Duncan Leys

Value of Propantheline Bromide in Treatment of Enuresis

A case is described of severe post-partum haemorrhage due to cervical laceration in a grand multipara. The laceration extended into the lower uterine segment extraperitoneally without evidence of this when the hand explored the uterus. The lesson is emphasized that a case of post-partum haemorrhage with a contracted uterus must be examined most carefully under general anaesthesia for high vaginal and cervical tears. Tearing of the cervix or vagina should be suspected when haemorrhage occurs round the head as it is delivered. After stitching a cervical laceration and packing the uterus the patients condition should improve when blood is transfused. If it does not, broad-ligament haematoma should be suspected and hysterectomy carried out without waiting for resuscitation of the patient-resuscitation which will not occur until haemorrhage has been arrested. Intra-arterial transfusion of blood can induce a quick response during operation when the bleeding-points have been secured. This patient required transfusion of 34 pints (19.3 litres) of blood and two operative procedures before recovery was assured.

Experiments on Animals

First let us review the moral argument up to this point. Chapter 2 discussed the principle of an equal consideration of the interests of animals and of humans, according to their respective natures. Chapter 3 has now thrown further light on this principle in demonstrating the importance of a moral standpoint on animals being armed not only with benevolence and impartiality, but also with relevant knowledge of their natures. Moral debt was explained in the earlier chapter as denoting no more than what is owing to an object (animal or human) with possible application in several ways: first, in a way that is forward-looking, as when our moral principles indicate what we owe to an animal prior to the performance of a moral act relating to it; second, in a way that is backward-looking, and then occasionally forward-looking, as when we refer to human acts leading to animal harm or suffering, leaving us with a debt that only in some circumstances may be repaid; third, in a way that is backward-looking in appreciation of an animal’s past services to us, and still more seldom forward-looking, since we normally have no intention of attempting any kind of compensatory benevolence.