I did not venture to apply the sponge long enough to produce a complete lethargy, but removed it when her opposition to its application in a measure ceased. I was fearful, if a complete state of lethargy was induced in her then low condition, she might not react. After being three hours and a half under the influence of the ether, the uterus was sufficiently dilatable to admit of the gradual introduction of the hand, the membranes which were still entire, were ruptured, and I succeeded in obtaining one foot, which was brought down and secured with a tape. Owing to the ungovernable restlessness of my patient, and to the powerful contractions of the uterus, I had great difficulty in finding the other; and when I had succeeded in getting it partly down, it offered so much resistance to my efforts, that I was apprehensive it might not be a fellow to the one I had. After comparing the direction of the toes, I ventured to exert a little more force, and brought away the child.

It was still living, though much exhausted, the lungs required. inflation before it breathed, but after respiration was once established it did very well. The placenta came away promptly, and there was no flooding.

No vapour was given after the child was delivered. The mother still continued in a stupor, with convulsions at intervals of forty-five minutes, till 4 o'clock next morning, when they ceased. She took, during the night, as an antispasmodic, forty drops of tr.assafœtida in milk, at intervals of two hours. In the evening her pulse was one hundred and twenty-eight, and quite feeble. I should mention that the convulsions had diminished in force, and continued to do so till they ceased.

At eight in the morning, the stupor still continuing, she took ten grains of calomel, and in one hour a tea-spoonful of fluid ext. of senna, which was repeated every hour for four hours, when it operated on the bowels, producing copious black and very fetid evacuations. From this time she recovered rapidly: the day following she noticed some things and answered questions. Her tongue had been sadly bitten; she could not account for its soreness; has no recollection of any thing that has occurred, and thinks it strange that her child could have been born without her knowledge. In two weeks she was about her room, having convalesced rapidly without an unpleasant symptom. The child, a fine boy, is doing well.

CASE 5th. September 4th, at 3 o'clock, A. M., I was called to see Mrs. of Lower Merion, in labour with her third child. She had been complaining all night. Her pains, when I first saw her, were not so frequent, nor so severe as they had been for some hours previous, and they continued to decline till they passed off altogether for a time during the middle of the day.

They again cane on in the afternoon with more force and increased frequency. An examination shewed that no progress whatever had been made in the labour. The usual vaginal secretion was wanting, the vagina being preternaturally dry and rigid. On inquiry I found that there had been a leucorrhoea of some standing. As there had been no progress, I left her, and returned at 7 o'clock. An examination now shewed the labour to be progressing rapidly; the os uteri was well dilated, the head presenting with the vertex to the left acetabulum. The membranes were not ruptured, and the secretion of mucus quite abundant. I ruptured the membranes, after which the pains became very severe. I now suggested the use of the ether to my patient and her friends, to which they immediately consented. In a minute after the application of the sponge, she began to talk in an excited strain on subjects unconnected with her case, till a pain came on, when she spoke of it in a light and merry mood, repeating the words, "a pain! a pain!" rapidly and mincing her words in such a way as to convey the idea that she was suffering very little. During the intervals between the pains, she talked wildly and incessantly, even when the sponge was applied to her face.

Her pulse was eighty-five when she commenced taking the vapour; it fell to seventy-six, and after she ceased to inhale, it rose to ninety-six. She seemed conscious of relief from the inhalation, and would call for more gas as she termed it, inhaling it with eagerness. She frequently remarked that she knew perfectly well what she was doing, knew her friends who were present, although she would call for them as though they were out of her sight, asking where they were when they were standing immediately over or by her. She boasted that the gas could not affect her: that her mind was superior to its influence. As the labour approached its termination, she seemed to suffer acutely, screaming violently, asserting that she would die,-"all your gas wont save me!"

At five minutes to 9 o'clock, P. M., 'she gave birth to a large male child, much larger than either of her others had been. She appeared to be perfectly conscious of its birth, but remarked, although she had suffered so much and complained so bitterly, that she could not have lived through it, if it had not been for the gas. This she repeated several times, after she had ceased to inhale the vapour, and after its effects had passed off.

The placenta came away in eight minutes after the birth of the child. There were no unpleasant symptoms, and the convalescence was rapid. A slight degree of inflammation of the child's eyes, which shewed itself in a few minutes after its birth, and which was attributable to the leucorrhoea of the mother, yielded to a mild astringent wash.

CASE 6th. September 11th, at 4 o'clock, A. M., I saw Mrs. E., of Roxborough, aged 37, in labour with her sixth child. She had been ill all the preceding day, but the pain had not been very severe till night, when the paroxysms became quite regular and continued so till I saw her. Her pulse was 84 to the minute. On making an examination, I found the head well down in the pelvis, the os uteri dilated to the extent of several inches, and the vertex presenting to the left acetabulum.

The membranes were entire; I ruptured them, and as she was suffering acutely, though there was not a prospect of its continuing long, I proposed to her the use of the ether, and she gladly embraced the proposition.

