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bot damp shut-up hold of the ship'; and Mr. Salisbury, to rebut Dr. Roxburgh's attack on the Sphagnum Palustre, adduces some respectable evidence of its power in preserving the vegetative principle of those plants which are carefully packed in it: but the testimony which he quotes respects voyages that are short in comparison with the distance to Bengal.

Aware of the great importance of the Teak-Tree of the East Indies, for Ship-building, Dr. Roxburgh specifies a method of cultivating it to advantage in the East, and recommends the sowing of its seed both in our African settlements and in our West-India islands. To his valuable suggestions in this respect we are pleased to find that Government has paid due attention. Dr. R. says;

The growth of the tree is rapid, and at all ages the wood (from various experiments) appears excellent. Some trees in the Honourable Company's Botanic Garden, brought from the Rajahmundry Circar in 1787, were in 1804 from three to upwards of four feet in girth, at three and a half feet above ground, and high in proportion *. These plants were about twelve months old when sent from the coast, so that their present age is about 17 years.

A tree promising so much advantage in so short a space, compared to what the oak requires in England to become serviceable in the marine yard, makes it highly worthy of every attention and encouragement.'

Though interrupted by bad health, Dr. Anderson, (the Dro Roxburgh of the West Indies,) forwards from the Royal Botanical Garden at St. Vincent, which he superintends, some fresh communications to the Society; and, faute de mieux, he presents some specimens of Sago, and of the Yellow Dye yielded by the Gardenia Florida.

As a token of respect to the memory of the late Earl of Romney, a portrait of him is prefixed to the present volume ; and it is recorded of him in the preface that he became a member of the Society in 1762, was elected a vice-president in 1771, and was an annual contributor of five guineas. It is added, moreover, that from this nobleman's family the Society have received great patronage and pecuniary support. His father was their second president, and in their proceedings of March 29. 1754, immediately on the formation of the

• * The largest of those trees measured, at three feet and a half above the ground, in February 1796, forty-two inches in circum. ference. The same tree was in February 1804, fifty-two inches in circumference, at the same place ; which gives an annual increase of one inch and a quarter. However, while the trees are younger,

and in a more favourable soil than where this tree stands, their yearly growth is from two to three inches, which is fully double the increase of oak in England.'


Society, the following minute is entered : “ Lord Romney and Lord Folkstone were so generous as to declare, that whatever deficiencies shall be in the premiums for this year, they will supply themselves; for which they had the thanks of the gentlemen present."' — It is pleasing and politic to record such acts; and to follow such examples confers nobility on nobility. Indeed, societies instituted for useful purposes demand the support of men of title and fortune.


Art. III. Facts and Observations relative to the Fever commonly

called Puerperal. By John Armstrong, M.D. one of the Physicians to the Sunderland Dispensary, &c. 8vo. Pp. 162. 8s. 60.

Boards. Longman and Co. 1814. We are informed in the preface to this volume that, under

the title of puerperal fever, the author includes both the ordinary peritoneal inflammation and the low malignant fever of lying-in-women, and that he considers them as modifications of the same disease. He was induced to direct his attention to this subject, principally in consequence of the difference of opinion that exists among medical men respecting the nature of this disorder; and partly, as it appears, by a desire to illustrate and establish the hypothesis that all fevers are connected with local inflammation, and that this local inflammation ought to constitute the chief object of consideration in the

The present treatise, he observes, is to be regarded as the first of a series of practical illustrations of fever, drawn from clinical facts and anatomical investigations.'

The work consists of eight sections, containing the description of an epidemic puerperal fever which appeared in Sunderland and its neighbourhood in 1813, the symptoms of the first stage, those of the second stage, the diagnosis, prognosis, and prevention of the disease, pathological remarks, and treatment. The puerperal fever, as it occurred in the author's practice, was composed of two stages, which varied considerably in their symptoms, and which required very different remedies. Of the first, which is called the stage of febrile excitement, we are told that it appeared in women who had not suffered from laborious parturition, and in whom no unfavourable symptoms had been previously remarked.

• The disease was ushered in by very slight shiverings, or rigors, by oppression at the præcordia, by vomiting, retching, or nausea, and by considerable anxiety of mind. When the shiverings or rigors abated, which were often very short, the skin became universally hot and dry, and the thirst urgent. The tongue was much paler than usual, and appeared as if it had been recently rubbed, or dusted REY. APRIL, 1815. Bb


with a very fine whitish powder : in some few instances, however, the tongue was tolerably clean and moist about the edges, and this was more especially the case when vomiting frequently occurred. The matter thrown up consisted of the ingesta, mixed with mucus, and yellow or greenish bile. The pulse was seldom less than 120 in the minute, and rather full, tense, and vibrating, or very small, sharp, or somewhat wiry.

• The countenance at this period assumed an inexpressible anxiety, the lips were pale and parched, and there was a kind of livid stripe under each eye, but the cheeks were flushed with a circumscribed redness, like that which is observed in the true hectic. The respiration soon became hurried, and the patient often sighed heavily, was restless, and turned from one part of the bed to another, or lay upon her back, and constantly moved her head from side to side, or suddenly lifted up her hands, and threw them down again with some force, upon the bed-clothes. Commonly a little before or at the very commencement of the shiverings or rigors, there was in the lower part of the belly more or less pain; occasionally it was very acute, shooting in the direction of Poupart's ligament, and through to the back and loins. In some instances the pain was deep and obtuse, and more confined to one particular part ; but in every case, it was aggravated by pressure in and about the hypogastric region. However limited in its extent at first, it afterwards gradually spread over the surface of the abdomen ; which became tender to the touch, tumid, and tense.'

