surface are indispensably necessary, and, for the most part, an alterative course of mercury and sarsaparilla.

The author prefers leeching to the hypogastrium. We prefer leeches applied directly to the os uteri, and occasionally scarifications with a sharp scarificator, attached to a long handle.

The French practice of applying a hot iron to the part is not so painful as might be supposed, if done with tact and delicately; in some obstinate cases of ulceration it is a valuable agent, more terrible in appearance than in reality.

The author lays down the three following positions from the cases narrated in these chapters on abortion.

1. That what is commonly called ulceration of the cervix uteri may be the predisposing, as well as the immediately exciting cause of abortion.

2. That the purulent product of uterine ulceration, under some forms, at least, possesses virulent properties, capable of producing disease in another individual, or in another part of the same individual, by inoculation; and probably capable also, by being absorbed into the circulation of the same person, of materially disordering the fluids, and of creating thereby a peculiar susceptibility to disease.

3. That the application of caustics to the uterus, and the employment of other active measures which I have heard practitioners object to during pregnancy, as likely to endanger the well-being of the offspring, may not only be safely administered, but that they constitute in fact one of the principal means of securing both mother and child from danger.

Several cases are narrated of varicose ulcer of the cervix, and the appropriate treatment given. We have not room for more than the three points which the author lays down, and which, if proved by experience hereafter to be true, will clear up some heretofore anomalous cases of what is termed menstruation during pregnancy.

1. That menstruation during pregnancy is, for the most part, perhaps always, associated with an abnormal condition, generally with ulcerative disease of the uterus, requiring at all times active remedial treatment.

2. That hæmorrhage during pregnancy is not necessarily associated with an altered relation of the parts within the uterus,

and, by timely care, need not interfere with the integrity of the

ovum.

3. That menstruation, during the early periods of lactation, is not always natural menstruation, but that it is generally associated with morbid conditions which are amply adequate to the satisfactory explanation of the phenomenon; that secondary hæmorrhage is, in the majority of instances, not owing to imperfect contraction, or atomy of the uterine fibres; and that the discharge very probably proceeds, under these circumstances, not from the inner surface of the uterus, but from the diseased surfaces situated upon parts external to the cavity of the organ.

Syphilis as a cause of Abortion.

The author confesses that when he commenced his investigations on the subject of abortion, he had no idea that syphilis was so common a cause as he afterwards was induced to believe it to be.

He thinks, and, we doubt not, justly, that the notion entertained of late by some that syphilis can be radically cured without the aid of mercury, is the cause of many disastrous consequences. Individuals have supposed themselves rid of this fearful disease, when, in fact, it was only covered over, as it were; subsequently they have married, and consequences most unhappy have followed. All practitioners in large cities must have seen examples of this kind. Mercury is to syphilis, what quinine is to ague. Without its use, in genuine syphilis, we do not think an individual safe.

The local pathognomonic signs of the uterus in a venereal taint are,

1. Endo-cervicitis, or inflammation of the lining membrane of the cervix uteri.

2. A mottled or patchy appearance of the cervix.

3. Apthæ of the cervix.

4. Warts on the cervix or walls of the vagina.

The author, as one of the remedial means, highly extols the Rumex Hydrolapathum. "I have used it for several years extensively, both in public and private practice, with the most gratifying results, in cases where sarsaparilla had been given in

large doses for many months together, without the slightest benefit."

Of Prolapsus Uteri it is said: "That prolapsus uteri can be effectually treated, and the position of the organ permanently restored, without the aid of the pessary, there exists not a doubt or my mind!" Would that this could be proved experimentally true! How much trouble, vexation, and disappointment at last, in this very affection, have not the fairest of our race suffered!

So far as our observation goes it confirms the following state

ment:

"The cases (prolapsus uteri) are generally accompanied with leucorrhoea, and with inflammation or ulceration of the cervix uteri, evidences of which are found in almost all instances to have prevailed at a period anterior to the occurrence of the displacement."

The treatment is to be directed locally to the diseased cervix, and generally to the constitution.

