- Email: [email protected]
COURT OF EXCHEQUER, WESTMINSTER,
544
CHELTENHAM GUARDIANS.—COURT OF EXCHEQUER.
the Council and the members may henceforth proceed, pari passu, to the Crown and to the Parliament for establishing, upon a broad and noble basis, the most important medical and surgical College in the United Kingdom.
We earnestly hope that, on an early occasion, at a full meeting of the Guardians, it will be decided that a resolution, which has at once the unusually conjoined characteristics of being both silly and malevolent, shall no longer be allowed to disgrace the records of the Board.
A CORRESPONDENT who resides at Cheltenham informs us that the Board of Guardians of the Union in that important town adopted, at their weekly meeting, on Thursday, Nov. 8, the following astounding resolution :-
THE Faculty of Medicine of Queen’s College, Cork, was opened on Thursday, the 8th instant, by an Inaugural Address, delivered by Dr. BULLEN, Dean of the Faculty. The Mr. Mr. seconded PARSONAGE,— Oration was received by a crowded auditory with loud BINCKES, "Proposed by by ’That the Board is of opinion that the system of medical The orator displayed a perfect knowledge of his relief at present in operation is susceptible of considerable applause. amendment, and that, at the election of medical officers in subject. Sir PHILIP CRAMPTON was present, and his appearMarch next, it be a rule that no gentleman holding any ance on the occasion elicited enthusiastic marks of approbahospital"appointment should be eligible as a union medical tion. officer:
If we had not had repeated proofs that Boards of Guardians could be guilty of any and every act of meanness, and that such
example of their being just and liberal to medical practitioners, as has lately been witnessed at Hull, in a handsome acknowledgment of the valuable services of Dr. AyRE, is the exception; and not the rule, we really should be inclined to
an
correspondent.
HAVING been informed, in a communication from Taunton, that out of 288 inmates of the Workhouse there, fifty-eight have died in the short space of nine days, we think it right to inquire whether inquests have been held on the bodies of any of the deceased persons. If not, some of the influential inhabitants should immediately address the Secretary-of-State and the Board of Health upon the subject.
doubt the accuracy of the statement of our There positively is no act of folly which some of the silly members of these Boards are not always ready to commit. Dressed in a little brief authority, the monkey tricks of many COURT OF EXCHEQUER, WESTMINSTER, of these silly wights might be amusing for their grotesque Tuesday, November 13th. IN BANCO BEFORE THE LORD CHIEF BARON AND THREE SITTINGS absurdity, if it were not for the pain which their rude antics OTHER JUDGES. cause to the sensitive feelings of gentlemen; and the injury which they are calculated to inflict upon the poor. WAKLEY, M.P., v. COOKE & HEALEY.—LIBEL.—THE HOUNSLOW FLOGGING CASE. we is the of It will this resolution ? What, ask, meaning be seen that it consists of two parts. The first portion is proper Tiais was an action instituted by the Coroner for Middlesex, to recover compensation in damages for certain libellous enough. Heaven knows that the system of medical relief articles which appeared in August, 1846, in the Medical Times, 11 its susceptible of amendment," for it is high time that medical of which publication the first defendant was the publisher, and practitioners should be no longer teased and almost worried the second the proprietor and editor. Portions of the libels out of their lives, without receiving anything more than an were published while the inquest on the body of the late insulting mockery of remuneration. But what is the kind of FREDERICK WHITE was sitting. The cause was tried before amendment which the members of the Cheltenham Board of the LORD CHIEF BARON and a Special Jury, at Westminster, at the sittings after last Hilary term. The trial occupied Guardians voted for, in this marvellously-queer resolution ? three days, and the jury returned a verdict for the Plaintiff Why, simply this: That if a surgeon be found in Cheltenham, on all the pleas, with DAMAGES THREE-HUNDRED AND FIFTY who happens to hold an office in which he has an opportunity POUNDS. of witnessing more of practice than his brother surgeons,-if Subsequently, a rule to show cause why the verdict should such a surgeon has been elected by the governors of a public not be set aside, and a new trial had on the ground of misinstitution to fill an important post, in consequence of his direction, was obtained by the defendant’s counsel; and it was arranged that the Court would consider whether the superior abilities and attainments,-the system is to be were excessive; but it was stated by the Court that 94 amended" by preventing such a practitioner from either adamages new trial could not be granted on that ground. remaining or becoming a medical officer of the Union! On Tuesday, the ATTORNEY-GENERAL, Mr. E. JAMES, and We can imagine that such