BLACKWELL FAMILY ELIZABETH BLACKWELL Subject File Medical NotesDR. ELIZBETH BLACKWELL An Appeal in behalf of the Medical Education of Women. New York, 1856 Excerpts: page 9. In 1854 a charter was obtained for the organization of the New York Infirmary and Dispensary for women and children. Under this charter a Dispensary has been organized in one of the most destitute sections of the city. This has been opened for the visits of those needing medical advice and medicine. It has been gratuitously attended by Dr. Elizabeth Blackwell, Drs. Parker, Camman, Kissam and Taylor, acting as consulting physicians. More than three hundred poor women have received assistance from this institution, and instruction as to healthy habits of life, and friendly counsel, has been often added to the medical advice and medicine. The time has now arrived for the extension of this charity so as to make it the foundation of the Institution so urgently needed, and it is proposed to do this, by the enlargement of the outpatient department, and the organization of the Hospital department, as contemplated in the charter. .......... Another object which it is hoped will be accomplished by this Institution, is that of the realizing the standard of the education and training of nurses. The want so strongly felt by all those who have anything to do with medicine, a body of thoroughly trained nurses, filled with a high sense of the moral responsibility of the profession, will never be fully met until woman's true position in medicine is recognized and granted. The reform, in this respect, which Florence Nightingale is so bravely endeavoring to effect in England, will, it is hoped, grow out of the proposed Woman's Hospital here. Particular attention will be paid to training nurses for the supply of families. .......... The present Executive Committee consists of the following members: Stacy B. Collins, President, 155 Bleecker Street Robt. Haydock, Treasurer, 46 Broadway Dr. Elizabeth Blackwell, 79 East 15th Street Dr. Marie E. Zakrzewska Dr. Emily Blackwell Appendix In view of the great importance of the undertaking and the appeal made to the confidence of the public in raising the funds necessary for its support, it is considered right to subjoin the following statement and testimonials in relation to the qualifications of the physicians most actively engaged in establishing the proposed hospital. Dr. Elizabeth Blackwell, after graduating at Geneva Medical College, N.Y., studied medicine for three years at the great Hospitals of England, France and Germany, bringing testimonials fromDubois, Burrows, Paget, and other distinguished physicians, with whom she had studied. She has been a successful practitioner of medicine during the last five years in New York City. [* [?] [?] 1854 notes *]May 12 _ 54 Emily in Edinburgh no medical sympathy collect sexual information Advantage of my house. May 22 Dr. Gines - Zackrzowska - Should a woman's society be formed - July 24 good letter Good advice to E on studying < Cases reported by E. Hot weather - Counsel her to stay - Aug. 11th pessary trial - Provost to Hackensade Ellen Channing. Raritan Bay settlements - Variety of cases discussed - Oct /54. Full accounts of practice - Female flag - Instruments &c sent by Emily Difficulties about dispensary - Account of Kitty - Zackrozwska going to Cleveland - Nov /54 - Advice & encouragement to Emily - Zackrzowskas german support - Reproach, women doctors not social - New York hospital encouragement - Longing references to England -Jan 23. /55 Marie's illness-criticism - 4th year's practice disappointing - reasons for this- Women received at N.Y. hospital- [Spring] of 55- March [or February] to April Sensible views on all [Eonced?] experience - Woman's slow development - Sinis conservation - D Harris, Watson, Silman Wiesty - Sep. 55 Domestic difficulties - Harry - the Benney * APPLICATION FOR SHARES. No To be retained by the Bankers. The Big Blow Gold Mines, Li Form of Application for shares To the Directors of The Big Blow God Mines, LIMITED. GENTLEMEN, Having paid to your Bankers the sum of __ of __ per Share on __Shares of £1 each of GOLD MINES, LIMITED, I hereby apply for that number of Shares on Prospectus, dated 10th November, 1894, and agree to accept the sam[e] number that may be allotted to me, and to pay the amount due ther[eof] with the terms of the Prospectus, and I authorise you to place m[?] Register of Members in respect of the Shares so allotted. I agree as Trustees for the Directors and other persons liable, to waive any [*ADELAIDE, 79, Cornhill, London, E.C., eds.*]There are 4 methods of excretion by which the blood is purified 1st by the Lungs in the production of carbonic acid & water. 