was found to give way, until the cervix was obliterated, and the os tincæ relaxed, and the contents of the uterus expelled with but little pain. After having been established the pains never entirely ceased until the end was accomplished. The increase of hemorrhage upon the first administration of the remedy is always to be expected under similar circumstances. Repeatedly have I used it after abortion with a view, not only to the expulsion of portions of involucra, but mechanically to diminish the cavity of the uterus, thereby, in a manner, closing the mouths of the bleeding vessels, and always with this effect-first, an increase of the flooding, and then a diminution and suspension of it.

The above is the only case in which I ever employed ergot in a rigid state of the os uteri, and have to regret that I did not resort to it a year earlier, since the patient would have been rescued from many months of anguish and apprehension. The expulsion of the foreign body would, probably, have been effected with less difficulty, as the parts, it may be presumed, were in a more relaxed condition. In regard to the medicinal properties of this article, an unfortunate diversity of opinion prevails among medical men, being esteemed inert by some, and incapable, under any circumstances, of producing uterine contractions; by others, as efficient only at the full period of gestation; while not a few would discard it altogether on account of the uncertainty of its operation— small doses sometimes exciting violent contractions, and at others, under apparently a similar state of the case, large doses proving inefficient.

I have employed ergot in my practice for a dozen years, and have seldom been disappointed in its effects. I have used it in abortion, where that event was already unavoidable, to quicken the expulsion of the ovum, and have administered it immediately afterwards, to arrest hemorrhage by di

minishing the uterine cavity. I have given it during labor to strengthen and accelerate the pains when the presentation was favorable, and the os uteri dilatable, where otherwise, doubtless, the forceps would have been required. In retention of the placenta, whether from adhesion or inertia, I have also administered the article, and uniformly with the desired effect. My mode is to give it in substance finely pulverized, in doses of from ten to thirty grains, at longer or shorter intervals, according to the urgency of the case and the effect produced, and my confidence in its specific action upon the womb is as great, as in the peculiar action of tartar emetic upon the stomach. Of the unfavorable occurrences said to result from its administration-hour-glass contractions, rupture of the uterus, &c.-I have seen none, but on the contrary in the only case of rupture of that organ which I ever witnessed, not a particle of the medicine had been employed.

The history of a single ease of its employment in retained placenta will close these remarks. It is one of many of a similar character:

Mrs. in the year 1837, had been delivered of an infant eighteen hours, without the supervention of labor pains, and in this inert condition of the uterus, the placenta was not expelled. I attempted to remove it by Velpeau's method, but without success. The hand was not introduced because my experience in the virtues of ergot taught me to expect that it might be extracted by an easier method, Thirty grains of the article were administered, and the dose was repeated in fifteen minutes. Uterine contractions were not long in coming on, and by one effort of the organ the placenta was expelled. The pains continued to be so violent that an opiate was thought necesary, showing that the last portion of the medicine ought not to have been given.

REVIEWS.

ART. IV.-Lectures on the Theory and Practice of Physic, delivered in the College of Physicians and Surgeons of the University of the State of New York. By the late David Hosack, M. D. L. L. D., F. R. S., Professor of the Theory and Practice, and of Clinical Medicine in that Institution. With an Introductory letter, by Nathaniel Chapman, M. D., Professor of the Theory and Practice of Medicine, in the University of Pennsylvania, &c. Edited by his friend and former pupil, Henry W. Duchachet, D. D., Rector of St. Stephen's Church, Philadelphia. Herman Hooker, Chesnut street, 1838. p. p. 699, Svo.

TIE author of this volume was classed, during his life-time, with the ablest teachers of medicine in the United States; and its recommender and endorser holds, at present, a similar rank. We are justified, moreover, in alleging that the production of the volume is the result of the labor of not less than thirty years, industriously employed by the writer in observation, reading, composition and thought. It is therefore a work of high authority, and must be regarded as presenting a full and fair view of the treatment of diseases in the Atlantic States, as well as of the style and manner in which, or at least of the doctrines and directions through which, their treatment is taught in the medical schools of that portion of the United States.

Did any doubt exist as to the correctness of these remarks the commendations contained in Professor Chapman's "In

troductory Letter" would dispel it. In his reference to the "Lectures" of which the volume consists, the Professor says:

"They embody a very large mass of curious and useful information, clearly and agreeably conveyed. Excepting some pathological doctrines I find little in them to which I would object. The practical part I consider sound, or at least it corresponds very much with my own views. Long and extensively engaged in the profession, and with his acute and discriminating mind, he, (Professor Hosack) could scarcely fail to arrive at just conclusions in whatever regards the management of disease. He deserves, and will no doubt rank, among the most authoritative of our writers. You (the Editor) have done well in publishing the work. No effort shall I spare to promote its distribution; and I mean especially to recommend it to the attention of my class."

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Such are the high and imposing auspices and recommendations to favor, under which this volume is ushered to the world. Is it worthy of them? and does it fill up completely the measure of expectation and confidence they are calculated to excite? Without assuming the responsibility or claiming the prerogative of giving to these questions categorical answers, we shall endeavor, by a brief discussion of the matter they embrace, to enable our readers to answer them for themselves.

Like all other productions of the kind, this which lies before us consists of an exposition of principles, and a system of practice. And with neither the one nor the other do we find reason to be satisfied; at least in their relation to this section of country where we ourselves reside, and respecting which alone we presume to decide. Whatever may be their amount of aptitude and value in the Eastern States, (and Pro fessor Chapman is earnest in their praise) we are greatly mis

taken if they have much of either in the States of the West. We do not positively say that they are better fitted to do mischief than good in this part of the Union; but we do say that nothing could tempt us to teach or recommend them to western students of medicine; and we should deeply grieve to see a sick friend treated in conformity to them. In truth they would be, of themselves, sufficient to convince us, were we not already convinced by other considerations, which have long been familar to us, that the Professors of the Atlantic schools are but very moderately qualified, or rather not qualified at all, to communicate to their pupils such views of practical medicine, as are suited to the diseases of the Mississippi Valley. How indeed can the case be otherwise? How is it possible for those professors, however able and learned they may be, to teach successful modes of treating diseases which they have never seen, and of whose ruling and peculiar features and character they are necessarily uninformed? In fact they neither do possess nor can possess, such resources for teaching. Nor can they ever attain them, unless they pass the mountains, and spend years in the midst of us, observing, studying, and treating our complaints. Let them thus act, and thus accomplish themselves, or else confine their instructions to the cure of maladies with which they have been conversant, and detail them only to the medical pupils of their own region For practical purposes in the West, those instructions have neither fitness nor value. However sectional and exceptionable these sentiments may be considered in some places, and represented by some Journalists, they are too true and plain to be candidly opposed by either fact or argument, though they may be sturdily denied, and dogmatically condemned. And suf ficient evidence to this effect shall be presently adduced. But a few farther introductory remarks must be previously offered.