a resolution had been proposed Mr. BRAMWELL, counsel for the plaintiff, appeared, to show by some inexperienced beardless boy, seconded by some dealer cause why the rule ought to be discharged. They argued in lead, whose brains had become as heavy as his wares, and that there had been no misdirection on the part of the learned carried by some rural jolterheads, in opposition to the intel- judge who presided at the trial; and that, considering the scandalous nature of the libels, the damages had not been ligent guardians of the town. A word in the ear of these excessive. conjurors. Are not you aware that the Poor-law CommisAfter Mr. Sergeant WILKINS and Mr. DEARSLEY had been sioners, acting under the provisions of the statute, have speci- heard in support of the rule, the whole day having been ocfied what are to be the qualifications of the medical officers of cupied by the arguments, the learned barons delivered judgthe Unions ? And can you imagine that it ever was intended ment seriatim, and they were unanimously of opinion that by the legislature that such a task should be confided to you? there were no grounds whatever for disturbing the verdict. The libels involved the character of Mr. WAKLEY as a Member Why, if you were left alone, without check or control, it is of Parliament, as the Editor of THE LANCET, as Coroner for probable that, within three years, you would adopt a resolution Middlesex, and as a man. Considering the nature of the libels, to the effect that no medical gentleman should be elected as a the jury might undoubtedly have given a much larger sum medical officer of the Union until he had furnished indisputable under the circumstances of the case. But it was stated that proof that he is as senseless as yourselves. Mr. HEALEY was not in a situation to pay large damages; and
545
probably’they took that circumstance
into their consideration.
therefore, having already decided that there had
been
no
mis-
direction, there was no ground for a new trial: the verdict must stand, and the- rule be discharged. Rule
discharged accordingly.
It- will be recollected by our readers, with reference to these libels, that the plaintiff moved for a criminal information against the defendant in the Court of Queen’s Bench. The obtained by the plaintiff, but after arguments had rut& was been heard against it, was subsequently discharged by the Court. Th& affidavits put in on that occasion by the defendant the plaintiff had no opportunity ofanswering, and consequently’ the effect of the hard swearing of some of the deponents might have exercised a pernicious influence in determining the decision of the Court. But, nothing daunted, and although he could find no cases to warrant him in adopting such a proceeding, the plaintiff resolved to bring an action in another Court, against the defendant, and try the question, whether a coroner, in the discharge of a difficult and anxious duty, was to be thus libelled with impunity, and the culprit escape from all responsibility and punishment. The result is now known, and testifies pretty strongly to the character of the decision in the Court of Queen’s Bench, where the rule was discharged; also to the propriety of the determination of the plaintiff to proceed in an action for damages, and the correct judgment and acumen of his counsel and solicitors, Sir J. JERVIS, (the ATTORNEY-GENERAL,) Mr. E. JAMES, Mr. BRAMWELL, and Messrs. LOFTY and POTTER, by whom the cause has been so ably conducted and
Correspondence. partem.11
TREATMENT OF CHOLERA IN HULL. [LETTER FROM DR. SANDWITH.] To the Editor of THE LANCET. SIR,—The report of the mortality from Asiatic cholera in the town of Hull, furnished by Dr. Ayre, goes to show, by figures, that the success of himself and his colleagues vastly exceeded that of the great body of the medical profession in Hull, although his losses, after all, were nearly fifty per cent. Success is obviously made to hinge on the adoption, and want of success on the rejection, of his treatment. Without for a moment impugning Dr. Ayre’s veracity, I am compelled to think that he imposes on himself by misconceptions, which, when expressed in words, are equally calculated to mislead others. His statement, that " the deaths with us were nearly two-thirds less than those of others whose rule it was not to adopt our treatment," rests on figures which need much alteration to harmonize with the facts. 1. Dr. Ayre and his colleagues, during a period of three months, had the charge of private patients, in addition to those under their care as members of the cholera staff. Whatever number of the former class, treated on his principles, was lost, that, in all fairness, should be deducted from the 9 56, and added to the 361. 2. A similar process must be adopted with the losses of such medical men, not of his staff, as strictly followed Dr. Ayre’s plan throughout. The writer knows one such at least, who registered fifty-three deaths from cholera in his own practice. 3. Dr. Ayre assures us that his plan made some converts from those who previously doubted or opposed. (THE LANCET, Sept. 22nd, 1849, p. 328.) Their losses, therefore, after their conversion, must undergo the same translation from the larger number to the less. 4. Some medical men began with Dr. Ayre’s plan, and afterwards abandoned it from want of success. Their registered deaths, also, so long as they pursued the Doctor’s method, must be similarly translated. 5. The registers show eighty-eight non-certified cases. These, of course, cannot be charged upon legally-qualified medical men, and should therefore be struck off from the
