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BOXING
127
The finding of chromosomal normality is in accord with reports of monozygotic twins one of whom was normal and the other anencephalic (see, e.g., Litt and Strauss 5), and tends to support the view that at least some cases of anencephaly could be due to purely developmental, rather than genetic, factors. Although this result does not bring us immediately any closer to a solution of this complex problem it does provide an additional piece of evidence on which such a solution will eventually be
based. We should like to acknowledge the expert technical assistance C. M. Scammell.
given by Miss
was examined gently, and a bakelite ring tucked around the cervix comfortably tight and pushed up around the cervix to the level of the internal os. The ring was left in position until a week before term; meanwhile the patient was given the routine treatment for multiple miscarriage. So far the results have been quite encouraging. 13 cases were treated, the details of which are given in the table. There were 2 failures, 8 fullterm pregnancies, and 3 are continuing well. It is suggested that the manoeuvre is simple, uncomplicated, and safe, and has the advantage that the ring can be removed easily at 39 weeks and a vaginal delivery achieved. Subsequently the cervix can be treated by trachelorrhaphy. Rotunda Hospital,
patient
Radiobiological
Research
Unit,
Atomic Energy Research Establishment, Harwell, Didcot, Berks. Endocrine Department,
Guy’s Hospital, London, S.E.1. Orthopædic Department, Glasgow Royal Infirmary, 84, Castle Street,
Glasgow, C.4.
BOXING
D. G. HARNDEN.
SIR,—A letter you
J. H. BRIGGS. J. S. S. STEWART.
TREATMENT OF HABITUAL ABORTION DUE TO CERVICAL INCOMPETENCE
SIR,-Operative treatment of the torn or deficient cervix patients with a history of habitual abortion gives excellent results. Trachelorrhaphy is carried out and Falkiner (personal communication) suggested using silk-
in
worm-gut suture instead of catgut. These in situ for six weeks.
sutures are
left
When the next pregnancy starts the patient is treated with vitamin E, 50 mg. twice daily, ascorbic acid (’ Redoxon ’) 200 mg. three times a day, and vitamin B12 (’Cytamen’) 1000 Vg. and bismuth oxychloride (’ Bisoxyl ’) are injected weekly. So far the results of this treatment have been satisfactory and of statistical significance.67 When the patient with a history of habitual abortion is first seen in early pregnancy, however, the problem is more difficult, as it is too late to do a Falkiner trachelorrhaphy. Many people find the Skirodkar operation formidable, possibly through lack of faith, facilities, or familiarity. An alternative simple was obviously desirable, so I have used a small ’ Bakelite’ ring to control incompetency of the internal cervical os. Rings from 1¼ in. inner diameter upwards were used. The
procedure 5. 6. 7.
R. G. CROSS.
Dublin.
Medical Research Council
Litt, S., Strauss, H. A. Amer. J. Obstet. Gynec. 1935, 30, Cross, R. G. Lancet, 1946, ii, 754. Cross, R. G. Clin. Rep. Rotunda Hosp. 1957, p. 10.
728.
June 13 says: " The London inter-hospital boxing competitions for medical students have been going on for over fifty years now and are vigorous affairs. How many cases of permanent harm from them can you produce ? Any ?"
published
on
I well remember the cloud that descended on our medical college in London a quarter of a century ago when a fellow student died from a knockout blow in this competition. This left a permanent impression on his friends, many of whom, like myself, had had their share of boxing and were not prejudiced against it.
Some correspondents seem to have overlooked an important point in your leader-namely, that in boxing a deliberate attempt is made to produce a cerebral injury (always potentially lethal) whereas the admitted hazards of other sports are accidental. Like yourself I feel strongly that our profession should strive to eliminate the cerebral hazard from boxing. If a blow in the belly be considered unsporting and a foul, surely a blow on the skull with its more
vulnerable
contents
should be
so
considered ?
