Gambar halaman

as it regards leucorrhea. That inflammation of the vagina, and often of the neck of the uterus, precedes leucorrhæa, no one will deny; and we are prepared to admit with Dr. Bennet that, after no long time, ulcerations of the cervix uteri frequently occur; but this does not account for uterine leucorrhæa,-in which the discharge comes from the cuvi'y of the uterus,

The author makes what he considers “a fundamental and most important distinction between inflammations and ulcerations which occur in the uterine neck of females who have never conceived, and those which take place in the same region in females who have conceived--that is, who have either miscarried or borne children.” In the consideration of these diseases, he carries this division throughout the hook; and in doing so, we cannot doubt that he magnifies unduly the influence of conception on the permanent condition of the parts. Those who bear children, and especially those who suffer frequent miscarriages, are undoubtedly most prone to inflammation and its consequences in the sexual organs, if we except prostitutes, with whom such complaints are almost universal, whether they have conceived or not. It is rare to meet with a woman has been long “on the town” who has not more or less disease of the neck of the uterus, although she may never have suffered from any of the forms of syphilis; nor is it rare to find individuals who have conceived, and even borne one or more children, in whom the condition of the neck of the uterus has returned in its physical condition very nearly to the virgin state-to a condition in no respect less healthy than before conception.

The following fact noticed by the author is one of great importance in practice, and often not appreciated by the prac. titioner.

“ The size and length of the cervix uteri vary considerably in different females-a fact which must necessarily be taken into consideration if we wish to appreciate the existence or non-existence of engorgement, or morbid increased volume, of the organ. Indeed, these physiological (anatomical) variations are so great, that were we to allow ourselves to be guided by size alone, as appreciated by the toucher or speculum, we should, undoubtedly be often misled, and induced to suppose that disease existed when it did not. In reality, a very voluminous healthy cervix uteri is perfectly compatible with entire freedom, even from un. VOL. X.


easy sensation. The difference in length of that part of the cervix uteri which projects into the vaginal cavity, is evidently owing principally, to the vagina being implanted, as it were, at different heights on the cervix, so that in some females it is merely a few lines in length, whereas in others it is an inch and a hall, or more. This physiological elongation of the cervix uteri may, it appears, be carried to such an extent, that its free extremity reaches the orifice of the vulva. Dr. Henning, in his essays on nterine diseases, lately published in The Lancet,' mentions several curious cases of the kind."

The following observations on the subject of hypertrophy of the cervix accords so fully with our own experience, that we cannot refrain from calling the attention of the profession to their importance.

“If the hypertrophy is considerable and general, the prolapsus of the cervix is constant, the irritation great; and ulceration and abundant lencorrhea are nearly always present. If inconsiderable, or limited to one region of the cervix, the surface of the organ may be free from the disease, and the uterus may prolapse only after long standing, or walking or great fatigue of any kind. These are by no means uncommon states. Indeed, I have no hesitation in saying, that a very large proportion of the cases, both of slight and of severe uterine prolapsus, which are met with in practice, and for which pessaries are so improperly used, are the result of chronic hypertrophy of the uterine cervix.”

[ocr errors][ocr errors]

We would even go further than the author, and say that a large number of the cases treated as prolapsus are either simple inflammation of the cervix or engorgement of the uterus, which result in ulceration or hypertrophy from neglect, and too osten from the irritation produced by the improper use of pessaries and other means for the cure of simple prolapse proceeding from relaxation of the interine supports.

The author witnessed the treatment of a great many cases of cancer of the uterus in the Parisian hospitals, and the following is the result of his observations.

“I have hitherto always found cancers of the cervix uteri, whether ulcerated or not, incurable; like cancer in other parts of the economy. In other words, I have never seen an evidently cancerous tumour or ulceration of the cervix, respecting the existence and identity of which there was not a shadow of doubt,

cured—that is, dissolved, removed, either by local applications or by general treatment."

Of " localized cancer of the cervix,” treated by amputation, he witnessed no better results. “ The cases in which it (amputation) has been performed successfully, are generally considered to have been merely cases of inflammatory induration of the cervix,” in which he thinks deep cauterization is a much safer remedy.

The Dog. By WILLIAM YOUATT, Edited, with additions, by E.

J. Lewis, M. D. Member of the Academy of Natural Sciences of Philadelphia; of the Philadelphia Medical Society; of the Parisian Medical Society, etc. 8 vo. pp. 403. Lea & Blanchard, Philadelphia, 1847.