In less than two minutes she was completely under its influence, and in a lethargic state, the pulse falling to 72. She was partially roused from this by the recurrence of a pain, but the re-application of the sponge re-induced the lethargy, during the continuance of which, and without any further inhalation, she gave birth to a healthy and vigorous female child. She knew nothing whatever of its birth, and was delighted with the relief she had experienced, saying she had been in a dream from the time she took the vapour. The mother and child are doing well.

BIBLIOGRAPHICAL NOTICES..

A System of Surgery, by J. M. Chelius, Doctor of Medicine and Surgery, Public professor of General and Ophthalmic Surgery, Director of the Chirurgical and Ophthalmic Clinic in the University of Heidelberg, &c. &c. &c. Translated from the German, and accompanied with additional Notes and Observations. By JOHN F. SOUTH, late Professor of Surgery to the Royal College of Surgeons of England, and one of the Surgeons to St. Thomas' Hospital. In three volumes, 8vo. Lea & Blanchard: Philadelphia, 1847.

The foundation of the present publication is one of those admirable handbooks, for which several recent German medical writers have rendered themselves famous. The object of the author in its preparation was to supply a text book which should give a short

and clear description of Surgical Diseases and their treatment, and point out the best works on the several subjects. According to his plan, many things were slightly treated of, and others only hinted at, leaving the deficiencies to be supplied in his lectures. In subsequent editions, however, the author rendered his work more complete, and in the English translation Mr. South has supplied, very extensively, the omissions of the text.

In looking over the work, we have been particularly struck with the intimate acquaintance displayed with minute anatomy, and the changes and morbid products which occur from disease; the soundest views, both as to surgical pathology and treatment, are advanced on every subject, and generally in the clearest and most concise language. We meet with no affectation of originality; on the contrary, the best authorities are constantly referred to, and their very language quoted, where information or illustration is best attained in that way; we do not find the statements and opinions of others quoted, however, for the idle purpose of refutation and triumph, nor are the names of authors quietly omitted and shunned, lest the reader should discover the source from whence the most valuable materials are drawn. No such pettifogging is to be found in Chelius or his annotator; nor is it necessary for the interest of the work, for on every point treated of, evidence is afforded of a thorough acquaintance with the subject.

Diseases, according to Chelius, are either dynamic or organic. "This distinction can, however, only indicate a relatively predominant suffering of one or other phase of life, since the organic body presents in itself an entire whole, of which the several parts and phenomena are in the closest mutual connexion with each other.

"The organic diseases are especially those which originate in a destruction of the natural condition, form, and structure of organized tissues, and therefore may generally depend, 1. On the disturbance of organic connexion; 2. On the unnatural union of parts; 3. On the presence of foreign bodies; 4. On the degeneration of organic parts, or on the production of new structures; 5. On the entire loss; and, 6. On the superfluity of organic parts."

Organic diseases must be distinguished," according to our author, "into such as have their seat in parts inaccessible to mechanical contrivances, and to our organs of touch, and whose cure therefore can only be attempted by dietetic and pharmaceutic reme

dies; or those whose seat permits the employment of external means, and regulated contrivances, and which in most cases can be brought to heal only by these contrivances, with the assistance of dietetic and pharmaceutical aids. We may therefore distinguish, as belonging to the province of Surgery, all those organic diseases which have their seat in parts accessible to our organs of touch, or which allow of the employment of mechanical means for their cure."

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Although inflammation is excluded from this general definition, we must, however, still enumerate it generally, and particularly among the manifold origins of surgical diseases, when it attacks external parts. Inflammation, in its course and results, produces for the most part organic changes, and requires, when attacking external parts, almost always the employment of the so-called surgical means; further, among the surgical diseases soon to be more particularly described, there is not one of which the cause is not inflammation, which in its course does not produce inflammation, or the cure of which is not, to a certain extent, simply and alone possible by inflammation."

The following is the author's division of the subjects embraced in his work.

1st DIVISION.-Of Inflammation-general, peculiar, and of special organs.

2d DIVISION.-Diseases which consist in a disturbance of physical connexion.--Solutions of continuity; fresh-wounds and fractures; old solutions—false joints, hare lip, &c., ulcers, fistula, &c. &c.

3d DIVISION.-Diseases dependant on unnatural adhesion of parts-Anchylosis, adhesion and closure of natural openings, as the mouth, nose, rectum, vagina, &c. &c.

4th DIVISION.-Foreign bodies-introduced externally into our organism; formed in our organism by the retention of natural products; accumulation of unnatural secreted fluids, from the concretion of secreted fluids.

5th DIVISION.-Diseases which consist in the degeneration of organic parts, or in the production of new structures-Enlargement of Tongue, Clitoris, &c., Bronchocele, Warts, Bunions, &c.

6th DIVISION.-Loss of organic parts.

7th DIVISION.-Superfluity of organic parts.