Additional observations on unavoidable hæmorrhage in cases of placental presentation / by J.Y. Simpson.

  • James Young Simpson
Date:
[1845]
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Licence: Public Domain Mark

Credit: Additional observations on unavoidable hæmorrhage in cases of placental presentation / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    in his practice, and as he had previously ad- mitted in his published accounts of the same cases. He has entered the fate of the mother in his seventh case thus : “ Death before turning was performed by Dr. Lee hut it appears that in this case Dr. Lee twice tried to turn the child, and at last effected it. The child was born alive ; and the mother, instead of dying before delivery by turning was performed, lived for “ a few days” afterwards. (See the full details of the case in Dr. Lee’s Clinical Midwifery, p. 145, Case 266 ; or Lectures, p. 376, Case 7.) 3. Dr. Lee avers that my table, shewing the average maternal mortality accompanying placental presentations, is copied “ largely” from the similar table previously published by Dr. Churchill. But Dr. Churchill’s table of uterine hsemorrhages contains the results of 174 cases of placental presenta- tion, while my table contains the results of 399 cases. Dr. Churchill’s table is made up of the returns of the practice of twenty- three different accoucheurs; my table is made up of larger returns, from the practice of fourteen different obstetric practitioners and institutions. Eight of the returns in my table (embracing 247 cases) are not given at all in Dr. Churchill’s. Of the six remaining returns, that are common to Dr. Churchill’s table and my own, in five the figures in the two are, in one or other re- spect, different; for after a careful analysis of the original works of the reporters, and some private correspondence with Dr. Churchill on the matter, I arrived at a result somewhat different in each instance from those pre- viously published by him. I could not at the time detect so large a number of cases as he stated, in the two works of Giffard and Smellie ; I found he had inadvertently given Dr. Lever’s cases as 13 instead of 14, and (4) the fatal results in Dr. Ramsbotham’s cases as 16, instead of 8; and, 5th, 1 was able to give a much larger number of cases as pertaining to Dr. Lee*, in consequence of his having published in the interim some additional data. In the sixth and last re- turn only—viz. that of the Dublin Hospital —Dr. Churchill and I both give the same numbers—viz. those reported by Drs. Clarke and Collins themselves, with regard to their own practice in that institution ; and I have already stated that so far we were both wrong, as Dr. Collins met with 12 cases of placental presentation, 3 of which terminated fatally, and not, as he himself inadvertently states, with 11 cases and 2 deaths. Hence, so far from my table being, as Dr. Lee * In his table of Uterine Haemorrhages, Dr. Churchill enters Dr. Lee as having seen 23 cases of placental presentation, with 6 maternal deaths. Among Dr. Lee’s first 23 cases (see Dr. Lee’s own table), there were 8 mothers lost. Dr. Lee has not corrected Dr. Churchill on this point. alleges, ” so largely copied” from Dr. Churchill’s, it is not copied from Dr. Churchill’s in one single instance. 4. Dr. Lee speeializes one instance in which he professes to have detected me actually copying directly from Dr. Churchill, the returns and figures of a particular author. Dr. Lee remarks : “ Dr. J. Rarasbotham is represented in the table [of Dr. Simpson,] to have reported 19 cases, 8 of which died. This (continues Dr. Lee) is copied from Dr. Churchill’s table.” The answer[to Dr. Lee’s statement is sufficiently simple. Most unfortunately for the veracity of the allega- tion, Dr. Churchill, in the columns of his table referring to unavoidable haemorrhage, does not mention or include Dr. John Ramsbotham’s cases at all, and hence, of course, I could not copy from Dr. Churchill what Dr. Churchill has not in reality given.* After Dr. Churchill’s work appeared. Dr. Francis Ramsbotham published some re- marks in the Medical Gazette to shew that his father’s printed cases were selected cases, and hence did not give a fair idea of his father’s average success. My attention was lately drawn to these remarks in a con- versation with Dr. F. Ramsbotham. Dr. Lee quotes Dr. F. Ramsbotham, as specially objecting to Dr. Churchill’s use of his father’s 19 cases of placental presentation. Of course this is a misstatement. I have already mentioned, under the last head, that, in his columns referring to placental pre- sentations, Dr. Churchill, in his table, does not enter Dr. John Ramsbothara’s 19 cases ; and consequently it was impossible for Dr. Francis Ramsbotham to find fault with Dr. Churchill on this special count, even though Dr. Lee professes to give the very words of the count itself, and that too, apparently as an extract, within inverted commas. 5. Dr. Lee adds, that, in despite of Dr. Francis Ramsbotham’s remarks on the pre- ceding point, publis':ed in 1842, that gen- tleman’s proper “ caution to the profession has not, however, prevented Dr. Simpson from stating in his table, that 19 cases had been reported by Dr. Ramsbotham, 8 of which proved fatal, as if this had been the average number of deaths in his practice.” In his lectures on unavoidable haemorrhage, after mentioning the returns of Boivin, Clarke, and Collins, Dr. Lee himself adds, “ Dr. Ramsbotham has related 19 cases of placental presentation, eight of which proved fatal.” (Lectures on the Theory and Prac- tice of Midwifery, by Dr. Lee, p. 371.) * In his column of unavoidable haemorrhage. Dr. Churchll has, opposite the name of Dr. Ramsbotham, given 44 cases, the number of partial placental presentations described by Dr. Francis Ramsbotham (the son), in the Medical Gazette of 1834, vol. xiv. p. 690.