1897 The Lancet  
say practically the same thing. The inspection by these gentlemen was made on Oct. 16th, 1896. There would seem, therefore, to be a very strong opinion with regard to the necessity of getting rid in scme manner or other of the overcrowding and the authorities are doing their utmost to bring this about. The question of boarding patients out was discussed, but owing to legal difficulties did not come to anything. A new asylum is in course of erection at Portrane which will provide sleeping
more » ... dation for 665 men and 733 women besides 128 attendants and at present there is temporary accommodation for 100 men at Portrane. ___ DOMESTIC HYGIENE. As a general rule lectures on medical subjects delivered at i a lay public are much to be deprecated. They are likely to produce an entirely wrong impression on the members of the audience when previous education and want of knowledge of physiology and the kindred branches of science do not prepare them for a right mental assimilation of the facts laid before them. There is one branch of medical knowledge, however, in respect to which exception must be allowed in giving expression to the above opinion and that is as regards matters concerning domestic hygiene. The utmost ignorance is generally displayed on this subject, by the poorer classes especially, and consequently the announcement made by the Mansion House Council on the Dwellings of the Poor that arrangements are being concluded for the delivery in the various districts of London of lectures on "Healthy Homes," and " Essentials of House Sanitation " is to be commended. The question remains whether the desired audiences will be obtained. Not only ignorance but utter want of interest are exhibited on such matters by the classes referred to, but we wish the council every success in their endeavours to instil into the minds of the people the most simple and essential points concerning the hygiene of home and body. --POST-MORTEM DELIVERY. IN German medical literature is found a term for which as far as we are aware there is no English equivalent, viz , "Sarggebuit," which literally translated means "coffinbirth "-that is to say, that a pregnant woman dies and the boey is placed in a coffin and then before or after burial delivery takes place. Very few cases of this kind are on record. A notable case, however, is recorded by Dr. Bleich, of Tschirnau.1 Before proceeding to describe the case Dr. Bleich makes some remarks on the theories that have been advanced to account for the causes which bring about post -mortem delivery and states that two explanations have been advanced ; the first supposes that the pressure produced in the abdomen by the gases evolved in post-' mortem decomposition is sufficient to cause the expulsion of I the uterine contents, whilst the second suggests that the I necessary force is brought about by the condition of rigor I mortis into which the muscular structure of the womb is thrown. Proceeding then to a description of the case which he himself observed, Dr. Bleich records that on July 6th the dead body of a woman was found lying in a shallow pool of water. It was ascertained that she had escaped from her home in a state of insanity. On examination no signs of injury could be found with the exception of slight bruises on the knees ; it was found that she was pregnant, probably in about the seventh month. Post-mortem rigidity was present; a few post-mortem stains were found on the back. It was concluded that the body had only been a short time in the water and that all the evidence pointed to suicide, and 1 Vierteljahrsschrift fur gerichtliche Medicin und öffentliches Sanitatswesen, 3. Folge, Band xiv., p. 2. the burial took place on July 9th. Eight days after the finding of the body it was ascertained that three young labourers had had sexual intercourse with the deceased woman shortly after one another. They were arrested anc closely questioned and all three persistently denied that any criminal force had been used, but, on the contrary, said that. the woman had been a consenting party. Exhumation of the body was ordered and a post-mortem examination was made on July 19th. Delivery was found to have taken place after the coffin had been closed with complete inversion and prolapse of the uterus and vagina. A full account of the necropsy is given in Dr. Bleich's paper. We can only give a brief abstract. The abdomen was greatly distended but exhibited no signs of injury. Between the thighs lay a dark-red mass (the uterus) about the size of a head, from the under side of which sprang a dark umbilical cord, and connected with the latter was the body of a child 36 cm. in length. The vulva was wide open. The uterus was flabby and like a sac and lay with its inner surface pressed against the thighs together with the vagina m the placenta had separated and was dark-brown in colour and of a hard consistence. The muscular walls were thin and brittle. Dr. Bleich suggests that the violence experienced by the woman shortly before death had been of such a nature as to render abortion probable and that the collection of the gases of decomposition in the abdomen had been sufficient to complete that process and also cause
doi:10.1016/s0140-6736(00)64827-4 fatcat:xm7at3laeneexpnjjx664djdfu