ment of the medical profession better than in France. The course of study and attainments required, before being admitted to practice, are decidedly better than in England or our own country. But we must not forget our own National Medical Convention, which assembled in May last, in the city of Philadelphia. This is the second meeting of the kind which has met in our country.

Its labors, thus far, are considered to have been greater and more promising of good than its most sanguine friends had anticipated or expected. We believe the "American Medical Association" will be an honor and a blessing to our nation.

The subject of Hygiene, as far as it regards the community in which we live, is a matter of the highest importance; and, as such, should be entrusted to those who will not fail to give it all the attention and consideration it so justly merits.

Insanity, its causes, forms, etc., and the question of moral responsibility, are matters which concern not only the medical profession, but the community at large. And it should be ever borne in mind, that the only reliable foundation on which rests all knowledge of this, as of the whole subject of mental philosophy, is a thorough acquaintance with the physiology and pathology of the encephalon, and the nervous system generally. The philosophy of mind, and of everything in relation to human nature and its relationship with the external world, belongs, legitimately, to the medical philosopher.

The fourth division, we trust, will not fail to give us much useful information in regard to the more common and serious diseases confined to our county, with their causes, and the chief and important means of treatment. It has ever been a difficult and important thing, to determine fully, in every case, not only the causes and nature of diseases, but the use and abuse of medicines. More light and knowledge upon this subject would relieve us greatly.

The next section has assigned to it a subject of the highest value to medicine, and confessedly important to the welfare and prosperity of the human race. The laws of hereditary descent, their influence on mankind, and the means of prolonging life, are surely eminently important. We think more attention and strict medical inquiry should be given this matter, believing, as we do, that those laws are not yet rightly understood.

Man can never be happy until he acquaints himself perfectly with the laws of his own nature, and his relation with the external world, submitting himself, at the same time, to them and the will of his Crea

tor.

The seventh and last section regards the great aim and object of the science of medicine. This is a subject upon which much ignorance obtains among the mass of mankind, who think the only thing that a physician has to do, is to bleed and give drugs. And should he honestly decline doing either, for the good reason, that he could prescribe other and better means for his patient, he need not be surprised, for the thing has happened a thousand times, if he should be dismissed, and another more ready and willing hand employed in his place, who, perhaps, may be so fortunate as to build, if not establish permanently, some reputation upon the case.

The great reformer, and founder of "similia similibus curantur," made it a rule, we are assured, to administer something in the shape

of medicine, in every case; and, perhaps, in a majority of instances, such practice will best succeed, in these days of pretension and humbug. But the honest and skilful physician will never do anything to disturb his patient's health or comfort, merely because he may think it necessary to take medicine, or submit to such means as would, in fact, injure rather than benefit himself; nor will the physician's sense of justice, or the dignity of his noble and useful profession, allow him to fall into such miserable and disgraceful practices.

It has long seemed to me as if medical men were regarded in the light of mere druggists or apothecaries, whose only business is to dispense medicines; but we claim for our profession a higher and nobler vocation that of giving mankind a correct knowledge of themselves, and the best means of preserving health and prolonging life to a good old age. Now, to accomplish this, they must be instructed in a knowledge of their own constitutions, and especially the philosophy of mind.

Man's understanding of himself, as to the great purposes of life, must be greatly enlightened, and the moral sentiments fully directed and rightly controlled, before he can attain to the true dignity of his nature, and fulfil the great purpose of his creation.

Ignorance, and a want of sound understanding, were regarded by two of the best and wisest teachers the world has ever known as the worst evils, and knowledge and understanding as the greatest good. We hazard nothing in saying, that a knowledge of the human constitution, both of mind and body, is pre-eminently useful, and, in importance, far above all other human attainments.

It is our glorious privilege to be employed as the instruments in carrying forward this great and mighty work of regenerating mankind.

Resolved, That, in order to carry into immediate and successful operation the objects set forth in the foregoing Report, there shall be organized from the society seven sections, and the same are hereby formed, consisting of three members in each. Said sections shall so arrange their duties as to favor the meetings with not less than two discourses at each of its sittings.

All which is respectfully submitted.

JOHN MCCALL, Chairman. Drs. Coventry, Hastings, Pope, Guiteau, Torbit, Preston, and McCall, were elected as chairmen of the sections. Prof. Coventry of the first, and McCall of the third sections.

