and duties, there was no little force in the appeal of a nobly brave-spirited woman to the chivalry of the American Navy. and in his heroic maintenance of the point of honor in all his intercourse with men. It is a matter of painful regret that the He was "bathing in the tepid waters of the source of his greatest renown should also have Gulf of Mexico,on the 12th of May, 1850," when been the source of the wasting disease by which he received his telegraphic order to proceed he has prematurely been called away. Never forthwith to New York, for duty upon the Arc- very strong, the constant hardships to which he tic expedition. In nine days from that date he was exposed in his last Arctic voyage, were too was beyond the limits of the United States, on much for his physical strength. Finding that his dismal voyage to the North Pole. Of this he did not derive from the climate of England first American expedition, as is well known to the benefits to his health which he sought, he the public, he was the surgeon, the naturalist, proceeded to the mild climate of Cuba. But and the historian. It returned disappointed the seeds of disease were too deeply sown. of its main object, after a winter in the regions Nothing could arrest its progress. With mind of eternal ice and a fifteen months' absence. unimpaired, and surrounded by his mother Scarcely allowing himself a day to recover and some intimate friends, he breathed his last from the hardships of this cruise, he set on foot on the 16th ult., in the flower of his age, and the second attempt, from which he returned, the enjoyment of a well-earned and world-wide after verifying by actual observation the long renown. questioned existence of an open sea beyond the The funeral of Dr. Kane at Havana was latitude of 82° and beyond the temperature, attended by a long procession of all the Ameralso, of 100° below the freezing point. His icans in the city, as well as by the Vice-Cap"Personal Narrative," published early in 1853, tain General of the island, and many other recounts the adventures of the first voyage, Spanish Officials. and discovers his diversified qualifications for such on enterprise. Before it was completed for the press he had effected his arrangements for the last Arctic expedition, appropriating to this cherished object his own pecuniary resources, as well as drawing largely on those of the scientific institutions of this country. The history of that expedition, and the remarkable discoveries to which it led, are now before the country. They constitute in themselves an imperishable monument to Dr. Kane's fame. As the remains were passing through the country on the way to Philadelphia for interment, the highest marks of respect for the character and services of the deceased were manifested. COMMUNICATIONS. (Communicated to the Medical World.] THE INDIA RUBBER TAMPON. BOSTON, FEB. 28, 1857. Dr. Kane was about five feet seven inches in height, and usually weighed about one hundred and thirty pounds. Complexion fair, hair brown, eyes dark gray, with a sharp, hawk-like look. He was never robust. With such gen- MESSRS. EDITORS: A discussion on the eral health as his, most men would call them- merits of the India Rubber Vaginal Tampon, sulves invalids, and live on furlough from all in uterine hemorrhage, at a recent meeting of the active duties of life; yet he has won the distinction of being the first civilized man to stand in latitude 82° 30′ and gaze upon the open Polar Sea-to reach the northernmost point of land on the globe-to report the lowest temperature ever endured-the heaviest sledge journeys ever performed-and the wildest life that civilized man has successfully undergone; and to return after all to tell the story of his adventures. The secret spring of all this energy was in his religious enthusiasm-discovered alike in the generous spirit of his adventures in pursuit of science, in his enthusiastic fidelity to duty, the Boston Society for Medical Observation, has led me to suppose that a description of one of the best forms of this instrument might prove interesting to your readers. The Tampon to which I refer, originated with Dr. Braun, of the lying-in hospital in Vienna. It is used not only as a plug, in hemorrhage, but also as a means of producing dilatation of the os, etc., and is thus applicable in various forms of abnormal gestation. The following is a translation of the most important portions of Dr. Braun's account of his instrument. A reliable method of producing speedy dilatation of the os uteri, preparatory to the ex æresis of the fœtus, has always been a great warm or cold water, injected either with a desideratum in various obstetrical operations. syringe or another sac, made so that they can To accomplish this purpose, a great variety of be attached to the mouth of the brass tube. methods have hitherto been employed. Of The band attached to the ring is now fastened these, the principal are: 1. Perforation of the membranes (Scheel, Meissner). 