22 were twins-one in every 119 cases- -1,372 males-1,269 females-2,437 head presentations-64 breech, or lower extremities-about one in every 41 births of these 17 were twins. In 18 cases there was retention of the placenta -one in every 145 cases-nine complicated with alarming hæmorrhage after expulsion of placenta, one in every 291 cases-three were delivered by craniotomy, one in every 873 cases. In three premature labour was induced-five were complicated with puerperal convulsions, about one in every 524 cases-16 women died either from puerperal causes, or within the puerperal month-one in about every 166 cases-2,556 children were born living-85 still-born.

Deaths.-Four from hemorrhages-one from puerperal convulsions-two from fever-one from diffused pelvic inflammation nine days after delivery by craniotomy-two from pneumonia-five from phthisis.

During the year 1834, there were delivered 2,447 women-of which cases 26 were twins, about one in every 94 cases-1,285 were males-1,188 females2,408 were head presentations-57 were breech or lower extremities-about one in every 43 births-eight were transverse—one in every 309 births-five had alarming accidental hæmorrhage, not the consequence of placental presentation— in 10 there was retention of placenta-6 had alarming hæmorrhage after placental expulsion-about one in 412 cases. Four were delivered by forceps-one in every 618 cases. Two had puerperal convulsions-in two premature labour was induced from contracted pelvis-one in every 1,236 cases-10 women died within the puerperal month, about one in 215. 2,408 children were born living -79 still-born, about one in every 31 births.

Deaths.-Three from hæmorrhage-one from convulsions one from rupture of uterus-one from hysteritis-two from cholera-one from universal dropsy. During the year 1835, 2,311 women were delivered in the Eastern District of the Royal Maternity Charity--of these cases 16 were twins-in 8 cases of these both hands presented; in 4 the presentation was head and breech or inferior extremities, and in one case the breech and shoulder presented. In 3 of those cases both children were males; in 6 both were females; and in 7 they were of different sexes-1,229 children were males-1,098 females-2,437 were head presentations-57 were breech or some part of the lower extremities-7 were transverse presentations-all of some part of the upper extremities. In 3 the placenta was implanted over the os uteri, that is, about 1 in every 776 cases.

Seven were complicated with alarming accidental hæmorrhage before delivery, not the result of placental presentation, that is, about 1 in every 330 cases. 8 the placenta was retained within the uterus, either by irregular contraction or atony of the uterine fibres, or by morbid adhesion to the uterus-all required the introduction of the hand-5 were complicated with alarming hæmorrhage after the natural expulsion of the placenta-1 in every 462 cases. One (a primary labour) was delivered by craniotomy. Three were delivered by the forcepsabout 1 in 776 cases. Four were complicated with puerperal convulsions— about 1 in every 578 cases. In all these cases the attack occurred during labour. All were benefited by bleeding and purging-they all recovered.

In one case premature labour was induced from the woman's possessing a small pelvis. Seven women died either from puerperal causes, or within the puerperal month, about 1 in every 330 cases. 2,241 children were born living -86 born dead-being about 1 in every 27 births.

Of the Deaths.-1 from the effects of hæmorrhage eleven days after labourthere had been a draining of blood for some weeks previously-2 after delivery under shoulder presentation, both on the third day-one after version, and one from hysteritis after decapitation. One on the eighth day after labour from apoplexy originating in violent mental agitation six days after labour. Two from malignant puerperal fever prevalent at the time-1 from peritonitis 31 days after delivery.

Of Still-born Children.-26 were premature- 6 were putrid, at or nearly at

their full time-16 were breech presentations, at or nearly at full time-4 were transverse-with 5 the funis prolapsed-one was delivered by craniotomy-1 by the forceps-2 under placental presentation-2 were acephalous.

