notices to correspondents
TRANSCRIPT
529
NOTICES TO CORRESPONDENTS.
TO Correspondents.Another T7ti2-d-Year’s Student.-The presumptive evidence was, that there
might be a small knuckle of intestine, the size of a marble, incarcerated ; butthe symptoms do not appear to have been at all suincierrtly urgent to justifythe operation. The vomiting has actually depeiicled upon some other cause,which no doubt would have been still further explained by a careful post-mortem examination. The most prudent course would have been to wait,especially as there was no evidence of a tumour in the groin. There can be
no doubt the patient’s sufferings were aggravated by the operation, and inall probability it hastened the fatal result, more especially as the dividedveinswere tied-a surgical procedure which is generally condemned, althoughsanctioned by a few surgeons. It is really a pity that such difference ofopinion should exist amongst men who are looked upon as the heads of theprofession, and who belong to the examining boards.
M.R.C.S.-English surgeons are not prohibited from entering the service.We do not know the emolument.
H. G., Fourteen Years’ Subseriber to THE LANCET.-Such a partnership Couldnot be legally formed. One of the contracting parties not being legallyqualified, virtually disqualifies the other.
Medical Society of London.-By accident, the following remarks of Dr. Snowwere omitted from the report of this Society last week :-Dr. Snow said thatDr. Beddoes had long since remarked that persons whose employments con-tracted the chest were liable to phthisis.
Studens.-It is a good book, but not superior to those mentioned.3fr. J. B. Budgett.-The subject has already been fully canvassed. It is pro-bable that a general meeting of the governors will be held on an early occa-sion.
DR. HUMBLE’S UTERO-ABDOMINAL TOURNIQUET. To the Editor of THE LANCET.
SIR,-I was much surprised on reading in your last number of a new invcn-tion-viz., a tourniquet bandage for arresting uterine haemorrhage. In theMedical Gazette, June, 1841, rny father wrote on the ‘’ Value of an OrdinaryTourniquet," as mentioned by Dr. Humble, and which he had been in the habitof using for many years, with a small padded band or piece of cork for a com-press. In the Medical Gazette, January, 1846, I wrote a paper on the "Treat-ment of Post-partum Hæmorrhage," and gave a description and woodcut of auterine compress, against which there can be no complaints on the score ofpartiality. It is also fully described in my work, "Aids during Labour," andin which the necessity for efricient pressure is fully insisted on. My father’spaper has long since been acknowledged by Dr. Ramsbotham, and mille by Dr.Murphy, in their several works.Dr. Humble will find that my belt is precisely similar to what he deseribes,
and that it presses from the top platform of the tourniquet. The webbing ofmy belt is an inch wider than the one he employs. " It has attached to it Mr.Coxeter’s improved tourniquet, the screw of which is only half the length ofthe one on the old principle, for the convenience of carriage, but by additionalrollers it raises as much web; the belt and compress, being separate, are easilycarried." (" Aids during Labour," p. 95.) The mod of using the tourniquet asdescribed by Dr. Humble, I consider open to grave objections, on account ofthe limited space to which powerful pressure is applied. A long stem to atourniquet is inconvenient, and will be found very liable to tilt over in practice.Moreover, a dilated uterus will escape unless well surrounded, and internalhemorrhage will ensue if external haemorrhage do not occur. " I inventedthe compress, by which I endeavoured to avail myself of the efticient pressureof the tourniquet, and at the same time to carry out Dr. Murphy’s principle of pressing on and around the uterus, which he effected by a series of linen com-presses that were confined by the ordinary bandage. (" Lectures on Partnri-tion," p. 354.) A powerful pressure can only be safely employed when it isuniform, and I believe that it will temporarily act, as contraction does, by pre-venting the venous sinuses becoming distended with blood, and that whentightened to the utmost it will interfere with the circulation through theabdominal vessels; for by twisting the tourniquet, you not only can regulatethe pressure to any amount, and tighten the belt, but from the webbing beingthreaded so as to pass out above the rollers, as you turn the screw you forceinwards the compress if you wish to the length of the screw. The compressis so shaped as to prevent the uterus escaping laterally from the pressure, andto press well above the fnndus should the uterus be contracted." (" Aids duringLabour," p. 195.) It folds up into a small compass. lf plessure be efficient,it arrests the haemorrhage temporarily until contraction ensues, if it do not atonce excite the latter.
