applied externally to the breasts would dry up the milk; and thinking it reasonable, I caused the areola of the breasts to be smeared with extract of belladonna, in the same way that it is used to dilate the pupil of the eye. I likewise ordered the addition of half-drachm doses of colchicum wine, knowing that whenever milch cows eat the meadow safron in the pasture, they immediately become dry; and though I have not much faith in colchicum as a remedy in rheumatic fever uncomplicated with gout, there could be no objection to its use, an it has the sanction of much higher authority than my own.

On my third visit the following day, the first inquiry was about the breasts. They were all right. But was it the colchicum or belladonna that had relieved them? The extract was used before I left the ward; before the mixture was given, the secretion of milk had been arrested and the breasts had become soft. The rest of the case has no further special interest. I will only state that there was no heart affection, and that the fever, though very severe while it lasted, was of short duration, and the patient left the hospital quite well in fourteen days.

The second case that occurred to me was uncomplicated with any disease, and such as would usually fall under the care of the accoucheur rather than the physician:

A lady, the wife of a clergyman, was travelling with her hus band, and in order to accompany him, had weaned her baby, (then seven months old). Happening to be at Oxford at the com inemoration festival, he came to me in great trouble, telling me that his wife had done a foolish thing in weaning the child, and that they were now arrested in their progress in consequence of the state of her breasts. They were tumid, very tender, painful, and hard, with large superficial veins, and the milk had been drawn with difficulty several times, with temporary relief. I recommended the application of the extract of belladonna to the areola, desiring them to send for a medical practitioner if the inconvenience did not immediately subside, or unless she felt quite well. A few days brought me a letter, giving a very satisfactory account, and thanking me for what she was pleased to call my wonderful prescription. Within two hours she was perfectly relieved, the milk absorbed, and (what is very important) there was no fever or other inconvenience attending the sudden suppression of the milk; and instead of taking the opening medicine I had prescribed for her, she continued her journey the next morning.

I have not been able to discover that the fact that belladonna is available for the purpose of arresting the milk secretions is at all generally known-certainly it was not to several accoucheurs in large practice of whom I have inquired. The fact is important, if true, for then milk abscesses will become a matter of past history, and probably many diseases of the breast may be rendered less complicated by its use.

The two cases I have detailed are not sufficient to prove that it will always be either successful or safe, but they render it highly probable that it is so. My assertion may have a temporary interest, and soon be forgotten, and the opportunities of observing milk abscesses, and their early progress, do not occur with such frequency to a hospital physician, even in private practice, as that I may hope to bring together a sufficient number of facts to lay them before you. The fact has already been noticed, and if you will invite others who have more opportunities of special observation to try the experiment, and give you short extracts of cases bearing on the subject, with the names of observers, I am sure you will confer a favor on the profession.-[London Lancet.

Extra-Uterine Pregnancy of Four Years' Standing, the patient in the interim being twice delivered of a healthy living child. By A. W. HEISE, M. D., of Addison, Illinois.

In November, 1855, I was called to visit Mrs. Yungels, residing one mile east of Aurora, and thirty miles west of this place. Upon my arrival I found the patient, a woman of robust constitution, 36 years of age, to have been ten days since delivered of a healthy male child. The three or four days following delivery she was quite well, since which time she has had a chill every day, followed by fever and profuse perspiration. Has had the usual lochial discharge, but no secretion of milk; pulse 100 to 110; tongue red, dry and hard; no appetite. On applying my hand to the abdomen, which is painful and irritable, I find an enlargement resembling a hard tumor, which is moveable, and not connected with the integuments commencing in the umbilical region about three inches above the umbilicus, extending downwards parallel with the linea alba to the os pubis, filling three-fourths of the lumbar and illiac region of the right side. Left of the linea alba it seems to be perfectly free from any morbid growth. Examination per vagina shows the uterus in situ, contracted; the os uteri somewhat enlarged, hot, dry and painful; vagina natural. By moving the uterus and placing the other hand over the tumor, the motion of uterus affects the tumor, and vice versa.

Upon inquiry, I was informed that, four years since, the patient supposed herself pregnant, experiencing the usual symptoms attendant upon gestation for a period of ten months, during which time the abdomen constantly enlarged, particularly the right side, which was hard and painful, rendering her unable to lie upon it after the third month. At the end of ten months, labor commenced, and a midwife was summoned, who, after expressing her fears that the child did not "lay right," declared it was yet out of her reach, the os uteri not at all dilated, would not be delivered yet, &c. Bearing-down pains, however, increased, and were finally re

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lieved by a discharge of a large quantity of watery matter having the appearance of beef brine, followed by coagulated blood. This not only very much relieved the patient, but diminished the size of the abdomen, and the mid-wife assured her she had suffered only from obstructed menstruation, and would soon recover. The abdomen gradually decreased in size, for the space of three weeks, when the lochial discharge ceased, and with it the diminishing of the bowels, leaving still an enlargement of the right side, which she was yet unable to lie upon.

Finding no alteration in the tumor from that time, four months afterward she consulted a physician, who told her he could not ascertain the nature of the tumor; could do nothing for her without an operation, which, so long as she suffered so little pain, and it did not enlarge, he would not advise.

She soon became enciente, and in time was delivered of a large, healthy child. Parturition was easy, and she soon regained her usual health, having experienced no unusual symptoms, with the exception of the total absence of any secretion of milk. The tumor had been painful during confinement, but otherwise retained its former appearance.

Eighteen months afterward, she again became pregnant, and in November, 1855, was once more delivered of a healthy male child-both are now living.

