5530 
 
 A TREATISE 
 
 ACUTE AND CHRONIC DISEASES 
 
 NECK OF THE UTERUS. 
 
 ILLUSTRATED WITH 
 
 NUMEROUS PLATES. COLORED AND PLAIN. 
 
 BY 
 
 CHARLES D. MEIGS. M.D., 
 
 PROFESSOR OF MIDWIFERY AND THE DISEASES OF WOMEN AND CHILDREN IN JEFFERSON MEDICAL COLLEGE; 
 MEMBER OF THE AMERICAN MEDICAL ASSOCIATION; OF THE AMERICAN PHILOSOPHICAL SOCIETY, 
 AND ONE OF THE COUNCIL; VICE-PRESIDENT OP THE PHILADELPHIA COLLEGE OF PHY- 
 SICIANS; AUTHOR OF "OBSTETRICS, THE SCIENCE AND THE ART;" "WOMAN, 
 HER DISEASES AND REMEDIES:" " A TREATISE ON CERTALS OS 
 THE DISEASES OF YOUNG CHILDREN," ETC. ETC. 
 
 PHILADELPHIA: 
 BLANC II ABD AND LEA 
 
 1854.
 
 Entered according to the Act of Congress, in the year 1854, by 
 
 BLANCIIARD AND LEA, 
 
 in the Office of the Clerk of the District Court of the United States in and for the 
 Eastern District of Pennsylvania. 
 
 PHILADELPHIA: 
 T. K. AND P. G. COLLINS, PRINTERS.
 
 rarj 
 
 WP 
 if 70 
 
 TO 
 
 ROBERT M. HUSTON, M.D., 
 
 PROFESSOR OF THERAPEUTICS AND THE MATERIA MEDICA IN JEFFERSON MEDICAL 
 COLLEGE AT PHILADELPHIA. 
 
 My dear sir : — 
 
 You are aware, I believe, that by command of the 
 American Medical Association, I was directed, as chair- 
 man of a committee appointed at Charleston, South 
 Carolina, to present a Report to that body on the subject 
 of Acute and Chronic Diseases of the Cervix Uteri. 
 
 Professor Channing, of Boston, and Dr. Thomas H. 
 Yardley, of Philadelphia, who were of the committee, 
 confided to me the duty of drawing up the Report, 
 which was presented to the Association at the New York 
 meeting in May, 1853. 
 
 The paper, with the drawings, was ordered to be 
 printed and engraved, and may be found in the last 
 volume of the Transactions. 
 
 Under the impression that the views of disease and 
 suggestions of treatment in this paper might, if more 
 generally diffused, prove of some service to our profes- 
 sional brethren, I have, with the liberal consent and 
 full approval of the publishing committee, made a sepa- 
 rate volume of the Tract, which I beg you to allow me 
 to dedicate, thus publicly, to you. I hope you will 
 
 6124024
 
 IV DEDICATION. 
 
 accept it as a mark of my most sincere respect and warm 
 attachment. I pray you also, as far as you properly 
 may, overlook its numerous faults of substance and 
 form ; to receive my book with wonted kindness, and 
 continue to favor me, as long as I live, with that course 
 of kind and friendly conduct, which, together with my 
 high appreciation of your sterling abilities and candor 
 as a man, has long made me, and ever shall make me, 
 feel that I ought to be, and am your sincere and re- 
 spectful friend and most grateful servant, 
 
 CHARLES D. MEIGS. 
 
 324 Walnut Street, 
 Jan. 15, 1854.
 
 ON 
 
 ACUTE AND CHRONIC DISEASES 
 
 THE NECK OF THE UTERUS. 
 
 The great prevalence of cases of sexual disorders 
 has of late called much of the attention of physi- 
 cians to a consideration of the causes, signs, and treat- 
 ment of those affections, and several recent publications 
 have thrown much light on them. It was to be 
 expected that the labors of ingenious men, devoted 
 to this species of research, should, by this time, have 
 placed all questions in this kind of practice so fairly 
 before us, and with solutions of the various problems so 
 clearly exposed, that there could be no farther real 
 necessity for making public one's observations or reflec- 
 tions. 
 
 It is, nevertheless, undeniable that our daily clinical 
 
 experience, as well as what we notice of the current 
 
 medical literature, and what we behold around us 
 
 among the sick, all concur to prove that it is in general 
 
 2
 
 18 ACUTE AND CHRONIC DISEASES 
 
 esteemed to be a difficult thing to comprehend the va- 
 rious disorders of the womb, and appreciate their pecu- 
 liar reaction upon the constitutions of women. 
 
 Notwithstanding the numerous learned works we 
 possess, whether they be of ancient date or modern, it 
 does appear to me that this class of disorders, as to the 
 clinical duties at least that are connected with them, 
 are not so well understood as they ought to be, and 
 that this is the chief reason why so many of the cases 
 tend, at last, to fall under the care of a few individuals, 
 who may have acquired a sort of fame or notoriety for 
 success in their treatment, instead of remaining, as they 
 ought, in charge of the family physician or surgeon, 
 usually the first to be consulted on account of them. 
 
 I regard this tendency to specialization as a thing 
 most injurious to the profession, which ought to be a 
 whole in the whole and a whole in every part. Such 
 specialization of the office of the physician is very far 
 from tending to elevate the whole body in its usefulness 
 to the public, however it may serve to exalt the inte- 
 rests of a few individuals, and it must be confessed that 
 any specialization as to this sort of clinical duties is 
 both highly inconvenient to the people, and disparaging 
 to the profession at large, while it is wholly uncalled 
 for by the nature of the cases. A little consideration 
 might serve to convince us that this class of disorders 
 presents to the practising physician nothing more essen- 
 tially inscrutable, or intractable, than the ordinary com- 
 plaints submitted for examination and advice to the 
 gentlemen of the Art.
 
 OF THE NECK OF THE UTERUS. 19 
 
 There would be less propensity to bring them into 
 the class of a specialty in practice, if the treatises now 
 in our possession, were as clear in the description and 
 illustration of disease, and as precise in the indication 
 and relation of methods, as they ought to be. Far from 
 this — we have to regret that many of the drawings and 
 colored prints serve rather to obscure, than enlighten 
 the path of the practitioner. It needs only to glance, 
 for example, at the plates to Madame Boivin's work, to 
 see that this remark is quite just, while the more ele- 
 gant volume of Dr. Hooper affords as little aid — his 
 engravings, however beautiful, exhibiting for us only 
 the ravages of diseases ended in death, and not those 
 curable forms and stages, which are far more worthy of 
 investigation, as guiding us in our attempts to cure. 
 
 It has seemed to the Author, that, before entering 
 upon the examination and description of the special 
 cases, he is called upon for a few remarks concerning 
 methods of proceeding — the usefulness and propriety of 
 which have, by some, been sharply called in question, 
 while others have contended that they are indispensable 
 to correct diagnostication and treatment. 
 
 I allude to the method introduced by M. Recamier, 
 Physician to the Hotel Dieu, at Paris. That celebrated 
 professor, in his work entitled Recherclies sur le Traite- 
 ment clu Cancer, 2 vols. 8vo. Paris, 1829, says, at page 
 317, t. i. :— 
 
 " Des l'annee 1801, consulte frequemment pour des 
 maladies organiques de l'uterus, je coinmencai a traiter
 
 20 ACUTE AND CHRONIC DISEASES 
 
 les ulceres du vagin et du museau de tanche de la 
 merae maniere que ceux de la gorge, qui m'en donne- 
 rent l'idee. Un tub d'etain du volume du doigt, et de 
 quatre ou cinq pouces de long, servait a ces panse- 
 ments, dans lesquels les surfaces ulcerees etoient 
 touchees avec un pinceau de charpie trempe dans du 
 miel rosat, ou dans du rob de Daucus, seul ou associe 
 avec du collyre de Lanfranc, du laudanum de Rousseau, 
 ou de l'extrait d'opium." 
 
 M. Recamier farther informs us, that, in 1812, M. 
 Bayle inquired of him concerning his methods, and that 
 the facts he communicated to that author were made 
 public in the Diet, des Sci. Med., art. Cancer, which 
 notice is found in torn. iii. p. 604, as follows : — 
 
 " Deja M. Recamier est parvenu a porter differentes 
 substances medicamenteuses immediatement sur l'ulcere, 
 a l'aide d'un pinceau conduit dans un tube de gomme 
 elastique ou de metal qui ecarte les parois du vagin, et 
 embrasse dans son orifice superieure toute la partie 
 saillante du col de i'uterus. Ces essais, conduits avec 
 prudence, conduiront peutetre un jour a quelque 
 methode de traitement, plus efficace que celles aux 
 quelles nous sommes encore reduits." 
 
 The great success, in treatment, that attended M. 
 Recamier's practice at the Hotel Dieu and the city ge- 
 nerally, led to the introduction of Ms method, which 
 may be denominated the surgical method of curing the 
 disorders of the cervix; and the question now is, 
 whether the advantages resulting from it are sufficient 
 to counterbalance certain evils supposed to have grown
 
 OF THE NECK OF THE UTERUS. 21 
 
 out of its introduction. These evils, it is alleged, 
 consist in the great mortification which any sensible 
 woman must experience, if subjected to a metroscopic 
 examination — some laxity of the moral sense likely to 
 grow out of such proceedings — the physical injury, by 
 contusion or laceration, sometimes attending the opera- 
 tion, and the mischievous effects of violent drugs and 
 dangerous instruments, to the employment of which it 
 leads and tempts us. Farther — it is asserted to be un- 
 necessary, since the exploration by touching, as it is 
 called, reveals sufficiently well the nature of diseases at- 
 tacking the cervix uteri. 
 
 I shall not here discuss the moral differences between 
 a diagnosis made by the operation of touching, and a 
 metroscopic one. Either of them is bad enough, in 
 itself considered ; but as neither of them could be sup" 
 posed possible, except out of some direful necessity of 
 the patient, and as the one is not essentially more revolt- 
 ing to the feelings of the sufferer than the other, it ap- 
 pears to me that the argument is as valid against the 
 one as the other. No one will deny that the delicacy 
 of those relations that exist between medical people 
 and their female patients, opposes, in a variety of cases, 
 an insuperable barrier against any successful treatment 
 whatever, for there are found individuals so fastidious 
 as to prefer pain, disease, and even death itself, to 
 any revelation concerning their disorders. 
 
 Some women, who do not object to relate the history 
 of their diseased sensations, compel us to rest satisfied 
 with such barren histories as they themselves can give,
 
 22 ACUTE AND CHRONIC DISEASES 
 
 and medical men, it is presumed, are often obliged to 
 adopt an empirical method, or — to use a common phrase 
 — to guess at the seat, nature, and phasis of the disease, 
 as well as the remedies for it, rather than resign the 
 woman to hopeless distress on the one hand, or, on the 
 other, urgently insist upon her waiver of that fastidious 
 sentimentality which ought, to a certain extent, to rule 
 her professional relations with the medical adviser, but 
 not wholly and exclusively, and to her ruin. 
 
 Even to examine by Touching, does, in many parts of 
 the United States, appear to be a revolting proposition ; 
 and there are some persons who prefer to make jour- 
 neys of hundreds of miles, in order that such an inquiry, 
 supposing it indispensable, may be instituted by a stran- 
 ger, and far from home. Some examination is, never- 
 theless, often an indispensable requisite to correct infor- 
 mation as to the sanitary wants of the patient ; and 
 physicians cannot always rely upon the historical relation 
 of the patient herself or her friends, who assuredly can- 
 not impart knowledge which they do not themselves 
 possess, and can by no possible means acquire. 
 
 It may be farther averred, that the Touch alone does 
 not surely impart this knowledge ; for as much as a 
 tint or color is often the clearest exponent of a morbid 
 state, it becomes sometimes an imperious necessity to 
 ascertain it by the metroscope. The question is, then, 
 not whether the instrument informs us better, but 
 whether, without its aid, we could at all learn our the- 
 rapeutical or surgical duty to the subject. 
 
 The objection as to danger of injury, and that other,
 
 OF THE NECK OF THE UTERUS. 23 
 
 the temptation to make use of too violent topical remedies, 
 is a question of the good sense and prudence, or con- 
 scientiousness of the medical man — subjects not for us 
 to discuss. Yet, we may adventure the remark, that no 
 sincere person will deny, that, in our profession in these 
 United States, there exists a great majority of gentle- 
 men, competently educated ; men skilled in their art ; 
 men of probity, and having elevated views in morals 
 and religion; and, as to life and conversation, irre- 
 proachable. 
 
 If the whole class of cases under consideration should 
 be confided to such persons as these, little objection 
 would be made to their professional opinions or practice. 
 There is conceded to them, by common consent, as well 
 as by governmental authority, a "jus docendi scribendi 
 atque exercendi, ubi rite vocaii fuerint ;" and the public 
 esteem them to be warranted in all their acts, done 
 within the metes and bounds of their real professional 
 privileges. They have no authority to violate those 
 rules and arrogate privileges beyond; and when they do 
 so it is at their own peril. 
 
 The question, then, seems to be still more narrowed 
 down; and we have only to determine what is, and what 
 is not, strictly within the limits of our duty and preroga- 
 tives — things to be resolved, not by formal council, but 
 by the physician himself, upon the spur of the occasion. 
 We must not repudiate, and, by wholesale reprobation, 
 condemn and annul a good method of cure, merely be- 
 cause incompetent or wicked persons might or do abuse 
 it to their own gain : to do so, would be to amerce
 
 24 ACUTE AND CHRONIC DISEASES 
 
 and punish the sick and the miserable for faults of our 
 brotherhood. 
 
 Lastly. — Even if it be true that some abuses, disgrace- 
 ful to Medicine, do exist, we are persuaded that such 
 discreditable examples must be very rare among a class 
 so generally acknowledged for wisdom, virtue, and po- 
 liteness, as the great body of the United States physi- 
 cians. Wherefore, we do not find ourselves called upon 
 to discountenance and reprobate the prudent and neces- 
 sary employment of modern methods and instruments, 
 invented to improve the means both of diagnosis and 
 surgical treatment of diseases of the cervix uteri; con- 
 ceiving that this is a matter to be left to the conscience 
 and judgment of our brethren, whenever the occasion 
 may arise. 
 
 The reactions of the reproductive organs upon the 
 other members of the animal economy are known to be 
 both diverse and comprehensive ; nor is it difficult to 
 perceive that this should be the case, seeing the great 
 importance of their functions. One could hardly sup- 
 pose, indeed, that a system of anatomical tissues, repre- 
 senting the complement of the vital powers, could be 
 an indifferent in their constitutional reaction. The 
 powerful sway they exert upon not only the physical, 
 but the psychical condition and nature of the woman, 
 might well persuade us that changes in their vital status, 
 even such as are inappreciable except by the reason, 
 should greatly affect both the body and mind of the 
 woman.
 
 OF THE NECK OF THE UTERUS. 25 
 
 The reproductive force can never, in fact, be an indif- 
 ferent, as regards the health and perfection of the woman 
 — who is always an imperfect being until she has, at full 
 puberty, acquired this complementary force, and begins 
 to decline from her perfections as soon as she lays it 
 down at the change of life. During all the period in 
 which she possesses this force, even very slight modifica- 
 tions of it must affect the direction, as well as intensity, 
 of many others of her physiological actions. 
 
 It is probable that the Hysteric malady, which assumes 
 such diverse forms, and comprehends in its range, so 
 many separate and distant organs, depends essentially 
 upon a vital status of the reproductive viscera, often so 
 slight as to escape all sensible detection. It is, at least, 
 certain that sexual diseases do give rise to severe distress 
 in distant regions of the body ; and, while they can in- 
 commode, vex, and even destroy the woman by degene- 
 rating the womb, the ovaries, or other parts, they can 
 likewise subvert her health, and destroy her life by per- 
 verting the strength and soundness of other vital por- 
 tions — the radiating point of the mischief being, in the 
 mean time, concealed within the depths of the pelvis, 
 and wholly masked by the constitutional disorders thus 
 set on foot by it. 
 
 A dark and mysterious veil hides from us many of 
 the laws that grow out of the intimate relation and 
 mutual dependency existing between the conservative 
 or generic forces of animals, and their reproductive or 
 genetic powers. Many stumbling-blocks in the path of 
 the practitioner would be taken away, if these laws and
 
 26 ACUTE AND CHRONIC DISEASES 
 
 relations could be fully understood ; and we should then 
 be able to take more precise indications, and adopt more 
 positive methods of treatment. Possessing full ana- 
 tomical and physiological information upon those organs 
 and forces, we might raise up in the mind a true ideal 
 of them, which would serve as a standard or scale by 
 which to measure and judge every aberration of form, 
 substance, power, or place, in the instances brought be- 
 fore us for our decision. 
 
 And it is proper, indeed, that the physician should, 
 in every case of disease, endeavor to acquire the perfect 
 idea of the organ whose state he is about to determine. 
 This determination he only can make, who hath al- 
 ready erected his ideal standard, as now proposed. 
 Otherwise, he cannot but frequently err in his diag- 
 nosis. But he who hath ever at hand in his scientific 
 store, a perfect ideal of the healthy organs, shall 
 scarcely err, since, in every diagnostication, he will 
 strictly compare the real with the perfect ideal, or 
 standard, and, from observing the deviations and aber- 
 rations, deduce a perfect knowledge of the case before 
 him. 
 
 In order to raise up such an ideal or standard of the 
 uterus, it is necessary to analyze its component tex- 
 tures, and arrange them ; for example, into a series, as : 
 1. The serous tissue. 2. The mucous tissue. 3. The 
 sanguiferous; 4, absorbent; 5, the muscular tissue. C. 
 The Nervous substance. 7. The glandules and folli- 
 cles. 8. The areolar texture. 
 
 These are the only things in the uterus that can be
 
 OF THE NECK OF THE UTERUS. 27 
 
 subjects of disease, whether severally or conjointly. 
 When they are combined in the just ratio of mass 
 crasis and vital force, they represent the form and 
 substance of the healthy womb, and, we might add, its 
 faculties also; whereas, every deviation from such 
 normal ratio of the elementary tissues, represents a 
 certain disease of that organ. 
 
 Equable augmentation of the elementary tissues con- 
 stitutes hypertrophy of the uterus — which may be 
 either local or general. 
 
 Hypertrophy of the womb may be physiological or 
 pathological. 
 
 The term physiological hypertrophy here applies to 
 those equable augmentations of the elements of the 
 uterus, that take place in pregnancy, in which the 
 womb acquires, in the course of 280 days, a greatly 
 increased volume, and a weight of 25 to 30 ounces. In 
 the non-gravid state, its length is about 2i inches : in 
 pregnancy, it is 12 inches in length. The non-gravid 
 weight is 2 J ounces, whereas it, not rarely, weighs two 
 pounds, at term. These great changes occurring in the 
 mass, while inconsiderable changes in the ratio of its 
 elements take place, can only be the result of a physio- 
 logical hypertrophization — and it is well to make such 
 a reflection, seeing that the womb recovers its non-gravid 
 form, substance, and faculties, in about thirty days after 
 the termination of pregnancy. 
 
 In this process of Normal-hypertrophy, the several 
 elementary textures are evolved in their equal gene- 
 rical ratios ; and the same kind of equable development
 
 28 ACUTE AND CHRONIC DISEASES 
 
 takes place in all the cases of true pathological hyper- 
 trophy. 
 
 As the womb readily recovers from any physiological 
 hypertrophy in about thirty days after the removal of 
 the cause, so, in like manner, it recovers from its patho- 
 logical hypertrophy soon after the removal of its cause. 
 Such cause may be a polypus developed within the 
 cavity ; chronic inflammation of the cervix or os uteri ; 
 dislocated states of the uterus, in retroversion, or ante- 
 version ; or any circumstance that should provoke the 
 organ to grow inordinately, but equably, as to the ratio 
 of its elements. 
 
 Unequable development of the several elements, 
 converts the womb into a Tumor, degenerates it, and 
 renders it incurable by medicines ; whereas, the state 
 of pathological hypertrophy is one to be recovered from 
 upon removal of the cause. 
 
 If, in a womb, the areolar or the vascular, or the 
 nervous element, should be augmented several hundred 
 per cent, beyond its normal ratio, the rest of the tissues 
 preserving their quantitative relations to each other, 
 the viscus would be changed into a hematoma, a ce- 
 phaloma, &c. &c, according to the nature of the case or 
 chief constituent element of such tumor. 
 
 Unhappily, the womb is, by nature, peculiarly sub- 
 ject to such changes. It may pass unharmed through 
 the hypertrophizations and recoveries of many conse- 
 cutive pregnancies, because of its innate aptitude to 
 recover its non-gravid form and substance by involution 
 as the antithesis of its acts of evolution ; a reflection
 
 OF THE NECK OF THE UTERUS. 29 
 
 this that affords us the greatest encouragement when 
 called on to undertake the treatment of cases of en- 
 larged womb. So true is this, that, in all cases where 
 we can clearly diagnosticate a uterine hypertrophy, we 
 may found on it a happy prognosis, provided we may 
 also reasonably expect to remove the cause of the ex- 
 cessive growth, e. g. if the cause should prove to be a 
 mere retroversion, we may count upon a cure if we can 
 reposit the womb and maintain it in its proper attitude 
 in the pelvis. This is, in fact, all that we shall be 
 called upon to do; for, this being done, the organ 
 hastens to recover by involution its non-gravid form 
 and substance, as after a delivery at term, or after an 
 abortion. 
 
 A perfect ideal of the normal womb, one fit to serve 
 as a standard, or scale of comparison or measurement 
 for cases, should comprise, in addition to a notion of its 
 elements, one of its form, volume, place, posture in that 
 place, sensibility, resistance, complexion, and all its 
 powers as well as its anatomical relations or connec- 
 tions. 
 
 A great help to the formation of this ideal standard, 
 may be found in drawings and engravings. And here 
 we beg leave to submit a figure (Fig. 1) copied from 
 nature. The womb, which was that of a young un- 
 married woman, was 2 \ inches in length, by If in 
 width at the widest part. Its weight might be 2 h 
 ounces. The specimen, a recent one, was presented to 
 us by Dr. Addinell Hewson, of Philadelphia. "We re- 
 gard this uterus as a fair standard specimen.
 
 30 ACUTE AND CHRONIC DISEASES 
 
 In respect to this drawing, and indeed all the figures 
 made use of as illustrating points treated of in this 
 essay, we owe an apology for their want of artistic 
 excellence. It is clearly out of the question that we 
 should show these things to artists, as well as that 
 no artist could represent them from mere description. 
 We did try that experiment, which failed. We were 
 then compelled to become artists in self-defence, and suc- 
 ceeded, as is here to be seen, in making very inelegant, 
 but very faithful representations of the subjects of the 
 sketches. As to their fidelitj' we have no other assur- 
 ance to give than such as we may refer to as profes- 
 sional experience ; and we feel assured that all those 
 physicians who have been obliged to acquire this pain- 
 ful experience must concur in the opinion that our 
 drawings are very truthful. 
 
 This figure, it is therefore believed, gives a fair ave- 
 rage representation of the form and size of the human 
 womb. The chirurgical neck projects within the re- 
 mains of the vagina, to the normal depth ; and the 
 aperture, or os uteri, preserves its appearance as a 
 transverse sulcus. 
 
 Fig. 2 represents an antero-posterior section, and ex- 
 hibits the left symmetrical half of the womb ; showing 
 the thickness of the walls, in this direction ; the size 
 and shape of the cavity ; as well as those of the canal 
 of the neck ; the two lips, anterior and posterior ; and 
 the length of the vaginal neck or surgical neck. 
 
 Fig. 3 is a transverse section of the womb, exhibiting 
 the posterior half, with the shape and size of the
 
 OF THE NECK OF THE UTERUS. 31 
 
 cavity; as well as the canal of the cervix, and the 
 orifice as seen in this way. 
 
 Fig. 4 is designed to give an idea of the womb's place 
 and position or attitude in the pelvis. It is on a scale 
 of half an inch to the inch ; and shows how far below 
 the plane of the superior strait (see dotted line) the 
 fundus uteri should be found. 
 
 Most of the published drawings have erroneously 
 exhibited the fundus uteri rising as high as the plane 
 of the strait, or even elevated somewhat above it, which 
 is incorrect, and leads to considerable errors in diag- 
 nosis. 
 
 Considering that the plane of the ischium is oh inches 
 long, and that the mean length of a normal womb is 
 about 21 inches, the figure may serve to give a correct 
 idea of standard as to place and altitude, since the 
 diagnosticator, by touching the os tincaB, at once recog- 
 nizes the place in the excavation where it is found, as 
 whether too high, or too low, and he also determines, 
 by palpation at the hypogastrium, whether the fundus 
 is too much elevated or no ; and so he judges of the 
 length and volume of the womb he is examining. 
 
 The anatomical relations of the womb are those which 
 unite it with the bladder in front ; the vagina inferior- 
 ly; the broad and the round ligaments, ovaries, and 
 Fallopian tubes at the sides and angles; while, poste- 
 riorly, it has no anatomical relations whatever; that 
 surface being there completely invested with a peri- 
 toneal covering. 
 
 The standard should comprise a true idea of the os
 
 32 ACUTE AND CHRONIC DISEASES 
 
 tincse or aperture of the canal, many deviations from 
 the standard being observable in practice ; all of which 
 may afford useful lights in diagnosis, prognosis, and 
 practice : certain changes of its form may be regarded 
 as pathognomonic. 
 
 The sensibility of the uterus to pressure or contact ; 
 its resistance and flexibility, ought also to form part of 
 the ideal ; and lastly, the color or tint — as observed in 
 the metroscope — as whether pale, rose-tinted, raspberry- 
 red, violaceous; or even of a hue approaching to that 
 of melanotic tissues, constitutes an important item in 
 the aggregate of characteristics. 
 
 Experience has shown that many instances of bad 
 health are to be attributed to acute or chronic ailments 
 of the womb, in women, where no topical pain or other 
 sign of local lesion is complained of. 
 
 Thus some of the examples of perverted innervation 
 exhibited in torpor of the bowels, chronic tympanitis, 
 frequent attacks of spasm, and general convulsion ; ce- 
 phalalgia, palpitation of the heart, pain in the back 
 loins and lower extremities ; fluor albus, and aggravated 
 hydrsemia, take their origin from disease of the cervix 
 uteri, which, meanwhile, gives no pain, and is wholly un- 
 suspected as the subject of any disease. In so far, there- 
 fore, as these affections spring from acute and chronic 
 disease of the neck of the uterus, they might be assumed 
 to come within the scope of inquiries assigned to this 
 essay ; but since an elaborate statement of all those sub-
 
 OF THE NECK OF THE UTERUS. 66 
 
 jects would fill a volume rather than this essay, we shall 
 confine our remarks within narrower limits. 
 
 Among the number of sexual disorders, few are more 
 frequently complained of than leucorrhoea, and it seems 
 probable that most women have occasion, at some period 
 of life, to complain of it. In general, it gives little in- 
 convenience, is of short duration, and ceases sponta- 
 neously; not requiring for its cure the advice of physi- 
 cians. Perhaps in a thousand cases of moderate fluor 
 albus, the physician would be consulted for one or two 
 only. This, however, is not the case always, for in cer- 
 tain exceptions the secretion becomes very great, and is 
 attended with debility, pain in the back and loins, a 
 sense of bearing down or weight in the pelvis, with heat 
 in the passages, which may pass into insufferable pruri- 
 tus. Instances in which the profluvium is very great, 
 will rarely be met with in any physician's practice ; and 
 not many of the subjects are found to require the use of 
 the guard-napkin, a precaution which could not be dis- 
 pensed with if the secretion were so abundant as is by 
 some supposed. We have heard of cases of leucorrhoeal 
 discharge to the amount of eight ounces per day, but 
 probably such examples occur not more than once or 
 twice in a long career of medical practice ; one in Avhich 
 the secretion should equal a tablespoonful per day, 
 even, would be very troublesome, as well as uncommon, 
 the majority of the patients complaining only of an in- 
 convenient humidity of the parts. 
 
 Where the discharge in leucorrhoea consists of merely 
 vaginal products, it may safely be assumed that such
 
 34 ACUTE AND CHRONIC DISEASES 
 
 leucorrhoea is of very little consequence to the woman's 
 general health. We speak here of the moderate cases. 
 Indeed, affections of the vagina may, for the most part, 
 be considered to interest very little the female constitu- 
 tion. 
 
 Such a statement as this might excite surprise, in 
 those who are accustomed to hear of the very debilitat- 
 ing effects of fluor albus ; and it becomes necessary to 
 qualify the statement, by showing that, in those cases 
 where the health has appeared greatly to suffer, the 
 essential malady is not in the vagina, but in the neck 
 of the uterus itself. 
 
 Patients do not, in general, make any discrimination 
 between the several different appearances presented in 
 fluor albus ; because they are satisfied to believe that 
 excessive humidity of the genital mucous surface is 
 fluor albus, or vaginal leucorrhoea, a disorder whose pre- 
 sence disturbs them, not only by the actual inconveni- 
 ence occasioned by it, but in a more considerable degree 
 by the apprehension it arouses of prospective mischiefs 
 to their health. 
 
 While our own observation convinces us that profuse 
 vaginal secretion is rarely met with in practice, we are 
 equally convinced that some of the patients are rendered 
 too moist by excessive activity of Duverney's glands, 
 and farther, that the most mischievous of leucorrhceal 
 secretions is that which comes from the canal of the 
 cervix of the womb. 
 
 The muciparous glands of the vagina furnish either a 
 thin watery mucus, or else one of a creamy consistence,
 
 OF THE NECK OF THE UTERUS. 35 
 
 which in other instances appears to be butyraceous, or 
 concrete. 
 
 The excretion from the follicles and glands of the canal 
 of the neck, however, is always gluey or albuminous, and 
 resembles fresh white of eggs ; and, when the patient, in 
 describing the disorder, informs us that she discovers a 
 slimy transparent mucus, and especially if it appears at 
 intervals of once a day, or oftener, we may take it for 
 granted that she labors under inflammation of the neck 
 of the womb. There is no apparatus in the vagina 
 itself for the secretion of this albumen ; but the abun- 
 dant follicles of the canal of the cervix are devoted 
 solely to such production — when the cervix is chroni- 
 cally inflamed, that production is much increased ; to 
 that degree, indeed, as to impart a character of sliminess 
 to the discharge, that makes it resemble albumen ovi 
 
 It very often happens to observe this transparent vis- 
 cid mucus to be wholly unaccompanied by any vaginal 
 excretion; the substance coming away from the os uteri, 
 and escaping upon the napkins without the least admix- 
 ture. In using the metroscope, the same albuminous 
 matter may be seen oozing forth from the orifice of the 
 womb only, and so tenacious that it cannot be wiped 
 away with the sponge. 
 
 Those physicians who have attended women in la- 
 bor, are familiar with the viscous excretion from the 
 neck of the womb, which generally discharges consider- 
 able quantities of it while the os is undergoing dilatation. 
 In a state of ordinary health, the production — which is 
 equal merely to the physiological demand — is so incon-
 
 36 ACUTE AND CHRONIC DISEASES 
 
 siderable, that the albumen is not to be observed ; but 
 any augmented vital activity in the cervix may make 
 its presence manifest. 
 
 It has already been remarked that subjects of leucor- 
 rhcea complain of it as a weakening disorder ; nor can 
 it be denied that this albuminous fluor from the cervix 
 mostly coincides with a sense of great lassitude and de- 
 bility — not because of the wastage of the material, but 
 because of the disturbing effect in the general economy, 
 produced by even slight modifications of the health of 
 the uterus. Hence I may venture to say, that those 
 women who complain of the exhausting effect of their 
 leucorrhoea, should be regarded as suffering, not from 
 the loss by secretion, but from the perturbating influ- 
 ence of a chronic inflammation of the womb. 
 
 Physicians consulted for these leucorrhceal affections, 
 ought, therefore, carefully to discriminate between the 
 different kinds of discharges. When the excretion is 
 deemed to proceed from the muciparous apparatus of the 
 vagina only, it may suffice to make astringent injections, 
 whether of mineral or vegetable sorts. In case such re- 
 medies prove unavailing, the vital activity of the mu- 
 cous body may be changed by solutions of argent, nitrat., 
 of feeble strength — and one might confidently look for a 
 cure under such a prescription. Yet, in fact, our ordi- 
 nances for those disorders are notoriously unsuccessful ; 
 and the reason is, we vainly attempt by these methods 
 to cure a disease of the vagina which does not exist, 
 which would not make the woman ill if it really did
 
 OF THE NECK OF THE UTERUS. 37 
 
 exist ; whereas we ought to be addressing our remedies 
 to the removal of a disease of the cervix. 
 
 We should cure a much greater number of leucor- 
 rhoeas if we would not misinterpret the disorder, call- 
 ing that a vaginal which is really a cervical malady, 
 and vice versa. 
 
 We repeat, that the serious cases are cases of disease 
 of the cervix — but, a vaginal injection for inflammation 
 of the canal of the neck, is, simply, ridiculous. The 
 albuminous leucorrhcea is a sign of inflammation of the 
 cervix, in which is included the canal, with its copious 
 muciparous apparatus. It is as much a surgical dis- 
 order as an ulcer of the leg, or an anthrax, or conjuncti- 
 vitis. When the surgical disorder is cured the sign dis- 
 appears. Hence we desire to express the opinion, that 
 such leucorrhoeas are to be held as acute or chronic in- 
 flammations of the canal of the neck, and ought to be 
 treated accordingly. 
 
 The most essential element of a successful practice 
 exists in a positive diagnosis. It will not do for us to 
 believe, or suspect, or infer, this or that — we must guard 
 the interests of the patient by knowing it is this, or 
 that, or the other form and stage of a disease. 
 
 The historical or descriptive account delivered by the 
 patient, or her friends, cannot serve as a guide for us ; 
 nor can they compare the actual state of the suffering 
 organ with that perfect ideal standard, by which we 
 ought to compare, weigh, and measure everything 
 brought before us for judgment. 
 
 It must ever be a very trying occasion, that of a sensi-
 
 38 ACUTE AND CHRONIC DISEASES 
 
 tive and delicate woman, who is brought into such a strait 
 as to require a physical examination of those parts 
 which naturally shun exposure. The medical man, 
 who has even a common share of sensibility, will al- 
 ways, therefore, defer this last resort as long as possible, 
 while he makes use of empirical treatment — if, haply, 
 he might thus be enabled to effect a cure without the 
 waiver, on her part, of those honorable scruples which 
 deserve from him the most perfect respect. 
 
 Of all the means of making a physical diagnosis, 
 Touching is the easiest and the least distressing to a 
 woman of sensibility, bad though it be. By Touching, 
 we can determine the place, the volume, the resistance, 
 the sensibility, the smoothness or roughness, the patu- 
 lousness, and other characteristics of the organ. 
 
 Where the touch gives sufficient information, let the 
 Touch suffice ; but, if any doubts as to the wants of the 
 case remain, then a Metroscopic examination should be 
 made. If declined — let the consequences rest with the 
 patient ; the physician is absolved from blame. 
 
 There are a great many sorts of Metroscopes now in 
 use — some consisting of a tube, as originally proposed 
 by Recamier, but composed of glass, or silver, or ivory, 
 &c. ; and some consisting of a bivalve, trivalve, or 
 quadrivalve Speculum uteri, each of which is pre- 
 ferred, according to the taste or caprice of the practi- 
 tioner. 
 
 The most reliable metroscope, probably, is a slightly 
 conical tube of silver, six inches and a half in length. 
 The uterine extremity should be one inch in diameter,
 
 OF THE NECK OF THE UTERUS. 39 
 
 bevelled with an angle of thirty-five or forty degrees. 
 The outer, or larger extremity, should be one inch and 
 a half in diameter. The silver should be highly 
 .polished, with the edges of the bevelled end rolled and 
 rendered blunt, lest they might catch in the folds of 
 the membrane, or even wound the cervix. 
 
 An olive-shaped piece of wood, secured in a steel 
 handle, and made to fit accurately in the smaller ex- 
 tremity of the cone, serves to guide it without pain to 
 the bottom of the vagina, whereupon the guide is with- 
 drawn, in order that the Surgical neck may engage in 
 the opening, and thus enable the surgeon to discern any 
 marks of disease there. 
 
 The light passing down the tube ought to be as clear 
 as possible, and the- inner surface of the metroscope 
 should not have a very high polish, lest, serving as a 
 reflector, it might pour a flood of chromatized light on 
 the parts, and thus give rise to the greatest misappre- 
 hension of their real condition. It would be better to 
 have the inner surface painted with black, in order that 
 no reflection from the walls should deceive us, and lead 
 to error. Any person accustomed to the use of the me- 
 troscope with a very bright inner surface, or bore, must 
 be familiar with the sparkling red points that it seems 
 to disclose upon the mucous surfaces exposed by it to 
 view, and also, must have seen how a slight change in 
 the direction of the tube, causes these red lights to 
 disappear ; but they are always apt to mislead, and 
 therefore it would be better to use a tube whose inner 
 surface should have no lustre : a tube blackened within,
 
 40 ACUTE AND CHRONIC DISEASES 
 
 like a microscope tube, would be far better than one 
 with a reflector, such as the glass speculum uteri. 
 
 An instrument on the plan above proposed can dis- 
 close the physical appearances of any square inch of the 
 inner walls of the vagina; for by merely rotating the 
 tube on its axis, and directing the bevelled end this 
 way or that, we may at leisure observe any part of the 
 cervix or vagina. 
 
 The bivalve and the quadrivalve speculum are some- 
 times convenient ; but they as often annoy us and ob- 
 struct the research by allowing folds of the vagina to fall 
 in between the parted blades, and thus completely hide 
 the parts sought to be studied. They are by no means 
 suitable for the application of the cautery, whether 
 liquid or solid ; and no one could conveniently make 
 use of leeches by means of them. In any case, where 
 the multi valve speculum is applicable, M. Recamier' s 
 tube is more so, on which account, we prefer it alto- 
 gether. 
 
 Plate 4 represents a Recamier metroscope, with its 
 guide. This instrument is of silver, and bevelled in a 
 way to facilitate the operation, in engaging the os tineas 
 in the open end of the tube, which readily catches the 
 cervix by its projecting long lip. It has not any 
 handle, a thing that, moreover, is both useless and 
 troublesome by catching in the bed-linen or the nap- 
 kins with which the patient is always to be enveloped 
 on such occasions. 
 
 With a Recamier tube, one can readily observe any, 
 even slight modifications of form or surface, hue, abra-
 
 OF THE NECK OF THE UTERUS. 41 
 
 sion, vegetations, druses or botryoiclal excrescences. 
 Small polypi, jutting from the canal of the neck, any 
 fissures or rhagades, ulcerations, cauliflower degenera- 
 tion, or open carcinoma, &c. &c, that shall have given 
 rise to the symptoms may be thus seen. The same 
 occasion may be seized to make such surgical dressings 
 as may be indicated, and the sacrifice of sensibility in 
 this way made by the sufferer, is almost sure to be re- 
 warded by a speedy cure of any curable disorder, which, 
 but for such sacrifice, would continue to make her un- 
 happy, leading, by a perpetual progress of deterioration, 
 to ruined health, and, finally, to the last refuge of the 
 miserable, which is the tomb. 
 
 A diagnosis by the metroscope should be made in the 
 daylight, and always in presence of a third person. 
 
 The patient should lie on the back, near the side or 
 foot of the bed ; the head, and not the shoulders, rest- 
 ing upon a pillow. A sheet or spread is to cover the 
 person ; the margin of the covering to descend nearly to 
 the floor. 
 
 The knees should be much flexed, and the feet near 
 to the trunk of the body. 
 
 Before proceeding to adjust the instrument, an exa- 
 mination should be made by Touching, to ascertain the 
 precise position of the uterus, and the place occupied 
 by the cervix ; the sensibility, resistance, volume, &c. 
 of the neck, and particularly, the state of the aperture 
 of the womb. 
 
 There should be provided a Speculum-forceps, and 
 some small bits of moistened sponge, or carded cotton,
 
 42 ACUTE AND CHRONIC DISEASES 
 
 which, being held in the forceps, serve to absorb or 
 remove any mucus or slime, or sanguineous excretion. 
 The most convenient Speculum-forceps that can be got 
 is probably a bullet forceps ; such as the one proposed 
 by Professor Gibson. 
 
 The Speculum-forceps of Charriere is far less conve- 
 nient. 
 
 If the Metroscope should now be adjusted beneath the 
 coverings, and the margin of the sheet be afterwards care- 
 fully wrapped around the outer end of the cylinder, it 
 will be easy to conceal, in this way, the entire person of 
 the patient, while the light falling down the tube, serves 
 to reveal any existing signs of disease of the parts to be 
 examined. 
 
 If these inquiries are instituted for the purpose of 
 determining the precise cause and learning the proper 
 treatment of a troublesome leucorrhcea, especially one 
 characterized by the albuminous discharges heretofore 
 mentioned, we shall rarely fail to observe a positive 
 inflammation of the cervix and os uteri, or to notice a 
 certain quantity of transparent viscid phlegm, oozing 
 slowly away, or tamponing the orifice of the canal of 
 the cervix. 
 
 One or both of the lips of the womb may be found 
 tumid, softened, granulated, or botryoidal in appear- 
 ance, and of a uniform red ; or else drusy as to the sur- 
 face, and presenting some resemblance to the surface 
 and color of a ripe raspberry; whence it has been the 
 custom of some to speak of this form of inflammation as 
 inflammation framboisee, a French word that very aptly 
 expresses the idea of it.
 