Offered by John McCall:

Whereas, the good work of Medical Reform having been commenced, and, thus far, well begun and carried out by our late "National Medical Convention," in the organization of the "American Medical Association," which is destined, it is believed, to elevate the medical profession in the United States, and render it an honor and a blessing to the nation; And, whereas, it now becomes the interest as well as the duty of the whole profession throughout the land, to adopt and carry forward with spirit, as far as may be, the great principles and measures now put forth to the world, therefore,

Resolved, That two delegates from this society be elected at this meeting, to attend the next annual sitting of said Association, to be held the first Tuesday in May next, at the city of Baltimore.

Unanimously carried.

Prof. Charles B. Coventry and Dr. John McCall were elected said delegates.

ART. VII.-Puerperal Anæmia. By H. N. BENNETT, M. D., of Bethel, Ct.-(Concluded.)

THE pathological views which I have advanced in relation to this disease, I consider fairly deducible from a variety of circumstances, among which are, the period of its occurrence, the general appearance of the patients laboring under it, and the physical character of those indivi. duals who are subject to it.

I have previously alluded to the changes which occur in the proportions of the constituent principles of the blood, during the latter months of pregnancy. I have never witnessed the characteristic symptoms of the puerperal anæmia prior to the sixth month, and it rarely occurs previous to the seventh month of gestation. At this period it is common, and in females who bear children in rapid succession, and who have once suffered from the disease, it almost invariably makes its appearance some weeks anterior to delivery, a time when the physiological condition of the female is one of anæmia in a minor degree.

Any one who has seen this disease, will not have failed to remark the general pallor of the cutaneous surface. This appearance of the skin, taken separately, is very similar to that of most anæmic conditions ; but, as I have before observed, it is not at first accompanied by emaciation; the female preserves her usual em bon point, and the facies is not expressive of visceral disease. In short, there is no indication of any other than a hæmatic lesion, to be derived from the general expression of the patient. There is, perhaps, in the early stages, a certain degree of similarity between the appearance of one laboring under this affection, and a chlorotic female. The symptoms upon the part of the digestive apparatus, and of the nervous system, are also similar to those of chlorosis. At a later period this symptomatic analogy ceases, and the puerperal anæmia manifests its peculiar pathological expressions. I conceive that the anasarca, which frequently occurs, can be referable to no other lesion than that of the fluids, since, at the period of the first occurrence of the infiltration there is evidently no organic difficulty sufficient to account for it. Indeed, a remarkable feature of this disease, is its very slight tendency to involve the more important viscera in serious organic changes, even when it is in its worst forms. The cessation of the causes which have produced it, namely, gestation and lactation, almost invariably suspends its farther progress, and the female is restored in a short time to her normal condition. This latter fact is also, to my mind, a strong argument in favor of the pathological views which I have taken.

The

In reference to the physical character of females who suffer from this complaint, my experience is very much in opposition to the assertion of Dr. Hale, that "women of a vigorous constitution and of good general health are subject to it, as well as those who are feeble." great majority of the cases which have occurred under my observation, have been those of delicate, irritable females, and disposed to hysterical affections. And those of a vigorous constitution, who have suffered from this disease, are females who have borne children in rapid succession, having scarcely time to recover from the exhaustion consequent upon parturition and lactation, before another conception.

Treatment.-If I am not mistaken in the results of my own practice,

much benefit may be derived in this disease from proper regimen as well as medicine. I need scarcely say, in view of the pathological opinions which I have advocated, that I consider venesection inadmissible, and I refer to the subject, merely for the purpose of denouncing, in females who present the first symptoms of this affection, or who have suffered from it in former pregnancies, the saignée de complaisance, so frequently practised upon pregnant women. If it is contra-indicated, it is none the less malpractice for having been solicited by the patient. In the first stages, this difficulty may be often counteracted by the proper use of nutritious and easily-digestible food, together with porter as a drink, or small doses of some tonic mixture. The mist. fer. composita has been an efficient medicine in my hands, not only in the commencement of the disease, but after the mouth and gastro-intestinal tube had become seriously implicated. I have also prescribed, with advantage, a pill composed of prot. carb. of iron and ext. hyos. given three or four times daily. This preparation is preferable where there is much diarrhoea. I have been compelled, however, in order to control this latter symptom, to resort to opium in repeated doses, the bow. els being excessively irritable. The nitrate of silver is also a valuable agent, and has succeeded in some cases in which the preparations of iron were wholly ineffectual. I believe it to be particularly serviceable where the mouth is severely affected A neighboring practitioner considers it almost a specific, in those cases of "Sore Mouth" which occur subsequent to delivery.

