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susceptibility, that in from twelve to sixteen hours the red line reached the axilla ; but rest, low diet, mild purgation ; a ley poultice, or rather a piece of lint soaked in ley and covered with oiled silk, applied to the part, but still more important, foreign leeches and a blister, arrested it completely..
The manner in which a blister acts upon a recent case of angioleucitis is not obvious, but several instances of its efficacy have been narrated to me, and above are two similar. The best place for it appears to be about the middle of the inflamed line-say about five inches by two.
By attending to the precaution of instantly sucking with care a dissecting or pus wound, there is reason to suppose that a large majority of these unpleasant, and occasionally fatal, inflammations might be altogether prevented; but after they have commenced, no delay should be allowed in the immediate application of at least free local depletion, and the observance of perfect rest.
REMARKS ON THE APPLICATION OF THE VAPOUR OF SULPHURIC ETHER IN PRACTICAL MEDICINE AND OBSTETRICS
BY THE EDITOR.
In the report of the Standing Committee of the New Jersey Medical Society, which will be found in another part of this journal, several pages are allotted to the detail of experiments with sulphuric ether in surgical operations, &c. Since the period when these experiments were tried, the evidence in favour of the ether inhalation has been constantly increasing, with such authority and force, that we devote a few moments to its further examination. In surgery, its use has been sufficiently tested, by some of the most distinguished surgeons of this country and Europe, to entitle it to general confidence in judicious hands. And while it is freely acknowledged that the remedy is not admissable in all cases, and that in several instances it has been productive of ill consequences, we believe it is right to give it a fair trial, particularly as the discovery is of American origin, and has been so extensively praised abroad. It would indeed be strange if no bad results had followed the administration of this powerful agent, having been freely employed by men who make no pretensions to physiological or pathological knowledge, for the purpose of allaying the pain of a mere mechanical operation, the performance of which requires no such knowledge.
As yet, but little is known of its therapeutic action. The last number of Ranking's Abstract furnishes intelligence that it has been used in six cases of tetanus. In the first two the symptoms were decidedly aggravated, and the patients died in paroxysms of extreme suffering. In two more, though death resulted, the tetanic symptoms were greatly mitigated. In the other two, the effects of the inhalation were to subdue the pain, and to relieve the spasms, terminating in complete recovery. It has also been used successfully in the treatment of neuralgia, spasmodic, asthma, laryngismus stridulus, hooping cough, colica pictonum, and dysmenorrhæa.
We have only space to remark further upon the most interesting quality possessed by this agent, to wit, its power of controlling the pains of child-birth. F Reference is made by the Standing Committee to cases which occurred in the practice of Prof. Simpson, which terminated favorably under the ethereal influence. This gentleman, to whom is due the honor of first administering the remedy in obstetric cases, continues to employ it in the Royal Maternity Hospital, and we have before us his report of several cases of forceps delivery, which terminated to his entire satisfaction. We pass them by, however, to refer to cases narrated by Dr. Prothéroe Smith, which are taken from the London Lancet, of May 1, 1847, by the editor of the “Half Yearly Abstract.”
The first of these was a female, æt. 40, with her first child. The ether vapour was administered at intervals during a period of four hours, with an entire relief from pain while under its in
fluence, though with a return of suffering, when the effect of the vapour had passed off. The forceps were used during a period of insensibility, and a living child extracted without the knowledge of the mother. On recovering her senses, she expressed a hope that the child would soon be born, and when informed of the termination of her troubles, she burst into a hysterical laugh, exclaiming, “ It is a dream—it must be a dream,” &c. Both mother and child did well in every respect. In another instance, Dr. Smith states that the effect of the ether was materially to increase the strength of the uterine and abdominal contractions, the patient uttering the usual cries of the last stage of labour, but positively denying having been aware of its termination. In concluding his account of these cases, the Dr. acknowledges the truth of the following deductions of M. Dubois, viz:
1st. That the ether prevented pains during obstetrical operations.
2d. That it does not suspend uterine or abdominal contractions.
3d. That it appears to lessen the natural resistance of the perinæal muscles.
4th. That it does not appear to exert any bad influence on the life or health of mother or child.
5th. That it does not retard the subsequent contraction of the uterus.
In regard to the admissability of this agent in the complicated process of parturition, we can not speak from experience. We have heard of a few instances where it has been successfully used in this vicinity, but we can not detail them without more positive knowledge. We have also seen cases reported in which the uterine contractions were for a while entirely suspended under its use, but Dr. P. Smith, whose experience we have quoted above, refers this to the impression made upon the nervous system by the novelty of the means employed, as is the result of other strong emotions of the mind, and such as often follows the first appearance of the accoucheur. We believe, however, that the weight of testimony is greatly in favour of the remedy, particularly in its application to surgery, and we hope
it may be thoroughly tried in this country. The mode of administering the vapour is very much simplified. Instead of the numerous instruments which have been invented for the purpose, it is now generally acknowledged among physicians that the safest mode is to inhale through a common sponge, well saturated with the ether, and applied to the mouth and nose. This method allows a more thorough admixture of atmospheric air with the ether gas, and is thought to guard against any danger of asphyxia or other like accidents, though it may probably require a little more time to produce its effect, than would be necessary by the methods first employed.
Proceedings of the National Medical Convention, held in New
York, May, 1846, and in Philadelphia, May, 1847. pp. 175.
'The first meeting of the National Medical Convention in New York, in 1846, was an event highly conducive to the progress of medical science in the United States. The project of bringing together the representatives of the great medical brotherhood, to discourse upon subjects in which they had a common interest, and to devise measures for the elevation of the Science, though not new, was here for the first time in the history of our country successfully carried out. The movement originated, if we remember rightly, in a district Medical Society in the State of New York, from whence it was carried up to the Medical Society of that State, and received the sanction and co-operation of that body. The individual who was the most active in promoting it and the most persevering and industrious in arranging the preliminary steps, was Dr. N. S. Davis, of Binghamton, New York, the chairman of the committee of the State Society, to whom the business of calling together the delegates was en
trusted. To this gentleman, the profession in the United States owes much, for his untiring energy in effecting an object, in the midst of discouragement, which would have baffled the efforts of a man of, ordinary ability.
It was with feelings of mingled hope and fear, that the ardent friends of medical reform throughout the Union, looked forward to the contemplated meeting in New York. Many of the gentlemen connected with chartered medical schools, it was well known, viewed it with distrust and suspicion; under a belief that there was a design on the part of its originators and active supporters, to infringe upon their rights, and break down their influence. Others feared that it was a local movement, intended to advance the interests of New York, as the medical centre of the Union, to the disadvantage of other cities, who might aspire to an equal rank with her; while a still larger class, looked upon any combined effort to relieve the profession from growing abuses, and to maintain its honor and respectability, as utterly vain and hopeless. There were, however, many who had a strong and abiding faith in the efficacy of a combined movement on the part of the honest and disinterested members of the profession, and who believed that the time had arrived, when a large number of the brightest intellects in our ranks, were ready to give in their adhesion to an organization, based upon a broad and liberal basis.
Nor were the anticipations of this class disappointed. Whatever of doubt or fear may have possessed their minds, it was dissipated at the coming together of the men who, from seventeen States of the Union, had left their pursuits, many of them at great personal sacrifices, and assembled in New York, determined to inake an effort for the elevation and advancement of our noble profession.
Among them were some of the most eminent physicians of the country, the representatives of medical societies and of colleges; the veteran and the tyro, the master and his former pupils, all meeting together on common ground, and animated alike by the feeling of consolidating the medical profession into a national compact, which should exercise a controlling influence over the future progress of the science. With the ex