2. Separation of the chorion from the uterine walls, with the fingers (Hamilton, Davis, Gooch), or with a curved catheter (Rieke). 3. Introduction of prepared sponge into the os (Brünninghausen, Kluge, Simpson, Siebold). to one of the thighs, or around the hips, to oppose any expulsive efforts, and thus we have an elastic tampon, pressing equally on all parts of the vagina. Our sac, being made of india rubber, cannot become offensive or putrid, like one made of animal substance, and, by letting off the water, it can be quickly removed or changed, in a manner perfectly easy, painless and safe. The effect of the curve in the neck of the 4. Introduction into the vagina of a tampon of charpie (Leroux, Cazeaux, Schöller, instrument is that only the upper part of the Scanzoni), or of a peeled lemon (Moreau), or of a caif's bladder (Hüter of Marburg). 5. Injections of water between the membranes and walls of the uterus (Cohen). 6. Injections of water with the Sphenosiphon of Schnakenberg, or with ordinary syr inges (Saxtorph, Jörg). 7. Use of the rising uterine douche, a most effective mode of treatment (Kiwisch of Rotteran). 8. Administration of ergot (Ramsbotham and others). 9. Application of electricity and galvanism (Mikschick, Benj. Frank, Dorrington, Simpson). vagina is distended, and all painful pressure is avoided on the nymphæ, urethra, or any portion of the external organs.. The application of this new method is reliable and satisfactory in the following abnormal conditions: 1. In hemorrhage, during the first stage of labor, dependent upon placenta prævia, mola hydatidosa, or abortus; and in hemorrhage after removal of the placenta, when the body of the uterus is well contracted, but the source of the hemorrhage is to be found in its lower segment. The use of the ordinary tampon for hemorrhage from placenta prævia is earnestly 10. Manual dilation of the os, either with recommended by Wigand, Peuker, Gardien, the fingers, or by the introduction of the hand Monfalcon, Osiander, Busch, Nagele, Ramsin a conical form (as in accouchement forcé). botham, Lee, Scanzoni, and others. Its ob 11. Instrumental dilatation of the os (Osi-ject is to allay the hemorrhage, increase the ander, Busch, Mende). 12. Scarification of the os (Bodin, Velpeau, Kilian, Kiwisch, Scanzoni). labor pains, and, if possible, to avoid the necessity of the dangerous accouchement forcé, and of the separation of the placenta previous Although the literature of this obstetrical to the extraction of the child, as taught by operation is very copious, I nevertheless feel Simpson, Radford and Churchill. But this impelled to make known a very simple, easy, proceedure often fails of a successful result, and safe method, which is different from those just mentioned, and may be applied in a variety of cases. because the lint becomes saturated with blood, the plug is expelled by an increase in the force of the pains, while the operation itself is very tedious and painful (Kilian). The apparatus necessary for this purpose consists of a vulcanized india rubber sac, from None of the objections to the ordinary tamtwo to four inches in diameter, ending in an pon apply to the india rubber plug. The apindia rubber tube, four inches long, and one- paratus can be filled with ice water in a few half inch thick. This tube is lined inside with seconds; the pains are excited, and the hemhorn, and at its end there is a short brass tube, orrhage can be instantly arrested by the gradwith a stop-cock and a ring, to which a band ual pressure, and by the cold, which can be is attached." When it is to be used, the increased by a frequent renewal of the injecempty india rubber sac is introduced into the tion. No collection of blood can take place vagina, and then gradually distended with between the walls of the vagina and the india rubber, and an expulsion of the sac is rendered axis of the pelvis. The whole instrument resembles a re- the thigh of the patient. The neck of the sac has a curve corresponding with the impossible by its attachment, with a band, to tort very much, in its shape. It is sold in Vienna, at about $1.50. H. (In 1849 and '50 the india rubber tampon was used with success by Dr. Braun, at the premature rupture of the membranes is likeVienna hospital, in two cases of placenta wise apt to take place, while the imperfect prævia centralis, in two cases of placenta dilatation of the os prevents the introduction prævia partialis, in one case of mola hydati dosa, and in one case of hemorrhage from lacerated vessels of the cervix, after the ineffectual use of other hæmostatics.