vestigation of the subjects of crime, penal legis-ality of conception, and power of illustration, to lation, capital punishment, trance, somnambulism, which I have no pretension? Sir, our position as dreaming, &c., are only to be solved by the phi- medical philosophers, occupied in the investigalosopher who, to an enlarged and cultivated under- tion of the phenomena of life, of mind, and of standing, unites a knowledge of the higher de- disease, entails upon us anxious, solemn, and repartments of physiology, joined to an acquaintance sponsible duties. In the hour of pain-when the with the science of mental philosophy. Need I spirit is humbled by suffering-in the day of dissay another word to conclusively demonstrate the tress-in the solemn moment of dissolution,-it imperative necessity of establishing, in connexion is our high and noble privilege, like guardian with our national universities, a professorship of angels, to hover about the couch of the sick and medical psychology, for the special investigation the dying. We enter the chamber of the man of these essentially necessary sections of philoso- writhing with agony, bereft, perhaps, of that phical inquiry, so important to the physician, the which alone made existence pleasurable, the right divine, the legislator, the jurist, the educator of exercise of the mental powers, and loud and afyouth, and to every one who feels, as all the educated classes should feel, an interest in the intcllectual and moral progress, the temporal and eternal welfare, of man ? fectionate demands are made upon our sagacity and skill. Life-the silken thread-the silver cord, of life-depends upon our rapid appreciation of the phenomena of disease, and ready adFinally, I would observe, that of all the subjects ministration of remedial agents for its relief and that can occupy the attention of the philosophic cure. Yes our profession is a noble one-a most physician, none equals in importance, or in gran- dignified, exalted, and honourable calling. Amidst deur, those which I have had the honour of re- the calumnies that assail us the obloquy to which commending to your special attention. What we are sometimes exposed-the cold neglect, can compare in dignity, in sublimity, in compre- contumely, and ingratitude of those who eagerly hensiveness, or in the lofty aim of its disquisitions, availed themselves of our skill in the hour of their to the study of the nature and operation of that deep distress,-it is gratifying to my feelings to spiritual essence, upon the right knowledge and place before you a portrait of the true Christian cultivation of which depends our happiness, both physician, sketched, not by one of ourselves but in time and in eternity? As the mind advances by the master-pencil of one who deservedly holds in a knowledge of its own phenomena, the intel- a high and distinguished rank among the female lect expands, new sources of delight open to us, writers of the day:and the pleasure we experience in the pursuit of "The skill of the physician puts in requisition these exalted speculations, impresses forciby upon the highest faculties of the human intellect, as its the mind itself conclusive evidences of its own administration calls forth the tenderest sympathies DIVINITY. He who has habituated himself to trace of the human heart. The able and kind physiout the numerous applications of mental philoso- cian is a human benefactor. He garners up the phy to the important subjects of education, morals, treasures of learning and experience, that he may and legislation; to analyse the nature of thought, dispense them again to the suffering brethren. the laws regulating the association of our ideas, He comes with his timely succour, cheering both the springs of action, the origin of our happiness, body and spirit with the single boon of health. the laws of moral science, the nature of the pas- He raises the sick man from his couch of pain, sions, the formation of character, the foundation and sends him forth, elate and vigorous, for fresh of our hopes, and the influence of our emotions, enjoyment. He restores the ailing, and rejoices -will appreciate the value of this branch of their despondent friends. He gives new life to science. The physician will be conscious, as he the sick, and revives the hopes of those who deadvances in a knowledge of the constitution of the pend on the sick man's recovery for subsistence."