Dr. Young, of Aurora, who attended her, says he observed nothing unusual in her case; did not notice any enlargement of the abdomen: called again and discharged her as doing well.

On the tenth day after her confinement, I first saw the patient, and found her as above stated.

I prescribed those medicines which were indicated, directed emolient poultices to the abdomen, and left, with directions that if the patient did not improve, or there was any alteration in the tumor, to inform me. Thought the tumor might be an enlargement of the right ovarium, and that when the irritation of the uterus subsided, and the fever abated, it would cease to be painful, and she might again enjoy her usual health.

Heard no more from her until May 5, 1856. I was summoned to see her again. I found her much emaciated, exhibiting a great degree of nervous excitability; pulse 90, small and irritable-has suffered much from pain since I saw her, having been constantly confined to her bed. The tumor at the umbilicus has ulcerated, and discharges a very offensive fluid. Through the orifice, which is nearly the size of a half dime, a bone has protruded; another now closes the opening.

The case was now plain, and I advised an immediate operation. Dr. Yonng, of Aurora, was called to assist, and upon his arrival, requested to have his friend, Dr. Allaire, of Aurora, present.

Adhesion of the peritonium had taken place around the orifice, to the extent of from three to three and a half inches. I made an

incision of about three inches toward the right lumbar region, and commenced at once to extract the bones. The flesh was decomposed, but the skeleton was perfect, and was of the size of a foetus at the seventh month, though the bones appeared to have the firmness of two years' growth. Its extraction through the rather small orifice was tedious, in which Dr. Allaire very kindly and effectually assisted,-Dr. Young, meantime, quieting the patient by administering chloroform. The bones of the head and pelvis were too large to pass through the incision, until they were severed by a strong pair of scissors. We succeeded in removing all the bones, together with a mass of semi-decomposed matter from the sac. The sac, which was formed of a gristly substance, and so hard as to almost resist the passing of the bistoury, seemed to have contracted close around the foetus, and evidently had performed the office of placenta and uterus, in being connected with the latter.

The wound was simply dressed with lint, a bandage applied, and the patient directed to lie in a position to facilitate the discharges. She was left under the care of Dr. Young, and up to May the 10th was doing well.-[North Western Med. and Surg.

Journal.

Uncontrolable Vomiting in Pregnancy.

REMARKS.-In connection with the above caption, we will record a remedy which we have not, elsewhere, seen reported. Our excellent friend, now Reverend Dr. C. T. Quintard, of Randolph, Tennessee, formerly Professor of Physiology and Pathology in Memphis Medical College, having been perplexed for a long time, with a case of obstinate vomiting during pregnancy, resorted to the expedient of cauterizing the fauces freely with a solution of Nitrate of Silver, about 15 grs. to the oz. of water. The experi ment was entirely successful.-We can very readily explain this result: The nerves supplying the fauces are the excitor nerves of vomition; from the long continued effort, they had become permanently irritable; the cautery obtunded their irritability, and their corresponding motor branches, from the pneumogastric, in the stomach, were no longer provoked to act. Query.-May not the above, be the pathology of protracted vomiting, under other circumstances, and might not a similar measure act as efficiently in relieving it?

H. F. C.

The attention of physicians has of late been directed towards the subject of excessive vomiting during pregnancy, with a view to discover some more efficient mode of treatment than that usual

ly employed for this unpleasant and sometimes alarming symptom. Although the cause of the vomiting has always been recognized as seated in the uterus, yet the means at our disposal for ascertaining the condition of that organ having until of late been limited, it has been necessary to treat the disease as one of the stomach, and to address remedies chiefly to that organ. It is needless to say that in many cases this mode of treatment is ineffectual. Instances now and then occur in which, in spite of the employment of prussic acid, creasote, alcalis, acids, narcotics, leeches, blisters, sinapisms, the vomiting still continues unabated, or increases sometimes to such a degree as to render necessary the artificial induction of abortion as the last resource, and that a doubtful one, in order to save the life of the woman, if indeed that result does not follow spontaneously the violent contractions of the stomach.

It is now well known that in these cases there is often something more than the presence of the ovum in the uterus, and the enlargement of this organ, to account for the sympathetic irritation of the stomach. The speculum often reveals various morbid conditions of the cervix, and since the removal of these conditions, or their diminution, by appropriate local treatment, is followed by a cessation or diminution of the vomiting, it is fair to attribute this exaggeration of a natural phenomenon to a morbid condition of the parts which are concerned in its production. An interesting case confirming this view, which we see reported in a foreign journal, suggested to us the above remarks, and believing that it may serve to call the attention of others to this interesting subject, we give a brief abstract of the paper, which was read by Dr. Brian, before the French Academy of Medicine.

A woman aged 25, of good constitution, became pregnant for the third time at the beginning of March, 1856. In the middle of April, vomiting began and continued, gradually increasing in frequency and violence. About the first of May, the patient was obliged to keep her bed. The stomach soon became incapable of retaining or digesting any thing. Severe gastralgia, thirst and constipation followed, combined with spasmodic movements, profound depression and emaciation. After all remedies which could be thought of had been tried, a vaginal examination showed that the uterus was completely retroverted, and incarcerated in the hollow of the sacrum. It was disengaged from this situation, and placed in its normal position. Immediate relief followed, and the vomiting ceased, to return no more.

It does not absolutely follow that because obstinate vomiting is sometimes owing to a definite source of irritation seated in the uterus, this effect should always follow such local cause. Women in whom there is every reason to believe that the so-called ulceration, or the granular condition of the cervix exists, may go through pregnancy without unusual vomiting, just as these same conditions are sometimes found after death in persons who never suffered