In addition to these circumstances, it is stated that the secre. tion of milk and the lochial discharge were interrupted, the urine became scanty, and the bowels constipated; that the restlessness was excessive; and that the patient was so insensible to external objects as to lose all solicitude even about her child. The second stage, or that of the low typhoid state, supervened about 30 or 40 hours after the commencement of the complaint, and was marked by symptoms of the greatest prostration of all the vital powers. The pulse rose to 140 or even 160, and was soft and feeble, the patient complained of chilliness, and delirium supervened.

The cheeks were alternately flushed and deadly pale, the eyes lost their lustre, the pupils were much dilated, and a kind of dewy per, spiration stood upon the face and forehead. The pain gradually and entirely, receded from the surface of the abdomen, when it usually happened that dark, slimy, and very fetid stools were discharged from that time onward. The thirst was unceasing, and when any liquid was offered, the patients hastily seized the vessel, and glutted down its contents, as if they had previously been expiring for want of drink. The tongue for the most part was brown, or rather black and parched, and had apthæ upon it, which even appeared about the edges of it at an early period. In one very bad case, however, the tongue continued clean and moist to the last, but there was an almost perpetual vomiting throughout the second stagę, though


only a slight nausea occurred in the beginning, and very little vomiting in the rest of the first stage. Indeed vomiting was always more urgent in the last than in the first stage of the disease, and the matter then thrown up very much resembled coffee-grounds, and was offensive to the smell. The teeth and gums were crusted with dark, slimy sordes, and the breath was disagreeable, as if it had been tainted with mercury. Throughout the complaint there was a short teasing cough, but this was more especially the case in the last stage, when the respiration grew very short, feeble, and frequent, and the ala nasi were thrown into perpetual motion.'

This disease runs its course in five days, or even sometimes in a shorter period; it was epidemic during a considerable portion of the year 1813, in different parts of the counties of Durham and Northumberland; and, the author observes, it is a fact worthy of particular notice that it has occurred to some individuals, while it has been entirely unknown in the practice of others, living in the same neighbourhood.' This circumstance proves the contagious nature of the disease, and gives rise to a very important part of the preventative treatment.

Considering, as Dr. Armstrong thinks, that peritonitis and the fever which he has been describing are the same disease, the diagnosis will not be difficult, since it is sufficiently distinct from the common milk-fever, or the other complaints to which the puerperal state is incident. He, however, again briefly enumerates the pathognomonic signs of the disease, which we believe will not be unacceptable to our medical readers : Abdominal pains and soreness, short anxious breathing, uncommon quickness of the pulse, increased temperature, anorexia, prostration of the vital powers, suppression or diminution of the milk and lochia, and an unnatural conditon of the excrements, are the chief pathognomonic signs of the disease.'

In the section intitled Pathological Remarks, the author again insists strongly on the identity of common peritonitis with the puerperal disease which has been described above; and, both from analogy and from the experience of remedies, he very decidedly and strenuously declares his belief of its highly inflammatory nature. He quotes a number of respectable authorities, both English and Continental, to prove that the common puerperal fever is inflammatory in its nature, and requires antiphlogistic treatment; and, being of opinion that the simple peritonitis and the epidemic malignant child-bed fever are the same disease, differing from each other only by insensible gradations, (as is the case with almost every other acute disorder,) he concludes that this last must also be highly inflammatory, and must require the same active antiphlogistic regimen. This is the main argument which is employed to prove the point that is so strenuously laboured through the whole of this treatise; and we must confess that, like most analogical arguments, it does not appear to us very convincing, The question of identity is by no means unimportant: but, even if we were able to decide on it with the utmost certainty, it would not be the point on which our practice must depend. The mildest innoculated small pox, and the most malignant confluent case, are varieties of the same disease ; yet who would argue from this circumstance that they require the same treatment? The only ground for admitting that the epidemic malignant puerperal fever ought to be treated on the antiphlogistic plan is the success which attended the very decisive measures that were adopted by Dr. Armstrong, and which constitute, as we are fully disposed to believe, a very important addition to our professional knowlege. When the medical man is called to the patient sufficiently early, and before the first stage has passed, it appears that the disease is effectually counteracted by copious bleeding and very active purging. The quantity of blood drawn was 20 ounces, or more, taken from a large orifice: the chief purgative employed was calomel, given to the extent of 20 or even 30 grains; and its operation was determined to the bowels by the solution of the sulphate of magnesia. This was the essential practice in the first stage; and indeed, if this stage was passed, very few hopes of relief remainedit seemed that evacuations were then as hurtful as they were before beneficial; a circumstance which strongly indicates the importance of discriminating between the two stages, and of endeavouring to arrest the complaint at its very commencement. We shall not, however, enter more fully in this place into the author's opinions or practices; the work is on many accounts of considerable interest; and we would not wish to do more, by the abstract which we have given, than to induce all our medical readers to peruse it for themselves. We are confident that they cannot do so without feeling impressed with its value; and, whether they admit or reject Dr. Armstrong's conclusions, they must acknowlege that he has very clearly and distinctly stated his opinions, and that the question at issue is of the utmost practical importance.

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