Additional observations on unavoidable hæmorrhage in cases of placental presentation / by J.Y. Simpson.
- James Young Simpson
- Date:
- [1845]
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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![6. Dr. Lee states that all the statistical er- rors committed by other writers “ contri- bute to vitiate Dr. Simpson’s table, as all these errors have been copied into it.” I have already shown that this is a mistake ; that, for instance, instead of copying from Dr. Churchill’s data, I have carefully en- deavoured to correct them ; and I have col- lated my data from the original works of the reporters, in all instances except two. In both of these instances I and others are now fully aware that I committed an indis- cretion in relying upon the accuracy of the writer from whom I quoted. Under the last head I have alluded to the first of these two instances. But in adopting, without due examination. Dr. Lee’s alleged account of the numbers of Dr. Ramsbotham’s pub- lished cases of placental presentation, I was thoughtlessly led into error. Dr. Rams- botham has given, in his excellent Practical Observations, the details of 21 cases of the kind, and not of 19, as stated by Dr. Lee. The second instance was accompa- nied with the same results. Dr. Lee had published an apparently careful and elabo- rate analysis of Mauriceau’s cases of uterine haemorrhage in the 51st vol. of the Edin- burgh Medical and Surgical Journal, and I thought I might depend upon its accuracy ; but ‘‘ I have had the vexation to discover more than one error” in Dr. Lee’s returns of Mauriceau’s cases. Mauriceau has left details of the result of 19 cases of unavoida- ble haemorrhage, instead of 17, as stated by Dr. Lee. Dr. Lee alleges further, that Mauriceau has recorded the histories of 37 cases of accidental uterine haemorrhage. He has recorded the histories of not less than 50 such cases. When Dr. Lee re- publishes either his essay on the History of Uterine Haemorrhage, or his Lectures on Midwifery, I shall be happy to furnish him with exact references to all the cases of Mauriceau which he has omitted. 7. In criticizing the data upon which my table of maternal deaths in placental presentations is founded. Dr. Lee charges me with having “ suppressed the well- known fact,” that of the three women lost by Mauriceau, under unavoidable haemorr- hage, one ‘‘ died undelivered.” I have else- where explicitly stated, (as Dr. Lee ought to know) that the table in question was expressly “made to shew the maternal mortality in all varieties of the complication, and under all modes of treatment, whether the membranes merely were ruptured, or the child turned, or the placenta spon- taneously expelled, or the mother sunk with- out aid of any kind.” The same extract is a sufficient reply to Dr. Lee’s analogous objection regarding Busch’s cases. My report of the placental cases at the Royal Maternity Charity is again adduced by Dr. Lee, not once, but twice (pp. 1107 and 1108). But I feel assured that to every member of the pro- fession, the explanation which I have already published on this point is satisfactory. “ Of Schweighauser’s cases I have not yet,” says Dr. Lee, “ succeeded in finding any report.” But Dr. Lee may find, if he pleases, Schweig- hauser’s own report of them, if he will take the trouble to consult the well-known work of that author, to the pages of which I have referred in the foot-note appended to his cases in my paper in Dr. Cormack’s Journal for March last. Again, Dr. Lee charges me with the “omission” from the table of “ Portal’s 18 cases, of which 1 only proved fatal.” I have already elsewhere explained that this error is one attributable to Dr. Lee’s own inaccuracy, for in constructing the table, in order to arrive at an accurate and statistical result, “ I noted down all the lists of in- stances I could detect, in which ten or more cases were reported. Latterly, I have found that I erroneously omitted Paul Portal, be- cause I relied on Dr. Lee’s accuracy, when, in his Clinical Midwifery, he stated that Portal’s work contained an account of ‘ eight’ cases only of unavoidable haemor- rhage, while it contains notices of the results of fourteen.” (Med. Gaz. p. 1016.) As seen in the quotation 1 have given above. Dr. Lee now increases thu number of Por- tal’s cases from “ eight” to “ eighteen.” It may be proper to add, that the last number is as incorrect as the first. In my observations on unavoidable haemor- rhage, in the Medical Gazette of Oc- tober 10, I pointed out that of all the cases of turning in Dr. Lee’s private and consul- tation practice, reported by himself in his Clinical Midwifery, the mothers operated upon died in the proportion of 1 in every 2-5^. Dr. Lee pronounces this to be a “ most extraordinary and astounding mis- representation,” and declares, that the “ mortality, instead of being 1 in 2-j%, was virtually less than 1 in 9.” My calcu- lation may possibly appear, to such as have not thought much upon the subject, “ most extraordinary,” but nevertheless it is strictly accurate ; for Dr. Lee, in the work referred to, has detailed altogether 24 cases of turn- ing in placental presentations, and 10 of these 24 mothers died, or exactly 1 in every 2^. The ten fatal cases are those marked No. 1, 7, 12, 15, 16, 22, 25, 26. 29, and 35, in his Table in the Gazette of Oct. 24.* Certainly not one of our great surgeons would be listened to, if, in order to explain away the mortality among his lithotomy patients, he gravely averred that some of * [Dr. Lee’s calculation prefers to those cases only in which turnins was performed by himself. See p. 1109.—Ed. Gaz.]](https://iiif.wellcomecollection.org/image/b24930520_0005.jp2/full/800%2C/0/default.jpg)