2nd to some extent by the alimentary canal, various secretions passing off with the refuse of the food - 3rd by the Skin - 4th by the Kidneys - No organ of the body is more important as a secretor, more complicated in structure & varied in function - Its basis serves as an integument - it is an organ of special sensation (tact) has important secreting organs imbedded in it, also hair & nails, The subcutaneous layer of fat & cellular tissue, lying upon the fascia superficialy & beneath the cutis vera, is the Cause of the most important differences which we see in skins- it is best seen in the heel, & palms of the hands, it consists of a coarser network below & in finer above next to the cutis. [drawing labelled subcutaneous fat]. The cutis consists of fibro cellular tissue, elastic tissue & muscular fibres - vessels & nerves but no fat - It is the part which acts especially as an integument for the body, being so tough & resisting gliding over parts, that in railroad accidents, it has remained unbroken while the rest has been one smash (bag of smash) - It is supplied by abundant fine blood vessels [*Tuneia interua, media, exteria - in the subcutaneous, cutis, papillae*] which are furnished from larger freely anastomising ones beneath the fascia superficialis -it is thus necessary to turn up a portion of the fasia with its vessels, in making a flap, or the fines vessels are not sufficient to nourish the skin - The smooth non striated muscular fibres that exist every where in the cutis, are particularly remarkable over the genital organs, (giving a pink hue of the scrotum) & around the nipple -the cutis auserinas, is owing to the contraction of these fibres, [*which are attached obliquely to the skin & to the base of the hair follicles -*] the pores, through which the hairs pass, being ordinarily depressed but [drawing labelled cutis auraisy] appearing to rise when cold contracts these muscular fibres - During parturition (Hunter) that preparation of the perineum] which takes place, before pressure is exerted there by the foetus, is owing to the paralysis of these muscular fibres, producing there relaxation, as is observed in the relaxation of sphincters- The papillae, the organs of sensation vary in number & size in different parts of the body - they are prolongations of the cutis, of varying shape - being carried [drawing labelled paillae] mammillary, pointed as only slightly elevated, being about the 30th of an inch or less, generally, in length, but as large as the 20th of an inch in the nipple, the lips where the skin joins the [men cavy mens?] brave &c - In the palms of the hands, fingers where we observe a succession of ridges & depressions, the papillae occupy the two sides of the top of the ridge, with a row of sweat glands between them - in general, hair & [follicles] papilla are not found together- [drawing] The sense of tact, by which form is appreciated, differs from ordinary sensation - it depends on the papillae, but in what manner is not known, not on number & fineness, for the face is more supplied than other parts more sensitive - not on the number of separate nerve fibres entering the papillae, for the same fibre may be traced into 2 or more exceedingly sensitive - The palmar surface of the hand, the sole of the foot the lip & face are amongst the most sensitive parts - the tongue however stands first - the fine papillae at its tip supplied by the lingual branches of the 5th pair, can appreciate two impressions 1/2 a line apart - Experiment on sensibility of skin by a pair of forceps covered with cork - the lips, the pulps of fingers can appreciate the two impressions very near together, while the thighs notes &c, confound in one, two impressions 1/2 an inch apart - Varies in individuals - The subcutaneous tissue not very sensitive, the cutis becomes highly so, probably from the number of close nerve fibres on which depends sensibility - The sweat glands or sudoriparous glands are found all over the surface of the body, in unequal quantities - in stripping off the epidermis from a peice of putrid skin, the little prolongations which are seen attached to the epidermis, like threads of nerves, are the lining of the sweat glands, which are pulled out strait. - the duty of these glandswhich open between the [papille], run spirally through the [epidermis?], straight through the [cutis?], and form a coiled bulb in the subcutaneous tissue - they are forward externally of a fibro cellular coat longitudinal and inside are found the [anoleated?] cells of muscular tissue circular. (this rudimental tissue possesses the contractile function of developed musculer tissue) which will account for the sudden sweats of fainting, fear, etc, from the sudden contraction of this tissue - the [faudy?] of the axilla are peculiarly large short and