 OF THE NECK OF THE UTERUS. 4d 
 
 Annexed is a drawing (vide Plate 5), by which we 
 hope to impart a correct idea of one of the forms assumed 
 in inflammation of the cervix uteri. It was drawn 
 soon after the inspection of a case that was under the 
 care of the Author. The lad}', about forty years of 
 age, was the mother of several children, of whom the 
 youngest was between three and four years old. 
 
 She had long complained of weakness, pain, and drag- 
 ging sensation in the back and loins, a bearing down at 
 the hypogaster, and a leucorrhoea, which she supposed 
 to be the whole malady. Her fastidious delicacy in- 
 duced her, for many months, to conceal her uneasiness ; 
 nor did she at last apply for counsel, until her health 
 was very much reduced, and her appearance greatly 
 changed. She had acquired a deep sallow tint of the 
 skin ; had anorexia ; lowness of spirits ; intestinal tor- 
 por; slight d^ysuria, and a constant fluor albus. 
 
 It was not until after presenting clearly to her com- 
 prehension a statement of the motives for it, that she 
 reluctantly consented to allow a metroscopic examina- 
 tion to be instituted ; and it manifestly appears that 
 none other could have possibly revealed the real nature 
 of her position and its danger. 
 
 The os tincse of a healthy woman with difficulty suffers 
 the passage of a small female catheter into the canal of 
 the cervix. In this case, the ends of two fingers could 
 be introduced nearly half an inch. The cervix, of course, 
 must be much enlarged to make so great an aperture. 
 But the drawing, which is believed to be as correct as
 
 44 ACUTE AND CHRONIC DISEASES 
 
 any daguerreotype could be, will show better than words 
 the appearance it presented. 
 
 Plate 5, which may be compared with Plate 1, will 
 show how enormously this Chirurgical neck and this os 
 uteri exceed in magnitude the one we have presented as 
 a sample of the ideal or standard uterus. 
 
 The cervix, although so greatly enlarged, and as red 
 as the tint in the drawing, was not exceedingly sensi- 
 tive. Its resistance was neither too hard nor too soft, 
 as is the case in the hypertrophies. The os had the 
 shape or form here expressed. It was enlarged, but 
 not deformed. Had it been deformed, that circumstance 
 alone would decide as to its being not hypertrophy ; 
 because, it would prove that the development or growth 
 was non-equable. 
 
 The orifice or aperture of the canal was occupied with 
 a viscid transparent slime, which was the albuminous 
 product of sur-excited muciparous glands and follicles, 
 which abundantly line the canal of the cervix. Its ap- 
 pearance is pretty well represented in the engraving. 
 
 Inspecting the interior of the canal of the neck, as 
 far as it could be observed, the red tint seen on the lips 
 gradually passed into the dark, almost black hue, which, 
 in the figure, approaches to the color of melanotic 
 tissues, and it was of so black a color as to lead 
 the writer at first to fear that it was due to some pro- 
 cess of sloughing. He had never, in any other case, 
 noticed anything similar. 
 
 This case was treated, by the author, by means of 
 antiphlogistic contacts of the nitrate of silver pencil.
 
 OF THE NECK OF THE UTERUS. 45 
 
 The number of those contacts, which were reiterated 
 with intervals of from five to seven days, did not exceed 
 six or eight, and as the inflammation vanished before 
 the therapeutical power of the remedy, the womb re- 
 turned rapidly to its form and dimensions; just as it 
 would do, if, being enlarged by gestation, it should be 
 set at liberty, by an abortion, to return to its non-gravid 
 condition. We shall shortly explain the meaning and 
 intention of the phraseology we have employed, as to 
 antiphlogistic applications of the argent, nitratum. 
 
 The ideal womb is two and a quarter inches long. 
 This specimen was so much augmented in size that, 
 while the os tincse was low down in the excavation, the 
 fundus was distinctly felt above the plane of the supe- 
 rior strait, being at least one inch higher than that. 
 
 It might, perhaps, be a desirable thing to know, if 
 possible, why it happens that, in certain cases of in- 
 flamed cervix, the surface of the lips of the womb should 
 be smooth or even, as is seen in the present specimen ; 
 while in others, the inflamed superficies become uneven, 
 or tuberculated, or drusy. To show the difference 
 here alluded to, the Authcft? begs to ask attention to 
 the annexed figure (Plate 6), which exhibits the uneven 
 surface in question. 
 
 This drawing is also copied from nature, and repre- 
 sents an appearance very commonly met with in prac- 
 tice. The Chirurgical neck is manifestly and much 
 enlarged, which does not imply merely swelling of the 
 texture, but rather, a condition of hypertrophic growth 
 or nutritive development. Here, as in almost all the
 
 46 ACUTE AND CHRONIC DISEASES 
 
 examples, the hypertrophy proceeds from the provoca- 
 tion contained in a positively inflamed state of the 
 corpus mucosum uteri. 
 
 Such an inflammation is, virtually, an advanced vital 
 ■status, which stimulates the whole organ, and compels 
 it to obey its natural law, which is that it shall wax or 
 increase in substance, equably under certain stimulation. 
 This is the power which enables it to go through those 
 vast but equable mutations of its form and substance 
 that coincide with gestations. 
 
 One might well, from inspection of such a specimen, 
 deem that the vital status of the corpus mucosum must 
 be dangerously exalted. It exhibits many tubercular 
 elevations, which, however, are soft and velvety to the 
 touch. There was no ulceration ; on the contrary, the 
 entire surface was covered with its pavemented epithe- 
 lium, which was so delicate, however, as easily to be 
 broken by a sponge, or by imprudent, awkward mani- 
 pulation with the tube. Madame Boivin seems to have 
 conceived the idea that a tuberculated surface like this 
 may possibly be the expression of a commencing stage 
 of cauliflower degeneration, and the thought is worthy of 
 attention. 
 
 The patient from whom this drawing was taken, was 
 rapidly cured, the irregularities of the surface subsiding 
 to the ordinary smooth level, and all the excess of mag- 
 nitude, sensibility, and color of the parts being taken 
 away, chiefly by contacts of the nitrate crayon — in 
 which surely resides a true antiphlogistic therapeutical
 
 OF THE NECK OF THE UTERUS. 47 
 
 force, as we shall hereafter endeavor to show and ex- 
 plain at greater length. 
 
 Out of a considerable number of drawings, faithfully 
 representing this appearance of disease in the subject, I 
 have selected these two as sufficient to explain or illus- 
 trate those physical lesions the practitioner may expect 
 to meet with; not wishing to load this essay with a use- 
 less array of specimens. I shall, however, add one 
 more of this class (Plate 7), taken from nature, in a 
 patient who had, for a long time, and in vain, been sub- 
 jected to treatment by nitrate of silver cauterizations. 
 It also presented the appearance, like that shown in 
 Plate 5, of a collection of albuminous mucus in the 
 orifice. As here, so it often happens to observe this 
 mucus-production to be greatly augmented; whereas, in 
 other samples closely resembling it in certain patients, 
 this peculiar sign is either not seen at all, or in indif- 
 ferent quantity. 
 
 It may well be supposed that variable degrees of vital 
 excitement in the muciparous apparatus, might, for one 
 individual, or now, cause excessive production, while at 
 another time, or in another case, it should give rise to 
 no excess in the albuminous production, and thus we 
 may justly infer that this albuminous discharge is not 
 invariably present as a pathognomonic characteristic ; 
 but on the contrary, the inflammation is the thing to be 
 considered, treated, and cured, if we would really restore 
 the patient's health. When the albuminous discharge 
 is seen, it is, however, always pathognomonic of the 
 cervical inflammation.
 
 48 ACUTE AND CHRONIC DISEASES 
 
 The Author respectfully submits, that these illustra- 
 tions are sufficient to confirm his assertion, precedently 
 made, that diagnostication by M. Recamier's method is 
 indispensable for the correct information of the medical 
 attendant. Not only do they show how concise and 
 absolute such a diagnosis may be; but they must con- 
 vince that diagnosis, by touching alone, could not convey 
 to the mind so precise a notion of the surgical and medi- 
 cal wants of the sufferer ; while they, farther, manifest 
 the facility, convenience, and exactitude, with which 
 surgical dressings and other treatment may be made by 
 the metroscopic method. 
 
 Whosoever should examine these illustrations might 
 be expected confidently to infer that so considerable an 
 inflammation as either of them represents, would be 
 likely, not only to give rise to the constitutional dis- 
 orders attendant upon many examples of leucorrhoea; 
 but he would also understand why, along with the 
 albuminous fluor, there might arise an excessive vaginal 
 secretion, which, nevertheless, would be but one of the 
 accidents of the principal case. 
 
 Daily experience convinces that multitudes of sick 
 women are treated by professional and other persons, 
 for affections like those here portrayed (without the 
 least inkling of the truth), with vaginal injections of 
 various astringent and other solutions and infusions, 
 which rarely produce any good effect upon the health; 
 though they serve, in many, to add to the mischief. 
 
 It would certainly be a considerable step in the pro- 
 gress of clinical medicine, were it possible to clear up 

 
 OF THE NECK OF THE UTERUS. 49 
 
 these obscurities, and banish from the art the mere 
 senilities which so much discredit it; but this can only 
 be done by means of perfect diagnostications. 
 
 I beg to repeat that physicians, in order that they 
 may make proper ministrations, require — not belief, but 
 knowledge of their cases. Where perfect knowledge 
 of the case can be obtained, there will be the most perfect 
 administration; there will be, at least, the meliorations; 
 and, in so far as remedies can succeed, there will be the 
 most successful results or cures. 
 
 A medical man, ordering injections for such disorders 
 as are here described, will assuredly be baffled, since no 
 such injections can be supposed to pass bej'ond the 
 limits of the vagina itself. They cannot penetrate into 
 the canal of the cervix. They bedew only the mam- 
 millary part of the uterus, while they bathe the entire 
 of the vaginal walls. It is the custom of many prac- 
 titioners, to order vaginal injections, composed of solu- 
 tions of argent, nitrat. of various strength. Few of 
 them, we are persuaded, can say they have found 
 much advantage to the patients from this operation. If 
 the Author is to be justified in asserting that the 
 major part of these cases consist, essentially, in disease 
 of the cervix itself, and not of the vagina, which is only 
 secondarily or symptomatically involved in the dis- 
 order — then such a practice is either useless or perni- 
 cious. If such a solution is strong enough, it is too 
 strong; and if it be too dilute, it is indifferent in the 
 treatment, or merely nugatory. 
 
 The patient requires a remedy for the raspberry- 
 4
 
 50 ACUTE AND CHRONIC DISEASES 
 
 colored inflammation of the neck — one fitted to bring to 
 
 * 
 
 its close a train of perverted and exalted vital force of an 
 organ, whose disturbance proves to be one of the most 
 considerable disturbers of the constitutional health. 
 The cure of the real disease, the radiating point of 
 disturbance, cures the leucorrhoea, as well as all the 
 balance of the perversions. 
 
 But, it is proper for us to exhibit other appearances 
 assumed by the inflamed cervix uteri, lest a false direc- 
 tion be given to opinions upon such special cases as 
 may come up in one's practice. We have already ex- 
 hibited several modifications of the cervical surfaces 
 observed in different specimens, and we here call atten- 
 tion to one represented in the annexed figure (Plate 8, 
 Fig. 1), one that is not quite so common as the inflam- 
 mation framboisee, yet so common as to be often met 
 with in practice. 
 
 The appearances here exhibited (Plate 8, Fig. 1) 
 were those observed in the case of a lady from a distant 
 city, who was addressed for treatment, to the writer, 
 by a distinguished member of the Profession. She 
 had been for a considerable time under his own medical 
 care, after having undergone a great variety of surgical 
 and medical treatment by others, but without any use- 
 ful effect. 
 
 She complained of pain in the interior of the pelvis ; 
 and of disordered menstruation, which was both menor- 
 rhagic and painful, as well as irregular in its returns. 
 She had dysuria; pain in the middle of the sacrum, 
 and tenesmus : she was excessively hydrsemical and de-
 
 OF THE NECK OF THE UTERUS. 51 
 
 sponding, and had capricious appetite; while acidity 
 and torpid bowels accompanied the affections above 
 enumerated, and, to crown all the rest, she was fre- 
 quently attacked with what might be called crispations, 
 or rather spasms and convulsions, simulating closely 
 certain epileptic forms. The nervous system was in a 
 state of such sur-excitement, that a word, a look, an 
 emotion, or any motion of the limbs, often served to 
 render her quite insensible from an attack resembling a 
 slight form of puerperal eclampsia. 
 
 She had borne three children, of whom she had, 
 within a year, lost two by scarlet fever; and that 
 event, by the moral shock it occasioned, had greatly 
 aggravated all her pre-existing complaints. 
 
 The womb was retroverted; the fundus resting in 
 the Douglass cul-de-sac, while the os was near to the 
 symphysis pubis. 
 
 Upon exposing the chirurgical neck to a beam of day- 
 light, by means of the Eecamier tube, the os proved to 
 be inflamed, with the margin of the anterior lip tinted 
 red, just as is here shown; while the lower lip was 
 covered by a disk of inflamed corpus mucosum, of a 
 square shape ; the whole of this square patch was evi- 
 dently a raised surface. One might almost venture to 
 call it a molluscum on the cervix. It is frequently met 
 with in clinical practice in sexual disorders ; and we 
 think always exhibits this peculiar character. Its 
 frequency in practice, we repeat, is considerable. 
 
 In reasoning upon such a case, it would seem super- 
 fluous to look beyond facts, like these as here stated,
 
 52 ACUTE AND CHRONIC DISEASES 
 
 for a rationale of the constitutional and local pheno- 
 mena. The healthiest young married woman is liable, 
 almost immediately after conception, to be affected by 
 those disturbing radiations of the uterine or hysteric 
 force that are developed by the new vital states of 
 pregnancy, and she may soon be seized with distressing 
 nausea, or frequent vomiting, or profuse salivation; with 
 anorexia, hydrasmia, hysterical passion, and a thousand 
 perversions both of the reason and the senses, as well 
 as of the organic functions. 
 
 If the hysteric malady, with its incoherent train of 
 vital manifestations, may arise out of a basis of repro- 
 ductive irritation, even less considerable than that of an 
 incipient gestation; we really are not called upon to 
 look farther for causes of the constitutional symptoms of 
 our case than to those morbid states of the womb that 
 are here set forth in the figure 9. 
 
 As to the treatment, the fundus uteri was lifted up 
 out of its false position, the cervix was thrust back to its 
 place near the sacrum (see the ideal standard, Plate 3), 
 and retained in it by means of an annular pessary, 
 whose sacral segment rested in the posterior vaginal 
 cul-de-sac, and its pubal segment against the pubis. 
 Nothing could now retro vert it again. 
 
 To take the womb thus out of its dislocated position 
 would, alone, go far towards insuring its recovery; and 
 it will be presently contended that many of the uterine 
 diseases, even great hypertrophies, require no farther 
 treatment; but being thus delivered over again under 
 dominion of their natural or generical laws, they hasten
 
 OF THE NECK OF THE UTERUS. 53 
 
 to recover their true generic substance and form, by in- 
 volution, as after parturition. In this instance, however, 
 the disk of inflamed tissue was treated by antiphlogistic 
 contacts of argent, nitrat., by which it was cured; and 
 thus provision was made for the early removal of a 
 cause of the constitutional disorders, additional to the 
 displacement cause. 
 
 Having repeatedly spoken of contacts of the nitrate of 
 silver as antiphlogistic contacts, it seems proper now to 
 explain my meaning in the use of that phraseology. 
 
 It is undeniable that a pencil of nitrate of silver ap- 
 plied to a soft, moist, living tissue, and held long in 
 contact with it, will disorganize the tissue, and so prove 
 to be a destructive contact. It is equally undeniable 
 that a contact may be effected with such rapidity and 
 lightness as to prove ineffective or indifferent, while 
 there is another mode or force which does resolve in- 
 flammation with great certainty; and this is the anti- 
 phlogistic contact above spoken of. "We therefore feel 
 warranted to speak of such use of the nitrate of silver 
 as being either destructive, or indifferent, or antiphlo- 
 gistic contacts; and experience confirms the propriety of 
 the classification; for, we meet with numerous examples 
 of treatment that conclusively prove it is not the mere 
 treatment by escharotics that is successful, but the use 
 of them in such a way as to provide for their due opera- 
 tion as antiphlogistics and not as destructives ; for as 
 any ulceration of the mouth of the womb is a thing of 
 very rare occurrence, we do not require, in the case, 
 the use of destructive contacts of the salt of silver
 
 54 ACUTE AND CHRONIC DISEASES 
 
 or other escharotic, but only their curative or antiphlo- 
 gistic power — a power which is perhaps really due to 
 their contro-stimulant faculty. Certain women, who 
 are in vain treated for these cervix-inflammations, for 
 months in succession, by contacts of nitrate of silver, 
 recover their health very speedily upon a few such an- 
 tiphlogistic or contro-stimulant touches, lightly made — 
 that is, made with due regard to the resolvent or an- 
 tiphlogistic power of the drug. It is not enough, there- 
 fore, in studying this subject, for the practitioner to 
 resolve upon the treatment by a method of escharotics 
 or cauterizations, as it is erroneously expressed. Far 
 from it — what he requires is, to create for himself an 
 ideal of his operation, so that, when about to perform 
 it, he may predetermine what it is he hath to do, and 
 whether the contact he is going to make shall be a de- 
 structive or an antiphlogistic one. It might 
 equally well be called a resolvent one. He who fails 
 to set up before him this ideal of his duty and pur- 
 pose, will be apt to fail in the cure; or his cure will 
 be a chance-medley and not the product of a rightly 
 reasoned purpose and conformable act. 
 
 This absence of precision in the design and act fre- 
 quently occasions the greatest and most dangerous 
 aggravations, and the most poignant sufferings — which, 
 in our estimation, is wicked and abominable. They are 
 disgraceful to the Art and the artist at once. 
 
 Believing these remarks to be both just and clinically 
 important, it is desirable they should arrest the atten- 
 tion of every practitioner in this line.
 
 OF THE NECK OF THE UTERUS. 55 
 
 After the foregoing observations, we will now aver 
 that, by means of antiphlogistic contacts of the nitrate 
 crayon, it is possible to cure, and that speedily, most of 
 the inflammations, and their accidents met with in this 
 humble department of clinical medicine or surgery; for 
 it is to be remembered that few of them are attended 
 with any, the least degree of ulceration, as we have 
 before asserted. 
 
 It is a common opinion, and it is generally agreed to 
 say so, that these are ulcers on the womb; and there 
 are people who seem never to fail to discover an ulcer 
 upon making an examination with the speculum ma- 
 tricis. An immense experience in a populous metropo- 
 lis — an experience greatly increased by the resort of 
 numerous invalids from the country, and from the dif- 
 ferent United States — enables me with confidence to 
 declare, that an ulceration of the womb is among the 
 rarest of disorders. I repeat the expression of my 
 opinion, that these disorders and framboisee inflamma- 
 tions and hypertrophies of the cervix, have been misin- 
 terpreted and accounted as ulcerations, which they. were 
 not, the superficies being covered with a delicate epithe- 
 lium, yet so very delicate as readily to give way and 
 suffer abrasion under improvident, unskilful manipula- 
 tion with the tube or the sponge. 
 
 A proper antiphlogistic and resolvent contact of the 
 crayon ought not to destroy even this delicate epithe- 
 lium; but rather to make it more firm and dense, and 
 so planish, as it were, the unevenness down to the 
 normal surface level. In this way, we may compel the
 
 56 ACUTE AND CHRONIC DISEASES 
 
 drusy or tubercular eminences to sink down again to 
 their place, and, by solidifying the epithelium, give a 
 firm physical delimitary support to the before debilitated 
 capillaries that rose up in the form of a soft molluscum. 
 
 My patient was thus treated. She was also advised 
 to take abundantly a nutritious diet, with a copious al- 
 lowance of Bordeaux wine and water; to swallow, soon 
 after each daily meal, two grains of iron revived by hy- 
 drogen, and made into a pill with clarified honey ; to 
 get into the open air, on foot, as much and as long as 
 possible, and, being a person inclined to follow the in- 
 structions, she soon recovered a good state of health. 
 
 As incidental to this part of our explanations, it 
 may be proper to remark, that the state of the canal 
 of the cervix so often referred to, is, in all probability, 
 one of the ordinary causes of sterility. In examining 
 these structures after death, we have observed the 
 whole cylinder of the canal of the cervix to be filled 
 or tamponed, so to speak, with a plug of viscid lymph, 
 so obstructing the passage as to render it apparently 
 impossible that any spermzoon could obtain access to 
 the uterine cavity. Certain it is, that some sterile 
 women are always affected with this excessive albumi- 
 nous mucous production. We have met with instances 
 of unrelieved sterility in women enjoying the most 
 robust health, with the sole exception of this vexation, 
 which never gave any pain, nor modified the mensual 
 phenomena in the least. Many women, who had tem- 
 porarily suspended the usual succession of their gesta- 
 tions, apparently in consequence of this derangement of
 
 OF THE NECK OF THE UTERUS. 57 
 
 the health, have again conceived after the cure of the 
 albuminous leucorrhcea; or rather, the inflammation of 
 which it was the sign and consequence. 
 
 Surprise has often been expressed on observing that 
 married women, after years of sterile cohabitation, have 
 suddenly become fruitful. In these instances, the want 
 of fruitfulness could not depend on failure of the ovu- 
 lations ; may it not be that the spontaneous cure of a 
 protracted and subacute inflammation of the kind herein 
 treated of may have restored the health, and so given 
 power to take away the woman's reproach ? 
 
 Continuing the plan adopted in this essay, we now 
 observe that other forms of cervical inflammation, than 
 those already described, will present themselves to the 
 observation of the clinical practitioner ; and we submit 
 the accompanying drawing, taken from the life, in a 
 case which proved unexpectedly rebellious to treatment, 
 though it was subdued at last. 
 
 This person, a lady of small stature and delicately 
 formed, of a sanguine choleric temperament, had given 
 birth in rather too rapid succession to six living child- 
 ren, and experienced, in the third lying-in, a very dan- 
 gerous attack of childbed fever ; and, a few years later, 
 subsequently to the birth of her sixth child, suffered 
 from a severe crural phlebitis, or milk-leg. The health 
 had been less firm than usual after her recovery from 
 the phlebitis, although she was not afterwards, on ac- 
 count of her valetudinary state, confined to the house. 
 
 After, for a long time, patiently enduring severe 
 pains, referred, in chief, to points in the neighborhood
 
 58 ACUTE AND CHRONIC DISEASES 
 
 of Poupart's ligament of the left side, with distressing 
 sensations in the range of the external obturator nerve, 
 bearing-down feeling, backache, debility, loss of appe- 
 tite, irregular action of the bowels, and dysmenorrhceal 
 symptoms, she asked for advice. There was incon- 
 siderable fluor albus, no positive dysury, nor other sign 
 of uterine deviation or displacement. Exercise on foot 
 invariably increased the pain, and the jarring of car- 
 riage-springs was highly annoying. She looked dispi- 
 rited and wan. 
 
 Touching the chirurgical neck, it was found to be 
 excessively solid, with the posterior lip not a little 
 longer than its fellow. The touch gave, from the resist- 
 ance, the idea of scirrhous induration; and was so 
 painful, even on slight pressure, as to be very unwill- 
 ingly borne, and then, not without some exclamations. 
 The left angle of the os was sulcated — as if it had 
 recovered imperfectly of some foregoing laceration in 
 labor. Pain excited by this pressure was felt not only 
 at the point of contact, but severely in the left groin 
 and inner side of the thigh. 
 
 The lady submitted, under advice, to an examination 
 by the metroscope, and it disclosed the form, size, and 
 hue, portrayed in the figure (Plate 8, Fig. 2). A long 
 familiarity with maladies of this class, did not prevent 
 the writer from having repeated misgivings as to the 
 result of this attack; which again and again seemed to 
 take upon it so many threatening characteristics of car- 
 cinoma, and resisted so obstinately the most careful, 
 reasoned, and persevering treatment, that, even now,
 
 OF THE NECK OF THE UTERUS. 59 
 
 he is led to doubt if the case was not strongly tinctured 
 with the malignant nature in question. 
 
 It was treated with antiphlogistic contacts of the 
 nitrate crayon, with emollient injections of flaxseed 
 mucilage, with anodyne enemata, containing, each, forty 
 drops of tinct. opii, at bedtime, with repeated applica- 
 tion of Swedish leeches to the cervix ; with a regulated 
 diet, occasional baths, a soluble state of the bowels; 
 much rest on the sofa, and the use of hydriodate of 
 potassa, combined with comp. syr. sarsa. 
 
 Of several hundred cases of inflamed cervix (at vari- 
 ous times, for many years) under treatment, this ap- 
 peared to be the most irresolvable. Yet it began at 
 last to give way, and slowly yielded — so completely, 
 that the patient was advised to take a course of the 
 waters at Saratoga ; from whence she returned in good 
 health, after an absence of a few weeks. Since that 
 time she has passed through a healthy gestation, and 
 has given birth to a robust infant with the easiest of all 
 her labors. During the dilating processes of the labor, 
 the whole cervix was found remarkably healthful. The 
 recovery was fortunate ; and, she has very good reason 
 to rejoice that M. Recamier has taught the profession 
 not only how to make a physical diagnosis, but also 
 how to treat these dreadful cases. We repeat here, that 
 an inspection of our drawing will communicate an idea 
 of the physical appearances, wellnigh as correct as the 
 direct observation of the inflamed cervix itself. It 
 cannot well be believed that such a form of inflamma- 
 tion as this could be made amenable to a treatment by
 
 60 ACUTE AND CHRONIC DISEASES 
 
 mere vaginal injection, by alterative doses of mass, 
 hydrarg., by preparations of iodine or tartar of anti- 
 mony, or any other merely constitutional medication. 
 It is true that, in some instances, the topical applications 
 may have been either incline rent, or positively injurious; 
 and it must ever happen, that even where one forms in 
 his mind a correct ideal of the therapeutical purpose and 
 act, he may err in the realization of it. It can only be 
 said, that the treatment rarely gave rise to other pain 
 than what was caused, sometimes, by pressure of the 
 instrument. But every sensible pressure with the index 
 finger gave as much. Be this as it may, the ultimate 
 final resolution of a detestable inflamed induration of 
 the cervix, and her complete recovery, furnish proof, 
 that the method (if not a safe, or a desirable one) is, at 
 least, in some very unpromising instances, crowned with 
 the happiest success. 
 
 The author having already set forth, in a preceding 
 part of this paper, his views in relation to hypertrophied 
 states of the womb, and the constitutional proneness of 
 that organ to undergo hypertrophic development, he 
 will now beg to call attention to some of the consequen- 
 ces of uterine irritation, that differ, at least in form, 
 from those already adverted to and illustrated. 
 
 Women, who complain of intrapelvic pain, and other 
 disorders of the lower part of the body, are inclined, 
 in general, to account for these incommodities by refer- 
 ring them to, what they call, womb-complaints. This 
 term is so vague and imprecise, that the pronouncing of
 
 OF THE NECK OF THE UTERUS. 61 
 
 it rarely excites any clear precise idea. Among these 
 cases of womb-complaints, probably none are so common 
 as those which depend upon retroversion of the womb. 
 So frequently does this affection occur in the course of 
 one's medical practice, that one almost acquires a dispo- 
 sition, in every case, before examination, to suspect it 
 has some dependency upon retroversio uteri. The 
 author has long been fully convinced that retroversion 
 of the womb constitutes seventy-five per cent, of all 
 cases of sexual disorders, that are of a gravity sufficient 
 to require appeal to medical advice. This may, at first, 
 appear to be an exaggerated estimate ; but it will pro- 
 bably be found sustained by statistical experience. 
 
 An inspection of Plate 3 shows how it must happen, 
 that alternating states of fulness or voidness of the uri- 
 nary bladder must interest the uterus, as to its place. 
 An overfilled bladder of urine, by thrusting the fundus 
 backwards towards the sacrum, puts violently on the 
 stretch the ligamenta rotunda ; and, as the uterus is, 
 to a certain extent, rigid and inflexible, it follows, that 
 if the fundus is thrust back so as to stretch the round 
 ligaments, the cervix must come forward, straining at 
 the same time the utero-sacral folds — for the womb 
 moves by the way of see-saw — in being retroverted. 
 
 A great many women and young girls suffer them- 
 selves to acquire the bad habit of retaining the urine 
 until a large quantity is accumulated within the blad- 
 der. Thirty ounces of liquid, in the urinary bladder, 
 make a mass as big as a quart measure, and it cannot 
 but thrust the uterus injuriously backwards, causing the
 
 62 ACUTE AND CHRONIC DISEASES 
 
 neck to see-saw at the same time forward, and approach 
 the pubis. 
 
 A long habit of this kind comes at last to ruin the 
 uterine ligaments; so that the fundus, being wholly 
 overset backwards, sinks down into the Douglass cul-de- 
 sac, while the os takes a permanent place near the sym- 
 physis pubis ; and this is retroversion. It is even some- 
 times a congenital malposition, as shown by Morgagni 
 and others. 
 
 But, let it be remembered that the womb is con- 
 stitutionally prone to set off on a race of hypertrophic 
 development, and we may then understand how it shall 
 be readily provoked to commence a process of hypertro- 
 phization, by the awkward, unnatural, and irritating 
 posture it acquires in retroversion. 
 
 We have met with some of these cases in which the 
 womb grew so much that the fundus was jammed 
 against the hollow of the sacrum, and the os against 
 the symphysis, or on the soft parts above it, compress- 
 ing the bladder most mischievously, but not at all 
 bending the womb itself. 
 
 In other specimens, we find the uterus bent like a 
 retort, as in the outline figure annexed. The angula- 
 
 Fie. 1.
 
 OF THE NECK OF THE UTERUS. 63 
 
 tion, in some of the examples, is almost acute ; so that 
 the caliber of the canal of the neck is seriously dimin- 
 ished, and its function as an efferent duct for the 
 menstrua, in a measure hindered ; whence we have dis- 
 tressing dysmenorrhcea. 
 
 Medical men, called upon to diagnosticate in such 
 cases, should be very careful, first to establish in their 
 minds the ideal or standard, by which to compare ; 
 otherwise they will be apt, upon finding the whole 
 pelvis occupied, or blocked up with an immense and 
 immovable solid mass, to conceive of it as a tumor; 
 whereas it may prove in fact to be no tumor, but only 
 an overset and enormously hypertrophied uterus. 
 
 We have met with repeated examples of such mis- 
 interpretation of the case, women being supposed to 
 labor under tumors within the pelvis, whereas the sup- 
 posed tumors were nothing more than the posterior 
 aspect of the corpus and fundus uteri, turned over and 
 touched through the posterior membranous wall of the 
 vagina ; and wholly disappearing as soon as the womb 
 could be properly reposited. 
 
 A young lady was brought to the Author from a 
 distant State, being accompanied by her attending 
 physician. In this case, a drawing was made, after 
 the most careful examination, of which we subjoin a 
 copy — Plate 9. 
 
 The figure is one-fourth less than the natural size, 
 and is made to exhibit a cross section of the pelvis con- 
 ducted through the pubis and sacrum, with the fifth 
 lumbar vertebra. In making this exploration, it was
 
 64 ACUTE AND CHRONIC DISEASES 
 
 easy to verify the diagnostic by hypogastric palpation, 
 and by examination conducted both by the rectum and 
 the vagina. The cervix was bent, as in the figure, and 
 the body of the uterus enlarged and turned over deep 
 into the recto-vaginal cul-de-sac. The entire mass was 
 so packed and immovably fixed in the excavation as to 
 make it impossible for one to raise it by any degree of 
 upward pressure with the fingers, and the canal was too 
 much curved to admit of correcting the deviation by 
 using Professor Simpson's sound. In general respects, 
 the patient's health, being not very greatly affected, she 
 was advised to return to her home and undergo at- 
 tempts to reposit the organ by the use of caoutchouc 
 bottles filled with curled hair, a method proposed by M. 
 Hervez de Chegoin. The result has not been commu- 
 nicated to us, farther than to inform us that the lady's 
 health is improved. 
 
 We have stated this case, because the diagram was 
 made after due reflection, at the time of our consulta- 
 tion, and because we rely upon its accuracy as a repre- 
 sentation of not infrequent cases of disorders of the 
 cervical portion of the uterus. Certainty, we have met 
 with a considerable number of analogous forms of dis- 
 ordered womb for many years past. 
 
 To reposit the uterus, and maintain it so, would ap- 
 pear to be the chief indication in such a case ; since 
 that alone would be to place it in a condition to obey 
 again its normal or generical law of form and substance. 
 We repeat that a considerable number of instances, in 
 which the womb was greatly augmented in every di-
 
 OF THE NECK OF THE UTERUS. 65 
 
 mension, in consequence of the irritation superinduced 
 by retroversion, have been treated with the happiest 
 success, on this principle, by the author of this essay. 
 
 To show how great is the change wrought in the 
 hypertrophied uterus by such reposition, we annex two 
 figures (Plate 10, Figs. 1 and 2). 
 
 These drawings represent one and the same uterus, 
 Fig. 1 being a view of it when the hypertrophy was at 
 the highest stage ; and Fig. 2, when it had entirely dis- 
 appeared. 
 
 The patient was a woman 39 or 40 years of age ; her 
 children were all grown up, except the youngest, a 
 daughter, some 13 or 14 years old. 
 
 When first called to the case, the belly was tumid, 
 and to a considerable degree tense and sonorous on per- 
 cussion, but, with the integuments, so strictly drawn 
 over the abdominal contents as to prevent any satisfac- 
 tory conclusion concerning the state and nature of the 
 substance giving rise to the so great distension. 
 
 There were dysury and pelvic fulness, with tenesmus ; 
 the menstrua absent, causing some suspicion, on her 
 part, of existing gestation. 
 
 Touching disclosed a retroversion. The pelvic cavity 
 was so full as to seem packed. The os uteri was higher 
 than the top of the symphysis pubis, and permanently 
 there. The substance of the womb could be traced 
 down and backwards to the hollow of the sacrum. 
 
 This womb was reposited, completely, and with con- 
 siderable relief. Subsequently, after severe catharsis, 
 it became possible to trace its outline in the belly, and 
 5
 
 66 ACUTE AND CHRONIC DISEASES 
 
 Professor Simpson's womb-sound was used, in order to 
 clear up the diagnosis. I next very slowly and cautiously 
 passed the sound into the os uteri, and it advanced with- 
 out giving pain or encountering any obstruction, until 
 the probe-point of it was arrested by coming in contact 
 with the vault of the fundus. The sound had gone six 
 and a half inches into the cavity, which proves that the 
 Fig. 1, Plate 10, is correct as to its length. I am an- 
 swerable that the volume of the chirurgical neck and 
 the orifice are also rightly illustrated, while the trans- 
 verse diameter is as near the truth as I could make it 
 by the most careful measurement, spanning it with the 
 thumb and fingers through the abdominal walls, relaxed 
 after the cathartic operations. 
 
 The rectification of the position did not, however, 
 save the life of the unfortunate patient, who proved to 
 be also affected with a colloid degeneration of the ovary. 
 This, which became an enormous mass of disease, spread 
 its ravages far and wide within the peritoneal cavity, 
 and she died at the end of six months from the time 
 here referred to, after repeated paracentesis abdominis. 
 Upon making a post-mortem examination, the uterus was 
 found to be of the size and form represented upon the 
 Fig. 2, Plate 10. 
 
 The case appears to us to present points of great in- 
 terest, since it shows that a vast increase of the volume 
 of the womb, unconnected with conception and gesta- 
 tion, is no more inconsistent with recovery of the non- 
 gravid form and size, than a similar recovery after 
 healthy pregnancy. The measurement, made with
 
 OF THE NECK OF THE UTERUS. 67 
 
 Simpson's sound, and the opportunity to determine the 
 appearances of the organ, after the death of the lady 
 from colloid cancer, rendered it an extremely favorable 
 example for illustrating the views set forth in this re- 
 port on the subject of uterine hypertrophy. It ought 
 not to be forgotten that this womb admitted of the in- 
 troduction of six and a half inches of Simpson's womb- 
 sound soon after it was relieved of its retroversion, and 
 that the lady perished, some six months later, with de- 
 generation of the ovary and other parts. If, therefore, the 
 hypertrophy of the womb had had any dependency upon 
 the ovarian disease, we should not expect to find it re- 
 duced back to its normal size ; whence we infer that, to 
 relieve it from its dislocated position, was the very thing 
 necessary for its cure. 
 
 Since writing the above, we have concluded to pre- 
 sent a drawing (Plate 13, Fig. 1), exhibiting the appear- 
 ance of a case of hypertrophy of the cervix uteri, which 
 came under care of the author. It was the case of a 
 maiden lady of some 35 years of age. It is believed that 
 this picture may serve to communicate a correct notion 
 of the physical characteristics of the chirurgical neck in 
 the instance referred to. This patient recovered under 
 resolvent contacts of the nitrate crayon, and the exhibi- 
 tion of internal remedies of an alterative kind. Proba- 
 bly such considerable augmentation as this of the cylin- 
 drical portion of the womb, yet not involving a state of 
 general hypertrophy of the organ, will not be very often 
 met with in practice. Still, cases of the kind are of 
 sufficient frequency to give interest to the description of
 
 68 ACUTE AND CHRONIC DISEASES 
 
 such a great change in the volume of the neck of the 
 womb. In this instance, and in others much resembling 
 it, we have not been accustomed to detect signs of posi- 
 tive inflammation in the part. Nevertheless, it would 
 be reasonable, from the resolving or deobstruent power 
 of the nitrate contacts in positively inflamed cervix, to 
 infer a similar availability in mere hypertrophic irrita- 
 tion; and practical experience justifies such an infer- 
 ence. 
 
 Another drawing (Plate 11), herewith presented, 
 shows the appearance of a cervix and os examined by 
 the writer. The patient was a resident of a neighbor- 
 ing State, who, some months previous to her visit to 
 Philadelphia, was visited, at her residence, in consulta- 
 tion. The womb, at that time, was completely retro- 
 verted, and so much enlarged as to fill the excavation j 
 pretty much as it is filled by the presenting part in a 
 labor. It was, at the time, immovable by the hand, 
 but was afterwards slowly raised by means of the 
 caoutchouc bags or pessaries of Hervez : vid. Trans. 
 Acad. Roy. de Med. torn. ii. p. 319. She was con- 
 sidered to be dangerously ill ; but began to recover 
 when the womb was replaced and relieved. After ac- 
 quiring a tolerable degree of health and strength, she 
 proceeded to Philadelphia, complaining of bearing-down 
 pains and intropelvic distress, with catamenial disorder, 
 attributable to the remaining and uncured disorders of 
 the uterus. 
 
 The metroscope showed the os tincse and cervix as 
 they seem in the figure, in which we have represented the
 
 OF THE NECK OF THE UTERUS. 69 
 
 organ foreshortened. The unhealthy state of the cervix 
 was attested, not only by its augmented size, the tuber- 
 cular elevations of the margins of the orifice, and the 
 red inflammation, but also by the viscid albuminous dis- 
 charges from the canal of the neck. 
 
 The treatment consisted, mainly, in the use of anti- 
 phlogistic impressions made by the nitrate of silver pen- 
 cil. The inflammation of the mucous body being cured, 
 the disordered womb returned to its accustomed obedi- 
 ence to its generical law of form and substance, and 
 recovered its normal magnitude. 
 
 An inspection of this specimen of disorder, remaining 
 after a very great hypertrophy had been reduced, 
 strengthens the inference hereinbefore expressed, that 
 the precise appearances manifested by the os and cervix, 
 in inflammation, are accidental — being either drusy, tu- 
 berculated, or smooth and even in surface ; and now we 
 present a case of hypertrophy, of which Plate 12 is a 
 just and fair exponent of the appearance, as it was 
 examined by us, both by touching and by the Recamier 
 speculum, as well as by M. Joubert de Lamballe's ivory 
 metroscope. 
 
 The os uteri was of this size, and the cervix could not 
 be embraced within the aperture of the Joubert instru- 
 ment. The neck of the womb, as far as it could be 
 explored by thrusting the fingers upwards all around the 
 neck, in the vaginal cul-de-sac, was of this shape, and 
 flaring out at this rate. The fundus, which was readily 
 detected in the hypogaster, was as high and as ample as 
 is here seen.
 
 70 ACUTE AXD CHRONIC DISEASES 
 
 The tint of the inflammation of the os tineas is care- 
 fully reproduced in the drawing. 
 
 The patient had been in apparent danger of imminent 
 death a few weeks before this sketch was taken, and 
 from causes connected with this uterine disease. She is 
 the mother of a numerous family. 
 
 Some leechings of the chirurgical neck, and repeated 
 applications of nitrate of silver to it, served to cure the 
 cervical inflammation, and the womb returned to the 
 size shown in Plate 13, Fig. 2. The patient was soon 
 restored to health, after several years of the greatest 
 inconvenience and many most painful and alarming 
 attacks endured before this treatment began. 
 
 No man, much experienced in the treatment of ute- 
 rine hypertrophies, can have failed to meet with persons 
 in whom, to examine by touching, was to find the pel- 
 vis filled up solid, so to speak, with the os uteri close to 
 the pubis. We have met with not a few such instances ; 
 and it has happened more than once, that we have been 
 so much disheartened upon a first examination, as to be 
 prompted to make a diagnosis of incurable disease. 
 