* mind, that his love of truth is growing strong; and whilst, in the spirit of true humility, he acknowledges the limited nature of his intellectual powers, he will, whilst contemplating their grandeur and importance, recognise the GOODNESS AND MAJESTY OF GOD. Mr. President, my task is drawing to a close. In glancing retrospectively at the preceding portion of this lecture, I feel oppressed by a consciousness of the imperfect and inadequate manner in which I have sketched the exalted spiritual functions of the physician. Have I not reason to blame myself for attempting to grasp a subject so great and sublime? And have not those whom I have the honour of addressing, a right to censure me for my presumption in selecting for illustration a theme requiring for its successful elucidation and expansion an amount of knowledge of the higher departments of philosophy, an origin To conclude: while feeling that the best of our works are imperfect, and that we must rely for our future happiness upon the great mercy of God, and not upon our own merits, I cannot be forgetful how great is our responsibility for the right use of our talents and the faithful discharge of our solemn and anxious duties; and I would therefore venture, with all deference and respect, to address to each of my professional brethren the admonition of one of America's most gifted poets :- "So live, that when thy snminons comes to join To that mysterious realm, where each shall take * The girlhood of Shakspeare's Heroines, chap. "The Vocation of the Physician." By Mrs. Mary Cowden Clarke. + William C. Bryant, ON SOME OF THE MORE IMPORTANT POINTS Br. J. POWER, M.D., &c. [Concluded from September No., p. 192.] Abnormal Parturition (continued.)-2. Where the abnormal conditian depends on morbid or unnatural actions of the organs concerned.-The more leading feature of the author's treatise on midwifery was an attempt to show that the pains so generally accompanying labour were not essential to the process, but admitted of being lessened or removed, with the effect. of inducing more vigorous and propitious uterine action, views suggested and confirmed by several years of previous observation and experience, and which, however they might have been questioned at the time, are now virtually admitted in the science of midwifery, but with little or no acknowledgment of the source from which they have been derived. In a recent work,* the only allusion made to these views is where its author, when treating of rheumatism and inflammation of the womb in labour-both rare if not suppositious cases, says :-"We presume it is to these cases that Dr. Power alludes when he says 'the improper action will be removed almost instantly, and as it were by a miracle, so that a case which has been protracted for the greater part of a week, under the most intense suffering, and without the least progress, has been happily terminated in fifteen or twenty minutes from the first commencement of the friction."" Whoever may think proper to consult the original work of the author cannot fail to be sensible of the injustice and inaccuracy of the above dictum, which can only have been suggested by a hasty or partial reading, or an imperfect comprehension of the views therein inculcated. A. an organ to be primarily affected; B, an organ to be se condarily affected; C, the general reservoir of nervous principle, comprising the cerebral, spinal, and ganglionic systems; to which is superadded, D, the mind, or source of the perceptive and volitionary principles; N N. nerves connecting the organs A B, with the reservoir C, by vir tue of which the organs become charged with nervous power. I a, a primary irritation, stimulus, or exciting cause, being applied to the letter A, throws it into action, represented by, the effect or sensation of which, represented by the dotted line..., is carried to C or D, where, producing an impression or sensation, it becomes a secondary irritation or stimulus, I b, which, acting on the secondary organ, B, throws it into motion, in which case the sensation or effect may, in its turn, be conveyed to Cor D, and produce new secondary action. In the above diagram, it can scarcely fail to be remarked, that the secondary action would have been well expressed, in so far as the diagram represents it, by the word "reflexion ;" and it will be further evident, that the nervous connexion between the organ A and C correctly corresponds with the kind of communication now assigned to an afferent, and that between C and B, to an efferent nerve. The above diagram may in itself be regarded as explanatory of simple primary excito-motory function A large majority of the morbid states comprised in and of secondary or metastatic or transferred action; the present consideration were advanced, in the first but let A be taken to represent a normal or proper instance, as the results of that principle then known motor organ in the system, and B any other distinct in the doctrines of medical science under the term organ, it will be seen how, in conformity with this "metastasis," the parturient energy being assumed to position, the action excited in A is transferred or be transferred, in consequence of sympathy or associa- reflected to B, so as to influence the latter, and produce tion, from the uterus to other, and sometimes very effects which admit of being carried forward in s distant and distinct parts. This principle may now way, as in a chain, through a series of addibe considered as virtually established, although it has tional distinct organs. It is on this principle that