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I apprehend, been established by ample andunequivocal testimony. Still, as it seemsthat there are some who entertain doubts ofits power as an obstetric agent, and as Ihave been given to understand that some ofthe public teachers of this branch of thehealing art have discouraged the use of theremedy, it may not be altogether a work ofsupererogation to furnish additional evidencein its favour.

I have now given it in many hundreds ofcases, and I have no hesitation in affirmingthat I know not a medicinal agent more

certain, determinate, or speedy in its opera-tion ; and, I !may add, when administeredunder certain conditions, more safe in itsoperation.Sometimes in ten, but more frequently in

twenty or thirty minutes after it has beentaken, it augments the force of the parturientefforts, and this it continues to do tili thefoetus is fairly expelled. I have observed,not unfrequently, that for a short time afterthe ergot has been administered, the painswhich had previously been experienced willbe suspended, and then they will be renewedin almost nnintermitting succession. Asfar as my observation has obtained, themedicine will generally fail in originatingthe expulsive efforts, unless, indeed, whengiven in large and repeated doses ; but thatwhen the pains have come on spontaneously,the ergot will seldom fail to increase theirforce and intensity.Under the influence of the remedy, the

placenta, though this is by no meansuniform-ly the case, will he thrown off more speedilythan in cases where its use has not beenhad recourse to.

Caution is undoubtedly requisite in theadministration of ergot where there is eitherwant of room in the pelvis, or great rigidityof the soft parts. Where the resistancearises mainly from an unyielding state ofthe os uteri, there is not, according to myexperience, the same objection to its use.

It may be given in forceps cases, where ithere is defect of pain, and where it is de-sirable to bring the head lower down intothe pelvis, in order that it may get withinreach of the instrument; and in all caseswhere the obstacle to the birth of the childlies in the absence of vigorous and efficientpain, the exhibition of the ergot will be inplace, and will often supersede the necessityfor the use of the forceus or vectis.

The cases in which I have found ergot Iinoperative have been those in which thereis a languid and enfeebled state of the

system, from whatever catise induced. Insuch cases it will be advisable, before ad-ministering the medicine, to endeavour toeffect a rally of the animal powers, by givingfood of a cordial and nourishing description.Perhaps few things will answer better, onsuch occasions, than gruel or arrow-root,

or sago, with a moderate quantity of wineor brandy superadded.

Ergot is not so effective in furthering theexpulsion of the placenta, in case of its re-tention, as it is in promoting the birth of thechild ; and should it be necessary, after all,to introduce the hand into the uterus, thecontraction induced by the medicine will belikely to increase the difficulty of manualinterference.When given in cases of menorrhagia, or of

uterine ha’morrhage induced by partial se-

paration of the ovum, and in such instancesI have now and then found the ergot anavailing remedy, it should be exhibited inlarge doses, as in cases of retarded par-turition.

I have repeatedly administered the ergotto pnmtpat’tp, not only with impunity butadvantage. In such cases I deem it expe-dient to give it in quantities short of a fulldose, and with this caution I should not,from the repeated trials I have made in suchcases, apprehend a greater likelihood of thechild being still-born, than if the case wereleft to the unassisted efforts of nature.The powder I find to be the most efficient

form in which the medicine can be exhi-bited. I mix it with water, as warm as thepatient can drink it, nor do I find it neces-

sary to make a decoction or infusion ofit. If any essence be used, it shouldbe given in warm water, as on this cir.cumstance I find much of its efficacy, orat any rate the speed with which it acts,would seem to depend. Though the essenceis not so certain or so speedy in its opera-tion, yet it is not so liable to be rejected bythe stomach as is the powder. My usualdose of the powder is half a drachm, but, infirst cases, I do not generally exceed fifteenor twenty grains.The powdered ergot should be kept in a

bottle closely corked, and covered so as toexclude the light as much as practicable.A lump of camphor, placed in the bottle inwhich it is kept, wilt effectually destroythe insects which are often engendered inthis vegetable powder. SENEX.

* This communication has been authen-ticated to the Editor.

OBJECTIONABLEUSE OF THE ERGOT OF RYE.

To the Editor oj THE LANCET.SIR :-As the following obstetric case il-

lustrates the fact, that in certain constitu-tions the ergot of rye may induce such vio-lent contractions of the uterus as to causepartial separation of the placenta, andthereby produce uterine haemorrhage, per-haps you wilt oblige me by inserting it inyour valuable journal.-I am, Sir, yourobedient servant, A. J. BUR119ESTER.

149, Aldersgate-street, October 21,1839.