During the year 1838, there were delivered in the Eastern District of the Royal Maternity Charity, 2,136 women, of which cases 25 were twins, that is about 1 in 85 cases-1,115 were males, 1,046 females-2,087 head presentations-68 were presentations of the breech, or some part of the lower extremities-about 1 in 32 births-6 were tranverse, all of the shoulder or of some part of the upper extremities. In 1 the placenta was implanted over the os uteri-the breech presenting above-6 were complicated with alarming hæmorrhage before delivery, not the result of placental presentation-1 in every 356 cases-all the women recovered. In 11 cases the placenta was retained either by atony, irregular contraction, or morbid adhesion, about 1 in every 194 cases. Four were complicated with alarming hæmorrhage after the placenta was born, 1 in every 534 cases. Three were delivered by the forceps. In 1 premature labour was induced artificially at 7 months from the woman's having but a small pelvis-2 were complicated with rupture of the uterus-9 women died either from puerperal causes, or within the puerperal month-2,076 children were born alive-85 children were still-born.

Deaths.-1 from hæmorrhage speedily after the birth of twins from injudicious extraction of the placenta-1 two hours after removing an adherent placenta-1 from hysteritis, 1 from collapse-2 from ruptured uterus-1 from puerperal mania, and 2 from common fever.

Of the Still-born Children.-19 premature-12 putrid at or near full time-14 were presentations of the breech or lower extremities-3 transverse-1 was delivered with the forceps: it was putrid-4 under lingering labour-2 under a ruptured uterus-2 under a face presentation-1 under a placental presentation2 after violent accidental hæmorrhage-with 5 the funis prolapsed by the side of the head-with 7 the funis prolapsed by the side of the breech-1 was acephalous. Twelve were at full time, not putrid, nor delivered by art.

CONTRIBUTIONS TO MIDWIFERY, No. V. ON THE INFLUENCE OF ERGOT OF RYE ON THE FETUS IN UTERO. By THOMAS EDWARD BEATTY, M.D., M.R.I.A. (Condensed from the Dublin Journal of Medical Science, May, 1844.)

VARIOUS and conflicting opinions have been entertained with respect to the influence of ergot of rye, as an obstetrical agent. Some very high authorities have declared that it is totally inefficient in exciting uterine action, under any circumstances. Other authorities, equally respectable, attribute the most energetic effects to its use, denouncing it as too violent an agent for obstetrical purposes, and as being injurious to the child at all times, and sometimes both to mother and child. A third class of authorities maintain an opinion equally at variance with the truth as the two preceding, viz. that the ergot may be given always with advantage, the safety of mother or child being never endangered. With respect to the first opinion, scil. that of its total inefficiency under any circumstances, Dr. Beatty says that two causes of such a failure may be suggested: 1, the employment of inadequate doses of the drug; 2, the inferior quality of that which was employed the second cause appears the more probable, as there is scarcely any medicine that spoils more rapidly, or that requires more care in its preservation than the ergot.

The second opinion, viz. that the ergot of rye is at all times destructive to the child, arose from the employment of the medicine at improper times, as in cases of difficult labour arising from mechanical opposition to the exit of the child;

in such a case the destruction of the child is almost sure to follow from the delay which necessarily occurs between the administration of the dose and the expul sion of the head. The third opinion, viz. that the ergot may be always given with advantage, is far too sweeping, and one likely to do mischief.

Dr. Beatty considers none of these opinions correct, but that the truth lies between them. The medicine, when fresh, and properly preserved, is one of great energy, and influences both mother and child. It requires to be used with great discretion; for, while it will in one case effect the delivery of a living child, it will, in another case, destroy the life of the child before birth, or operate so injuriously on it, as to cause its death shortly after birth, or produce a peculiarly dangerous effect on its nervous system. The difference of effect on the infant depends on the length of time intervening between the administration of the dose and the conclusion of the labour-if this takes place quickly, no harm is done to the child; if it be alive when the medicine is taken, it will be born so; but if a delay of even two hours should occur, the probability is, the child will be still-born. He here gives some cases wherein the duration of the labour after the adminstration of the medicine varied from a quarter of an hour to two hours, and in all the child was born without any unpleasant consequences.

In the cases which proved fatal, the condition of the infants was very unlike that of still-born children delivered under ordinary circumstances, and when no ergot had been administered to the mother. The distinguishing characteristics are, the general lividity of the surface, the universal rigidity of the muscular system, producing the stiffened limbs and clenched hands in those infants in whom life was extinguished; and thé remarkable kind of alternating spasm and palsy which supervened in those that were resuscitated.

