THE EQUIPOISE COUCH COMPANY: A CORRECTION.

307 for use during narcosis of edentulous patients. The smallest prop may be useful in children. The illustrations well show the shape and relative size of the set of props. I am much

Asphyxia, by Ivy McKenzie, M.A., M.B. Glasg. 6. On the Development of the Hind Brain of the Pig, by 0. Charnock Bradley, M.B., D.Sc.Edin., with six plates. 7. A Study of the Astragalus, by R. B. Seymour Sewell, B.A. 8. The Arrangement of the Elastic Fibres in the Bronchi and Lung, by James Miller, D.Sc., M.D. Edin., with five illustrations in the text. 9. A New Method of Demonstratng the Topographical Anatomy of the Adult Human Skull, by Sydney R. Scott, M.B. Lond. 10. A Note upon the Mode of Termination of the Posterior Tibial Artery and Nerve, by Charles R. Whittaker, L.R.C.S. Edin., with three drawings in the text. This part also contains the Proceedings of the Anatomical Society of Great Britain and Ireland for August, 1905. ______________

indebted to Messrs. Down Bros., of St. Thomas’s-street, London, S.E., for the care and trouble which they have taken in carrying out my wishes in the matter. W. J. MCCARDIE, Anæsthetist to the General, Dental, and Ear and Throat Hospitals, Birmingham.

New Inventions.

THE EQUIPOISE COUCH COMPANY: A CORRECTION. THE Equipoise Couch Company have pointed out to us that our description of the principle upon which the IMPROVED GOUGE FOR MASTOID Equipoise Bed, Couch, and Chair works, as published in THE LANCET of Jan. 27th, is in certain respects not OPERATION. accurate. The principle on which these inventions work, Ix the performance of the radicaland, indeed, upon which the main claim for novelty depends, mastoid operation for suppurative dis- has l not, we admit, been made clear. And this principle is of the middle ear I have found particularly ingenious. ] All the articles are made in three parts, corresponding to two instruments very useful. They the back, seat, and leg, and are connected by hinged joints. are both modifications of those usually IThe novelty lies in the fact of the rear supports, or employed. The first is a quarter-inch legs, being pivoted to the base and also to the back at the exact centre of equipoise, so that when in use gouge of very shallow curvature with the occupant can either remain level as in an ordinary square ends..The second is shaped bed or, if he so desire, he may, by merely bending the like a carving chisel and its appearance body at the hips, smoothly and easily raise himself is well shown in the accompanying

ease

This latter instrument illustration. is especially useful in removing the posterior wall of the meatus in young

children, of the

only a very cutting edge is as

small

portion

used at

one

time. Both instruments are made with Ballance’s handles and they form part of a complete set which have been specially made for me by Messrs. Cuxson, Gerrard, and Co., Birmingham, with the handles all of uniform weight and

size ; this is

changing

from

a

convenience in

one

instrument

to

another. A.

Medical

KNYVETT

GORDON, Monsall Hospital, Manchester.

Superintendent,

MOUTH PROPS FOR USE DURING SURGICAL ANÆSTHESIA. HAYING up to recent times used solid vulcanite dental mouth props placed sideways between the teeth when it was necessary to keep them apart in certain cases of jaw spasm and obstruction to nasal breathing, I have lately devised an improved set of three hollow metal props which have a good deal of advantage over the other makeshift ones. Their superiority lies in the facts : (1) That they are sterilisable and indestructible by boiling or strong antiseptics ; (2) that they allow of respiration when the jaws and lips are closed on and around them (a very important point in edentulous patients and people with full lips) ; and (3) that two of them are flattened at one end in order to make introduction easier during anaesthesia. The large one I usually place between the teeth before anassthetising big strong men, cases of intestinal obstruction with vomiting, and patients suffering from nasal obstruction, because it gives a very free way for air or fluid and keeps the jaws well apart; it is also intended

sitting or any intermediate position. As the back rises the seat declines at the back end, so that there is no tendency for the patient to slip towards the foot of the ’ bed, as undoubtedly often happens when bed-rests are used, The leg part of the Equipose or merely supporting pillows. couches is arranged to remain on the level or to decline in unison with the movement of the back, so that a change of position, often most grateful to the invalid,. can be assumed for any purpose at any time. The patient merely releases a catch and the balance principle does the work. The new illustration shows the ease with which an Equipoise Bed can be raised or lowered ; the child represented is moving the bed with one finger only, a point which will particularly appeal to those nursing heavy and helpless invalids. The bed can be locked securely in any position by depressing a handle, one of which will be found in a convenient position on either side of the bed. We recommend our readers to inspect the productions of the Equipoise Couch Company at the Institute of Hygiene. to the

A CONSCIENTIOUS OBJECTION TO VACCINATION.Brixham, Devon, on Jan. 26th, a stonemason applied for a vaccination exemption order chiefly on the ground that, being a vegetarian, he did not wish to have "animal matter" The exemption was introduced into his child’s system. eventually granted, although one of the magistrates (Lord Churston) strongly urged the applicant to have his child

At

vaccinated.

