death of a football player from tetanus

1619

of this condition. Otherwise we fear that through I

mistaken motives of charity the Jubilee nurse in a

remote country district may be liable to be sent to "look:after" a patient without the cognisance of any medical

practitioner. It would be most unfortunate if the fulfilment

cf an object so worthy and so considerate should be im-

periled by any fostering of independent action on the partof the nurse. District visitors and the like must alwaysremember that any sufferer who requires the attentions ofa sick nurse is primarily in need of the advice and directionof a medical man. We ’say this in no spirit of cavil at thework of an institution for which indeed we have the highestMgard and which is likely to prove a fitting memorial of thereign of our beloved Sovereign.

THE PORTSMOUTH LUNATIC ASYLUM.

SOME little time ago the Asylum Committee at Portsmouthappointed as medical superintendent Dr. Mumby, the

borough medical officer of health. We felt constrained to

protest against the appointment, as Dr. Mumby, although amost admirable and experienced officer of health, had had noexperience in lunacy. We see that the chairman of the com-mittee is now advertising for an assistant medical officer, onewith "some previous experience in an asylum preferred." Ifthe superintendent has no previous experience-and webelieve that this is undisputed-and it is not necessary, butonly preferable, for the assistant medical officer to have any,we cannot help thinking that the 600 or 800 lunatics in thePortsmouth Asylum will not be placed in the best position’for either cure or amelioration.

DEATH OF A FOOTBALL PLAYER FROM TETANUS.MuCH commiseration has been shown in football circles at

the death of Joseph Powell, a member of the Royal ArsenalFootball Team, in consequence of an accident whichoccurred during a match at Kettering on Monday, Nov. 23rd.The injury consisted of a compound fracture of the leftradius and ulna. This was attended to on the groundby some persons who were said to be qualified to renderfirst aid to the injured, one of whom seems, however, tohave fainted at the sight of the protruding bone. Mr.

Dryland, of Kettering, subsequently syringed and disinfectedthe wound, putting it up in splints with iodoform and bluegauze. When seen the same night by Dr. R. E. Williams, ofWoolwich, the surgeon to the Arsenal club, the temperaturewas slightly elevated, but there was no symptom to causealarm. The wound was carefully cleaned and dressed andmoulded splints applied the next day, but on the morningof Nov. 27th slight symptoms of tetanus presented them-selves. Chloroform was given and the wound opened andscraped and scrubbed out. Dr. Williams then obtained all thetetanus antitoxin that he could get and immediately injectedit. The next day the condition of the patient, which hadappeared at first to have improved under the injection,became worse and Mr. Symonds of Guy’s Hospital wascalled in, who decided to amputate above the elbow. Moreantitoxin was obtained and injected and the patient waskept absolutely still, as even swallowing a mouthful of waterbrought on a convulsion. Death, however, occurred verysuddenly, with only a slight spasm, on the morning of the29th. At the inquest, which was held on Wednesday last,evidence was given that the accident was due to Powell’sfoot lighting on his opponent’s shoulder after a flying kickwhen the ball was high. The ground was sloping, and Powellfell heavily on his left arm. The jury unanimously expressedtheir appreciation of the great care and skill with whichDr. Williams had attended to the deceased. Dr. Williamsmentioned that the anti-tetanus serum appeared to be mostdifficult to obtain. We understand that he was only able toprocure 60 c.c. on the Friday and a similar quantity on the

Saturday. Of this 20 c.c. were injected on Friday night,10 on Saturday morning, 20 in the evening, and the

remaining 10 late the same night.

THE HEALTH OF SIR WILLIAM MAC CORMAC.

SIR WILLIAM MAC CORMAC continues to progress favour-

ably. Both the local and the general condition show furthermarked improvement during the past week. The temperaturekeeps quite normal. He is able once more to sit up for ashort time each day.

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OXFORD MEDICAL SOCIETY.

, AN address will be delivered before the Oxford Medical

Society by Mr. William Macewen, M.D. Glasg , F.R.S., RegiusProfessor of Surgery in the University of Glasgow, in thetheatre of the Department of Human Anatomy, UniversityMuseum, Oxford, on Friday, Dec. llth, at 5 30 P.M.

Subject: Abscess of the Lung. The meeting will be opento all practitioners and students of medicine.

BEATTY v. CULLINGWORTH.

IN another column will be found a letter from Dr. Theodore

Acland and Mr. Bernard Pitts with reference to the formation

of a fund intended to help Dr. Cullingworth in the paymentof expenses incurred by him in the recent action. We need

say no more than to recommend this fund most warmly toour readers. Here is a man who did, at great personal incon-venience, without fee, what he thought best for his patientunder very difficult circumstances. And what has been hisreward ? Vilification and a fine of some .BlOOO spent on

his legal defence. -

THE SEQUEL OF A HEAD INJURY.

THE case of an old woman who recently died in Birming-ham, after being knocked down by a parcels van, and whosedeath formed the subject of an inquest, has raised questionsof suggestive interest to the practical surgeon. After the

injury, which was due partly to her deafness and partly toher being drunk, she was taken to the General Hospital andthere examined by the resident surgeon. A scalp woundwas found on the right side of the forehead but no fracture.No signs of cranial or cerebral injury appear to have shownthemselves. The wound was therefore dressed and the

patient given over to the police to be taken to her relatives.This arrangement was not carried out, however, and

owing to a misunderstanding she passed a restless nightin a police cell, was worse the next day though ableto walk, and was sent to the workhouse infirmary whereshe died on the following day. A post-mortem examina-tion, while it revealed no fracture at the site of the scalpinjury, showed that intra-cranial hæmorrhage had takenplace and that death was due to this cause. The case was

clearly a hopeless one from the first, and the only questionon which any difference of opinion could exist was whethershe should, or should not, have remained in the hospitalwhen first taken thither. It is always easy to be wise afteran event, and we might, if disposed, being thus wise, ignorethe perplexities of diagnosis and the possibilities of treatmentand suggest that in this instance a patient who, besides theproof of drunkenness, presented only the signs of a com-paratively trifling injury was wrongly dismissed to her home.The coroner’s jury declined to adopt this course, and weconsider that they acted wisely. Censure can in no wayattach to the resident surgeon, who was guided in his decisionby the only evidence obtainable at the time of the patient’sadmission. The incident nevertheless suggests the wisdomof even hazarding an error on the side of precaution incases which present a history of a severe blow to the headand of placing them for, say, forty-eight hours under medical