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, hæmoptysis, 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 24 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. I 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 hemorrhage 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. Hieræ Picra, 3 ss., Sapo.

Venet. gr. iv., Syrup. Rhei, q. s., M. ft. pil. x., S. two every night.

July 5th. Bowels opened; discharge still continues, and profuse, and increased by motion; treatment continued.

July 6th. Returned to the city and saw her with Dr. B. No abatement of the discharge. Treatment-to take of the infusion of secale cornutum a table-spoonful every hour; elixir vitriol, 30 gtt. in “eau sucre,” at the same time.

Vesper. Discharge continues; feels very weak. Treatment-R. Secale Cornutum Pulv. Sacch. Alb. aa Dij, M. ft. pulv. No. viii., S. one every half hour until pains are produced.

July 7th. Has taken seventy grains of ergot without causing uterine pains, or affecting the discharge. Treatment— R. Acet. Plumbi jss., Tict. Opii f3j., Aq. Font. f3ij., ft. enema, S, one half at once, the remainder in an hour; elixir vitriol, as a tonic, iced drinks, astringent injections per vaginam, warming plaster to sacral region.

July 8th. The uterus, on examination per vaginam, was soft and spongy; in the commencement of the treatment it was slightly swollen, and the anterior lip enlarged; pain in the back and the discharge continue. Treatment-R. Tinct. Cinnamon f3ij., S. thirty drops every hour; R. Prussiat Ferri, 3j., G. Aloes, gr. v., Conserv. Rosar. q. s., M. et divid. in pil. xx. S. one four times daily; alum water injections, a compress of folded napkins, and a broad roller, applied tightly over the uterine region.

Vesper. Feels better; bowels opened freely; to take but two pills and tinct. cinnamon, as before; discharge as before. July 9th. The discharge having increased in frequency and quantity, I procured twelve pills of the EXTRACT OF MONESIA, of three grains each, and at 2 o'clock, P. M. gave her six pills-one to be taken every hour and a half, until they had an effect upon the discharge.

Vesper. Has taken about three pills, (3 grs. each ;) the first pill having caused pretty severe uterine pains-as she expressed herself, "as if she was going to be sick," (i. e. be confined ;) after taking the third pill, the discharge was "a mere show." Treatment-to take the remaing three pills, one every two hours.

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July 10. Slept well; pain in the back gone; the discharge entirely ceased; feels well; pulse natural; appetite good; skin cool; the uterus contracted and free from pain, on examination per vaginam. Treatment-perfect rest, nourishing diet and cold drinks.

Vesper. Improving; no return of the discharge.

July 11. Still no return of the hemorrhage; gaining strength; to take tonics, &c.

July 12. Appetite indifferent; no return. R. Pulv. Colombo, Pulv. Sub-Carb. Ferri, Rhei, Zingiberis aa 3j. M. ft. chart. No. xii. S. one three times a day in molasses. Infusion of Prunus Virginiana, a wine-glassful three times a day. Diet-oysters, &c.

Vesper. Has had, owing to the exertion required in changing her bedding, some slight discharge; checked by one or two pills of the monesia, every four hours.

July 16. Still using tonics; no pain; no return of the hemorrhage; feels well; anxious to get out of bed.

Supposing that the above case may be interesting as showing, that in the Extract of Monesia we have a substance capable of causing powerful uterine contractions, even in small doses, and of arresting profuse menorrhagia of long duration, after the exhibition of all the usual remedies had failed, even when pushed to the extreme; and trusting that this hasty outline of the effects of monesia in this, to me, troublesome (although not uninteresting) case, may be of some interest to members of the profession generally, I remain, gentlemen,

Philadelphia, July 10, 1840.

Your obedient servant,
A. D. CHALONER, M.D.

In this case, the monesia appeared to arrest the hemorrhage by exciting contraction in the muscular fibres of the uterus, in consequence of which its tissue was condensed, and compression made upon the bleeding vessels. Muscular atony is a frequent cause of metrorrhagia, occurring after abortion or labor at the full term, and in such cases we have been long accustomed to prescribe the ergot, in pills or emulson, with the most satisfactory results; indeed, in our hands, it so uniformily succeeds that we are not a little surprised at its failure in Dr. Chaloner's case. It is scarcely necessary to add that the sugar of lead, though a remedy of decided efficacy, when hemorrhage arises from a morbid state of the exhalent vessels, cannot possibly avail when impaired muscular contractility permits the blood to escape from their patulous mouths. On the contrary, it is probable that the lead,

if administered in sufficient quantity, might paralize the uterine muscular fibres, as it is known to do certain of the voluntary muscles, and thus aggravate the discharge. Be this as it may, it is certain that lead is not to be confided in as a remedy for this special hemorrhage, and that ergot is calculated directly to fulfil the indication which it presents. If it should be found, on further trial, that the monesia belongs to the same class of remedies as the ergot and acts with greater certainty and efficiency in exciting uterine contraction, it will prove a valuable addition to the materia medica.

H. M.