Dr. Humble remarks-" Should the severity of the case require the use ofthe plug also, a ribbon attached to the instrument in front, carried betweenthe thighs and pinned to the belt behincl, will suffice admirably to retain theplug." I would beg to observe that a plug cannot prevent post-partumhæmorrhage, but may only conceal it, and that it is not admissible in cases offlooding.The Dublin Quarterly, in its review of my work, amongst other mistakes,
has stated that I recommend the application of my uterine compress before thebirth of the child. Nothing could be more mischievous and objectionable thansuch a practice. I am, Sir, your obedient servant,Bayham-terrace, Camden-town, Nov. 1856. J. R. PRETTY, M.D.
To the Editor of THE LANCET.SIR,-Under the head of " New Inventions" in last Saturday’s number of
TUE LANCET, I observed a notice of a Bandage for Uterine Htcmorrhage,"the merit of the invention of which is claimed by Dr. Humble. It is nowabout two years since 1 made an instrument upon the same principle of tour-niquet compression, so that the merit (if any) of the invention belongs to me,and not to Dr. Humble. There is some difference in the attachment of thebelt in my instrument, and the tourniquet, is of the ordinary size; but theprinciple and its application are exactly the same as that referred to by Dr.Humble. The original pattern of the instrument can be seen by any gentle-man taking an interest in the matter at Mr. Bailey’s, 418, Oxford-street.Trusting to your sense of justice for an insertion of this note,
I remain, Sir, your obedient servant, November, 1856. THOMAS P. KELLY.
F.-We think Gcclong might be a suitable place, or perhaps Melbourne, butthe latter is most likely overstocked by medical men. Sidney is a desirablespot to start from, but not to settle in. A good plan of proceeding would beto go to Sidney, and, after obtaining the requisite information there, startfor some place in the interior, where medical practitioners are often muchwanted, and likely to be well paid. Under any circumstances, severia hun-dred pounds would be required to start with, say not less than five or six;and it would prove a safer matter if a good supply of drugs and chemicalswere taken out. The necessaries of life are not now so dear as they weresome time ago.
Mr. J. E. Brine.-Under the circumstances, the patient is personally liable,and can be personally sued with success.
A Student inquires whether Nachet, of Paris, has any agent in London for thesale of his students’ microscopes ?
An Old Subsuriber.-We do not remember such an advertisement having everappeared in THE LANCET.
S. K. B.-M. H. Lebaigne, 10, Little Lichfield-street, Cavendish-square.A. Q.-There is no virtue in the "medicine" named.A Constant Subscriber.-In the present unsettled state of the profession, it is
doubtful whether any proceedings would be instituted by the only body-the Society of Apothecaries-who have power to proceed against theoffender.
CHOLERA IN 1856.To the Editor of THE LANCET.
SIR,-Within the last fortnight, intelligence has arrived from India of amost terrible outbreak of cholera in the upper provinces. A garrison, unex-ceptionably situated, exceedingly well ventilated, and effeetually drained, hashad so fearful a mortality, that nearly one-half of the men were hors de combat.two hours being sufficient to destroy life in a number of instances after theattack; and the Imperador, which sailed from St. Vincent, Cape de Verde,only on the 18th October last, a week’s passage from our shores, has broughtthe news that that island, with a population of 1200, has had deaths to theamount of 800, and this principally amongst males. This peculiarity of attackas confined to males has been noticed as most remarkable. In Madeira thischaracter was observed, and likewise in Upper India; and most probably ifthe epidemic should come to our latitude, I doubt not the same immunity toattacks of females would be indicated. Hence I would advise, on the first out-break of the disease in England, the apprehensions of the sex being allayed;that they should be largely enaagcd in the pious work of niiiiistratior. to thesick poor, and in reporting to the professional men of the district the localities.and houses infected. Upon what physiological grounds, I ask, is one sexlargely exempted, and the other attacked ? And again, why does the diseasein its present form select situations and places well supplied with the bestsanitary embel ishments ? I am, Sir, your obedient servant,Romney-terrace, Westminster, Nov. 1856. J. C. ATKINSON. M.D.