straight - not found with the hair of the scalp - about 10,000 glands, on a sq inch of surface (Wilson says 8 miles of gland surface in the body) Chemical analysis does not explain the immense importance of this secretion - carbonic acid, water, salts of soda etc nitrogen, all that is found - acid reaction at first, afterward, alkaline from the [cleael openiut?] of [aureroseia?] from the [agote] - oily as seen by pressing finger and on a razor on a warm day, the water evaporating, leaves an oily impress of the sweat ducts - The french have [opanad?] and [oar?] [nited?] dogs leaving [ecofsieation?] free - they died in 4 hours - same result when encased in [thackin tool?] - animals die in from 4 to 24 hours, with every mark of asphyxia checked perspiration in the human subject - the division of sensible & insensible perspiration is bad this depending on the atmosphere - true distinction, secretion from the glands & simple [transudation?] through the skin - sweat glands secrete from this whole surface, the ducts being lined by secreting cells - Absorption [lathes?] place probably by the blood vessels, for it is not proved that [lymphatics?] enter the epidermis - not solid [substances] they must be in the solution, but [draching?] (of opium for instance) will not act as powerfully by the skin, as do many drops in the stomach - [nales?] appear to be absorped with difficulty - from the thick & oily nature of the epidermis - in the experiments - by immersion how ever, the small [mirease?] of weight is the absolute excess of absorption over secretion. He then performs a species of respiration - as by evaporation, it is only the water which is removed, the oil & salts remaining on the skin, cleanliness is necessary, to free the orifaces from too thick a layer - The hair follicles are formed by an inversion of the thin layer of the [cutigloss gitudinal?], with circular fibresinside which are uncleated & may be muscular - a layer of epidermis is inflected & appears continuous with the side of the hair - the cutis lay is richly supplied with blood vessels, the [bulbad?] extremity turns up forming to papillae which secrete the hair substance - the hair follicles are very long, extending into the subcutaneous tissue. The very short hairs however, over the body only reach below the epidermis - curly hair has a curved bulb - Sebaceous follicles accompaning hair often in an inverse ratio to their size - sometimes a small sebaceous duct opens on each side the hair follicle - at others the gland may be the principle, bilobed, many lobed or a conglomerate gland like the [pucibmean?] around the vagina & scrotum a corona of ducts surround the hair. these glands which contain a white fatty substance, thickly surround parts liable to liquid secreting or discharges - strait hair curly hair sebaceous ducts opening into follicle hair follicle opening into sebaceous gland forming of sebaceous glands The fibrous capsule of the kidney can be stripped off in health - no fibrocellular tissue in the substance. The ureter expands into the pelvis, divides into the infundibula, which divide into the calices - on the other side, the kidney consists of the [coutical?] or [vaseudas?] portion, & the tubular or secreting portion ; this tubular portion forms papillae which dip into the calices as the fingers into a glove - the ureter portion is lined by a mucous membrane, covered by pyramidal epethelium - disease of this part never causes regurgitation into the tubales, for all dilatation would serve to close the fine urinary ducts - The papillae A which exist to the number of 12 or 15 & are about 1/2 inch in length, are the Pyramids of Malpighi, which are composed of tufts of uriniferous tubes & dip into the Colius - the separate tufts which compose them are the pyramids of & the single tubes are the tubules of Bellini - each tubule which opens by a fine aperture on the point of the cone proceed, by strait [diaotoueous?] branches through the tubular portion of the kidney. each division being as large as the main branch - when it reaches the cortical portion, it curls over forming convolutions till it reaches the side or surface of the kidney, where it expands into the Malpighian body. B. or two ducts an as [toruose?] and from their point of union , grows a fine tubule which expands into the Malpighian body - C - The tubes are formed of a fine pellicle membrane like the capillary vessel, with an occasional nucleus in their wall, - they are lined fro a short distance by the pyramidal epithelium like the uretral portion - then by the spheroidal epithelium, which may be a collection of neucleated cells - D - these cells become more numerous & fill the tubes in some diseased states - The renal artery is very large - the vein comparatively small - a [eafoid?] circulation taking place. The arrangement of the vessels is [pe] remarkable - The arterial branches do not [paiuify?] directly upon the walls of the tubule - A considerable anterial branch penetrates the Malpighian body, forming a convoluted ball of vessels in its' interior, from which arise venous bunches which collects into one, which passes out near the point where the arterial branch entered, which then proceeds to [ramify?] on the tubule - In some animals (the frog) the Malpighian bodies are lined by ciliated epithelium, which in the breeding season is in active suction - The secretion of urine is acid in the morning when the stomach is alkaline & vice-versa - bearing an minute [rates?] to the gastric secretion. The urea is formed in the blood, the salts are formed in the kidneys. All [c] erchions are low compounds, the high chemical compounds are all retained in the body - Strange fact, that though. The blood of the renal artery & vein are alkaline like the rest of the blood. The urine is acid - The salts of the urine, inorganic compounds cast out, we know not why - Over excitement of the nervous system as companied by development of the phosphates in the urine - they in inflammation of the brain ([Benne Sorus?]) - In those cases of paralysis of the lower part of body from disease of spinal cord, where sloughing often occurs much ammonia is secreted in the urine - formed probably in the bladder, not the kidney. On the Nervous System Two kinds of nervous substance to be considered - the nerve fibre & nerve corpuscle - The nerve fibre consists of neurilemma a continuation of the [Deara Mater?] moistening the nerve, with cellular tissue partitioning which separate it into bundles - the first division is the primitive nerve fibre, this consists of a pellucid membrane without nuclei, which when examined by the microscope immediately after death appears to contain an oily fluid, in a tubular layer, with a central fibre of forin gray substances - after some time the oily matter seems to congeal, the central fibre remaining the same b - this oily substance ceases near the two extremities of the nerve, & is supposed by some to serve [enerely?] as an insulator during its' course to preserve by the escape too soon of the nervous influence conveyed by the central gray fibre - nerves, terminate some times by loops A B C D a at death b after death in the bulb of the teeth, the fingers &c-by branching & disappearing as in the muscles-in [paeclesirian?] corpuscles as in the soles & palms [?] the several layers of the capsule containing fluid-The darker gray colour of the sympathetic nerve as owing to the prolongation of the [ganglionic?] substance beyond the ganglia- [drawing][Extraties?] an abcess of liver or spleen, opened the abdomen to apply remedies directly to the diseased parts. Galen says there were or many special physicians or organs of the body, [diebetic?] pharmcentrical, chirurgical [neruia?] deuliot articular 2nd century Archigenes invented an instrument to dilate the vagina to open an abcess- Galen removed a portion of the sternum & finding the pericardium diseased, removed it leaving the heart bare, he [?] the patient recovered!- [Phil?] was well aquainted with uterine displacements-Moschior extirpated the prolapsed uterus- Water 790 Blood dises 127 Albumen 30 Fibrine 3Emetics Direct Carbonate of Ammonia 30g Sulfonate of Zinc Sulphate of copper Mustard Seed teasp Indirect Tartar emetic Ipecacuanha 20-30 Gillenia Lobelia [30-13] Squills 30-13 Violets. Laxatives Prunes tamarinds Figs Cassein Pulp Sulphur Olive oil Almond oil Castor oil Magnolia (calcium carbonate) Manna Mustard seed Linseed oil Salinic Cathartics Sulphate Magnesia Sulp - Soda Phosphate Soda Soda Potassa Tartres Bitartrate Potassa Sulphate Potassa Milder Acrids Lenna - Aloes Rhubarb - Podophyllum Butternut - Blue Flag Turpentine &c Drastics Jalap Colchacium Scammorny Croton oil Hellebre Elaterium Colocynth Mercurials Samboge Sedativies direct 1. Hydrocyanic acid 2. Cherry Laurel 3. Wild Cherry 4. Peach-Apricot 5. Cyanuret Potash 6. Cyanide of tiree 7. [?] cyanide of Tine Carbonic Acid Chloroform Bleeding Nauseants. Anthelmintics. Spigelia Marylandica Chenopodium Anthelminticuni Geoffroya Inermis. Punica Granatum Artemesia Absinthium Ruta Graverlens. Aspidium Felix Mas. Terebinthina Oleum Laurus Camphora. Cathartics. Expectorant Direct Stimulating Inhalations Sedative Astringent Senega Squills Lobelia Benjoir Bloodroot Stimulating Acetic Acid Assafatoda Tolu Sum guai a cum Canada Balsam Galbanurn [Ann ?] Copaiva Myrrh-Styam Benjoin Chlorine Tolu-Peru_Naptha Iodine Lopaiba Tar-redin[?] Turpentine Stamouriesm Ammonia Sedative Opium [Blood root] Couirrme Creosote Tobacco Hydoxrganic Acid Digitalis 1 gr- 10-20bm