the more recently been explained by referring the trans-author has attempted to explain the numerous com ference in question to "reflex action," or, in other plications in which parturition abounds. words, by contemplating it under a new name. similar the various and more complicated transferences of nervous power, throughout the system at large, are attempted to be made manifest. Independently of the above, the author is in posses The doctrine of reflex or diastaltic action pre-made nearly a quarter of a century since, in which sion of a number of similarly-constructed diagrams, viously alluded to (THE LANCET,) has doubtless conferred lasting honour on Dr. Marshall Hall, and contributed essentially to a better intelligence of the nervous system and its functions; nevertheless, the author of the present papers humbly conceives, that Admitting, with the above reservations, but still if he did in no respect precede that gentlemen, when maintaining the virtual analogy with the metastatic he applied the metastatic principle to the subject of principle, that the theory of reflex action, corroborated midwifery, he at least made a decided step in advance as it is by anatomical and physiological research, affords a more lucid explanation of the phenomena of of previous science, and which contributed materially to the improvement of that art; nor does he think parturition, the author now proceeds, in conformity that the practice thence deduced has since been with it, to investigate the morbid or abnormal states materially improved upon. In both his original work of labour to which it appears applicable. and subsequent lectures, the parallelism of his metas- It is presumed by this theory, that incident sensory tatic principle with the doctrine of reflex action is actions are conveyed by the afferent fibrilla of sensory clearly indicated, and he was in the habit of demon-nerves to their respective nervous centres, where, becoming, as it were, stimuli de novo, a new action is strating his opinions to his pupils by diagrams undeniably confirmatory of their virtual resemblance, of induced, which, by means of efferent motory fibrille, which the following is an example :— is transmitted to the muscular organs therewith connected, and which are consequently thrown into motion. This system forms what has been termed s In a normal state of parturition, the * Rigby's System of Midwifery, p. 242. nervous arc. primary incident part or sensor periphery is placed The causes of abnormal reflex action in labour at the orificial part of the cervix or os uteri; while might be considered under the heads of proximate, its nervous centre is probably situated in the spinal predisposing, and exciting causes. The two former cord, rather than presumed to exist in ganglia placed of these, however, are probably sufficiently involved in the immediate neighbourhood of the uterus itself in the preceding observations. The exciting causes -in fact, through the medium of that independent are of practical importance; their modus operandi, nervous centre, the spinal cord, which some have however, until we have a better comprehension of the assumed to consist of a chain of ganglia imbedded in nature of nervous influences, is necessarily obscure, white matter, inasmuch as it is known that one isolated and their effects occasionally manifest themselves, portion of it is capable of producing reflex action in even when the labour is apparently proceeding most a muscle whose nerves are connected with it. This satisfactorily, suddenly and unexpectedly, so as to uterine arc, in itself, however, possesses no necessary produce great protraction and distress; and in a connexion with the spino-cerebral cord, and the uterus similar way, when existing, they admit of removal, in consequence, may be regarded as an involuntary the case then immediately reverting to the most organ, capable of expelling its contents without being propitious state. necessarily associated with other parts of the system. This simple expulsatory system probably exists with respect to many of the lower animals, and is occasionally, although rarely, met with in the human female, particularly amongst those people who are living in the less civilized state. But it is almost invariably found, in our existing state of civilized life, that numerous additional arcs, with their nervous centres situated in, or more or less connected with, the spino-cerebral and great sympathetic ganglionic systems, exist, and are associated with the above normal uterine arc by virtue of sensor or motor nervous fibrillæ running from one to the other, and which give rise to numerous associated and frequently distinct actions, the results of which may be to derive from the uterus that principle which ought to actuate it, and thus weaken its power. Another and most important effect is, that these new and secondary actions are not unfrequently accompanied by morbid or painful actions of any of the various parts thus associated-the