"euthanasia."

1
532 _pounds and was 20 inches in length, the diameters of the head were normal. After the operation the patient’s highest .recorded temperature was 38.6° C. (1014° F.). She left her bed on Sept. 1st and was discharged recovered on Sept. 10th -namely 25 days after the operation. Two months sub- sequently Dr. Pozzan found her to be in excellent health. The uterus had subsided to its normal dimensions but was anteflexed as a’result of the cicatrisation anteriorly. He .says that Merz in 1894 was able to collect histories of 39 daparotomies after rupture of the uterus, of which 18 were successful. To this number must be added a case which occurred in the practice of Dr. Paolo Rossi of Vicenza in June, 1891. The patient was 40 years of age and had had six normal labours Rupture of the uterus occurred in the seventh and laparotomy without suturing the uterus was performed at her own home. She was able to leave her bed after 29 days and was then perfectly recovered. THE INTERNATIONAL CONGRESS OF GYNÆCO- LOGY AND OBSTETRICS. THE third session of the International Congress of Gynaecology and Obstetrics will be held at Amsterdam from August 8th to 12th, 1899. The questions arranged for dis- ,e,ussions (at which already several prominent medical men of different nationalities have promised to be present) are as follows: 1. The Surgical Treatment of Fibro-myoma. .2. The Relative Value of Antisepsis and Improved Technic for the Actual Results in Gynaecological Surgery. 3. The Influence of Posture on the Form and Dimensions of the .Pelvis. 4. The Indication for Caesarean Section compared with that for Symphysiotomy, Craniotomy, and Premature Induction of Labour. The official languages are English, French, German, and Italian, and the reports with their translations in the official languages will be sent to all the members a month before the opening of the Congress. As regards private communications preference will be given to those bearing upon the above-mentioned leading questions. Time will also be allowed sufficient for any demonstrations. The subscription for membership is one guinea. Subscrip- tion forms and further particulars may be obtained from the ’honorary secretary for Great Britain and Ireland, Dr. Arthur Giles, 37, Queen Anne-street, London, W. "EUTHANASIA." THE letter which we print this week fro:n Mr. W. G * .Burnie in reply to one from Euthanasia calls to mind a question which from time to time must suggest itself to every medical man. Such cases as I our correspondent described occur only too frequently and the doubt as to how far we are justified in pushing anodynes and anaesthetics naturally causes us con- siderable anxiety. In reply to his queries we believe, however, it would have been perfectly justifiable for him to have used morphia hypodermically and patients .are frequently kept under chloroform cautiously adminis- tered for hours to mitigate the sufferings caused by .convulsions-e.g., those of tetanus. Medical men must frequently ask themselves whether it would not be more humane in certain cases to purposely administer .an overdose of morphia or of an anæsthetic. We refer, of course, to those patients suffering from a malady which is perfectly incurable, which will undoubtedly cause death within a very short period, and in which as long as the patient survives intense agony will be experienced. No one can deny "that it would be the kindest thing to do," but the physician’s duty is to attempt to save life, never to destroy it. It is wonderful how much pain can be relieved without danger to life by the suitable administra- tion of anodynes, and we consider that a practitioner is perfectly justified in pushing such treatment to an extreme degree, if that is the only way of affording freedom from acute suffering. With morphia, in the majority of cases, there is but little risk ; in cases of extreme cardiac weakness it may certainly be given ; the only doubtful cases are those in which there is advanced renal disease, and then it is for the physician to decide which is likely to be of more harm to the patient, the prolonged agony or the morphia, or whether the administration of some other anodyne should be tried, and if that fails then whether chloroform inhalation should be given. If the risks be explained to the friends we are of opinion that even should death result the medical man has done the best he can for his patient. But this is a very different matter from purposely giving a larger dose than is necessary. The various suggestions which have been made as to consultations for discussing the question of pain- lessly shortening the existence of a fellow-being are hardly to be taken seriously. If such a mode of treatment were suggested it would be so open to abuse by the unscrupulous persons who are unfortunately to be found in every rank of life that the medical profession would never countenance it. PETROLEUM LEGISLATION. WE are evidently a long way from obtaining a definite pro- nouncement from the Government on the vexed question cf altering by statute the flash-point of petroleum oil. Mr. Jesse Collings stated to a deputation last week that the matter was receiving close and serious consideration. The members of the deputation who spoke and who represented the Federation of Grocers’ Associations urged that legislation should be directed to the construction of the lamp rather than to the adoption of a much higher minimum flash- point of the oil. One remarkable statement was worthy of note. A gentleman stated that " the vendors who pro- vided oil for the 10,000,000 lamps in use every night and day in Great Britain wish to enlist the sympathy of the department in opposing any legislation which suggested the raising of the flash point, the evidence before the committee being entirely in favour of no alteration." The subject of future legislation in this matter is beset with peculiar and great difficulty and it is a pity that this difficulty is not diminished by the sensational statements as to lamp accidents which appear so frequently in the daily press. THE COLOUR OF PRIMITIVE MAN. IN the February issue of Knowledge Professor Arthur Thomson writes the first instalment of what promises to be a series of very interesting articles on the Treatment and Utilisation of Anthropological Data. The first article deals with the question of colour-a question which has attracted considerable attention in the fields of physical anthropology. Whilst on the one band it has been maintained that primi- tive man was fair in complexion, on the other hand it has been maintained that he was of a dark tint. "It is not necessary for us," says Professor Thomson, 11 two accept the extreme position....... A middle course is open as suggested by Dr. A. R. Wallace who advances the view that primitive man was probably of a Mongoloid stock and that his subsequent modification into white and brown and black varieties was due to his migrations into geo- graphical areas where he was subject to the influence of varied conditions of climates." The writer, however, does not commit himself to the acceptance of such opinion but remarking that the theory is suggestive draws attention to associated details of importance in studying the question. Among them " Temperature may be mentioned, diurnal as well as nocturnal. The moisture of the atmosphere. The nature of the soil. The diet. The manner of life, whether dwellers in dense forest or jungle-where, for example, the natives are screened from the sun’s rays, or dwellers on the hills and