Camphor Tanninc Astringent Oak bark lorau tea [?] Vinegar Sialagoquet Pyrethrum Mezereon Calamus Ginger Tobacco Errhines Veratrum Tobacco Asarum Iris Euphorbium Duiretics Oil of turpentine Juniper Iodine Liquor Potasoe Hydriodate of Potash Acetate - - Nitrate - - Bitartrate - - Cautharides - Copaiban Cubebs - Squills Colchicum - Dandelion Indian Hemp - Parsley Winter green - Carrot Erigerou - digitalis Diaphoretics External Mohair bath Vapour bath Warm & hot water bath Cold affusion Electricity Friction (Shampooing) Exercise Refrigmerant Cold Citrate of Potash Nitrate - - Acetate of Ammonia Nauseating Ipecacacuanha Antimory James Powder Alternative Sarsaparilla Guaiac Mezereum Sassafras Xanthoxylon Antilithics Acid Muriatic acid Lactic -- Nitric -- Alkaline Liquor Patassoe Carbonate of Patash - - Soda Ammonia Carbonae Ammonia Magnesia Lime water Uva Urse Chimapohila Parenira Brava Buchu Emmenagogues Electricity Saveir Polygala Senega Hellabore Pantharides Berry royal Valerian Drastic cathartics Ergot Narcotcs Opium Lactucarium Aconite Couisem Tolanum Nigrum Solanum Duleamera Atropa Belladonna Datura Stramonium Hyasyamus Niger Humulus Lupulus Comphor Cannabis Indica Atcoho. antispasmodics Assafortida Castor Musk Valerian Amber Coffee Tea Tetanics Sauchnia Brucia Arnic Alteratives Mercury Taraxacum Alkalis Mineral Water Rvulsives. Rebefocients Musterd Caramine Pepper Oil of Trupentine Cajmphor Epiopasteas Suppurants Mineral acids Tartaremetic Ipecaeuanha Croton oil Caustic Potash Actual Cantiy Escharotied. Nitrate of Mercary Nitrate of silver Potassa fuda Astringents. gr 2-5 Tannin - 10-20 Gallic acid f oz 1-2 1-2 Rhatany x 1[?]- 1pt f oz 2 Water Dock 1[?]-1pt Bistort x Tormentilla f oz 1-2 blackberry root 1[?]-1 pt f oz 1-2 Geraniaicc Maculatum f oz 1-2 Geum Nioale - Witch Hazel Persimmon Oak bark gr 2-10 Monesia x f oz 1-2 Matico x f oz 1 Kinio x oz-8 oz gr 10-30 Catecju x Gall nuts sulphuric Acid Acetic - gr 10-20 Alium Sulphate of Copper Sulphate of Tine Nitrate of silver Acetate of lead Gold Elizabeth Blackwell's “Notes, From a Thesis on Albuminos Urine" 4 pp. in her handwriting undatedWith best wishes for Christmas and the New Year Notes From a Thesis on Albuminous Urine.Observations on the albuminous urine of pregnant women, based on the examination of 205 cases. By M. Blot. Definition. The passage of albumin into the urine. Prop: I. The normal condition of urine in pregnant women is without albumin - in 205 cases it was present in 41. Prop: II. Albuminurina exists much oftener than is suspected, having no distinguishing sign, but the condition of the urine. Prop: III. It is always worthy of observation from the grave accidents it sometimes accompanies, but is not in itself dangerous. Prop: IV. It is not a cause of albuminous nephritis - of 7 deaths, 3 only presented disease of the Kidneys. Prop: V. It always indicates some lesion of the urinary passages, but in general, a simple physiological trouble. Causes. Venous congestion active or passive, sympathetic nervous irritation of the kidneys. Disease of the urinary passages. Primiparity a predisposing cause of 41, 30 were Primipara. Autopsy. Every complication may be found after death - the kidneys not specially affected.Signs. None, infiltration partial or general did not exist in half the cases. Course. Generally very rapid, commencing shortly, or immediately before labor, increasing during labor and diminishing after it, in from two days, to two hours. Diagnosis. Urine must be examined - distinguish from nephritis. Seek the common cause, renal congestion. Prognosis. According to its duration, and the existing complications. Effects. Its effects on gestation, labor, the fœtus, & the sequences of labor are proved by these cases to be nul. Relations to Eclampsia. Its connexion with Eclampsia, seems to be one of co-incidence not cause. Albuminous urine is always present in Eclampsia, but of the 41 cases, 7 only suffered from Eclampsia - Albumin is present in greater abundance during the attack 19/20, after it 1/4 - vanishing within 8 hours after delivery. Congestion the probable cause of both. Stupor, coma, hemiplegia, resulting from infiltration of the sub-arachnaide cellular tissue & of the ventricles, are like general infiltration, connected with eclampsia. The treatment of this condition should rather be by saline purgatives than depletion by bleeding. Comission with uterine hemorrhage, before & after [acc?ment] The fibroplastia elements of the serum are found to be diminished [in the se] from 72 to 57, when this condition has continued for some time, the formation of clots may thus be rendered slow, or impossible; in one case the hemorrhage continued for 17 hours when the patient died, of a pale colour, unchecked by any means. Albuminurine