are constantly rising to the surface of the water and escaping from it, in the same way as in the Warm and Hot Springs. Its other contents are lime, magnesia, soda, iron, organic matter and precipitated sulphur. This latter ingredient seems to be very abundant, and a copious deposit of it may be seen at all times at the bottom of the spring, though it is usually cleaned out every few days. From the white appearance of this deposit the spring takes its name.

"The water of the White Sulphur Spring no doubt possesses medicinal properties of great power. Multitudes who resort to it annually are benefited by its use, while a few, perhaps, deriving no advantage, are inclined to believe that the water has no remediate powers. But it should be recollected that these waters are not calculated to relieve all cases, and that in those where they might be useful, they may prove mischievous if not judiciously taken. Many persons, immediately on arriving at the springs, drink the water immoderately, and not a few suffer for their rashness. When taken in this way it is said to produce a powerful determination of blood to the head, attended with pain and dizziness, and sometimes followed by severe cerebral symptoms.

Though this water is nauseous to most persons on first drinking it, a relish for it is soon acquired, and in a short time, in most instances, it becomes a favourite beverage. I met with several individuals, in perfect health, who declared to me that they preferred it to any other liquor, and drank it merely as a luxury.

"It is said to act on the kidneys, the bowels, the liver, and the skin. As a diuretic, its effects are very soon apparent, but it usually requires some days before it produces a decided action on the bowels. Its operation on the liver, too, is not manifest for some time, and where there is a great torpor of this organ, some auxiliary means may at first be required. Its effect on the skin is very apparent, though not immediate; after drinking the water a few weeks the perspiration becomes strongly impregnated with sulphur.

"The use of this water is no doubt beneficial in a variety of affections, and I am inclined to believe that it will be found signally useful in those functional derangements of the digestive organs, which are so common, and at the same time so unmanageable, especially when they are connected with disturbance of the liver, or a torpid state of the bowels. The whole tribe of dyspeptics, if their trouble be not the effect of organic disease, may resort, with a well-grounded expectation of relief, to these healing waters.

"Another numerous class of patients, known under the very common, but not very significant name of bilious, is said to find, very often, relief from them. Many persons of this description come to the springs from the south and southwest, whose constitutions have been shattered by the diseases incident to the climate, and they almost invariably derive benefit from a residence there. In such individuals there is, hardly without exception, some derangement of the biliary secretion, consequent very often on intermittents and other fevers of the country.

"Chronic rheumatism is a disease from which relief is, in very many instances, obtained by a resort to this spring. In this case great advantage is derived from the external as well as internal use of the waters, and for this purpose an excellent bathing house has this year been erected, with every convenience for using the bath in every form and at any temperature that may be desired.

"Cutaneous eruptions of various kinds are frequently removed by a similar management.

66 Many of the distressing symptoms, which are by no means the unusual attendants of chronic affections of the urinary organs, are in many cases alleviated, and in some entirely removed, by a judicious use of the White Sulphur water.

"There are other maladies over which, it is said, it exerts a favourable

control. But it is unnecessary to enumerate them, partly because I cannot speak from personal knowledge, and partly because I suspect that in some of them the advocates of the springs may have exaggerated the virtues of the water.

"But of this much I feel confident, that these springs will, in a majority of cases, be useful not only in those diseases which I have named, but also to that numerous class of patients who are affected with debility connected with functional derangement, or that which is consequent on previous disease, or excess and imprudence in living."

"Sweet Springs.-The temperature of the water is seventy-six degrees, and is the same at all seasons. It is very abundant, and is situated in one of the most beautiful mountain valleys of that region. It contains a large quantity of gas, particularly the carbonic acid gas, and this imparts to it a sparkling and agreeable taste. In what way it obtained the name of sweet, cannot learn; it certainly does not deserve it, for it is decidedly acidulous. It contains lime, magnesia, soda, iron, &c., but in what quantities I do not know.

"The water of the Sweet Springs, when taken internally, is not supposed to possess medicinal properties equal to that of some of the other springs; but in combination with the bath, it is found useful in many diseases, as rheumatism, paralytic affections, and general debility. It has also been extolled in dyspepsia, and in that countless tribe of maladies which follow in its train. It is certainly a very agreeable bath, pleasant while you are in it, and followed by a delightful glow as soon as you come out."—p. 10 The Blue, the Salt, the Gray and the Red Sulphur, were not visited by Dr. Hayward.

MISCELLANEOUS NOTICES.

Report of the Obstetric Department of the Philadelphia Dispensary for the year 1839. JOSEPH WARRINGTON, M. D., Accoucheur.-Seventy-seven women have been under the care of the accoucheur in this institution during the year.