—H.) 2. In shoulder presentations; to produce dilatation of the os, and prevent early rupture of the membranes, as a preparation for version. of the hand for turning, and the use of the In abnormal positions of the foetus, the too early rupture of the membranes, the os being Cases of hernia vaginalis in the last months still undilated, often gives rise to a necessity of pregnancy are very rare; but a case of for the most dangerous operations. It is this description came under my treatment at therefore most important in shoulder presenta- the Vienna hospital. The patient, a primi tions, to induce a careful dilatation of the os, and to preserve the integrity of the membranes, until a cephalic version, or version by the feet can be resorted to without danger to the patient. para, twenty-three years old, in the eighth month of pregnancy, entered the hospital, January 10th, 1850. Three weeks before she felt a violent pain on lifting a heavy box, and since then she had noticed a pressing In transverse positions of the foetus, the down of the vagina. On the day of her adcervix is generally occupied at first, not by a mission she had fallen over some stairs at her presenting part, but by the amniotic fluid. dwelling. This was followed by the appearDuring a pain the chorion is pushed through ance of a tumor in the vagina, violent pain the os in a conical form, and its rupture is and fainting, but no nausea or difficulty in the brought about in these cases by the pressure urinary excretion. The tumor was very tense, of a long column of fluid. This rupture gen- of a dark bluish-red color, of the size of a erally takes place while the os is still undi- man's fist, giving a tympanitic sound on perlated, at a time when any effectual operative cussion. The gurgling sound of the intestines procedure is still impossible. was but slight, owing to the great tension. This dilemma can be avoided by the use of The hernia was replaced, the india rubber the india rubber tampon. The tampon, intro- tampon introduced, but not filled to its full duced into the vagina, and filled with tepid capacity. After this the pain ceased, and two water, covers the external orifice and prevents days after, on the morning of January 12th, the protrusion of the membranes. The hydro- the tampon was expelled by the advancing static pressure which takes place during a head of the child. No return of the hernia pain, is divided equally between the walls of was found on a subsequent examination, and the tampon and the uterus. The tense walls in about two weeks the patient was discharged of the tampon, pressing on the softer and more well. yielding uterine walls, cause a speedy dilatation of the os, at the same time protecting the membranes; and thus the most favorable conditions for version are attained. (In 1850, this treatment was used at the Vienna hospital in fourteen cases out of thirtysix of transverse positions. The result was that all the children were delivered alive, except one affected with hydrocephalus congeni tus, while all the mothers passed through their childbed without accident.-H.) 3. In contractions of the pelvis with head presentations, to dilate the o8, to prevent too early rupture of the memrbanes, to facilitate the exit of the foetus in turning, as well as the application of forceps, and the performance of perforation. In cases of contracted pelvis at full term, 5. In eclampsia during pregnancy, and in the early stages of labor. It is a matter of experience, that puerperal convulsions are most dangerous during preg nancy and in the early periods of labor, and that the violence of the attacks frequently diminishes after the termination of labor. Relying on these facts, most authors recommend artificial delivery, for the safety of the child, and to diminish the perils of the mother; and often, in urgent cases, nothing can be done but to have recourse to the dangerous accouchement forcé, or instrumental dilatation of the os. The use of the india rubber tampon, in cases of eclampsia where premature delivery was indicated, has been followed by such favorable results, as to entitle this painless and safe method to a more extended trial. A while in the other there was a light attack of strong india rubber tampon being introduced, perimetidis and hydrops acutus genu. But and filled