1
661 witnessed the sufferings of such an awful disease, without feeling an anxious desire to understand the cause and alleviate the mi- sery, has neither a head nor a heart worth the caring for." It is the duty of an editor, or of a pro- fessed critic, to lay before his readers a clear view of facts, and, if necessary, to rea- son from these as fairly as he can. It is one at least of the essential chara cteristics of a gentleman not to attack the honour of another until he is fairly convinced that he deserves such treatment. I have, however, stated the facts, and whether Dr. Johnson has acted with wisdom towards himself, or fairness towards me, I shall now leave to the decision of the public. By inserting the above you will oblige, Sir, your obedient servant, , WM. STEVENS, M.D. Albany St., Regent’s Park, Jan. 23, 1832. WM. STEVENS. M.D. EFFECTS OF STRANGULATION ON THE ORGANS OF GENERATION. To the Editor of THE LANCET. SIR,—In reference to several communi. cations which have appeared in THE LANCET on the effects of hanging on the ma’e and female organs of generation, and the sexual functions of the cerebellum, permit me to lay before you a short statement of what has fallen under my own observation in relation to this subject. In October, 1820, I was accoucheur to a lady who, as soon as she was delivered, anxiously wished to know the sex of the child. Accordingly, in absence of light, I ascertained by feeling with my hand the sex of the infant, and told her that it was a fine boy. But what particularly arrested my attention on this occasion was, a strong penal erection in the child, who seemed to have been almost strangled in the birth. The presentation was natural, and the pains vigorous, and at short intervals ; the head was very much compressed, and the labour was finished nearly in an hour. Since my at- tentionhas been directed to this subj ect many opportunities have occurred to me o veri- fyiug the accuracy of the position of some of your correspondents. But the circum- stances in which the accoucheur is most likely to recognise its truth are, when the labour is vigorous, the head strongly com- pressed, and retarded for a time in the pas- sage through the pelves, but the child ulti- mately born without much resistance from the soft parts. Sometimes, however, the rigidity and resistance of the soft parts pro- duce nearly a similar effect. The fact may be noticed in very protracted labours, and in most inatances the child’s face is turgid and livid, and respiration often does not take place for some minutes after delivery. It may be now three years since 1 attended the follo wing case, of a woman, about 30 years of age, in child-bed. The labour was severe, though not remarkabiy so, for in two or three hours she was delivered of a female child without any particular assistance. It was on the second day after delivery, when I called to see my patient, that she directed my attention to some marks of blood on the child’s linen. At first I thought lightly of the matter, supposing the appearance to have been produced by some drops of blood from the umbilical cords. She however spoke significantly on the subject, and talked of it as catamenial. In confirmation of her view of the subject she remarked that this was the second female child which she had had that exhibited this appearance during the first and second day after delivery. This was quite new to me; at the same time I endeavoured by a careful examination to ascertain the source of this singular pheno- menon. No fluid blood was discovered, but ’around the root ofthe clitoris, some sangui- neous matter was found in a dry, granular, form, whence it is presumed the discharge, if it deserved the name, had proceeded. I took an early opportunity of inquiring of a professional gentleman who had been nearly 40 years in the practice of midwifery, if he had ever noticed anything similar to what has been just mentioned, but he frankly ac- knowledged that he had not. In a conver- sation which I had on this subject with a midwife of extensive practice in this place, she stated to me that she had noticed the appearance referred to several times in the course of her business. Since I began to make inquiries on the subject, some other cases of the kind have been mentioned to me. About seven weeks ago I was consulted in a case of apoplexy. The woman had been remarkable for regularity with regard to the recurrence of the catamenia, but while she was labouring under this disease, which proved fatal on the tenth day, the menses appeared on the beginning ofthe third week, and continued two days, being’nearly a fort- night sooner than usual. In severe epileptic fits, when the face is turgid, livid, and the veins of the head are ready to burst, seminal emissions are, as I understand, not uncommon. Now in all these different kinds of cases the cause of the phenomena seems to be a mechanical effect which is produced on the cerebellum, which, through the medium of the nervous system, becomes apparent in the organs of generation, and bears a striking’analogy to the consequences which, hanging has upon eunuchs and criminals. 1 am, Sir, Jan. 12, 1832. A.* * This signature has been authenticated,—ED. L.

EFFECTS OF STRANGULATION ON THE ORGANS OF GENERATION

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661

witnessed the sufferings of such an awfuldisease, without feeling an anxious desire tounderstand the cause and alleviate the mi-

sery, has neither a head nor a heart worththe caring for."