does not necessarily produce hemorrhage of 41, 12 suffered from hemorrhage, 3 only seriously. There is however a tendancy to hemorrhage which is not always uterine, in pregnant women with albuminurine. Treatment. If caused by renal congestion general & local bleeding with caution. Remarks on the treatment of the urine. When the urine, filtered of troubled, acid [related?] if alkaline, loses its transparence by heat, or gives an insoluble coagulumwith nitric acid, it contains albumen (Exceptions - The presence of a small quantity of nitric acetic, or phosphoric acid, prevents the coagulation of albumen - heat would therefore be useless if phosphoric acid be present. - Add then some [?] of nitric acid, & the coagulation takes place. The albumin urine of pregnant women contains many salts especially urates, which is not the case in albuminous nephritis developed in other cases; these salts which trouble the urine at an ordinary temperature, disappear on boiling or adding nitric acid. To the skilful eye also they appear pulverulent instead of flocculant. Nitric acid may precipitate salts, therefore microscopic observation is necessary. Albumen as precipitated by nitric acid, is in flakes of milky white, or yellowish grey, which after being washed, dissolves in caustic potash, and cannot be precipitated by nitric acid. Coagulated albumen, seen by the microscope, appears lamellar, of varying dimensions, irregular form, festooned at the circumference, while oftener yellowish, areolar, punctuated, semi-transparent in points, opaque in others. The salts present crystals. Albuminous urine may appear to the eye - Sanguinous - ordinary - Purulent - Mucous. -Mecical notes, Dr. E. Human ovologyHuman Ovology. Human embryogine gathered not only from analogy but actual observation — The ovum composed as in other mammifera of 1 membrane vitelline — 2 a little grey mast the vitellus — 3 the diaphanous vesicles, which life that of Purkinje, breaks after fecundations & deposits the materials which contribute to form the rudiments of the ?ine being. — The decidua of Authors formed before the arrival of the ovide a pushed aside by the latter, an abnormal state — 1 not found in animals. — 2 only found in abortions or extra uterine gestations. "Taken in the ovarium, the human ovule, offers no difference with that of birds & mammifers, it is composed; 1 Of an external membrane (vitelline) the Chorion, 2 Of a granulous mass contained in the membrane (vitellus) 3 Of a little vesicle, analogous to that of Purkinje. When it has passed into the uterus, this ovule is formed of two vesicles only, closely adherent, the external preserved always the same signification; the internal takes the name of Blastomeric vesicle in it the essential phenomena of developement take place. Or it is manifested the embryonic spot having an elliptic form, & constituting one of two lobed the second being the Ombilical vesicle. During developement a third lobe appears; thus we find 1 An embryonic lobe, the embryo being placed horizontally, and the back turned towards the neighboring wall of the vitelline membrane, from which it is only separated by a fine pellicle; transparent without colour or organization, which pellicle is detached from all the surface of the embryo, and is adherent only round the ombilical opening which is expanded widely. This pellicle is the Amnios, the accessory layer of the Blastoderma. 2. An umbilical lobe, directed to the side of the cephalic extremity, and communicating with the middle portion of the intestine, which is straight at this epoch. The swelled portions of the umbilical vesicle, never acquires large extensions, and finally disappears at an early period of gestation, its pedicle on the contrary attains a considerable length, but slight trapes only, of its existence remain in the umbilical cord in which it is comprised. 3. The Allantoïde lobe. It is continuous with the symphysis pubis and the inferior lateral walls of the abdomen, & is in communication with the rectum, by what will be the [?]. It is this which carries the vascular allantoïdien system, is converted into umbilical cord, by the spiral torsion to which the embryo in its evolutions subjects the pedicle, & realises the placenta in applying its fundus to the vitelline membrane & through the medium of this to the uterus. The envelopes of the fetus, proceeding from the interior to the exterior arc. 1. The Aminos, a general epidermis of the whole blastoderma, which not only envelopes the umbilical cord but is applied to all the surface of the chorion with which it contracts adherances by means of little fibrilla. In its interior are the waters of the Aminos. 