to you by my friend, Doctor Drane, which subsequently fell under my care. It was a case novel in its character, and worthy of being reported, and I intended to give it to the profession, and accordingly noted all the symptoms as they occurred at the time, with the minutiæ of medication, the character of the secretions, excretions, etc. But unfortunately my memorandum was destroyed by fire, some years since, and consequently I am unable, at this late period, to present the case to you in detail, as I am obliged to depend altogether upon memory.

This case so far as my reading extends is unique. It occurred about the 20th or 22d of June, 1828, in remarkably hot weather, the mercury ranging from 90° to 100° of Fah. The subject was thirty-two years of age and very corpulent. I saw her about 3 o'clock, P. M. Her breathing was short, difficult, and hurried; her pulse small, quick and thread-like; skin covered with perspiration; she complained of a sense of suffocation, but the hæmorrhage at the time was trifling. I gave her sixty drops of tincture opii which operated like a charm, her breathing becoming comparatively easy in a few minutes, and her pulse more slow, soft, and free from irritation. After she had rested for an hour or two upon the featherbed on which I found her, she was removed to one of straw, placed in a position to admit a free circulation of air.

About two hours after my arrival my patient became troubled with flatus in the stomach, of which she was relieved by a few grains of magnesia, and a little essence of peppermint. She slept some that night and appeared quite comfortable in the morning. The excessive perspiration had entirely subsided, but her skin was neither hot nor dry. I now directed an ounce of sulph. magnes. to be given every three hours until catharsis should be established, and cloths wet in cold water to be applied over the abdomen, so soon as the temperature of that region should rise above the natural standard. I then left her with a promise to return at 4 o'clock, P. M.

The salts I found had produced no effect, nor were there yet developed any symptoms of inflammation-no soreness, no increase of temperature-the patient free from pain and comfortable. She was ordered to continue the sulph. magnes.

It was now twenty-eight hours since the violence had been done, and I expected inflammation to supervene before morning, and in this I was not mistaken. About 12 o'clock I was summoned in

haste; found my patient complaining of great pain and soreness in the abdomen, especially above the arch of the pubis; pulse full, strong and bounding; skin hot and dry. No action had been produced by the medicine upon the bowels. I immediately from a large orifice took thirty-six ounces of blood from the arm. Her pulse sunk, and she grew faint. An enema was administered which produced three or four copious discharges from the bowels, which, with the bleeding, relieved completely both the pain and arterial excitement. I directed the cold applications to be rigidly attended to, and gave the following powder every two hours: tart. antimon. gr., nit. potas. 8 grs., pulv. camph. 2 grs. The patient rested well the remainder of the night, and her pulse was quiet, and her skin cool and moist at 5 o'clock, A. M. At 6 the inflammatory action had returned with all its force, and I again took thirty-six ounces of blood from the arm, with the former decided and happy effects.

4 o'clock, P. M., the powders and cold applications have been continued; patient has taken a few spoonfuls of rice water; bowels have been moved three or four times; she had rested well until 3 o'clock, when slight arterial excitement came on, accompanied by a corresponding increase of pain and soreness in the abdomen, but the abstraction of twelve ounces of blood was sufficient to arrest it, and it returned no more. Morning of the third day.-Patient free from pain, pulse soft, skin moist, kidneys acting freely, tongue clean. She has had three or four copious dejections from the bowels during the night without any diminution of muscular strength. The antimonial to be continued.

The patient enjoyed from this time an uninterrupted convalescence, and although she continued to take the powders every two hours, for ten or twelve days, and had from six to ten discharges from the bowels every twenty-four hours, she experienced neither nausea nor prostration from their action. During this period the only nutriment she was permitted to take, was six or eight tablespoonfuls of rice water in the twenty-four hours. No secondary hæmorrhage occurred. When the sloughing stage came on, which was well marked by strong fœtor, followed by a moderate purulent discharge, an opposite treatment was observed; and under this she rapidly recovered, and has enjoyed good health, so far as I know, ever since. In this case, there was no lochial discharge, nor was lactation established; shewing the controlling influence of the uterus over this important secretion. Another interesting physiologi

cal fact.-Inquiries instituted two years after the recovery of my patient convinced me, that the accident had not entirely deprived her of sexual propensities: yet both the ovaria were removed with the uterus. July, 1840.

C. G. BALLARD.

MEDICINE IN PARIS.-TROUSSEAU ON IRON.

