in ten days they were difmiffed cured. On the 27th, four more children having been admitted with the fame difeafe, the before-mentioned treatment was adopted with the like fuccefs. Every fucceeding day, two or three new cafes occurred, till between forty and fifty had gone through the difcafe; every one of which terminated favourably, except the three first mentioned, prior to the mercurial treatment: fo that this disease, which, occurring upon a plantation where there were nearly two hundred children under the age of eight years, had neceffarily excited at first so much alarm, after the recovery of ten or fifteen of the cases, was confidered fo manageable that、 all apprehenfion fubfided. Two or three children continuing to be admitted with it daily for a fortnight, I recommended the removal of all the healthy children upon the estate, to Farenough, a very high and healthy fituation, about a mile distant from Killit's; and from this time, the disease gradually disappeared. It is to be observed, that many of the children who were affected with this complaint, were infants, under the age of fix months; and notwithstanding, not less than a grain of calomel was given every four hours to the youngeft, with the use of frictions in the fame proportion, no injury nor inconvenience whatever, refulted from the mercury. In thefe very young children, the use of the gargle in the ordinary way being inadmiffible, the blunt end of a filver probe was armed with a little lint, and being moistened with fome of the gargle, was applied frequently to the floughs, which answered every purpofe. Among the number of thofe affected with angina maligna, only one cafe of an adult occurred, which was in a woman of a relaxed weakly habit, the mother of two of the affected infants, and the calomel was given to her in double the dofes of that to the elder children. From the foregoing cafes, it will be easily observed, that whatever benefit may refult from the use of blifters in this disease, in cold climates, in tropical countrics they are attended with no benefit, if they are not prejudicial; neither is there any reliance to be placed on the bark. As the angina maligna is not a local difeafe, but attended with a putrid diathesis of the fyftem, the capficum gargle can only be confidered as an auxiliary; it will be admitted, however, it is a very powerful one. What would have been the refult of the use of mercury independent of the local stimulus, is uncertain: it is unquestionably, in many complaints, a most invaluable medicine; and may be given with fafety to the infant and the aged, and to perfons of every description, to an extent, that, twenty years ago, would have excited the aftonishment of the most experienced practitioner. An Examination of Dr. OSBURN's Opinion, of the Phyfical Neceffity of Pain and Difficulty in Human Parturition. DEAR SIR, Philadelphia, December 1ft, 1804. HE fubftance of the following paper, was originally de Tlivered as an Introductory Lecture; firft in 1799, and afterwards in 1803. It was alfo regularly delivered every winter fince '99, as a concluding Lecture on the Pelvis. As fome of the opinions it contains have been confidered of fufficient importance to be promulgated without acknowledgment, I have thought proper to alter its form, and thus affert a right, of however little value that right may be. I am, Sir, with the highest respect, Yours, WILLIAM DEWEES. DR. JOHN R. COXE. DR. OSBURN, in the introduction to his effay on laborious parturition, has endeavoured to prove, that pain and difficulty are natural to woman in parturition. He conceives, "that in forrow fhalt thou bring forth children," was a curse pronounced by GoD against man, and that it was his intention it should be fulfilled and continued, as long as the world endured. That this curfe was felt and perpetuated, by the erect form which he gave man; while the horizontal one of the fubordinate quadruped exempted it from these evils; he also supposes, "the peculiar advantages of pofitions fo different from each other, can no more exift in the fame creature, than the strength of the draft-horfe and the fleetnefs of the racer, can be united in the fame animal; as thefe depend on qualities incompatible with each other, and which cannot exist together in the fame subject, fo thofe depend on circumstances of structure, or phyfical laws equally incompatible and inconsistent." From this it would appear, first,. that God intended that woman should bring forth with pain and difficulty; and fecondly, that this intention was answered by a physical peculiarity, that is, an erect form. From these positions I must diffent. GOD in giving the erect form to man, could not mean it should serve as a balance, to the disadvantages refulting from it to the female; he intended man for the most perfect, and the most powerful animal; he gave him faculties, capacities, and appetites, different from all others; he gave him the erect form as the most dignified, and best calculated to display and improve those