ART. I.-ON THE SEDATIVE PROPERTIES OF ERGOT. [In the first volume of the "Intelligencer," on the occasion of a communication from Dr. Bishop, of New Haven, we drew attention to the investigations of Professor Hooker, of Yale College, into the properties possessed by the ergot. We then stated, that Dr. Hooker found-when a quantity of pulverised ergot was macerated for several days in sulphuric ether, and the liquid was evaporated in a glass vessel until it no longer afforded the smell of ether, there remained, at the bottom of the vessel, a small quantity of thick heavy oil, resembling, in appearance, fish oil; above this was a lighter oil, much more abundant than the former, of a light reddish-brown colour, and of a sweetish nauseous taste. This light oil was found, by Dr. Hooker, to possess narcotic properties; and—as he has repeated to us within the last few weeks-invariably acts, according to his experience, as a sedative, reducing the force and frequency of the pulse to a degree not to be mistaken.

Desirous of examining into this subject still farther, we requested Drs. Cottman and McKee, two intelligent resident physicians of the Philadelphia Hospital, to institute trials both with the preparation of Dr. Hooker, and the ergot, itself in powder; and it will appear, from the following communications that the narcotic effects were decided; that in some cases the sedative was not readily separable from the nauseant effect; but that even where nausea was not induced, there could be no doubt as to a resulting action of sedation.-Ed.]

Experiments with the Secale Cornutum, in Powder.

Cottman, M. D.

By Joseph B.

The subjects of these experiments were strong, healthy men, but lunatics. A diminution in the frequency of the pulse, and, in several, of the volume, were the only phenomena observed, except in three cases; in these, it produced slight nausea, but no vomiting; in two others, to whom it was given the day before, violent emesis was brought on in the course of one hour. When administered in half dram doses, it either produced nausea—and, consequently, sedation--or diminished the frequency of the pulse, without nauseating, in the course of twenty-five or thirty minutes; but, when given in scruple doses, it appeared to excite rather than diminish the pulse in that.. time; in fifteen or twenty minutes, however, the pulse lost a few beats in the minute, but not to the same extent as when given in larger doses: in

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several cases it produced little or no effect when given in the smaller doses. No other cause operated in producing this result, unless we presume that the fact of giving the men medicine when they were in health, excited them; and as I examined the pulse in every case just before giving the medicine, and forty or forty-five minutes afterwards, the excitement might have passed off, and, consequently, the pulse be diminished in frequency; this, indeed, is not unlikely, as the pulse, in several cases, was much above the natural standard.

It is necessary, I need scarcely say, to be very cautious in drawing conclusions with regard to the medical properties of any drug from a limited number of experiments, but I think we may safely infer, that the ergot has a power of depressing the pulse when given in large doses, but may question very much its sedative agency in small doses. The following is a list of the cases. The age of each individual is affixed to his name.

Dear Sir,-At your request, the ethereal preparation of secale cornutum was given in several cases in the dose of from ten to forty drops.

It was used in two cases, both of which were opium eaters. On the fir it had little or no effect; at first, she seemed quiet, but soon found, from he feelings, that she had been persuaded to take that which was not laudanum at It was administered in the dose of gtt. xl., and under the belief, on the par

of the patient, that it was laudanum. The second appeared to be quite composed for upwards of an hour. The pulse became less frequent, though nausea supervened, and in the course of a few hours was followed by very violent purging.

In every case, in which I prescribed it, it at first produced slight exhilaration of spirits, with increased frequency of pulse; but when the largest dose -forty drops-was given, nausea supervened, and consequent sedation. The smaller doses, however, were equally followed by signs of depression. When the dose exceeded thirty drops, nausea generally resulted. Professor Dunglison. W. H. McKEE.

For the American Medical Intelligencer.

ART. II.-ON THE USE OF COLD WATER IN UTERINE HEMORRHAGE.

BY W. J. DUFffee, m. d. oF MOYAMENSING.