PROFESSOR TROUSSEAU, it appears from the subjoined letter from DR. LINTON, is reviving an old practice with much success in the great emporium of the Medical Sciences. We have had a good deal of experience in the use of iron in dropsy, amenorrhoea, and intermittent fever, and could cite some striking cases of cure confirmatory of the views of the French Professor. Intermittent fever is a common complaint in this city, and it is well known that it is apt to recur in the spring after having attacked an individual the preceding autumn. Such cases are often exceedingly obstinate, chills continuing often to return at longer or shorter intervals until mid-summor. The appearance of the patients is strongly anemic. For three summers past we have been in the habit of prescribing carbonate of iron for such cases, conjoined with an infusion of the bark of the wild cherry tree-of the former, five grains, in a pill, before each meal, and of the latter, as much as the patient is inclined to drink. In some instances, the iron alone has been used with the desired effect, and will generally prove, we think, in these chronic cases of intermittent fever, a much more efficacious remedy than sulphate of quinine. In the complaints of females, iron was in the highest repute with physicians of a former century. Hoffman relates, that he frequently gave it with remarkable success in obstinate chlorotic cases accompanied with excessive headaches and other violent symptoms. He usually joined with it an alkali, and some vegetable bitter or aromatic.

PARIS, May, 1840.

Y.

Dear Sir:-I propose, in the present letter, as I promised in my last, to give you a summary of the lectures of PROF. TROUSSEAU on iron. He remarked that in the blood of women and children this metal exists in a less quantity than in that of man-that it is an

ingredient necessary to the health and plasticity of that fluid-that without it the blood is thin, uncoagulable, and incapable of nourishing the organs, or stimulating them to the performance of their functions; and that, in addition to the fact, that this state of things, anemia, is more common in women and children than in men, the impoverished state of the fluids, in the latter, when it does exist, depends more upon other causes than upon the loss of the ferruginous principle in the blood. Hence iron is peculiarly a medicine for women and children. In chlorosis, the principal element of which is anemia, or the state above alluded to, this medicine is the sheet anchor. The soluble or the insoluble preparations are to be used according to circumstances. If, for example, the patient be subject to uterine and other hemorrhages, which are often consequent upon a thin and dissolved state of the blood, the soluble forms are to be preferred, because of their directly styptic, in addition to their tonic action-otherwise, the insoluble preparations of the medicine will answer better, as the carbonas or limatura ferri. This latter, iron filings, he thinks, will subserve most of the objects of administration of iron. The mode of administration is also a matter of importance. It should be taken with the meals of the patient, or just before them-the best of all modes being to incorporate it with the bread. A sufficient quantity may be thus taken without affecting disagreeably the taste of this article of food. This method is especially adapted to anemic children. The dose should at first be small, especially if the stomach does not seem to tolerate the medicine; but should be gradually increased to 20 or 30 grains, for adults for children proportionably less.

One of the principal faults, Professor T. remarked, in the treatment of anemic affections, consists in leaving off the medication too soon. It should be continued long after the countenance has assumed its wonted color, and the functions their accustomed energy. The disease being chronic demands a chronic course of treatment—a remark applicable to most affections.

The ordinary symptoms of chlorosis, besides the exsanguineous and pale surface, and general debility, are derangements in the menstrual functions-sometimes hemorrhage, sometimes the reverse -a variable appetite, frequently an entire absence of any disposition for food-costive bowels, alternated with diarrhoea-neuralgia, and various other nervous affections.

All these disagreeable symptoms, says the Professor, may be combatted by appropriate means, while the iron is doing the slow but certain work of curing the pathological state in which tho disease more essentially consists. For example, an opiate may be given, or the extract of belladonna may be rubbed on the gums, to quiet the neuralgia, which generally affects the nerves of the face; a little aloes may be combined with the iron to remove constipation; or some astringent, when there is diarrhea, and when there is great want of appetite, the extract of gentian is a valuable adjunct to the metal preparation.

For the preparations of iron to be successful in any disease, it is the opinion of the Professor, that the disease should be dependent on, or closely connected with, anemia. Many physicians, said he, have boasted of the powers of this article in neuralgia, and have published numerous cases in which it has triumphed; but it cures this painful affection only, he maintains, when it is connected with an impoverished state of the blood; you will find, gentlemen, said he, in consulting the statistics of this subject, that most of the cases reported as having been cured by this remedy, have been those of anemic women.

Amenorrhea is a diseased condition which depends upon opposite states of the system, and consequently iron cannot be said to be its specific. It sometimes depends upon a phlogistic and plethoric habit, and in such cases this medicino is by no means to be resorted to. In a word, it is only when connected with anemia, that ame norrhoea calls for this therapeutic agent. The same remark may be made in reference to dysmenorrhea-it is very common in this affection, said the Professor, for the physician to advise marriage. This is bad advice when given to those whose diseased state is associated with anemia. In such cases, the disease should be cured before marriage. When, however, the habit is plethoric, and the organs generally in a comparatively healthy exercise of their functions, marriage will be found advantageous.

There are no better remedies than the preparations of iron in dropsies dependent on an impoverished condition of the circulating fluids. Every one who has had the opportunity of observing knows, that the thin and dissolved state of the blood which obtains in intermittents and other fevers, predisposes to congestions, hemorrhages, and dropsical infiltrations. The timely administration of iron