transcendant advantages. It would indeed be limiting the power of the DEITY, to fuppofe, that a mechanism fo elaborate, and so perfect as that of man, was neceffary to effect a curfe (as Dr. O. believes it) fo limited. Had this been the intention of GOD, why should not the male participate in its difadvantages? or in other words, why should the female alone incur the penalty? fince the doctor himself admits, that, except for this, the erect form is a mark of pre-eminence, and a bleffing. Befides, the phyfical neceffity of pain and difficulty is by no means proved, by the text he has brought forward to demonftrate it. For, "in forrow fhalt thou bring forth chil dren," does not neceffarily imply, they fhall be brought forth with pain and difficulty; for forrow is, in no one instance in the holy writings, made fynonimous with pain or difficulty; in no one instance is it made to fignify corporeal fenfation :-on the contrary, it is invariably used to exprefs a certain painful ftate of mind. I therefore believe, it was only intended to exprefs the anxiety every woman feels for her own fafety, and for that of her infant, at the interefting moment of her becoming a mother. This ftate of mind is infeparable from the pregnant woman; the joyless favage on the banks of the Oroonoko, is not more exempt from it, than the enervated female of civilized fociety. When the reflects on what uncertain tenurelife is held, that one half, or more, of the human race is doomed to certain death before they arrive at maturity; the variety of accidents, as well phyfical as moral, the heir of man is expofed to, fhe forrows, and "in forrow" fhe brings forth. This I conceive to be the true meaning of the text quoted by Doctor O.-for were it otherwise, and made to fignify pain and difficulty, it would neceffarily simply punishment; this punishment ought univerfally to obtain, agreeably to the intention with which it is faid to have been inflicted: but this is not the cafe; we therefore cannot fuppofe it was intended as a punishment. On the contrary, it is more than probable that pain and difficulty are artificial, and are the confequences merely, of civilization and refinement. For the human conftitution, when not under the influence of thefe caufes, will, cæteris paribus, be found capable of meeting and overcoming without any difficulty, the ordinary changes produced by gestation and delivery. Of this, abundant proofs might be given; for the female favage, wherever found, whether under the fcorching heat of an African fun, or beneath the rigorous fky of the unfriendly Labrador, brings forth her young, without the affiftance of an accoucheur or midwife; but the reverfe of this almost universally obtains among the females of the civilized world: thefe differences are moft probably occafioned, by the changes produced on the human constitution, by civilization and refinement. The mischiefs derived from the fources juft mentioned, are: found to confift in the disposition to, or existence of diseases, either general, or local, or both; in those which may affect the fyftem in general, or thofe which may exist in the uterus or pelvis in particular; in the introduction and continuance of certain pernicious cuftoms, habits, or modes of life, thereby inducing a preternatural degree of inability, fenfibility, laxity or rigidity, and hence the physical neceffity of pain and difficulty in parturition, among the greater part of women in a state of civilization and refinement. The difference then, in the opinions of Dr. O. and myfelf, confifts in, what he fuppofes natural and unavoidable, I believe artificial and in part remediable. - I will now examine the Doctor's arguments in favour of this natural physical neceffity; and if their futility or inconclufiveness can clearly be fhewn, I truft my point will be eftablished, without the neceffity of much pofitive reasoning. - Dr. O. thinks it as incompatible to unite the advantages of pofitions, fo different as thofe of man and the quadruped, as it would be to unite the strength of the draft-horse, with the Aleetness of the racer ;-yet it is well known that many women bring forth children without pain, confequently the horizontal. pofition of the brute is not exclusively the only one, in which a fœtus may be born without it. Dr. O. having laid down his favourite pofitions-namely, that pain and difficulty were intended by the Deity as concomitants on human parturition; and fecondly, that these were effected, by the erect form of man; goes on to confider how this is brought about; "to understand," fays he, "how the erect position of body neceffarily operates, in making natural Jabour in woman more painful, tedious, and difficult, than in the quadruped, it is fufficient to obferve, that in fuch a fituation there is the general and powerful influence of gravitation to counteract; in a certain degree, during the whole period, but in a much greater degree, towards the conclufion of uterogeftation; for as geftation advances, the ability in the foft Vol. I. N n |