Of the first, nit. argent., or other suitable remedies; medicated tents are to be applied to the os, by means of a tube, and changed every one or two days. The metallic preparations should be used not oftener than every third or fourth day, vegetable applications, as matico, tannin, &c., being adopted intermediately.

Of the second, when all febrile excitement is absent, quinine, metallic oxides, iodine, iron combined with cinchona extract or taraxacum, gentian, &c.

CHAPTER 10. Sterility. It is true, as the author observes, that the cause of sterility is generally attributed to a faulty condition of the female organs. No doubt correctly. When we consider the complicated female genital apparatus, the chances are certainly vastly in favour of the faulty condition of this, as compared with that of the male.

The author, however, in this work proposes merely to treat of those cases of sterility, which result from a morbid state of the uterus, originally of a normal condition.

Three principal causes are mentioned, viz: 1. Endo-uteritis; 2. Spyhilis; and 3. Ulceration of the cervix.

The means employed in the treatment of the first and third, are such as have been already given-viz: local applications to the

diseased surfaces, and constitutional treatment of an alterative and tonic character, as iodide of iron and sarsaparilla.

In some cases, according to Mr. Whitehead, the uterus has resumed its natural function, after an appropriate course of treatment; leading to the hope that as our knowledge advances we may be more and more enabled to overcome this abnormal state of the uterine function, the cause often of much unhappiness.

We trust that the views expressed by the author of this work, especially on the subject of abortion, will be more generally entertained and carried out in daily practice. We feel confident that if they do become more generally understood, and practised upon, much suffering and danger will be obviated, and relief and comparative health afforded to those who otherwise may be doomed to drag out a miserable existence.

The American Medical Almanac, for 1848, containing statistics of the various Medical Colleges, Hospitals, Dispensaries, etc., of the United States; together with other information of value to the Physician and Student. 18mo. pp. 224. Lindsay & Blakiston, Philadelphia.

The title page of this publication indicates very truly the character of its contents. Beside the account of Colleges, Hospitals, Dispensaries, private associations for granting instruction on the various branches of Medical Science, the work contains the organization of the National Medical Association; the code of ethics adopted by the late National Medical Convention; a chapter on Poisons, their antidotes, and the treatment proper in cases in which the various poisons have been taken; several articles on the inhalation of ether; Dr. Burder's letters on the importance of promoting the religious welfare of patients, and various miscellaneous articles of general interest to medical men, making altogether an exceedingly interesting and useful volume.

THE MEDICAL EXAMINER.

PHILADELPHIA, DECEMBER, 1847.

BRITISH AND FOREIGN MEDICAL REVIEW.

The October number of this admirable Review announces that it is the last which we are to receive. It is melancholy for us to state, that its discontinuance is owing to its never having received such a patronage from the profession as to authorize its distinguished editor to continue it. Still he persevered in his useful exertions until prudence compelled him to abandon the undertaking, and to permit it to pass into other hands, under another form. We have watched this Journal from its inception to its termination. Not a number has escaped our attention; and not a number has been issued that has not afforded us valuable instruction. We are amongst those, who daily feel, more and more, how much we have still to learn, and who mourn over our limited knowledge, albeit there is no want of effort to maintain ourselves à portée with the existing state of science. Doubtless, happy, thrice happy, are they who can admit that "ignorance is bliss; " but this privilege has been denied to those who feel irresistibly, that their life must be spent in incessant toil to allay that thirst for knowledge, which has been implanted in them by the author of nature. To slake this thirst how effectual have been the pure waters issuing, from time to time, from the fount now about to be closed to them. To the profession at large-and especially to the reading, thinking, studying portion-alas! how few in number! the privation of their accustomed intellectual treat from abroad will be felt like the loss of a cherished friend and counsellor; whilst those who are engaged in the active and important occupation of teaching will deplore that one great source of their information, in regard to the novelties and the niceties of science, is about to be shut out from them. May we not hope that the amalgamation of the British and Foreign Medical Review, with its elder brother-the Medico-Chirurgical-may supply the place of the lost one; and that the wonted fires' of each parent may burn more brightly in the progeny.

Of Dr. Forbes-who we regret to find is to have no connection with the new Journal-we take our leave with extreme regret; trust