until quite tense, the vagina is these unfavorable results cannot fairly be atdilated; the irritation of the nerves of the tributed to the operations, which were conlower uterine segment produces powerful re- ducted with equal care in both cases. flex action in the body of the womb; this as sists in the development of the lower segment, and causes specdy dilatation of the os, and thus the birth of the foetus, either by turning, or with the aid of the forceps, can be accomplished in a few hours. The energetic increase of the pains, caused by the tampon, was never found to produce an increase of the violence or rapid recurrence of the convulsions; but, on the contrary, the paroxysms recurred in a manner perfectly independent of the action of the tampon. This is well shown in one of the cases I have re Summary of the advantages, and application of the india rubber tampon. 1. The application of the tampon is very simple and easy; it takes but little time and leads to no dangerous accidents; it increases the irritation of the uterine nerves, and causes steady and energetic pains. 2. There being no pressure on the lower portion of the vagina, the use of this tampon cannot be painful, if proper care is taken in filling it, and if it is occasionally removed when necessary. prepares the lower uterine segment quickly fore undertaking this operation. ported elsewhere, where two attacks of convulsions occurred before any appearance of labor pains, and before any change in the os. The use of the tampon for four hours caused energetic pains and full dilation of the os, without any return of the convulsions. This speedy dilatation of the os facilitates an opera- or the sexual organs; neither is the foetal 5. No injury can be done to the membranes tive interference and the birth of a living life endangered. child, before the mother is attacked by oedema of the lungs, emphysema, or other accidents.the first and in subsequent pregnancies. 6. This method can be used equally well in 6. To induce premature delivery in cases of contracted pelvis, or for general diseases of the mother. (In the same manner as the uterine douche). The induction of premature delivery with the tampon of charpie has already been recommended by Schöller, but this method has seldom been employed, on account of the laborious manipulations which it demands. On April 7th, 1851, two cases came to the hospital, in whom the induction of premature delivery was indicated by contracted pelvis. The india rubber tampon was used in one case, and the uterine douche in the other, for the purpose of comparing the effects of these two modes of treatment. In the first case the 7. The tampon is a reliable means of arrestta prævia, mola hydatidosa, as well as in cases ing hemorrhage and hastening labor in placenalso applicable in hemorrhage from torn vessels when abortion cannot be prevented. It is of the vagina or cervix, during labor. 8. In uncertain positions of the child, the tampon is of service in preparing the parts for tursing. induced with great facility and speed; and the 9. In eclampsia, premature delivery can be sectio cæsarea post mortem can be avoided, where, without the tampon, it would often be necessary. 10. In contracted pelvis, premature delivwith the uterine douche, with the least possiery can be induced in a similar manner as ble danger to the mother and child. tampon was introduced and retained for eight hours, without causing the patient any pain or uneasiness; the labor commenced and had a regular course of twenty-four hours. In the This account is taken from the Klinik der second case the douche was used in two ses-Geburtshulfe, by Drs. Chiari, Braun, and sions; labor commenced seven hours later, and Spaeth. This volume contains plates repreterminated in sixteen hours. In the first case senting Braun's tampon and his uterine puerperal fever set in with a fatal termination, douche. I shall be happy to show them to any one interested in obstetrical matters, as * For the administration of the uterine douche, Dr. they give a much better idea of the instruBraun uses a voy convenient and portable apparatus, only eight inches high and four inches wide, constructed on the ment than can be obtained from a verbal deprinciples of the force pump, which throws a continuous scription. stream of water, with great force. The price of this in strument, in Vienna, is only about $5. H. H. L. H. HOFFENDAHL, M. D. (Communicated for the Medical World.) BELLADONNA IN SCARLATINA. healthy body. He also pointed out the symptoms characterizing a scarlet-fever epidemic in which belladonna would prove curative and prophylactic. If an