Chirui-giis, (Fourteen Years’ .Subscriber.)-1. The security is liable for anydeficiency, notwithstanding the act of self-destruction on the part of the de-faulter.--2. Unless twelve jurors sign the inquisition, the verdict is not alegal one.-3. No doubt he would.-4. To the Crown.-5. The Crown woulddoubtless grant the request.
Doutful.-We cannot recommend him.House-Surgeon.-Such allowances, being part of income, might be assessed r
but an appeal might be made with probable success.M.R.C.S. & L.S.A.-There is no evidence of the paragraph in the West Briton,being an advertisement.
A Subscriber of Twenty Years.-It may admit of a quibble; but it is a legalclaim, and can be enforced.
E. H.-The list could not be published until after the meeting of the Court,which took place yesterday, the 7th inst.
THE letters of L. M. and A Surgeon are in type, but unavoidably postponeduntil next week.
COMMUNICATION, LETTERS, &c., have been received from-Mr. Fergusson ;Mr. J. Birkett; Dr. Tyler Smith; Dr. Henry Bennet; Dr. Birkett; Mr.J. Dixon; Dr. J. R. Pretty; Dr. J. C. Atkinson; Mr. Griffin, (Weymouth;)Mr. F. S. Fletcher; Mr. Benjamin Daniel; Mr. W. Ramsay Stewart, (Halifax,Nova Scotia;) Dr. Hill; Mr. W.M. I-Iughes; Mr. Henry Behrend, (Liver-pool ;) Mr. Thomas P. Kelly; Mr.Wilson; Mr. Fisher; Mr. Stevens, (Cam-bridge-road;) Mr. S. Smith, (Birmingham;) Mr. J. E. Brine, (Shaftesbury;)Dr. Henry Barnett, (Fooehowpoo, China;) Mr. J. B. Budgett; Mr. Silwall;Mr. E. B. Halford; Mr. S. Lee Rymer; Dr. Richard Barnett; Mr. H. E,Watts, (York;) Mr. C. Stonehouse, (Normanton, with enclosure;) Dr. NoMe,(Manchester, with enclosure;) Mr. F. Hinde, (Liverpool, with enclosure;)Mr. Howell, (Builth;) Mr. Greenwood, (Iluddersfield Infirmary, with, enclo-sure ;) Mr. Potter, (Manchester, with enclosure;) Mr. Hare,. (Derby, withenclosure;) Mr. Rush, (Southminste)’;) Mr. Morgan, (Jesus College, Cam-bridge;) Mr. Evans, (Littlehal11ptoll;) Mr. Lawrence; Mr. Jessop, (Leeds,with enclosure;) Mr. R. Woods, (Newry;) Dr. Hitchman, (Liverpool;) Dr.Stone, (Canteibury;) Mr. Lawler, (Dublin;) Mr. Timmon, (Gland,udno;)Mr. ilowmer, (Dublin;) Mr. Barker; (Leatherhead;) 5Ir. Beale, (Driffield.with enclosure;) Mr. Carmichael, (Drayton Bassett, with enclosure ;) Mr.Wimpenny, (Rawtenstall, with enclosure ;) Mr. Brown, (Stourport;) Mr.
Carter, (Billericay, with enclosure;) ;) M.R.C.S.& L.S.A. ; H. G., FourteenYears’ Subscriber to THE LANCET; A Student; E. X.; M.R.C.S.; A WearyWill, but not one of the Deluded; A Surgeon, (Woolwich;) Such is Life;L.M., (Wolverhampton;) An Old Subscriber; Another Third-Year’s Student.Chirurgus, and a Ten Years’ Subscriber to THE LANCET; House-Surgeon,(Lancashire;) A Constant Subscriber; Hon. Sees. of the North London.Medical Society; A Subscriber of Twenty Years; Studens, (Edinburgh;)The Council of the Ethnological Society; Medicus; A. M. ; A Country Sub-scriber; S. K. B. ; S. S. S. ; Jumus; Doubtful; F.; A. Q.; &e. &c.
529