Correspondence between Dr. Simpson, Dr. Ramsbotham and Dr. Lee in relation to uterine hæmorrhage from placental presentation.

  • Simpson, James Young, 1811-1870.
Date:
[1845]
Catalogue details

Licence: Public Domain Mark

Credit: Correspondence between Dr. Simpson, Dr. Ramsbotham and Dr. Lee in relation to uterine hæmorrhage from placental presentation. Source: Wellcome Collection.

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    number of maternal deaths in these placental cases as fifteen : I find six¬ teen deaths among the mothers in the cases mentioned in your published re¬ ports, viz. I. in the report for 1S29 ; I. in 1830; I. in 1832; I. in 1833; I. in 1836; I. in 1837; HI. in 1839; IY. in 1840; II. in 1842 ; and I. in 1843. I have been thus particular in noting the years, because, as you are aware, it is not always very easy to discover the precise results of the placental cases, from the form in which you have arranged and published your reports in the Gazette. And if, in comparing the above list with yours, you detect any error, however slight, I shall, I sincerely assure you, feel very greatly obliged by your pointing it out to me, and be delighted to correct my tables accordingly, my great object of course being as great a degree of accuracy in them as possible. I do not think that the returns of Lying-in Hospitals afford us by any means such correct estimates of the frequency and fatality of placental pre¬ sentations, as of other obstetric com¬ plications : for women do not seek, and are generally not admitted into them, but at or near the full time, while the most common, and also certainly the most dangerous cases of unavoidable heemorrhage, are found occurring from the sixth to the ninth month. Only two, for instance, of Dr. Collins’ eleven hospital cases were premature; the other nine were at the full term. Hence the value, in one respect, of re¬ turns like those of the Maternity Cha¬ rity. I was very sorry I missed seeing you to-day when you called. Professor Liebig was here at the time. Believe me, my dear sir, Very faithfully yours, J. Y. Simpson. To Dr. Ramsbotham, Stafford House, London, 26th Sept., 1845. No. 3.—From Dr. Ramsbotham to Dr. Simpson. My dear sir,—I thank you much for your letter of yesterday. I had already detected an omission of one case of placental presentation among my pub¬ lished reports, having looked carefully over both the original tables and the summary in the Gazette since I wrote you to Edinburgh. I could not at first account for it, but now it has become quite clear to me. For the sake of greater accuracy, and less chance of error, as I thought, I compiled the tables published in the Gazette for August 9th, of last year, from my manuscript, instead of taking them from the published yearly state¬ ment; and I find that in the year 1837, one of the shoulder presentations, which was also complicated with pla¬ centa prsevia, had been overlooked, as regarded the latter irregularity, by me, owing to the manner in which I had entered the case in my column for “ Remarks;” so that I left it out, in¬ troducing it only as a transverse pre¬ sentation. Thus my extra anxiety for correctness in respect to those tables from which I drew my calculations, led me into a mistake. One death I purposely omitted, —and it occurs in the same year,—because, although the patient had been delivered under a placental presentation, that irregularity could have had nothing to do with her death. She recovered perfectly, had been for many days engaged in do¬ mestic affairs, though she had never left her house ; our superintendence of her had ceased ; and on the day month from her delivery she was seized with a fit of apoplexy or convulsions, while in a violent passion, and died almost immediately. From this history you will agree with me, I think, that I am fully warranted in omitting the case as one of death consequent upon placental presentation in my synopsis. I have no doubt this woman would have been