We should press vigorously for the rules to be amended make a knockout blow, and perhaps any blow above the neck, a foul. Contests would then be decided on points and the verdict lie, as it should with superior skill. They would still remain as good a test of courage and endurance as before, and if the sport lost its appeal it would but prove your point that one of the things we are up against is the " public appetite for violence and bloodshed ". A. L. CRADDOCK. Nakuru, Kenya.
to
RESULTS OF TREATMENT WITH CERVICAL RING
The finding of chromosomal normality is in accord with reports of monozygotic twins one of whom was normal and the other anencephalic (see, e.g., Litt and Strauss 5), and tends to support the view that at least some cases of anencephaly could be due to purely developmental, rather than genetic, factors. Although this result does not bring us immediately any closer to a solution of this complex problem it does provide an additional piece of evidence on which such a solution will eventually be
based. We should like to acknowledge the expert technical assistance C. M. Scammell.
given by Miss
was examined gently, and a bakelite ring tucked around the cervix comfortably tight and pushed up around the cervix to the level of the internal os. The ring was left in position until a week before term; meanwhile the patient was given the routine treatment for multiple miscarriage. So far the results have been quite encouraging. 13 cases were treated, the details of which are given in the table. There were 2 failures, 8 fullterm pregnancies, and 3 are continuing well. It is suggested that the manoeuvre is simple, uncomplicated, and safe, and has the advantage that the ring can be removed easily at 39 weeks and a vaginal delivery achieved. Subsequently the cervix can be treated by trachelorrhaphy. Rotunda Hospital,
patient
Radiobiological
Research
Unit,
Atomic Energy Research Establishment, Harwell, Didcot, Berks. Endocrine Department,
Guy’s Hospital, London, S.E.1. Orthopædic Department, Glasgow Royal Infirmary, 84, Castle Street,
Glasgow, C.4.
BOXING
D. G. HARNDEN.
SIR,—A letter you
J. H. BRIGGS. J. S. S. STEWART.
TREATMENT OF HABITUAL ABORTION DUE TO CERVICAL INCOMPETENCE
SIR,-Operative treatment of the torn or deficient cervix patients with a history of habitual abortion gives excellent results. Trachelorrhaphy is carried out and Falkiner (personal communication) suggested using silk-
in
worm-gut suture instead of catgut. These in situ for six weeks.
sutures are
left
When the next pregnancy starts the patient is treated with vitamin E, 50 mg. twice daily, ascorbic acid (’ Redoxon ’) 200 mg. three times a day, and vitamin B12 (’Cytamen’) 1000 Vg. and bismuth oxychloride (’ Bisoxyl ’) are injected weekly. So far the results of this treatment have been satisfactory and of statistical significance.67 When the patient with a history of habitual abortion is first seen in early pregnancy, however, the problem is more difficult, as it is too late to do a Falkiner trachelorrhaphy. Many people find the Skirodkar operation formidable, possibly through lack of faith, facilities, or familiarity. An alternative simple was obviously desirable, so I have used a small ’ Bakelite’ ring to control incompetency of the internal cervical os. Rings from 1¼ in. inner diameter upwards were used. The
procedure 5. 6. 7.
R. G. CROSS.
Dublin.
Medical Research Council
Litt, S., Strauss, H. A. Amer. J. Obstet. Gynec. 1935, 30, Cross, R. G. Lancet, 1946, ii, 754. Cross, R. G. Clin. Rep. Rotunda Hosp. 1957, p. 10.
728.
June 13 says: " The London inter-hospital boxing competitions for medical students have been going on for over fifty years now and are vigorous affairs. How many cases of permanent harm from them can you produce ? Any ?"
published
on
I well remember the cloud that descended on our medical college in London a quarter of a century ago when a fellow student died from a knockout blow in this competition. This left a permanent impression on his friends, many of whom, like myself, had had their share of boxing and were not prejudiced against it.
Some correspondents seem to have overlooked an important point in your leader-namely, that in boxing a deliberate attempt is made to produce a cerebral injury (always potentially lethal) whereas the admitted hazards of other sports are accidental. Like yourself I feel strongly that our profession should strive to eliminate the cerebral hazard from boxing. If a blow in the belly be considered unsporting and a foul, surely a blow on the skull with its more
vulnerable
contents
should be
so
considered ?
We should press vigorously for the rules to be amended make a knockout blow, and perhaps any blow above the neck, a foul. Contests would then be decided on points and the verdict lie, as it should with superior skill. They would still remain as good a test of courage and endurance as before, and if the sport lost its appeal it would but prove your point that one of the things we are up against is the " public appetite for violence and bloodshed ". A. L. CRADDOCK. Nakuru, Kenya.
to
RESULTS OF TREATMENT WITH CERVICAL RING