exact similarity exists, he tells us that beladonna, given in the MESSRS. EDITORS:-The fatal character of 32000th part of a grain of the extract, every the prevailing scarlatina epidemic, in your forty-eight to seventy-two hours, avoiding city, seems to have revived the question of the acids, wine and coffee, will protect all who are prophylactic and curative properties of bella- exposed to the infection. This was Hahnedonna, in this dreaded scourge of childhood. mann's experience, and it has been confirmed The question has often been discussed by by hundreds, yea, we may say, thousands of homœopaths and allopaths, the former affirming, physicians, who stand high, not only as accuand the latter, with some exceptions, denying rate observers and diagnosticians, but also as that it possesses any such preventive power as proficients in other departments of medical has been attributed to it by Hahnemann and science. Such, then, are the conditions to be homoeopaths. This conflict of opinion origin- scrupulously observed in conducting the exates, we believe, in a misconception of the periments. teachings of Hahnemann and homoeopathy, Every physician knows, who is capable of acand a consequent misapplication of the drug, curate observation, and has had much experience, on the part of our allopathic brethren, rather that scarlet-fever epidemics, as well as others, than in limited experiments, or infidelity of exhibit a marked difference in their symptoms purpose. We think the name of the disease and course. The scarlet-fever epidemic of has been taken as the indication for the trial, this year may prove unyielding to the remeinstead of a peculiar combination of symptoms, dies which controlled the scarlet-fever epidemic upon which alone the prophylactic power is of last year, and for the reason that it differs predicated. essentially in its character. Let us illustrate A disputation, however lengthy and learned, by noting the symptoms of a single impli cannot advance the settlement of the question cated tissue. In the one epidemic the exanthe breadth of a single hair in the minds of theme appears at first on the upper part of those who have not a clear understanding of the body, and gradually extends downwards; the conditions upon which it rests. The ques- is erysipelatous, bright scarlet-red, glossy, and tion, nevertheless, is a plain one, and may be perfectly smooth to the feel; turns white under easily settled by every member of the pro- pressure, but instantly resumes the bright fession,-not by persistent debate, not by scarlet appearance when the pressure is reridicule and abuse,-not by theory and specu- moved; the parts occupied by the efflorescence lation, nor by indiscriminate and loose experi- are swollen, hot, and dry, whilst those parts mentation, but by experiments conducted according to specified conditions, easily comprehended, and not difficult of application. not yet covered, are cool and moist; the angina is also scarlet, and its severity is generally in proportion to the extent of the erupIt is generally known that Hahnemann, in tion: while in the other epidemic, the exanthe year 1801, eleven years after he discov- theme does not appear with any regularity; is ered the homoeopathic law of cure, announced rash-like, imparting a roughness to the feel, to the medical profession of Germany, that occasioned by the slightly enlarged papilla, belladonna possesses not only curative, but and miliary glands; presents a crimson or prophylactic properties in scarlet-fever. He purplish-red appearance, and under pressure, accompanied this announcement by specific instead of becoming white, the places are left conditions, which he set forth as indispensable dotted with dark points; the parts involved to the success of the drug. Hahnemann no- by the eruption are not swollen and hot, but where asserted that belladonna is, UNCONDI- moist, whilst those parts not yet occupied by TIONALLY, either curative or preventive; but the eruption, are dry; and the more limited he most unequivocally denied that he ever the eruption, the greater the angina. Nottaught such a doctrine, or that such could be withstanding there is this marked difference in the case. The requisite conditions he indi- the skin symptoms, and this dissimilarity cated by stating explicitly, that an exact simi- maintains throughout, to a greater or less larity MUST exist between the symptoms of the extent, both are called scarlatina. Now as prevailing epidemic, and the symptoms that these epidemics differ in their symptomatic belladonna is capable of producing in the development, we infer that they differ essen |