four hours, through several days in succession. The diarrhoea continued, but was changed to a free discharge of copious liquid yellow stools. In one week the respiration became natural, and the cough ceased; but the diarrhoea, fever with distinct remissions, and constant delirium, continued until I had visited her thirty-two days. Rhubarb was occasionally united with the ipecac., infusion of hops and of the serpentaria, mucilages, and diet of Indian suppawn and milk, were all useful auxiliaries in the case. The delirium was followed by a childish mental imbecility; the patient crying for her favorite article of diet, candies, and infantile toys. She is now well, in the city of New York.

This law of epidemics, so important as a guide in diagnosis, is founded on this principle, viz.: The whole community are under the influence of one common invisible cause of disease; that the first effect of this invisible agent, is a pathological unity in the prime-moving cause of all the various phenomena of the different cases; that there is unity in relation to certain leading remedies. For this reason, I have been compelled to lay on the shelf all antimonial preparations, nitrate of potash, and even Coxe's hive syrup. The continued diseased mucous mem brane forbids the use of these articles. They have had their day of usefulness, and they may have it again; but not until the present "constitution" of febrile diseases shall have passed away. At the same time the ipecacuanha, and the eupatorium perfoliatum have risen in importance.

Our epidemic of 1847, thus far, could, in more able hands, furnish an interesting subject for a volume. I will mention some few of its characteristics. It was a continuance of the old tendency to abdominal disease; even in the winter and vernal months, it was highly bilous. One of its outward forms was erysipelas. M. Desault, in his journal of the Hotel Dieu, at Paris, asserted forty years ago, that erysipelas is always the result of a bilious cause. In our fevers of the winter, Brandreth's, Lee's, or any other pills of the vegetable gums, would leave a distressing nausea, by irritating the mucous membrane; and some three or four hours after brisk evacuations from the bowels, the patient would vomit yellow bile, whilst the headache and fever would rage with increased violence until calomel came to the rescue. In such cases, the mercurial purge must be given in two divided doses, three hours intervening, that it may exert its slow specific powers in equalizing action. I derived no benefit from emetics. A pioneer dose of calomel at night, with Epsom salts or castor oil next morning, was indispensable in all cases. The "Samson of the materia medica," in no epidemic was ever entitled to higher honors. One of the most curious properties of this epidemic was its innumerable outward forms; but in all cases the fever was remittent.

It appeared from the operation of remedies, that some morbid action in the portal circulation was the prime-moving cause of all the phenomena; and this circumstance, through the fortuitous freaks of the nervous system, would send its influence to as many different tissues and localities, as the disease showed external forms. If directed to the skin, there was a case of purple erysipelas; if to the glandular system, there were soreness and swellings of the parotids, submaxillary, the tonsils, and cervical glands; if to the mucous membrane, there were cough, from irritation of the throat, without swelling of the tonsils, sore throat, otalgia, sore nostrils, and weeping eyes, or a painful diarrhoea;

but the bronchial tubes, and the whole pulmonic organization, seemed to be exempt from all these fortuitous circumstances. Sometimes the disease would assume the form of inflammatory rheumatism, and that in the same house at the same time, in which the disease was prevailing in a different form. The rheumatism would disappear, by the occurrence of an eruption on the skin. The diarrhoea was always painful, with some evidence of peritoneal inflammation of the erysipelatous kind. In this case it was necessary to add opium to our mercurials. The local inflammation seemed to interpose an obstacle to the tendency of the opium to link cerebral with abdominal disease in bilious fevers. In one case of this character, the diarrhoea continued five days, with chills alternating with febrile heat, before the patient consulted a physician. Now, the purple erysipelas had wandered downward, and fixed itself through the whole extent of the inward half of the right leg. Some days after it changed its location to the other side, and became phlegmonous, discharging matter. The patient was moved twelve miles to the house of his father, where the case terminated fatally, proving itself contagious, causing the death of his mother by erysipelas of the face, and affecting others in the same family.