 In one case, a lady from the distant South, and in the 
 most wretched health, had the excavation so filled up 
 with a hypertrophied and solidified mass, that there was 
 scarcely space sufficient to allow an introduction of the 
 index finger betwixt this mass and the floor of the pel- 
 vis upon which it rested. The neck and os were near 
 the symphysis. It was a case of complete immobility of 
 the uterus, which seemed as big as a foetal head in a 
 labor at term. By means of a Para gum-elastic bottle,
 
 OF THE NECK OF THE UTERUS. 71 
 
 a very small one, stuffed with mattress-hair, we made 
 an oviform pessary, a little bigger than the thumb. 
 This was forced into the vagina, and retained by an 
 outer compress. In a few days, one somewhat larger 
 was substituted. The elasticity or spring of the caout- 
 chouc bottle steadily pressed the mass upwards, and the 
 size of the balls being occasionally increased, we had the 
 satisfaction to find, after no very protracted service, that 
 the intropelvic tissues had acquired a natural character, 
 and the lady returned to her country in very good 
 health, which she still enjoys. 
 
 We might relate a great number of cases to show that 
 upon removing the causes of augmented volume of the 
 womb, it falls speedily into its generical habits of nutri- 
 tion, but we abstain, considering that the declaration of 
 this doctrine, indeed, with a few illustrations and expla- 
 nations, ought to suffice to present the matter clearly to 
 the apprehension of any of our intelligent colleagues. 
 
 It is, by many, very confidently supposed that the 
 use of escharotics in these cervical inflammations will 
 speedily suffice to restore the health of the patient ; and 
 those who are most accustomed to use them, are, per- 
 haps, more thoroughly convinced, than any other per- 
 sons, of their great efficacy. It will not, however, 
 always answer to make the application to the mammil- 
 lary part of the cervix alone, because the inflammation 
 is, in some of the examples, found to attack, with greater 
 or less severity, the corpus mucosum and the mucous 
 follicles of the candlis cervicis. Here it is proper to 
 apply the nitrate by means of Lallemand's port-caustic,
 
 72 ACUTE AND CHRONIC DISEASES 
 
 or by means of a fitch pencil, which is composed of hairs 
 so rigid that one can readily pass it, loaded with a solu- 
 tion, some distance up the canal. It would be dan- 
 gerous to inject such solution with a syringe whose 
 canula should be introduced within the os. But after 
 all, we must meet with cases, at first to all appearance 
 tractable, that will, in the end, be found to foil our most 
 patient and well-reasoned efforts to cure them. 
 
 One makes up a diagnosis upon the means or elements 
 of a diagnosis — there is no other way. One cannot, 
 therefore, positively declare what is the state of the tis- 
 sues that compose the walls of the canal of the neck, 
 and it may, and does happen that those tissues undergo 
 changes which render a cure by the means herein 
 treated of out of the question. All the parts that come 
 into view might be apparently little changed, while 
 other parts beyond the reach of sight and touch should 
 be in a very different condition. Here is a drawing 
 taken from a specimen in the author's collection, that 
 illustrates this point. (Plate 14.) 
 
 This figure answers correctly, as to its scale, to the 
 preparation from which it was drawn ; and shows how 
 considerably the womb was enlarged at the time of the 
 woman's death; upon looking at the specimen, after 
 closing the incision, we might be easily misled, so far as 
 to think such a case would, in life, be readily amenable 
 to treatment like Fig. 12 ; but on cutting it open by an 
 incision from the fundus down to the cavity and canal, 
 and to the os, it is seen that the interior is irremediably 
 diseased, the substance of the walls being converted into
 
 OF THE NECK OF THE UTERUS. 73 
 
 a sort of pennicillated structure, of which the ends of 
 the pencils exhibit small tubercular elevations all along 
 the inner wall. 
 
 A casual examination by touching, or even a careful 
 metroscopy could not be expected to clear up such a 
 diagnosis as this one; and all attempts to restore a 
 healthful crasis and form to such degenerated tissues, by 
 leeches, by escharotics, either on the outside of the neck 
 or within the canal, must have failed. We know nothing 
 farther of this case — it having come into our possession 
 by the politeness of a stranger. Nevertheless, it is a 
 specimen most useful in the study and minute research 
 so desirable, as to these recondite sexual maladies. We 
 have recently witnessed the death of a fine woman, who 
 perished under this precise form of disorder immensely 
 aggravated. 
 
 Changes taking place in parts of the texture of the 
 inner wall of the cervix must be as various as accident 
 could make them. Such a pennicillated degeneration 
 as the above, being one form, it is not difficult to con- 
 ceive of other modifications as producing either fibrous 
 or cellular polypus, or the more unmanageable forms of 
 Hosmatomatous degeneration, of which we have met 
 with not a few examples in our practice, and we shall 
 now introduce into our Essay the figure (Plate 15) repre- 
 senting a case which was for a considerable length of 
 time under treatment without any useful influence being 
 produced therefrom. 
 
 The womb was carefully examined, with a view to 
 determine its dimensions and probable weight. It was
 
 74 ACUTE AND CHRONIC DISEASES 
 
 not more than four inches in its longest diameter. 
 The os was of an oval shape, and the edges or lip was 
 much condensed — to such a degree, indeed, as to com- 
 municate, by touching, the idea of scirrhous induration. 
 Projecting very little beyond the plane of the orifice 
 was a hsematomatous mass, that evidently sprung from 
 the right side of the wall of the canalis cervicis by a 
 broad origin. This bleeding tumor is well represented 
 in the drawing, in which the chirurgical neck, fore- 
 shortened, is seen to look like a bourrelet or ring pro- 
 jecting in the vagina, which is opened. 
 
 The hemorrhages, here, were on some occasions very 
 threatening. There was little encouragement to be 
 taken from the suggestion to remove the fungus by 
 strangulation — a step forbidden, also, by the delicate 
 state of the woman's general health. 
 
 Without indulging idle hopes of effecting a cure, and 
 with clear understanding that no promises to that effect 
 were given, or any flattering hopes held out, the case 
 was conducted for a few months under very unfavor- 
 able circumstances, by means of nitrate cauterizations, 
 destructive as to the ha3matorne, but antiphlogistic as 
 to the cervical ring. They, perhaps, cannot be said to 
 have done any good; unless, indeed, we might attribute 
 to them the diminished frequency and force of the 
 hemorrhages, and, perhaps, also some positive reduction 
 of the fungus itself. 
 
 Circumstances rendered it inexpedient to continue 
 these attempts at amelioration, which were unattended 
 with pain or any other sanitary inconvenience. The
 
 OF THE NECK OF TIIE UTERUS. 75 
 
 treatment was repeated about once in every seven days, 
 from the date in May, 1852, until the close of autumn. 
 Certainly no aggravation was noticeable up to the final 
 period of these attempts; and the patient went away 
 supposing herself to be somewhat improved in general 
 health. She is since dead. 
 
 As a general conclusion, a physician might venture, 
 in such cases, to pronounce them incurable. 
 
 Women often complain of irregular mensual returns, 
 saying, that while the legitimate periods are duly and 
 healthfully observed, they are, in addition, vexed with 
 an occasional show after any considerable exertion. 
 Women are apt to regard every sanguineous discharge 
 from the genitalia as menstrual discharge. 
 
 All those who recognize the truth that menstruation 
 is one of the phenomena of ovulation, will at once sus- 
 pect that such irregular markings must arise from some 
 cause other than the physiological hypersemia of the 
 ovulative act. And, in fact, it is mostly found, upon 
 due inquiry, that the patient has the raspberry-colored 
 inflammation of the cervix, already described ; or she 
 has certain small vivaces, or bunches of red cellular and 
 capillary tissue, which are either found peeping out at 
 the plane level of a somewhat patulous os tineas, or 
 jutting quite forth out of and beyond it, and attached 
 by a delicate peduncle or footstalk. 
 
 No one could expect to cure such a disorder as this 
 by any sort of constitutional therapy, or by any vaginal 
 injections; and it is not safe to leave them to their own 
 tendencies, which would perhaps convert them into very
 
 76 ACUTE AND CHRONIC DISEASES 
 
 troublesome bleeding polypi — many of which are to be 
 met with in a long professional course of observation. 
 A specimen of this kind is seen in the annexed figure 
 (Plate 16, Fig. 1). It represents the os uteri of a lady, 
 who, without having much real indisposition, was never- 
 theless excessively annoyed by circumstances like those 
 we have now detailed; and who indulged apprehensions 
 of some disastrous term to them. Examine the draw- 
 ing: it so very accurately exhibits the appearance both 
 of the neck of the womb, and the little tumor or ex- 
 crescence, that it scarcely requires description. Never- 
 theless, it is proper to call attention to the hyperemia, 
 or inflammatory turgescence of the os tineas, and to 
 suggest the notion that this redness and appearance of 
 phlogosis probably extended some distance upwards 
 within the canalis cervicis, thus maintaining a molimen 
 hemorrhagicum, which, upon the slightest provocation, 
 might cause a moderate gush, or marking of blood to 
 appear, as particularly after a sexual union. 
 
 In a great many cases like this, it is customary with 
 the author carefully to seize the excrescence, or nascent 
 polypus, with the dressing forceps, and so twist it off at 
 the base, if practicable, and, immediately afterwards, to 
 apply the nitrate pencil strongly to that base, or, on 
 some occasions, to use a camel-hair brush dipped in acid 
 nitrate of mercury, which answers well and is followed 
 by no inconvenience, particularly if a small velvet 
 sponge, thoroughly imbibed with soap-suds, is immedi- 
 ately afterwards pressed against the surfaces. The soap
 
 OF THE NECK OF THE UTERUS. 77 
 
 decomposes the excess of acid, and prevents the spread- 
 ing of the escharotic beyond the place of contact. 
 
 One need not expect that the avulsion of these little 
 polypi shall certainly effect the cure — for they are very 
 likely to be reproduced; probably, because only the 
 most outward parts have been removed. When pro- 
 perly removed, even down to the very source, it is un- 
 likely to reappear; but a second and a third attempt 
 should be made, if necessary. The case above illustrat- 
 ed was cured in 1851, and to all appearance remained 
 so — the lady having no annoyance of the kind until, in 
 the winter of 1852-3, she began again to perceive signs 
 of its return, and now she has an excrescence like the 
 one in the drawing, at the left angle of the os. 
 
 We have other drawings, exhibiting cases in which 
 man3 T such little excrescences were observed to jut forth 
 of the opened os, looking not unlike so many very ripe 
 red currants. We have treated them as above proposed, 
 and with satisfactory results. It seems needless to in- 
 troduce many of them here. Nevertheless, we have in- 
 troduced the figure (Plate 17), showing the appearance 
 of the excrescences protruding like ripe currants from 
 the os tincce, as mentioned on the opposite page. In this 
 case, under treatment in the spring of 1853, there was 
 hypertrophy of the womb to such degree, as to allow the 
 fundus to be felt quite two and a half inches higher 
 than the plane of the superior strait. 
 
 In continuation of these clinical details, we now re- 
 mark, that the lady from whom the drawing (Plate 16, 
 Fig. 2) was taken, complained of monorrhagia gradually
 
 78 ACUTE AND CHRONIC DISEASES 
 
 increasing in violence, and settling at length into an 
 incessant drainage, under which she became excessively 
 weakened and pallid. She had borne no child for some 
 sixteen years, and, like a majority of women similarly 
 affected, was confident that her trouble arose from what 
 they call change of life. She refused, during some 
 eighteen months, to submit to a physical diagnosis, and 
 became, at length, so dreadfully affected with hydrsemia, 
 that her life seemed to be in great danger. She was 
 repeatedly informed that the word change of life, as used 
 in general, conveys no distinct idea, and that her issue 
 of blood must arise from some organic fault. 
 
 At length the blood, from continual waste of the solid 
 constituents of it, became so dilute, so hydremic, that 
 she could not walk across the carpet without bringing 
 on palpitation, nor ascend the stairs but with caution, 
 and always with much difficulty. Seeing that she had 
 no other hope of amendment, she submitted to an ex- 
 amination, whereupon the small pedunculated vascular 
 excrescence, or polypus, was discovered, as shown in 
 Plate 16, Fig. 2. It was immediately twisted off. The 
 hemorrhages never returned afterwards, and she has had 
 good health these now many years. 
 
 This example and statement suffice to fulfil our pur- 
 pose in this relation, which is the reason why we detail 
 no other similar instances — which w r e could do, drawling 
 on the stores of our personal experience in practice. 
 
 It is of the utmost importance in the practice of 
 physic and surgery, to make absolutely correct diagnos- 
 tications, since all our prognosis, as well as treatment,
 
 OF THE NECK OF THE UTERUS. 79 
 
 which is contained within the diagnosis, depends upon 
 being right in the beginning. 
 
 This opinion will be admitted to be just by all those 
 who belong not to the empirical schools of our art, but, 
 on the contrary, adhere to the rationalists in Medicine. 
 
 There is a great liability, even among the most ex- 
 perienced men, to be led into ludicrous or even fatal 
 mistakes in the diagnostication of the so-called diseases 
 of the cervix. 
 
 A lady came to Philadelphia complaining of uterine 
 disease, that had baffled her physicians at home, and 
 applied for advice to an expert. Upon some considera- 
 tion, the author was invited to attend in consultation, 
 and dissented from the opinion that was entertained by 
 the attendant. 
 
 Patient had been affected with some form of violent 
 intro-pelvic inflammation, which, we believe, had been 
 regarded as metritis, by a misapprehension of its seat. 
 After protracted and great suffering, and after several 
 operations with the knife — the precise nature of which 
 we do not know — she was observed to have the vagina 
 so much diminished in length, that her relations of a 
 marital nature became impossible. She came to Phila- 
 delphia, as before mentioned. The canal of the vagina 
 was about an inch in depth, and no more. At the 
 bottom of this cul-de-sac was a firm substance, that was 
 mistaken for the chirurgical neck, and the delicate aper- 
 ture in it for the os uteri. 
 
 To the touch, such a case presents the greatest simili- 
 tude to the mammillary projection of the womb, and is,
 
 80 ACUTE AND CHRONIC DISEASES 
 
 therefore, a great stumbling-block in the way of diag- 
 nosis. The medical gentleman, whom I met, insisted 
 that it was the os uteri, and that adhesion of the vagina 
 to the whole exterior vaginal cervix gave it the present 
 appearance, as at a in the diagram on the next page. 
 
 Dissenting from this opinion, we averred with equal 
 confidence that the womb could not be touched, nor 
 even approached, and that the so-called os was nothing 
 more than one of the apertures in a long vaginal stric- 
 ture, and that the womb itself was not at all implicated 
 in the disorder, save in so far as it was imprisoned 
 above this impracticable stricture, amounting nearly to 
 atresia vaginae. See (b) in the diagram. 
 
 Some months subsequent to these discussions, the lady 
 returned to Philadelphia, and placed herself under the 
 sole direction of the writer of this statement, and went 
 away cured. 
 
 On the next page we have given an outline drawing, 
 or diagram, which shows how readily one might mistake 
 the thickened bourrelet (a) for a vaginal cervix and os 
 uteri; whereas, in truth, the os uteri is above, and in 
 the free part of the vagina marked (b) . 
 
 To look at the diagram, it is easy to perceive the 
 truth as to such a case, while, in practice, the diagnos- 
 tication had, and has deceived many an experienced and 
 able physician. 
 
 We have now under treatment a case precisely ana- 
 logous, affecting a woman about fifty-five years of age, 
 which was handed over to us by an eminent practi- 
 tioner, who had treated it for some time under the con- 

 
 OF THE NECK OF THE UTERUS. 
 
 81 
 
 viction that what he touched, as in the figure (at a), 
 was the os tineas, in a state of cancerous induration. 
 And it ought to be observed that, in all such instances 
 
 Fig. 2. 
 
 coming under our notice, we have found the part so 
 very solid and scirrhous, as to lead to fears that it could 
 not be amenable to any power of resolution. It is well 
 known that some urethral strictures do become almost 
 callous. 
 
 When called to examine the state of the parts in this 
 6
 
 82 ACUTE AND CHRONIC DISEASES 
 
 case, we were, at first, startled to find such an appear- 
 ance of malignant disease ; but a little reflection enabled 
 us to doubt of the fact. This doubt was easily resolved 
 by passing the probe point of Simpson's sound along and 
 quite through the lengthy stricture, into the free and 
 ample vaginal cavity above. That this was done was 
 verified by an examination made through the walls of 
 the rectum, in doing which the probe point, in the free 
 cavity, was recognized, as well as the shaft of the sound 
 lying in the stricture, and closely embraced by it. The 
 same method of making this diagnosis was employed 
 in the first case described in this connection; and it is 
 one always to be resorted to and relied upon with im- 
 plicit confidence. 
 
 Having stated these cases, which are not affections of 
 the cervix uteri, we hope to be absolved from any charge 
 of transcending the limits assigned to us, inasmuch as 
 we have deemed it proper to array all the means of 
 differential diagnosis that might haply serve to prevent 
 misapprehension in the cases we have felt charged to 
 treat of, and shall now ask liberty to refer to a work 
 entitled "Woman, her Diseases and Remedies," page 
 106, for the history of a case whose circumstances are 
 forcibly recalled to memory by the above observations. 
 
 Hitherto we have not, in this treatise, said anything 
 in regard to the malignant degenerations of the texture, 
 so often met with in inquiring into diseases of the neck 
 of the uterus. 
 
 To dilate upon all the forms of malignant chronic or 
 acute diseases of the cervix would require a considerable
 
 OF THE NECK OF THE UTERUS. 83 
 
 volume, and it is not to be supposed that such a detail 
 would fail to exhaust the patience of the reader. The 
 figure (Plate 18), which we have in this connection pre- 
 sented, is designed to illustrate one form, of chronic dis- 
 ease of the neck of the womb, which, in the case at 
 least from which the figure has been carefully designed, 
 was found susceptible of a radical cure. 
 
 The patient was a very robust and stout married 
 woman, aged about 30 years, less or more. She had 
 children. Complaining of frequent attacks of irregular 
 menstrua, she appealed for advice to a physician, who, 
 giving an unfavorable prognosis, so excited her fears 
 and the anxiety of her family, that the author was 
 invited to form an opinion on the case. 
 
 The vagina contained a substance of the size and 
 shape of the red mass which, in Plate 18, is seen spring- 
 ing from the anterior aspect of the vaginal cervix. To 
 the touch, it communicated the impression always pro- 
 duced by touching the tissues in scirrhus or carcinoma 
 uteri. It had the same resistance, and roughness or 
 grater-like feel that belong to cancer of the womb or 
 vagina. The gentlest touch caused it to bleed. It was 
 not sensitive so as to be intolerant of pressure. 
 
 The posterior aspect of the cervix gave, by the touch, 
 the idea of normal tissue; and this was likewise the 
 case as to both the lips of the os tineas ; and, indeed, all 
 the accessible parts of the womb seemed to be perfectly 
 sound and healthy, save only where the peduncle, or 
 root of this malignant mass, arose from the anterior 
 aspect of the neck. The vagina was everywhere quite
 
 84 ACUTE AND CHRONIC DISEASES 
 
 healthy. An inspection of the figure must produce the 
 same impressions as were excited in the author's mind 
 by the physical diagnosis. 
 
 It would, in such a case, evidently be useless to apply 
 any dressings to the surface of the tumor, which must 
 be supposed to be all of one quality and vital temper, 
 from the base to the apex. It would be a mere waste 
 of time, therefore, to act upon the surface of it only. 
 But if the diseased mass, in fact, proceeded from the 
 base alone, on which it rested and depended for its ex- 
 istence, then one might hope that, in eradicating the 
 very base itself, would be found a sure remedy for an 
 otherwise fatal extension of the degeneration. 
 
 It was, accordingly, proposed that the mass should be 
 removed, either with a uvula scissors, or by means of a 
 ligature. The ligature being preferred, was applied, and 
 the mass came away after a few days. 
 
 It was also proposed that, as soon as the tumor 
 should come away, the base or root should be destroyed 
 by actual cautery, or by acid nitrate of mercury. The 
 latter was adopted. Every vestige of diseased structure 
 was thus removed, and the lady has now, for three years, 
 enjoyed good health ; having experienced very little in- 
 convenience during the whole process of cure. 
 
 The question naturally here arises, whether this was 
 a malignant tumor or no. We are aware that some 
 persons will be likely to regard its curability as evidence 
 of its non-malignant nature ; but, as for us, we consider 
 that such a mass, being left to work out its own com- 
 plete development, could not fail, in the progress of it,
 
 1 
 
 OF THE NECK OF THE UTERUS. 85 
 
 to involve in destruction larger and still larger portions 
 of the uterine tissue, and at last bring the life of the 
 patient to a premature close. If the tumor was not 
 malignant, it would become so if left uncured. 
 
 It would have been, perhaps, hopeless to attempt the 
 cure, had the examination not given the most flattering 
 assurances that the diseased mass sprung from a rather 
 superficial portion of the cervix, as was ascertained by 
 the touch. We doubt not that, in numerous instances 
 of parts wholly changed like this, cures have been and 
 will be effected by removing all changed texture — ex- 
 posing sound surfaces, which, being filled by healthy 
 granulation, restore completely, or almost completely, 
 both form and function to the before diseased parts. 
 
 We shall next beg leave to call attention to a form of 
 diseased cervix, of which, during a very long and co- 
 pious experience in practice, we have met with but one 
 solitary example. And even this is rendered less use- 
 ful, perhaps, by coincident circumstances of the patient, 
 that serve to lessen the value of the case as furnishing 
 experimental results of the treatment. The lady was 
 near fifty years of age, had borne several children, but 
 none since seven or eight years. She was in an ad- 
 vanced stage of pulmonary tuberculosis, and evidently 
 destined, at an early day, to die with pulmonary con- 
 sumption. 
 
 Certain symptoms, proceeding from intro-pelvic dis- 
 turbance, and causing great distress, led to the opinion 
 that the whole case was aggravated by some form of 
 uterine irritation ; and as she was anxious to be re-
 
 86 ACUTE AND CHRONIC DISEASES 
 
 lieved, and willing to undergo an examination, it was 
 found, on making one by the touch, that the vaginal 
 neck and os were both enlarged and painful. The 
 mouth of the womb was much more patulous than it 
 ought to be, and a lump was perceived upon the anterior 
 aspect of the chirurgical neck. On exposing the point 
 by means of a Recamier tube, there was seen a bright 
 elastic tumor of a translucent appearance, which is 
 represented in Plate 19, Fig. 2. 
 
 The lady, even in her low state of health, was con- 
 vinced that she was pregnant ; but the womb could not 
 be felt through the hypogastric integuments. Whence 
 it was inferred that the organ was of the form and 
 dimensions given in Plate 19, Fig. 1. 
 
 Professor Mutter opened this hygroma with a sharp- 
 pointed, narrow bistoury, and there issued from it a few 
 drops of colloid fluid, but as transparent as albumen ovi; 
 after which came away a few drops of blood, whereupon 
 the tumor, or hygroma, collapsed, and the lady, whose 
 consumption made continual progress, had little or no 
 farther trouble from this special cause ; a few touches 
 of the pencil of argent, nitrat. having dissipated the 
 inflammation and engorgement of the womb. 
 
 A few months later, she died, exhausted with hectic 
 — the lungs being utterly disorganized by softened tuber- 
 cles and numerous vomicse. 
 
 A post-mortem examination being allowed, it was 
 found that the hygroma had not filled again, but left a 
 bluish spot or blain. The os was still a good deal open, 
 but the neck was little enlarged. Plate 19, Fig. 1, shows
 
 OF THE NECK OF THE UTERUS. 87 
 
 a profile view of this uterus, which is deemed well 
 worthy of observation, particularly because the fundus 
 was converted into a tumor, which is seen like a sub- 
 rotund swelling at the left hand end of the figure, and 
 somewhat separated from the general mass of the uterus 
 by the sort of strangulation or groove seen in the pic- 
 ture. This was a firm fibrous product, developed out of 
 the substance of the fundus itself, which underwent this 
 fibrous conversion, while every other part of the organ 
 retained the equable ratios of its several elementary or 
 constituent tissues. 
 
 We observed that we deemed this case interesting, 
 and it is so, chiefly in this, that it would be likely to 
 give rise to a false diagnosis, and that on the following 
 accounts : — 
 
 Leaving out of consideration the tuberculosis, which, 
 it was manifest, must, at no distant day, destroy the 
 patient, and judging only from the results of the pelvic 
 examination, and the inquiries made at the surpubal 
 region, one would be led to pronounce a flattering prog- 
 nosis, since one would scarcely doubt of his ability to 
 cure all the evident disorders of this womb. Yet, no 
 one could examine the necroscopic specimen without at 
 once perceiving that it would be impossible to cure such 
 a womb as this. The apparent fundus is not the fundus, 
 in fact, but is a fibrous tumor, into which parts of the 
 true fundus have been converted. It is inaccessible to 
 any surgical means, and is wholly disobedient or indiffer- 
 ent to every therapeutical force. As well might we 
 administer medicines to convert a femur into a tibia,
 
 88 ACUTE AND CHRONIC DISEASES 
 
 and vice versa, as to give them ip convert a tumor into 
 a natural tissue again. The attempt is ever a ridicu- 
 lous one, evincing a complete misunderstanding of the 
 laws of life, as well as of the scope of the medical art. 
 
 A swelling may be cured again ; but a tumor is a 
 new product, and as much an independent organism as a 
 lung, an eye, or a muscle. It has, however, no generical 
 destiny ; and, therefore, can obey no therapeutical law. 
 
 Before bringing this paper to a close, we shall present 
 a few remarks on the subject of displacement of the 
 neck of the womb ; and we begin by referring to our 
 Plate 3, to show the due relations, as to distance, of the 
 os tincce from the walls of the pelvis. 
 
 The ligamenta utero-sacralia, so called by the anato- 
 mists, appear to us to be rather deserving the denomina- 
 tion ligamenta vagino-sacralia ; for they are in reality 
 duplicatures of peritoneum running backwards, one on 
 each side of the pelvis, from the posterior or upper 
 extremity of the vagina to the sacrum. It seems to us 
 that their office is to keep the end of the vagina at a 
 certain place, near enough to the lower part of the sa- 
 crum ; and certain it is that, as long as they preserve 
 their due firmness or tension, the upper end of the 
 vagina cannot drop down from near the sacrum to near 
 the arch of the pubis. A line drawn from the lower 
 part of the sacrum, say near its fourth segment, to the 
 top of the arch, is at least four and a half inches. When 
 we find the os tincaB jutting outside of the arch, we 
 know that the vagina has fallen at least three and a 
 half inches, and of course that the ligamenta utero-sacra-
 
 OF THE NECK OF THE UTERUS. 89 
 
 lia are stretched or elongated to that amount. But 
 when, on making such an examination, we thrust or 
 carry the cervix uteri backwards and upwards to its true 
 place, then the ligamenta utero-sacralia become again as 
 short as they ought to be; and if they would remain 
 permanently so, we should cure the patient merely by 
 thus thrusting the uterus up to its true place. But, un- 
 fortunately, when we take away the support, it falls 
 down again ; because the utero-sacral folds, and all the 
 serous and cellular or areolar relations of the vagina are 
 weak and relaxed, and cannot hold it up. 
 
 Now, if this be a just representation of the facts, no 
 one can deny that prolapsus uteri is a disorder or weak- 
 ness of the vagina and its ligaments, and that to cure 
 the prolapsus we must cure the vagina first ; it being 
 evident that, with a vagina of three and a half inches 
 in length, the womb cannot quit its place in the pelvis. 
 
 The womb, as we have already said, is two and a 
 quarter inches in length, and the longest antero-pos- 
 terior plane within the pelvis may be assumed to be 
 four inches and a half. Hence, it is clear that, if the 
 womb be thrown over backwards, so as to let its fundus 
 fall into the rectovaginal cul-de-sac of peritoneum, called 
 the Douglass cul-de-sac, it is inevitable for the cervix 
 uteri to come forward ; for the uterus cannot well turn 
 over without a see-saw movement. If, therefore, the 
 womb preserve its rigidity, and it be retroverted, the os 
 tineas must come near to the symphysis pubis. This 
 would be the case in all instances of retroversion with- 
 out flexion of the longitudinal axis of the uterus. We
 
 90 ACUTE AND CHRONIC DISEASES 
 
 have met, in practice, with many instances of this kind, 
 and in more than one remarkable case have found the 
 fundus fastened down in its unnatural bed in the pelvis, 
 by means of strong adhesions, which it was necessary 
 to divide with the scalpel before we could reduce the 
 uterus into its proper position again. One was a case of 
 retroversion, with hypertrophy of the womb coinciding 
 with fatal Fallopian pregnancy. The organ stretched 
 across the pelvis, from the sacrum to the pubis, fully 
 four and a half inches. The specimen is in our collec- 
 tion. Another was a case of uterine pregnancy. 
 
 But, while it is true that the uterus, being of a rigid 
 and firm consistence, does not always bend in retrover- 
 sion, it is very common to meet with specimens in 
 which the organ is bent at a right angle, or even more 
 than that. Retroversion, with an unbent womb, is a 
 
 Fig. 3. 
 
 mere accident or chirurgical disorder ; whereas retrover- 
 sion, with a bent or angulated uterus, is a case in which 
 the womb has itself become diseased. It is a case in
 
 OF THE NECK OF THE UTERUS. 91 
 
 which, by the nutrition of one segment or half of the 
 womb, it has grown smaller or larger than the other 
 symmetrical half or segment ; for, it is clear, if both the 
 anterior and posterior halves should grow or be de- 
 veloped pari passu, the organ could be only straight, 
 and could be by no means crooked or bent, as in the 
 above diagram. The quantity of the convex must greatly 
 exceed the quantity of the concave half; otherwise, the 
 womb could not be bent, but must remain straight or 
 fusiform. 
 
 In treating these retroversions, therefore, we must 
 expect to meet with greater difficulty and delay in the 
 case, if we have an angulated organ to rectify, as well 
 as a case of retroversion. We do not mean to say that 
 the methods are different, since there is but one good 
 method for all of them, and that is a treatment by the 
 pessarium of a proper form. 
 
 And here we may beg leave to notice what we regard 
 as a great oversight on the part of practitioners, in re- 
 gard to one of the chiefest sources of embarrassment and 
 ultimate disappointment of the cure. The circum- 
 stance here alluded to is this. In retroversions of some 
 considerable duration, the anterior column a of the va- 
 gina has become shortened, and, in consequence of 
 its being without any antagonistic or opposing force, 
 allowed so to coacervate its material as to be indisposed 
 afterwards to remain in the state of extension natural 
 to it. 
 
 We believe that all living soft parts have an inde- 
 feasible tendency to consolidation, when not prevented
 
 92 ACUTE AND CHRONIC DISEASES 
 
 by an antagonizing power. This depends, indeed, on 
 what Bichat announces as the contractility par defaut 
 d extension. If the os uteri should be brought close to 
 the symphysis pubis, and kept there for some months 
 or years, it is clear that if any one should cause it to 
 remove backwards again to its place three and a half 
 inches away from the crown of the arch, and then let it 
 go, it would leap back again to the vicinity of the pubis, 
 being drawn thither by the anterior column of the 
 vagina, which soon contracts again like a bit of stretched 
 caoutchouc. Now, this is the circumstance which we 
 complained of as being too much overlooked by our 
 physicians in their intentions as to a cure. They are 
 well enough aware that when the womb is overset, or 
 retroverted, it is useless to reposit it, and then abandon 
 it to itself, since it always falls over again with the first 
 motion, or effort to stoop, or to cough, &c. They have 
 used pessaries of every possible shape, and they have 
 been much annoyed to find their patients worse instead 
 of being better for their use. 
 
 An immense use has been made of the globe-pessary; 
 and certainly, in a simple prolapsus uteri, it answers 
 admirably. But it does not answer well for the cases of 
 retroversion; because the morbidly condensed and elastic 
 anterior columna of the vagina, slowly contracting in 
 order to recover a state of rest, pulls the os uteri for- 
 wards over and above the convex upper surface of the 
 ball, and draws it again close up to the symphysis, the 
 fundus meanwhile sinking down backwards into the 
 peritoneal cul-de-sac between the rectum and the vagina.
 
 OF THE NECK OF THE UTERUS. 93 
 
 In this case, the woman is greatly annoyed, having both 
 a pessary and a retroversion to contend with. 
 
 Many years ago, the author was in attendance on an 
 aged woman, who had long suffered from prolapsus 
 uteri. She had been taught, by a nurse, to construct a 
 pessary, by making a whalebone ring, some three inches 
 in diameter. This ring being wrapped or served with 
 bobbin, was dipped in melted wax, until a sufficient 
 coating of wax was given. In this way she made an 
 elastic annular pessary, by means of which she was 
 enabled to pass through many years of an advanced age, 
 without any inconvenience from a procidentia which 
 always threatened to return upon the removal of the 
 support. 
 
 The globe-pessary of Dr. Physick, and the concavo- 
 convex disk, or Dewees's pessary, have been much em- 
 ployed in Philadelphia, and throughout the United 
 States generally, as might be expected from the eminent 
 position and repute of both those gentlemen. 
 
 The globe of Dr. Physick is liable to the objection 
 above stated, as a remedy for retroversion ; and Dewees's 
 disk is equally obnoxious to criticism, as being liable to 
 injure the os uteri, which rests nearly vertically upon 
 the metallic surface. Of course, the same objections lie 
 against all the glass-pessaries, of which many thousands 
 have been on sale in the drug establishments of our 
 people. Indeed, they are at last becoming justly dis- 
 credited. 
 
 Seeing the difficulties that surround this subject, and 
 acting on the experience of the aged lady already men-
 
 94 
 
 ACUTE AND CHRONIC DISEASES 
 
 tioned, the author constructed pessaries with watch- 
 spring, as follows : — 
 
 Take a piece of watch-spring of the proper length. 
 That is to say, if a pessary of three inches diameter is 
 required, take a lamina of watch-spring nine inches and 
 three-sixteenths in length. Bend it into a circle, and 
 rivet or solder it, to make an annul us three inches 
 in diameter. Serve it all round with bobbin, or large 
 twine, and then dip it again and again in melted virgin 
 wax, so as to infiltrate the threads completely. Polish 
 the waxen surface with the hands. This ring, which is 
 
 Fig. 4. 
 
 as elastic as watch-spring, can be compressed betwixt 
 the thumb and fingers, so as to be converted from the
 
 OF THE NECK OF THE UTERUS, 
 
 95 
 
 shape of this figure (4) to that of Fig. 5, and then intro- 
 duced into the vagina without giving the woman any 
 pain. As soon as it has taken its place, it expands 
 again, and recovers its original form. 
 
 Previous to introducing the annulus, the womb should 
 be reposited, either by the hand alone or by Professor 
 Simpson's womb-sound ; and, that being done, the annulus 
 acts in the manner illustrated by Plate 20, in which a 
 silver ring, gilt, is made use of. 
 
 Fig;. 5. 
 
 Let it be observed that the distance from the pubis to 
 the sacrum, in this plane, is at least four inches and a 
 half, and that the annulus is three inches in diameter.
 
 96 ACUTE AND CHRONIC DISEASES 
 
 Now, if the ring is introduced in such a manner as to 
 cause the sacral segment of it to pass behind the cervix, 
 and rest in the cul-de-sac behind, formed by the poste- 
 rior columna of the vagina, while the pubal or anterior 
 segment rests on the symphysis pubis, it is impossi- 
 ble that the cervix uteri should again come forward to 
 the symphysis, or that the retroversion can occur again 
 while the annulus is left in situ to prevent it. Indeed, 
 the vagina is now full three inches in length, and not 
 even prolapsus uteri can vex the patient ; for prolapsus 
 is shortening of the vagina, and nothing more and 
 nothing less. 
 
 Such an annular pessary as this, left in situ for a few 
 months, must effectually overcome the contraction par 
 defaut d' extension of the anterior vaginal column ; and 
 by allowing the ligamenta utero-sacralia to be at long 
 rest, they, by coacervation of their substance, will re- 
 cover their normal density or tone ; and so, the ring 
 being at last taken away, the woman is found to be 
 cured ; for the ligam. utero-sacralia are now condensed 
 again, and the anterior columna vaginalis has regained 
 its ductility. 
 
 The method of constructing annular pessaries of 
 watch-spring, as above set forth, was detailed at a meet- 
 ing of the College of Physicians of Philadelphia, by the 
 reporter. 
 
 At a subsequent meeting of that College, one of the 
 Fellows thereof, Dr. Charles Evans, reported an im- 
 provement, consisting in coating the watch-spring- 
 served annules with gutta percha dissolved in chloro-
 
 OF THE NECK OF THE UTERUS. 97 
 
 form ; and this fortunate idea has rendered the instru- 
 ment so perfect, that we may suppose it to be all that 
 could be wished for as an apparatus for the purpose of 
 treating retroversions. 
 
 Reporter has long used annules made of absolutely 
 pure silver cylinders, bent into a circle and gilt with 
 fire gilding. Such an instrument is excellent, and is so 
 pliable that it may be crushed into an elliptical form 
 before its introduction, and then, by a little dexterity, 
 opened again into the circular form while lying within 
 the vagina. This is perhaps the most perfect of these 
 instruments, yet difficult to use and to obtain. 
 
 A reference to Plate 20 shows that, if the posterior 
 segment of such an annulus is lodged within the cul-de- 
 sac of the vagina that is found behind the neck of the 
 womb, while the anterior segment reposes upon the 
 tissues just above and behind the crown of the pubal 
 arch, it is absolutely impossible for the retroversion to 
 take place ; and it is to be believed that, in a space of 
 time, greater or less, according to a variety of circum- 
 stances, all the tissues concerned in keeping the uterus 
 in its place will recover their tone, by virtue of the phy- 
 siological force called by Bichat contractilite par defaut 
 $ extension. It could not be otherwise. As to the ex- 
 ternal apparatus called utero-abdominal supporters, 
 which we have the mortification to see prescribed and 
 applauded by physicians and surgeons, even eminent 
 persons in our class, we can but express again our con- 
 viction of their utter uselessness, as well as the liability 
 7
 
 98 ACUTE AND CHRONIC DISEASES 
 
 of those who use them to aggravation of all the evils for 
 which they are the pretended remedies. 
 
 We have here placed a drawing (Plate 21), taken 
 from the museum of Jefferson Medical College, at Phila- 
 delphia, which represents one of the specimens there of 
 polypus of the womb ; and we have felt constrained to 
 present some remarks upon cases of this kind, inasmuch 
 as they greatly interest the cervix of the uterus, whose 
 acute and chronic diseases we are commanded to de- 
 scribe. And herein we do not feel called upon to go 
 into a full account of the various uterine polypi. Let it 
 suffice to say that they consist of tumors, hard or soft, 
 which rise up from the surface, whether exterior or 
 interior, of the child-bearing organ : many of them, 
 however, being developed in the very substance of the 
 organ, and invading greater or lesser portions of its 
 structure. 
 
 These growing polypi depend upon non-equable de- 
 velopment of certain of the elementary tissues of the 
 womb, which, being produced out of all normal rate, 
 may attain a great magnitude or mass. They vary 
 from a few grains in weight, like the currant-shaped ex- 
 crescence in Plate 16, Fig. 1, or the bunches in Plate 16, 
 Fig. 2, or the more considerable tumor projecting from 
 the os, in Plate 21. We possess specimens of the size 
 of an ostrich egg, and one that was at least six inches 
 in longitudinal by five in the conjugate diameter. We 
 were present at the examination of a specimen, which 
 was, at the time, weighed by the late Professor Wm. E. 
 Horner, and found, with the womb which contained it,
 
 OF THE NECK OF THE UTERUS. 99 
 
 to weigh thirty-two pounds. The degenerated develop- 
 ment-force, by means of which a fibrous polypus rises 
 up on the surface of the womb, or within its substance, 
 may, in some cases, extend so far throughout the whole 
 limits of the uterus as to apparently convert the whole 
 substance of it into the material or nature of polypus. 
 We possess a specimen, in which it would be difficult to 
 discriminate between the character of the large mass, 
 into which the whole womb has become converted, and 
 the substance of the large polypi just now mentioned as 
 in our possession. 
 
 But lest we should be tempted to carry this investiga- 
 tion far beyond the limits proper for this paper, we 
 shall confine ourselves to remarks upon the interior 
 polypus, or polypus of the cavity of the womb. 
 
 A tumor of this sort, which, at the commencement, 
 might be supposed to be no bigger than a split pea, 
 growing, by constant nutrition of its mass, soon comes 
 to distend the cavity which it occupies, and that cavity 
 must expand upon the same principles as those which 
 regulate the physiological hypertrophization or evolu- 
 tion of the womb in true pregnancy. If the polypus 
 should take its origin within the true cavity of the 
 uterus, the fundus and corpus uteri would, of course, 
 first expand for the accommodation of the growing 
 mass, just as happens in the early stages of a gestation. 
 
 Under these circumstances, the form and size of the 
 neck of the womb do not undergo any change, and an 
 examination per vaginam would not enable a physician
 
 100 ACUTE AND CHRONIC DISEASES 
 
 to pronounce with assurance that any change whatever 
 had taken place in the form and volume of the organ. 
 
 The term expansion does not here imply merely a 
 stretching of the walls — as when a bladder is blown, but 
 it means a regular physiological hypertrophy, or growth. 
 Now, when the womb grows, it must grow generically, 
 and will, in such case, preserve its generical character 
 as to form ; for the idea of genus and species cannot but 
 include ideas of both form and substance, of superficies 
 and solid contents; when the womb, or parts of it dege- 
 nerate, then the form goes in the most convenient direc- 
 tion, or qua data porta. 
 
 A great uncertainty as to the existence or non-exist- 
 ence of pregnancy ever attends the vaginal examination 
 in the early stages; but in proportion as a polypus 
 or an ovum becomes larger, so must the cervical por- 
 tion of the womb grow shorter, until, at last, the cylin- 
 droidal neck acquires the shape of a cone, or rather a 
 conoidal form ; for a polypus, though it can grow indefi- 
 nitely, and come to be of an enormous size at last, must 
 ever mould itself upon the internal walls of the womb. 
 The polypus, therefore, cannot so alter the shape of the 
 womb as to give it a figure other than such as naturally 
 belongs to it, and characterizes it whether gravid or not 
 gravid. 
 