That the fœtus in utero may be influenced by the circulating fluids of the mother, is proved by the well-known fact of the communication of syphilis, small-pox, &c. to the unborn child.

Dr. B. here notices some of the epidemics of spasmodic ergotism, caused by eating bread made of rye containing a large portion of ergot, which visited different parts of the Continent during the last century. The patients were attacked with spasms and convulsions, accompanied with violent pains. In some instances the patients became lethargic, and when recovering from such state gave respectively signs of stupidity, intoxication, and extreme lassitude, after which the fit subsided for a time. There generally remained vertigo, tinnitus aurium, nebulæ oculorum, rigidity of the limbs, and great feebleness. It has been ascertained by actual experiment, that the blood of the mother becomes impreg nated with the noxious properties of the ergot. In this way we can comprehend how the influence of the drug may be extended from the mother to the child. It may seem strange that a medicine taken in the usual medicinal doses, and with apparent impunity, by the mother, shall act injuriously on the child. The fact is, the system of the mother is very generally acted on by the ergot, though not injuriously, as is shown by the great depression in the pulse, caused by the drug. We must also recollect the great susceptibility of infants to the action of narcotics.

From the preceding observations, Dr. Beatty comes to the conclusion, that the administration of ergot to a woman in labour is attended with danger to the child, whenever a time sufficient for the absorption and transmission of its noxious properties elapses before the child is born. The degree of effect produced differs with the time that elapses between the exhibition of the dose and the birth of the child. Hence, the ergot should never be given in any case where there is a likelihood of the labour lasting more than two hours after its administration, except when it may be employed to save the mother's life-and, 2dly, if delivery is delayed to two hours, we should resort to artificial assistance to save the life of the child.

Miscellanies.

THE NAVAL LUNATICS AT HASLAR.

IN no situation has the humane system of treating lunatics been carried out with greater vigour than in the Royal Naval Hospital at Haslar, and nowhere with more satisfactory and gratifying results. So soon as the happy consequences of Dr. Conolly's new system at Hanwell came to the knowledge of the Director General of the Medical Department of the Navy, Sir William Burnett, he deter mined on introducing it into the Government Asylum at Haslar; and he had the good fortune to find in one of the officers of his own service, Dr. Anderson, a man not merely fully convinced of its immense superiority, but practically con versant with its details. For some time previously to his appointment, Dr. Anderson had been the resident physician of the well-known private institution at Denham Park, near Uxbridge, where the non-restraint system was and is carried to its full extent. At the period of Dr. Anderson's appointment, the naval lunatics, both men and officers, were treated pretty much in the old plan, although Sir William Burnett had made strenuous efforts for the introduction of the more rational system. Dr. Anderson's arrival at Haslar was the epoch of a complete reform; and as his views coincided in every respect with those of Sir William Burnett, and as that officer had the entire confidence of the Lords of the Admiralty, (who entered into the question with a degree of zeal and liberality highly honourable to themselves), every projected improvement was car ried into effect with true nautical energy. The change for the better was the more remarkable for its rapidity. Those who had known the asylum under the old rule could scarcely credit their senses when witnessing, after a few months, the new discipline of the place and the new habits and dispositions of the inmates. Chains, straps, corsets, imprisonment all vanished at the will of the Superintendent; and the false fears of the attendants, and much of the gloom and misery of the patients, soon followed. This altered condition of things has now existed about two years, and not a single accident has occurred to checker the satisfaction of those who brought it about.

