade by my colleague, Dr. Belilovsky. I feel confidentthat the British medical profession, which has always
been most responsive to any appeals in the name ofhumanity to alleviate suffering, will not turn a deafear to such a heart-rending S.O.S. from my unfortunatecountry. I view with great satisfaction that theInternational Red Cross Committee and the actingDirector of the League of Red Cross Societies havejointly issued a statement proposing the formationof an international relief organisation to coordinatethe activities of all the voluntary bodies. The SupremeCouncil, too, is giving attention to this urgent problem.But meanwhile what is needed is immediate assistancefrom each individual doctor in this country and fromthe British medical profession as a whole.
I am, Sir, yours faithfully,L. ZEITLINE, M.R.C.S. Eng.
Uatoshead, August Vth, 1921.
Obituary.WILFRED W. E. FLETCHER, M.B.CAMB., D.P.H.,
LATE MEDICAL INSPECTOR, LOCAL GOVERNMENT BOARD.
IT was with great sorrow that the many friends of-Wilfred William Ernest Fletcher heard of his deathon July 31st, at the age of 64, in a London nursinghome after a serious operation. In compliance with,his expressed wish he was buried in the graveyardof his native village of Tarleton, which lies about eight.miles from Ormskirk. Dr. Fletcher was a Lancashireman and came of an old clerical family well known inthe county, his father having been for many yearsrector of Tarleton, and his late brother rector ofChorley and archdeacon of Blackburn. He was:
educated at Rossall School and Caius College, Cam-bridge, his medical studies being carried out at StBartholomew’s Hospital. He took his B.A. degree-in 1881 and his M.B. in 1884, in which year h&obtained also the M.R.C.S. and L.S.A. Later hetook the D.P.H. Not long after obtaining hismedical qualifications Dr. Fletcher was appointedwhole-time medical officer of health for the WestLancashire Rural District, and this post he held until1892 when he was invited to join the medical depart-ment of the Local Government Board. This latterappointment he relinquished in 1917 after completing25 years’ service as a medical inspector. After his:retirement the post of medical officer of healthfor the Metropolitan Borough of Hackney became-suddenly vacant, and Dr. Fletcher was offered the-temporary appointment until the end of the war,or until such time as a suitable permanent officer-could be found. He filled this appointment for abouttwo years and performed his duties to the entire-satisfaction of the Council and of the staff whichserved under him. His genial personality was well’known throughout a large part of England, especiallyin the Midlands and the North-Western Districts.,in which he conducted many public inquiries, andnumerous printed reports by him were published by-the Local Government Board. It may be rememberedthat one of his more recent and interesting reports-concerned a joint inquiry made by himself along witha superintending inspector of factories and a senior-labour adviser of the Home Office, regarding thealleged danger of the transmission of certain diseasesfrom person to person in weaving sheds by means ofwhat is known among factory workers as " shuttle-kissing."
Fletcher was very popular with his colleagues at.Whitehall, as also with the large number of medicalmen with whom he came in contact in the dischargeof his official duties. His kindly disposition andengaging personality often turned opponents into.friends. He held strong and pronounced views onpolitics, but his transparent honesty of purpose andhis candour led those who differed from him to listento his arguments even when expressed in somewhat.forcible language. He leaves a widow to mourn his.decease.