 Sooner or later, in any case of polypus uteri, it may 
 be expected that the lower segment of the tumor shall 
 appear at the os uteri, and gradually dilating it more 
 and more, open it at last so widely that the contractility
 
 OF THE NECK OF THE UTERUS. 101 
 
 of the fundus and body shall be able to thrust the 
 tumor out into the vagina. 
 
 In the figure (Plate 21) it is seen that the polypus 
 begins to show itself very plainly at the opening mouth 
 of the womb. But, with the cone of the cervix, and the 
 circle of the os so thick and strong as here shown, it 
 could not be that the polypus shall very soon be ex- 
 pelled from the uterine cavity. 
 
 It might be a question whether the diagnosis of such 
 a tumor is to be absolutely relied upon, seeing that it so 
 closely resembles the case of haaniatoma or bleeding 
 fungus, represented at Plate 15 of this report. Yet it is 
 not difficult, either with the index finger alone or with 
 a womb-sound, to ascertain that the fungus at Plate 15 
 is a hematoma springing directly from the inner wall of 
 the canalis cervicis, while the other tumor (Plate 21) 
 is a real uterine polypus rising from a portion of the 
 wall of the true cavity. I may repeat that the 
 shape assumed by the womb in a natural pregnancy 
 is well known ; and that in all cases where the womb 
 contains a true polypus of the cavity, it in like manner 
 preserves its natural form. But, if a fibrous or other 
 degeneration within its texture takes place in the very 
 substance or walls of the womb, making one or many 
 fibrous tumors, the womb loses its normal form, and 
 becomes lumpy or botryoidal. 
 
 The examination of such cases should, hence, always 
 be so conducted as to lead to a knowledge of the form 
 actually possessed by the enlarged organ. If that form 
 be normal, or generical, then we infer that the enlarge-
 
 102 ACUTE AND CHRONIC DISEASES 
 
 ment is occasioned by the presence of something 
 moulded into shape by the womb itself, and that it is 
 an ovum or a polypus. If, on the other hand, the 
 generical form is not preserved, we may infer the exist- 
 ence of some morbid growth outside of the cavity, but 
 within the very substance or walls of the womb. 
 
 The uterus is destined, normally, to discharge a 
 quantity of blood from its cavity with every periodical 
 ovulation, and the custom of women is one so regularly 
 observed, that it gives to the mind a tendency to regard 
 every discharge of blood from the organ as a menstrual 
 discharge. Hence, when women find themselves bleed- 
 ing too often, too copiously, or in a way too greatly pro- 
 longed, it is their habit to consider the deviation as a 
 fault of their courses. They do not, in general, consider 
 that blood may issue from such a sanguine organ, with- 
 out the discharge having any relation whatever to their 
 mensual act ; and they usually speak of all such preflu- 
 via as disorders of the menstruation. A medical man, 
 on the contrary, ought to possess an ideal standard, by 
 which to compare every such case, and he must at once 
 perceive that such a state cannot possibly be a men- 
 sual state, but must be related to some other quality 
 and faculty than those of ovulation and menstruation. 
 
 Enough has been already said in this work to show 
 that morbid changes in the corpus mucosum of the 
 womb may serve to explain the frequent reappearance 
 of sanguine discharges from the genitalia. Such dis- 
 charges as these, however, are not for the most part 
 copious and wasting. It is true, however, that such
 
 OF THE NECK OF THE UTERUS. 103 
 
 discharges are most apt to coincide with the hyperaemia 
 of the ovulation, or to have relation to some mental or 
 physical shock, or to the sexual insult, &c. &c. 
 
 In cases like that portrayed at Plate 21, the proflu- 
 vium of blood is likely to be independent of any perio- 
 dical ovulation, and, indeed, in some instances, is never 
 wholly absent, while the subject of it is liable to sudden 
 enormous effusions of blood, generally greatest at the 
 mensual periods. "We have elsewhere related a case, in 
 which the woman was never, during six years and a 
 half, without bloody issue from the genitalia ; an issue 
 which arose from a polypus passed into the vagina. So 
 many striking instances of this either frequent or con- 
 stant hemorrhage have occurred to us in practice, that 
 we spontaneously, as it were, adopt it as prima facie 
 evidence of the presence of a uterine polypus, when we 
 discover such frequent, or copious, or constant sanguine 
 evacuations. 
 
 A polypus, like that in Plate 21, whose lower seg- 
 ment peeps out from the opening os, and whose sides 
 are compressed or strictured by the firm walls of the 
 cervix uteri, could hardly do otherwise than bleed more 
 or less day and night, since the stricturing cervix must 
 necessarily keep up a molimen hgemorrhagicum in the 
 uncovered and uncompressed superficies of the tumor. 
 
 It is not always, however, the polypus alone that has 
 begun to project beyond the stricturing circle of the os 
 that bleeds. Many wombs are kept in a state of hy- 
 peraemia and hemorrhagica! fulness by the presence and
 
 104 ACUTE AND CHRONIC DISEASES 
 
 pressure of the polypus, and such cases are marked by 
 the most violent floodings. Now, when we come to 
 inquire diagnostically into such cases, and find, upon 
 touching, that the os tincse is unmodified, and the cylin- 
 drical neck unchanged, all that we can do is to infer, for 
 we cannot know, that the hemorrhages are caused by a 
 polypus in the cavity, whose existence, however, we can 
 only conjecture or infer ; and especially where the poly- 
 pus is still so small as not greatly to magnify the womb 
 and make its increase perceptible, to the touch, in the 
 surpubal region. 
 
 There can scarcely be found, in the whole range of 
 medical duties, a more difficult case of diagnosis than 
 this. Time alone can solve the problem; and then 
 only by protruding the mass into the cervix, or out into 
 the vagina, whereupon all doubt is at an end. 
 
 In numerous instances, our inferential diagnosis has 
 been verified by immediate examination, or by after 
 events. Yet we have met with samples of such hemor- 
 rhage impressing us with a sort of inward conviction 
 that they could only arise from polypus, a conviction 
 which proved to be a baseless hypothesis, destitute of 
 any foundation of truth. 
 
 We have dwelt thus long on this subject, chiefly out 
 of an anxious desire to put our friends and brethren on 
 guard against making too hurried a diagnosis, and also 
 as a preface to the drawing, Plate 22. 
 
 The annexed figure, Plate 22, was drawn from the 
 specimen at the time a jpost-mortem examination was
 
 OF THE NECK OF THE UTERUS. 105 
 
 made to ascertain the cause of a fatal uterine hemor- 
 rhage. 
 
 The woman, several years married, had borne no 
 children. During two or three years, she had been 
 under the medical care of the author, who, observing 
 her to be occasionally seized with frightful uterine 
 hemorrhages that left her always excessively hydrsemi- 
 cal, could not avoid the conclusion that a small polypus 
 concealed within the cavity of the womb, but undiscern- 
 ible by any physical examination, would at some future 
 time be thrust out into the vagina, so as to allow of its 
 removal. Repeated careful examination left the same 
 impression upon the mind. 
 
 Meanwhile, when the floodings should be too wast- 
 ing, she was advised to resort to rest, to haemostatics, 
 and, above all, to the tampon for the vagina. 
 
 Having removed her residence to a greater distance, 
 she took counsel of another physician, and for more 
 than a year occasionally suffered from attacks of very 
 alarming floodings. Upon the last of these occasions, 
 the writer was called in consultation with the attending 
 physician, and, hastening to the rendezvous, found she 
 had expired some four or five minutes before he arrived. 
 It was with him and the attending physician anxiously 
 desired, that the question of the existence, or non-ex- 
 istence, of a polypus uteri should, in this case, be set- 
 tled, and the figure (Plate 22) exhibits a very correct 
 view of the cavity and walls of the womb. There was 
 nothing upon the lining membrane that should throw 
 any light upon the strange and most obstinate hemor-
 
 106 ACUTE AND CHRONIC DISEASES 
 
 rhages, unless, indeed, the magnitude of the cavity be 
 so regarded; and its size is truly given, and may be 
 compared with our figure, Plate 2, Fig. 2. But, upon 
 the left ovary was a cystica! tumor, which is shown in 
 the figure. Yet no one can assign such a cyst as a suf- 
 ficient cause for those irregular and enormous uterine 
 evacuations. 
 
 I have, at this moment, under treatment the case of a 
 maiden lady, about forty-three years of age, in whom 
 the hemorrhages are immense and irregular — sometimes 
 very alarming. In this instance, I can by no means 
 detect any, the least, modification of the form, size, re- 
 sistance, or natural place of the womb ; and, it is proba- 
 ble that no man can say whether these distressing 
 attacks arise from polypus, or no. 
 
 It would be a most useful thing to possess some cer- 
 tain methods by which to distinguish between habitual 
 violent floodings without polypus uteri, and cases in 
 which the polypus does exist, but cannot be come at. 
 One can scarcely, in medical practice, be put to greater 
 loss for some certainty in discrimination, than in such 
 cases as these. 
 
 The great length of this paper renders it necessary to 
 bring it to a close. There is a considerable number of 
 affections to which the cervix uteri is liable, which it 
 would be easy to discuss ; and, in regard to the so-called 
 malignant disorders of the part, it would be gratifying 
 to us to describe and illustrate their various appear- 
 ances, and suggest methods for their treatment. But 
 we refrain from farther trespass on the time of the
 
 OF THE NECK OF THE UTERUS. 107 
 
 reader, to whom we offer the foregoing observations, in 
 the hope that they may serve to remove some of the 
 difficulties which we have noticed to exist in the path 
 of the practitioner, not only in our own earlier days of 
 observation, but now, and daily, in the numerous cases 
 submitted under advice for our revision and counsel. If 
 what has been presented is at once true and clear, we 
 shall indulge the hope hereafter to have fewer calls from 
 persons residing in distant States. 
 
 In closing this essay, the Author takes the occasion 
 to renew the expression of his sincere desire that the 
 class of cases herein treated of may receive a greater 
 share of attention from his brethren in the practice ; so 
 that they may less frequently, than heretofore, be found 
 to accumulate in the large cities and towns, or in the 
 hands of specialists : he is convinced that, as such dis- 
 orders require no greater amount of particular informa- 
 tion or dexterity than other surgical and constitutional 
 maladies, it is within the ability, and is the duty of the 
 brethren generally, to conduct them safely and gently 
 to a satisfactory cure. In our opinion, it would be 
 much more creditable that such skill and discrimination 
 should belong generally to the whole profession, than 
 for one or two individuals in a district, or in a great 
 metropolis, as London or Paris, to acquire a notoriety, 
 which, to say the least of it, is scarcely enviable ; since, 
 among the humiliating services that physicians and 
 surgeons are by their vocation obliged to render to the 
 distressed, none can be more revolting to the sensitive 
 mind than these.
 
 108 DISEASES OF THE NECK OF THE UTERUS. 
 
 It might, perhaps with consoling truth, be added, 
 that few professional ministrations turn aside with 
 greater certainty and celerity the attacks of disease, or 
 arrest the shafts they aim at the existence of our clients.
 
 INDEX. 
 
 A. 
 
 PAGE 
 
 Abdominal supporters reprobated 97 
 
 Abrasion of mucous surface of os, case 55 
 
 Abrasion of mucous surface of os to be avoided in cauterizations 55 
 
 Albuminous leucorrhoea 35 
 
 Annular pessary of gilt silver 97 
 
 Acid nitrate for small polypi 77 
 
 Acid nitrate in bleeding tumor 84 
 
 Adjustment of metroscope 41 
 
 Argent, nitrat. in inflamed cervix 53 
 
 Antiphlogistic contacts with argent, nitrat 53 
 
 Adherent fundus in retroversion 90 
 
 Adhesion of fundus 90 
 
 Angulated uterus in retroversion 91 
 
 Antagonism of parts 92 
 
 Anterior columna vaginae in retroversion 91 
 
 Anatomical relations and place of womb 31 
 
 Argument for metroscopic diagnosis 48 
 
 B. 
 
 Bayle's account of Ricamier's instrument 20 
 
 Bivalve speculum-uteri 40 
 
 Blood from the genitalia often mistaken for menstrua 102 
 
 Bleeding from polypus 103 
 
 Bleeding tumor or hsematoma of womb 73 
 
 Boivin's plates not useful 19 
 
 C. 
 
 Caoutchouc bottles of Hervez 68 
 
 Case to show in what instance diagnosis is impossible 72
 
 110 INDEX. 
 
 PAGE 
 
 Case of strictured vagina mistaken for diseased os 79 
 
 Case of hydrgemia from small bleeding polypus 78 
 
 Case of inflammation framboistc, with plate 43 
 
 Case of molluscum on cervix 50 
 
 Case of bleeding tumor in cervix 83 
 
 Case of hygroma on cervix > 85 
 
 Carcinomatous tumor of cervix cured 83 
 
 Component elements of womb 26 
 
 Corpus mucosum of cervix inflamed 46 
 
 Cauterization of cervix by Lallemand's port-caustic 71 
 
 Currant-like polypi of os, with plate 76, 77 
 
 Canal of cervix obstructed by albumen, cause of sterility 56 
 
 Canal of cervix, hcematoma in the 73 
 
 Complement of the forces in the reproductive organs 24 
 
 Contracted columna anterior renders retroversion less curable 92 
 
 Contro-stimulant power of the nitrate of silver 54 
 
 Cervix uteri, hypertrophy of the 67 
 
 Columna anterior vagina permanently contracted 91 
 
 Cervix, inflamed case of, with plate 57, 58 
 
 Cervical distinguished from vaginal leucorrhcea 34 
 
 Comparison of touching with metroscopy as diagnostic 21 
 
 Cephalalgia from irritation of womb 32 
 
 Cervix uteri, bleeding tumor removed from the 83 
 
 Chronic tympany from irritated womb 32 
 
 Competency of professional people in the cases 23 
 
 D. 
 
 Diagnostics of sexual diseases deemed difficult 18 
 
 Diagnosis, its importance as means of success 37 
 
 Diagnosis, physical, being declined, the practice is empirical 22 
 
 Diagnosis by touching by some persons supposed to be always sufficient.. 21 
 
 Diagnosis of retroversion 66 
 
 Diagnosis of polypus uteri difficult in some cases 99 
 
 Diagnosis of hypertrophy of the womb 101 
 
 Diagnosis of stricture vaginae 79 
 
 Debility from leucorrhcea explained 38 
 
 Differential means of diagnosis 21 
 
 Dimensions of the womb 27 
 
 Dimensions of the gravid womb 27 
 
 Discrimination of vaginal and cervical leucorrhcea necessary 34, 36 
 
 Disturbing power of sexual disorders 25 
 
 Drawings and colored prints unsatisfactory in most cases 19 
 
 Duverney's glands, discharge from, mistaken for fluor albus 34
 
 INDEX. Ill 
 
 E. 
 
 PAGE 
 
 Elementary or constituent tissues of the womb 21 
 
 Empirical practice when physical diagnosis is disallowed 22 
 
 Epithelial surface of os rarely abraded 55 
 
 Equable development of womb or hypertrophy 28 
 
 Evans's (Dr. Charles) improved elastic annular pessary 96 
 
 Falling of the womb is relaxation of utero-sacral ligaments 88 
 
 Fatal monorrhagia without organic lesion, case of 104 
 
 Fastidiousness as to diagnosis 22 
 
 Flexion of womb, with figure 90 
 
 Fluor albus often depends on inflamed cervix 32, 33 
 
 Follicles of cervix, albuminous secretion from the 35 
 
 Framboisee inflammation, irregular show from 75 
 
 Frequency of retroversion 61 
 
 Fundus uteri, adhesion of 90 
 
 G. 
 
 Generic and genetic forces, relations of the 26 
 
 Gluey fluor albus 38 
 
 Guessing at the case 22 
 
 Gutta percha ring-pessary of Evans 96 
 
 H. 
 
 Hoematoma in cervix uteri 73 
 
 Hemorrhage from hsematoma uteri fatal 74 
 
 Hemorrhage from the womb, often mistaken for menstrua 75 
 
 Hemorrhage from the womb, fatal, with no organic lesion 104 
 
 Hooper's plates referred to 19 
 
 Hygroma on cervix uteri, with a plate 85 
 
 Hypertrophy of the womb, diagnosis of 101 
 
 Hypertrophy of the womb 27 
 
 Hypertrophy of the womb, physiological or pathological 27, 28, 29 
 
 Hydrsemia from sexual disorders 32 
 
 Hysteria, probably radiated from reproductive system 25 
 
 Hysterical state from inflamed cervix, case of 50
 
 112 INDEX. 
 
 I. 
 
 PAGE 
 
 Ideal of reproductive apparatus 26 
 
 Ideal model or standard specimen of uterus 29 
 
 Ideal of operations to be performed with escharotics 54 
 
 Inadequacy of touching for diagnosis 22 
 
 Inner wall of womb degenerated, not to be diagnosticated always 72 
 
 Indurating inflammation of cervix, obstinate case of. 57 
 
 Injections per vaginam for inflamed cervix, little relied on 37 
 
 Involution of womb as antithesis of evolution 29 
 
 Involutive force cures hypertrophy 29 
 
 J. 
 
 Jus docendi, &c 23 
 
 K. 
 
 Knowledge, not belief, demanded in diagnosis 49 
 
 L. 
 
 Lallemand's porM&iustic 77 
 
 Leucorrhcea from affections of uterus alone 33 
 
 Ligamenta utero-sacralia 88 
 
 Ligation for tumor of cervix, case, with plate 83 
 
 M. 
 
 Medical men alone to decide on necessity for metrdscopic diagnosis.... 24 
 
 Medical men of United States, competent and honest 23 
 
 Medical profession injured by specialization of practice 18 
 
 Menstrua depend alone on ovulation 75 
 
 Menstrua not always coincident with bleeding from organs 102 
 
 Menstrua, irregularity of as to quantity from inflamed cervix 75 
 
 Menstruation, profuse, often depends on currant-like excrescences of os 76 
 
 Menorrhagia, fatal case of 104 
 
 Metroscope of Recamier, his account of 20 
 
 Metroscope objected to by some as useless 21 
 
 Metroscope, various forms of 38 
 
 Metroscope, Recamier's, preferred by author 39 
 
 Molluscum of cervix uteri 50
 
 INDEX. 113 
 
 PAGE 
 
 Metroscopy, relative indelicacy of Touching and 21 
 
 Motives to write this essay 17 
 
 Muciparous apparatus of cervix 47 
 
 N. 
 
 Nitrate of silver, antiphlogistic contacts with 53, 
 
 Nitrate of silver, curative contacts with t 53 
 
 Nitrate of silver, destructive contacts with 53 
 
 Nitrate of silver, indifferent contacts with 53 
 
 Non-coincidence of menstruation and genital hemorrhages 75 
 
 Normal hypertrophy of the womb 27 
 
 0. 
 
 Orifice of stricture in vagina mistaken for os uteri 79 
 
 Os uteri, its normal appearance 43 
 
 Os uteri, excessively patulous 75 
 
 Os uteri near pubis in retroversions 89 
 
 Ovulation is the direct cause of menstruation 75 
 
 Palpitation of heart from womb diseases 32 
 
 Pathology of retroversion 84 
 
 Pathology of hypertrophy 27, 28, 29 
 
 Pathology of raspberry-coloured inflammation 42, 55 
 
 Pessary, Evans's annular 93 
 
 Pessary, silver gilt, of author 97 
 
 Pessary, glass, objections to 93 
 
 Pessary, globe, fails to cure retroversion 92 
 
 Pessary, watch-spring, of author 94 
 
 Pessary, whalebone ring 93 
 
 Pathological hypertrophy 27, 29 
 
 Physiological hypertrophy of womb 27 
 
 Physical diagnosis of sexual disorders indispensable 38 
 
 Place of the womb in the pelvis, and its anatomical relations 31 
 
 Plate of the womb 29 
 
 Polypus with hemorrhage 103 
 
 Polypus of thirty-two pounds weight 98
 
 114 INDEX. 
 
 PAGE 
 
 Polypus of the os causes drainage of blood, with anaemia 78 
 
 Practice in sexual maladies not a specialty 18 
 
 Prolapsus uteri 88 
 
 Pure silver to make annular pessary with 97 
 
 R. 
 
 Rareness of ulcer of os uteri or cervix 24 
 
 Raspberry-colored cervix 42 
 
 Raspberry tinted inflammation of os, with plate 43 
 
 Recamier's (Professor) metroscope 19 
 
 Recamier's (Professor) Recherches sur le Cancer quoted 19 
 
 Recamier's (Professor) speculum uteri described, with plate 40 
 
 Reaction of reproductive organs on the animal economy 24 
 
 Reproductive force not an indifferent in woman's health 25 
 
 Reproductive force, when morbid, becomes a radiant of disturbance ... 28 
 
 Retroflexion of womb 62 
 
 Retroversion certainly curable by means of the annulus 96 
 
 Retroversion, old cases of, with condensed anterior columna 91 
 
 Retroversion, see-saw descent of womb in 89 
 
 Retroversion not easily treated with the globe 92 
 
 Retroversion, gilt annulus of author in 97 
 
 Retroversion with hypertrophy 63 
 
 Retroversion, its frequency 61 
 
 Resolvent or deobstruent power of arg. nitrat 53 
 
 S. 
 
 Sanguine discharges of vagina mistaken for menstrua 102 
 
 Sexual diseases act on the constitution as hysteria 25 
 
 See-saw descent of womb 89 
 
 Shortening of anterior columna in retroversion, its effects 91 
 
 Silver, nitrate of, in diseases of cervix and os 43 
 
 Silver, nitrate of, ideal of purpose in using the 54 
 
 Simpson's sound, a case in which it passed 6j inches in utero 66 
 
 Speculum uteri, objections to, motives for 19-21 
 
 Speculum uteri, Recamier's 19 
 
 Speculum uteri, bivalve 40 
 
 Speculum uteri preferred by author, with plate 39 
 
 Spasm from sexual diseases 32 
 
 Specialty, objections to 107
 
 INDEX. 115 
 
 PAGE 
 
 Specialty injurious to medical profession 18 
 
 Standard or ideal uterus 26 
 
 Sterility by albuminous leucorrhoea 56 
 
 Stricture of vagina 79 
 
 Stricture of cervix 80 
 
 Swellings and tumors, difference between them 88 
 
 T. 
 
 Tissues of the womb 26 
 
 Torpor of bowels from uterine irritations 32 
 
 Tympany from diseased os 86 
 
 Touching averred to supersede the metroscopic diagnosis 21 
 
 Touching for diagnosis 38 
 
 U. 
 
 Ulcer of womb a rare disorder 55 
 
 Unequable development of womb constitutes a tumor 28 
 
 Uterine disorders as easily diagnosticated as other diseases 18 
 
 Uterine disorders should be treated by the family physician 18 
 
 Uterine polypus, remarks on, as in plate 98 
 
 Utero-sacral ligaments or folds of peritoneum 88 
 
 Utero-abdominal supporters, reprobation of 97 
 
 Uterus with hygroma and tumor on fundus, plate 86 
 
 Vagina restrained from falling by ligamenta utero sacralia 88 
 
 Vaginal stricture mistook for os uteri, figure 79 
 
 Vaginal leucorrhoea not albuminous 35 
 
 Vaginal leucorrhoea less important than uterine 33 
 
 Vaginal injections little to be relied on in inflamed cervix 37 
 
 Vagueness of opinion on sexual disorders 17 
 
 W. 
 
 "VVatchspring annular pessary of author 94 
 
 Watery or cream-like fluor albus 34 
 
 Weight of womb, non-gravid and gravid 27
 
 116 INDEX, 
 
 PAGE 
 
 Womb, ideal model or standard of, plate 29 
 
 Womb, normal, hypertrophy of 25, 101 
 
 Womb, pathological hypertrophy of the 27, 29 
 
 Womb, involutive power of the „• 28 
 
 Womb, flexion of, with figure 90 
 
 Womb, falling or prolapsus of , 88 
 
 Womb, how situated in pelvis 31 
 
 Womb, retroverted, with plate , 61 
 
 Womb-sound, Simpson's 101 
 
 THE END,

 
 

 
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 :' \««nitaw* :;?SiufHiai
 
 

 
 CATALOGUE 
 
 OF 
 
 BLANCHARD & LEA'S 
 MEDICAL AND SURGICAL PUBLICATIONS. 
 
 TO THE MEDICAL PROFESSION. 
 
 In submitting the following catalogue of our publications in medicine and the 
 collateral sciences, we beg to remark that no exertions are spared to render the issues 
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 both as regards the high character of the works themselves, and in respect to every 
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 BLANCHARD & LEA. 
 
 Philadelphia, March, 185G. 
 
 TWO MEDICAL PERIODICALS, FREE OF POSTAGE, 
 
 FOR FIVE DOLLARS PES3, AJ¥T¥OI. 
 
 THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES, subject to 
 
 postage, when not paid for in advance, -$5 00 
 
 THE MEDICAL NEWS AND LIBRARY, invariably in advance, - - 1 00 
 or, both periodicals furnished, free of postage, for Five Dollars remitted 
 in advance. 
 
 THE AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 
 Edited by ISAAC HAYS, M. D., 
 
 is published Quarterly, on the first of January, April, July, and October. Each number contains 
 at least two hundred and eighty large octavo pages, handsomely and appropriately illustrated, 
 wherever necessary. It has now been issued regularly for more than thirty-five years, and it has 
 been under the control ot the present editor for more than a quarter ot a century. Throughout 
 this long period, it has maintained its position in the highest rank of medical periodicals both at home 
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 Collaborators will be found to contain a large number of the most distinguished names of the pro- 
 fession in every section of the United States, rendering the department devoted to 
 
 ORIGINAL COMMUNICATIONS 
 
 full of varied and important matter, of great interest to all practitioners. 
 
 As the aim of the Journal, however, is to combine the advantages presented by all the different 
 varieties of periodicals, in its 
 
 REVIEW DEPARTMENT 
 
 will be found extended and impartial reviews of all important new work 1 *, presenting subjects of 
 novelty and interest, together with very numerous 
 
 BIBLIOGRAPHICAL NOTICES, 
 
 including nearly all the medical publications of the day, both in this country and Great Britain, with 
 a choice selection of the more important continental works. This is followed by the
 
 BLANCHARD & LEA'S MEDICAL 
 
 QUARTERLY SUMMARY, 
 
 being a very full and complete abstract, methodically arranged, of the 
 
 IMPROVEMENTS AND DISCOVERIES IN THE MEDICAL SCIENCES. 
 
 This department of the Journal, so important to the practising physician, is the object of especial 
 care on the part of the editor. It is classified and arranged under different heads, thus facilitating 
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 editor complete materials for this purpose, as he not only regularly receives 
 
 ALL THE AMERICAN MEDICAL AND SCIENTIFIC PERIODICALS, 
 
 but also twenty or thirty of the more important Journals issued in Great Britain and on the Conti- 
 nent, thus enabling him to present in a convenient compass a thorough and complete abstract of 
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 An evidence of the success which has attended these efforts may be found in the constant and 
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 By reference to the terms it will be seen that, in addition to this large amount of valuable and 
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 becomes entitled, without further charge, to 
 
 THE MEDICAL NEWS AND LIBRARY, 
 
 a monthly periodical of thirty-two large octavo pages. Its "News Department" presents the 
 current information of the day, while the " Library Department" is devoted to presenting stand- 
 ard works on various branches of medicine. Within a few years, subscribers have thus received, 
 without expense, the following works which have passed through its columns: — 
 WATSON'S LECTURES ON THE PRACTICE OF PHYSIC. 
 BRODIE'S CLINICAL LECTURES ON SURGERY. 
 TODD AND BOWMAN'S PHYSIOLOGICAL ANATOMY AND PHYSIOLOGY OF MAN. 
 
 724 pages, with numerous wood-cuts, being all that has yet appeared in England. 
 WEST'S LECTURES ON THE DISEASES OF INFANCY AND CHILDHOOD. 
 MALGAIGNE'S OPERATIVE SURGERY, with wood-cuts. 
 SIMON'S LECTURES ON GENERAL PATHOLOGY. 
 BENNETT ON PULMONARY TUBERCULOSIS, with wood-cuts, and 
 WEST ON ULCERATION OF THE OS UTERI. 
 
 While the year 1855, presents 
 
 BROWN ON THE SURGICAL DISEASES OF FEMALES. 
 HANDSOMELY illustrated on WOOD, 
 Which will be continued and completed in 1856. 
 The diseases treated in this volume have hitherto not received from writers of systematic 
 works the attention to which their importance entitles them. In treatises on female diseases they 
 have been but little noticed, as belonging more properly to the surgeon, while our surgical text-books 
 have iu like manner referred them to the writer on midwifery and female affections. In supplying 
 this palpable vacancy in medical literature, Mr. Brown has brought to his subject the result of 
 manv years of observation and experience, and his labors will prove of much value to all practi- 
 tioners'. The publishers therefore flatter themselves that in securing this volume for the " Library 
 Department" of (he " Medical News" they will meet the wishes of their numerous subscri- 
 bers, who will thus receive this highly important work tree of all expense. 
 
 It will thus be seen that for the small sum of FIVE DOLLARS, paid in advance, the subscriber 
 will obtain a Quarterly and a Monthly periodical, 
 
 EMBRACING A80UT FIFTEEN HUNDRED LARGE OCTAVO PAGES, 
 
 mailed to anv pari of the United States, free of postage. 
 
 These very favorable terms are now presented by the publishers with the view of removing all 
 difficulties aiid objections to a full and extended circulation of the Medical Journal to the office of 
 every member of the profession throughout the United States. The rapid extension of mail facili- 
 ties will now place the numbers before subscribers with a certainty and dispatch not heretofore 
 attainable' while by the system now proposed, every subscriber throughout the Union is placed 
 H»oa an equal footing, at 'the very reasonable price of Five Dollars for two periodicals, without 
 
 further expense. . ,.',.. ,. ^. 
 
 Tlio~e subscribers who do not pay m advance will bear m mind that their subscription of r lve 
 Dollar*- will entitle them to the Journal only, without the News, and that they will beat the expense 
 of their own postage on the receipt of each number. The advantage of a remittance when order- 
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 A« the Medical News and Library is in no'case sent without advance payment, its subscribers 
 will aJw»y* receive it free of postage. 
 
 It should a^so be borne in mind that the publishers will now take the risk of remittances by mail, 
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 Address BLANCHARD <5c LEA, Philadelphia. 
 
 m
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 ALLEN (J. M.), M. D., 
 
 Professor of Anatomy in the Pennsylvania Medical College, &c. 
 
 THE PRACTICAL ANATOMIST; or, The Student's Guide in the Disseetiag- 
 
 ROOM. With over 200 illustrations. la one handsome royal 12mo. volume. {Now Ready.)' 
 In the arrangement of this work the author has endeavored to present a complete and thorough 
 course of dissections in a clearer and more available form tor practical use in the dissecting-room, 
 than has as yet been accomplished. His long experience as a teacher of anatomy has given him a 
 familiarity with the wants of students, and has shown him the best modes of obviating or relieving 
 the difficulties which present themselves in the progress of dissection. As adapted to the course 
 pursued in our colleges, and containing ample practical directions and instructions, in addition to 
 the anatomical details presented, it possesses claims to the immediate attention of teachers and 
 students. It will appear in time for the Fall session of the present year. 
 
 ANALYTICAL COMPENDIUM 
 
 OF MEDICAL SCIENCE, containing Anatomy, Physiology, Surgery, Midwifery, 
 Chemistry, Materia Medica, Therapeutics, and Practice of Medicine. By John Neill, M. D., 
 ondF. G Smith, M. D. Second and enlarged edition, one thick volume royal 12mo. of over 
 1000 pages, with 350 illustrations. |2P See Neill. 
 
 ABEL (F. A.), F. C. S. 
 Professor of Chemistry in the Royal Military Academy, Woolwich. 
 
 AND 
 
 C. L. BLOXAM, 
 
 Formerly First Assistant at the Royal College of Chemistry. 
 
 HANDBOOK OF CHEMISTRY, Theoretical, Practical, and Technical, with a 
 
 Recommendatory Preface by Dr. Hofmann. In one large octavo volume of 062 pages, with 
 
 illustrations. {Just Issued.) 
 
 It must be underwood that this is a work fitted for \ cessary, with such manipulatory details as rendered 
 the earnest student, who resolves to pursue for him- j Faraday's ' Chemical Manipulations' so valuable at 
 self a steady search into the chemical mysteries of the time of its publication. Beyond this, the im- 
 creation. For such a student the ' Handbook' will portance of the work is increased by the introduc- 
 prove an excellent guide, since he will find in it, tion of much of the technical chemistry of the manu- 
 not merely the approved modes of analytical investi- I factory." — Dr. Hofmann' s Preface. 
 g-ation, but most descriptions of the apparatus ne- j 
 
 ASHWELL (SAMUEL), M. D., 
 
 Obstetric Physician and Lecturer to Guv's Hospital, London 
 
 A PRACTICAL TREATISE ON THE DISEASES PECULIAR TO WOMEN. 
 
 Illustrated by Cases derived from Hospital and Private Practice. Third American, from the Third 
 and revised London edition. In one octavo volume, of 528 pages. {Now Ready.) 
 The most useful practical work on the subject in 
 
 the English language. — Boston Med. and Surg. 
 
 Journal. 
 
 The most able, and certainly the most standard 
 and practical, work on female diseases that we have 
 yet seen. — Medico-Chirurgical Review. 
 
 We commend it to our readers as the best, practi- 
 tieul treatise on the subject which has yet appeared 
 — London Lancet. 
 
 The young practitioner will find it invaluable, 
 while those who have had most experience will yet 
 find something to learn, and much to commend, in a 
 
 book which shows so much patient observation, 
 practical skill, and sound sense. — British and Fo- 
 reign Med. Review. 
 
 With no work are we acquainted, in which the 
 pleasant and the useful are more happily blended. 1 
 combines the greatest elegance of style with the 
 most sound and valuable practical information. 
 We feel justitied in recommending it. in unqualified 
 terms, to our readers, as a book from which they 
 can scarcely fail to derive both pleasure and im- 
 provement. It is truly a model for medical compo- 
 sitions. — Southern Med. and Surg. Journal. 
 
 ARNOTT (NEILL), M. D. 
 ELEMENTS OF PHYSICS; or Natural Philosophy, General %nd Medical. 
 
 Written for universal use, in plain or non-technical language. A new edition, by Isaac Days, 
 M. D. Complete in one octavo volume, of 484 pages, with about two hundred illustrations. 
 
 TACTICAL TREATISE ON INFLAMMATION OF THE UTERUS, 
 
 CERVIX AND APPENDAGES, and on its connection with Uterine Disease. Fourth 
 
 BENNETT (HENRY), M. D. 
 A PRj 
 
 ITS CER 
 
 American, from the third and revised London edition. In one neat octavo volume, of 430 pages, 
 
 with wood-cuts. Just Issued.) 
 
 This edition will be found materially improved over its predecessors, the author having carefully 
 revised it, and made considerable additions, amounting to about seventy-live pages. . 
 
 This edition has been carefully revised and altered, When, a few years back, the first edition of the 
 and various additions have been made, which render present work was published, the subject was one al- 
 ii more complete, and, if possible, more worthy of most entirely unknown to the obstetrical celebrities 
 the high appreciation in which it is held by the \ of the day ; and even now we have reason to know 
 medical profession throughout the world. A copy j that the bulk of the profession are not fully itlive to 
 should be in the possession of every physician. — : the importance and frequency of the disease of which 
 Charleston Med. Journal and Review. \ it takes cognizance. The present edition is so much 
 
 We are firmly of opinion that in proportion as a enlarged, altered, and improved, that it can scarcely 
 kuowledge of uterine diseases becomes more appre- he considered the same work.-Dr. Ranking* s 46- 
 siuted, this work will be proportionality established strilct - 
 as a text-book in the profession. — The Lancet. ,
 
 BLANCHARD <fc LEA'S MEDICAL 
 
 BROWN (ISAAC BAKER), 
 
 Surgeon- Accoucheur to St. Mary's Hospital, &c. 
 
 ON SOME DISEASES OF WOMEN ADMITTING OF SURGICAL TREAT- 
 
 MENT. Wilh handsome illustrations. One vol. 8vo. (At Press.) 
 
 Publishing in the "Medical News and Library" for 1855 and 185G. See preceding page. 
 
 Mr. Brown has earned for himself a high reputa- [ and merit the careful attention of every surgeon- 
 tion in the operative treatment of sundry diseases ] accoucheur. — Association Journal. 
 and injuries to which females are peculiarly subject, j ,, T . , . . ,. ... , . 
 
 We can truly say of his work that it is an important ' * e have no hesitation in recommending tins book 
 addition to obstetrical literature. The operative I ^ the carelul attention of a 1 surgeons who make 
 suggestions and contrivances which Mr. Brown dp- I female complaints a part of heir study and practice, 
 scnbes, exhibit much practical sagacity and skill, -Dvblm Quarterly Journal. 
 
 BENNETT (J. HUGHES), M.D., F. R. S. E., 
 
 Professor of Clinical Medicine in the University of Edinburgh, &c. 
 
 THE PATHOLOGY AND TREATMENT OF PULMONARY TUBERCU- 
 
 LOSIS, and on the Local Medication of Pharyngeal and Laryngeal Diseases frequently mistaken 
 for or associated with, Phthisis. In one handsome octavo volume, with beautiful wood-cuts, 
 pp. 130. (Lately Issued.) 
 
 BILLING (ARCHIBALD), M. D. 
 THE PRINCIPLES OF MEDICINE. Second American, from the Fifth and 
 
 Improved London edition. In one handsome octavo volume, extra cloth, 250 pages. 
 
 BLAKISTON (PEYTON), M. D., F. R. S., &.c. 
 PRACTICAL OBSERVATIONS ON CERTAIN DISEASES OF THE 
 
 CHEST, and on the Principles of Auscultation. In one volume, 8vo., pp. 384. 
 
 BURROWS (GEORGE), M.D. 
 ON DISORDERS OF THE CEREBRAL CIRCULATION, and on the Con- 
 
 nection between the Affections of the Brain and Diseases of the Heart. In one 8vo. vol., with 
 colored plates, pp. 216. 
 
 BUDD (GEORGE), M. D., F. R. S., 
 
 Professor of Medicine in King's College, London. 
 
 ON DISEASES OF THE LIVER. Second American, from the second and 
 
 enlarged London edition. In one very handsome octavo volume, with four beautifully colored 
 plates, and numerous wood-cuts, pp.468. New edition. (Lately Issued.) 
 
 The full digest we have given of the new matter work must be the authority of the srreat mass of 
 Introduced into the present volume, is evidence of British practitioners on the hepatic diseases ; and it 
 the value we place on it. The fact that the profes- is satisfactory that the subject has been taken up by 
 sion has required a second edition of a monograph so able and experienced a physician. — British and 
 such as that before us, bears honorable testimony Foreign Medico-Chirurgical Review. 
 to its usefulness. For many years, Dr. Budd's 
 
 BY THE SAME AUTHOR. (Just Ready.) 
 
 ON THE ORGANIC DISEASES AND FUNCTIONAL DISORDERS OF 
 
 THE STOMACH. In one neat octavo volume. 
 
 While special treatises have been multiplying upon almost all the different classes of diseases, there 
 has lony been felt the want of an authoritative work on the disorders of the stomach, which con- 
 stitute, perhaps, a larger proportion of the daily practice of the physician than any other class of 
 maladies. To supply this want has been the object of the author, and his reputation is an ample 
 guarantee o( the value of his labors. 
 
 From the high position occupied by Dr. Budd as ' precepts, both of diagnosis and treatment, denote 
 a teacher, a writer, and a practitioner, it is almost the character of a thoughtful and experienced phy- 
 needless to state that the present book may be con- j sician. — London Med. Times and Gazette, December, 
 suited with great advantage. It is written in an easy j 1855. 
 style, the subjects are welt arranged, and the practiul | 
 
 BUSHNAN (J. S.), M. D. 
 THE PHYSIOLOGY OF ANIMAL AND VEGETABLE LIFE; a Popular 
 
 Treatise on the Functions and Phenomena of Organic Life. In one handsome royal 12mo. volume, 
 with over one hundred illustrations, pp. 234. 
 
 BIRD (GOLDING), A. M., M . D., &c. 
 URINARY DEPOSITS : THEIR DIAGNOSIS, PATHOLOGY, AND 
 
 THERAPEUTICAL INDICATIONS. A new and enlarged American, from the last improved 
 London edition. With over sixty illustrations. In one royal 12ino. volume, extra cloth, pp. 372. 
 
 It can scarcely be necessary for us to say anything . extension and satisfactory employment of our thera- 
 of the merits of this well-known Treatise, which so 1 peutic resources. In the preparation of this new 
 admirably briugs into practical application the re- 
 sults of those microscopical and chemical researches 
 regarding the physiology and pathology of the uri- 
 nary secretion, which have contributed so much to 
 the increase of our diagnostic powers, aud to the < Medico-C hirurgical Review 
 
 j. ...w .~v...„. — u . ... ...^ ,,. w 1 . u . uv ..... ... „... u u ^ ., 
 
 edition of his work, it is obvious that Dr. Golding 
 Bird has sparedno pains to render ita faithful reprt*- 
 sentation of the present state of scientific knowledge 
 on the subject it emh races. — The British and Foreign 
 
 BY THE SAME AUTHOR, 
 r-n-v-rmo r\T7\ XT I TTTD A T DEJTT ,TkCrkT>TJA7" .
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 BARTLETT (ELISHA), M . D. 
 THE HISTORY, DIAGNOSIS, AND TREATMENT OF THE FEVERS 
 
 OF THE UNITED STATES. Third edition, revised and improved. In one octavo volume, 
 
 of six hundred pages, beautifully printed, and strongly bound. 
 