In

Now, there is an important question connected with these contagious cases of erysipelas, which I will lay before you, to close my address. Does this contagion arm the accoucheur with the cause of a deadly puerperal peritonitis? Whilst attending the above case I lost two such patients, both sound, robust constitutions, having short and easy labors. One sickened forty-eight, the other seventy-two hours after their accouchment. Dr. Stewart, while attending bad cases of erysipelas, lost three puerperal cases, and Dr. Hopkins one. The women exhibit no external marks of erysipelas, but the infants die a few days after the death of their mothers, by a purple erysipelas of the whole body. the New York Journal of Medicine, you have doubtless seen the history of such an epidemic in the western part of this state.* There was a general alarm on the subject of this serious question. In Dr. Ranking's Half-yearly Abstract of the Medical Sciences, published in December, 1846, you will find a report of Dr. Peddie, on epidemic erysipelas, as connected with a fatal puerperal peritonitis. I will extract for your convenience one of his conclusions, which his own personal experience had led him to adopt : "Patients in child-bed should either not be attended at the same period with cases of malignant or severe erysipelas, or proper caution should be observed as to ablutions, more especially after contact with any discharge from such patients, and when a case of puerperal fever does occur, chlorinated ablutions should be used; and if a second occur, he should withdraw from obstetrical practice for two or three weeks, if possible."

The question is involved in darkness, after all the facts disclosed in publications. The accoucheur in one of my cases was present with the patient in labor one half hour, the infant in his hands two minutes, then delivered to the hands of the nurse. Did the accoucheur communicate the disease to both at the same time; if so, why do not both sicken at the same time? Does the infant contract the disease from its mother's milk? In this very case a healthy infant five months old without my orders, drew the breasts of the patient twice on the day of her death,

*By Austin Flint, M. D., editor of the Buffalo Medical Journal, etc.

and that with perfect impunity; yet, the patient's infant some days after dies of erysipelas. The mother could not have the disease communicated by the accoucheur, so as to affect the child in one half hour previous to their separation. It is one of the most important questions ever presented for the contemplation of our profession, and facts well attested urge upon us the exercise of extreme caution.

ART. VI.-Report of a Committee to the Oneida County (N. Y.) Medical Society. By JOHN MCCALL, M. D., late President of the State Medical Society.

TO THE EDITOR of the New-York Journal of Medicine and the Collateral Sciences:

DEAR SIR,-Should the following matters, which are some of the more important of the transactions of the late annual meeting of our society, held the first Tuesday in July last, be deemed worthy of a place in your valuable and most useful Journal, they are at your service, with such corrections and amendments as you may think necessary.

Their publication may, perhaps, induce other Medical Societies to take some action of the kind, as a step towards "medical reform." The next meeting of our society will be held on the first Tuesday of October next, at this place; hitherto we have had two regular yearly meetings; for the future we hope to meet at least three, if not four times, in the year. Very truly and sincerely,

Utica, August, 1847.

JOHN MCCALL.

THE Committee to whom has been referred the subject matter in relation to the formation of a portion of the society into sections, in order that more laborers may be brought into the field in behalf of medical improvement, beg leave to present the following Report, on the preamble and resolution offered by one of your committee, (John McCall,) at the last meeting. The preamble and resolution are as follows:

"Whereas, the prosperity and usefulness of this, as of every society, must depend in a great measure on the interest felt and the labors performed by all its members. And, whereas, an idea has obtained, and is yet entertained, that our meetings, for some time past, have become less interesting, and virtually useless to many of the country members, therefore,

"Resolved, That for the purpose of enlisting the best feelings of all in its cause, and for securing and promoting the welfare of the society, a portion thereof should be divided into several sections, for the purpose of apportioning among them the labor which is deemed so necessary in sustaining our character and usefulness as an association."

It will not be pretended that we have, in all cases, improved to the best advantage the privileges and opportunities connected with our meetings.

These might have been made more useful to ourselves and our profession, as well as beneficial to the community in which we live; yet, under the circumstances, it is believed that collectively, if not individually, we have contributed at all our meetings a reasonable share of labor, in the way of discourses, reports, etc., both interesting and useful to the members generally. And as it regards the idea of a diminution

of interest felt and complained of by some, we have only to remark, that it will give us great pleasure in being instrumental in removing any future occasion for a like complaint; and to that end we wish, if possible, (and certainly there is no difficulty whatever in the way,) to devise such means as shall stimulate the society to new and more vigorous action in behalf of our noble profession.

Several means have been tried to engage the attention and secure the best interests of the members, by the appointment of committees in the several towns, upon the subject of insanity, the number of in. sane, the form and modification of that fearful disease, etc., and in the distribution of the offices among the brethren throughout the several towns, in order that a good feeling of brotherhood, and a higher and more exalted sense of respect for our profession and ourselves might be thus elicited and maintained.