probable basis of the present varieties of abnormal labour. It is, however, generally believed that some of these secondary arcs are normally associated with the primary uterine arc in producing or assisting the expulsive power, as, for instance, those which give rise to accompanying expulsive efforts of the abdominal muscles. Nature, however, is generally simple in her operations, and it is questionable whether this view be strictly correct; and it can scarcely be denied that powerful or voluntary exertions of the abdominal muscles will have a tendency to detract from and weaken the proper action of the uterus; at the same time it is admitted that the complication in question is now so general as to entitle it to be regarded as depending on a quasi normal association. The numerous exciting causes may be regarded generally as irritations existing in some other part or parts of the general system with which the uterus may have become associated, so as not only to derive from the uterus that nervous principle requisite to maintain its function, and thus lead to abnormal conditions, but also to occasion morbid or painful actions of the associated parts themselves. Among the more influential of these causes are irritations affecting the digestive system, whether connected with improper ingesta, such as food, spirits, &c. or in the. lower portions of the alimentary canal, as regard defaults not excretions; irritations of the urinary organs, in which respect a very common source of derangement is an undue retention of urine, the removal of which by the catheter will often at once restore the proper uterine action. Another important set of exciting causes are affections of the mind; these are the same as have already been described as sources of suspended labour; in fact, there appears to be a strong alliance between the latter and metastatic or reflected action in labour; but why in the one case the result should be negative, and in the other positive abnormal action, it may not be easy to explain: a variety of accidental causes may be named, as improper ventilation or temperature of the lying-in room, too close confinement to bed, fatigue induced by walking about the room, want of sleep, and such analogous causes. Additional exciting causes may be found in voluntary attempts to hasten the delivery, by exerting forcibly the abdominal muscles, and also in an undue irritation or sensibility affecting the os uteri, vagina, rectum, or parts contiguous to the uterus, or even any other part of the system more or less distant from it. The effects of reflex action in abnormal parturition are extremely diversified, so as almost to warrant the How the various above associations have originally assertion that no two cases of labour are precisely been established, is a point of the greatest abstrusity; alike. The more general ones relate to the influence some of them are so whimsical as to baffle all con- exerted over the uterine contractions, which, in projecture-for instance, the author's father knew a portion as the nervous principle is diverted, always lady who in the act of micturition always experienced fail to be less efficacious, and are in many instances an acutely agonizing pain in one of her little fingers. entirely negatived, a fact readily detected by either It appears certain that comparatively few of them utero-abdominal or utero-vaginal examination. A exist in the uncivilized state of man, and therefore necessary consequence is, that the case becomes more they ought to be attributed more or less to the habits or less protracted. An immense variety of particular and circumstances of civilized life, which have pro- effects may be manifested, depending on the particular gressively formed, extended, and perpetuated them parts implicated, and the nature of the actions ininto hereditary principles. We find an interesting duced in them. They may be referred to the followelucidation of this view in the book of Genesis, where Pharoah, having reproved the midwives for not destroying the males of the Israelites in the birth, the reply was, "the Hebrew women are not as the Egyptian women, for they are lively and are delivered ere the midwives come in unto them." Now the one was a pastoral and simple people, and the other the most highly civilized and luxurious nation in the then known world. The subject admits of great amplification, which the brevity of the present papers will not admit of. ing heads:-1st. When painful affections are produced. 2nd. When they influence the heart and circulating system, so as to give rise to fever, local congestion or determination, syncope or convulsions. 