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Page 1: "EUTHANASIA."

532

_pounds and was 20 inches in length, the diameters of thehead were normal. After the operation the patient’s highest.recorded temperature was 38.6° C. (1014° F.). She left herbed on Sept. 1st and was discharged recovered on Sept. 10th-namely 25 days after the operation. Two months sub-

sequently Dr. Pozzan found her to be in excellent health.The uterus had subsided to its normal dimensions but wasanteflexed as a’result of the cicatrisation anteriorly. He

.says that Merz in 1894 was able to collect histories of 39

daparotomies after rupture of the uterus, of which 18 weresuccessful. To this number must be added a case which

occurred in the practice of Dr. Paolo Rossi of Vicenza inJune, 1891. The patient was 40 years of age and had hadsix normal labours Rupture of the uterus occurred in theseventh and laparotomy without suturing the uterus was

performed at her own home. She was able to leave her bedafter 29 days and was then perfectly recovered.

THE INTERNATIONAL CONGRESS OF GYNÆCO-LOGY AND OBSTETRICS.

THE third session of the International Congress of

Gynaecology and Obstetrics will be held at Amsterdam fromAugust 8th to 12th, 1899. The questions arranged for dis-,e,ussions (at which already several prominent medical menof different nationalities have promised to be present) areas follows: 1. The Surgical Treatment of Fibro-myoma..2. The Relative Value of Antisepsis and Improved Technicfor the Actual Results in Gynaecological Surgery. 3. TheInfluence of Posture on the Form and Dimensions of the

.Pelvis. 4. The Indication for Caesarean Section comparedwith that for Symphysiotomy, Craniotomy, and PrematureInduction of Labour. The official languages are English,French, German, and Italian, and the reports with theirtranslations in the official languages will be sent to all themembers a month before the opening of the Congress. As

regards private communications preference will be givento those bearing upon the above-mentioned leading questions.Time will also be allowed sufficient for any demonstrations.The subscription for membership is one guinea. Subscrip-tion forms and further particulars may be obtained from the’honorary secretary for Great Britain and Ireland, Dr. ArthurGiles, 37, Queen Anne-street, London, W.

"EUTHANASIA."

