661

witnessed the sufferings of such an awfuldisease, without feeling an anxious desire tounderstand the cause and alleviate the mi-

sery, has neither a head nor a heart worththe caring for."

It is the duty of an editor, or of a pro-fessed critic, to lay before his readers aclear view of facts, and, if necessary, to rea-son from these as fairly as he can. It isone at least of the essential chara cteristicsof a gentleman not to attack the honour ofanother until he is fairly convinced that hedeserves such treatment. I have, however,stated the facts, and whether Dr. Johnsonhas acted with wisdom towards himself, orfairness towards me, I shall now leave tothe decision of the public.By inserting the above you will oblige,

Sir, your obedient servant, ,

WM. STEVENS, M.D.Albany St., Regent’s Park, Jan. 23, 1832.

WM. STEVENS. M.D.

EFFECTS OF STRANGULATION

ON THE ORGANS OF GENERATION.

To the Editor of THE LANCET.SIR,—In reference to several communi.

cations which have appeared in THE LANCETon the effects of hanging on the ma’e andfemale organs of generation, and the sexualfunctions of the cerebellum, permit me tolay before you a short statement of what hasfallen under my own observation in relationto this subject.

In October, 1820, I was accoucheur to alady who, as soon as she was delivered,anxiously wished to know the sex of thechild. Accordingly, in absence of light, Iascertained by feeling with my hand the sexof the infant, and told her that it was a fineboy. But what particularly arrested myattention on this occasion was, a strongpenal erection in the child, who seemed tohave been almost strangled in the birth.The presentation was natural, and the painsvigorous, and at short intervals ; the headwas very much compressed, and the labourwas finished nearly in an hour. Since my at-tentionhas been directed to this subj ect manyopportunities have occurred to me o veri-fyiug the accuracy of the position of someof your correspondents. But the circum-stances in which the accoucheur is most

likely to recognise its truth are, when thelabour is vigorous, the head strongly com-pressed, and retarded for a time in the pas-sage through the pelves, but the child ulti-mately born without much resistance fromthe soft parts. Sometimes, however, the

rigidity and resistance of the soft parts pro-duce nearly a similar effect. The fact maybe noticed in very protracted labours, andin most inatances the child’s face is turgid

and livid, and respiration often does nottake place for some minutes after delivery.

It may be now three years since 1 attendedthe follo wing case, of a woman, about 30 yearsof age, in child-bed. The labour was severe,though not remarkabiy so, for in two or

three hours she was delivered of a femalechild without any particular assistance. Itwas on the second day after delivery, whenI called to see my patient, that she directedmy attention to some marks of blood on thechild’s linen. At first I thought lightly ofthe matter, supposing the appearance to havebeen produced by some drops of blood fromthe umbilical cords. She however spokesignificantly on the subject, and talked of itas catamenial. In confirmation of her viewof the subject she remarked that this wasthe second female child which she had hadthat exhibited this appearance during thefirst and second day after delivery. Thiswas quite new to me; at the same time Iendeavoured by a careful examination toascertain the source of this singular pheno-menon. No fluid blood was discovered, but’around the root ofthe clitoris, some sangui-neous matter was found in a dry, granular,form, whence it is presumed the discharge,if it deserved the name, had proceeded. Itook an early opportunity of inquiring of aprofessional gentleman who had been nearly40 years in the practice of midwifery, if hehad ever noticed anything similar to whathas been just mentioned, but he frankly ac-knowledged that he had not. In a conver-sation which I had on this subject with amidwife of extensive practice in this place,she stated to me that she had noticed the

appearance referred to several times in thecourse of her business. Since I began tomake inquiries on the subject, some othercases of the kind have been mentioned to me.About seven weeks ago I was consulted

in a case of apoplexy. The woman hadbeen remarkable for regularity with regardto the recurrence of the catamenia, but whileshe was labouring under this disease, whichproved fatal on the tenth day, the mensesappeared on the beginning ofthe third week,and continued two days, being’nearly a fort-night sooner than usual.

In severe epileptic fits, when the face isturgid, livid, and the veins of the head are

ready to burst, seminal emissions are, as Iunderstand, not uncommon. Now in allthese different kinds of cases the cause ofthe phenomena seems to be a mechanicaleffect which is produced on the cerebellum,which, through the medium of the nervoussystem, becomes apparent in the organs ofgeneration, and bears a striking’analogy tothe consequences which, hanging has uponeunuchs and criminals. 1 am, Sir,

Jan. 12, 1832. A.** This signature has been authenticated,—ED. L.