that nothing ought to be done for it. He shows that it is not only not useful, but decidedly injurious to the little patientsthat it weakens them, and lays the foundation of marasmus, which if not checked in time, soon goes on to a fatal termination.-Lond. and Edin. Monthly Jour. Med. Sci., May, 1842, from Gaz. Méd de Paris, 4th Feb. 1842. Expulsion of a mass of hair from the Uterus.-By HENRY R. FROST, M. D., Charleston, South Carolina.-To give full interest to the above extraordinary occurrence, it is necessary to detail the circumstances connected with a case of tedious and instrumental labor. A colored girl aged 25 years, pregnant with her first child, was taken with the pains of labor, about 6 o'clock on the evening of the 9th of September, 1838. The habit of the patient was strong, and her health good. There was no occurrence during the first twenty-four hours to excite uneasiness, but the delay which occasioned the accoucheuse to suppose that there was something wrong. On the evening of the 10th, I was called to see her. Upon examination, I discovered nothing at fault, but the slowness of dilatation in the os uteri. There appeared to be some thickening of its orifice. The liquor amnii was passing off slowly, the hairy scalp could be felt protruding, and the ver tex resting upon the brim of the pelvis. To favor relaxation, a dose of castor oil had been administered in the morning, and a small quantity of blood taken from the arm. Expecting that the pains would be renewed, and finding nothing requiring my assistance, left the patient in charge of the midwife. Sept. 11th. This morning at 9 o'clock, find upon examination, that the vertex had made little progress; the os uteri being a little dilated, and thinner; repeated the venesection. 1 o'clock. But little progress made, and as the pains were exhausting without producing much effect, recommended that they be allayed as much as possible; directed acetate of morphia in doses of one-sixth of a grain every half hour until easier. 7 o'clock. The medicine had been taken, and some relief experienced. 12th. The pains were removed during the night, but with little benefit. Upon examination, but little change was perceptible; the head had descended a little lower, and the protruding scalp filled up the os uteri. Apprehending that there might be some obstruction in the passage of the head, and that difficulty would occur in the course of the labor, requested assistance. The late Professor Wagner was called, and upon examina tion of the patient, concurred in the opinion I had formed of the presentation; recommended patience and perseverance. The powers of the patient were good, and as the pulse was more active than proper, further venesection was recommended. The condition of the patient was little altered during the day and night. 13th. Still trusting to nature, and nothing done to expedite delivery. At 8 o'clock P. M., the forceps were applied, but with no advantage. In the course of the night, the ergot in infusion was freely administered, but without any effect. During the day a discharge of meconium in considerable quantity was noticed, an occurrence in a presentation of the vertex very unusual. In the progress of the labor, it became necessary to draw off the urine twice a day, but it is somewhat singular, that though the catheter was introduced, a very small quantity of urine was removed, while a tumor which was formed by the distended bladder could not be reduced, though pressure was made upon it. 14th. At 9 o'clock, A. M. the head was perforated and the child extracted. The operation was completed in about half an hour, and was well supported by the patient. The placenta was extracted, and the patient made as comfortable as possible; some soreness and tumefaction was experienced, and at night nearly two quarts of urine were removed. sentin orcep hes in ter, Cand red es in ing 15th, 16th, 17th.-The patient continues to improve. Nov. 17th.-The progress of the patient was a very slow, but gradual amendment. About this period, she complained of fever, which continued at variable periods during the day, followed by very profuse perspiration. There was considerable discharge from the vagina of a puriform and very offensive fluid, pains about the region of the pubes at times considerable, occasionally tumefaction of the abdomen, the appetite variable. To relieve some of these symptoms, general treat ment was adopted, and the use of an astringent injection. the ion of The 19th. The patient informed me that the vagina was filled with a substance, which prevented the introduction of the syringe, that sitting was very uncomfortable, and the feeling of something which was to be removed. Upon examination, I discovered a substance of a dark color, ing Co of m bo th er presenting at the os externum. I provided myself with a pair of forceps, and with little trouble extracted a mass, several inches in length (say 5 inches), and an inch and a half in diameter, at its largest part, looking like wet tow, of an irregular and somewhat pear-like shape. Carefully inspecting it, it proved to be a mass of hair, in short pieces, of an inch to two inches in length, very offensive, and saturated with a purulent looking fluid. The symptoms above noticed soon subsided, and the person recovered in a considerable degree. The preparation is now to be seen in the museum of the Medical College of the State of South Carolina. The preceding occurrence affords a subject for speculation and inquiry. It could not have been an offcast from the first child, the quantity of hair being too considerable, and of a different texture from what is usually found on a colored child. It must have existed in the uterus at the time the first child was born, and must have remained in the cavity of this organ, and the vagina, nearly two months after the delivery. This is more remarkable, inasmuch as the placenta was removed after the birth of the child, and the condition of the uterus carefully examined. When removed, it had no appearance of being enveloped with membranes. Was it an abortive effort of nature in the production of twins? or was it of that class of morbid growths, which are so frequently formed in the ovaria?