- Email: [email protected]
THE DUTCH AMBULANCE AT THE BALKAN WAR.
706 seem
their and
to
be
made
arrangement,
of
a reddish violet with Giemsa’s stain. Similar bodies have been demonstrated by Noguchi The third generain films from infected nervous tissues. tion from the human disease and the fifth in the case The of monkeys have produced typical poliomyelitis. observers are, however,cautious, and further experiments are being made with later generations in order to exclude
showing
the possibility that the results are due to the carrying over - of the original virus from culture to culture. In this disease we have apparently a visible though filterable virus.
FATAL
AIR
and thumb a crackling sensation was felt, that of surgical emphysema. On section of the uterine wall this was found to be due to air in the venous sinuses, which issued from all parts of the out surface on pressure. The external os was patulous, admitting the index finger easily. The uterus contained an unruptured ovum which was separated along the whole of its posterior and lateral surfaces and for a considerable part of its anterior There remained attached only the upper twosurface. of the thirds placenta with a small area of membrane at the fundus. In spite of this detachment no haemorrhage had occurred. The cervix and vagina were carefully examined for injuries with negative result. The ovum contained The heart a male foetus of four months’ development. and lungs were removed together from the chest. On dividing the superior vena cava a large quantity of air escaped. The heart was of normal size. The right auricle and ventricle were empty except for a small quantity The pulmonary arteries contained much of frothy blood. blood. The left side of the heart did not contain frothy The air bubbles. mitral valve was slightly thickened, any and there was slight atheroma in the first inch of the aorta, but the coronary arteries were normal throughout their whole extent. The lungs and brain were normal. The conclusion come to was that death was due to the entrance of air under pressure into the uterine cavity separating the ovum and entering the uterine sinuses through the open vessels of the placental site. Hence it travelled by the ovarian and uterine veins to the inferior cava, heart, and pulmonary arteries. Probably the air was injected by inserting the nozzle of an enema syringe into the cervix. The fact that no blood was found in the uterine cavity was attributed to high pressure of the air. We may add that in the previous cases blood or bloody discharge was found at the os uteri and vulva.
globular bodies, varying in the finger averaging O. 15 M to O. 3 M in size resembling up
EMBOLISM DUE TO ATTEMPTS TO INDUCE ABORTION.
WE recently referred to an accident which may occur in the attempt to induce abortion by injecting fluids into the uterus—the production of fatal air embolism.1 So far as we know no case has been recorded in this country, and yet, as we remarked, four cases have been reported in one Australian medical journal2 in a little over three years. In the .New Zealand Medical Joztrnal for November, 1912, is published a paper read before the Canterbury Division of the British Medical Association by Dr. J. W. Crawshaw which is further evidence that this is a common method of inducing abortion at the Antipodes. Two cases have been before the courts in the North Island of New Zealand, in one of which a conviction was obtained. Dr. Crawshaw reports the following case from the South Island. On May 17th, 1912, he was called to the house of a woman whom he found dead. She had four living children and had had five or six miscarriages, the last in August, 1911. Her health, except for anæmia, caused by severe haemorrhages at several of these miscarriages, had generally been good. When Dr. Crawshaw arrived there was a woman in the house who was All she would say was that while her uncommunicative. back was turned she suddenly heard a cry and the sound of a fall and found the deceased on the floor perfectly still. On Dr. Crawshaw’s arrival the body had been placed on the bed and was quite warm. There were no signs of violence. The pupils were of medium size. The clothing was unfastened It had been unfastened after the on the chest and was wet. woman fell and the wetting was due to an attempt to make her drink. The rest of the clothing was not disarranged ; indeed, the chemise was tucked into the drawers very tightly. ’There was no haemorrhage or discharge from the vagina, and A the underclothing was dry and showed no stains. death. The was was made hours after 17 body necropsy well nourished. Examination of the organs iva sitit showed that the uterus was of the size of a four months’ pregnancy. The liver and spleen appeared to be slightly enlarged. In the thorax nothing abnormal was noticed. It was decided to make a detailed examination of the abdomen first. The liver was first removed. Numerous large bubbles of gas escaped from the divided portal vein. On detaching the liver from the vena cava inferior a great quantity of gas escaped from that vessel. The liver was slightly enlarged but on section quite normal. The uterus, vagina, tubes, and ovaries were removed en masse. On dividing the ovarian and uterine vessels gas escaped from the veins on both sides in a continuous succession of bubbles, and pressure on the uterus forced out a considerable quantity of air from the cut ends. The uterus was of a peculiar mottled appearance, purple areas alternating with others of a lighter greyish colour. The muscle felt soft and flabby, no mortis being apparent. On rolling the uterine wall between
THE
DUTCH AMBULANCE AT THE BALKAN WAR.