OVERLYING.

308

mind, however, that required to make

is

in

LONDON:

SATURDAY, FEBRUARY 3, 1906.

bed and that warmth is essential His parents may be sleeping young child. bed almost devoid of blankets and bedding and would no doubt say that although a box alone

the

to

THE LANCET.

the actual bedstead is not all that a

a

they might be obtainable, bedding would be beyond their means. They probably reflect also that warmth by making the baby comfortable keeps him quiet at the same time and that when in the bed he

can

be nursed with the least On the other

amount of trouble to his mother.

Overlying. OUR Manchester correspondentrecently called attention to the frequency with which the suffocation of children sleeping with their parents takes place at Manchester at " week-ends," and he mentioned that four inquests had been held by the city coroner upon infants thus overlain during the late Christmas season. In the case upon which he was commenting four persons had been sleeping in one bed and this had been the condition also in two instances which recently occurred at Lambeth and with regard to which Mr. TROUTBECK held inquests on the same day. In one of these latter instances it was alleged by way of excuse that the bed in which the children usually slept could not be occupied by them because the rain came in upon it and the statement was made that in three years’ time the house was going to be pulled down. However this may have been there can be little doubt that in a great number of cases poverty and the inability to provide a separate crib are pleaded by the parents as an excuse for the dangerous position which the infant occupies in their bed, and further, that a drunken or semidrunken condition of both or perhaps only of the mother is in fact the cause of the child’s death. The parents’ drunken negligence ought to make them criminally liable. The Manchester coroner expressed himself to this effect and in the case alluded to by our correspondent avowed his intention to commit for trial upon a charge of manslaughter any parents overlying their infants against whom evidence of their being under the influence of alcohol could be found. The nature of the occurrence, however, renders such evidence almost impossible to obtain. The parents may live among neighbours whose standard of duty and of decency is no higher than their own ; they may have been seen by no one when they returned home from the public house or they may have consumed their liquor in the privacy of their own room. They may not, moreover, have attained to a pitch of intoxication which those about them would recognise as drunkenness and yet may have been sufficiently fuddled by I drink to fall asleep and . to remain asleep in complete indifference as to the baby’s welfare. Therefore, whether there is drunkenness or not, it is almost incapable of proof and if the frequency of overlying is to be diminished it must be done in such a manner that all cases may be covered and the matter must be considered generally and apart from a particular phase of it. Mention has been made of the alleged poverty of the parents or parent, and in connexion’with this the observation is often made that any box, such as an old orange box, can be

adapted

for 1

use

as

a

cradle.

THE LANCET, Jan.

It must

20th, 1906, p. 189.

be borne in

possible hand, it

may be said that a decent and an intelligent woman, fond of her child and solicitous for his welfare, would never sleep with him in the bed which she occupies with his father, and that where the parents at the time of the child’s death are so poor that they could not have assigned to him bed and bedding of some kind the question may be raised whether this poverty is not due to their own fault. In other words, if decently behaved, frugal, and industrious parents can put their children to sleep in conditions consistent with their health and safety, must we permit other parents to imperil human lives merely because by their improvident and self-indulgent habits they have put it out of their own power to do otherwise ? Can we not provide for the punishment of these in order to prevent the sacrifice of life without dealing too hardly with cases of extreme poverty where this is the result of genuine misfortune ?

punishment has been used because it appears that if this particular variety of preventable infant mortality is to be put an end to the method adopted must be measures, such as education and advice, would affect but few instances, for they would only The word

to

us

penal. Gentler

appeal to women of a respectable class who as a rule do adopt the practice complained of. Education and

not

advice would have little effect upon the drunkard and would entirely fail to touch those wl ose action is more or less deliberate and intentional. We must not forget in dealing with this matter that the deathof an infant in many families is, perhaps tacitly, regarded as a blessing and that in many those who would not deliberately comInstances pass it look back upon it with no regret. married in which a mother in the course of her occur life overlies not one but several infants, with the inconvenience to herelf that she may have to submit to reproof at the hands of a coroner but with the certain result that she avoids the daily burden of bringing up a family. As to the manner in which the law should operate this is hardly for us to suggest. In order that all parents killing their children in the manner indicated might be sent for trial and convicted in a substantial number of cases of manslaughter by criminal negligence no legislative change would be necessary, but it would imply the introduction of a new practice in which juries might or might not be willing to acquiesce, even though judges were On the other hand, the comfavourable towards it. pulsory provision of a separate sleeping place for a child under a fixed age would be objected to by some as an interference with the liberty of the parent and as tending to expose the child to suffering from cold. It would also be difficult to enforce. A parallel nevertheless may be found in the comparatively recent obligation laid upon parents to provide their children with medical aid when