We had hoped that those, thus selected, would have availed themselves of the opportunity of presenting us with at least a share of the fruit gathered from the field of their own labors and experience. In a few instances, we have been favored with excellent articles and highlyinteresting reports, while, in others, we were sadly disappointed. But we will not relinquish the hope that our members will yet do their duty like men. And as there is nothing like trying, while backed up with a determination upon a course of right doing, it is hoped and believed that the formation of our younger members into sections, cannot fail to accomplish, in a short time, much good, not only to the society, but in securing a desirable share of honor and glory for themselves.

For all present purposes, it is thought that seven sections, composed of three members in each, may be sufficient as a test of what may be done in that way, on the plan of the British Association. Notwithstanding the great and important improvements made in medicine within the recollection of some of your committee, and especially in physiology, pathology, surgery, midwifery, and in the treatment of many diseases, more remains to be done.

In the field of mental philosophy, which is an all-important part of medicine, much ground remains in a state of barrenness. Truly, this is the unweeded garden grown to seed. "Things rank and gross in ignorance possess it" entirely.

What system of mental philosophy have we? Have we any founded on a knowledge of the physiology and pathology of the brain?

The department of therapeutics, too, requires more careful investigation, to enable us to judge correctly as to what credit may be due, in all cases, to those articles used and considered as medicines.

It is always desirable to know, if possible, what honor should be given to the medical attendant and his means, at the same time not forgetting the restorative powers of the human economy, and their agency in the cure of diseases. "Nulla medicina aliquando optima medicina." No medicine was once considered, under certain circumstances, as the best medicine. Whether this be a sound maxim, is a matter to be determined by the members individually, though, in our judgment, the great principles in medicine, like those in other sciences, are as unchangeable as any of God's laws. The venerable and illustrious Hufeland confessed that two-thirds of his patients would have recovered without his prescriptions; in other words, by the salutary efforts of nature.

Medicine depends, for its right understanding, upon observation and sound reflection. And even here, our observations must be progressive; again and again repeated, and never stationary in our researches. The science of medicine is, in its very nature, progressive, like all human knowledge. Progression is one of God's laws.

While in other hands, it continued in the same dull round, without making any sensible or useful advancement in the way of improvement. We would thank God that we live in an age in which mighty achievements are being made in the cause of humanity; and that the spirit of improvement, for the good of our race, is abroad in the world.

The great object with the medical inquirer is, the ascertainment of medical and scientific truth, and its right application for the good of mankind. Now, for the attainment of that end, the division of labor is well calculated to accomplish that purpose. No one, however highly favored his mental constitution and attainments in knowledge, can make himself master of all the branches of the healing art. Life is too short-our profession, as an art and science, too long-opportunities rare, and too often neglected-experience frequently deceitful, and judgment ever difficult, to enable even a John Hunter to become eminently great and skilful in all the departments of medicine.

In such a state of things, the formation and arrangement of our forces into efficient sections, or committees, becomes advisable and necessary.

In all assemblies for the transaction of business, some such course is taken. Nothing is done without the instrumentality of committees. They are the moving springs of all conventions, and, without them, the body cannot move onward with life and energy in the great objects in which the whole are engaged. Now for the sections.

To the 1st section should be entrusted the great subject of “Medical Reform."

To the 2d, Public Hygiene, confined to our own county, (Oneida). To the 3d, Insanity-its causes and forms, together with the all-important question of moral responsibility.

To the 4th, the prominent diseases of our county, their causes, and a full account of the means of treatment.

To the 5th, the best means of studying the human constitution, in health and disease.

To the 6th, the laws of hereditary descent, their influence on the human race, and the best means of prolonging life..

To the 7th, the great purpose of the science of medicine.

The idea of reform is not confined to medicine-law and theology are now being moved by the same mighty agent.

But the great matter is, to know what reformation is most needed, either among the members of the healing art, or in its principles and practice, and what are the best means for their attainment.

We think there is yet room for improvement in all these respects. "Medical reform," we think, should bring to its aid the best talents among us.

This subject has engaged, and is still engaging, many of the ablest minds in England, Scotland, Ireland, France, and the United States.

A medical congress assembled lately in Paris, and from what we have been able to learn of its doings, much useful labor was accomplished. In no country are the laws and regulations for the govern