It is the duty of an editor, or of a pro-fessed critic, to lay before his readers aclear view of facts, and, if necessary, to rea-son from these as fairly as he can. It isone at least of the essential chara cteristicsof a gentleman not to attack the honour ofanother until he is fairly convinced that hedeserves such treatment. I have, however,stated the facts, and whether Dr. Johnsonhas acted with wisdom towards himself, orfairness towards me, I shall now leave tothe decision of the public.By inserting the above you will oblige,

Sir, your obedient servant, ,

WM. STEVENS, M.D.Albany St., Regent’s Park, Jan. 23, 1832.

WM. STEVENS. M.D.

EFFECTS OF STRANGULATION

ON THE ORGANS OF GENERATION.

To the Editor of THE LANCET.SIR,—In reference to several communi.

cations which have appeared in THE LANCETon the effects of hanging on the ma’e andfemale organs of generation, and the sexualfunctions of the cerebellum, permit me tolay before you a short statement of what hasfallen under my own observation in relationto this subject.

In October, 1820, I was accoucheur to alady who, as soon as she was delivered,anxiously wished to know the sex of thechild. Accordingly, in absence of light, Iascertained by feeling with my hand the sexof the infant, and told her that it was a fineboy. But what particularly arrested myattention on this occasion was, a strongpenal erection in the child, who seemed tohave been almost strangled in the birth.The presentation was natural, and the painsvigorous, and at short intervals ; the headwas very much compressed, and the labourwas finished nearly in an hour. Since my at-tentionhas been directed to this subj ect manyopportunities have occurred to me o veri-fyiug the accuracy of the position of someof your correspondents. But the circum-stances in which the accoucheur is most

likely to recognise its truth are, when thelabour is vigorous, the head strongly com-pressed, and retarded for a time in the pas-sage through the pelves, but the child ulti-mately born without much resistance fromthe soft parts. Sometimes, however, the

rigidity and resistance of the soft parts pro-duce nearly a similar effect. The fact maybe noticed in very protracted labours, andin most inatances the child’s face is turgid

and livid, and respiration often does nottake place for some minutes after delivery.

It may be now three years since 1 attendedthe follo wing case, of a woman, about 30 yearsof age, in child-bed. The labour was severe,though not remarkabiy so, for in two or

three hours she was delivered of a femalechild without any particular assistance. Itwas on the second day after delivery, whenI called to see my patient, that she directedmy attention to some marks of blood on thechild’s linen. At first I thought lightly ofthe matter, supposing the appearance to havebeen produced by some drops of blood fromthe umbilical cords. She however spokesignificantly on the subject, and talked of itas catamenial. In confirmation of her viewof the subject she remarked that this wasthe second female child which she had hadthat exhibited this appearance during thefirst and second day after delivery. Thiswas quite new to me; at the same time Iendeavoured by a careful examination toascertain the source of this singular pheno-menon. No fluid blood was discovered, but’around the root ofthe clitoris, some sangui-neous matter was found in a dry, granular,form, whence it is presumed the discharge,if it deserved the name, had proceeded. Itook an early opportunity of inquiring of aprofessional gentleman who had been nearly40 years in the practice of midwifery, if hehad ever noticed anything similar to whathas been just mentioned, but he frankly ac-knowledged that he had not. In a conver-sation which I had on this subject with amidwife of extensive practice in this place,she stated to me that she had noticed the

appearance referred to several times in thecourse of her business. Since I began tomake inquiries on the subject, some othercases of the kind have been mentioned to me.About seven weeks ago I was consulted

in a case of apoplexy. The woman hadbeen remarkable for regularity with regardto the recurrence of the catamenia, but whileshe was labouring under this disease, whichproved fatal on the tenth day, the mensesappeared on the beginning ofthe third week,and continued two days, being’nearly a fort-night sooner than usual.

In severe epileptic fits, when the face isturgid, livid, and the veins of the head are

ready to burst, seminal emissions are, as Iunderstand, not uncommon. Now in allthese different kinds of cases the cause ofthe phenomena seems to be a mechanicaleffect which is produced on the cerebellum,which, through the medium of the nervoussystem, becomes apparent in the organs ofgeneration, and bears a striking’analogy tothe consequences which, hanging has uponeunuchs and criminals. 1 am, Sir,

Jan. 12, 1832. A.** This signature has been authenticated,—ED. L.