REFLECTIONS ON THE LATE INQUEST AT HAMPTON.

140

in TiiF- LANCET in favour of

edlyused

profession must effect it; and while allow the evils to remaiu, and do not act to remove them, they must blame themselves."

medical

a

they

RADICAL MEDICAL REFORM.

1 am,

_

Sir,

your obedient servant, A PUPIL.

Now it is the aristocracy both in medicine and politics (aud by the term medical REFLECTIONS ON THE LATE INQUEST AT HAMPTON. aristocracy I mean monopolv of power) which is the proximate cause of the tyranny of private interest and intrigue—that tyTo the Editor of THE LANCET. ranny which always tends to crush merit, whether it be in medicine or in politicsSIR,—It is impossible to review the proand that tyranny which has been the disat the late inquest at Hampton, yace and partial ruin of the English. which called for your animadversions in the Where,I mav observe, we have an over- last Number of your impartial Journal, powering political aristocracy, we shall, as without a lull conviction of the gross ignoso many contaminated ramifications of the rance of the practitioner whose conduct was root, find the same system of things exist- the subject of investigation, or without a ing in, and regulating the departments of, due share of surprise at the verdict deliverscience, and in every-thing else connected ed, together with the utmost sympathy for in an important way with the nation-first the unfortunate sufferer. The proceedings begotten by the aristocracy, and then aid-on the part of the surgical attendant were ing in the support of its fruits or measures. such as no one would have anticipated in See how members are elected to rotten earliest period of the practice of midboroughs, professors to government wifery, and yet attempts were made to palthe bluuder, and evengrave professor tutions, and hospital surgeons to it is all one piece of contamination; instead of midwifery, to whose skill, probably, the of the election of medical officers beingupon accoucheur was indebted, had the effrontery the basis of merit—instead of men being to sanction every stage of the proceeding, publicly elected by all the members of the and to justify the removal of the superior profession, they are shuflled in by the in- extremities in a presentation of the face of child. It is perfectly unnecessary to go trigue and private interest of themselves and their friends, who are non-medical and into a full detail of this case, as you have 4iiiite incompetent to judge of medical mat- already supplied your readers with a full tf-rs and the merits of medical persons. This, statement of it ; but from the evidence of then, is thn scourge of England—that public the female accoucheur, whose testimony good is sacrificed to personal influence and was delivered in a jolaiii and simple manner, interest. And why? liecause there are no appeared that the head was in some delaws and regulations to counteract it. Mebelow the upper strait of the gree advanced dical politics always were linked with, or when Mr. B—n was called in, and pelvis, immediately affected by, general politics, and that no part of the arm had protruded. cannot he completely separated from them; Opposed to this, we have the opinion of it is on these grounds 1 say (and 1 am en- Mr. Jewel, who was not present at the couraged to speak in this strain from the time of the labour, that it could hardly be impulse of the moment, because 1 see many a face presentation, but that the arm members of the medical profession now pre-must have fallen down." Plost practitionwho are conversant with the difficulties sent.), that evety medical man should be a .

ceedings

insti-the

hospitals :liate the

it

called

ers, that

of preternatural presentations can certify, the face of the foetus with one hand will " Let us turn our attention to France : ther e the medical profession is immediately not unfrequently be found to present simulumicr the wing ofa liberal gorernment, andtaneously; such might have been the phethere we find a lmtitv existing iu its eco-. nomen3. on this occasion. The obvious inwould then have been to have regarded as the only nomy, and merit means of recommendation to public favour.returned the hand, and to have made some on the face, with a view to bring Now, then, that our brethren, the French, are opening the sluggish eyes of English--the occiput nearer the symphysis pubis. we cannot accomplish this turn by men from thelr lethargy, and now that we ’ have a virtuous king upon the throne, who)! assiduous and gentle means in a reasonable is m reality the king of the English, if not,, time, provided the woman’s strength is not unfortunately, nominally, let us hope for exhausted, wehave been advised by Denthe days ot merit to stiiiie upon England,man to wait for nature’s spontaneous effects; that every growing merit shall succeed to or, to use the language of Mr. Taylor, to its just right,’ ’and make the grove har-allow the head to right itself. If the surm mous.’ But w e must recollect that hopegeon in attendance was not-equal to this of administering relief, before he had alone will not do this; the members of the

politician.

justly

dication

, pressure

Where

r

’

