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January, 35; February, 25; March, 27; April, 22; May, 26; June, 30 July, 26; August, 30; September, 32; October, 35; November, 45; December, 49.

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Of the total number of deaths, 258 were males and 122 females; 138 were born in California and the Pacific States; 121 in the Atlantic States of North America, and 121 in foreign countries.

Ages.-Under 1 year, 84; 1 and under 10, 57; 10 and under 20, 17; 20 and under 30, 30; 30 and under 40, 83; 40 and under 50, 54; 50 and under 60, 32; 60 and under 70, 10; 70 and under 80, 4.

The mortality for 1852 was 353, or 27 less than for 1863.

Health of San Francisco.

DURING the month of December, the total number of deaths was 295-the largest monthly mortality on record-being 54 more than for the month of November.

Of the 295 deaths, 206 were recorded at the Lone Mountain cemetery, of which 51 were under three years; 83 in the Roman Catholic burying ground of which 25 were under three years; and 6 in the Jewish cemeteries.

The principal causes of death were reported as follows: Consumption, 33; other lung diseases, 12; brain diseases, 6; heart diseases, 4; liver diseases, 1; enteritis, 1; fever, 3; typh fevers, 10; congestive fever, 1; scarlet fever, 8; diphtheria, 10; croup, 4; whooping cough, 2; erysipelas, 2; convulsions, 7; tetanus, 1; paralysis, 3; neuralgia, 1; influenza, 1; gangrene, 2; general debility, 5; still-born, 12.

Comparative Table of Monthly Mortality in San Francisco for the Years

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Notwithstanding the unusally large mortality during the three last months of 1863, the total number of deaths for the whole year does not, as might be supposed, exhibit an unfavorable result. Compared with the total

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number of deaths for 1862 (2194), the total number for 1863 (2300) shows only an increase of 106. If we take into consideration our gain in population, we will find that the difference does not change materially the ratio of of mortality to the population, and that the proportion in this respect for 1863 does not differ much from that of 1862.

According to the table compiled by Mr. Henry G. Langley, the population of San Francisco was estimated August 1, 1863, at 103,400.

Taking this estimate for basis, the ratio of mortality for 1863 was about 1 in 45-a ratio which still continues to maintain for our city her high reputation for healthfulness.

We regret that the imperfect and unreliable manner in which the causes of death have been stated, prevents us from giving more complete and useful annual statistics of the mortality among us. Strange as it may appear, the certificate of a physician, specifying the cause of death, is not required in San Francisco! Therefore, the various causes assigned cannot be deemed reliable, and in a large number of cases no causes whatsoever are entered upon the books.

Reform in this respect is much needed. General statistics, informing us annually of the character-the mode of termination—the seasons of various diseases, and the different ages of their victims, are, to us, of primary importance. They fix our attention on the most important maladies, and lead us to the study of their causes, cures and means of prevention. And, especially, is this desirable in a region newly populated, and a city born of yesterday.

THE

Pacific Medical and Surgical Journal.

SELECTIONS.

Annual Meeting of the Ohio State Medical Society.

We make the following abstract from the Transactions of the Eighteenth Annual Meeting of the Ohio State Medical Society:

ON THE EMPLOYMENT OF ELECTRICITY IN MIDWIFERY.

BY D. S. GANS, M. D., OF CINCINNATI.

Electricity has in modern times been variously employed in midwifery with undoubted and good success. This result could, a priori, be expected as the uterus, a perfect muscular organ, could not possibly be exempted from electric impression. The experiments of E. Weber had already proven that the uterus contracts by the electric current. "The gravid uterus of a dog," says Weber," contracted by galvanic impressions at all points touched by the wires, and the contractions produced lasted for a long time after the impressions had ceased; and also in the non-gravid uterus of a rabbit I have observed visible contractions by the galvanic stimulus. Mackenzie convinced himself also by repeated experiments on animals that the uterus contracted energetically and promptly by electric impressions. Experience has now taught that electricity, according to these views, is a certain means to produce uterine contractions, and that its employment has consequently proven highly successful in many cases of hæmorrhages which happened before and and after delivery in consequence of deficient contractions of the uterus, and which only cease after a quick expulsion of its contents. It was employed also with equal and good success in tedious labor, in consequence of too weak labors, or in total inaction of the uterus, and finally for the production of (artificial) premature labor.

Nothwithstanding all this, we do not see this agent employed in this country,--not even subjected to a trial, nor treated of by authors of obstetric works, although the observations and experience of a good number of very respectable physicians of Europe, principally of England, has shown that electricity is of great value in many cases,-even not to be replaced in certain cases by any other agent. The subject is, at any rate, unquestionably of such vast importance that I considered it worth while to make it the subject of my report for the purpose of directing your attention to it.

Perhaps a brief historical review of the cases already known, or rather of the physicians who have employed it, might, in the absence of any considerable experience on my part, tend that this method be practically tested and its merits recognized. We will, therefore, discuss the various cases in which electricity becomes indicated, and draw from the experience of others as many proofs as possible; and finally enter into an explanation in what manner we have to employ it, according to present views and experience.

ARTIFICIAL PREMATURE LABOR.

The introduction of premature labor is, according to the opinion of most modern obstetricians, principally indicated where, in consequence of a positively narrow pelvis, it is certain that a foetus at maturity can neither be delivered by the efforts of nature nor by the usual artificial means; or in cases of diseases which greatly threaten the life of the mother, and which can only be preserved by an abbreviation of the pregnancy. We then produce labor pains at a period when the foetus is capable of living outside of the uterus; and we accomplish this by means which cause such strong and lasting uterine contractions that the labor will be finished by it. To that end various methods have been recommended, which partly act by dilatation and distention of the os uteri, partly in the way of reflex action. But already the fact that for this operation so many and so various methods have been recommended, proves that not one of them is without objection.

