When upon the subject of treatment, and after urging in strong terms, the impropriety in these cases of occlusion of venesection, and permitting the labor to be protracted to a great length of time, in hopes of discovering an os uteri, or that nature will remedy the evil, the Doctor says: "there are two methods of remedying the closure of this important orifice:

1. By such an amount of pressure by the finger, female catheter, sound or bougie, as shall puncture or open the occlusion: and 2. By incision made by a bistoury or knife."

The first named method may be employed when the occlusion is slight, and depending upon a thin membrane stretched across the os. But the author differs from some writers upon the subject, in thinking that incision is preferable, when this membrane has become completely organized, firm and unyielding. And he also recommends incision when the occlusion is dependent upon adhesion or morbid deposit. He assigns two reasons for this preference. First, that if the finger or bougie, &c., be employed, contusion of the part will necessarily follow, and thus render the patient liable to local or general uterine inflammation. Secondly, he thinks that there is less liability to extensive laceration where a free incision is made, than where a small puncture is made by any of the above mentioned methods. In support of this last position, he cites some cases in which incision was employed, with the effect first named.

Rigidity, which is treated of in the second division of his subject, and which is of much more frequent occurrence than occlusion, may (in that form of it which requires incision) result from a contracted orifice being surrounded by a "structure almost entirely undilatable," or from the cicatrization of abscesses, ulcerations, &c., or from a hard tumor or malignant deposit, which alters the structure of the part.

If the nature of the case be made out in the early stage of labor, it is considered not only prudent but highly important to resort to bloodletting, antimony, opium, &c., with the hope of producing relaxation. But when these means have been resorted to and a sufficient time has been allowed to give nature, with these adjuvants, an opportunity of overcoming the rigidity, and without success, the author says: "The case may then be treated by artificial dilatation or by incision, or it may be left to nature." To adopt the last course, he considers, would be to consign the woman to unlimited laceration or death by inflammation from protracted uterine contraction. To artificial dilatation he is decidedly opposed, for the same reasons which have been assigned against its employment in occlusion. In regard to incision he thinks it should be at once resorted to, when it is perceived that nature is unequal to the task. "If there be distressing and constant pain about the neck or body of the uterus, or in any other part; if the countenance becomes turgid and dark; if perspiration issues at every pore, and the pulse is full, strong, quick and incompressible; and if these symptoms continue, although perhaps somewhat lessened by bleeding and antimony; there can be no doubt that recourse snould be had to the incision." We should not wait until the woman is worn out by fruitless contractions, and is already in a state of collapse, when the operation would of course be unavailing towards saving the life of the patient.

After describing the manner of performing the operation, (which is so simple, and will suggest itself so readily, as to render a description of it unnecessary here) Dr. Ashwell devotes the balance of his paper to detailing some cases in which incision had been employed, in which no unpleasant consequences grew out of its use, and success attended it when early enough resorted to.

Selections from American and Foreign Journals.

A new article of the materia medica, the Monesia, of South American growth, having attracted no inconsiderable share of attention in the French metropolis, has been recently introduced to the profession in this country by Joseph G. Nancrede, M.D., whose opinion of the eclat which it is destined to win, may be inferred from his eagerness to be the first to extend a welcoming hand to the new comer. We introduce the stranger to our readers, by presenting Dr. Nancrede's let

ter.

To the Editors of the Medical Examiner:

GENTLEMEN:-With the intention of extending a knowledge of the properties of monesia, and of thus rendering practically useful, to our community, the very interesting paper of Dr. Martin Saint Ange, a translation of which appeared in the last number of your journal, I beg leave, through the medium of its pages, to acquaint the medical profession, that a portion of monesia, recently received from Paris, has been placed in the hands of Mr. F. Brown, corner of Fifth and Chesnut streets, where it can be obtained by those who may wish to prescribe it.

The preparations which have reached me, and which are to be obtained here, are, 1, the aqueous extract; 2, a syrup containing about six grains of the extract to the ounce; 3, a hydro-alcoholic tincture, containing about thirty-two grains to the ounce; 4, an ointment, containing one-eighth of its weight of extract.

