Nov. 7, 1891.] THE BRITISH MEDICAL JOURNAL. 993 margins of the broad ligaments, and took origin in a network surrounding the corpus uteri. The efferents of the latter con- sisted of two or three large vessels lying between the tube MEMO RANDAl and ovary, receiving numerous branches from these. As MEDICAL, SURGICAL, OBSTETRICAL, THERA- valves were comparatively few in these vessels, retrograde in- fection was not only possible but probable. By these net- PEUTICAL, PATHOLOGICAL, ETC. works of lymphatics septic mischief was conveyed to the pelvic cavity, whereas salpingitis was invariably the result of extension of the disease along the mucous membrane of the A CASE OF HIP DISEASE AND BACK SORE IN tubes, the lymphatics of the uterus and those of the tubes WHICH THE PRINCIPLE OF THE} ELLIPSE not being intimately connected. Poirier had supported this WAS APPLIED TO A LONG OUTSIDE assertion by pointing to the fact that the lumbar glands were SPLINT. never affected in tubal inflammation. On the other land, the uterine THE patient was a lady, aged 54, and had suffered for about ovariani and lymphatic systems hiad direct com- 24 years witlh hip disease, terminating in abscess which re- munication with each other. so that ovarian disease could quired incision and drainage. She was very thin, and had readily be consequent upon endometritis without the tube profuse haemoptysis on three occasions, from a tuberculous being in any way concerned. lung, during the time I attended her. The discharge from Native Obstetric Operations in India.-Surgeon-Major ROB3ERT the PRINGLE, IM.D., M.A.O.Edin., said that the colndition of the thigh, which was very copious, soaked down in spite of all native women in India differed very much in the three Presi- care between the water pillow and her back. The result was dencies; in 'Madras an extensive back sore which necessitated frequent turning seclusion, as seen in Bengal, was un- of the patient, and caused severe pain by disturbing the limb. known; their position in Bombay seemed midway between I suggested to Mr. Ernst, of Charlotte Street, Fitzroy these two extremes, For years the residents of Madras had Square, who carried out the suggestion extremely well, that enjoyed to the full the benefits of a lying-in hospital; Bom- he should make an iron ellipse, 9j- inches in its long diameter, bay, thanks to the aid of the Parsees, was not far behind 9 inches in the short Madras; but in Bengal, if Calcuttawere excepted, medical treat- diameter, with a bent bar of the shape merit of shown in the woodcut rivetted at one end to the extremity native women had been unknowil till very lately; of the long diameter of the ellipse, the other end of the bar to when the lying-in hospital at Agra was opened, the only indi- fit into a vidual who entered the zenana for the purpose of profession- socket of an iron splint moulded to the shape of the ally limb. The splint was fitted with a flexible metal support or (if such it could be called) treating the inmates was the trough, embracing about two-thirds of the circumference of /anai dhai, or midwife of India. These women were of a the and distinct aind separate class or caste. The qualifications of the leg a similar support for the thigh; the upper ex- art were held to be hereditary. It had been estimated that tremity of the splint was fitted and fixed by thumb screws to 30 a metal girdle partly encircling the waist. to 40 per cent. of women treated by them succumbed The three portions embracing the trunk, thigh, and leg within the first fortnight after childbirth. The medical were well treatment of the zenana women was carried on by the family padded, and when buckled firmly to the splint, hukeem, or native maintained the limb in complete apposition to the splint doctor, who prescribed for symptoms re- when the patient was rolled over on her right side; the foot ported to him, either by male representatives of the family, and leg or the dhai. The hukeern might feel a pulse or see a tongue following the rotation of the ellipse as shown by the through a curtain, but no more. The surgical treatment was woodcut. a blank. The Zenana Bible and Medical Mission em- ployed only fully qualified ladies. In Lucknow its hlospital lhad won its way into the confidence of the natives, until the work had far exceeded the capacity of the present building; and anotlier hospital to the memory of the friend of the women, not only of this country, but also of her sisters in India-the late Dowager Lady Kinnaird-would soon be completed. The early work of the present Lucknow Female Hospital and similar ones in the Bengal Presidency at a distance from Calcutta had led to the schleme known aIs the Countess of Dufferin's Association for Supplying Medical Aid to the Women of India, by exhibiting the possi- bilities of the work when undertaken on proper lines.