Among the happy changes introduced by Dr. Anderson was one suggested by Sir William Burnett, which does great credit to his humanity, and has been a source of immense gratification to the patients. The airing-court attached to the asylum being at the back of the hospital, which stands on flat ground, was necessarily deprived of all prospect of the surrounding country, and even of the neighbouring sea. To remedy this defect, it was determined to erect a lofty mound in the centre of the airing-ground; and this was no sooner suggested than it was carried into effect by the lunatics themselves, under the direction of their benevolent superintendent. This mound is of large dimensions, solidly and beautifully constructed, and furnished with a gravel-walk leading by a gentle slope to the summit. It is sufficiently lofty to command a very extensive and beautiful view of the Isle of Wight as far as Cowes and St. Helen's, the towns of Portsmouth and Portsea, great part of Portsmouth harbour, all Spithead, and the neighbouring sea, with the ever-busy and ever-shifting panorama of masts and sails and flags that crowd that nautical thoroughfare. It is impossible to contemplate, without emotion, the happy influence that such a change as this must have had on the feelings of the sailors. The famous shout of Xenophon's soldiers, "The sea! the sea!" seems again realized to the imagination when we think of the feelings that may have stirred the withered souls of those solitary men, when, after years of imprisonment within gloomy walls, they were again,

as it were, restored to their old element. How much they prize the privilege thus accorded by the purest and most refined humanity, is proved by the continued eagerness displayed by them in climbing this "sacred mount." A similar elevation is now being built in the grounds of the officers' department. A still bolder step in the progress of the rational and humane treatment of these poor fellows, and, we doubt not, in the cure of their bruised and broken minds,-a -an improvement which strikes us almost as much by its happy boldness as by its genuine benevolence,-has been more recently introduced. A boat has been granted to them by the Admiralty; and in this they may now be seen pulling and steering their fearless and noble-hearted friend and master, Dr. Anderson, not only through Portsmouth harbour, but actually out to sea, calmly enjoying the cooling breeze, or busy in their long-forgotten pastime of fishing.

But the account of this affecting experiment, and a few more interesting particulars of the proceedings of the Naval Asylum, we are enabled, through the kindness of Sir William Burnett, to give in Dr. Anderson's own words: and we cannot present them to our readers without offering to that gentleman the tribute of our respect and gratitude for his enlightened and noble exertions.

Extract from Dr. Anderson's Report, Midsummer Quarter, 1843.-"The calm and orderly conduct which now prevails throughout the asylum, together with the cleanly, and I may add industrious, habits of a large proportion of the patients, render the duties of the attendants and nurses comparatively easy. For the accomplishment of these desirable ends, I have endeavoured to carry out the excellent precepts laid down by Dr. Conolly of Hanwell; and in order to point out clearly the principles by which the medical officers themselves are guided, and that they constantly inculcate on the attendants and nurses, I cannot do better than quote the following paragraph from one of that talented physician's Reports. To endeavour to gain and preserve the confidence of each patient; to create or maintain a character of kindness and tranquillity throughout the asylum; to forbid the exercise of violence, threats, or deception; to be careful of their diet and clothing; to occupy and amuse them; to secure their cheerfulness or content by day and comfortable rest at night; to consider all their weakness and infirmities; and to pay a general regard to whatever may act favourably on the mind and body.' These have been and continue to be the principles on which our moral management is based, and the fruits of this mild and rational treatment are now clearly developed in the altered condition of our inmates, whose conduct for many months past has very generally been characterized by a constant and orderly demeanour, which I am persuaded no coercive measures could ever have produced. The means of recreation and exercise which have wisely been extended to the patients in allowing them to walk into the surrounding country, continue to be a source of great delight to many; and nothing is felt as a more severe punishment than this salutary freedom being withheld from any of those who are usually in the habit of joining the party in these country excursions. The cheerful aspect of the new airing-grounds with the mound in the centre, has been very much increased by the late alterations; and being now thrown open in fine weather, have become the daily resort of a large proportion of the patients. The inducement thus offered to the indolent and melancholic to take a view of Spithead, Portsmouth harbour, Isle of Wight, and the surrounding country, is found not only to form the means of amusement and exercise, but, it may almost be said, some alleviation of their malady.

"The religious services continue to be regularly performed in the asylum morning and evening; and it is rather surprising to find between sixty and seventy insane persons assembled together for the purpose of divine worship without the occurrence of any disturbance, except on very rare occasions. Upwards of twenty attend the service in the chapel every Sunday; and their con