There are some cases which become severe prior to confinement, in spite of every method of treatment, and in these, after the birth of the child, I uniformly recommend to make no attempt at suckling. Pursuing this advice, I have seen females recover their usual health in a short period, after having manifested symptoms of a threatening nature, and I have been sometimes surprised at the rapidity of their restoration.

The cases which are most remediable by medicine, are those which occur during lactation, and the judicious employment of tonics, together with a nutritive diet, will rarely fail to mitigate, though it may be insufficient to cure the disease. Instances are not wanting, however, in which weaning must be resorted to, in order to avoid the continuance and progress of the malady; it will be arrested by nothing else, and, in feeble and delicate females, there is much reason to fear from its continuation a serious and irreparable undermining of the constitution. The affection of the mouth, is, according to my experience, rarely benefitted by topical applications, when unaccompanied by general means. The infusion of oak bark, and other mild astringents, have sometimes appeared to allay the irritation of the inflamed parts, temporarily.

In a general way, I believe the ferruginous preparations are the most appropriate medicines in this disease, and they may be varied or selected according to the circumstances of the case. The bitter tonics, however, are occasionally very useful. A favorite bitter with me, and one which I have seen succeed when iron was not tolerated in any form, is a wine of the bark of the common white wood, (Liriodendron tulipifera). I attribute its superior efficacy to the slight balsamic properties which it evidently possesses, in addition to its bitter principle.

ART. VIII.-Case of sudden Death, from Entrance of Air into the Internal Jugular Vein. Reported by RICHARD H. COOLIDGE, M. D., Assistant Surgeon U. S. Army.

ON Sunday, the 13th of December, 1840, I assisted Doctors Hoffman and Aitkens in the examination of the body of Mr. J————, at the Mansion House, in your city. It appeared that the deceased had been under the care of Doctor Aitkens, with variola discreta, from which it was probable he would recover. In a temporary delirium, he seized a razor and inflicted a wound, commencing over the sterno-mastoid muscle, about three fingers breadth below the lobe of the left ear, and extending to a corresponding point on the right side. In the course of the wound the left internal jugular vein was divided obliquely for about two-thirds of its circumference, and the carotid artery and pneumo-gastric nerve were exposed, but not injured; the razor then passed through the larynx into the pharynx, so that the finger could be passed from the external wound into the trachea and œsophagus; the remainder of the incision was superficial. On the entrance of Doctor Hoffman, the patient was lying with his left side on the floor, with the head bent forward so as partially to close the wound. His back was towards the door, and the noise made by the Doctor on entering the room, attracted his attention, and caused him to turn his head in that direction, thus opening the wound; a convulsive struggle ensued, and before any assistance could be rendered, he had ceased to exist. The hemorrhage had not been great, the amount being estimated by the appearance of the carpet and clothing not to exceed two pints. My impression is, that when Doctor Hoffman entered, Doctor Aitkens was by the side of the wounded man, that the hemorrhage had been partially arrested, and that the pulse was good, and immediate death not expected; but there is no mention of this in my note-book from which this case is transcribed.

Autopsy. This was not as complete as desirable, owing to the anxiety of some persons to remove the body from the hotel as soon as possible. The anterior portion of the parietes of the chest was removed in the usual manner. The lungs presented a natural appearance; there was no emphysema. On opening the pericardium the right ventricle and pulmonary artery appeared more prominent than usual, and were elastic on pressure. The pericardium was now filled with water, and the right auricle punctured under water with a sharp-pointed bistoury; no air or blood escaped. The right ventricle was now punctured in the same manner, when a large quantity of air bubbled up through the water. There was no air in the left cavities of the heart. The quantity of air was not measured. On opening the heart, the right auricle was found to contain a clot of blood; the right ventricle, pulmonary arteries, left auricle and ventricle were entirely empty; the venæ cavæ were filled with blood, but the pulmonary veins were comparatively empty.

REMARKS.

Bichat was of opinion that death, in consequence of entrance of air into the heart, was caused by the paralyzing effects of the contact of air on the brain. Lysteur and Magendie believed that death was produced by the forcible and permanent dilatation of the heart. M. Leroy d'Etiolles, wrote a memoir to prove that death from this accident is