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CASE.—On the 10th instant, Mrs. N., amarried woman, of a delicate frame, aged 23,who had always enjoyed pretty good health,was taken in labour with her first child. Onthe Itth, after the pains had lasted 24 hours,the os uteri was found, on examination, to bedilated to the size of a half-crown piece, themembranes protruding, and the head present-ing, the strength of the patient being at thesame time greatly exhausted. Notwith-standing that some slight stimulants wereadministered and gentle friction repeatedlyapplied to the abdomen, the contrac-tions of the uterus were still incapable ofadvancing labour, the exhaustion at thesame time continuing to increase. Afterthis state’ had existed three hours, 20 minimsof Battley’s solution of the ergot of rye wereadministered, without, however, producingany elfect. In half an hour more the samedose was repeated, but still to no purpose.After waiting two hours longer, without thecondition of the patient being altered in anyother respect than that the exhaustion hadincreased, the following was prescribed:-R Powder of the ergot l’f rye, 1 scruple ;

Solution of the ergot of rye, 15 minims.To be taken in tea.

In about 25 minu’tes after which a succes-sion of violent contractions of the uterus en.sued, accompanied in the intervals by hæ-morrhage, which increased in quantity aftereach pain. The loss of blood being consi-derable, it was deemed necessary to hastenthe birth of the child, whiuh was done bymeans of the forceps, whereby the head wasbrought down into the lower part of thevagina, a bandage being at the same timefirmly applied round the abdomen of themother. The haemorrhage now ceased, thefurther escape of blood from the vaginabeing prevented by the head of the child

acting as a plug. After the head had beenbrought into the outlet of the pelvis theforceps were retracted, when the uterus con-tracted sufficiently to complete the act ofparturition at three o’clock P.M., the headpresenting in the second position. Scarcelyany loss of blood attended the extraction ofthe placenta, which was removed about 20minutes after the birth of the child. Bothmother and child are doing exceedinglywell.

SANATORIUMS, LISSON-GROVEASYLUMS, AND DISPENSARIES.

To the Editor of THE LANCET.SIR:—I have perused with much pleasure

your remarks on the hypocritical scheme ofthe " Sanatorium," the details of whichabound in magnificent advantages which areto accrue to those wbo are silly enough toembark capital in such an undertaking, andhold out the " inestimable blessings" thatwill be the lot of those who intrust their

diseases to the care of the proposers of thisknight-errant speculation. Has not thisscheme already been tried, and signallyfailed ; and was the prosperity of the" Asylum for the Recovery of Health," inLisson-grove, such that shareholders can

be found for a new partnership of the samekind ? Alas! no such fortune attendedit, for, after lingering on for a number ofyears in miserable decrepitude, it at lastwent off in colliquative diarrhoea, and thehouse and grounds, and the porringers, pots,and pans, were sold for a third of theirvalue. Heartily sick of the concern werethe proprietors. From what cause is thisattempt made to revive the dead Sanatorium?It is mere dissimulation to use the names ofCharity and Religion to induce the good.hearted and unwary to adopt this interestedplan. If those respectable men, bankers’and merchants’ clerks, felt that they la-boured under the want of medical aid morepressingly than other people, and had call.ed on the profession to give them cheapphysic, then, indeed, a case would exist forour interference. But, as a body, the clerksof London are much better off than the greatmajority of their fellows. Perhaps that isthe very thing for the few pseudo-Samari.tans, who wish to have the clerks undertheir especial protection. Philanthropy hasless to do with the proposal, than the desireto extend the private interests and reputa.tion of the projectors of such institutions.It is usual with them to calculate thus :-" If this scheme be successful, we shall havethe advantage of adding to our names thetitle of Surgeon or Physician to the RoyalAsylum for Bankers’ Clerks." Attend theclerk now; the master stands in perspective.Such, in my opinion, is the ultimate view ofthe speculation.A question of great importance arises out

of this subject. Are Hospitals and Dispen-saries really and invariably useful to society?I contend that a portion of positive evil isconnected with them, inasmuch as that theyhold out a bouus to improvidence in the

poorer walks of life. An instance, amongmany, in illustration, has recently passedunder my observation. The husband of aMrs. Francis, on Saturday last, requestedthat I would have the kindness to visit her,as he considered that she was dying. I ac-

cordingly proceeded to their dwelling, whichis situated in Britannia-gardens, Moore-street, Bryanston-square. It was truly awretched hovel; the walls were black, anddripping with water; there was no fire-placein it, and the windows were broken. Thebed on which she lay was a filthy truckle,without sheets, and only covered with a rag-ged rug. On inquiry, I was informed thatshe was visited once in two days by some oneof the medical officers of the Western GeneralDispensary, and her disease was stated tobe typhus, which, by the by, was, in reality,