 The masterly and elegant treatise, by Dr. Bartlett 
 is invaluable to the American student and practi- 
 tioner. — Dr. Hohnes's Report to the Nat. Med. Asso- 
 ciation. 
 
 We regard it, from the examination we have made 
 of it, the best work on fevers extant in our language, 
 and as such cordially recommend it to the medical 
 public. — St. Louis Medical and Surgical Journal. 
 
 Take it altogether, it is the most complete history 
 of our fevers which has yet been published, and 
 every practitioner should avail himself of its con- 
 tents. — The Western Lancet. 
 
 Of the value and importance of such a work, it is 
 needless here to speak ; the profession of the United 
 States owe much to the author for the very able 
 volume which he has presented to them, and for the 
 careful and judicious manner in which he has exe- 
 cuted his task. No one volume with which we are 
 acquainted contains so complete a history of our 
 fevers as this. To Dr. Bartlett we owe our best 
 thanks for the very able volume he has given us, as 
 embodying certainly the most complete, methodical, 
 and satisfactory account of our fevers anywhere to 
 be met with. — The Charleston Med. Journal and 
 Review. 
 
 BUCKLER (T. H.), M. D., 
 
 Formerly Physician to the Baltimore Almshouse Infirmary, &c. 
 
 ON THE ETIOLOGY, PATHOLOGY, AND TREATMENT OF FIBRO- 
 
 BRONCHITIS AND RHEUMATIC PNEUMONIA. In one8vo. volume, extra cloth, pp. 150. 
 
 BOWMAN (JOHN E.), M.D. 
 PRACTICAL HANDBOOK OF MEDICAL CHEMISTRY. Second Ame- 
 
 rican, from the third and revised Engli>h Edition. In one neat volume, royal 12mo., with nu- 
 merous illustrations, pp. 288. (Now Ready.) 
 
 BY THE SAME AUTHOR. 
 
 INTRODUCTION TO PRACTICAL CHEMISTRY, INCLUDING ANA- 
 
 LYSIS. With numerous illustrations. In one neat volume, royal 12mo. pp. 350. 
 
 BARLOW (GEORGE H.), M.D. 
 A MANUAL OF THE PRACTICE OF MEDICINE. With Notes and Ad- 
 
 ditions by the American Editor. In one octavo volume. (Now Ready.) 
 
 The position of the author as physician to Guy's Hospital and other large public institutions, is 
 a sufficient guarantee of the extent and value of the experience which is here systematically re- 
 corded and condensed. His aim throughout has been to produce a practical work, on which the 
 student can rely as a guide, and to which the practitioner can refer with confidence. The additions 
 by the editor comprise chapters on Cerebro-spinal Meningitis, Cholera Infantum, and Yellow Fever, 
 besides numerous notes wherever the diseases or practice of this country seemed to render them 
 necessary or desirable. 
 
 BEALE (LIONEL JOHN), M. R. C. S., &c. 
 THE LAWS OF HEALTH IN RELATION TO MIND AND BODY. 
 
 A Series of Letters from an old Practitioner to a Patient. In one volume, royal 12mo. pp.296. 
 
 BLOOD AND URINE (MANUALS ON). 
 BY JOHN WILLIAM GRIFFITH, G. OWEN REESE, AND ALFRED 
 
 MARKWICK. One thick volume, royal 12mo., extra cloth, with plates, pp. 460. 
 
 BRODIE (SIR BENJAMIN C), M. D., &.c. 
 CLINICAL LECTURES ON SURGERY. 1 vol. 8vo., cloth. 350 pp. 
 
 COLOMBAT DE L'ISERE. 
 A TREATISE ON THE DISEASES OF FEMALES, and on the Special 
 
 Hygiene of their Sex. Translated, with many Notes and Additions, by C. D. Meigs, M. D. 
 Second edition, revised and improved. In one large volume, octavo, with numerous wood-cuts, 
 pp. 720. 
 
 The treatise of M. Colombat is a learned and la- 
 borious commentary on these diseases, indicating 
 very considerable research, great accuracy of judg- 
 ment, and no inconsiderable personal experience. 
 With the copious notes and additions of its experi- 
 
 enced and very erudite translator and editor, Dr. 
 Meigs, it presents, probably, one of the most com- 
 plete and comprehensive works on the subject we 
 possess. — American Med. Journal. 
 
 CURLING (T. B.), F. R.S., 
 Surgeon to the London Hospital, &c. 
 
 A PRACTICAL TREATISE ON DISEASES OF THE TESTIS, SPERMA- 
 TIC CORD, AND SCROTUM. Second American, from the second and enlarged English edi- 
 tion. In one handsome octavo volume, with numerous illustrations. (At Press.) 
 
 COPLAND (JAMES), M. D., F. R. S., &c. 
 OF THE CAUSES, NATURE, AND TREATMENT OF PALSY AND 
 
 APOPLEXY. In one volume, royal 12mo., extra cloth, pp. 326.
 
 f> 
 
 BLANCHARD & LEA'S MEDICAL 
 
 CARPENTER (WILLIAM B.), M. D., F. R. S., &.C., 
 
 Examiner in Physiology and Comparative Anatomy in the University of London. 
 
 PRINCIPLES OF HUMAN PHYSIOLOGY; with their chief applications to 
 
 Psychology, Pathology, Therapeutics, Hygiene, and Forensic Medicine. A new American, from 
 the last anil revised London edition. With nearly three hundred illustrations. Edited, with addi- 
 tions, by Francis Gurney Smith, M. D., Professor of the Institutes of Medicine in the Pennsyl- 
 vania Medical College, &c. In one very large and beautiful octavo volume, of about nine hundred 
 large pages, handsomely printed and strongly bound in leather, with raised bands. (Now Ready.) 
 
 The best text-book in the language on this ex- 
 tensive subject. — London Med. Times. 
 
 A complete cyclopaedia of this branch of science. 
 — N. Y. Med. times. 
 
 The most complete work on the science in our 
 language.— Am. Med. Journal. 
 
 The most complete exposition of physiology which 
 any language can at present give.— Brit, and For. 
 Med.-Chirurg. Review. 
 
 We have thus adverted to some of the leading 
 -'additions and alterations," which have been in- 
 troduced by the author into this edition of his phy- 
 siology. These will be found, however, very far to 
 exceed the ordinary limits of a new edition, "the 
 old materials having been incorporated with the 
 new, rather than the new witli the old." It now 
 certainly presents the most complete treatise on the 
 subject within the reach of the American reader; 
 nnd while, for availability as a text-book, we may 
 perhaps regret its growth in bulk, we are sure that 
 the student of physiology will feel the impossibility 
 of presenting a thorough digest of the facts of the 
 science within a more limited compass. — Medical 
 Examiner. 
 
 The greatest, the most reliable, and the best book 
 on the subject which we know of in the English 
 language. — Stethoscope. 
 
 The standard of authority on physiological sub- 
 jects. * * * In the present edition, to particularize 
 the alterations and additions which have been made, 
 would require a review of the whole work, since 
 scarcely a subject has not been revised and altered, 
 added to, or entirely remodelled to adapt it to the 
 present state of the science. — Charleston Med. Journ. 
 
 Any reader who desires a treatise on physiology 
 may feel himself entirely safe in ordering this. — 
 Western Med. and Surg. Journal. 
 
 From this hasty and imperfect nllusion it will be 
 seen by our readers that the alterations and addi- 
 tions to this edition render it almost a new work — 
 and we can assure our readers that it is one of the 
 best summaries of the existing facts of physiological 
 science within the reach of the English student and 
 physician. — JV. Y. Journal of Medicine . 
 
 The profession of this country, and perhaps also 
 of Europe, have anxiously and for some lime awaited 
 the announcement of tiiis newedition of Carpenter's 
 
 The most complete work now extant in our Ian- , Human Physiology. His former editions have for 
 euage — N. O. Med. Register. m; ' n >' years been almost the only text-book on Phy- 
 
 * b I siology in all our medical schools, and its cneula- 
 
 The changes are too numerous to admit of an ex- j tion among the profession has been unsurpassed by 
 tended notice in this place. At every point where : any work in any department of medical science, 
 the recent diligent labors of organic chemists and I it is quite unnecessary for us to speak of this 
 micrographers have furnished interesting and v.ilu- ! work as its merits would justify. The mere an 
 able facts, they have been appropriated, and no pains | nouncement of its appearance will afford the highest 
 have been spared, in so incorporating and arranging ; pleasure to every student of Physiology, while its 
 them that the work may constitute one harmonious I perusal will be of infinite service in advancing 
 system. — Southern Med. and Surg. Journal. physiological science. — Ohio Med. and Surg. Journ. 
 
 RY THE SAME AUTHOR. (Now Ready.) 
 
 PRINCIPLES OF COMPARATIVE PHYSIOLOGY. New American, from 
 
 the Fourth and Revised London edition. In one large and handsome octavo volume, with over 
 
 three hundred beautiful illustrations, pp. 752. 
 
 The delay which has existed in the appearance of this work has been caused by the very ihorotigh 
 revision and remodelling which it has undergone at the hands of the author, and the large number 
 of new illustrations which have been prepared for it. It will, therefore, be found almost a new 
 wcrk, nnd fully up to the day in every department of the subject, rendering it a reliable text-book 
 for all students engaged in this branch of science. Every effort has been made to render its typo- 
 graphical linish and mechanical execution worthy of its exalted reputation, and creditable to the 
 mechanical arts of this country. 
 
 This book should not only be read but thoroughly 
 sludied by every member of the profession. None 
 are too wise or old, to be benefited thereby. But 
 especially to the younger class would we cordially 
 commend it as best fitted of any work in the English 
 language to qualify them for the reception and coin- 
 prehension of those truths which are daily being de- 
 veloped in physiology. — Medical Counsellor. 
 
 Without pretending to it, it is an Encyclopedia of 
 the subject, accurate and complete in all respects — 
 a truthful reflection of the advanced state at which 
 the science has now arrived. — Dublin Quarterly 
 Journal of Medical Science. 
 
 A truly magnificent work — in itself a perfect phy- 
 siological study. — Ranking's Abstract. 
 
 This work stands without its fellow. It ia one 
 few men in Europe could have undertaken ; it is one 
 
 no man, we believe, could have brought to so suc- 
 cessful an issue as Dr. Carpenter. It required for 
 its production a physiologist at once deeply read in 
 the labors of others capable of taking a general, 
 critical, and unprejudiced view of those labors and 
 of combining the varied, heterogeneous materials at 
 his disposal, so as to form an harmonious whole. 
 We feel that this abstract can give the reader a very 
 imperfect idea of the fulness of this work, and no 
 idea of its unity, of the admirable manner in which 
 material has been brought, from the most various 
 sources, to conduce to its completeness, of the lucid- 
 ity of the reasoning it contains, or of the clearness 
 of language in which the whole is clothed. Not the 
 profession only, but the scientific world at large, 
 must feel deeply indebted to Dr. Carpenler for this 
 great work. It must, indeed, add hugely even to 
 his high reputation. — Medical Times. 
 
 BY the same author. (Preparing.) 
 
 PRINCIPLES OF GENERAL PHYSIOLOGY, INCLUDING ORGANIC 
 
 CHEMISTRY AND HISTOLOGY. With a General Sketch of the Vegetable and Animal 
 Kingdom. In one large and very handsome octavo volume, with several hundred illustrations. 
 The subject of general physiology having been omilted in the last edition of (he author's " Com- 
 parative Physiology," he has undertaken to prepare a volume which shall present it more tho- 
 roughly and fully than has yet been attempted, and which may be regarded as an introduction to 
 his other works.
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 CARPENTER (WILLIAM B.), M. D., F. R. S., 
 
 Examiner in Physiology and Comparative Anatomy in the University of London. 
 
 ELEMENTS (OR MANUAL) OF PHYSIOLOGY, INCLUDING PHYSIO- 
 LOGICAL ANATOMY. Second American, from a new and revised London edition. Withi 
 one hundred and ninety illustrations. In one very handsome octavo volume, pp. 506. 
 
 In publishing the first edition of this work, its title was altered from that of the London volume, 
 by the substitution of the word " Elements" for that of " Manual," and with the author's sanction 
 the title of " Elements" is still retained as being more expressive of the scope of the treatise. 
 
 To say that it is the best manual of Physiology 
 now before the public, would not do sufficient justice 
 to the author. — Buffalo Medical Journal. 
 
 In his former works it would seem that he had 
 exhausted the subject of Physiology. In the present, 
 he gives the essence, as it were, of the whole. — N. Y. 
 Journal of Medicine. 
 
 Those who have occasion for an elementary trea- 
 tise on Physiology, cannot do better than to possess 
 themselves of the manual of Dr. Carpenter. — Medical 
 Examiner . 
 
 The best and most complete exposd of modern 
 Physiology, in one volume, extant in the English 
 language.— Si. Louis Medical Journal. 
 
 With such an aid in his hand, there is no excuse 
 for the ignorance often displayed respecting the sub- 
 jects of which it treats. From its unpretending di- 
 mensions, it may not be so esteemed by those anxious 
 to make a parade of their erudition; but whoever 
 masters its contents will have reason to be proud of 
 his physiological acquirements. The illustrations 
 are well selected and finely executed.— Dublin Med. 
 Press. 
 
 BY the same author. (Nearly Ready.) 
 
 THE MICROSCOPE AND ITS REVELATIONS. In one handsome volume, 
 
 with several hundred beautiful illustrations. 
 
 Various literary engagements have delayed the author's progress with this long expected work. 
 It is now, however, in an advanced state of preparation, and may be expected in a few month?. 
 The importance which the microscope has assumed within the last few years, both as a guide to 
 the practising physician who wishes to avail himself of the progress of his science, and as an indis- 
 pensable assistant to the physiological and pathological observer, has caused the want to be severely 
 felt of a volume which should serve as a guide to the learner and a book of reference to the more 
 advanced student. This want Dr. Carpenter has endeavored to supply in the present volume. His 
 great practical familiarity with the instrument and all its uses, and his acknowledged ability as a 
 teacher, are a sufficient guarantee that the work will prove in every way admirably adapted to its 
 purpose, and superior to any as yet presented to the scientific world. 
 
 BY THE SAME AUTHOR. 
 
 A PRIZE ESSAY ON THE USE OF ALCOHOLIC LIQUORS IN HEALTH 
 
 AND DISEASE. New edition, with a Preface by D. F. Condie, M. D., and explanations of 
 scientific words. In one neat 12mo. volume, pp. 178. {Just Issued.) 
 
 CHELIUS (J. M.), M. D., 
 
 Professor of Surgery in the University of Heidelberg, &.C. 
 
 A SYSTEM OF SURGERY. Translated from the German, and accompanied 
 
 with additional Notes and References, by John F. South. Complete in three very large octavo 
 volumes, of nearly 2200 pages, strongly bound, with raised bands and double titles. 
 We do not hesitate to pronounce it the best and 
 most comprehensive system of modern surgery with 
 which we are acquainted. — Medico-Chirurgical Re- 
 view. 
 
 The fullest and ablest digest extant of all that re- 
 
 lates to the present advanced state of surgical pa- 
 thology. — American Medical Journal. 
 
 The most learned and complete systematic treatise 
 now extant.— Edinburgh Medical Journal. 
 
 CLYMER (MEREDITH), M. D., &.c. 
 FEVERS; THEIR DIAGNOSIS, PATHOLOGY, AND TREATMENT. 
 
 Prepared and Edited, with large Additions, from the Essays on Fever in Tweedie's Library ot 
 Practical Medicine. In one octavo volume, of 600 pages. 
 
 CHRISTISON (ROBERT), M. D., V. P. R. S. E., &.c. 
 A DISPENSATORY; or, Commentary on the Pharmacopoeias of Great Britain 
 
 the United States; comprising the Natural History, Description, Chemistry, Pharmacy, Ac- 
 is, Uses, and Doses of the Articles of the Materia Medica. Second edition, revised and im- 
 
 and I 
 tions 
 
 proved, with a Supplement containing the most important New Remedies. With copious Addi 
 lions, and two hundred and thirteen large wood-engravings. By 11. Eglesfeld Griffith, M. D. 
 In one very large and handsome octavo volume, of over 1000 pages. 
 
 It is not needful that w, should compare it with 
 the other pharmacopoeias extant, which enjoy and 
 merit the confidence of the profession : it is enough 
 to say that it appears to us as perfect as a Dispensa- 
 tory, in the present state of pharmaceutical science, 
 could be made. If it omits any details pertaining to 
 this branch of knowledge which the student has a 
 right to expect in such a work, we confess the omis- 
 sion has escaped our scrutiny. We cordially recom- 
 mend this work to such of our readers as are in need 
 of a Dispensatory. They cannot make choice of a 
 better. — Western Journ. of Medicine and Surgery. 
 
 There is not in any language a more complete and 
 perfect Treatise. — A'. Y. Annalist. 
 
 In conclusion, we need scarcely say that we 
 strongly recommend this work to all classes of our 
 readers. Asa Dispensatory and commentary on the 
 Pharmacopoeias, it is unrivalled in the English or 
 any other language. — The Dublin Quarterly Journal. 
 
 We earnestly recommend Dr. Christison's Dis- 
 pensatory to all our readers, as an indispensable 
 companion, not in the Study only, but in the Surgery 
 also. — British and Foreign Medical llevteto.
 
 BLANCHARD & LEA'S MEDICAL 
 
 CONDIE (D. F.), M. D., &c. 
 A PRACTICAL TREATISE ON THE DISEASES OF CHILDREN. Fourth 
 
 edition, revised and augmented. In one large volume, 8vo., of nearly 750 pages. {Lately Issued.) 
 From the Author's Preface. 
 
 The demand for another edition has afforded the author an opportunity of again subjecting the 
 entire treatise to a careful revision, and of incorporating in it every important observation recorded 
 since the appearance of the last edition, in reference to the pathology and therapeutics of the several 
 diseases of which it treats. 
 
 In the preparation of the present edition, as in those which have preceded, while the author has 
 appropriated to his use every important fact that he has found recorded in the works of others, 
 having a direct bearing upon either of the subjects of which he treats, and the numerous valuable 
 observations — pathological as well as practical — dispersed throughout the pages of the medical 
 journals of Europe and America, he has, nevertheless, relied chiefly upon his own observations and 
 experience, acquired during a long and somewhat extensive practice, and under circumstances pe- 
 culiarly well adapted for the clinical study of the diseases of early life. 
 
 Every species of hypothetical reasoning has, as much as possible, been avoided. The author has 
 endeavored throughout the work to confine himself to a simple statement of well-ascertained patho- 
 logical facts, and plain therapeutical directions — his chief desire being to render it what its title 
 imports it to be, a practical treatise on the diseases of children. 
 
 Dr. Condie's scholarship, acumen, industry, and 
 practical sense are manifested in this, as in all his 
 numerous contributions to science. — Dr. Holmes's 
 Report to the American Medical Association. 
 
 Taken as a whole, in our judgment, Dr. Condie's 
 Treatise is the one from the perusal of which the 
 practitioner in this country will rise with the great- 
 est satisfaction — Western Journal of Medicine and 
 Surgery. 
 
 One of the best works upon the Diseases of Chil- 
 dren in the English language. — Western Lancet. 
 
 Perhaps the most full and complete work now be- 
 fore the profession of the United States; indeed, we 
 may say in the English language. It is vastly supe- 
 rior to most of its predecessors. — Transylvania Med. 
 Journal. 
 
 We feel assured from actual experience that no 
 physician's library can be complete without a copy 
 of this work. — N. Y. Journal of Medicine. 
 
 A veritable pediatric encyclopaedia, and an honor 
 to American medical literature. — Ohio Medical and 
 Surgical Journal. 
 
 We feel persuaded that the American medical pro- 
 fession will soon regard it not only as a very good, 
 but as the very best "Practical Treatise on the 
 Diseases of Children." — American Medical Journal. 
 
 We pronounced the first edition to be the best 
 work on the diseases of children in the English 
 language, and, notwithstanding all that has been 
 published, we still regard it in that light. — Medical 
 Examiner. 
 
 COOPER (BRANSBY B.), F. R. S., 
 
 Senior Surgeon to Guy's Hospital, &c. 
 
 LECTURES ON THE PRINCIPLES AND PRACTICE OF SURGERY. 
 
 In one very large octavo volume, of 750 pages. {Lately Issued.) 
 
 For twenty-five years Mr. Bransby Cooper has 
 been surgeon to Guy's Hospital; and the volume 
 before us may be said to consist of an account of 
 the results of his surgical experience during that 
 long period. We cordially recommend Mr. Bransby 
 
 Cooper's Lectures as a most valuable addition to 
 our surgical literature, and one which cannot fail 
 to be of service both to students and to those who 
 are actively engaged in the practice of their profes- 
 sion. — The Lancet. 
 
 COOPER (SIR ASTLEY P.), F. R. S., &c. 
 A TREATISE ON DISLOCATIONS AND FRACTURES OF THE JOINTS. 
 
 Edited by Bransby B. Cooper, F. R. S., &c. With additional Observations by Prof. J. C. 
 Warren. A new American edition. In one handsome octavo volume, of about 500 pages, with 
 numerous illustrations on wood. 
 
 BY THE SAME AUTHOR. 
 
 ON THE ANATOMY AND TREATMENT OF ABDOMINAL HERNIA. 
 
 One large volume, imperial 8vo., with over 130 lithographic figures. 
 
 BY THE SAME AUTHOR. 
 
 ON THE STRUCTURE AND DISEASES OF THE TESTIS, AND ON 
 
 THE THYMUS GLAND. One vol. imperial 8vo., with 177 figures, on 2d plates. 
 
 BY THE SAME AUTHOR. 
 
 ON THE ANATOMY AND DISEASES OF THE BREAST, with twenty- 
 
 five Miscellaneous and Surgical Papers. One large volume, imperial 8vo., with 252 figures, on 
 
 36 plates. 
 
 These last three volumes complete the surgical writings of Sir Astley Cooper. They are very 
 handsomely printed, with a large number of lithographic plates, executed in the best style, and are 
 preseuted at exceedingly low prices. 
 
 CARSON (JOSEPH), M. D., 
 
 Professor of Materia Medica and Pharmacy in the University of Pennsylvania. 
 
 SYNOPSIS OF THE COURSE OF LECTURES ON MATERIA MEDICA 
 
 AND PHARMACY, delivered in the University of Pennsylvania. Second and revised edi- 
 tion. In one very neat octavo volume, of 208 pages. {Note Heady.)
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 CHURCHILL (FLEETWOOD), M. D., M. R. I. A. 
 ON THE THEORY AND PRACTICE OP MIDWIFERY. A new American, 
 
 from (he last and improved English edition. Edited, with Notes and Additions, by D. Francis 
 Condie, M. D., author of a "Practical Treatise on the Diseases of Children," &c. With 139 
 illustrations. In one very handsome octavo volume, pp. 510. {Lately Issued.) 
 
 To bestow prai se on a book that has received such 
 marked approbation would be superfluous. We need 
 only say, therefore, that if the first edition was 
 thought worthy of a favorable reception by the 
 medical public, we can confidently affirm that this 
 will be found much more so. The lecturer, the 
 practitioner, and the student, may all have recourse 
 to its pages, and derive from their perusal much in- 
 terest and instruction in everything; relating to theo- 
 retical and practical midwifery. — Dublin Quarterly 
 Journal of Medical Science. 
 
 A work of very great merit, and such as we can 
 confidently recommend to the study of every obste- 
 tric practitioner. — London Medical Gazette. 
 
 This is certainly the most perfect system extant. 
 It is the best adapted for the purposes of a text- 
 book, and that which he whose necessities confine 
 him to one book, should select in preference to all 
 others. — Southern Medical and Surgical Journal. 
 
 The most popular work on midwifery ever issued 
 from the American press. — Charleston Med. Journal. 
 
 Were we reduced to the necessity of having but 
 one work on midwifery, and permitted to choose, 
 we would unhesitatingly take Churchill. — Western 
 Med. and Surg. Journal. 
 
 It is impossible to conceive a more useful and 
 elegant manual than Dr. Churchill's Practice of 
 Midwifery. — Provincial Medical Journal. 
 
 Certainly, in our opinion, the very best work on 
 the subject which exists. — N. Y. Annalist. 
 
 No work holds a higher position, or is more de- 
 serving of being placed in the hands of the tyro, 
 the advanced student, or the practitioner. — Medical 
 Examiner. 
 
 Previous editions, under the editorial supervision 
 of Prof R. M. Huston, have been received with 
 marked favor, and they deserved it; but this, re- 
 printed from a very late Dublin edition, carefully 
 revised and brought up by the author to the present 
 time, does present an unusually accurate and able 
 exposition of every important particular embraced 
 in the department of midwifery. * * The clearness, 
 directness, and precision of its teachings, together 
 with the great amount of statistical research which 
 its text exhibits, have served to place it already in 
 the foremost rank of works in this department of re- 
 medial science. — N. O. Med. and Surg. Journal. 
 
 In our opinion, it forms one of the best if not the 
 very best text-book and epitome of obstetric science 
 which we at present possess in the English lan- 
 guage. — Monthly Journal of Medical Science. 
 
 The clearness and precision of style in which it is 
 written, and the great amount of statistical research 
 which it contains, have served to place it in the first 
 rank of works in this departmentof medical science. 
 — N. Y. Journal of Medicine. 
 
 Few treatises will be found better adapted as a 
 text-book for the student, or as a manual for the 
 frequent consultation of the young practitioner. — 
 American Medical Journal. 
 
 BY THE SAME AUTHOR. 
 
 ON THE. DISEASES OF INFANTS AND CHILDREN. In one large and 
 
 handsome volume of over 600 pages. 
 
 We regard this volume as possessing more claims 
 to completeness than any other of the kind with 
 which we are acquainted. Most cordially and earn- 
 estly, therefore, do we commend it to our profession- 
 al brethren, and we feel assured that the stamp of 
 their approbation will in due time be impressed upon 
 it. After an attentive perusal of its contents, we 
 hesitate not to say, that it is one of the most com- 
 prehensive ever written upon the diseases of chil- 
 dren, and that, for copiousness of reference, extentof 
 research, and perspicuity of detail, it is scarcely to 
 be equalled, and not to be excelled, in any lan- 
 guage. — Dublin Quarterly Journal. 
 
 After this meagre, and we know, very imperfect 
 notice of Dr. Churchill's work, we snail conclude 
 by saying, that it is one that cannot fail from its co- 
 piousness, extensive research, and general accuracy, 
 to exalt still higher the reputation of the author in 
 this country. The American reader will be particu- 
 larly pleased to find that Dr. Churchill has done full 
 justice throughout his work to the various American 
 authors on this subject. The names of Dewees, 
 Eberle, Condie, and Stewart, occur on nearly every 
 page, and these authors are constantly referred to by 
 the author in terms of the highest praise, and with 
 the most liberal courtesy. — The Medical Examiner. 
 
 The present volume will sustain the reputation 
 acquired by the author from his previous works. 
 The reader will find in it full and judicious direc- 
 tions for the management of infants at. birth, and a 
 compendious, but clear account of the diseases to 
 which children are liable, and the most successful 
 mode of treating them. We must not close this no- 
 tice without calling attention to the author's style, 
 which is perspicuous and polished to a degree, we 
 regret to say, not generally characteristic of medica. 
 works. We recommend the work of Dr. Churchill 
 most cordially, both to students and practitioners, 
 as a valuable and reliable guide in the treatment of 
 the diseases of children. — Am. Journ. of the Med. 
 Sciences. 
 
 We know of no work on this department of Prac- 
 tical Medicine which presents so candid and unpre- 
 judiced a statement or posting up of our actual 
 knowledge as this. — N. Y. Journal of Medicine. 
 
 Its claims to merit both as a scientific and practi- 
 cal work, are of the highest order. Whilst we 
 would not elevate it above every other treatise on 
 the same subject, we certainly believe that very few 
 are equal to it, and none superior. — Southern Med. 
 and Surgical Journal. 
 
 BY THE SAME AUTHOR. 
 
 ESSAYS ON THE PUERPERAL FEVER, AND OTHER DISEASES PE- 
 CULIAR TO WOMEN. Selected from the writings of British Authors previous to the close of 
 the Eighteenth Century. In one neat octavo volume, of about four hundred and fifty pages. 
 
 To these papers Dr. Churchill has appended notes, 
 embodying whatever information has been laid be- 
 fore the profession since their authors' time. He has 
 also prefixed to the Essays on Puerperal Fever, 
 which occupy the larger portion of the volume, an 
 interesting historical sketch of the principal epi- 
 
 demics of that disease. The whole forms a very 
 valuable collection of papers, by professional writers 
 of eminence, on some of the most important accident! 
 to which the puerperal female is liable. — American 
 Journal of Medical Sciences.
 
 10 
 
 BLANCHARD & LEA'S MEDICAL 
 
 CHURCHILL (FLEETWOOD), M. D., M. R. I. A., &c. 
 
 ON THE DISEASES OF WOMEN; including those of Pregnancy and Child- 
 bed. A new American edition, revised by the Author. With Notes and Additions, by D Fran- 
 cis Condie, M. D., author of "A Practical Treatise on the. Diseases of Children." In one large 
 and handsome octavo volume, with wood-cuts, pp. 684. [Just Issued.) 
 We now regretfully take, leave of Dr. Churchill's 
 
 book. Had our typographical limits permitted, we 
 should gladly have borrowed more from its richly 
 stored pages. In conclusion, wo heartily recom- 
 mend it to the profession, and would at the same 
 time express our firm conviction that it will not only 
 add to the reputation of its author, but will prove a 
 work of great and extensive utility to obstetric 
 practitioners. — Dublin Medical Press. 
 
 Former editions of this work have been noticed in 
 previous numbers of the Journal. The sentiments of 
 high commendation expressed in those notices, have 
 only to be repeated in this; not from the fact that 
 the profession at large are not aware of the high 
 merits which this work really possesses, but from a 
 desire to see the principles and doctrines therein 
 contained more generally recognized, and more uni- 
 versally carried out in practice. — N. Y. Journal of 
 Medicine. 
 
 We know of no author who deserves that appro- 
 bation, on " the diseases of females," to the same 
 txrent that Dr. Churchill does. His, indeed, is the 
 only thorough treatise we know of on the subject; 
 and it may be commended to practitioners and stu- 
 dents as a masterpiece in its particular department. 
 The former editions of this work have been com- 
 mended strongly in this journal, and they have won 
 their way to an extended, and a well-deserved popu- 
 
 larity. This fifth edition, before us. is well calcu- 
 lated to maintain Dr. Churchill's high reputation. 
 It was revised and enlarged by the author, for his 
 American publishers, and it seems to us that there is 
 scarcely any species of desirable information on its 
 subjects that may not be found in this work. — The 
 Western Journal of Medicine and Surgery. 
 
 AVe are gratified to announce a new and revised 
 edition of Dr. Churchill's valuable work on the dis- 
 eases of females We have ever regarded it as one 
 of the very best works on the subjects embraced 
 within its scope, in the English language; and the 
 present edition, enlarged and revised by the author, 
 renders it still more entitled to the confidence of the 
 profession. The valuable notes of Prof. Huston 
 have been retained, and contribute, in no small de- 
 gree, to enhance the value of the work. It is a 
 source of congratulation that the publishers have 
 permitted the author to be, in this instance, his 
 own editor, thus securing all the revision which 
 an author alone is capable of making. — The Western 
 Lancet. 
 
 Asa comprehensive manual for students, or a 
 work of reference for practitioners, we only speak 
 with common justice when we say that it surpasses 
 any other that has ever issued on the same sub- 
 ject from the British press. — The Dublin Quarterly 
 Journal. 
 
 DICKSON (S. H.), M. D., 
 
 Professor of Institutes and Practice of Medicine in the Medical College of South Carolina. 
 
 ELEMENTS OF MEDICINE; a Compendious View of Pathology and Thera- 
 
 petitics, or ihe History and Treatment of Diseases. In one large and handsome octavo volume 
 
 of nearly 800 pages (Noiv Ready.) 
 
 As a text- book on the Practice of Medicine for the student, and as a condensed work of reference 
 for the practitioner, this volume will have strong claims on the attention of the American profession. 
 Few physicians have had wider opportunities, than the author, for observation and experience, and 
 few perhaps have used them belter. As the result of a life of study and practice, therefore, the 
 present volume will doubtless be received with the welcome it deserves. 
 
 From the Preface. 
 
 Tffe present volume is inlended as an aid to young men who have engaged in the study of medi- 
 cine, to physician-; who have recently assumed the responsibilities of practice, and to my fellow 
 professors of the Institutes of Medicine, and private instructors who have felt the difficulty of com- 
 municating to the two (irst classes the knowledge which they are earnestly seeking to acquire. 
 Having been a teacher of medicine for thirty years, and a student more than forly, I must have 
 accumulated some experience in both characters. I have prepared and printed for those in attend- 
 ance on my lectures many successive manuals or text-books. I have also written and published 
 several volumes on medical subjects in general. The following pages are ihe result of a careful 
 collation of all that has been esteemed valuable in bolh, with such matter as continued study and 
 enlarged experience has enabled me to add. 
 
 DEWEES (W. P.), M.D., &c. 
 A COMPREHENSIVE SYSTEM OF MIDWIFERY. Illustrated by occa- 
 
 sional Cases and many Engravings. Twelfth edition, with the Author's last Improvements and 
 Corrections. In one octavo volume, of 600 pages. (Just Issued.) 
 
 BY THE SAME AUTHOR. 
 
 A TREATISE ON THE PHYSICAL AND MEDICAL TREATMENT OF 
 
 CHILDREN. Tenth edition. In one volume, octavo, 548 pages. (Just Issued.) 
 
 BY THE SAME AUTHOR. 
 
 A TREATISE ON THE DISEASES OF FEMALES. 
 
 one volume, octavo, 532 pages, with plates. (Just Issued.) 
 
 Tenth edition. In 
 
 DANA (JAMES D). 
 ZOOPHYTES AND CORALS. In one volume, imperial quarto, extra cloth, 
 
 with wood-cuts. Also, AN ATLAS,- in one volume, imperial folio, with sixty-one magnificent 
 plates, colored after nature. Bound in half morocco. 
 
 DE LA BECHE (SIR 
 THE GEOLOGICAL OBSERVER 
 
 volume, of 700 pages. With over three hundred wood-cuts 
 
 HENRY T.), F. R. S., &c. 
 
 In one very large and handsome octavo 
 (Lately Issued.)
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 a! 
 
 DRUITT (ROBERT), M.R. C.S., &c. 
 THE PRINCIPLES AND PRACTICE OF MODERN SURGERY. A new 
 
 American, from, the improved London edition. Edited by F. W. Sargent, M. D., author of 
 "Minor Surgery," &c. Illustrated with one hundred and ninety-three wood-engravings. In 
 one very handsomely printed octavo volume, of 576 large pages. 
 
 Dr. Druitt's researches into the literature of his I is really practically useful at the bedside will be 
 ubject have been not only extensive, but well di- found in a form at once clear, distinct, and interest- 
 
 rected ; the most discordant authors are fairly and 
 impartially quoted, and, while due credit is given 
 to each, their respective merits are weighed with 
 an unprejudiced hand. The grain of wheat is pre- 
 served, and the chaff is unmercifully stripped off. 
 The arrangement is simple and philosophical, and 
 the style, though clear and interesting, is so precise, 
 that the book contains more information condensed 
 into a few words than any other surgical work with 
 which we are acquainted. — London Medical Times 
 and Gazette, February 18, 1S5I. 
 
 No work, in our opinion, equals it in presenting 
 so much valuable surgical matter in so small a 
 compass. — St. Louis Med. and Surgical Journal. 
 
 Druitt's Surgery is too well known to the Ameri- 
 can medical profession to require its announcement 
 anywhere. Probably no work of the kind has ever 
 been more cordially received and extensively circu- 
 lated than this. The fact that it comprehends in a 
 comparatively small compass, all the essential ele- 
 ments of theoretical and practical Surgery — that it 
 is found to contain reliable and authentic informa- 
 tion on the nature and treatment of nearly all surgi- 
 cal atfections — is a sufficient reason for the liberal 
 patronage it has obtained. The editor, Dr. F. W. 
 Sargent, has contributed much to enhance the value 
 of the work, by such American improvements as are 
 calculated more perfectly to adapt it to our own 
 views and practice in this country. It abounds 
 everywhere with spirited and life-like illustrations, 
 which to the young surgeon, especially, are of no 
 minor consideration. Every medical man frequently 
 needs just such a work as this, for immediate refe- 
 rence in moments of sudden emergency, when he has 
 not time to consult more elaborate treatises. — The 
 Ohio Medical and Surgical Journal. 
 
 The author has evidently ransacked every stand- 
 ard treatise of ancient and modern times, and all that 
 
 ing. — Edinburgh Monthly Medical Journal. 
 
 Druitt's work, condensed, systematic, lucid, and 
 practical as it is, beyond most works on Surgery 
 accessible to the American student, has had much 
 currency in this country, and under its present au- 
 spices promises to rise to yet higher favor. — The 
 Western Journal of Medicine and Surgery. 
 
 The most accurate and ample resume of the pre- 
 sent state of Surgery that we are acquainted with. — 
 Dublin Medical Journal. 
 
 A better book on the principles and practice of 
 Surgery as now understood in England and America, 
 has not been given to the profession. — Boston Mtdi- 
 cal and Surgical Journal. 
 
 An unsurpassable compendium, not only of Sur- 
 gical, but of Medical Practice. — London Medical 
 Gazette. 
 
 This work merits our warmest commendations, 
 and we strongly recommend it to young surgeons as 
 an admirable digest of the principles and practice of 
 modern Surgery. — Medical Gazette. 
 
 It maybe said with truth that the work of Mr. 
 Druitt affords a complete, though brief and con- 
 densed view, of the entire field of modern surgery. 
 We know of no work on the same subject having the 
 appearance of a manual, which includes so many 
 topics of interest to the surgeon ; and the terse man- 
 ner in which each has been treated evinces a most 
 enviable quality of mind on the part of the author, 
 who seems to have an innate power of searching 
 out and grasping the leading facts and features of 
 the most elaborate productions of the pen. It is a 
 useful handbook for the practitioner, and we should 
 deem a teacher of surgery unpardonable who did not 
 recommend it to his pupils. In our own opinion, it 
 is admirably adapted to the wants of the student. — 
 Provincial Medical and Surgical Journal. 
 
 DUNGLISON, FORBES, TWEEDIE, AND CONOLLY. 
 THE CYCLOPAEDIA OF PRACTICAL MEDICINE: comprising Treatises on 
 
 the Nature and Treatment of Diseases, Materia Medica, and Therapeutics, Diseases of Women 
 and Children, Medical Jurisprudence, &c. &c. In four large super royal octavo volumes, of 
 3254 double-columned pages, strongly and handsomely bound. 
 
 *#* This work contains no less than four hundred and eighteen distinct treatises, contributed by 
 eix-ty-eighl distinguished physicians. 
 
 The most complete work on Practical Medicine 
 extant; or, at least, in our language.— Buffalo 
 Medical and Surgical Journal. 
 
 For reference, it is above all price to every prac- 
 titioner. — Western Lancet. 
 
 One of the most valuable medical publications of 
 the day — as a work of reference it is invaluable. — 
 Western Journal of Medicine and Surgery. 
 
 It has been to us, both as learner and teacher, a 
 work for ready and frequent reference, one in which 
 modern English medicine is exhibited in the most 
 advantageous light. — Medical Examiner. 
 
 We rejoice that this work is to be placed within 
 the reach of the profession in this country, it being 
 
 unquestionably one of very great value to the prac- 
 titioner. This estimate of it has not been formed 
 from a hasty examination, but after an intimate ac- 
 quaintance derived from frequent consultation of it 
 during the past nine or ten years. The editors are 
 practitioners of established reputation, and the list 
 of contributors embraces many of the most eminent 
 professors and teachers of London, Edinburgh, Dub- 
 lin, and Glasgow. It is, indeed, the great merit of 
 this work that the principal articles have been fur- 
 nished by practitioners who have not only devoted 
 especial attention to the diseases about which they 
 have written, but have also enjoyed opportunities 
 for an extensive practical acquaintance with them, 
 and whose reputation carries the assurance of their 
 competency justly to appreciate the opinions of 
 others, while it stamps their own doctrines with 
 high and just authority. — American Medical Journ. 
 
 DUNGLISON (ROBLEY), M.D., 
 Professor of the Institutes of Medicine in the Jefferson Medical College, Philadelphia. 
 
 HUMAN HEALTH; or, the Influence of Atmosphere and Locality, Change of 
 
 Air and Climate, Seasons, Food, Clothing, Bathing, Exercir-e, Sleep, fee. &0 , on Healthy Man ; 
 constituting Elements of Hygiene. Second edition, with many modifications and additions. In 
 one octavo volume, of 464 pages.
 
 12 
 
 BLANCHARD & LEA'S MEDICAL 
 
 DUNGLISON (ROBLEY), M.D., 
 
 Professor of Institutes of Medicine in the Jefferson Medical College, Philadelphia. 
 
 MEDICAL LEXICON; a Dictionary of Medical Science, containing a concise 
 
 Explanation of'the various Subjects and Terms of Physiology, Pathology, Hygiene, Therapeutics, 
 Pharmacology, Obstetrics, Medical Jurisprudence, &c. Wilh the French and other Synonymes; 
 Notices of Climate and of celebrated Mineral Waters; Formulae for various Officinal, Empirical, 
 and Dietetic Preparations, etc. Twelfth edition, revised. In one very thick octavo volume, ot 
 over nine hundred large double-columned pages, strongly bound in leather, with raised bands. 
 (Just Issued.) 
 
