SOUTH-WEST LONDON MEDICAL SOCIETY.

1402 swollen in 5, ulcerated in 7, and perforated in 2. In thosewomen’s societies. He thought that a certificate of character cases perforation (including the appendix cases) occurred would be of no use and that it would be a very difficult in 18, so that the appendix was perforated in 11 per cent. thing to provide against the risk of the midwife practising of cases of entire perforation. This was the percentage for gain. arrived at by Nacke; Osler found it even higher (4. in Dr. EDEN said that since the Bill had been condemned by 16), while Finney placed it at 5 per cent. and Fitz at 3 per the General Medical Council it ought not to be allowed to cent. The statistics of operative interference in perforation pass into law. The Bill should have been promoted by the during enteric fever were referred to and 2 recent cases profession at large and not by any particular body, no matter reported by Deaven in which a perforated appendix was how good their intentions. At present there were no means successfully removed during enteric fever were mentioned.- of dealing with midwives who were deserving of censure; Dr. E. W. GOODALL was surprised to hear that the com- they were practically under no control. This was very plication was so frequent. Although he had a some- different from the regulations on the Continent-in Italy, what extended experience of enteric fever at the fever for example, where every midwife must give full particulars hospitals he had not yet come across a single case. He had of each case which she has attended to the local authority. seen one case of operation for perforation in enteric fever. There, also, midwives are trained gratuitously, but in this The patient was a girl, eight years of age, who was country the probabilities are that the certified midwife will suffering from a recrudescence of enteric fever. She was not reach the class for which she is intended-viz., the very exceedingly ill and the operation was somewhat prolonged poor. Dr. McCooK WEIR said that if this Bill passed the midowing to difficulty in finding the site of the perforation. It was also noticeable that there was little sign of the wives would ultimately treat all diseases of women and other typhoid ulcers from the outside of the gut, although children. He stated that the signatures in favour of the they were shown after death to have been numerous. Bill were obtained by canvassing, that in his opinion the The aperture was closed by sutures. The patient lived constitution of the Midwives’ Board was bad, and that the four days. It was found that not the slightest attempt General Medical Council had been overridden by the Ptivy at repair had taken place and another perforation Council and by other influences. He gave an outline of a had been caused by one of the sutures having been passed Bill prepared by himself which he would call the Obstetric through an adjoining ulcer. He agreed with Mr. Bland Nurses Bill and was strongly of opinion that a certificate of Button that it would be better in such a case to bring the character was a most essential qualification. Dr. BARKWELL spOKe against line joiu. perforation up to the abdominal incision and fix the gut there. Dr. Goodall mentioned that Mr. Parkin of Hull had operated successfully in one case of perforation and there were two more successful cases in the recent reports of the ÆSCULAPIAN SOCIETY OF LONDON. Belvidere Hospital, Glasgow.-Mr. BARKER took exception to the wording of a statement that "the mortality after surgical treatment was appalling." The cases without The Management of Labour in Contracted Pelves.-Sacral Spina Bifida with absence of Skin Covering and with operation might be considered as uniformly fatal, while Skull Bones imperrfect.-Spontaneous Complete Disappearafter operation 23 per cent. had recovered, which was ance M’7(’L7C in said that he had of LGG%(JG of Large lElLG’lG’llGWD4li J.’GV7V’lIGWDW. encouraging.-Dr. ROLLESTON, reply, also been surprised to find that the condition occurred in so A MEETING of this society was held on May 13th, the large a percentage of cases. Most of them were derived President, Dr. B. G. MORISON, being in the chair. from American literature. Dr. THOMAS G. STEVENS read a paper on the Management of Labour in Contracted Pelves in which he related particulars of the following cases :-

60

Rheumatic Fibromata.

-

SOUTH-WEST LONDON MEDICAL SOCIETY.

--

-

-

-

Full-Time Children.

The Proposed Midwives Bill. A MEETING of this society was held at Wandsworth Town-hall on May 4th, under the presidency of Mr. T. A. I. HOWELL, to discuss the questions raised by the proposed

Midwives Bill. The PRESIDENT argued that among the reasons for the Bill were the facts that in a large proportion of the women attended by unskilled persons the mortality both among mothers and children was increased and that those cases also were responsible for much of the ophthalmia neonatorum which later drifts towards the hospital. For these and other reasons it is agreed on all hands that something ought to be done. In a general criticism of the Bill he pointed out the necessity for limiting the responsibility to the person who actually had the conduct of the the omission from the case and called attention to Bill of all reference to stillbirths and the absence of any clause making it necessary on the part of the proposed midwife to provide a certificate of character. He pointed out the necessity, in his opinion, of protecting the practice as well as the title of the medical man and of restricting the practice of the midwife solely to the functions which she was intended by the Bill to fulfil. He showed that by-laws cannot be made contrary to the spirit of the Act, which seems to be the case in the Bill under consideration. As regards local funds they ought not to be available for expenses incurred in carrying out the provisions of the Act, and he especially objected to Clause 9, which virtually appoints medical detectives. Public opinion, he was sure, was generally adverse to the passing of such a measure. Mr. ROWLAND HUMPHREYS said that the proposed Bill was only there in outline and that the details were left to be filled in by the board. He assured the meeting that deputations representing 20,000 persons in favour of the Bill had been received and that petitions to the same effect were constantly being sent in. Legislation had been hampered to a great extent by the views taken of the matter by various

I born.

All mothers

recover

ed.

5 children

were

born alive and 9 were still-