CROWN VERSOS HONEYWELL.

Evening Star, Issue 3477, 15 April 1874, Page 2

CROWN VERSOS HONEYWELL.

To the Editor. Si§, —For tjie sa|io of scientific accuracy, will you allow me to mske few comments upon the medical evidence in the above case. The medical witness says “he found it necessary tn turn because the case was one of cross presentation." Now this conclusion is not to be come to in all cases. There are many exceptions, and the present case was one. Professor Davis says, “It may be considered a good general rule never to turn when the death of the child is known to have taken place.” He further says “It ought to be au established rule in practice to decapitate ia arm-presentations, not admitting of the safer performance of turning ” Dr Ramsbotham says, “ It appears to me better practice either to 6vi» cerate or decapitate the foetus, than to endeavor to deliver by turning, in all cases where the uterus is so strongly contracted round the child’s body as te cause apprehension of its being lacerated by the introduction of the hand.” This treatment is advocated by the most eminent practitioners of the past and present, ua by I'aletta, Braun, Dubois, Laggati, and Barnes. Witness now says, “He had no hope of patient’s recovery. ->he had lost a good deal of blood, and was still losing it internally.” Why was there no hope ? Ca m ot recovery are on record where the uterus was more severely ruptured than in the precase, eVen after th* child had w-

caped into the abdomen. Hie loss of blood, though predisposing to future evils peritonitis among them—was no founds* ion upon which to base such a conclusion. It is said by witness that “ in a case of cross presentation, to pull the child’s arm would probably cause this rupture ’’ That would depend upon sev ral circuitst'.nccs First, the seat and direction . f the rupture : the size of the pelvis; the siUation of thcos uteri; the size of the cnild, and whether it be flaccid or not. Several cases are reported of u-1 1 fca . n s P lace b y * doubling-up of the child, with and without traction on the arm. Moreover, very many well-authenticated cases are reported where rupture took place spontaneously. Dr Hooper saw a case at the third month of pregnancy, where this occurred after dancing. L)r M'Kinlay tells of a case where a patient died from this cause without injury j the rupture extended across the fundus. The writer could relate three or four of a similar nature, all occurring* before the full time, where no violence was used. There are many causes which operate to produce rupture at full time.

Dr Barnes says:—“l have been more frequently consulted in criminal charges connected with rupture of the uterus than with any other obstetric casualty. Tn almost every instance it was proved that the aocident arose from unavoidable causes.”—l am, Geo. W. Cole. Dunedin, April 14.