much nearer to a level. Not satisfied with figures, Dr. Ayre calls in the aid of testimony also, when he speaks of his treatment as ‘ recommended by numerous correspondents in the public journals." But, here again some sort of balance must be struck between evidence the most conflicting. In my last communication I adverted to " the thundering letter of Dr. Hughes," which strongly denounces the treatment in question.. In a medical of 22nd September, a tabular view of eighteen succes! sive cases is given by Dr. William Robertson, of Edinburgh, respecting which he- tells us,—"Calomel was given in twograin doses every ten minutes, accompanied by half, one, or. two drops of tincture of opium. I sat for nights at the bedside noting every change, and when I did not administer it myself, I have every reason to place confidence in those ta whom I entrusted it. The results, as seen by the accompanying table, are far from satisfactory." Those results were but three recoveries from cholera in the whole number. Again, in THE LANCET of October 27th, Dr. Golding Bird is reported to have said, in a debate on cholera by the members of the Medical Society of London,-" With respect to the calomel treatment,-that by small and often-repeated doses-he had seen much of it both at home and abroad; he had tried it himself, carefully, assiduously, and constantly, and he had come to the conclusion, that it was of no benefit whatever. He could only reiterate the opinion of his colleague, Dr..Hughes, on this point." But I repeat, what I insisted on in my former letter, that if even Dr. Ayre’s plan of treatment were as efficient as he contends it is, it could never compensate for the want of that strict medical espionage of the habits-and health of a pauper community, along with early treatment, which a more numerous and better organized medical staff alone could secure." My burden of complaint then was, and still is, that the design of such an organized system of prevention and early appliances for the town of Hull, as was projected by the Medical Sanitary Society, should have been frustrated. If such a system had been established, there are the strongest grounds for believing, from the examples of Sheffield and Nottingham, that the country would have been presented with a far less appalling report of our mortality. I ami Sir. vour obedient servant.
journal
won.
"Audi alteram
cases. Therewere also eighteen deaths under the homosopathic treatment, which should be similarly disposed of. This corrective process, if I am not greatly mastaken, will materially alter the figures on both sides of the question, and, if it fail to reverse the proportions, will at least bring them
956
It did not appear that the damages were at all too high, for there was a vast portion of the libels wholly unjustified; and
,
I
HUMPHRY SANDWITH.
TURNING, OR CE PHALOTOMIA, IN DIFFICULT PARTURITION? To the Editor
of THE LANCET. correspondent in the country for his my 11 Illustrations of Difficult Parturiforward, through your columns, the following reply ,
SIR,—I thank your favourable mention of and to his criticism :" Whether in such
tion,"
a case as that’ of Mrs. -, June 10, (THE LANCET, Nov. 3, 1849,) who appears to have been without any deformity, and who had previously given birth to a child of average size, the operation of turning would not have proved effectual, rather than cephalotomia, which entails so much danger to the mother, and, of necessity, the
death of the child ?" The objections to such a course were sound and obvious, and may be found, without any additions, in the following five extracts from the case, as reported in the above number of THE LANCET. 1. I saw the patient, aged thirty, in her labour, at the full term of gestation, at seven o’clock in the evening, the " waters" having escaped at half-past nine that morning. 2. The head (i.e., cranium) presented; a puffy tumour had formed on it during the last three hours; there was a deficiency in the vaginal secretion. 3. At my second visit (eleven P.M.), no further descent of the head, although there had been good pains; there was evident to the taxis impaction of the head; the soft tissues adjacent to the head had become much heated. 4. In the delivery by craniotomy, the child proving large; it became necessary, for the safety of the mother’s tissues, to facilitate the extraction by removing sections from the cranium by the osteotomist. 5. The child being larger than an average-sized pelvic brim could transmit, was the obstacle in the above labour.