Seventy-nine children have been delivered, viz. 53 boys and 26 girls. One woman having twin boys, and one twin girls.

In forty-seven cases in which the presentations and positions of the fœtuses were carefully observed, they were as follows:-28 in the first position of vertex, 11 in second do., 4 in fourth do. ; 3 in first position of breech, 1 in fourth position of knees.

The average duration of labour in forty-five cases, was 11 hours 26 minutes, the extremes being 30 minutes and 31 hours.

The average time required for the spontaneous expulsion of the placenta in fifty-one cases was 19 minutes, the extremes being 5 and 60 minutes. In six other cases, some manual aid was necessary to the delivery of this mass, after a retention for 30, 60, 99, 120, and 240 minutes respectively.

In each of these cases the delay of its delivery depended upon either atony of the uterus, or the manner in which the placenta presented at its orifice, and not to adhesion or hour-glass contraction. The insinuation of the finger in four of the cases, and of the hand into the vagina and os uteri in two, was found sufficient for the completion of delivery.

In one case the fœtus presented originally in the fourth, but became spontaneously changed to the second position of the vertex.

In one case, flexion of the head upon the thorax did not take place until the hand was introduced to assist the change.

The forceps were applied in four cases, viz., in one, which 1 year and 15 days previously had been delivered by the crotchet, in consequence of defi

cient amplitude of the pelvis, (child now delivered alive.) One in consequence of contraction of the antero-posterior diameter, with the additional obstacle of the jutting in of the left acetabulum, (child living.) Case given in detail by Wm. H. Müller,' one of the obstetric class. In one in consequence of an irreducible prolapsus of the cord, (child not quite dead when delivered, but could not be resuscitated.) And in a fourth case in consequence of the defect of uterine action, and a small but well-formed pelvis -ergot having failed to effect delivery, (child living.)

year.

Ergot was used in this one case only, during the whole All the women recovered, except one who died of phthisis eight days after delivered, which occurred three weeks before term-the patient not being expected to live till that time. Delivery was effected by the uterine efforts merely, and almost unconsciously to the emaciated and enfeebled mother.

Two patients had metritis, coming on after natural and easy labour, and one, (the case of which has been given with some detail,) after considerable manipulation and the use of the forceps.

These were cured in a few days by blood-letting, general and local, moderate purging, fomentations to abdomen, and mucilaginous injections into vagina.

There was one case of severe uterine and mammary engorgement, occurring on the third day after a natural labour; it was promptly cured by two doses of calomel and castor oil, with the frequent use of fomentations to the mammæ and abdomen.

One patient suffered much from ovaritis during the latter part of gestation. She was greatly relieved by cupping before delivery, and a free leeching subsequently.

In one case, in which there was slight hemorrhage at the time of delivery, the placenta was found to be studded with numerous calcareous deposits upon its uterine surface.

Several other placenta were remarked to contain this species of forma tion, but no peculiar condition of the patient or child was noticed in connection with the circumstance.

Four or five of the children had ophthalmia; all of them recovered except one, which died in convulsions eight days after its birth; the inflammation being intense, and no nurse could be obtained to attend upon the mother, and apply the remedies proposed for the relief of the child.

Dr. Warrington holds the appointment of accoucheur to this ancient and extensive institution, with the view to establish a school of practical midwifery. The cases are distributed amongst those members of his class who attend upon his course of practical instructions in obstetrics, after having attended a full course of anatomy and midwifery in some respectable medical school.

Twenty-five gentlemen have participated in his courses of instruction at the Dispensary, and attended upon the above list of cases the past year. The number of patients for 1839 exceeded those of the previous year by twenty-four.

The Connection of the Human Placenta and Uterus, shown without the aid of Injection. By WILLIAM CUMIN, M. D., Regius Professor of Midwifery. On the 16th of June, 1839, a gentleman very kindly sent me the uterus of a female, who had died of diseased heart fourteen days after the expulsion of a seven months' fœtus. The uterus measured externally, from the margin of the fundus to the margin of the anterior lip, five inches, and its greatest breadth was three inches. The os uteri was of a dark purple colour, with a granular and somewhat shreddy surface; but it was not fissured.

'See p. 341.

Lond. Med. Gaz. Oct. 12, 1839, p. 95.