While on this subject, I may be permitted to state, that having had in my possession for about a week, this new substance accompanied by the Gazette Medicale de Paris, of 19th

October, 1839, in which I read Dr. Martin Saint Ange's original paper, and also the Notices sur le Monesia by M. Bernard Derosne, to whom is due the credit of having introduced the new article to the notice of the profession, and who, in conjunction with M. O'Henry, has made of it a chemical analysis, I naturally felt desirous of being the first on this side of the Atlantic to test the properties of so interesting a remedy.

Accordingly I have exhibited it in five cases; and though it may be premature, in so short a period, to form any positive conclusions, yet I may be allowed to state, that, during the short period of its use in my hands, the medicine has realised the expectations held out by its friends in Paris.

I will merely add for the present, that I have exhibited the extract internally in the form of pills, in three cases, of which the first was diarrhoea, of long standing. Here its tonic and astringent qualities evidently arrested the disease. The two next cases were those of patients laboring under dysmenorrhoea; in both which, the symptoms have been materially improved under its exhibition. The fourth case is one of ulceration of the mouth, involving the tongue, of some week's duration, which I have treated by a solution of one part of the tincture, to five of water, as a local application, for the three last days, I think, with some benefit to my patient. The fifth case, is one of scrofulous ulceration, upon which I have applied the powdered extract twice. As yet, I cannot discover any change for the better.

These cases of the administration of the monesia, in several of its preparations, are recent, the oldest being only of a week's date, yet the results are so far encouraging, as to induce the wish that the American Medical Profession, which has now an opportunity of becoming acquanted with monesia, may fairly and fully test the properties of this new addition to the Materia Medica.

Walnut street, April 1840.

A translation of Dr. G. J. Martin St. Ange's paper was published in the London Gazette, and copied from thence into the Examiner; we cannot find room for it, but may say that it is a collection of the testimony of a number of eminent French practitioners in favor of the efficacy of monesia as a remedy for nearly all sorts of diseases:-diarrhoea, hæmopty sis, chronic coughs, scrofula, menorrhagia, dyspepsia, &c. &c.

In the Medical Examiner, of July 11th, 1840, a very interesting case of menorrhagia, of seven weeks' duration, cured by the extract of monesia, is reported by A. D. Chaloner, M. D., which is worthy of attentive perusal, and with it we shall close the testimony that has been adduced in favor of the new remedy.

On Friday, July, 2d, at 2 o'clock, P. M., I was called to see Mrs. Lrs, æt. 35, of sanguine temperament, who was suffering under a severe attack of menorrhagia of seven weeks' duration. A month previous to the attack, she had miscarried, (three and a half months advanced in pregnancy,) and recovered under the usual course of treatment; but having over exerted her strength, and taken cold, she was attacked with a profuse "flow of blood from her womb," at first mistaken for the return of the catamenia. It increased, however, gradually, and she had recourse, previously to my visit, to various cold and astringent injections, in connexion with the elixir vitriol. These remedies failing, and the discharge increasing, she became alarmed and sent for me. found her, on my arrival, sitting up in a chair, countenance pale and anxious, pulse slow, violent pains in lumbar and sacral region, and the slightest motion causing a profuse discharge. She was immediately placed in her bed, ordered to take cold drinks, and the following recipe: R. Acetat. Plumbi, jss., G. Opii, gr. iv. M. ft. pil. No. xii. S. one every hour, and an injection per vaginam of R., Sulphat. Zinci, gr. viii., Aq. Font. f3i.her feet and legs were elevated by means of blocks of wood placed beneath the feet of the bedstead, and perfect rest enjoined.

July 3d. Had slept some, pulse more natural, skin cool, the discharge undiminished.

Treatment.-Increase the acetas plumbi, &c. to 8 grs. every hour, in conjunction with a third of a grain of opium; continue injections; ice in a bladder to be applied over the pubic region.

Vesper. Feels better; a perceptible diminution of the discharge; treatment to be continued as before.

July 4th. Having been prevented from seeing Mrs. L-rs to-day, my friend, Dr. N. Benedict, saw her for me, and finding the hæmorrhage returning, and bowels constipated, gave her the following R. Secale Cornutum, 3i., Sacch. Albi., G. Acaciæ, q. s., Aq. Font. f3 vi., M. S. a table-spoonful every four hours, also, these pills: R. Hiera Picra, 3 ss., Sapo.