CHELTENHAM GUARDIANS.—COURT OF EXCHEQUER.
the Council and the members may henceforth proceed, pari passu, to the Crown and to the Parliament for establishing, upon a broad and noble basis, the most important medical and surgical College in the United Kingdom.
We earnestly hope that, on an early occasion, at a full meeting of the Guardians, it will be decided that a resolution, which has at once the unusually conjoined characteristics of being both silly and malevolent, shall no longer be allowed to disgrace the records of the Board.
A CORRESPONDENT who resides at Cheltenham informs us that the Board of Guardians of the Union in that important town adopted, at their weekly meeting, on Thursday, Nov. 8, the following astounding resolution :-
THE Faculty of Medicine of Queen’s College, Cork, was opened on Thursday, the 8th instant, by an Inaugural Address, delivered by Dr. BULLEN, Dean of the Faculty. The Mr. Mr. seconded PARSONAGE,— Oration was received by a crowded auditory with loud BINCKES, "Proposed by by ’That the Board is of opinion that the system of medical The orator displayed a perfect knowledge of his relief at present in operation is susceptible of considerable applause. amendment, and that, at the election of medical officers in subject. Sir PHILIP CRAMPTON was present, and his appearMarch next, it be a rule that no gentleman holding any ance on the occasion elicited enthusiastic marks of approbahospital"appointment should be eligible as a union medical tion. officer:
If we had not had repeated proofs that Boards of Guardians could be guilty of any and every act of meanness, and that such
example of their being just and liberal to medical practitioners, as has lately been witnessed at Hull, in a handsome acknowledgment of the valuable services of Dr. AyRE, is the exception; and not the rule, we really should be inclined to
an
correspondent.
HAVING been informed, in a communication from Taunton, that out of 288 inmates of the Workhouse there, fifty-eight have died in the short space of nine days, we think it right to inquire whether inquests have been held on the bodies of any of the deceased persons. If not, some of the influential inhabitants should immediately address the Secretary-of-State and the Board of Health upon the subject.
doubt the accuracy of the statement of our There positively is no act of folly which some of the silly members of these Boards are not always ready to commit. Dressed in a little brief authority, the monkey tricks of many COURT OF EXCHEQUER, WESTMINSTER, of these silly wights might be amusing for their grotesque Tuesday, November 13th. IN BANCO BEFORE THE LORD CHIEF BARON AND THREE SITTINGS absurdity, if it were not for the pain which their rude antics OTHER JUDGES. cause to the sensitive feelings of gentlemen; and the injury which they are calculated to inflict upon the poor. WAKLEY, M.P., v. COOKE & HEALEY.—LIBEL.—THE HOUNSLOW FLOGGING CASE. we is the of It will this resolution ? What, ask, meaning be seen that it consists of two parts. The first portion is proper Tiais was an action instituted by the Coroner for Middlesex, to recover compensation in damages for certain libellous enough. Heaven knows that the system of medical relief articles which appeared in August, 1846, in the Medical Times, 11 its susceptible of amendment," for it is high time that medical of which publication the first defendant was the publisher, and practitioners should be no longer teased and almost worried the second the proprietor and editor. Portions of the libels out of their lives, without receiving anything more than an were published while the inquest on the body of the late insulting mockery of remuneration. But what is the kind of FREDERICK WHITE was sitting. The cause was tried before amendment which the members of the Cheltenham Board of the LORD CHIEF BARON and a Special Jury, at Westminster, at the sittings after last Hilary term. The trial occupied Guardians voted for, in this marvellously-queer resolution ? three days, and the jury returned a verdict for the Plaintiff Why, simply this: That if a surgeon be found in Cheltenham, on all the pleas, with DAMAGES THREE-HUNDRED AND FIFTY who happens to hold an office in which he has an opportunity POUNDS. of witnessing more of practice than his brother surgeons,-if Subsequently, a rule to show cause why the verdict should such a surgeon has been elected by the governors of a public not be set aside, and a new trial had on the ground of misinstitution to fill an important post, in consequence of his direction, was obtained by the defendant’s counsel; and it was arranged that the Court would consider whether the superior abilities and attainments,-the system is to be were excessive; but it was stated by the Court that 94 amended" by preventing such a practitioner from either adamages new trial could not be granted on that ground. remaining or becoming a medical officer of the Union! On Tuesday, the ATTORNEY-GENERAL, Mr. E. JAMES, and We can imagine that such a resolution had been proposed