 Every successive edition of this work bears the marks of the industry of the author, and of his 
 determination to keep it fully on a level with the most advanced state of medical science. Thus 
 nearly fifteen thousand words have been added to it within the last few vears. As a complete 
 Medical Dictionary, therefore, embracing over FIFTY THOUSAND DEFINITIONS, in all the 
 branches of the science, it is presented as meriting a continuance of the great favor and popularity 
 which have carried it, within no very long space of time, to a twelfth edition. 
 
 Every precaution has been taken in the preparation of the present volume, to render its mecha- 
 nical execution and typographical accuracy worthy of its extended reputation and universal use. 
 The very extensive additions have been accommodated, without materially increasing the bulk of 
 the volume by the employment of a small but exceedingly clear type, cast for this purpose. The 
 press has been watched with great care, and every effort used to insure the verbal accuracy so ne- 
 cessary to a work of this nature. The whole is printed on fine white paper ; and, while thus exhi- 
 biting in every respect so great an improvement over former issues, it is presented at the original 
 exceedingly low price. 
 
 We welcome it cordially ; it is an admirable work, 
 and indispensable to all literary medical men. The 
 labor which has been bestowed upon it is something 
 prodigious. The work, however, has now been 
 done, and we are hnppy in the thought that no hu- 
 man bring will have again to undertake the same 
 gigantic task. Revised and corrected from time to 
 time, Dr. Dunglison's " Medical Lexicon" will last 
 for centuries. — British and Foreign Med. Chirurg. 
 Review. 
 
 The fact that this excellent and learned work has 
 passed through eight editions, and that a ninth is 
 rendered necessary by the demands of the public, 
 affords a sufficient evidence of the general apprecia- 
 tion of Dr. Dunglison's labors by the medical pro- 
 fession in England and America. It is a book which 
 will be of great service to the student, in teaching 
 him the meaning of all the technical terms used in 
 medicine, and will be of no less use to the practi- 
 tioner who desires to keep himself on a level with 
 the advance of medical science. — London Medical 
 Times and Gazette. 
 
 In taking leave of our author, we feel compelled 
 to confess that his work bears evidence of almost 
 incredible labor having been bestowed upon its com- 
 position. — Edinburgh Journal of Med. Sciences. 
 A miracle of labor and industry in one who has 
 written able and voluminous works on nearly every 
 branch of medical science. There could be no more 
 useful book to the student or practitioner, in the 
 present advancing age, than one in which would be 
 found, in addition to the ordinary meaningand deri- 
 vation of medical terms — so many of which are of 
 modern introduction — concise descriptions of their 
 explanation and employment; and all this and much 
 more is contained in the volume before us. It is 
 therefore almost as indispensable to the other learned 
 professions as to our own. In fact, to all who may 
 have occasion to ascertain the meaning of any word 
 belonging to the many branches of medicine. From 
 a careful examination of the present edition, wecan 
 vouch for its accuracy, and for its being brought 
 quite up to the date of publication ; the author states 
 in his preface that hehusadded to it aboutfonr thou- 
 sand terms, which are not to be found in the piece- 
 
 readers to its peculiar merits; and we need do 
 little more than state, in reference to the present 
 reissue, that, notwithstanding the large additions 
 previously made to it, no fewer than four thou- 
 sand terms, not to be found in the preceding edi- 
 tion, are contained in the volume hi fore us. — 
 Whilst it is a wonderful monument of its author's 
 erudition and industry, it is also a work of great 
 practical utility, as we can testify from our own 
 experience; for we keep it constantly within our 
 reach, and make very frequent reference to it, 
 nearly always finding in it the information we seek. 
 — British and Foreign Med.-Chirurg. Review. 
 
 It has the rare merit that it certainly has no rival 
 in the English language for accuracy and extent 
 of references. The terms generally include short 
 physiological and pathological descriptions, so that, 
 as the author justly observes, the reader does not 
 possess in this work a mere dictionary, but a book, 
 which, while it instructs him in medical etymo- 
 logy, furnishes him with a large amount of useful 
 information. The author's labors have been pro- 
 perly appreciated by his own countrymen ; and we 
 can only confirm their judgment, by recommending 
 this most useful volume to the notice of our cisat- 
 lantic readers. No medical library will be complete 
 without it. — London Med. Gazette. 
 
 It is certainly more complete and comprehensive 
 than any with which we are acquainted in the 
 English language. Few, in fact, could be found 
 belter qualified than Dr. Dunglison for the produc- 
 tion of such a work. Learned, industrious, per- 
 severing, and accurate, he brings to the task all 
 the peculiar talents necessary for its successful 
 performance; while, at the same time, his fami- 
 liarity with the writings of the ancient and modern 
 '• masters of our art," renders him skilful to note 
 the exact usage of the several terms of science, 
 and the various modifications which medical term 
 inology has undergone with the change of theo- 
 ries or the progress of improvement. — American 
 Journal of the Medical Sciences. 
 
 One of the most complete and copious known to 
 the cultivators of medical science. — Boston Med. 
 
 ding one. — Dublin Quarterly Journal of Medical Journal. 
 Sci-nc.s. i Tne most comprehensive and best English Die- 
 
 On the appearance of the last edition of this I tionary of medical terms extant. — Buffalo Medical 
 valuable work, we directed the attention of our | Journal. 
 
 BY THE SAME AUTHOR. 
 
 THE PKACTICE OF MEDICINE. A Treatise on Special Pathology and The 
 
 rapeuties. Third Edition. In two large octavo volumes, of fifteen hundred pages. 
 
 Upon every topic embraced in the work the latest 
 information will be found carefully posted up. — 
 Medical Examiner . 
 
 The student of medicine will find, in these two 
 elegant volumes, a mine of facts, a gathering of 
 precepts and advice from the world of experience, 
 that will nerve nim with courage, and faithfully 
 direct him in his efforts to relieve the physical suf- 
 
 ferings of the race.— Boston Medical and Surgical 
 Journal. 
 
 It is certainly the most complete treatise of which 
 we haveany knowledge. — Western Journal of Medi- 
 cine and Surgery. 
 
 One of the most elaborate treatises of the kind 
 we have. — Southern Med. and Surg. Journal.
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 13 
 
 DUNGLISON (ROBLEY), M.D., 
 
 Professor of Institutes of Medicine in the Jefferson Medical College, Philadelphia. 
 
 HUMAN PHYSIOLOGY. Seventh edition. Thoroughly revised and exten- 
 sively modified and enlarged, with nearly five hundred illustrations. In two large and hand- 
 somely printed octavo volumes, containing nearly 1450 pages. 
 It has long since taken rank as one of the medi- 
 cal classics of our language. To say that it is by 
 far the best text-book of physiology ever published 
 
 in this country, is but echoing the general testi- 
 mony of the profession. — N. Y. Journal of Medicine . 
 
 There is no single book we would recommend to 
 the student or physician, with greater confidence 
 than the present, because in it will be found a mir- 
 ror of almost every standard physiological work of 
 the day. We most cordially recommend the work 
 to every member of the profession, and no student 
 should be without it. It is the completest work on 
 
 Physiology in the English language, and is highly 
 creditable to the author and publishers.— Canadian 
 Medical Journal. 
 
 The most complete and satisfactory system of 
 Physiology in the English language. — Amer. Med. 
 Journal . 
 
 The best work of the kind in the English lan- 
 guage. — Siliiman's Journal. 
 
 The most full and complete system of Physiology 
 in our language. — Western Lancet. 
 
 BY THE SAME author. (Just Issued.) 
 
 GENEEAL THERAPEUTICS AND MATERIA MEDICA; adapted for a 
 
 Medical Text-book. Fifth edition, much improved. With one hundred and eighty-seven illus- 
 trations. In two large and handsomely printed octavo vols., of about 1100 pages. 
 The new editions of the United States Pharmacopoeia and those of London and Dublin, have ren- 
 dered necessary a thorough revision of this work. In accomplishing ibis the author has spared no 
 pains in rendering it a complete exponent of all that is new and reliable, both in the departments 
 of Therapeutics and Materia Medica. The book has thus been somewhat enlarged, and a like im- 
 provement will be found in every department of its mechanical execution. As a convenient text- 
 book for the student, therefore, containing within a moderate compass a satisfactory resume of its 
 important subject, it is again presented as even more worthy than heretofore of the very great favor 
 which it has received. 
 
 As a text-book for students, for whom it is par- 
 ticularly designed, we know of none superior to 
 it. — St. Louis Medical and Surgical Journal. 
 
 In this work of Dr. Dunglison, we recognize the 
 same untiring industry in the collection and em- 
 bodying of facts on the several subjects of which he 
 treats, that has heretofore distinguished him, and 
 we cheerfully point to these volumes, as two of the 
 most interesting that we know of. In noticing the 
 additions to this, the fourth edition, there is very 
 little in the periodical or annual literature of the 
 profession, published in the interval which has 
 elapsed since the issue of the first, that has escaped 
 the careful search of the author. As a book for 
 reference, it is invaluable. — Charleston Med. Jour- 
 nal and Review. 
 
 It may be said to be the work now upon the sub- 
 jects upon which it treats. — Western Lancet. 
 
 It purports to be a new edition, but it is rather 
 a new book, so greatly has it been improved, both 
 in the amount and quality of the matter which it 
 contains. — iV. O. Medical and Surgical Journal. 
 
 We bespeak for this edition, from the profession, 
 an increase of patronage over any of its former 
 ones, on account of its increased merit. — N. Y. 
 Journal of Medicine. 
 
 We consider this work unequalled. 
 and Surg. Journal. 
 
 -Boston Med. 
 
 BY THE SAME AUTHOR. 
 
 NEW REMEDIES, WITH FORMULA FOR THEIR ADMINISTRATION. 
 
 Sixth edition, with extensive Additions. In one very large octavo volume, of over 750 pages. 
 One of the most useful of the author's works. — diseases and for remedies, will be found greatly to 
 Southern Medical and Surgical Journal. enhance its value. — New York Med. Gazette. 
 
 This well-known and standard book has now 
 reached its sixth edition, and has been enlarged and 
 improved by the introduction of all the recent gifts 
 to therapeutics which the last few years have so 
 richly produced, including the anaesthetic agents, 
 &c. This elaborate and useful volume should be 
 found in every medical library, for as a book of re- 
 ference, for physicians, it is unsurpassed by any 
 other work in existence, and the double index for 
 
 The great learning of the author, and his remark- 
 able industry in pushing his researches into every 
 source whence information is derivable, has enabled 
 him to throw together an extensive mass of facts 
 and statements, accompanied by full reference to 
 authorities; which last feature renders the work 
 practically valuable to investigators who desire to 
 examine the original papers. — The American Journal 
 of Pharmacy. 
 
 DE JONGH (L. J.), M. D., &c. 
 THE THREE KINDS OF COD-LIVER OIL, comparatively considered, with 
 
 their Chemical and Therapeutic Properties. Translated, with an Appendix and Cases, by 
 Edward Carey, M. D. To which is added an article on the subject from "Dunglison on New 
 Remedies." In one small 12mo. volume, extra cloth. 
 
 DAY (GEORGE E.), M . D. 
 A PRACTICAL TREATISE ON THE DOMESTIC MANAGEMENT AND 
 
 MORE IMPORTANT DISEASES OF ADVANCED LIFE. With an Appendix on a new 
 and successful mode of treating Lumbago and other lorms of Chronic Rheumatism. One volume, 
 octavo, 226 pages. 
 
 FRICK (CHARLES), M. D. 
 RENAL AFFECTIONS; their Diagnosis and Pathology. 
 
 One volume, royal 12mo., extra cloth. 
 
 With illustrations.
 
 14 
 
 BLANCHARD & LEA'S MEDICAL 
 
 ERICHSEN (JOHN), 
 Professor of Surgery in University College, London, &c. 
 
 THE SCIENCE AND ART OP SURGERY; being a Treatise on Surgical 
 
 Injuries, Diseases, and Operations. Edited by John H. Brinton, M. D. Illustrated with 
 
 fhree hundred and eleven engravings on wood. In one large and handsome octavo volume, of 
 
 over nine hundred closely printed pages. {Just Issued.) 
 
 It is, in our humble judgment, decidedly tlie best 
 book of the kind in the English language. Strange 
 that just such books are notoftener produced by pui> 
 lie teachers of surgery in this country and Great 
 Britain Indeed, it is a matter of great astonishment. 
 
 but no les* true than astonishing, that of the many 
 works on surgery republished in this country within 
 i tie jast fifteen or twenty years as text-books for 
 medical siuiients, this is the only one, that even ap- 
 proximates to ihr fulfilment of the peculiar wants Ol 
 young men just entering upon the study of thi* branch 
 of ihe profession. — Western Jour. of Med. and Surgery. 
 
 Embracing, as will be perceived, the whole surgi- 
 cal domarii, and each division of itself almost com- 
 plete and perfect, each chapter full and explicit, each 
 subject faithfully exhibited, we can only express our 
 exiimaie ol it in the aggregate. We consider it an 
 excellent contribution to surgery, as probably the 
 lies! single volume now extant on ihe subject, and 
 with great pleasure we add it 10 our text books — 
 Nashville. Journal of Medicine and Surgery. 
 
 lis value is greatly enhanced by a very copious 
 well-arranged index. We regard this as one of the 
 most valuable contributions to modern surgery. To 
 one entering his novitiate of practice, we regard il 
 
 the most serviceable guide which he can consult. He 
 will find a fulness of detail leading him through every 
 step of the operation, and not deserting him until the 
 final issue of the case is decided. For the same rea- 
 son we recommend it to those whose routine of prac- 
 tice lies in such parts of the country that they must 
 rarely encounter cases requiring surgical manage- 
 ment. — Stethoscope. 
 
 Prof. Erichsen's work, for its size, has not been 
 surpassed; his nine hundred and eight pages, pro- 
 fusely illustrated, are rich in physiological, patholo- 
 gical, and operative suggestions, doctrines, details, 
 and processes; and will prove a reliable resource 
 for information, boih to physician and surgeon, in trie 
 hour of peril — iY. 0. Med. and Surg Journal. 
 
 We are acquainted with nn other work wherein 
 so much good sense, sound principle, and practical 
 inferences, stamp every page. To say more of the 
 volume would be useless; to say less would be doing 
 injustice to a production which we consider above 
 all others at the present day, and superior and more 
 complete than the many excellent treatises ot the 
 Knglish and Scotch surgeons, and this is no small 
 encomium. — American Lancet. 
 
 ELLIS (BENJAMIN), M.D. 
 THE MEDICAL FORMULARY : being a Collection of Prescriptions, derived 
 
 from Ihe writings and praciice of many of the most eminent physicians of America and Europe. 
 Together with the usual Dietetic Preparations and Antidotes for Poisons. To which is added 
 an Appendix, on the Endermic use of Medicines, and on the use of El her and Chloroform. The 
 whole accompanied with a few brief Pharmaceutic and Medical Observations. Tenth edition, 
 revised and much extended by Robert P. Thomas, M. D., Professor of Materia Mcdica in the 
 Philadelphia College of Pharmacy. In one neal octavo volume, of two hundred and ninety-six 
 pages. (Lately Issued.) 
 
 After an examination of the new matter and the 
 alterations, we believe the reputation of the work 
 built up by the author, and the late distinguished 
 editor, will continue to flourish under the ao spices 
 of the present editor, who has the industry and accu- 
 racy, and, we would say, conscientiousness requi- 
 site for the responsible task. — American Journal of 
 Pharmacy, March, 1&J4. 
 
 It will prove particularly useful to students and 
 young practitioners, as the most important prescrip- 
 tions employed in modern practice, which lie scat- 
 tered through our medical literature, are here col- 
 lected and conveniently arranged for reference. — 
 Charleston Med. Journal and Review. 
 
 FOWNES (GEORGE), PH. D., &.c. 
 ELEMENTARY CHEMISTRY; Theoretical and Practical. With numerons 
 
 illustrations. A new American, from the last and revised London edition. Edited, wilh Addi- 
 tions, by Robert Bridges, M. D. In one large royal 12mo. volume, of over 550 pages, wilh 181 
 wood-cuts, sheep, or extra cloth. (Now Ready.) 
 
 We know of no better text-book, especially in the l The work of Dr. Fownes has long been before 
 difficult department of organic chemistry, upon the public, and its merits have been fully appreci- 
 which it is particularly full and satisfactory. We ated as the best text-book on chemistry now in 
 would recommend it to preceptors as a capital existence. We do not. of course, place it in a rank 
 " office book" for their students who are beginners superior to the works of Erande, Graham, Turner, 
 in Chemistry. It is copiously illustrated with ex- Gregory, or Gmelin, but we say that, as a work 
 cellent wood-cuts, and altogether admirably "got for students, it is preferable to any of them. — Lon.- 
 up." — IV. J. Medical Reporter, March, 1S54. don Journal of Medicine. 
 
 A standard manual, which has long enjoyed the 
 reputation of embodying much knowledge in a .small 
 space. The author baB achieved the difficult task of 
 condensation with masterly tact. His book is con- 
 cise without being dry, and brief without being too 
 dogmatical or general. — Virginia Med. and Surgical 
 Journal. 
 
 A work well adapted to the wants of the student. 
 It. is an excellent exposition of the chief doctrines 
 and factsof modern chemistry. The size of the work, 
 and still more the condensed yet perspicuous style 
 in which it is written, absolve it from the charges 
 very properly urged against most manuals termed 
 popular. — Edinburgh Monthly Journal of Medical 
 Science. 
 
 FLINT (AUSTIN), M . D., 
 
 Professor of the Theory and Practice of Medicine in the University of Louisville, &c. 
 
 PHYSICAL EXPLORATION AND DIAGNOSIS OF DISEASES AFFECT- 
 ING THE ORGANS OF RESPIRATION. In one handsome octavo volume. (Now Ready.) 
 
 The reputation already acquired by the author with respect to his researches on this and kindred 
 topics, is sufficient guarantee that he will accomplish his object in presenting the student with a 
 good practical text-book, which will facilitate the acquirement of a knowledge of this dilficult sub- 
 ject. The work will be ready in time for the Fall sessions.
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 IS 
 
 FERGUSSOM (WILLIAM), F. R. S., 
 
 Professor of Surgery in King's College, London, &c. 
 
 A SYSTEM OF PRACTICAL SURGERY. Fourth American, from the third 
 
 and enlarged London edition. In one large and beautifully printed octavo volume, of about seven 
 
 hundred pages, with three hundred and ninety-three handsome illustrations. {Just Issued.) 
 
 The most important subjects in connection with I No work was ever written which more nearly 
 
 practical surgery which have been more recently comprehended the necessities of the student and 
 
 brought under the notice of, and discussed by, the | practitioner, and was more carefully arranged to 
 
 surgeons of Great Britain, are fully and dispassion 
 ately considered by Mr. Fergusson, and that which 
 was before wanting has now been supplied, so that 
 we can now look upon itasa work on practical sur- 
 gery instead of one on operative surgery alone. 
 There was some ground formerly for the complaint 
 before alluded to, that it dwelt too exclusively on 
 operative surgery ; but this defect is now removed, 
 and the book is more than ever adapted for the pur- 
 poses of the practitioner, whether he confines him- 
 self more strictly to the operative department, or 
 follows surgery on a more comprehensive scale. — 
 Medical Times and Gazette. 
 
 that single purpose than this. — N. Y. Mud. and Surg. 
 Journal. 
 
 The addition of many new pages makes this work 
 more than ever indispensable to the student and prac- 
 titioner. — Ranking- s Abstract. 
 
 Among the numerous works upon surgery pub- 
 lished of late years, we know of none we value 
 more highly than the one before us. It is perhaps 
 the very best we have for a text-book and for ordi- 
 nary reference, being concise and eminently practi- 
 cal. — Southern Med. and Surg. Journal. 
 
 GRAHAM (THOMAS), F. R.S., 
 
 Professor of Chemistry in University College, London, &c. 
 
 THE ELEMENTS OF CHEMISTRY. Including the application of the Science 
 
 to the Arts. With numerous illustrations. With Notes and Additions, by Robert Bridges, 
 M. D., &c. ecc. Second American, from the second and enlarged London edition 
 
 PART I. (Lately Issued) large 8vo., 430 pages, 185 illustrations. 
 
 PART II. {Preparing) to match. 
 
 The great changes which the science of chemistry has undergone within the last few years, ren- 
 der a new edition of a treatise like the present, almost a new work. The author has devoted 
 several years to the revision of his treatise, and has endeavored to embody in it every fact and 
 inference of importance which has been observed and recorded by the great body of chemical 
 investigators who are so rapidly changing the face of the science. In this manner the work has 
 been greatly increased in size, and the number of illustrations doubled ; while the labors of the editor 
 have been directed towards the introduction of such matters as have escaped the attention of the 
 author, or as have arisen since the publication of the first portion of this edition in London, ml8.'")0. 
 Printed in handsome style, and at a very low price, it is therefore confidently presented to the pro- 
 fession and the student as a very complete and thorough text-book of this important subject. 
 
 GRIFFITH (ROBERT E.), M. D., &c. 
 A UNIVERSAL FORMULARY, containing the methods of Preparing and Ad- 
 ministering Officinal and other Medicines. The whole adapted to Physicians and Pharmaceu- 
 tists. Second Edition, thoroughly revised, with numerous additions, by Robert P. Thomas, 
 M. D., Professor of Materia Medica in the Philadelphia College of Pharmacy. In one large and 
 handsome octavo volume, of over six hundred pages, double columns. (Just Issued.) 
 It was a work requiring much perseverance, and j It is one of the most useful books a country practi- 
 when published was looked upon a< by far the best 
 work of its kind lhat had issued from the American 
 press, being free of much of lhe trashy, and embrac- 
 ing most of the non-officinal formulae used or known 
 in American, English, or French practice, arranged 
 under the heads of'the several consiitueutdrugs. plac- 
 ing the receipt under its more important constituent. 
 Prof Thomas has certainly "improved." as well as 
 added o this Formulary, and has rendered it addition- 
 ally deserving of the confidence of pharmaceutists 
 and physicians. — American Journal of Pharmacy. 
 
 We are happy to announce a new and improved 
 edition of litis, one of lhe most valuable and useful 
 works that have emanated from an American pen. 
 It would do credit to any country, and will be found 
 of daily usefulness to practitioners of medicine; it is 
 belter adapted 10 their purposes than the dispen?ato 
 rie&.— Southern Med. and Surg. Journal. 
 
 A new edition of this well-known work, edited by 
 R. P. Thomas, M D., affords occasion for renewing 
 our commendation of so useful a handbook, which 
 ought to be universally studied by medical men of 
 every class, ami made use of by way of reference by 
 office pupils, as a standard authority. It has been 
 much enlarged, and now condenses a vast amount 
 of needful and necessary knowledge in small com- 
 pass. The more of such books the better for the pro- 
 fession and the public— N. Y. Med. Gazette. 
 
 lioner can possibly have in his possession. — Medical 
 Chronicle. 
 
 The amount of u=efu l.every-day matter, for a prac- 
 ticing physician, is really immense.— Boston Med. 
 and Surg. Journal. 
 
 Tbi= is a work of six hundred and fifty one pasres, 
 embracing all on the subject of preparing and admi- 
 nistering medicines that can be desired by the. physi- 
 cian and pharmaceutist. — Western Lancet. 
 
 In short, it is full and complete work of the kind, 
 and should be m the hands of every physician and 
 apothecary. O ■ Med. and Surg. Journal. 
 
 We predic a great sale for this work, and we espe- 
 cially recommend it to all medical teachers. — Rich- 
 mond Stethoscope. 
 
 This edition of Dr Griffith's work has been greatly 
 improved by the revision and ample additions of Dr. 
 Thomas, ami is now. we believe, one of the most 
 complete works of it* kind in any language. The 
 additions amount to about seventy pages, and no 
 effort has been spared to include in them all the re- 
 cent improvements which have been published in 
 medical journals, and systematic, treatises. A work 
 of this kind appears io us indispensable to the physi- 
 cian, and lh»reis none we can more cordially recom- 
 mend. — iV. JT. Journal of Medicine. 
 
 BY THE SAME AUTHOR. 
 
 MEDICAL BOTANY; or, a Description of all the more important Plants used 
 
 in Medicine, and of their Properties, Uses, and Modes of Administration. In one large octavo 
 volume, of 704 pages, handsomely printed, with nearly 350 illustrations on wood. 
 
 GREGORY (WILLIAM), F. R. S. E., 
 
 LETTERS TO A CANDID INQUIRER ON ANIMAL 
 
 In one neat volume, royal 12mo., extra cloth, pp. 384. 
 
 MAGNETISM.
 
 IG 
 
 BLANCHARD & LEA'S MEDICAL 
 
 GROSS (SAMUEL D.), M. D., 
 
 Professor of Surgery in the University of Louisville, &c. 
 
 A PRACTICAL TREATISE ON THE DISEASES, INJURIES, AND 
 
 MALFORMATIONS OF THE URINARY BLADDER, THE PROSTATE GLAND, AND 
 THE URETHRA. Second Edition, revised and much enlarged, with one hundred and eighty- 
 tour illustrations. In one large and very handsome octavo volume, of over nine hundred pages. 
 (JYow Ready.) 
 
 The author has availed himself of the opportunity afforded by a call for a new edition of this 
 work, to thoroughly revise and render it in every respect worthy, so far as in his power, of the very 
 flattering reception whicn has been accorded to it by the profession. The new matter thus added 
 amounts to almost one-third of the original work, while the number of illustrations has been nearly 
 doubled. These additions pervade every portion of the work, which thus lias rather the aspect of 
 a new treatise than a new edition. In its present improved form, therefore, it may confidently be 
 presented as a complete and reliable storehouse of information on this important class of diseases, 
 and as in every way fitted to maintain the position which it has acquired in Europe and in this 
 country, as the standard of authority on the subjects treated of. 
 
 On the appearance of the first edition of this work, I away this reproach ; and so completely has the task 
 the leading English medical review predicted that it ' been fulfilled, that we venture to predict for Dr. 
 would have a " permanent place in the literature of I Gross's treatise a permanent place in the literature 
 surgery worthy to rank with the best works of the of surgery, worthy to rank with the best works of 
 present age." This prediction has been amply ful- the present age. Not merely is the matter good, 
 filled. Dr. Gross's treatise has been found to sup- but the getting up of the volume is most creditable 
 ply completely the want which has been felt ever to transatlantic enterprise; the paper and print 
 since the elevation of surgery to the rank of science, would do credit to a first-rate London establishment ; 
 of a good practical treatise on the diseases of the I and the numerous wood-cuts which illustrate it, de- 
 bladder and its accessory organs. Philos iphical in monstrate that America is making rapid advances in 
 its design, methodical in its arrangement, ample and this department of art. We have, indeed, unfeigned 
 sound in its practical details, it may in truth he said pleasure in congratulating all concerned in this pub- 
 to leave scarcely anything to be desired on so im- lication, on the result of their labours; and expe- 
 portant a subject, and with the additions and modi- rience a feeling something like what animates a long- 
 fications resulting from future discoveries and im- expectant .husbandman, who, oftentimes disappointed 
 provemtnts, it will probably remain one of the most by the produce of a favorite field, is at last agree- 
 valuuble works on this subject so long as the science ably surprised by a stately crop which may bear 
 of medicine shall exist. — Boston Med. and Surg, comparison with any of its former rivals. The 
 Journal, June 7, 1855. : grounds of our high appreciation of the work will 
 
 A volume replete with truths and principles of the ! &e obvious as we proceed ; and we doubt not that 
 utmost value in the investigation of these diseases.— i the Present facilities for obtaining American books 
 
 will induce many of our readers to verify our re- 
 commendation by their own perusal of it. — British 
 and Foreign Medico-C hirurgical Review. 
 
 Whoever will peruse the vast amount of valuable 
 
 American Medical Journal 
 
 Dr. Gross has brought all his learning, experi- 
 ence, tact, and judgment to the task, and has pro- 
 duced a work worthy of his high reputation. We 
 feel perfectly safe in recommending it to our read- 
 ers us a monograph unequalled in interest and 
 practical value by any other on the subject in our 
 language. — Western Journal of Med. and Surg. 
 
 It has remained for an American writer to wipe 
 
 practical information it contains, and which we 
 have been unable even to notice, will, we think, 
 agree with us, that there is no work in the English 
 language which can make any just pretensions to 
 be its equal. — N. Y. Journal of Medicine. 
 
 BY THE SAME AUTHOR. (Just Issued). 
 
 A PRACTICAL TREATISE ON FOREIGN BODIES IN THE AIR-PAS- 
 
 SAGES. In one handsome octavo volume, with illustrations, pp. 468. 
 
 A very elaborate work. It is a complete summary a most interesting and hitherto a most neglected de- 
 of the whole subject, and will be a useful book of partment of surgical pathology and practice. — St. 
 reference. — British and Foreign Medico-Chirurg. Louis Med. and Surg. Journal, May, 11555. 
 Keview. Surgical authors, isolated reports in medical pe- 
 
 A highly valuable book of reference on a most im- riodicals and modern surgeons ' blend their common 
 portant subject in the practice of medicine. We ' toil" to make a book which exhausts the subject, 
 conclude by recommending it to our readers, fully and must forever remain the standard work on the 
 persuaded that its perusal will afford them much management of this accident. — Buffalo Med. J ourn. 
 practical information well conveyed, evidently de- | We consider tnis work one of the most important 
 
 of the recent additions to practical surgery. Con- 
 taining all that has been recorded relating to the 
 class of accidents of which it treats, admirably 
 arranged and systematized, it should find a place in 
 
 rived from considerable experience and deduced from 
 an ample collection of facts. — Dublin Quarterly 
 Journal, May, 1855. 
 
 In this valuable monograph Dr. Gross has cer- 
 tainly struck a new lead in Surgery, and is entitled everyinedical library. — Montreal Med. Chronicle. 
 to the credit of having illustrated and systematized I 
 
 by the same author. (Preparing.) 
 
 A SYSTEM OF SURGERY; Diagnostic, Pathological, Therapeutic, and Opera- 
 
 tive. With very numerous engravings on wood. 
 
 BY THE SAME AUTHOR. 
 
 ELEMENTS OF PATHOLOGICAL ANATOMY; illustrated by colored En- 
 
 gravings, and two hundred and fifty wood-cuts. Second edition, thoroughly revised and greatly 
 
 enlarged. In one very large and handsome imperial octavo volume, pp. 822. 
 
 We recommend it as the most complete, and, on The colored engravings and wood-cuts are exceed- 
 
 the whole, the least defective compilation on the 
 subject in the English language. — Brit, and For. 
 Med. Journal. 
 
 It is altogether the most complete exposition of 
 Pathological Anatomy in our language. — American 
 Journal of Medical Sciences. 
 
 if. is the most complete and useful systematic work 
 on Kthological Anatomy in the English language. 
 
 ingly well executed, and the entire getting up of the 
 work does much credit to the enterprising publishers. 
 We regard it as one of the most valuable works 
 ever issued from the American press, and it does 
 great honor alike to the author, and the country of 
 his birth. — N. Y. Journal of Medicine. 
 
 We commend it to the attention of the profession 
 as one of the best extant upon the subject on which 
 it treats. — Southern Journal Med. and Pharmacy.
 
 AND SCIENTIFIC PUBLICATIONS. 17 
 
 GLUGE (GOTTLIEB), M. D., 
 
 Professor of Physiology and Pathological Anatomy in the University of Brussels, &c. 
 
 AN ATLAS OF PATHOLOGICAL HISTOLOGY. Translated, with Notes 
 
 and Additions, by Joseph Leidy, M. D., Professor of Anatomy in the University of Pennsylva- 
 nia. In one volume, very large imperial quarto, with three hundred and twenty figures, plain 
 and colored, on twelve copperplates. 
 
 This being, as far as we know, the only work in the unconnected observations of a great number of 
 which pathological histology is separately treated authors. The development of the morbid tissues, 
 of in a comprehensive manner, it will, we think, for and the formation of abnormal products, raav now 
 this reason, be of infinite service to those who desire be followed and studied witli the same ease and 
 to investigate the subject systematically, and who satisfaction as the best arranged Bystem of phy- 
 have felt the difficulty of arranging in their mind siology.— American Med. Journal. 
 
 GARDNER (D. PEREIRA), M . D. 
 MEDICAL CHEMISTRY, for the use of Students and the Profession: being a 
 
 Manual oi the Science, with its Applications to Toxicology, Physiology, Therapeutics, Hygiene, 
 &c. In one handsome royal 12mo. volume, of about 400 pages, with illustrations. 
 
 HASSE (C. E.), M. D. 
 AN ANATOMICAL DESCRIPTION OF THE DISEASES OF RESPIRA- 
 TION AND CIRCULATION. Translated and Edited by Swaine. In one volume, octavo. 
 
 HARRISON (JOHN), M . D. 
 AN ESSAY TOWARDS A CORRECT THEORY OF THE NERVOUS 
 
 SYSTEM. In one octavo volume, 292 pages. 
 
 HUNTER (JOHN). 
 TREATISE ON THE VENEREAL DISEASE. With copious Additions, by 
 
 Dr. Ph. Ricord, Surgeon to the Venereal Hospital of Paris. Edited, with additional Notes, by 
 F. J. Bumstead, M. D. In one octavo volume, with plates (Now Ready.) 1^° See Ricord. 
 Also, HUNTER'S COMPLETE WORKS, with Memoir, Notes, &c. &c. In four neat octavo 
 volumes, with plates. 
 
 HUGHES (H. M.), M . D., 
 Assistant Physician to Guy's Hospital, &c. 
 
 A CLINICAL INTRODUCTION TO THE PRACTICE OF AUSCULTA- 
 
 TION, and other Modes of Physical Diagnosis, in Diseases of the Lungs and Heart. Second 
 American from the Second and Improved London Edition. In one royal 12mo. vol. pp. 304. 
 
 HORNER (WILLIAM E.), M. D., 
 
 Professor of Anatomy in the University of Pennsylvania. 
 
 SPECIAL ANATOMY AND HISTOLOGY. Eighth edition. Extensively 
 
 revised and modified. In two large octavo volumes, of more than one thousand pages, hand- 
 somely printed, with over three hundred illustrations. 
 
 This work has enjoyed a thorough and laborious revision on the part of the author, with the 
 view of bringing it fully up to the existing state of knowledge on the subject of general and special 
 anatomy. To adapt it more perfectly to the wants-of the student, he has introduced a large number 
 of additional wood-engravings, illustrative of the objects described, while the publishers have en- 
 deavored to render the mechanical execution of the work worthy of the extended reputation which 
 it has acquired. The demand which has carried it to an EIGHTH EDITION is a sufficient evi- 
 dence of the value of the work, and oi its adaptation to the wants oi the student and professional 
 reader. 
 
 HOBLYN (RICHARD D.), A. M . 
 A DICTIONARY OF THE TERMS USED IN MEDICINE AND THE 
 
 COLLATERAL SCIENCES. New and much improved American Edition. Revised, with 
 numerous Additions, from the last London edition, by Isaac Hays, M. D., &c. In one large 
 royal 12mo. volume, of over five hundred pages, double columns. (Now Ready.) 
 In passing this work a second time through the press, the editor has subjected it to a very tho- 
 rough revision, making such additions as the progress of science has rendered desirable, and sup- 
 plying any omissions that may have previously existed. The extent of these addilions may be 
 estimated from the fact that this edition contains about one-third more mailer than the previous 
 one, notwithstanding which it has been kept at the former very moderate rate. As a concise and 
 convenient Dictionary of Medical Terms, at an exceedingly low price, it will therefore be found of 
 great value to the student and practitioner. 
 
 JONES (T. WHARTON), F. R. S., &c. 
 THE PRINCIPLES AND PRACTICE OF OPHTHALMIC MEDICLNE 
 
 AND SURGERY. Edited by Isaac Hays, M. D., &c. In one very neat volume, large royal 
 12mo., of 529 pages, with four plates, plain or colored, and ninety-eight wood-cuis. 
 
 The work amply sustains, in every point the al- 
 ready high reputation of the author as an ophthalmic 
 surgeon as well as a physiologist and pathologist. 
 The book is evidently the result of much labor and 
 research, and has been written with the greatest 
 care and attention. We entertain little doubt that 
 this book will become what its author hoped it 
 
 might become, a manual for daily reference and 
 consultation by the student and t lie general practi- 
 tioner. The work is marked by that correctness, 
 clearness, and precision of style which distinguish 
 all the productions of the learned author. — British 
 and Foreign Medical Review.
 
 BLANCHARD & LEA'S MEDICAL 
 
 JONES (C. HANDFIELD), F. R. S., &, EDWARD H. SIEVEKING, M.D., 
 
 Assistant Physicians and Lecturers in St. Mary's Hospital, London. 
 
 A MANUAL OF PATHOLOGICAL ANATOMY. First American Edition, 
 
 Revised. With three hundred and ninety-seven handsome wood engravings. In one large and 
 beautiful octavo volume of nearly seven hundred and fifty pages. (Just Issued.) 
 In a work like the present, intended as a text-book for the student of pathology, accurate engrav- 
 ings of the various results of morbid action are of the greatest assistance. The American pub- 
 lishers have, therefore, considered that the value of the work might be enhanced by increasing the 
 number of illustrations, and, with this object, many wood-cuts, from the best authorities, have been 
 introduced, increasing the number from one hundred and sixty-seven, in the London Edition, to 
 three hundred and ninety-seven in this. The selection of these wood-cuts has been made by a 
 competent member of the profession, who has supervised the progress of the work through the 
 press, with the view of securing an accurate reprint, and of correcting such errors as had escaped 
 the attention of the authors. 
 
 With these improvements, the volume is therefore presented in the hope of supplying the ac- 
 knowledged want of a work which, within a moderate compass, should embody a condensed and 
 accurate digest of the present state of pathological science, as extended by recent microscopical, 
 chemical, and physiological researches. 
 
 Asa concise text-book, containing, in a condensed authors have not attempted to intrude new views on 
 form, a complete outline of what is known in the their professional brethren, but simply to lay before 
 domain of Pathological Anatomy, it is perhaps the them, what has long been wanted, an outline of the 
 beat work in the English language. Its great merit present condition of pathological anatomy. In this 
 consists in its completeness and brevity, and in this they have been completely successful. The work is 
 respect it supplies a great desideratum in our lite- one of the best compilations which we have ever 
 rat u re. Heretofore the student of pathology was ' perused. The opinions and discoveries of all the 
 obliged to glean from a great number of monographs, leading pathologists and physiologists are engrossed, 
 and the field was so extensive that but few cultivated bo that by reading any subject treated in the book 
 it with sny degree of success. The authors of the you have a synopsis of the views of the most ap- 
 present work have sought to corrrct this defect by proved authors. — Charleston Medical Journal and 
 placing before the reader a summary of ascertained Review. 
 
 B^hilSK!llh^ i rfA e ^ l Tiw tte ^^?Jf ,,, ^" ,,t w e have no hesitation in recommending it 
 pathologists both ot the Old and New \\ odd. 
 
 simple work of reference, therefore, it is 
 
 value to the student of pathological anato 
 
 should be in every physician's library.— Western 
 
 i eminent vve ] mve nn hesitation in recommending it as 
 
 Id. As a worthy of careful and thorough study by every mem- 
 
 of great i, er ))f (ne p r<) f eS sion, old, or young. — iV. W. Med. 
 
 omy, and and Sur? Joltrna i. 
 
 Lancet, 
 
 We urge upon our readers and the profession gene- 
 rally the importance of informing themselves in re- 
 gard to modern views of pathology, and recommend 
 to tiiem to procure the work before us as the best 
 means of obtaining this information.— Stethoscope. 
 
 From the casual examination we have given we 
 are inclined to regard it as a text-book, plain, ra- 
 tional, and intelligible, such a book as the practical 
 man needs for daily reference. For this reason it 
 will be likely to be largely useful, as it suits itself 
 to those busy men who have little time for minute 
 investigation, and prefer a summary to an elaborate 
 
 in offering the above titled work to the public, the treatise. — Buffalo Medical Journal. 
 
 KIRKES (WILLIAM SENHOUSE), M . D., 
 
 Demonstrator of Morbid Anatomy at St. Bartholomew's Hospital, &c.j and 
 
 JAMES PAGET, F. R. S., 
 
 Lecturer on General Anatomy and Physiology in St. Bartholomew's Hospital. 
 
 A MANUAL OF PHYSIOLOGY. Second American, from the second and 
 
 improved London edition. With one hundred and sixty-five illustrations. In one large and 
 handsome royal 12oio. volume, pp. 5-">0. (Just Issued.) 
 
 In the present edition, the Manual of Physiology i the practitioner who has but leisure to refresh his 
 has been brought up to the actual condition of the l memory, this book is invaluable, as it contains all 
 science, and fully sustains the reputation which it that it is important to know, without special details, 
 has already so deservedly attained. We consider which are read with interest only by those who 
 the work of MM. Kirkes and Paget to constitute one I would make a specialty, or desire to possessa criti- 
 of the very best handbooks of Physiology we possess ', cal knowledge of the subject. — Charleston Medical 
 — presenting just such an outline of thescienee, coin- | Journal. 
 
 prising an account of its leading facts and generally \ 0ne of the best treatises that can be put into the 
 admitted principles, as the student requires during hands of the stu dent.— London Medical Gazette. 
 his attendance upon a course of lectures, or for re- | 
 
 Particularly adapted to those who desire to pos- 
 sess a concise" digest of the facts of Human Physi- 
 ology. — British and Foreign Med.-Chirurg. Review. 
 We conscientiously recommend it as an admira- 
 ble " Handbook of Physiology."— London Journal 
 of Medicine. 
 
 lor examination. — Am. 
 
 ference whilst preparing 
 Medical Journal . 
 