Dr.
voor
THE LANCET, Oct. 19th, 1912, p. 1097 The Australasian Medical Gazette.
2
has sent
an
interesting
letter to the
Tijdschrift
Geneeskunde, in which he describes the deplorably filthy
condition in which patients were brought in. Many who had been operated on were lying in a bath of pus. When, however, these had been cleansed and their dressings changed regularly, abscesses and sinuses being opened, it was wonderful how rapidly they began to recover. He found the Roentgen ray apparatus often very valuable in showing the seat of mischief. ____
AMONGST the 15 candidates who have been selected by the Council of the Royal Society to be recommended for election as Fellows, Dr. William Bulloch, bacteriologist to the London Hospital, Dr. T. R. Elliott, assistant physician to University College Hospital, Dr. J. S. Flett, of Edinburgh, and Professor Arthur Keith are members of the medical
profession.
_
ProfessorF. Gowland Hopkins, F.R.S., has been appointed President of the Section of Physiology at the meeting of the British Association to be held in September next at
Birmingham.
-
Sir Arthur Branfoot, K.C.I.E., has handed over the presidency of the Medical Board of the India Office to Sir Richard Havelock Charles, G.C.V.O.
ROYAL DENTAL HOSPITAL.—The annual
rigor meeting
1
Ommeren, of the Dutch ambulance in Con-
van
stantinople,
of the
general
governors will be held at the hospital, Leicester-square, London, on Thursday, March l3th, at 5.30 P.M., Dr. Dudley W. Buxton, a vice-president of the hospital, in the chair.
their and
to
be
made
arrangement,
of
a reddish violet with Giemsa’s stain. Similar bodies have been demonstrated by Noguchi The third generain films from infected nervous tissues. tion from the human disease and the fifth in the case The of monkeys have produced typical poliomyelitis. observers are, however,cautious, and further experiments are being made with later generations in order to exclude
showing
the possibility that the results are due to the carrying over - of the original virus from culture to culture. In this disease we have apparently a visible though filterable virus.
FATAL
AIR
and thumb a crackling sensation was felt, that of surgical emphysema. On section of the uterine wall this was found to be due to air in the venous sinuses, which issued from all parts of the out surface on pressure. The external os was patulous, admitting the index finger easily. The uterus contained an unruptured ovum which was separated along the whole of its posterior and lateral surfaces and for a considerable part of its anterior There remained attached only the upper twosurface. of the thirds placenta with a small area of membrane at the fundus. In spite of this detachment no haemorrhage had occurred. The cervix and vagina were carefully examined for injuries with negative result. The ovum contained The heart a male foetus of four months’ development. and lungs were removed together from the chest. On dividing the superior vena cava a large quantity of air escaped. The heart was of normal size. The right auricle and ventricle were empty except for a small quantity The pulmonary arteries contained much of frothy blood. blood. The left side of the heart did not contain frothy The air bubbles. mitral valve was slightly thickened, any and there was slight atheroma in the first inch of the aorta, but the coronary arteries were normal throughout their whole extent. The lungs and brain were normal. The conclusion come to was that death was due to the entrance of air under pressure into the uterine cavity separating the ovum and entering the uterine sinuses through the open vessels of the placental site. Hence it travelled by the ovarian and uterine veins to the inferior cava, heart, and pulmonary arteries. Probably the air was injected by inserting the nozzle of an enema syringe into the cervix. The fact that no blood was found in the uterine cavity was attributed to high pressure of the air. We may add that in the previous cases blood or bloody discharge was found at the os uteri and vulva.
globular bodies, varying in the finger averaging O. 15 M to O. 3 M in size resembling up
EMBOLISM DUE TO ATTEMPTS TO INDUCE ABORTION.