Mr. BRAMWELL, counsel for the plaintiff, appeared, to show by some inexperienced beardless boy, seconded by some dealer cause why the rule ought to be discharged. They argued in lead, whose brains had become as heavy as his wares, and that there had been no misdirection on the part of the learned carried by some rural jolterheads, in opposition to the intel- judge who presided at the trial; and that, considering the scandalous nature of the libels, the damages had not been ligent guardians of the town. A word in the ear of these excessive. conjurors. Are not you aware that the Poor-law CommisAfter Mr. Sergeant WILKINS and Mr. DEARSLEY had been sioners, acting under the provisions of the statute, have speci- heard in support of the rule, the whole day having been ocfied what are to be the qualifications of the medical officers of cupied by the arguments, the learned barons delivered judgthe Unions ? And can you imagine that it ever was intended ment seriatim, and they were unanimously of opinion that by the legislature that such a task should be confided to you? there were no grounds whatever for disturbing the verdict. The libels involved the character of Mr. WAKLEY as a Member Why, if you were left alone, without check or control, it is of Parliament, as the Editor of THE LANCET, as Coroner for probable that, within three years, you would adopt a resolution Middlesex, and as a man. Considering the nature of the libels, to the effect that no medical gentleman should be elected as a the jury might undoubtedly have given a much larger sum medical officer of the Union until he had furnished indisputable under the circumstances of the case. But it was stated that proof that he is as senseless as yourselves. Mr. HEALEY was not in a situation to pay large damages; and
545
probably’they took that circumstance
into their consideration.
therefore, having already decided that there had
been
no
mis-
direction, there was no ground for a new trial: the verdict must stand, and the- rule be discharged. Rule
discharged accordingly.
It- will be recollected by our readers, with reference to these libels, that the plaintiff moved for a criminal information against the defendant in the Court of Queen’s Bench. The obtained by the plaintiff, but after arguments had rut& was been heard against it, was subsequently discharged by the Court. Th& affidavits put in on that occasion by the defendant the plaintiff had no opportunity ofanswering, and consequently’ the effect of the hard swearing of some of the deponents might have exercised a pernicious influence in determining the decision of the Court. But, nothing daunted, and although he could find no cases to warrant him in adopting such a proceeding, the plaintiff resolved to bring an action in another Court, against the defendant, and try the question, whether a coroner, in the discharge of a difficult and anxious duty, was to be thus libelled with impunity, and the culprit escape from all responsibility and punishment. The result is now known, and testifies pretty strongly to the character of the decision in the Court of Queen’s Bench, where the rule was discharged; also to the propriety of the determination of the plaintiff to proceed in an action for damages, and the correct judgment and acumen of his counsel and solicitors, Sir J. JERVIS, (the ATTORNEY-GENERAL,) Mr. E. JAMES, Mr. BRAMWELL, and Messrs. LOFTY and POTTER, by whom the cause has been so ably conducted and
Correspondence. partem.11
TREATMENT OF CHOLERA IN HULL. [LETTER FROM DR. SANDWITH.] To the Editor of THE LANCET. SIR,—The report of the mortality from Asiatic cholera in the town of Hull, furnished by Dr. Ayre, goes to show, by figures, that the success of himself and his colleagues vastly exceeded that of the great body of the medical profession in Hull, although his losses, after all, were nearly fifty per cent. Success is obviously made to hinge on the adoption, and want of success on the rejection, of his treatment. Without for a moment impugning Dr. Ayre’s veracity, I am compelled to think that he imposes on himself by misconceptions, which, when expressed in words, are equally calculated to mislead others. His statement, that " the deaths with us were nearly two-thirds less than those of others whose rule it was not to adopt our treatment," rests on figures which need much alteration to harmonize with the facts. 1. Dr. Ayre and his colleagues, during a period of three months, had the charge of private patients, in addition to those under their care as members of the cholera staff. Whatever number of the former class, treated on his principles, was lost, that, in all fairness, should be deducted from the 9 56, and added to the 361. 2. A similar process must be adopted with the losses of such medical men, not of his staff, as strictly followed Dr. Ayre’s plan throughout. The writer knows one such at least, who registered fifty-three deaths from cholera in his own practice. 3. Dr. Ayre assures us that his plan made some converts from those who previously doubted or opposed. (THE LANCET, Sept. 22nd, 1849, p. 328.) Their losses, therefore, after their conversion, must undergo the same translation from the larger number to the less. 4. Some medical men began with Dr. Ayre’s plan, and afterwards abandoned it from want of success. Their registered deaths, also, so long as they pursued the Doctor’s method, must be similarly translated. 5. The registers show eighty-eight non-certified cases. These, of course, cannot be charged upon legally-qualified medical men, and should therefore be struck off from the