 We need only say, that, without entering into dis- 
 cussions of unsettled questions, it contains all the 
 recent improvements in this department of medical 
 science. For the student beginning this study, and 
 
 KNAPP (F.), PH. D., &.c. 
 TECHNOLOGY; or, Chemistry applied to the Arts and to Manufactures. Edited, 
 with numerous Notes and Additions, by Dr. Edmund Ronalds and Dr. Thomas Richardson. 
 First American edition, with Notes and Additions, by Prof. Walter R. Johnson. In two hand- 
 some octavo volumes, printed and illustrated in the highest style of art, with about five hundred 
 wood-engraving's. 
 
 LONGET (F. A.) 
 TREATISE ON PHYSIOLOGY. With numerous Illustrations. Translated 
 
 from the French by F. G. Smith, M. D., Professor of Institutes of Medicine in the Pennsylvania 
 (Preparing.) 
 
 Medical Colles 
 
 LALLEMAND (M.). 
 THE CAUSES, SYMPTOMS, AND TREATMENT OF SPERMATOR- 
 
 RHCEA. Translated and edited bv Henry J. McDougal. In one volume, octavo, 320 pages.
 
 AND SCIENTIFIC PUBLICATIONS. 19 
 
 LEHMANN (G. C.) 
 PHYSIOLOGICAL CHEMISTRY. Translated by George E. Day, M. D., 
 
 and edited by Prof. R. E. Rogers, of the University of Pennsylvania. In two large octavo 
 
 volumes, with nearly two hundred illustrations. (Now Ready.) 
 
 This great work, universally recognized as the most complete and authoritative exposition of ita 
 intricate and important subject in its most advanced condition, has received every care during- n* 
 passage through the press, under the superintendence of Prof. Rogers, to insure the entire accuracy 
 indispensable to a work of this character. It has also been improved by the distribution in the 
 appropriate places throughout the text of the numerous additions and corrections embodied in the 
 Appendix, while a number of illustrations have been introduced from "Funke's Atlas of Physiological 
 Chemistry," and an Appendix of Plates has been added. The publishers, therefore, trust that it 
 will he found a complete and accurate edition, and in every respect worthy of the reputation of the 
 work. 
 
 The progress of research in this department is so and exact view of its present aspect, should lose no 
 rapid, that Prof. Lehmann's treatise must he re- time in attaching themselves to the Society by which 
 garded as having completely superseded that of it is in course of publication. — British and Foreign 
 Simon; and all who desire to possess a systematic , Medico-Chirurgical Review. 
 
 work on Physiological Chemistry by a man who is T]]e work of Lehmann stands unri valled as the 
 thoroughly qualified, both by his physiological and most comprehensive book of reference and informa- 
 Chemical acquirements, by his own eminence as an tion ext;lnt „„ ny br . inch of ll|t , Bub j ect ,,„ which 
 experimentalist, and by the philosophic impartiality it treats — 2Jrfia6«rg- Monthly Journal of Medical 
 of his habits of thought, to afford a comprehensive Science. 
 
 by the same author. (Now Ready.) 
 
 CHEMICAL PHYSIOLOGY. Translated, with numerous additions, by J. 
 
 Cheston Morris, M. D., with an Introduction by Prof. S. Jackson, of the University of Penn- 
 sylvania, la one handsome octavo volume, with illustrations. 
 
 The original of this work, though but lately issued by its distinguished author, has already 
 assumed the highest position, as presenting in their latest development the modern doctrines and 
 discoveries in the chemistry of life. The numerous additions by the translator, and the Introduc- 
 tion by Professor Jackson will render its physiological aspect more complete than designed by the 
 author, and will adapt it for use as a text-book of physiology, presenting more thoroughly than has 
 yet been attempled, the modifications arising from the vast impulse which organic chemistry has 
 received within a few years past. 
 
 LAWRENCE (W.), F. R. S., Sic. 
 A TREATISE ON DISEASES OF THE EYE. A new edition, edited, 
 
 with numerous additions, and 243 illustrations, by Isaac Hays, M. D., Surgeon to Wills Hospi- 
 tal, &c. In one very large and handsome octavo volume, of'950 pages, strongly bound in leather 
 with raised bands. (Lately Issued.) 
 
 This work is so universally recognized as the standard authority on the subject, that the pub- 
 lishers in presenting this new edition have only to remark that in its preparation the editor has 
 carefully revised every portion, introducing additions and illustrations wherever the advance of 
 science has rendered them necessary or desirable. The various important contributions to 
 ophthalmological science, recently made by Dalrymple, Jacob, Walton, Wilde, Cooper, &c, 
 both in the form of separate treatises and contributions to periodicals, have been carefully 
 examined by the editor, and, combined with the results of his own experience, have been 
 freely introduced throughout the volume, rendering it a complete and thorough exponent of 
 the most advanced state of the subject. 
 
 This admirable treatise- the safest guide and most ] octavo pages- has enabled both author and editor to 
 comprehensive work of reference, which is within j do justice to all the details of this subject, and o n- 
 the reach of the profession. — Stethoscope. dense in this single volume the present state of oar 
 
 This standard text-book on the department of 
 whieh it treats, has not been superseded, by any or 
 all of the numerous publications on the subject 
 heretofore issued. Nor with the multiplied improve- 
 ments of Dr. Hays, the American editor, is it at all 
 likely that this great work will cease to merit the 
 confidence and preference of students or practition- 
 
 knowledge of the whole science in tltis department, 
 whereby its practical value cannot he excelled. We 
 heartily commend it, especially as a book of refe- 
 rence, indispensable in every medical library. The 
 additions of the American editor very greatly en- 
 hance the value of the work, exhibiting the learning 
 and experience of Dr. Hays, in the light in whieh he 
 ousht to be held, as a standard authority on all sab- 
 
 - . . .._ :_;_' ... .u: ....;. .It.- M V ATtA C±n~ 
 
 ers. Its ample extent — nearly one thousand large; jects appertaining to this specialty.— A. Y. Med. Gaz. 
 
 LEE (ROBERT), M. D., F. R. S., &c. 
 CLINICAL MIDWIFERY; comprising the Histories of Five Huudred and 
 
 Forty-five Cases of Difficult, Preternatural, and Complicated Labor, with Commentaries. From 
 an edition. In one royal 12mo. volume, extra cloth, of 238 pages. 
 
 the second London edition. In one royi 
 
 LUDLOW (J. L.), M. D., 
 
 Lecturer on Clinical Medicine at the Philadelphia Almshouse, &c. 
 
 A MANUAL OF EXAMINATIONS upon Anatomy and Physiology, Surgery, 
 
 Practice of Medicine, Chemistry, Obstetrics, Materia Medica, Pharmacy, and Therapeutics. 
 Designed for Students of Medicine throughout the United States. A new edition, revised and 
 improved. In one large royal 12mo. volume, with several hundred illustrations. (Preparing.) 
 
 LISTON (ROBERT), F. R. S., &c. 
 LECTURES ON THE OPERATIONS OF SURGERY, and on Diseases and 
 
 Accidents requiring Operations. Edited, with numerous Additions and Alterations, by T. D. 
 Mutter, M. D. In one large and handsome octavo volume, of 506 pages, with 216 wood-cuts.
 
 20 
 
 BLANCHARD & LEA'S MEDICAL 
 
 LA ROCHE (R.), M . D., &c. 
 PNEUMONIA ; its Supposed Connection, Pathological and Etiological, with Au- 
 tumnal Fevers, including an Inquiry into the Existence and Morbid Agency of Malaria. In one 
 handsome octavo volume, extra cloth, of 500 pages. 
 
 A more simple, clear, and forcible exposition of I This work should be carefully studied by Southern 
 the groundless nature and dangerous tendency of | physicians, embodying as it does the reflections of 
 certain pathological and etiological heresies, has I an original thinker and close observer on a subject 
 seldom been presented to our notice. — N. Y. Journal peculiarly their own. — Virginia Med. and Surgical 
 0/ Medicine and Collateral Science. j Journal. 
 
 by the same author. (Now Ready.) 
 
 YELLOW FEVER,, considered in its Historical, Pathological, Etiological, and 
 
 Therapeutical Relations. Including a Sketch of the Disease as it has occurred in Philadelphia 
 from 1699 to 1854, with an examination of the connections between it and the fevers known under 
 the same name in other parts of temperate as well as in tropical regions. In two large and 
 handsome octavo volumes of nearly 1500 pages. 
 
 The publishers are happy in being able at length to present to the profession this great work, 
 which they are assured will be regarded as an honor to the medical literature of the country. As 
 the result of many years of personal observation and study, as embodying an intelligent resume of 
 all that has been written regarding the disease, and as exhausting 1he subject in all its various 
 aspects, these volumes must at once take the position of the standard authority and work of refe- 
 rence on the many important questions brought into consideration. 
 
 curate and thorough knowledge of the subject, ac- 
 quired by ample experience and opportunities for 
 investigations both at home and abroad, while he 
 brings to his task peculiar qualifications by his pro- 
 found learning in all that appertains to the science 
 and art of healing. AVe recommend it to the pro- 
 fesaioo and the public as an able and elaborate ri- 
 l ,, "I all that is known on the subject of Yellow 
 Fever, with a vast amount of information upon 
 every aspect of this important topic, upon which 
 the author has expended an amount of industry and 
 renins which can never be adequately rewarded, 
 however appreciated by his brethren. — N. Y. Medi- 
 cal Gazette, October, 1655. 
 
 From Professor S. J{. Dickson. Charlestcn, S. C, 
 September 18, 1855. 
 A monument of intelligent and well applied re- 
 search, almost without example. It is, indeed, in 
 itself, a large library, and is destined to constitute 
 the special resort as a book of reference, in the 
 subject of which it treats, to all future time. 
 
 This truly great work has just appeared in two 
 large octavo volumes, and while it will be hailed 
 throughout our country as a must timely and desira- 
 ble contribution to American Medical Literature, it, 
 will be sought for and read with avidity abroad, for 
 its author has a world-wide reputation in scholastic 
 and practical medicine. Dr. La Roche has an ac- 
 
 LARDNER (DIONYSIUS), D. C. L., &.c. 
 HANDBOOKS OF NATURAL PHILOSOPHY AND 
 
 ASTRONOMY. 
 
 Revised, with numerous Additions, by the American editor. First Course, containing Mecha- 
 nics, Hydrostatics, Hydraulics, Pneumatics, Sound, and Optics. In one large royal 12mo. 
 volume, of 750 pages, with -124 wood-cuts. Second Course, containing Heat, Electricity, Mag- 
 netism, and Galvanism, one volume, large royal 12mo., of 450 pages, with 250 illustrations. 
 Third Course ( now ready), containing Meteorology and Astronomy, in one large volume, royal 
 12mo. of nearly eight hundred pages, with thirty-seven plates and two hundred wood-cuts. The 
 whole complete in three volumes, of about two thousand large pages, with over one thousand 
 figures on steel and wood. Any volume sold separate. 
 The various sciences treated in this work will be found brought thoroughly up to the latest period. 
 
 MACKENZIE (W.), M.D., 
 Surgeon Oculist in Scotland in ordinary to Her Majesty, &C.&C. 
 
 A PRACTICAL TREATISE ON DISEASES AND INJURIES OF THE 
 
 EYE. To which is prefixed an Anatomical Introduction explanatory of a Horizontal Section of 
 the Human Eyeball, by Thomas Wharton Jones, F. R. S. From the Fourth Revised and En- 
 larged London Edition. With Notes and Additions by Addinell Hewson, M.D., Surgeon to 
 Wills Hospital, &c. ccc. In one very large and handsome octavo volume, with plates and numerous 
 wood-cuts. (Now Ready.) 
 
 The treatise of Dr. Mackenzie indisputably holds 1 accordance with the advances in the science which 
 the first place, and forms, in respect of learning and have been made of late years. Nothing worthy of 
 
 repetition upon any branch of the subject appears to 
 have escaped the author's notice. We consider it 
 the duty of every one who has the love of his profes- 
 sion and the welfare of his patient at heart, to make 
 himself familiar with this the most complete work 
 in the English language upon the diseases of the eye. 
 — Med. Times and Gazette. 
 
 The fourth edition of this standard work will no 
 doubt be as fully appreciated as the three former edi- 
 tions. It is unnecessary to say aword in its praise, 
 for the verdict has already been passed upon it by 
 the most competent judges, and " Mackenzie on the 
 Eye" has justly obtained a reputation which it is 
 no figure of speech to call world-wide. — British and 
 Foreign Medico-C 'hirurgical Review. 
 
 This new edition of Dr. Mackenzie's celebrated 
 treatise on diseases of the eye, is truly a miracle of 
 industry and learning. We need scarcely say that 
 he has entirely exhausted the subject of his specialty. 
 — Dublin Quarterly Journal. 
 
 research, an Encyclopaedia unequalled in extent by 
 any other work of the kind, either English or foreign. 
 — Dixon on Diseases of the Eye. 
 
 Few modern books on any department of medicine 
 or surgery have met with such extended circulation, 
 or have procured for their authors a like amount of 
 European celebrity. The immense research which 
 it displayed, the thorough acquaintance with the 
 subject, practically as well as theoretically . and the 
 able manner in which the author's stores of learning 
 and experience were rendered available for general 
 use, at once procured for the first edition, as well on 
 the continent as in this country, that high position 
 as a standard work which each successive edition 
 has more firmly established, in spite of the attrac- 
 tions of several rivals of no mean ability. This, the 
 fourth edition, has been in a great measure re-writ- 
 ten ; new matter, to the extent of one hundred and 
 fifty pages, has been added, and in several instances 
 formerly expressed opinions have been modified in
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 21 
 
 MEIGS (CHARLES D.), M. D., 
 
 Professor of Obstetrics, &c. in the Jefferson Medical College, Philadelphia. 
 
 ON THE NATURE, SIGNS, AND TREATMENT OF CHILDBED 
 
 FEVER. In a Series of Letters addressed to the Students of his Class. In one handsome 
 
 octavo volume, of three hundred and sixty-five pages. (Now Ready.) 
 
 The instructive and interesting author of this | This book will add move to his fame than either 
 
 of those which bear his name. Indeed we doubt 
 whether any material improvement will be made on 
 the teachings of this volume for a century to come, 
 since it is so eminently practical, and based on pro- 
 found knowledge of the science and consummate 
 skill in the art of healing, and ratified by an ample 
 and extensive experience, such as few men have the 
 industry or good fortune to acquire. — N. Y. Med. 
 Gazette. 
 
 work, whose previous labors in the department of 
 medicine which he so sedulously cultivates, have 
 placed his countrymen under deep and abiding obli- 
 gations, again challenges their admiration in the 
 fresh and vigorous, attractive and racy pages before 
 us. It is a delectable book. * # # This treatise 
 upon child-bed fevers will have an extensive sale, 
 being destined, as it deserves, to find a place in the 
 library of every practitioner who scorns to lag in the 
 rear of his brethren. — Nashville Journal of Medi- 
 cine and Surgery. 
 
 BY THE SAME AUTHOR. 
 
 WOMAN : HER DISEASES AND THEIR REMEDIES. A Series of Lec- 
 tures to his Class. Third and Improved edition. In one large and beautifully printed octavo 
 volume. (Just Issued.) pp. 672. 
 
 The gratifying appreciation of his labors, as evinced by the exhaustion of two large impressions 
 of this work within a tew years, has not been lost upon the author, who has endeavored in every 
 way lo render it worthy of the favor with which it has been received. The opportunity thus 
 afforded for a second revision has been improved, and the work is now presented as in every way 
 superior to its predecessors, additions and alterations having been made whenever the advance of 
 science has rendered them desirable. The typographical execution of the work will also be found 
 to have undergone a similar improvement and the work is now confidently presented as in every 
 way worthy the position it has acquired as the standard American text-book on the Diseases of 
 Females. 
 
 It contains a vast amount of practical knowledge, 
 by one who has accurately observed and retained 
 the experience of many years, and who tells the re- 
 sult in a free, familiar, and pleasant manner. — Dub- 
 lin Quarterly Journal. 
 
 There is an off-hand fervor, a glow, and a warm- 
 heartedness infecting the effort of Dr. Meigs, which 
 is entirely captivating, and which absolutely hur- 
 ries the reader through from beginning to end. Be- 
 sides, the book teems with solid instruction, and 
 it shows the very highest evidence of ability, viz., 
 the clearness with which the information is pre- 
 sented. We know of no better test of one's under- 
 standing a subject than the evidence of the power 
 of lucidly explaining it. The most elementary, as 
 well as the obscurest subjects, under the pencil of 
 Prof. Meigs, are isolated and made to stand out in 
 
 such bold relief, as to produce distinct impressions 
 upon the mind and memory of the reader. — The 
 Charleston Med. Journal. 
 
 Professor Meigs has enlarged and amended this 
 great work, for such it unquestionably is, having 
 passed the ordeal of criticism at home and abroad, 
 but been improved thereby j for in this new edition 
 the author has introduced real improvements, and 
 increased the value and utility of the book im- 
 measurably. It presents so many novel, bright, 
 and sparkling thoughts; such an exuberance of new 
 ideas on almost every page, that we confess our- 
 selves to have become enamored with the book 
 and its author ; and cannot withhold our congratu- 
 lations from our Philadelphia confreres, that such a 
 teacher is in their service. — N. Y. Med. Gazette. 
 
 BY THE SAME AUTHOR. 
 
 OBSTETRICS : THE SCIENCE AND THE ART. Second edition, revised 
 
 and improved. With one hundred and thirty-one illustrations. In one beautifully printed octavo 
 volume, of seven hundred and fifty-two large pages. (Lately Published.) 
 
 The rapid demand for a second edition of this work is a sufficient evidence that it has supplied 
 a desideratum of the profession, notwithstanding the numerous treatises on the same subject which 
 have appeared within the last few years. Adopting a system of his own, the author has combined 
 the leading principles of his interesting and difficult subject, with a thorough exposition of its rules 
 of practice, presenting the results of long and extensive experience and of familiar acquaintance 
 with all the modern writers on this department of medicine. As an American Treatise on Mid- 
 wifery, which has at once assumed the position of a classic, it possesses peculiar claims to the at- 
 tention and study of the practitioner and student, while the numerous alterations and revisions 
 which it has undergone in the present edition are shown by the great enlargement of the work, 
 which is not only increased as to the size of the page, but also in the number. 
 
 BY the same author. (Lately Published.) 
 
 A TREATISE ON ACUTE AND CHRONIC DISEASES OF THE NECK 
 
 OF THE UTERUS. With numerous plates, drawn and colored from nature in the highest 
 style of art. In one handsome octavo volume, extra cloth. 
 
 The object of the author in this work has been to present in a small compass the practical results 
 of his long experience in this important and distressing class of diseases. The great changes intro- 
 duced into practice, and the accessions to our knowledge on the subject, within the last few years, 
 resulting from the use of the metroscope, brings within the ordinary practice of every physician 
 numerous cases which were formerly regarded as incurable, and renders of great value a work like 
 the present combining practical directions for diagnosis and treatment with an ample series of illus- 
 trations, copied accurately from colored drawings made by the author, alter nature. 
 
 BY THE SAME AUTHOR. 
 
 OBSERVATIONS ON CERTAIN OF THE DISEASES OF YOUNG 
 
 CHILDREN. In one handsome octavo volume, of 214 pages.
 
 £2 
 
 BLANCHARD & LEA'S MEDICAL. 
 
 MACLISE (JOSEPH), SURGEON. 
 SURGICAL ANATOMY. Forming one volume, very large imperial quarto. 
 
 With sixty-eight large and splendid Plates, drawn in the best style and beautifully colored. Con- 
 taining- one hundred and ninety Figures, many of them the size of life. Together with copious 
 and explanatory letter-press. Strongly and handsomely bound in extra cloth, being one of the 
 cheapest and best executed Surgical works as yet issued in this country. 
 
 Copies can be sent by mail, in five parts, done up in stout covers. 
 
 This great work being now concluded, the publishers confidently present it to the attention of the 
 profession as worthy in every respect of their approbation and patronage. No complete work ot 
 the kind has yet been published in the Engli>h language, and it therefore will supply a want long 
 felt in this country of an accurate and comprehensive Atlas of Surgical Anatomy to which the 
 student and practitioner can at all times refer, to ascertain the exact relative position ol the various 
 portions of the human frame towards each other and to the surface, as well as their abnormal de- 
 viations. The importance of such a work to the student in the absence of anatomical material, and 
 to the practitioner when about attempting an operation, is evident, while the price of the book, not- 
 withstanding the large size, beauty, and finish of the very numerous illustrations, is so low as to 
 place it within the reach of every member of the profession. The publishers therefore confidently 
 anticipate a very extended circulation for this magnificent work. 
 
 One of the greatest artistic triumphs of the age 
 in Surgical Anatomy. — British American Medical 
 Journal. 
 
 Too mueh cannot be said in its praise; indeed, 
 we have not language to do it justice. — Ohio Medi- 
 cal and Surgical Journal. 
 
 The most admirable surgical atlas we have seen. 
 To the practitioner deprived of demonstrative dis- 
 sections upon the human subject, it is an invaluable 
 companion. — N. J. Medical Reporter. 
 
 The most accurately engraved and beautifully 
 colored plates we have ever seen in an American 
 book — one of the best and cheapest surgical works 
 ever published. — Buffalo Medical Journal. 
 
 It is very rare that so elegantly printed, so well 
 illustrated, and so useful a work, is offered at so 
 moderate a price. — Charleston Medical Journal. 
 
 Its plates can boast a superiority which places 
 them almost beyond the reach of competition. — Midi- 
 cat Examiner. 
 
 Every practitioner, we think, should have a work 
 of this kind within reach. — Southern Medical and 
 Surgical Journal. 
 
 No such lithographic illustrations of surgical re- 
 gions have hitherto, we think, been given. — Boston 
 Medical and Surgical Journal. 
 
 As a surgical anatomist, Mr. Maclise has proba- 
 bly no superior. — British and Foreign Medico-Chi- 
 rurgical Review. 
 
 Of great value to the student engaged in dissect- 
 ing, and to the surgeon at a distance from the means 
 
 of keeping up his anatomical knowledge. — Medical 
 Times. 
 
 The mechanical execution cannot be excelled. — 
 Transylvania Medical Journal. 
 
 A work which has no parallel in point of accu- 
 racy and cheapness in the English language. — iV. Y. 
 Journal of Medicine. 
 
 To all engaged in the study or practice of their 
 profession, such a work is almost indispensable. — 
 Dublin Quarterly Medical Journal. 
 
 No practitioner whose means will admit should 
 fail to possess it. — hanking's Abstract. 
 
 Country practitioners will find these plates of im- 
 mense value. — N. Y. Medical Gazette. 
 
 We are extremely gratified to announce to the 
 profession the completion of tins truly magnificent 
 work, which, as a whole, certainly stands unri- 
 valled, both for accuracy of drawing, beauty of 
 coloring, and all the requisite explanations of the 
 subject in hand. — The New Orleans Medical and 
 Surgical Journal. 
 
 This is by far the ablest work on Surgical Ana- 
 tomy that has come under our observation. We 
 know of no other work that would justify a stu- 
 dent, in any degree, for neglect of actual dissec- 
 tion. In those sudden emergencies that so often 
 arise, and which require the instantaneous command 
 of minute anatomical knowledge, a work of this kind 
 keeps the details of the dissecting-room perpetually 
 fresh in the memory — The Western Journal of Medi- 
 cine and Surgery. 
 
 fi^ST 1 The very low price at which this work is furnished, and the beauty of its execution, 
 require an extended sale to compensate the publishers tor the heavy expenses incurred. 
 
 MULLER (PROFESSOR J.), M.D. 
 PRINCIPLES OF PHYSICS AND METEOROLOGY. Edited, with Addi- 
 
 tions, by 11. Eglesfeld Griffith, M. D. In one large and handsome octavo volume, extra 
 cloth, with 550 wood-cuts, and two colored plates, pp. 636. 
 
 The Physics of MQller is a work superb, complete, | tion to the scientific records of this country may be 
 unique : tiie greatest want known to English Science | duly estimated by the fact that, the cost of the origi- 
 coufd not have been better supplied. The work is I nal drawings and engravings alone liaE exceeded the 
 of surpassing interest. The value of this contribu- | sum of £2,000. — Lancet. 
 
 MAYNE (JOHN), M . D., M . R. C. S. 
 A DISPENSATORY AND THERAPEUTICAL REMEMBRANCER. Cora- 
 
 prising the entire lists of Materia Medica, with every Practical Formula contained in the three 
 British Pharmacopoeias. With relative Tables subjoined, illustrating, by upwards of six hundred 
 and sixty examples, the Extemporaneous Forms and Combinations suitable for the different 
 Medicines. Edited, with the addition of the Formulae of the United States Pharmacopoeia, by 
 R. Eglesfeld Griffith, M. D. In one 12mo. volume, extra cloth, of over 300 large pages. 
 
 MATTEUCCI (CARLO). 
 LECTURES ON THE PHYSICAL PHENOMENA OF LIVING BEINGS. 
 
 Edited by J. Pereira, M. D. In one neat royal 12mo. volume, extra cloth, with cuts, 388 pages.
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 23 
 
 MILLER (JAMES), F. R. S. E., 
 
 Professor of Surgery in the University of Edinburgh, &c. 
 
 PRINCIPLES OF SURGERY. A new American, from the third and revised 
 
 Edinburgh edition. In one large and very beautiful volume, of about seven hundred pages, with 
 two hundred and forty exquisite illustrations on wood. 'Novj Ready.) 
 
 This edition is far superior, both in the abundance 
 and quality of its material, to any of the preceding. 
 We hope it will be extensively read, and the sound 
 principles which are herein taught treasured up for 
 future application. The work takes rank with 
 Watson's Practice of Physic; it certainly does not 
 fall behind that great work in soundness of princi- 
 ple or depth of reasoning and research. No physi- 
 cian who values his reputation,^or seeks the interests 
 of his clients, can acquit himself before his God and 
 the world without making himself familiar with the 
 sound and philosophical views developed in the fore- 
 going book. — New Orleans Med. and Surg. Journal. 
 
 Without doubt the ablest exposition of the prin- 
 ciples of that branch of the healing art in any lan- 
 
 guage. This opinion, deliberately formed after a 
 careful study of the first edition, we have had no 
 cause to change on examining the second. This 
 edition has undergone thorough revision by the au- 
 thor ; many expressions have been modified, and a 
 mass of new matter introduced. The hook is got up 
 in the finest style, and is an evidence of the progress 
 of typography in our country. — Charleston Medical 
 Journal and Review. 
 
 We recommend it to both student and practitioner, 
 feeling assured that as it now comes to us, it pre- 
 sents the most satisfactory exposition of the modern 
 doctrines of the principles of surgery to be found in 
 any volume in any language. — N.' Y. Journal of 
 Medicine. 
 
 BY the same author. (Lately Published.) 
 
 THE PRACTICE OF SURGERY. Third American from the second Edin- 
 burgh edition. Edited, with Additions, by F. W. Sargent, M. D , one of the Surgeons to Will's 
 Hospital, cV*c Illustrated by- three hundred and nineteen engravings on wood. In one large 
 octavo volume, of over seven hundred pages. 
 
 No encomium of ours could add to the popularity 
 of Miller's Surgery. Its reputation in this country 
 is unsurpassed by that of any other work, and, when 
 taken in connection with the author's Principles of 
 Surgery, constitutes a whole, without reference to 
 which no conscientious surgeon would be willing 
 to practice his art The additions, by Dr. Sargent, 
 have materially enhanced the value of the work. — 
 Southern Medical and Surgical Journal. 
 
 It is seldom that two volumes have ever made so 
 profound an impression in so short a time as the 
 " Principles" and the " Practice" of Surgery by 
 Mr. Miller — or so richly merited the reputation they 
 have acquired. The author is an eminently sensi- 
 ble, practical, and well-informed man, who knows 
 exactly what he is talking about and exactly how to 
 talk it. — Kentucky Medical Recorder. 
 
 The two volumes together form a complete expose 
 of the present state of Surgery, and they ought to be 
 on the shelves of every surgeon. — N. J. Med. Re- 
 porter. 
 
 By the almost unanimous voice of the profession, 
 his works, both on the principles and practice of 
 surgery have been assigned the highest rank. If we 
 were limited to but one work on surgery, that one 
 should be Miller's, as we regard it as superior to all 
 others. — St. Louis Med. and Surg. Journal. 
 
 The author distinguished alike as a practitioner 
 and writer, has in this and his il Principles," pre- 
 sented to the profession one of the most completeand 
 reliable systems of Surgery extant. His style of 
 writing is original, impressive, and engaging, ener- 
 getic, concise, and lucid. Few have the faculty of 
 condensing so much in small space, and at the same 
 time so persistently holding the attention; indeed, 
 he appears to make the very process of condensation 
 a means of eliminating attractions. Whether as a 
 text-book for students or a book of reference for 
 practitioners, it cannot be too strongly recommend- 
 ed. — Southern Journal of the Medical and Physical 
 Sciences. 
 
 MALGAIGNE (J. F.). 
 OPERATIVE SURGERY, based on Normal and Pathological Anatomy. Trans- 
 
 lated from the French, by Frederick Brittan, A. B., M. D. With numerous illustrations on 
 wood. In one handsome octavo volume, of nearly six hundred pages. 
 
 MOHR (FRANCIS) PH.D., AND RED WOO D (TH EOPH I LUS). 
 PRACTICAL PHARMACY. Comprising the Arrangements, Apparatus, and 
 Manipulations of the Pharmaceutical Shop and Laboratory. Exiled, with extensive Additions, 
 by Prof. William Procter, of the Philadelphia College of Pharmacy. In one handsomely 
 printed octavo volume, of 570 pages, with over 500 engravings on wood. 
 
 NEILL (JOHN), M. D., 
 
 Professor of Surgery in the Pennsylvania Medical College, &c. 
 
 OUTLINES OF THE ARTERIES. With short Descriptions. Designed for 
 
 the Use of Medical Students. With handsome colored plates. Second and improved edition. 
 In one octavo volume, extra cloth. 
 
 OUTLINES OF THE NERVES. With short Descriptions. Designed for the 
 
 Use of Medical Students. With handsome plates. Second and improved edition. In one octavo 
 volume, extra cloth. 
 
 OUTLINES OF THE VEINS AND LYMPHATICS. With short Descrip- 
 tions. Designed for the Use of Medical Students. With handsome colored plates. In one octavo 
 volume, extra cloth. 
 
 ALSO — The three works done up in one handsome volume, half bound, with numerous plates, pre- 
 senting a complete view of the Circulatory, Nervous, and Lymphatic Systems. 
 
 This book should be in the hand of every medical 
 Btudent. It is cheap, portable, and precisely the 
 thing needed in studying an important, though diffi- 
 cult part of Anatomy. — Boston Med. and Surg. 
 Journal. 
 
 We recommend every student of medicine to pur- 
 chase a copy of this work, as a labor-saving ma- 
 chine, admirably adapted to refresh the memory, 
 with knowledge gained by lectures, dissections, 
 
 and the reading of larger works. — N. Y. Journal of 
 Medicine. 
 
 This work is from the pen of a Philadelphia ana- 
 tomist, whose familiar knowledge of the subject has 
 been aided by the press, the result of which is a vo- 
 lume of great beauty and excellence. Its fine exe- 
 cution commends it to the siudent of Anatomy. It 
 requires no other recommendations. — Western Jvurn. 
 of Medicine and Surgery.
 
 24 BLANCHARD & LEA'S MEDICAL 
 
 NEILL (JOHN), M. D., 
 
 Surgeon to the Pennsylvania Hospital , &c .; and 
 FRANCIS GURNEY SMITH, M. D., 
 
 Professor of Institutes of Medicine in the Pennsylvania Medical College. 
 
 AN ANALYTICAL COMPENDIUM OF THE VARIOUS BRANCHES 
 
 OF MEDICAL SCIENCE ; for the Use and Examination of Students. A new edition, revised 
 and improved. In one very large and handsomely printed royal 12mo. volume, of about one 
 thousand pages, with three hundred and seventy-four illustrations on wood. Strongly bound in 
 leather, with raised bands. [Now Ready.) 
 
 The speedy sale of a large impression of this work has afforded to the authors gratifying evidence 
 of the correctness of the views which actuated Ihem in its preparation. In meeting the demand 
 for a second edition, they have therefore been desirous to render it more worthy of the favor with 
 which it has been received. To accomplish this, they have spared neither time nor labor in embo- 
 dying in it such discoveries and improvements as have been made since its first appearance, and 
 such alterations as have been suggested by its practical use in the class and examination-room. 
 Considerable modifications have thus been introduced throughout all the departments treated of in 
 the volume, but more especially in the portion devoted to the "Practice of Medicine," which has 
 been entirely rearranged and rewritten. 
 
 Notwithstanding the enlarged size and improved execution of this work, the price has not been 
 increased, and it is confidently presented as one of the cheapest volumes now before the profession. 
 
 Having made free use of this volume in our ex- 
 aminations of pupils, we can speak from experi- 
 ence in recommending it as an admirable compend 
 for students, and as especially useful to preceptors 
 who examine their pupils. It will save the teacher 
 much labor by enabling him readily to recall all of 
 the points upon which his pupils should be ex- 
 amined. A work of this sort should be in the hands 
 of every one who takes pupils into his office with a 
 view of examining them; and this is unquestionably 
 the bestof its class. Let every practitioner who has 
 pupils provide himself with it, and he will find the 
 labor of refreshing his knowledge so much facilitated 
 that he will be able to do justice to his pupils at very 
 little cost of time or trouble to himself. — Transyl- 
 vania Med. Journal. 
 
 In the rapid course of lectures, where work for 
 the students is heavy, and review necessary for an 
 examination, a compend is not only valuable, but 
 it is almost a sine qua non. The one before us is, 
 in most of the divisions, the most unexceptionable 
 of all books of the kind that we know of. The 
 newest and soundest doctrines and the latest im- 
 provements and discoveries are explicitly, though 
 concisely, laid before the student. Of course it is 
 useless for us to recommend it to all last course 
 students, but there is a class to whom we very 
 sincerely commend this cheap book as worth its 
 weight in silver — that class is the graduates in 
 medicine of more than ten years' standing, who 
 have not studied medicine since. They will perhaps 
 find out from it that the science is not exactly now 
 what it was when they left it off. — The Stethoscope 
 
 NELIGAN (J. MOORE), M. D., M. R. I. A., &c. 
 A PRACTICAL TREATISE ON DISEASES OF THE SKIN. In one 
 
 neat royal 12mo. volume, of 334 pages. 
 
 BY THE SAME AUTHOR. (JllSt Ready.) 
 
 ATLAS OF CUTANEOUS DISEASES. In one beautiful quarto volume, with 
 
 splendid Colored plates, presenting nearly one hundred elaborate representations of disease. 
 
 This beautiful volume is intended to accompany the author's " Treatise on Diseases of the Skin," 
 so favorably received by the profession some vears since. In the description of the plates, reference 
 is made to the chapter and page of the " Treatise," so that together the two constitute, at a much 
 smaller cost than has been hitherto attempted, a complete work of reference for the Diagnosis and 
 Treatment of this difficult class of diseases, which, more than any other, perhaps, require this mode 
 of pictorial elucidation. 
 
 Dr. Neligan deserves our best thanks for this i ence to the chapter of that work where the disease 
 attempt to supply a want which has been long felt, j receives special mention. Great care has evidently 
 For a small sum he here presents us with an Atlas , been taken to procure proper subjects for the artist 
 containing some ninety plates of the more com- and the daguerreotype, which has been employed in 
 mon and rarer forms of affections of the skin, and ; several of the plates, " to secure correctness in the 
 for the benefit of those who possess his useful I design." — Edinburgh Medical Journal, September, 
 Manual, he supplies with each illustration a refer- | 1855. 
 
 OWEN (PROF. R.), 
 
 Author of" Lectures on Comparative Anatomy," " Archetype of the Skeleton," &c. 
 
 ON THE DIFFERENT FORMS OF THE SKELETON, AND OF THE 
 
 TEETH. One vol. royal 12mo., with numerous illustrations. (Just Issued.) 
 
 PANCOAST (J.), M. D., 
 Professor of Anatomy in the Jefferson Medical College, Philadelphia, ice. 
 
 OPERATIVE SURGERY; or, A Description and Demonstration of the various 
 
 Processes of the Art ; including all the New Operations, and exhibiting the State of Surgical 
 Science in its present advanced condition. Complete in one royal 4lo. volume, of 380 pages of 
 letter-press description and eighty large 4to. plates, comprising 486 illustrations. Second edition, 
 improved. 
 
 This excellent work is constructed on the model cerned, we are proud as an American to say that, 
 of the French Surgical Works by Velpeau and Mai- of its kixd it has no superior. — N. Y. Journal of 
 gaigne; and, so far as the English language is con- Medicine. 
 
 PARKER (LANGSTON), 
 
 Surgeon to the Queen's Hospital, Birmingham. 
 
 THE MODERN TREATMENT OF SYPHILITIC DISEASES, BOTH PRI- 
 MARY" AND SECONDARY; comprising the Treatment of Constitutional and Confirmed Syphi- 
 lis, by a safe and successful method. With numerous Cases, Formulfe, and Clinical Observa- 
 tions. From the Third and entirely rewritten London edition. In one neat octavo volume,
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 25 
 
 (Noiv Complete.) 
 
 PEREIRA (JONATHAN), M. D., F. R. S., AND L. S. 
 
 THE ELEMENTS OF MATERIA MEDICA AND THERAPEUTICS. 
 
 Third American edition, enlarged and improved by the author; including Notices of most of the 
 Medicinal Substances in use in the civilized world, and forming an Encyclopaedia of Materia 
 Medica. Edited, with Additions, by Joseph Carson, M. D., Professor of Materia Medica and 
 Pharmacy in the University of Pennsylvania. In two very large octavo volumes of 2100 pages, 
 on small type, with over four hundred and fifty illustrations. 
 Volume I. — Lately issued, containing the Inorganic Materia Medica, over 800 pages, with 145 
 
 illustrations. 
 Volume II. — Now ready, embraces the Organic Materia Medica, and forms a very large octavo 
 volume of 1250 pages, with two plates and three hundred handsome wood-cuts. 
 The present edition of this valuable and standard work will enhance in every respect its well- 
 deserved reputation. The care bestowed upon its revision by the author may be estimated by the 
 fact that its size has been increased by about five hundred pages. These additions have extended 
 to every portion of the work, and embrace not only the materials afforded by the recent editions of 
 the pharmacopoeias, but also all the important information accessible to the care and industry of 
 the author in treatises, essays, memoirs, monographs, and from correspondents in various parts of 
 the globe. In this manner the work comprises the most recent and reliable information respecting 
 all the articles of the Materia Medica, their natural and commercial history, chemical and thera- 
 peutical properties, preparation, uses, doses, and modes of administration, brought up to the present 
 lime, with a completeness not to be met with elsewhere. A considerable portion of the work 
 which preceded the remainder in London, has also enjoyed the advantage of a further revision by 
 the author expressly for this country, and in addition to this the editor, Professor Carson, has made 
 whatever additions appeared desirable to adapt it thoroughly to the U. S. Pharmacopoeia, and to 
 the wants of the American profession. An equal improvement will likewise be observable in every 
 department of its mechanical execution. It is printed from new type, on good white paper, with a 
 greatly extended and improved series of illustrations. 
 
 Gentlemen who have the first volume are recommended to complete their copies without delay. 
 The first volume will no longer be sold separate. 
 
 When we remember that Philology, Natural His- [ Medica, although completed under the supervision of 
 tory, Botany, Chemistry, Physics, anil the Micro- I others, is by far the most elaborate treatise in the 
 scope, are all brought forward to elucidate the sub- | English language, and will, while medical literature 
 ject, one cannot fail to see that the reader has here , is cherished, continue a monument alike honorable 
 a work worthy of the name of an encyclopedia of j to his genius, as to his learning and industry. — 
 
 Materia Medica. Our own opinion of its merits is 
 that of its editors, and also that of the whole profes- 
 sion, both of this and foreign countries— namely, 
 '• that in copiousness of details, in extent, variety, 
 and accuracy of information, and in lucid explana- 
 tion of difficult and recondite subjects, it surpasses 
 all other works on Materia Medica hitherto pub- 
 lished." We cannot close this notice without allud- 
 ing to the special additions of the American editor, 
 which pertain to the prominent vegetable produc- 
 tions of this country, and to the directions of the 
 United States Pharmacopoeia, in connection with all 
 the articles contained in the volume which are re- 
 ferred toby it. The illustrations have been increased, 
 and this edition by Dr. Carson cannot well be re- 
 garded in any other light than that of a treasure 
 which should be found in the library of every physi- 
 cian. — New York Journal of Medical and Collateral 
 Science, March, 1854. 
 
 The third edition of his "Elements of Materia 
 
 American Journal of Pharmacy, March, 1854. 
 
 The work, in its present shape, and so far as can 
 be judged from the portion before the public, forms 
 the most comprehensive and complete treatise on 
 materia medica extant in the English language. — 
 Dr. Pereira has been at great pains to introduce 
 into his work, not only all the information on the 
 natural, chemical, and commercial history of medi- 
 cines, which might be serviceable to the physician 
 and surgeon, but whatever might enable his read- 
 ers to understand thoroughly the mode of prepar- 
 ing and manufacturing various articles employed 
 either for preparing medicines, or for certain pur- 
 poses in the arts connected with materia medica 
 and the practice of medicine. The accounts of the 
 physiological and therapeutic effects of remedies are 
 given with great clearness and accuracy, and in a 
 manner calculated to interest as well as instruct 
 the reader. — The Edinburgh Medical and Surgical 
 Journal. 
 