On the 4th November, 1838, at 9, A. M., I was requested to call upon Mrs. S., aged about 40 years, who was supposed to be in labour with her eighth child. Complying with the request, I found her complaining of constant pain in the lower part of the abdomen-pulse small and frequent-labouring under great depression of mind as to her approaching accouchement; said "she was sure she would never get over it." Ordered half a tea-spoonful of tincture of hops, and the room to be darkened, for the purpose of enabling her to obtain a little rest, she having passed a sleepless night. In a few hours I returned-found the medicine had the desired effect-patient more composed in mind-pains had shifted from the bottom of the stomach to the lower part of the back; the os uteri had commenced dilating; every thing went on regularly, and at the expiration of four hours from the time I was called in, she was delivered of a fine male child. The child and placenta were thrown off together. Being informed by the husband, that she had been subject to flooding after delivery, I had her bandaged tightly and kept perfectly quiet in the recumbent posture, not even allowing the limbs to be moved; frictions with the hand were then made by an assistant over the uterus. At this time the patient complained of no pain whatever. Things continued in this state for half an hour or more, when she suddenly screamed out "I am fainting." Suspecting internal hemorrhage, I immediately placed my hand on the abdomen, and found it larger than before delivery. Having recovered, ergot in scruple doses was administered every fifteen minutes; constant frictions on the abdomen; ice to the vulva; but all these remedies were of no avail, the blood continuing to flow, having been momentarily checked, however, by the fainting.

I removed the ice and filled the vagina with cloths wrung out of ice water; but this did not prevent the return of the hemorrhage. I then introduced my right hand into the uterus, and with my left on the abdomen made pressure on the vessels themselves: this for a time seemed to have the desired effect, when the blood gushed out in a torrent, and she again fainted. I had now made use of every remedy with which I was acquainted, excepting cold water. To the use of this, however, the family objected, as they said they were confident she was dead or dying, and that it was useless to torment her. Finding it impossible to overcome their scruples on this point, I insisted on a consultation, still keeping my hand in the uterus. Dr. B. H. Coates being sent for came immediately to my assistance, who, finding that every thing we could think of had already been done, agreed, as the last resource, to use cold water: she seemingly being in a dying condition. Her abdomen was covered with a thin sheet to prevent exposure, and the water poured at a height from a pitcher. The shock experienced was great, caus

ing the patient to open her eyes and, with an almost inaudible voice, to complain of being cold, and now, for the first time, of pain. The water was continued for a few minutes longer, when the uterus began to contract. In about twenty minutes she again fainted; at this time the discharge was inconsiderable, notwithstanding which the water was again resorted to with the same happy effect. The uterus could now (five hours after delivery) be felt in the left iliac fossa of the size of an ordinary fist; pulse scarcely perceptible; face remarkably blanched.

We now administered 2 grains of carb. of ammonia every ten or fifteen minutes during the space of an hour or more, and then enjoined perfect quiescence.

5th. Skin hot; pulse small and frequent; ordered acid. sulphur. dil. gtt. v. every two hours; diet, oat-meal gruel.

6th. Complained of violent pain in the head; carotids throb violently; face flushed; pulse full; cannot bear any one to walk across the room; ordered ten drops of sp. of nitre every hour; acid discontinued; diet, gruel; drink, barley water.

7th. Feels better, though nervous; when well, had of late made use of assafoetida pills; sp. of nitre discontinued; tea-spoonful of lac assafœtidæ three times a day.

Sth. Fever entirely subsided; lochia continue; has a considerable quantity of milk; ordered chicken water.

9th. All things going on favourably; bowels opened twice since yesterday.

10th. Convalesces rapidly; sitting up in bed.

19th. Down stairs and attending to her ordinary duties; says "she is perfectly well, and never felt better."

It might be thought an exaggeration were I to name the supposed quantity of blood lost by this patient. This much, however, I may say: her bed was soaked through, and a tub that had been placed under it was a third or more full.

She was, at the time of her lying-in, labouring under ptyalism, produced by the administration of a dose of calomel and jalap to relieve her of costiveness, previous to my attendance. She also states, that from the time she first felt the motion of her child until the day of delivery, she had been subject to a constant pain in the region of the uterus.

The placenta was of a very extraordinary size, several patulous vessels were distinctly seen on its uterine surface, a considerable portion of which was covered by adherent coagula; the cord was thick and short.

