Note on ovariotomy and ovarian tapping / by J. Matthews Duncan.

Date:
[1857]
Catalogue details

Licence: Public Domain Mark

Credit: Note on ovariotomy and ovarian tapping / by J. Matthews Duncan. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    will agree that an operation which is justifiable once is justifiable a thousand times, and the reverse. 2. Dr Simpson designates objections against the use of statistics in therapeu- tical questions, common platitudes usually offered by young medical critics. I am already older than Newton was when he had completed many of his greatest discoveries. (Readers will pardon my presumption in introducing such a name into so small a question.) On the other hand, I think I have little more than half the number of years of Dr Alison, the most distinguished medical philospher of this age, when writing the'ominous warnings, designated as platitudes, etc., concerning the dangers of applying statistics to therapeu- tical questions. The age of an opponent is but a sorry argument. I am rapidly correcting this fault of mine. 8. Dr Simpson fixes upon amputation at the hip-joint as the ai'ena on which to defend his statistics against my objection, that the circumstances of the cases included in the statistics were not known, so as to make us sure they had such reasonable amount of likeness to one another as to be fairly clubbed together. His defence consists in telling us only one circumstance, and that true, only of twenty-four out of eighty-four cases. The one circumstance is, that the am- putations were for the cure of chronic disease. But this is evidently not even a good palliation of the error I point out. I have again to ask, what was the chronic disease ? When an ovary is cut out, we have the well-known multilocular dropsy of it. But what is chronic disease ? Is it cancerous, tubercular, or inflammatory, or all together ? Is it of the bone, the joint, or of the whole limb ? Alas! we are still in total darkness. 4. In concluding his remarks on cases of amputation at the hip-joint, Dr Simpson points out that the amputation was fatal in the proportion of 75 in 100 cases in which it was adopted for the removal of hopeless chronic disease of the limb,—a mortality which is nearly double the mortality accompanying ovariotomy, when performed for the removal of hopeless chronic disease of the ovary. Here, it is evident, we have two defects, which vitiate the whole argument! for, we do not know on what grounds, if any, the cases are said to be hopeless, nor do we know whether the hopelessness was of life, or merely of cure of the disease. ,6. Dr Simpson publishes a long defence of the absurd statement, that first tappings are fatal in one case out of every five operated on. It would be tedi- ous to follow him through his argument, and useless; for my original article, already referred to, disposes of the whole matter in an irrefragable manner, and Dr Simpson's objections, so far from being at it, are scarcely beside it. For instance, he points out that a child passing through its sixth year has already passed through its first year, and adds something clever about a dull and dis- passionate school-boy. He forgets that Dr Southam's table was first siiown to be unworthy of any confidence in this question, and then that it is not one of first tappings, and that if a woman has been tapped twelve times, the first tap- ping could not have proved fatal. But such diversions from real argument are unworthy of the subject. All Dr Simpson's argument, as to this point, is conducted as if he knew what use I would make of Southam's table, were it one of first tappings. I have not