THE letter which we print this week fro:n Mr. W. G *.Burnie in reply to one from Euthanasia calls to

mind a question which from time to time mustsuggest itself to every medical man. Such cases as Iour correspondent described occur only too frequentlyand the doubt as to how far we are justified in

pushing anodynes and anaesthetics naturally causes us con-siderable anxiety. In reply to his queries we believe,however, it would have been perfectly justifiable for

him to have used morphia hypodermically and patients.are frequently kept under chloroform cautiously adminis-tered for hours to mitigate the sufferings caused by.convulsions-e.g., those of tetanus. Medical men must

frequently ask themselves whether it would not be

more humane in certain cases to purposely administer.an overdose of morphia or of an anæsthetic. We refer, ofcourse, to those patients suffering from a malady which isperfectly incurable, which will undoubtedly cause deathwithin a very short period, and in which as long as thepatient survives intense agony will be experienced. No onecan deny "that it would be the kindest thing to do," butthe physician’s duty is to attempt to save life, never

to destroy it. It is wonderful how much pain can berelieved without danger to life by the suitable administra-tion of anodynes, and we consider that a practitioner isperfectly justified in pushing such treatment to an

extreme degree, if that is the only way of affordingfreedom from acute suffering. With morphia, in the majorityof cases, there is but little risk ; in cases of extreme cardiacweakness it may certainly be given ; the only doubtful casesare those in which there is advanced renal disease, and thenit is for the physician to decide which is likely to be of moreharm to the patient, the prolonged agony or the morphia, orwhether the administration of some other anodyne shouldbe tried, and if that fails then whether chloroform inhalationshould be given. If the risks be explained to the friends weare of opinion that even should death result the medical manhas done the best he can for his patient. But this isa very different matter from purposely giving a larger dosethan is necessary. The various suggestions which have beenmade as to consultations for discussing the question of pain-lessly shortening the existence of a fellow-being are hardlyto be taken seriously. If such a mode of treatment were

suggested it would be so open to abuse by the unscrupulouspersons who are unfortunately to be found in every rank oflife that the medical profession would never countenance it.

PETROLEUM LEGISLATION.

WE are evidently a long way from obtaining a definite pro-nouncement from the Government on the vexed question cfaltering by statute the flash-point of petroleum oil. Mr.

Jesse Collings stated to a deputation last week that thematter was receiving close and serious consideration. The

members of the deputation who spoke and who representedthe Federation of Grocers’ Associations urged that legislationshould be directed to the construction of the lamp ratherthan to the adoption of a much higher minimum flash-

point of the oil. One remarkable statement was worthyof note. A gentleman stated that " the vendors who pro-vided oil for the 10,000,000 lamps in use every nightand day in Great Britain wish to enlist the sympathy of thedepartment in opposing any legislation which suggested theraising of the flash point, the evidence before the committeebeing entirely in favour of no alteration." The subject offuture legislation in this matter is beset with peculiar andgreat difficulty and it is a pity that this difficulty is not

diminished by the sensational statements as to lamp accidentswhich appear so frequently in the daily press.

THE COLOUR OF PRIMITIVE MAN.

IN the February issue of Knowledge Professor ArthurThomson writes the first instalment of what promises to bea series of very interesting articles on the Treatment andUtilisation of Anthropological Data. The first article dealswith the question of colour-a question which has attractedconsiderable attention in the fields of physical anthropology.Whilst on the one band it has been maintained that primi-tive man was fair in complexion, on the other hand it hasbeen maintained that he was of a dark tint. "It is not

necessary for us," says Professor Thomson, 11 two acceptthe extreme position....... A middle course is open as

suggested by Dr. A. R. Wallace who advances the

view that primitive man was probably of a Mongoloid stockand that his subsequent modification into white and brownand black varieties was due to his migrations into geo-graphical areas where he was subject to the influence ofvaried conditions of climates." The writer, however, doesnot commit himself to the acceptance of such opinion butremarking that the theory is suggestive draws attention toassociated details of importance in studying the question.Among them

" Temperature may be mentioned, diurnal as well as

nocturnal. The moisture of the atmosphere. The nature ofthe soil. The diet. The manner of life, whether dwellers indense forest or jungle-where, for example, the natives arescreened from the sun’s rays, or dwellers on the hills and