3 mode

141 on the issue of the case, rather than barbarous and ineffectual hands l that of tearingthe child to have insulted the wounded feelings of limb from limb, it was incumbent on him to the family, by persisting that the patient would soon be released by delivery, when have suspended any further forcible him, ceeding, till he could have availed himself’ the least refleclion might have of further advice. It appeared in evidence, that the practice employed could not in the that Mr. Taylor had succeeded in delivering leastjustifv so favourable a prognostic1 The the same patieut on a prior occasion by verdict delivered in this case was a plain turning. What could have been more ra- sacrifice of truth and honesty, to an unaetional on the part of the friends, than to countable degree of false delicacy. In every solicit his aid. The woman’s conceiving that science a set of rules or axioms is necessathe child was dead, would not authorize any rily established for the general guidance of accoucheur in the premature dismember- those who are called upon to act; and no ment of the child. But we are told that the one can be justified in discarding those rules practitioner had exhausted all his skill, and after they had obtained the universal sancfound the common instruments unavailable; tion of the most enlightened practitioners, that it was therefore allowable to indulge in order to embark on a hopeless emergency him with a boot-hook, previous to which he without an anchor, or a particle of prudence haddislocated the cervical vertebrae, and to direct the accouchenr. The fatal conseinflicted some injury on the head; indeed, quences of such a violation of reason must as the coroner had learnedly expressed it, be too obvious to need any further com" he had not made a half business of it, but ment ; or, at least, the salvo of another persisted to the last," and resolved that one practitioner ought to be considered as the arm should not survive the delivery of the iudispensable law of the land. That a misother. Taking it for granted, that the head take like the foregoing will never be again was not impacted in the pelvis, which, we recorded in your useful Journal, is the sincere are informed, was very capacious (though hope of, Your obedient servant, the child is stated to have exceeded the! common bulk of a full-grown foetus), the same! OBSTETRICUS. room that allowed of the introduction of the surgeon’s hand to tear away the arm, might have been afforded to ascertain the situation POPLITEAL ANEURISM. of the feet, which in this instance must have been close in contact with the fundus To the Editor of THE LANCET. of the uterus. I am far from wishinbto underrate the difficulties of turning a fœtus SIR,—In your Number of TIlE LANCET f where the membranes have been long rup- for September 18th, 1830, you have pubi the remarks of Mr. Lawrence on a tured, and can truly attest, that having once lished secured a foot, I have felt a sort of Pytha- ’" Case of Popliteal Aneurism," in which, goran ecstacy in the prospect of a apeedy in my opinion, he relies too much on the termination of delivery. In the unfortunatebruit de soufflet, as indicatingcirculation of example under discussion, it would be quite blood in the aneurismal tumour. From exas revolting to sound practice to have pro- perience we know that there are aneurismal posed cranrotomy, as that of the violent tumours in which there are evident signs of separation of the superior extremities. Upon circulation of blood, such as pulsation and surgical assistance being called in, the only reduction of the tumour by pressure, withmode of rescuing the patient from out the bruit de soufflet; and again, there are her future suffering, was that of a steady tumours that press upon arteries in which but fixed determination to deliver by the we have the bruit de soufflet; lence we have feet. What advantage towards the full ex- circulation in an aneurismal tumour without clusion of the foetus can attach to a removal the symptom, and wP have a tumour in of the upper extremities as a precursory which there is no circulation with it. I remeasure’! The answer given by Mr. Jewel, member seeing the common carotid taken that " when one arm was taken off, there up for a tumour in the neck, from this very is more room to take off the other," will symptom, in which death fiorn haemorrhage hardly satisfy any tyio in midwifery, al- took place in three weeks after the operathough he is obliged to admit, that it could tion, and dissection proved the case to be have been turned otely with difficulty. But one of fungoid tumour pressing upon the this difficulty ought to have been surmount- artery ; this first made me think of the ed. ’’ Humanum est errare," but who would cause by which the symptom must be pron’jt have sacrificed any petty feeling of jea- duced. lousy on the score ot other advice, by conThe cause of bruit de soufflet appears to senting to call in aId, in seasonable time,, me to be the rush of blood through a conv. bellthe life of a fellow-creature was atttracted space. This may be in the artery, or, stake, and both parties perhaps have shakent as I think very seldom takes place in the

determined an

on so

expedient

as

i pro-

taught

.

legitimate