1. Painful affections, of which two modifications are to be noticed the one when the pain is situate in the uterine muscles, the other when it affects parts distinct from them. In the former of these modifications the painful action appears to be referable to the primary uterine nervous arc solely, the muscles affected, instead of be more or less calculated upon, that cases of this character, constituting what obstetricians commonly regard as "natural labours," if left to themselves, will at length terminate safely, if not satisfactorily; and therefore it becomes questionable whether they should or should not be interfered with, as the attentions of the accoucheur, however properly meant, may be misconstrued, even by his professional brethren, into officiousness, and, however beneficial to his patient. prove ultimately injurious to his own interests. Such is the weakness of human nature and the influence of prejudice! Such results the author has occasionally experienced; but he retains the conviction, that, by adopting the principles he has advocated, he has not only conscientiously discharged his duty, but essen tially contributed to the comfort and welfare, if not the happiness, of his patients. rine system. The general principles on which it depends differ little, if at all, from what have been advanced with respect to uterine pain, in the preceding paper; it is therefore the varieties of effects depend ing on the particular parts to which the transferrence is made, which is now to be considered. assuming their proper normal action, becoming abnormally affected; notwithstanding, it by no means follows that there is no concatenation of secondary or distant arcs with that of the uterus, by virtue of which the latter may be thrown into its abnormal state, the actions of such intermediate arcs or links remaining apparently quiescent or nearly so: thus in gout, although the primary exciting cause and action be situate in the digestive organs, an emotion taking place in the mind of the patient may either aggravate or relieve the painful actions of the foot. But if this be not the case, and admitting the uterine pain in labour to be unconnected with any secondary nervous arc, reason might be assigned to explain why the primary orificial irritation, instead of normally affecting the uterine muscles, may produce abnormally painful actions of those muscles. There remains, as yet, much to be explained respecting the nature of spasmodic Painful Reflex Action in Labour.-2. The second action and its consequent pain. Whether they depend modification of painful reflex action in labour, is when on minor nervous arcs possessing polar arrangement the abnormal state affects parts distinct from the uteand situate in the fibrilla of the nerves of the muscles affected, is certainly at present far from demonstrated; or is it possible that the abnormal spasmodic contractions are the results of spontaneous electro-like discharges of nervous fluid, arising from a peculiar condition of the terminal loopings of the nerve fibres lying in close approximation with the muscular The painful affections induced are situate in one cr tissues, and permitting irregular transmissions of more of the following parts: the muscles of the abnervous principle to the latter? Supposing this to be domen-the back-the hip-the thighs; those st the case, there is reason to believe that the spasmodic tached to the sacrum and coccyx; and even the more effect is not necessarily dependent on any positive distant muscles of the upper or lower extremities excess or accumulation of nervous principle, or vigorous may be affected; and not unfrequently the bladder. condition of the system, inasmuch as it is not unfre- the rectum, and the vagina itself. If the organ or quently a symptom of debility, and manifests itself part affected possess expulsive property, in addition when a patient is nearly in articulo mortis; hence, in to the ordinary spasmodic pain, the case may exhibit labour, spasmodic pain more generally occurs when a degree of expulsive character which is not always causes of depression are in operation. One fact, how-to be readily distinguished from true expulsive uteever, appears certain-namely, that spasmodic pain rine action; but in general the sensation induced is admits of being relieved by pressure and friction; of the most acute and distressing kind, resembling whether in consequence of their changing or equalizing what the older obstetricians termed "grinding or de the nervous relations of the part, or by the support lating pains," and distinct from " expulsive or bear they give to it, is quite problematical. Various ing-down pains." These agonizing pains are gene sedative means, direct or indirect, and counter-irri- rally accompanied by great depression of mind, and tants, also appear capable of removing the spasmodic the most gloomy anticipations. The above unprep state. As the principles in question admit of being tious state may occur during any portion of the laapplied to all the modifications of painful labour, it bour, even when the case is apparently near its ter has been deemed important to advert to them in the mination, and then be productive of a long state of present instance. protraction; it may also at any time suddenly disap pear, and genuine action return; and occasionally the two