The internal surface of the uterus presented a granular appearance, from particles of adherent plastic lymph. A portion of the placenta, about half an inch in thickness at the thickest part, adhered to the anterior part of the body and fundus of the uterus. The free surface of the placenta was granulated and very irregular, with many prominences and depressions. The structure of the placenta was throughout free from any appearance of decay, and perfectly healthy. On cutting perpendicularly through the uterus and placenta, several of the uterine veins were seen to contain tubular concretions of plastic lymph, not adherent to the walls of the vessels, and having both their surfaces besmeared with blood. One remarkably distinct concretion of this kind was seen projecting from the surface of the incision in the fundus. Similar tubular concretions were observed in the oblique vessels passing between the uterus and placenta, quite as beautifully displayed as in William Hunter's preparations now deposited at Glasgow, where they are injected with wax. These, however, were less exactly tubular, and of a less firm consistence, than what were seen in the uterine vessels. Other concretions of plastic lymph within vessels were observed in the substance of the remnant of the placenta. They were the same in their nature, but less distinctly tubular.

On cutting into a dark puckered spot in the left ovarium, a corpus luteum was discovered, having a fleshy disc, and a firm white substance in the

centre.

The preparation is in my possession.

College of Physicians and Surgeons, Upper Canada.-We learn from our correspondent, Dr. Lucius O'Brien, that the following gentlemen constitute the board of officers of the College of Physicians and Surgeons of Upper Canada :—

President, Christopher Widmer, Esq.; Vice President, John King, M. D.; Tresaurer, R. C. Horne, Esq.; Secretary and Registrar, Lucius O'Brien, M. D.; Censors, John King, M. D., Lucius O'Brien, M. D., Walter Telfer, Esq., W. C. Gwynne, M. D., George Herrick, M. D.; Inspector of Apothecaries' Shops, John King, M. D.

Medical Almanack.-We have not received-doubtless owing to accident the Medical Almanack, by Dr. Smith, the able editor of the Boston Medical and Surgical Journal. Such a work, carefully executed, and yearly improved by successive additions, and corrections, cannot fail to be well received by the profession.

Northern Dispensary of Philadelphia.-The Northern Dispensary for the Medical Relief of the Poor of Philadelphia-with a copy of the Rules, Regulations, and By-Laws of which we have been favoured by Dr. Thomas H. Yardley, one of the Consulting Physicians to the Lying-in Department -is one of those excellent charities which shed their blessings on the locality in which they are situate. It has been established twenty-three years, and has been instrumental in furnishing relief to 18,846 persons. During the past year, 409 cases have been treated; and 24 obstetrical cases have occurred in the lying-in department.

The disbursements of the institution amount to $1916.51.

Gross's Pathological Anatomy.-We are glad to find that this valuable work meets with high commendation from the medical press.

THE

AMERICAN MEDICAL INTELLIGENCER.

Vol. III.

March 1, 1840.

No. 23.

ART. I.-ON SOME STATES WHICH RESEMBLE INFLAMMA

TION.

BY WILLIAM BROWN, F. r. s. e.'

Fellow of the Royal College of Surgeons.

It is strange that, while the cultivators of medicine are so numerous, and their zeal and assiduity so thoroughly unwearied, it should still be a matter of question whether the art be now in a progressive state. The more gene

ral and perhaps the nearly unanimous opinion is, that medicine is advancing with a steady progress to perfection, but, meanwhile, a few names, not undistinguished in science, maintain that there is no real progress, or only progression in the circumference of a circle, that is, constant motion, but, at the same time, constant return to the position formerly occupied. Dr. Francis Home, in his Treatise on Croup, published in 1765, observes that "the science of medicine has been gradually advancing for the 2000 years bypast, and is now brought to a great degree of improvement, perhaps to as great, every circumstance considered, as the difficulty of the art, the limitation of the human faculties, and the continual attempts to further refinement, too often conducted merely by fancy, will admit of." We smile at the boast of Dr. Home, and think of the improvements and discoveries since his day; but we are as ready to plume ourselves as he was on the existing state of medicine, and we find nearly his own expressions made use of by writers of the present period. But what are the real facts of the case? Is medicine truly progressive, or is it stationary ?

When we think of medical hypotheses, we may very readily adopt the latter opinion. We observe now the same restless search after first principles, and the same disposition to gather these from a few observations, which characterised the more ancient physicians; and even the younger members of the society will recollect opinions started by their zealous inventors as irrefragably certain, which a very few years have first undermined and then demolished. With regard to new diseases, do we not find hints of almost every one in the older authors, and do not the critics of the present day often detect in this way the plagiarism of modern discoverers? If we turn our attention to remedies, we find much to discourage our boastings. Disease appears to be as rife as it was in former days, and our vaunted improvements in the materia medica have not made death less frequent than before, have not added to the average duration of human existence. Increased longevity has not yet been attained, and if there be any diminution in the rate of mortality, it is attributable, not to the increased power of medicine, but to those happy arrangements of modern civilised society which have prevented the frequent occurrence of famine and of its

'Edinb. Med. and Surg. Journal, Oct. 1839. p. 342.