WE recently referred to an accident which may occur in the attempt to induce abortion by injecting fluids into the uterus—the production of fatal air embolism.1 So far as we know no case has been recorded in this country, and yet, as we remarked, four cases have been reported in one Australian medical journal2 in a little over three years. In the .New Zealand Medical Joztrnal for November, 1912, is published a paper read before the Canterbury Division of the British Medical Association by Dr. J. W. Crawshaw which is further evidence that this is a common method of inducing abortion at the Antipodes. Two cases have been before the courts in the North Island of New Zealand, in one of which a conviction was obtained. Dr. Crawshaw reports the following case from the South Island. On May 17th, 1912, he was called to the house of a woman whom he found dead. She had four living children and had had five or six miscarriages, the last in August, 1911. Her health, except for anæmia, caused by severe haemorrhages at several of these miscarriages, had generally been good. When Dr. Crawshaw arrived there was a woman in the house who was All she would say was that while her uncommunicative. back was turned she suddenly heard a cry and the sound of a fall and found the deceased on the floor perfectly still. On Dr. Crawshaw’s arrival the body had been placed on the bed and was quite warm. There were no signs of violence. The pupils were of medium size. The clothing was unfastened It had been unfastened after the on the chest and was wet. woman fell and the wetting was due to an attempt to make her drink. The rest of the clothing was not disarranged ; indeed, the chemise was tucked into the drawers very tightly. ’There was no haemorrhage or discharge from the vagina, and A the underclothing was dry and showed no stains. death. The was was made hours after 17 body necropsy well nourished. Examination of the organs iva sitit showed that the uterus was of the size of a four months’ pregnancy. The liver and spleen appeared to be slightly enlarged. In the thorax nothing abnormal was noticed. It was decided to make a detailed examination of the abdomen first. The liver was first removed. Numerous large bubbles of gas escaped from the divided portal vein. On detaching the liver from the vena cava inferior a great quantity of gas escaped from that vessel. The liver was slightly enlarged but on section quite normal. The uterus, vagina, tubes, and ovaries were removed en masse. On dividing the ovarian and uterine vessels gas escaped from the veins on both sides in a continuous succession of bubbles, and pressure on the uterus forced out a considerable quantity of air from the cut ends. The uterus was of a peculiar mottled appearance, purple areas alternating with others of a lighter greyish colour. The muscle felt soft and flabby, no mortis being apparent. On rolling the uterine wall between
THE
DUTCH AMBULANCE AT THE BALKAN WAR.
Dr.
voor
THE LANCET, Oct. 19th, 1912, p. 1097 The Australasian Medical Gazette.
2
has sent
an
interesting
letter to the
Tijdschrift
Geneeskunde, in which he describes the deplorably filthy
condition in which patients were brought in. Many who had been operated on were lying in a bath of pus. When, however, these had been cleansed and their dressings changed regularly, abscesses and sinuses being opened, it was wonderful how rapidly they began to recover. He found the Roentgen ray apparatus often very valuable in showing the seat of mischief. ____
AMONGST the 15 candidates who have been selected by the Council of the Royal Society to be recommended for election as Fellows, Dr. William Bulloch, bacteriologist to the London Hospital, Dr. T. R. Elliott, assistant physician to University College Hospital, Dr. J. S. Flett, of Edinburgh, and Professor Arthur Keith are members of the medical
profession.
_
ProfessorF. Gowland Hopkins, F.R.S., has been appointed President of the Section of Physiology at the meeting of the British Association to be held in September next at
Birmingham.
-
Sir Arthur Branfoot, K.C.I.E., has handed over the presidency of the Medical Board of the India Office to Sir Richard Havelock Charles, G.C.V.O.
ROYAL DENTAL HOSPITAL.—The annual
rigor meeting
1
Ommeren, of the Dutch ambulance in Con-
van
stantinople,
of the
general
governors will be held at the hospital, Leicester-square, London, on Thursday, March l3th, at 5.30 P.M., Dr. Dudley W. Buxton, a vice-president of the hospital, in the chair.