much nearer to a level. Not satisfied with figures, Dr. Ayre calls in the aid of testimony also, when he speaks of his treatment as ‘ recommended by numerous correspondents in the public journals." But, here again some sort of balance must be struck between evidence the most conflicting. In my last communication I adverted to " the thundering letter of Dr. Hughes," which strongly denounces the treatment in question.. In a medical of 22nd September, a tabular view of eighteen succes! sive cases is given by Dr. William Robertson, of Edinburgh, respecting which he- tells us,—"Calomel was given in twograin doses every ten minutes, accompanied by half, one, or. two drops of tincture of opium. I sat for nights at the bedside noting every change, and when I did not administer it myself, I have every reason to place confidence in those ta whom I entrusted it. The results, as seen by the accompanying table, are far from satisfactory." Those results were but three recoveries from cholera in the whole number. Again, in THE LANCET of October 27th, Dr. Golding Bird is reported to have said, in a debate on cholera by the members of the Medical Society of London,-" With respect to the calomel treatment,-that by small and often-repeated doses-he had seen much of it both at home and abroad; he had tried it himself, carefully, assiduously, and constantly, and he had come to the conclusion, that it was of no benefit whatever. He could only reiterate the opinion of his colleague, Dr..Hughes, on this point." But I repeat, what I insisted on in my former letter, that if even Dr. Ayre’s plan of treatment were as efficient as he contends it is, it could never compensate for the want of that strict medical espionage of the habits-and health of a pauper community, along with early treatment, which a more numerous and better organized medical staff alone could secure." My burden of complaint then was, and still is, that the design of such an organized system of prevention and early appliances for the town of Hull, as was projected by the Medical Sanitary Society, should have been frustrated. If such a system had been established, there are the strongest grounds for believing, from the examples of Sheffield and Nottingham, that the country would have been presented with a far less appalling report of our mortality. I ami Sir. vour obedient servant.
journal
won.
"Audi alteram
cases. Therewere also eighteen deaths under the homosopathic treatment, which should be similarly disposed of. This corrective process, if I am not greatly mastaken, will materially alter the figures on both sides of the question, and, if it fail to reverse the proportions, will at least bring them
956
It did not appear that the damages were at all too high, for there was a vast portion of the libels wholly unjustified; and
,
I
HUMPHRY SANDWITH.
TURNING, OR CE PHALOTOMIA, IN DIFFICULT PARTURITION? To the Editor
of THE LANCET. correspondent in the country for his my 11 Illustrations of Difficult Parturiforward, through your columns, the following reply ,
SIR,—I thank your favourable mention of and to his criticism :" Whether in such
tion,"
a case as that’ of Mrs. -, June 10, (THE LANCET, Nov. 3, 1849,) who appears to have been without any deformity, and who had previously given birth to a child of average size, the operation of turning would not have proved effectual, rather than cephalotomia, which entails so much danger to the mother, and, of necessity, the
death of the child ?" The objections to such a course were sound and obvious, and may be found, without any additions, in the following five extracts from the case, as reported in the above number of THE LANCET. 1. I saw the patient, aged thirty, in her labour, at the full term of gestation, at seven o’clock in the evening, the " waters" having escaped at half-past nine that morning. 2. The head (i.e., cranium) presented; a puffy tumour had formed on it during the last three hours; there was a deficiency in the vaginal secretion. 3. At my second visit (eleven P.M.), no further descent of the head, although there had been good pains; there was evident to the taxis impaction of the head; the soft tissues adjacent to the head had become much heated. 4. In the delivery by craniotomy, the child proving large; it became necessary, for the safety of the mother’s tissues, to facilitate the extraction by removing sections from the cranium by the osteotomist. 5. The child being larger than an average-sized pelvic brim could transmit, was the obstacle in the above labour.