conditions will repeatedly alternate in distinct paroxysms, or even be manifested in one and the same paroxysm-in the latter case affording an explanation of that passage in Denman, in which he says, "There is, in the first instance, some degree of dilatation, and afterwards an effort to expel, and then there will be the expression which denotes sharp pain, immediately succeeded by a grave tone of voice." Under all circumstances where spasmodic pain occurs, it is incompatible with the proper function of the organ affected by it: thus, in the act of deglutition, if it take place in the muscles of the oesophagus, the passage of the food is arrested or rendered difficult; the same principle applies precisely to the uterus in labour. It by no means follows that cases of this nature will show no symptom of advancement, as there will often be a considerable accompaniment of uterine contraction, which may be sufficient to overcome the resisting powers, however slightly; otherwise the progress will be indefinitely negatived. The treatment of painful uterine action must be generally similar to what will hereafter be detailed with respect to the more important modification of extra-uterine pain, and, to avoid needless repetition, will now be only briefly adverted to. One leading point is, to remove the various exciting causes, and to relieve the painful action by a more or less active attention to the following remedial means-namely, by the administration of anti-spasmodics and sedatives, direct or indirect, as bleeding, opium, anaesthetics, fomentations, warm injections, bandaging, pressure, and friction. It is to be observed, however, that it may generally It is impossible to conceive a situation more dis tressing than that of a female suffering under a vere case of painful extra-uterine labour. The treatment is obviously of the highest impor tance. It involves the following indications: the A. To remove the exciting causes. Particular at tention should be paid to the state of the alimentary canal, indigestible food and too stimulating beverages being carefully avoided. If there be constipation, it may be relieved by a mild purgative, or, what is more prompt and preferable, an enema. Distension of bladder is to be relieved by the catheter, and the pa tient ought not to be allowed to continue too long without an attempt to pass urine. If the mind be depressed, it should be soothed and reassured, so as to encourage hope and confidence; and this moral treatment may be assisted by a moderate use of cor dials, such as camphor, sal volatile, lavender, warm the following fact deserves notice: So long since as gruel, tea, &c. If any accidental irritation affect the patient, it should be obviated by appropriate means. the year 1827 or 1828, the author was in the habit of suggesting to his class the inhalation of the nitrous oxide, for which suggestion he was indebted to his friend and then colleague, the late Mr. Jackson, of Rotherhithe, who, in some cases, had exhibited it with decided advantage, its effect being to exhilarate the patient, relieve the pain, and promote uterine action. It is not improbable that, in some cases at least, its use might even now be preferable to that of the chloroform; the great objection is the difficulty The author did for a long time keep a gasometer charged with the gas, but never found a convenient opportunity or necessity for resorting to it. Mr. Jackson's former private pupil, Dr. Broughton, now of Preston, Lancashire, and a magistrate for the West Riding of Yorkshire, could doubtless confirm this statement, and communicate further details respecting it. B. The second indication of treatment is, to relieve the painful action, which effected, the succeeding actions of the uterus may be confidently expected to become more normal; the case not unfrequently proceeding to a propitious, rapid, and felicitous termination. The means of pursuing this indication are as follows:a. Bleeding the favourite remedy of many in pain-of being provided with the requisite apparatus, &c. ful and protracted labour. Dr. Hamilton, in his lectures, used to boast that he could, with his lancet, finish any such case within twenty-four hours. Dr. Dewees, of Philadelphia, bled repeatedly, even ad deliquium, and says, "It is a divine remedy, which the women of this country speak of with rapturous effusions of gratitude; independently of its good effects on the labour, it extends its benefits to the future health and happiness of the patients." If this means be adopted, it certainly should not be carried to the above extent, which will risk too great a diminution of vital power, and at the same time, by suspending the placental circulation, implicate the safety of the child. Nevertheless, sufficient blood should be abstracted to secure the desired sedative effect. The author has rarely had recourse to it, believing that he has succeeded more satisfactorily by less objection able means. b. Opium.