- Brigade-Surgeon HARvEY, M.D., said that as superintendent of the Eden Ilospital, Calcutta, lie had had ample oppor- tunity of confirming Dr. Pringle's statements. Exaggeration of the horrors of an Indian lying-in room was impossible. He had himself operated for vesico-vaginal fistula in a woman (?) of 11. He had seeni a little girl of 10 with her pelvis blocked by The comfort and convenience afforded by the splint and inflammatory exudation due to gonorrhiea communicated the ellipse allowed of the necessary attendance to the back, by her husband. In one week at the Eden Hospital lie lhad which soon seen two women brought in with the heads of children whose healed, and the patient was able to lie on her side bodies had been without disturbance of the affected limb. She wore the splint torn away left in utero, one case of transverse for many montlhs, up to the time of her death, which took presentation with the arm torn off, and the child's chest place from exhaustion. The opened by the fingers of the widwife; anotlher in which, after three portions of the splint, the four days' waistband, outside bar, and ellipse, were made in separate labour, the uterus was so moulded on the child that pieces for convenience of appliance and removal. Mr. turning was rendered most difficult. Nearly twenty years ago Howard lie had placed on record two cases of child-wives killed on Marsh, who kindly saw the patient with me on their several occasions, writes: "I think your splint quite worth wedding nights which were dismissed by the police as describing; it was very useful in the late case." I have hither- examples of legitimate intercourse, and had officially described to never met with them as " examples of the legalised rape, for it is nothingf any appliance which allows of rotation of a else, so limb when placed on a long splint, and I believe in cases of common in India as a result of infant marriage." A intracapsular fracture of the neck of the thigh bone, in hip brighter day was in store, he hoped, for Indian women, disease, and perhaps in fracture of the thigh, the proper mainly due to the noble efforts of Lady Differin. It was a adaptation of an ellipse such as I have described, by allowing mistake to suppose that these outrages would be abolished by the patient to change the position, may be of great comfort. the Age of Consent Bill. They would still go on in the seclu- The position of the ellipse need not interfere with extension sion of the zenana, and the only effect of the Bill would be a by weight and moral effect; it would' strengthen the hands of the few en- pulley, which can be easily adapted. lightened men *ho *ished to protect these girls. BrightoD. WILLOuG+HBY FUINEB, PA.R.a. S., M.D.Durh. 994 THE BRITISH MEDICAL JOURNAL. [Nov. 7, 1891. THE FATAL DOSE OF ACONITE. THE recent death of a pauper patient in Shoreditch by the OF accidental adminiistration of aconite liniment, and the effects REPORTS SOCIETIES, of the same medicine among patients, affords instructive in- PATHOLOGICAL SOCIETY OF LONDON. formation as to the fatal dose of aconite and aconitine; and I am indebted to MIr. Frederick L. Norris, -M.B., for assistance TUESDAY, NOVEMBER 3RD, 1891. in giving this. SIR GEORGE MUIRRAY HUJMPHRY, F.R.S., President, in the Chair. By some error a dispensinig bottle of tinct. nuc. vom. was Exrverimental Observations on the Ammoniacal Decomposition filled up with metliylated aconite liniment. My analysis of U'rine.-Mr. S. G. SHATTOCK read a communication on the- showved that the supposed tincture was nearly all aconite lini- action of proteus vulgaris and of pyococci on urine; he also ment. with a qjuite smnall proportion of tincture of nux gave an explanation of the deposit of phosphates from urine vomica. Of this liquid, a dose of 9 munims was prescribed on boiling, and made remarks on the amphoteric reaction of and given to Eliza Barley, aged .58, and slie died in rather urine. He said that an assertion commonly made was that more than four lhours after its administration with decided the conversion of urea into carbonate of ammonia always symptoms of aconite poisoning. The 9 minims correspond depended on the action of living micro-organisms. Pasteur's to about 5 grains of aconite root, contained about one- researches on this matter were well known, and his observa- thirtieth of a grain of aconitine, and is about half the quantity tions were afterwards confirmed and extended by Lister.