 PEASLEE (E. R.), M. D., 
 
 Professor of Anatomy and Physiology in Dartmouth College, &c. 
 
 HUMAN HISTOLOGY, in its applications to Physiology and General Pathology; 
 
 designed as a Text-Book for Medical Students. With numerous illustrations. In one handsome 
 
 royal 12mo. volume. [Preparing.) 
 
 The subject of this work is one, the growing importance of which, as the basis of Anatomy and 
 Physiology, demands for it a separate volume. The book will therefore supply an acknowledged 
 deficiencyin medical text-books, while the name of the author, and his experience as a teacher for 
 the las.t thirteen years, is a guarantee that it will be thoroughly adapted to the use of the student. 
 
 P1RRIE (WILLIAM), F. R. S. E., 
 
 Professor of Surgery in the University of Aberdeen. 
 
 THE PRINCIPLES AND PRACTICE OF SURGERY. Edited by John 
 
 Neill, M. D., Professor of Surgery in the Penna. Medical College, Surgeon to the Pennsylvania 
 Hospital, &c. In one very handsome octavo volume, of 780 pages, with 316 illustrations. 
 
 We know of no other surgical work of a reason- 
 able size, wherein there is so much theory and prac- 
 tice, or where subjects are more soundly or clearly 
 taught. — The Stethoscope. 
 
 There is scarcely a disease of the bone or soft 
 rmrts, fracture, or dislocation, that is not illustrated 
 by accurate wood-engravings. Then, again, every 
 instrument employed by the surgeon is thus repre- 
 sented. These engravings are not only correct, but 
 really beautiful, showing the astonishing degree of 
 perfection to which the art of wood-engraving has 
 
 arrived. Prof. Pirrie, in the work before us, has 
 elaborately discussed the principles of surgery, and 
 a safe and effectual practice predicated upon them. 
 Perhaps no work upon this subject heretofore issued 
 is so full upon the science of the art of surgery. — 
 Nashville Journal of Medicine and Surgery. 
 
 One of the best treatises on surgery in the English 
 language. — Canada Med. Journal. 
 
 Our impression is, that, as a manual for students, 
 Pirrie's is the best work extant. — Western Med. and 
 Surg. Journal.
 
 26 BLANCHARD & LEA'S MEDICAL 
 
 PARRISH (EDWARD), 
 
 Lecturer on Practical Pharmacy and Materia Medica in the Pennsylvania Academy of Medicine, &c. 
 
 A PRACTICAL INTRODUCTION TO PHARMACY. Designed as a Text- 
 
 Book for the Student, and as a Guide to the Physician and Pharmaceutist. With numerous 
 Formulae and over 200 Illustrations. In one handsome octavo volume. (Now Ready.) 
 The want of an elementary textbook on this subject has long- been felt and acknowledged 
 While vast stores of information on all the collateral brandies of pharmacy are contained in such 
 works as Mohr and Redwood, the U. S. Dispensatory, the Pharmacopoeia, Pereira, and others, 
 there has been no compendious manual presenting wiihin a moderate compass, and in systematic 
 order, the innumerable minor details which make up the everyday business of those who dispense 
 medicines. It has been the object of the author to supply this want, and while to the pharmaceutist 
 such a work is manifestly indispensable, its utility will hardly be less to the country practitioner, 
 residing at a distance from drug stores, and obliged to dispense the remedies which he prescribes. 
 Familiarized with the elements of therapeutics and the essentials of materia medica, by his at- 
 tendance at lectures, he has hitherto been obliged to learn for himself the details of prescribing, 
 compounding, and preparing medicines. The volume commences with a chapter on the "outfit" 
 of the country physician, describing the different articles, their various kinds and comparative ad- 
 vantages; the Pharmacopoeia is described, explained, and commented upon, its contents classified 
 and arranged so as to be easily comprehended and referred to; all the operations of pharmacy are 
 given in minute detail, and under each head the various preparations are specified to which it is 
 applicable, with directions for making them, giving in this manner a comprehensive and practical 
 view of the materia medica, with much valuable information regarding all the more important ar- 
 ticles. All the officinal formulae are thus presented, with directions for their preparation and use, 
 together with many empirical ones of interest, and numerous new ones derived from the praclice 
 of distinguished physicians. Especial attention lias been bestowed on the new remedies, the 
 more important of which are minutely described, particularly those derived from our indigenous 
 plants, which have of late attracted so much attention, and which the author has thoroughly 
 investigated. The chapters on extemporaneous pharmacy contain clear and accurate instructions 
 for writing prescriptions, selecting, combining, dispensing, and compounding medicines, making 
 powders, piils, mixtures, ointments, &c. &c, with formulae; and the work concludes with an ap- 
 pendix of valuable hints and advice to those purchasing articles connected with their profession. 
 Numerous tables interspersed throughout elucidate the various subjects, which are rendered still 
 clearer by a large number of engravings. Care lias been taken in all instances to indicate and 
 describe the simplest apparatus and procedures affording satisfactory results. The long experience 
 of the author, both as a teacher of pharmacy, and as a practical pharmaceutist, is BUfficienl guarantee 
 of his familiarity with the wants and necessities of the student, and of his ability to satisfy them. 
 
 ROKITANSKY (CARD, M.D., 
 Curator of the Imperial Pathological Museum, and Professor at the University of Vienna, Ice. 
 
 A MANUAL OF PATHOLOGICAL ANATOMY. Four volumes octavo, 
 
 bound in two. (Now Ready.) 
 Vol. I. — Manual of General Pathological Anatomy. Translated by W. E. Swaine. 
 Vol. II.— Pathological Anatomy of the Abdominal Viscera. Translated by Edward Sieveking, 
 
 M. D. 
 Vol. III. — Pathological Anatomy of the Bones, Cartilages, Muscles, and Skin, Cellular and Fibrous 
 
 Tissue, Serous and Mucous Membrane, and Nervous System. Translated by C. H. Moore. 
 Vol. IV. — Pathological Anatomy of the Organs of Respiration and Circulation. Translated bv G. 
 
 E. Day. 
 To render this large and important work more easy of reference, and at the same time less cum- 
 brous and costly, the publishers have arranged the four volumes in two, retaining, however, the 
 separate paging, &c. 
 
 The publishers feel much pleasure in presenting to the profession of the United States the great 
 work of Prof. Rokitansky, which is universally referred to as the standard of authority by the pa- 
 thologists of all nations. Under the auspices of the Sydenham Society of London, the combined 
 labor of four translators has at length overcome the almost insuperable difficulties which have so 
 long prevented the appearance of the work in an English dress, while the additions made from 
 various papers and essays of the author present his views on all the topics embraced, in their latest 
 published form. To a work so widely known, eulogy is unnecessary, and the publishers would 
 merely slate that it contains the results of not less than thirty thousand post-morte.m examina- 
 tions made by 1 he author, diligently compared, generalized, and wrought into one complete and 
 harmonious system. 
 
 R1GBY (EDWARD), M.D., 
 Physician to the General Lying-in Hospital, &e. 
 
 A SYSTEM OF MIDWIFERY. With Notes and Additional Illustrations. 
 
 Second American Edition. One volume octavo, 422 pages. 
 
 ROYLE (J. FORBES), M. D. 
 MATERIA MEDICA AND THERAPEUTICS; including the Preparations of 
 
 the Pharmacopoeias of London, Edinburgh, Dublin, and of the United States. With many new 
 medicines. Edited by Joseph Carson, M. D., Professor of Materia Medica and Pharmacy in 
 the University of Pennsylvania. With ninety-eight illustrations. In one large octavo volume, 
 of about seven hundred pages. 
 
 This work is, indeed, a most valuable one, and 
 will fill up an important vacancy that existed be- 
 tween Dr. Pereira's most learned and complete 
 system of Materia Medica, and the class of pro- 
 
 ductions on the other extreme, which are neces- 
 sarily imperfect from their small extent. — British 
 and Foreign Medical Review.
 
 AND SCIENTIFIC PUBLICATIONS. 
 
 27 
 
 RAMSBOTHAM (FRANCIS H.), M.D. 
 THE PRINCIPLES AND PRACTICE OF OBSTETRIC MEDICINE AND 
 
 SURGERY, in reference to the Process of Parturition. A new and enlarged edition, thoroughly 
 revised by the Author. With Additions by W. V. Keating, M. D. In one large and handsome 
 imperial oclavo volume, of 650 pages, with sixty-four beautiful Plates, and numerous Wood-cuts 
 in the text, containing in all nearly two hundred large and beautiful figures. (Now Ready.) 
 In calling the attention of the profession to the new edition of this standard work, the publishers 
 would remark that no efforts have been spared to secure for it a continuance and extension of the 
 remarkable favor with which it has been received. The last London issue, which was considera- 
 bly enlarged, has received a further revision from the author, especially for this country. Its pas- 
 sage through the press here has been supervised by Dr. Keating, who has made numerous addi- 
 tions with a view of presenting more fully whatever was necessary to adapt it thoroughly to 
 American modes of practice. In its mechanical execution, a like superiority over former editions 
 will be found. The plates have all been re-engraved in a new and beautiful style ; many additional 
 illustrations have been introduced, and in every point of typographical finish it will be found one of 
 the handsomest issues of the American press. In its present improved and enlarged form the pub- 
 lishers therefore confidently ask for it a place in every medical library, as a text-book for the student, 
 or a manual for daily reference by the practitioner. 
 
 From Prof. Hodge, of the University of Pa. 
 To the American public, it is most valuable, from its intrinsic undoubted excellence, and as being 
 the best authorized exponent of British Midwifery. Its circulation will, I trust, be extensive throughout 
 our country. 
 
 The publishers have shown their appreciation of ; cine and Surgery to our library, and confidently 
 the merits of this work and secured its success by recommend it to our readers, with the assurance 
 the truly elegant style in which they have brought that it will not disappoint their most sanguine ex- 
 it out, excelling themselves in its production, espe- I pectations. — Western Lancet. 
 cially in its plates. It is dedicated to Prof. Meigs, 
 
 and has the emphatic endorsement of Prof. Hodge, 
 as the best exponent of British Midwifery. Wc 
 know of no text-book which deserves in all respects 
 to be more highly recommended to studeuts, and we 
 could wish to see it in the hands of every practitioner, 
 for they will find it invaluable for reference. — Med. 
 Gazette. 
 
 It is unnecessary to say anything in regard to the 
 utility of this work. It is already appreciated in our 
 country for the value of the matter, the clearness of 
 its style, and the fulness of its illustrations. To the 
 physician's library it is indispensable, while to the 
 student as a text-book, from which to extract the 
 material for laying the foundation of an education on 
 obstetrical science, it has no superior. — Ohio Med. 
 and Surg. Journal. 
 
 We will only add that the student will learn from 
 it all he need to know, and the practitioner will find 
 
 But once in a long time some brilliant genius rears 
 bis head above the horizon of science, and illumi- 
 nates and purifies every department that he investi- 
 gates ; and his works become types, by which innu- . 
 
 merable imitators model their feeble productions, it- as a book of reference, surpassed by none other.— 
 Such a genius we lind in the younger Ramsbotham, Stethoscope. 
 
 and such a type we find in the work now before us. The character and merits of Dr. Ramsbothara's 
 The binding, p;'per, type, the engravings and wood- t work are so well known and thoroughly established, 
 cuts are all so excellent as to make this book one of i that comment is unnecessary and praise superfluous, 
 the finest specimens of the art of printing that have The illustrations, which are numerous and accurate, 
 given such a world-wide reputation to its cnterpri- j are executed in the highest style of art. We cannot 
 sins' and liberal publishers. We welcome Rams- ! too highly recommend the work to our readers. — St. 
 boiham's Principles and Practice of Obstetric Medi- i Louis Med. and Surg. Journal. 
 
 RICORD (P.), M. D., 
 
 Surgeon to the Hopital du Midi, Paris, ice. 
 
 ILLUSTRATIONS OF SYPHILITIC DISEASE. Translated from the French, 
 
 by Thomas F. Betton, M. D. With the addition of a History of Syphilis, and a complete Bib- 
 liography and Formulary of Remedies, collated and arranged, by Paul B. Goddard, M. D. With 
 fifty large quarto plates, comprising one hundred and seventeen beautifully colored illustrations, 
 hi one large and handsome quarto volume. 
 
 by the same author. (Lately Publislted.) 
 
 A TREATISE ON THE VENEREAL DISEASE. By John Hunter, F. R. S. 
 
 With copious Additions, by Ph. Ricord, M. D. Edited, with Notes, by Freeman J. Bumstead, 
 M. D. In one handsome octavo volume, of 520 pages, with plates. 
 
 Kvery one will recognize the attractiveness and 
 value which this work derives from thus presenting 
 the opinions of these two masters side by side. But, 
 K must be admitted, what has made tiie fortune of 
 the book, is i lie fact that it contains the "most com- 
 plete embodiment of the veritable doctrines of the 
 Hopital du Midi," which has ever been made public. 
 The doctrinal ideas of M. Ricord, ideas which, if not 
 universally adopted, are incontestably dominant, have 
 heretofore only been interpreted by more or less skilful 
 secretaries, sometimes accredited and sometimes not. 
 
 In the notes to Hunter, the mister substitutes him- 
 selfforhis interpreters, and gives his original thoughts 
 to the world, in a summary form it is true, but in a 
 lucid and perfectly intelligible manner. In eonclu 
 sion we can say that this is incontestably the best 
 treatise on syphilis with which wc are acquainted, 
 and, as we do not often employ the phrase, we may 
 be excused for expressing the hope that it may find 
 a place in the library of every physician — Virginia 
 Med. and Stcrg. Journal. 
 
 BY THE SAME AUTHOR. 
 
 LETTERS ON SYPHILIS, addressed to the Chief Editor of the Union Medieale. 
 
 With an Introduction, by Amedee Latour. Translated by \V. P. Laltimore, M. D. In one neat 
 octavo volume of 270 pages. 
 
 » BY THE SAME AUTHOR. 
 
 A PRACTICAL TREATISE ON VENEREAL DISEASES. With a Thcra- 
 
 peutical Summary and Special Formulary. Translated by Sidney Doane, M. D. Fourth edition. 
 One volume, octavo, ,110 pages.
 
 28 
 
 BLANCHARD & LEA'S "MEDICAL 
 
 SMITH (HENRY H.), 
 
 Professor of Surgery in the University of I enns t vania, &c. 
 
 MINOR SURGERY; or, Hints on the E very-day Duties of the Surgeon. Illus- 
 trated by two hundred and forty-seven illustrations. Third and enlarged edition. In one hand- 
 some royal 12mo. volume, pp. 456. 
 
 And a capital little book it is. . . Minor Surgery, 
 we repeat, is really Major Surgery, and anything 
 which teaches it is worth having. So we cordially 
 recommend this little book of Dr. Smith's.— Med.- 
 Chir. Review, 
 
 A work such as the present is therefore highly 
 useful to the student, and we commend this one 
 to their attention. — American Journal of Medical 
 Sciences. 
 
 No operator, however eminent, need hesitate to 
 consult this unpretending yet excellent book. Those 
 who are young in the business would find Dr. Smith's 
 treatise a necessary companion, after once under- 
 standing its true character. — Boston Me J. and Surg. 
 Journal. 
 
 This beautiful little work has been compiled with 
 a view to the wants of the profession in the matter 
 of bandaging, &c.,and well and ably has the author 
 performed his labors. Well adapted to give the 
 requisite information on the subjects of which it 
 treats. — Medical Examiner. 
 
 The directions are plain, and illustrated through- 
 out with clear engravings. — London Lancet. 
 
 One of the best works they can consult on the 
 subject of which it treats. — Southern Journal of 
 Medicine and Pharmacy. 
 
 BY THE SAME AUTHOR, AND 
 
 HORNER (WILLIAM E.) f M. D., 
 
 Late Professor of Anatomy in the University of Pennsylvania. 
 
 AN ANATOMICAL ATLAS, illustrative of the Structure of the Human Body. 
 
 In one volume, large imperial octavo, with about six hundred and fifty beautiful figures. 
 
 These figures are well selected, and present a late the student upon the completion of this Atlas, 
 
 No young practitioner should be without this little 
 volume; and we venture to assert, that it maybe 
 consulted by the senior members of the profession 
 with more real benefit, than the more voluminous 
 works. — Western Lancet. 
 
 complete and accurate representation of that won- 
 derful fabric, the human body. The plan of this 
 Atlas, which renders it so peculiarly convenient 
 for the student, and its superb artistical execution, 
 have been already pointed out. We must eongrato- 
 
 as it is the most convenient work of the kind that 
 has yet appeared ; and we must add, the very beau- 
 tiful manner in which it is ■' got up - ' is so creditable 
 to the country as to be flattering to our national 
 pride. — American Medical Journal. 
 
 SARGENT iF. W.), M. D. 
 
 ON BANDAGING AND OTHEi; OPERATIONS OF MINOR SURGERY. 
 
 Second edition, enlarged. One handsome royal L2mo. vol., of nearly 400 pages, with 182 wood-cuts. 
 
 {Now Ready.) 
 
 The very best manual of Minor Surgery we have 
 seen; an American volume, with nearly four hundred 
 pages of good practical lessons, illustrated by about 
 one hundred and thirty wood-cuts. In thes^ 
 
 days 
 
 of "trial," when a doctor's reputation hangs upon 
 a clove hitch, or the roll of a bandage, it Would he 
 well, perhaps, to carry such a volume as Air 
 
 We have carefully examined this work, and find it 
 well executed and admirably adapted to the use of 
 the student. Besides the subjects usually embraced 
 in works on Minor Surgery, there is a short chapter 
 on bathing, another on anaesthetic agents, and an 
 appendix of formulae. The author has given an ex- 
 cellent work on this subject, and Ins publishers have 
 
 gent's always in our coat-pocket, or, at all i vents, illustrated and printed it in most beautiful style. — 
 to listen attentively to his instructions at home — The Charleston Medical Journal. 
 Buffalo Med. Journal. 
 
 SKEY (FREDERICK C), F. R. S., &c. 
 OPERATIVE SURGERY. In om very handsome octavo volume of over 650 
 pages, with about one hundred wood-cut> 
 
 SHARPEY (WILLIAM), rV >., JONES QUAIN, M.D., AND 
 RICHARD QUAIN, F. R. S., &c. 
 
 HUMAN ANATOMY. Revised, with Notes and Additions, by Joseph Leidy, 
 
 M. D. Complete in two large octavo volumes, of about thirteen hundred pages. Beautifully 
 illustrated with over five hundred engra\ ings on wood. 
 
 We have no hesitation in recommending this trea- 
 tise on anatomy as the most complete on that sub- 
 ject in the English language ; and the only one, 
 perhaps, in any language, which brings the state 
 of knowledge forward to the most recent disco- 
 veries. — The Edinburgh Med. and Surg. Journal. 
 
 Admirably calculated to fulfil the object for which 
 it is intended. — Provincial Medical Journal. 
 
 It is indeed a work calculated to make an in 
 
 anatomical study, by placing before the student 
 every department of his science, with a view to 
 the relative importance of each ; and so skilfully 
 have the different parts been interwoven, n i no 
 one who makes this work the basis of his studies, 
 will hereafter have any excuse for neglecting ir 
 undervaluing any important particulars coin.'" ed 
 with the structure of the human frame, nd 
 whether the bias of his mind lead him in a ml re 
 especial manner to surgery, physic, or physiology, 
 he will find here a work at once so compreli isive 
 and practical as to defend him from exclusi 
 on the one hand, and pedantry on the 01 
 Journal and Retrospect of the Medical S ' 
 
 The most complete Treatise on Anatomy in the 
 English language. — Edinburgh Medical Journal. 
 
 There is no work in the English language to be 
 preferred to Dr. Quain's Elements of Anatomy. — 
 London Journal of Medicine. 
 
 In one volume, octavo, 
 
 STANLEY (EDWARD). 
 A TREATISE ON DISEASES ( '■■ THE BONES. 
 
 extra cloth, 2S6 pages. 
 
 SOLLY (SAMUEL), F. R. S. 
 THE HUMAN BRAIN; its Structure, Physiology, and Diseases. With a 
 
 Description of the Typical Forms of the I'.iain in the Animal Kingdom. From the Second and 
 much enlarged London edition. In one octavo volume of 500 pages, with 120 wood-cuts.
 
 AND SCIENTIFIC PUBLICATIONS. 29 
 
 STILLE (ALFRED), M. D. 
 
 PRINCIPLES OF GENERAL AND SPECIAL THERAPEUTICS. In 
 
 handsome octavo. (Preparing.) 
 
 SIMON (JOHN), F. R. S. 
 GENERAL PATHOLOGY, as conducive to the Establishment of Rational 
 
 Principles for the Prevention and Cure of Disease. A Course of Lectures delivered at St. 
 Thomas's Hospital during the summer Session of 1850. In one neat octavo volume, of 212 
 pages. 
 
 SMITH (W. TYLER), M.D., 
 
 Physician Accoucheur to St. Mary's Hospital, &c. 
 
 ON PARTURITION, AND THE PRINCIPLES AND PRACTICE OF 
 
 OBSTETRICS. In one large duodecimo volume, of 400 pages. 
 
 by the same author. — (Now Ready.) 
 
 A PRACTICAL TREATISE ON THE PATHOLOGY AND TREATMENT 
 
 OF LETJCORRHOZA. With numerous illustrations. In one very handsome octavo volume ot 
 about 250 pages. 
 
 The investigation of the pathology and treatment 
 of leucorrhcen is a task that may well engage the 
 time and energies of the most philosophical and 
 skilled physician ; and there are few men more capa- 
 ble of conducting and deducing important observa- 
 tions from sucli a study than the author of the pre- 
 sent treatise. l;r. Tyler Smith's previous researches, 
 not less than his devotion to physiology and scientific 
 medicine, point him out as one eminently Calculated 
 to throw light on many subjects, which less able 
 men might fail to elucidate. We consequently take 
 his work in hand with high expectations and we 
 have not been in the least disappointed. The fore- 
 going cursory examination of Dr. Tyler Smith's 
 
 work will be sufficient to prove its value, and we 
 hope more than enough to induce every practitioner 
 to study it for himself. — Tke Lancet. 
 
 The above list contains simply the general head- 
 ings of the different chapters; to have enumerated 
 all the subjects discussed, or to have made further 
 extracts, would have compelled us much to exceed 
 our limits. This, however, we scarcely regret; 
 because we think a perusal of the extracts given 
 will induce the reader to examine the work for him- 
 self; and we would advise all who are anxious for 
 correct ideas respecting these discharges, and their 
 sources, to possess themselves of it. — Dublin Med. 
 Press. 
 
 SIBSON (FRANCIS), M.D., 
 
 Physician to St. Mary's Hospital. 
 
 MEDICAL ANATOMY. Illustrating the Form, Structure, and Position of the 
 
 Internal Organs in Health and Disease. In large imperial quarto, with splendid colored plates. 
 To match "Maclise's Surgical Anatomy." Part I. (Nearly Ready.) 
 
 SCHOEDLER iFRIEDRICH), PH.D., 
 
 Professor of the Natural Sciences at Worms, &c. 
 
 THE BOOK OF NATURE; an Elementary Introduction to the Sciences of 
 
 Physics, Astronomy, Chemistry, Mineralogy, Geology, Botany, Zoology, and Physiology. First 
 American edition, with a Glossary and oilier Additions and Improvements; from the second 
 English edition. Translated from the sixih German edition, by Henry Mkdlock, F. C. S., &c. 
 In one thick volume, small octavo, of about seven hundred pages, with G79 illustrations on wood. 
 Suitable for the higher Schools and private students. (Now Ready.) 
 
 TOMES (JOHN), F. R. S. 
 A MANUAL OF DENTAL PRACTICE. Illustrated by numerous engravings 
 
 on wood. In one handsome volume. (Preparing.) 
 
 . TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION. 
 VOLUME VIII, for 1855, 8vo., extra cloth. (Nearly Ready.) 
 
 A few complete sets can still be had, in eight volumes, price $38. Applications and remittances 
 
 to be made to Caspar Wister, M. D., Tivu-urer, Philadelphia. 
 *#* These volumes are published by and sold for account of the Association. 
 
 TODD (R. B.), M. D., AND BOWMAN (WILLIAM), F. R. S. 
 PHYSIOLOGICAL ANATOMY AND PHYSIOLOGY OF MAN. With 
 
 numerous handsome wood-cuts. Parts I, IJ, and III, in one octavo volume, 552 pages. Part IV 
 
 will complete the work. 
 
 The first portion of Part IV, with numerous original illustrations, was published in the Medical 
 News and Library for 1853, and the completion will be issued immediately on its appearance in 
 London. Those who have subscribed since the appearance of the preceding portion of the work 
 oan have the three parts by mail, on remittance of $2 50 to the publishers. 
 
 TOYNBEE (JOSEPH), F. R. S., 
 
 Aural Surgeon to St. Mary's Hospital, &c. 
 
 A MANUAL OF AURAL SURGE RY; being a complete Treatise on Diseases 
 
 of the Ear. Illustrated with numerous engravings on wood, from original drawings. In one 
 octavo volume. (Preparing.)
 
 30 BLANCHARD & LEA'S MEDICAL 
 
 TANNER (T. H.), M. D. 
 
 Physician to the Hospital for Women, &c. 
 
 A MANUAL OF CLINICAL MEDICINE AND PHYSICAL DIAGNOSIS. 
 
 To which is added The Code of Elhics of the American Medical Association. In one neat 
 
 volume, small 12mo., extra cloth. (Note Ready.) 
 
 The object of this little work is to furnish the practitioner, in a condensed and convenient com- 
 pass, and at a trifling cost, with a guide for the daily exigencies of his practice. A large portion of 
 the volume is occupied with details of diagnostic symptoms, classified under the different seats of 
 disease. This, in itself, is well worth the price of the book, but in addition, there will be found an 
 immense amount of information, not usually touched upon in the systematic works, or scattered 
 throughout many different volumes — such as general rules for conduct, taking notes, clinical exami- 
 nation of children and of the insane, post-mortem examinations, medico-legal examinations, exami- 
 nations for life insurance, instruments employed in diagnosis, such as the microscope, tests, the 
 spirometer, dynamometer, stethometcr, stethoscope, pleximeter, ophthalmoscope, speculum, uterine 
 *ound, &c. ; directions for the chemical and microscopical examination of the blood, urine, sputa, 
 &c. &c. ; with many other subjects of" equal importance which hitherto the young practitioner has 
 had to learn in a great measure from experience alone. Although necessarily treated in a condensed 
 manner, the topics will be found to embrace the latest and most approved modes of procedure, while 
 the addition of the admirable " Code of Ethics" of the American Medical Association renders it 
 complete as a guide for the student and as a manual of daily reference for the younger practitioner. 
 
 Those who desire to u<e it as a vade-mecum for the pocket, can obtain copies neatly done up in 
 flexible cloth. 
 
 TAYLOR (ALFRED S.), M. D., F. R. S., 
 
 Lecturer on Medical Jurisprudence and Chemistry in Guy's Hospital. 
 
 MEDICAL JURISPRUDENCE. Third American, from the fourth and improved 
 
 English Edition. With Notes and References to American Decisions, by Edward Hartshorne, 
 M. D. In one large octavo volume, of about seven hundred pages. (Just fssned.) 
 We know of no work on Medical Jurisprudence none could be offered to the busy practitioner of 
 which contains in the same space anything like the either calling, for the. purpose of casual or hasty 
 same amount of valuable matter — If. Y. Journal of reference, that would be more likely to afford the aid 
 Medicine, desired. We therefore recommend it as the best and 
 
 No work upon the subject can be put into the i s,l / est manual for daily we.— American Journal of 
 hands of students either of law or medicine which Medical Sciences. 
 will engage them more closely or profitably j and j 
 
 BY THE SAME AUTHOR. 
 
 ON POISONS, IN RELATION TO MEDICAL JURISPRUDENCE AND 
 
 MEDICINE. Edited, with Notes and Additions, by R. E. Griffith, M. D. In one large octavo 
 volume, of 6S8 pages. 
 
 The most elaborate work on the subject that our 
 literature possesses. — British and Foreign Mtdiro- 
 Chirur§ical Review. 
 
 One of the most practical and trustworthy works 
 on Poisons in our language. — Western Journal oj 
 Medicine . 
 
 THOMSON (A. T.), M . D., F. R. S., &c. 
 DOMESTIC MANAGEMENT OF THE SICK ROOM, necessary in aid of 
 
 Medical Treatment for the Cure of Diseases. Edited by R. E. Griffith, M. D. In one large 
 royal 12mo. volume, with wood-cuts, 360 pages 
 
 WATSON (THOMAS), M.D., &c. 
 LECTURES ON THE PRINCIPLES AND PRACTICE OP PHYSIC. 
 
 Third American, from the last London edition. Revised, with Additions, by D. Francis Condie, 
 
 M. D . author of a "Treatise on the Diseases of Children," &c. In one octavo volume, of nearly 
 
 eleven hundred large pages, strongly bound with raised bands* 
 
 To say that it is the very best work on the sub- I Confessedly one of the very best works on the 
 ject now extant, is but to echo the sentiment of the ; principles and practice of physic in the English or 
 medical press throughout the country. — N. O. any other language. — Med. Examiner. 
 Medical Journal. Asa text-book it hasnoequal; as a compendium 
 
 Of the text-books recently republished Watson is [ <* pathology and practice no superior.— New York 
 very justly the principal favorite. — Holmes's Rep. Annalist 
 
 to Nat. Med. Assoc. 
 
 By universal consent the work ranks among the 
 very best text-books in our language. — Illinois and 
 Indiana Med. journal. 
 
 Regarded on all hands as one of the very best, if 
 not the very best, systematic treatise on practical 
 
 medicine extant. — St. Louis Med. Journal. I Journal 
 
 We know of no work better calculated for being 
 placed in the hands of the student, and fur a text- 
 book; on every important point the author seems 
 to have posted up his knowledge to the day. — 
 Amer. Med. Journal. 
 
 One of the most practically useful books that 
 ever was presented to the student. — N. Y. Med. 
 
 WHAT TO OBSERVE 
 AT THE BEDSIDE AND AFTER DEATH, IN MEDICAL CASES. 
 
 Published under the authority of the London Society for Medical Observation. A new American, 
 
 from the second and revised London edition. In one very handsome volume, royal 12mo., extra 
 
 cloth. (Now Ready.) 
 
 The demand which has so rapidly exhausted the first edition of this little work, shows that the 
 advantages it offers to the profession have been duly appreciated, and has stimulated the authors to 
 render it more worthy of its reputation. It has therefore been thoroughly revised, and such im- 
 provements (among which is a section on Treatment) have been made as further experience in 
 its use has shown to be desirable. 
 
 To the observer who prefers accuracy to blunders I One of the finest aids to a young practitioner we 
 and precision to carelessness, this little book is in- have ever seen. — Peninsular Journal of Medicine .
 
 AND SCIENTIFIC PUBLICATIONS. 31 
 
 WILSON (ERASMUS), M.D., F. R. S., 
 
 Lecturer on Anatomy, London. 
 
 A SYSTEM OP HUMAN ANATOMY, General and Special. Fourth Ameri- 
 can, from the last English edition. Edited by Paul B. Goddard, A. M., M. D. With two hun- 
 dred and fifty illustrations. Beautifully printed, in one large octavo volume, of nearly six hun- 
 dred pages. 
 
 In many, if not all the Colleges of the Union, it 
 has become a standard text-book. This, of itself, 
 is sufficiently expressive of its value. A work very 
 desirable to the student; one, the possession of 
 which will greatly facilitate his progress in the 
 study of Practical Anatomy. — New York Journal of 
 Medicine. 
 
 Its author ranks with the highest on Anatomy. — 
 Southern Medical and Surgical Journal. 
 
 It offers to the student all the assistance that can 
 be expected from such a work. — Medical Examiner. 
 
 The most complete and convenient manual for the 
 student we possess. — American Journal of Medical 
 Science. 
 
 In every respect, this work as an anatomical 
 guide for the student and practitioner, merits our 
 warmest and most decided praise. — London Medical 
 I Gazette. 
 
 BY THE SAME AUTHOR. 
 
 THE DISSECTOR; or, Practical and Surgical Anatomy. Modified and Re- 
 arranged, by Paul Beck Goddard, M. D. A new edition, with Revisions and Additions. In 
 one large and handsome volume, royal 12mo., of 458 pages, with 115 illustrations. 
 In passing this work again through the press, the editor has made such additions and improve- 
 ments as the advance of anatomical knowledge has rendered necessary to maintain the work in the 
 high reputation which it has acquired in the schools of the United Slates, as a complete and faithful 
 guide to the student of practical anatomy. A number of new illustrations have been added, espe- 
 cially in the portion relating to the complicated anatomy of Hernia. In mechanical execution the 
 work will be found superior to former editions. 
 
 BY THE SAME AUTHOR. 
 
 ON DISEASES OF THE SKIN. Third American, from the third London 
 
 edition. In one neat octavo volume, of about five hundred pages, extra cloih. (Just Issued.) 
 Also, to be had done up with fifteen beautiful steel plates, of which eight are exquisitely colored ; 
 representing the Normal and Pathological Anatomy of the Skin, together with accurately colored 
 delineations of more than sixty varieties of disease, most of them the size of nature. The Plates 
 are also for sale separate, done up in boards. 
 
 The "Diseases of the Skin," by Mr. Krasmns I nothing to be desired, so far as excellence of delinea- 
 Wilson, may now be regarded as the standard work | tion and perfect accuracy of illustration are con- 
 in that department of medical literature. The I cerned. — Medico-Chirurgical Review. 
 plates by which this edition is accompanied leave | 
 
 BY THE SAME AUTHOR. 
 
 ON CONSTITUTIONAL AND HEREDITARY SYPHILIS, AND ON 
 
 SYPHILITIC ERUPTIONS. In one small octavo volume, beautifully printed, with four exqui- 
 site colored plates, presenting more than thirty varieties of syphilitic eruptions. 
 
 BY THE same author. (Now Ready.) 
 
 HEALTHY SKIN; A Popular Treatise on the Skin and Hair, their Preserva- 
 tion and Management. Second American, from the fourth London edition. One neat volume, 
 royal 12mo., of about 300 pages, with numerous illustrations. 
 
 Copies can be had done up in paper covers for mailing, price 75 cents. 
 
 WHITEHEAD (JAMES), F. R. C. S., &.c. 
 THE CAUSES AND TREATMENT OF ABORTION AND STERILITY; 
 
 being the Result of an Extended Practical Inquiry into the Physiological and Morbid Conditions 
 of the Uterus. Second American Edition. In one volume, octavo, 368 pages. (Now Ready.) 
 
 Such are the advances marie from year to year in 
 this department of our profession, that the practi- 
 tioner who does not consult the recent works on the 
 complaints of females, will soon find himself in the 
 rear of Ins more studious brethren. This is oue o( 
 
 the works which must be studied by those who 
 would know what the present state of our knowledge 
 is respecting the causes and treatment, of abortion 
 and sterility. — The Western Journal of Medicine and 
 
 Surgery. 
 
 WALSHE (W. H.), M. D., 
 
 Professor of the Principles and Practice of Medicine in University College, London. 
 
 DISEASES OF THE HEART, LUNGS, AND APPENDAGES; their 
 
 Symptoms and Treatment. In one handsome volume, large royal 12mo., 512 pages. 
 
 We consider this as the ablest work in the En- I the author being the first stethoscopist of the day — 
 glish language, on the subject of which it treats; | Charleston Medical Journal. 
 
 WILDE (W. R.), 
 Surgeon to St. Mark's Ophthalmic and Aural Hospital, Dublin. 
 
 AURAL SURGERY, AND THE NATURE AND TREATMENT OF DIS- 
 EASES OF THE EAR. In one handsome octavo volume of 476 pages, with illustrations. 
 This work certainly contains more information on 
 
 the subject to which it is devoted than any other 
 
 with which we are acquainted. We feel grateful 10 
 
 the author for his manful effort to rescue, this depart 
 
 ment of surgery from the hands of the empirics who 
 
 nearly monopolize it. We think he hag successfully 
 
 shown that aural diseases are not beyond the re 
 
 sources of art; dial they are governed by the same 
 
 laws, and amenable to the same general methods of 
 Heat ment as other morbid proces-rs I'lie work is 
 not written to supply the cravings of popular patro- 
 nage, but ii is wholly addressed to the profession, 
 and bears on every page the impress of die reflections 
 of a sagacious and practical surgeon. — Va. Sui .-. and 
 Med. Journal.
 
 32 BLANCHARD & LEA'S SCIENTIFIC PUBLICAT IONS. 
 
 WEST (CHARLES), M. D., 
 
 Physician to the Hospital for Sick Children, &c. 
 
 LECTURES ON THE DISEASES OF INFANCY AND CHILDHOOD. 
 
 Second American, from the Second and Enlarged London edition. In one volume, octavo, of 
 nearly five hundred pages. (Just Issued.) 
 
 We take leave of Dr. West with great respect for 
 his attainments, a due appreciation of his acute 
 powers of observation, and a deep sense of obliga- 
 tion for this valuable contribution to our profes- 
 sional literature. His book is undoubtedly in many 
 respects the best we possess on diseases of children. 
 The extracts we have given will, we hope, satisfy 
 our readers of its value; and yet in all candor we 
 must say that they are even inferior to some other 
 parts, the length of which prohibited our entering 
 upon them. That the book will shortly be in the 
 hands of most of our readers we do not doubt, and it 
 will give us much pleasure if our strong recommend- 
 ation of it may contribute towards the result. — The 
 Dublin Quarterly Journal of Medical Science. 
 
 Dr. West has placed the profession under deep ob- 
 ligation by this able, thorough, and finished work 
 
 upon a subject which almost daily taxes to the ut- 
 most the skill of the general practitioner. He has 
 with singular felicity threaded his way through all 
 the tortuous labyrinths of the difficult subject he has 
 undertaken to elucidate, and has in many of the 
 darkest corners left a light, for the benefit of suc- 
 ceeding travellers, which will never be extinguished. 
 Not the least captivating feature in this admirable 
 performance is its easy, conversational style, which 
 acquires force from its very simplicity, and leaves 
 an impression upon the memory, of the truths it 
 conveys, as clear and refreshing as its own purity. 
 The author's position secured him extraordinary fa- 
 cilities for the investigation of children's diseases, 
 and his powers of observation and discrimination 
 have enabled him to make the most of these great 
 advantages. — Nashville Medical Journal. 
 
 BY the same author. (Just Issued) 
 
 AN ENQUIRY INTO THE PATHOLOGICAL IMPORTANCE OF ULCER- 
 ATION OF THE OS UTERI. Being the Croonian Lectures for the year 1854. In one neat 
 octavo volume, extra cloth. 
 
 WILLIAMS (C. J. B.), M.D., F. R. S., 
 
 Professor of Clinical Medicine in University College, London, &c. 
 
 PRINCIPLES OF MEDICINE; comprising General Pathology and Therapeu- 
 
 tics, and a brief general view of Etiology, Nosology, Semeiology, Diagnosis, Prognosis, and 
 Hygienics. Edited, with Additions, by Meredith Clymer, M. D. Fourth American, from the 
 last and enlarged London edition. In one octavo volume, of 476 pages. {Lately Issued.) 
 
 It possesses the strongest claims to the attention of the medical student and practitioner, from 
 (he admirable manner in which the various inquiries in the different branches of pathology are 
 investigated, combined, and generalized by an experienced practical physician, and directly applied 
 to the investigation and treatment of disease. — Editor's Preface. 
 
 The best exposition in our language, or, we be- I Few books have proved more useful, or met with 
 lieve, in any language, of rational medicine, in its | a more ready sale than this, and no practitioner 
 present improved and rapidly improving state. — I should regard his library as complete without it. 
 British and Foreign Medico-Chirurg. Review. | — Ohio Med. and Surg. Journal. 
 
 BY THE SAME AUTHOR. 
 
 A PRACTICAL TREATISE ON DISEASES OF THE RESPIRATORY 
 
 ORGANS; including Diseases of the Larynx, Trachea, Lungs, and Pleurae. With numerous 
 Additions and Notes, by M. Clymer, M. D. With wood-cuts. In one octavo volume, pp. 508. 
 
 YOUATT (WILLIAM), V. S. 
 THE HORSE. A new edition, with numerous illustrations; together with a 
 
 general history of the Horse; a Dissertation on the American Trotting Horse ; how Trained and 
 Jockeyed : an Account of his Remarkable Performances ; and an Essay on the Ass and the Mule. 
 By J. S. Skinner, formerly Assistant Postmaster-General, and Editor of the Turf Register. 
 One large •^•»^vo volume. 
 
 BY THE SAME AUTHOR. 
 
 THE DCG. Edited by E. J. Lewis, M. D. With numerous and beautiful 
 
 illustrations. In one very handsome volume, crown Svo., crimson cloth, gilt. 
 
 ILLUSTRATED MEDICAL CATALOGUE. 
 
 BLANCHARD & LEA have now ready a Catalogue of their Medical, Surgical, and Scien- 
 tific Publications, containing descriptions of the works, with Notices of the Press, and 
 specimens of the Illustrations, making a pamphlet of sixty-four large octavo pages. It has 
 been prepared with great care, and without regard to expense, forming one of the most beau- 
 tiful specimens of typographical execution as yet issued in this country. Copies will be 
 sent by mail, and the postage paid, on application to the Publishers, by inclosing two three 
 cent postage stamps. 
 
 Catalogues of Blanchard & Lea's numerous Miscellaneous and Educational Publications 
 will be forwarded free by mail, on application.
 
 X
 
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