To the lovers of the dog, and who does not love that brave and devoted animal?) this is a most acceptable volume.

Not only to the sportsman and the naturalist, but to the physician, and the housekeeper of every grade, the history of this faithful and sagacious animal,--his diseases and his habits,- is full of interest. "The dog, next to the human being, ranks highest in the scale of intelligence, and was evidently designed to be the companion and the friend of man." "Man,” says Burns, “is the God of the dog; he knows no other; and see how he worships him. With what reverencc he crouches at his feet-with what reverence he looks up to him—with what delight he fawns upon him, and with what cheerful alacrity he obeys him!” An animal that guards us while we sleep, enjoys our pastimes, and watches with almost parental care the tottering footsteps of our children, has strong claims on our benevolence, and it is the duty of those who exact his services to minister to his wants not less in sickness than in health. To do this effectually, they must study his constitution, his habits, his diseases and their remedies. To all such we commend Mr. Yonatt's book. The medical reader will be surprised to learn from its pages “how many ills that animal shares in common with the human race;" whilst the general reader will find its pages rich with anecdotes and varied informa. tion. No inconsiderable part of this has been supplied by the editor, who has, indeed, performed his part with much care and ability.

The work is beautifully got up by the Philadelphia publishers -paper, typography, binding-every thing is in keeping. The engravings representing the varieties of the dog are by Gilbert & Gihon, and are well executed.

A System of Human Anatomy, General and Special. By

Erasmus Wilson, M. D. Lecturer on Anatomy, London. Third American, from the third London edition. Edited by Paul B. GODDARD, A. M., M. D. Professor of Anatomy in the Franklin College of Philadelphia. With two hundred and thirty-three illustrations by Gilbert. 8vo. pp. 610. Lea & Blanchard: Philadelphia, 1847.

Since the publication of the former American edition, a third edition has been issued by the author in London, containing some additions and improvements. The present edition, we are assured by the editor, "is a careful and exact reprint of the English work, with the addition of such other illustrations as were deemed necessary to a more complete elucidation of the text.” Thus it will be seen that the value of the present edition is materially enhanced over that of its predecessors, and in its present improved form offers to the student all the assistance that can reasonably be expected from such a work.

Second Annual Announcement of the Medical Institute of Cin

cinnati, Session of 1947. The lecturers of this Association are Drs. Judkins, Woodward, Warder, Kendrick, Vattier, Mendenhall, Raymond, and Stuart ; several of whom are advantageously known as contributors to the Medical Journals, and all, we have no doubt, well qualified for the duties they have assumed. The lectures are to commence on the first Monday in March, and continue four months, embracing all the subjects usually taught in summer schools.

We are glad to see our younger brethren in the Queen City of the West," exerting themselves in increasing the facilities for gaining instruction in their beautiful town. We have ever regarded such enterprises favourably, and can see no reason why the attempt should not succeed in a city of so large a population as Cincinnati, when made in the right spirit and sustained with becoming energy. From the impossibility of carrying on dissections, and of giving demonstrations in anatomy on the recent subject, during warm weather, a full and complete course on all the branches of medical education, such as is necessary to qualify a young man for graduation, cannot be expected, even if it were possible, which no one will pretend, for the student to undergo the fatigue, in hot weather, of following the requisite number of lectures each day to complete the whole in four or even six months but attendance on one or two lectures a day will hardly be too great a tax upon his health, while it will materially assist his comprehension of what he reads; and when the subjects taught are collateral, and not mere repetitions of the winter lectures, great advantage must accrue to the industrious learner.


Remarks on the use of Quinine in Intermiltent and Remittent Fevers. By L. A. Dugas, M. D., Professor in the Medical College of Georgia.--Having received during the past season a number of coinmunications requesting my views on the use of quinine in the treatment of our autumnal fevers, I beg leave to reply to them through the medium of this Journal.

The fevers of this section of our country being almost exclusively paroxysmal, it may be well to premise, very briefly, my views of Their pathology, by which it will be perceived that I regard them as essentially different from those continued fevers more commonly encountered in colder latitudes, and which have been denominated Typhoid, Typhus, Follicular enteritis, Dothenenteritis, Jail fever, Ship fever, &c.

Our paroxysmal severs are either intermittent or remittent at their onset ; but, if not arrested, the former may, more or less early, become remittent, or the remittent assume the intermittent type ; thus showing them to be only different degrees of the same disease. They both present the same paroxysmal phenomena, that is to say,

« SebelumnyaLanjutkan »