—Am. Jour. Med. Sci. Structure of the Small-pox Pustule.-Mr. W. H. JUDD has communicated, in the Lancet (June 12, 1841), some interesting observations on the structure of the small-pox pustule. Mr. J. has dissected the skin whilst it was under the influence of variola, in its various stages, and has discovered, he states, a very extraordinary septum and band in the small-pox pustule. The eruption, he remarks, commences by little red points on the skin resembling flea-bites. This appearance Mr. J. found "to arise from increased vascularity, caused by zones of minute vessels enlarging and projecting from the surface of the cutis; they secrete a thin serum, which gradually raises a ring of the cuticula externa from the rete mucosum, and so forms a vesicle without breaking up some of the thread-like attachments and ducts in the centre, between the cutis, rete, and cuticle. Hence the cuticular covering of the vesicle is bound down at this spot by that thread-like band, which causes Mr. Judd next describes the decline of the pustule and its consequences. "About the eleventh day (varying a day more or less in different epidemics) the cuticular covering bursts a little to one side of the apex of each pustule, and its contents gradually ooze out. If the affection has run through its sta ges mildly, the chief part of the fluid evacuated is but opaque lymph, which drying, forms a dark crust; if, on the contrary, the disease has been severe or confluent, an offensive pus is let out, which leads to scabs, sores, and ulcers in various parts. In bad and confluent cases, where inflammation has run high, not only is pus formed in contact with the cutis at the base of each pustule, but there are also thrown off shreds or sloughs from the true skin, causing permanent depressions, or white pits, for life. Temporary red stains are always left upon the skin, for a time after this eruption, and are caused by increased nlari bear if Havi pared preve the fir the Ans; rise ceed tion nced adv the ise to est a vascularity, thickening and rising of the rete; but these disappear if no ulceration takes place. "Having anatomically traced the cause, we are now fully prepared to enter upon the second stage of our inquiry; viz. the prevention of the effect, or pits, and consequent deformity. In the first place, I shall premise the propriety of lessening, on the attack, the attendant fever and heat by all prudent means; as the height to which the edges of the cup, or scar, will rise, and the depth to which ulceration, or slough, will proceed, depend in a great measure upon the degree of inflammation and fever (though some families are certainly also influenced by constitutional peculiarity; *) but, commonly, I can. not advise blood-letting, especially to any extent, on account of the debility that invariably follows this disease; nor can I praise the use of antimonials and medicines that determine to the skin, as by increasing the cutaneous circulation they give rise to a fuller development of the pustules. I believe the safest and best mode of treatment is to give a brisk cathartic of calomel and jalap; to keep the patient on a strictly antiphlogistic diet; to put out the fire and lighten the clothing, so as to keep the sufferer's temperature as near the standard of health by the thermometer as possible, yet not so low as to impede a fair development of the eruption on most parts of the body. Nor must we abstract food, for so many days in succession, as to let the system flag from that cause; for a certain degree of vigor is needful: but all beyond this does harm. Just after maturation the patient will require support; and in some cases, meat, wine, or even bark. I should not have touched upon treatment, had not the size of the pustule, and consequent extent of the pit and deformity that will remain after the eruption, so much depended on it: and also the prevention of cerebral symptoms, sometimes said to occur on interfering, or suppressing, much of the general eruption. "I shall next remind the reader, that the face, arms, and parts commonly exposed to light and air, always, as we might anticipate, suffer most deformity by small-pox pits; for air and light give vigor to arterial action, darkly tint the leaf, and heightens color in the cheek and pits. Hence small-pox pustules on the tongue, throat, and parts excluded from their agency, are nearly white, and seldom fully developed; and hence the success of Dr. Picton's method of preventing the ulcerative process, pits and stains, by the exclusion of light * As is more fully described in my treatise on Syphilis, p. 122, |