I am perfectly satisfied that this patient must have perished had we not made use of the cold water, applied as above. All remedies, generally resorted to on such occasions, had been tried, and ample time allowed for their operation, and not one had the effect of producing any pain or contraction of the uterus, on which hangs the patient's only hope of safety.

I therefore respectfully urge its claims on the profession as a remedy of the greatest importance in uterine hemorrhage consecutive to delivery. Professor Dunglison.

Respectfully,

W. J. DUFFEE.

ART. III-A CASE OF SPERMATOCELE, OR VARICOCELE, TREATED BY EXCISION OF A PORTION OF THE SCROTUM.

BY BRANSBY B. COOPER, F. R. S.1

In the last number of the Guy's Hospital Reports, there is a paper published by Sir Astley Cooper on the subject of spermatocele, in which he has introduced to the notice of the profession a novel mode of treating that

1 Guy's Hospital Reports, No. viii. April, 1839, p. 201.

disease; the principle of which, it appears, is founded upon the changes induced upon the structures composing the scrotum.' According to Sir Astley Cooper, the process, by which the ultimate benefit is effected, is the contraction and increased firmness of the remaining parts, in consequence of which they perform the office of a permanent and accurately-adjusted bandage, providing a general support to the diseased vessels.

This view of the subject, as well as the operation founded upon it, being entirely new, I have thought that any additional facts bearing upon, or illustrative of the matter, could not be unacceptable to the profession. I have therefore been induced to publish the following case; more especially as the result of it, on being laid before Sir Astley Cooper, drew from him the following note:-"The case of spermatocele you have sent for my inspection is singularly gratifying to me: the operation has been more successful than in any instance in which I myself have performed it."

About three months ago I was consulted by a young farmer from the Isle of Sheppey, who had been the subject, for more than two years, of a varicose state of the veins of the left spermatic-cord, which had produced a more than usual degree of corporeal and mental suffering. Upon examination, I found the scrotum nearly double its natural size; and on the left side so pendulous as to reach at least a third lower than on the opposite side. The spermatic cord, between the testicle and the external ring, presented the appearance of an irregularly-formed tumour, which was readily diminished in size by gentle pressure towards the abdomen, or by the recumbent posture. The slightest manipulation produced considerable pain, both in the testicle and in the course of the cord; and the testicle itself was wasted, and denoted all the usual signs of an irritable condition. The enlarged veins, contained within, or rather forming the spermatic tumour, upon being rolled between the fingers, gave the ordinary sensation of strings of whip-cord, or a collection of earth-worms passing over the fingers which readily sunk into the interstices between them. Within the last two months some slight enlargement, accompanied with pain, commenced on the right spermatic vessels, which were, at the time of examination, abnormally distended.

The patient complained of a constant sense of weight, attended with a heavy dull pain, extending from the testicle, along the spermatic cord, to the loins, with an habitual feeling of restlessness and anxiety. His appetite was impaired, and a constant depression of spirits induced him to seek medical relief. All the usual remedies had been employed, as purging,' recumbent posture, suspensory bandages, and cold applications; but ineffectually. On questioning the patient as to the probable cause of the complaint, he could attribute it to none of the usual local causes, as a blow, &c., but admitted that he had always been more or less affected with a constipated state of bowels. I therefore proposed to him, that he should return into the country, submit himself to the continued influence of purgative medicine for a short time, abstaining from all violent exercise; and that if this plan did not remove his disease, I would attempt a radical cure, by the operation of excision of a portion of his scrotum. To this he readily acceded; seeming willing to submit to any temporary pain, rather than bear his protracted suffering. He therefore returned home, strictly adhered to the prescribed discipline for six weeks; at the end of which period, finding himself in no way improved, he came to London, determined to undergo any operation which could offer him a hope of permanent relief from his pain and anxiety. On the 8th of February, assisted by my friend, Mr. John Birkett, I performed the operation of excision of a portion of the scrotum, as recommended by Sir Astley Cooper. I proceeded in the steps of the operation in the following manner:-The patient being placed in the recumbent posture at

1 This paper of Sir Astley was printed in the volume of " Medical Monographs" of the "Library" during the last year.-Ed.