-This remedy, in doses of one or two grains, was originally recommended in labour by Dr. Mead, in his "Monita Medica;" and there can be no doubt that in such doses it is capable of allaying pain and promoting better uterine action. The late Dr. Sparks, of Ipswich, however, has been its warmest advocate, carrying his doses to the extent of six or ten grains. He says, "I have exhibited these doses in more than 100 cases without any particular inconvenience; the spirits of the woman are exhilarated, the uterus performs its functions with vigour, it gives way rapidly to the pressure of the child, the placenta never adheres, the patient is not affected with afterpains, and she recovers more quickly than those who need not the use of opium." Other practitioners, on the contrary, disapprove of the use of opium in labour. Dr. Dewees says, "I have repeatedly tried it myself, and seen it employed by others, but without, in a single instance, producing the effect for which it was prescribed; sometimes it evidently did harm." The author has frequently administered opium in doses of one or two grains, or from thirty to fifty drops of laudanum, and is convinced of its great utility; but when given in larger doses, he has known it suspend uterine action, so that it has ultimately become necessary to deliver with the forceps. c. Anaesthetics, or the inhalation of certain chemical compounds, as chloroform, the vapour of ether, &c., a mode of treating painful and protracted labour which has within the last few years been introduced, and which has the effect of producing more or less exhilaration, and ultimately, if carried to a sufficient extent, of throwing the patient into a state of insensibility, during which the pain lessens, or entirely subsides, effects which to the patient are frequently highly gratifying. According to the author's experience, a great objection to these means is, that they not unfrequently weaken or suspend the uterine action; the suspension, however, he admits, has not been of long duration, but he has felt assured that the case would have gone on as favourably, and been less protracted, had he been allowed to depend upon the means to be presently noticed. With respect to this mode of treatment in labour, 33-VOL. II. d. Fomentation, applied hot to the parts affected, will generally give great relief; even warm fluids may sometimes be injected with advantage per anum, vel per vaginam, when the pudendum or rectum participates in the painful action. e. Friction-affords one of the most effectual modes of relieving spasmodic pain. Its application was for merly only resorted to in cases of placental retention. Its use in active parturition, suggested by the analogy existing between the pains accompanying protracted labour and those of spasmodic pain under other circumstances, was first promulgated by the author, who for many years previously had found the effects almost miraculous. In his work published in 1819, and its succeeding edition in 1823, the principles and modes of its application, illustrated by numerous cases, were fully detailed, and to them the reader is respectfully referred, as the brevity of the present pages, which profess to be a mere sketch, will not admit of their repetition; besides, the statements of the author were at the time deemed unnecessarily prolix, and, not unlike the gentlemen mentioned in the preceding pages, he doubtless, and perhaps not without justice, may have been chargeable with too great enthusiasm with respect to his favourite remedy; nevertheless, he still feels justified in asserting, that whereas previously to the adoption of this mode of treatment, in common with all other accoucheurs, he was in the habit of being long detained with painfully protracted cases, he was then enabled to terminate almost every individual case with comparative comfort to the patient within six hours from entering the lying-in chamber, the few more prolonged ones being justly entitled to be regarded as rare exceptions to a general rule. Another happy result is, that the subjects of his treatment, without exception, recover most felicitously without any subsequent illness which could be attributed to it. The friction should be applied with the hand to the part affected, the object in view being to produce a warmth and glow in it, and to effect this the fingers should be used in preference to the flat of the hand. At the first commencement the great soreness or tenderness of the part will occasionally prove an obstacle, but a little perseverance and tact alleviate this, and the benefit soon becomes evident. Should the pain on being expelled from one part shift, as it occasionally will, to another, as from the abdominal muscles to those of the back, it should be pursued there. The patient will not unfrequently express her sense of relief, and scarcely permit the rubbing to be discontinued for an instant. It may not be easy to explain how the friction acts, but probably its good effects arise partly from the warmth it occasions, and |