Electricity applied to the uterus ought to be able to induce labor with more safety, and quite analogous to the natural process of parturition.

In 1843, Schreiber proposed to produce premature labor by galvanic electricity. Of the advantages of this method, he remarks quite correctly, "that labor may be induced by this power in a manner corresponding to the natural process, with first slight and gradually stronger pains, first in longer and then in shorter intervals; that this process, moreover, remains entirely in the hands of the midwife, who may, according to circumstances, hasten retard or arrest it." In Germany this proposition has been carried out only by a few, the principal of whom seems to be Benj. Frank, who recommended this method strongly, citing several cases of profuse hæmorrhage in which he used electricity with perfect success after several other remedies had failed. In another case, in which the conclusion of the labor was very desirable, and circumstances not admitting the use of other means for that purpose, he resolved to employ the magnet electricity; and the success was such a surprising one that he employed it from that time on in all cases where he found indication to cause labor pains, except in those where electricity was positively contraindicated. But for the purpose of producing premature labor he advises first to dilate the os uteri by a press sponge, so as to imitate nature, which begins the normal process of labor by exciting the spinal marrow through the action of the foetus upon the uterine nerves. After that no agent is more capable, he says, to call forth stronger and more lasting pain than the magnet electricity. He is supported in this opinion by Drs. Jacobi and Honingev, who, amongst several cases, report one of artificial premature labor. Violent asthmatic attacks, and spasms gave indication to artificial premature labor. They applied the press sponge and gave infusion of ergot. The os uteri dilated about the width of two and a half fingers, but the labor pain ceased; and when the general condition of the woman demanded a conclusion of the labor, they concluded to use electro-magnetism. The apparatus hardly acted half a minute when a strong and lasting labor pain resulted, returning whenever the poles were applied. One conductor was placed to the os uteri, the other to the left side of the abdomen.

Much more extensively, with more perseverance, and consequently with better result,electricity was employed in England, where it was first introduced into the obstetric practice by Radford. He first tried this method on a patient

in whom profuse internal hemorrhage had taken place during labor, and he became convinced that galvanism produced tonic and periodically returning contractions of the uterus by applying it from time to time. "From the moment the circle was complete," says Radford, (London Medical Gazette, 1845, Jan.,) "uterine pains were excited, and a bearing down effect produced. The effect was observed to be more or less intense according to the length of time the conductors were allowed to remain. The uterus was felt to be tonically contracted during the intervals, and this effect was increased after each temporary action induced by the application of the connecting rod." In another case, in which he used electricity on account of profuse hæmorrhage before delivery, he saw the hæmorrhage immediately diminish, and finally cease altogether, by the application of the conductors. The os uteri became softened, and after six hours was sufficiently dilated to permit the child to be delivered. The placenta was also expelled without any assistance. No further hæmorrhage took place, and the uterus felt firm and contracted.

Against these observations of Radford, Dr. Simpson (Dublin Medical Journal 1852, Feb.,) steps forward with eight cases in which electricity was employed without producing uterine contractions. Whilst Radford and others assert that electricity is capable of exciting contraction in a yet inactive uterus, as is needed for the production of premature labor. Dr. Simpson denies to this agent any effect. But he says it would be hasty and illogical to conclude, after the existing trials and observations, that galvanism was not capable, under some modification and by some mode of application, of producing labor pain or increasing uterine action. New methods of application may be discovered, leading to different results.

The experience of numerous observers, as Dorrington, Demsey, Golding, Bird, Barnes, Mackenzie, Houghton, and others, speak against this opinion of Simpson. Th. Dorrington, reports for instance, in the year 1846, five cases in which he employed galvanism according to Radford's directions. In all of these cases the uterus became hard and firm during the action of the electric current; contractions took place immediately, which had the desired result. He also reports, in 1849, two cases in one of which premature labor

became necessary on account of narrow pelvis. When the applied press sponge had no effect at all, he resorted to galvanism, using it for twenty minutes in intervals. Tonic contractions of the uterus and labor pain succeeded, and a dead child was born after forty-three hours. Dorrington hence declares, that he is convinced that galvanism is a very effective means, even at perfect inertia of the uterus and after all other means have failed, and from which no bad consequences can result.

Of particular interest are the observations of Demsey, who used in twenty cases the usual electro-magnetic apparatus. Of these, seven were hæmorrhage before and after delivery; eight amenorrhoea; one, retarded labor in consequence of atony of the uterus; one, hæmorrhage in the third month of pregnancy without uterine contractions; one, artificial premature labor at the seventh month, on account of pelvic deformities; two passive hæmorrhages with fibroid in the os and neck of the uteri. Dempsey concludes, according to his experience, that-"1. Electricity is capable of increasing an already existing action of the uterus; 2. The electric current can excite uterine action de novo, the organ being predisposed to it, be it by congestion, peculiar nervous condition, or by mechanical action of its contents; 3. It is necessary to use it in accordance with nature, at intervals; 4. The use of the current is not associated with bad consequences."

Robert Barnes reports (London Lancet, vol. ii., 20,) another and later case of Dempsey. It became necessary to procure premature labor. For that purpose the membranes were ruptured and a press-sponge applied; but no sign of uterine contraction followed. Electricity was then employed for half an hour; the os uteri dilated soon, and the labor was finished. Barnes

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