2. The Chorion or Vitelline offers villous prolongations destined to multiply the surface of contact, $ thus favor the passage of fluids from the mother to the fœtus, when the placenta is not yet developed. These villi atrophy as the placenta is developed, wither [sic] they nor the membrane is organized. It is not continuous with the umbilical cord & simply serves as organ of protection. 3. The Caduca is exhaled by the uterus, in a normal state, after the arrival of the ovule. Like the other envelopes of the fœtus it is inorganic." O ombilical vesicle A allantoïd [?] external layer [?] internal layer [?] cavity abdominalCoste's Ovologie. Abstract An egg is a complex vesicle, emanated from the ovary, and enclosing in itself the elements of a future being. It is divided into essential & accessory parts. The Ovary in all Vertebrata has the same general structure. - viz 1st a parenchyma varying in sensible qualities - 2nd an enveloping membrane, inseparable. 3rd a peritoneal covering. The Ovary is sown with transparent globules whose envelope is formed at the expense of that Ovary, & enclosing a transparent liquid - this the vesicle of Graaf, when cut, a granulous liquid issues, & a little spherical visicular body - This body is the egg. The egg is composed 1st of a transparent envelope "The Vitellina as in birds it is formed in the ovary, enclosed the Vitellus, new developed vessels, and later encloses the foetus & its annexes, but has no link of continuity with them." 2 the membrane vitellina encloses a spherical mass of greyish yellow granules, at whose expense the Blastodermia is formed. 3rd a transparent point placed at the surface of the vitellus, which is a vesicle of extreme tenicity, which disappeared on fecondation or exposure to the air, & is the analogue of the vesicle of Purkinge in birds. After fecondation, the vesicles of Graaf, secrete an increased quantity of liquid burst in one or two spots, through which pass the liquid & egg. The tissue of the ovary, by the remnant of the vesicle inflames [turnefies?], then indurates, becomes discolored, forming the corporalutea (corps jounes). During conception the organs [?], the egg enters the uterus & presents that point of its surface which corresponds with the embryonic spot, to the "[Masentime?] line of the uterus" (formed on each side by the entrance of the vessels) - The presence of the egg in the uterus, provokes an albuminous exhalation, which envelopes it, and forms an accessory or protective membrane (adventive). The space which was occupied by the Vitellus, whose condensation served to form the Blastoderma, is filled with a transparent liquid. Soon by a process of endosmosis, a second membrane is unrolled within the first, this is the blastodermic vesicle, formed by the condensation of the Vitellus, whose place is filled by a transparent fluid - This membrane has the same functions as the Blastoderma of birds; on one point of its circumference, appear the first globules of the embryo. It is formed of three layers. Soon a circular spot of cloudy granules appears on a point of the blastodermic vesicle, this is the embryonic spot; it takes an elliptic form, like a guitar, with two faci. The grand axis always takes a determinate position to the uterus in each species. The circular embryonic spot, receives its elliptic form, by the folding of the blastodermic vesicle, which then consists of 2 lobes, the little elliptic portion, and a larger or Umbilical vesicle, connected by a contraction, with that portion of the ellipse which represents the pelvis, a portion of this contraction gradually projects from the pelvis and forms a cul de sac or third love, the Allantoide. Thus the Blastodermia which consisting of three layers, is converted into three lobes. Of the three layers, two are principal. At this period the embryo resembles a slipper, with a cephalic & caudal extremity, & open abdominal cavity, consisting of two layers, and presenting the type of the Hydras. The outer layer forms the skin or rather envelope, consisting of the bony, muscular, & nervous systems, and probably sends a projection to form the peritoneum. The internal layer folds in, at first as a simple tune from the cephalic to the caudal extremity, when the embryo resembles a leech - As the abdominal walls close, this tube sends forth [?], which become the glandular organs of the two cavities. The Umbilical vesicle destined to furnish nourishment to the embryo, during the earliest period of gestation, gradually disappears, in most mammifers and presents an antagonism with the Allantoid. It is formed of the external & internal layers of the embryo, develops the transitory omphalo [mesenterne?] vessels, and communicates at first with the small intestines, which communications is obliterated as its pedicle closes. The Allantoid, composed of the same two layers, developed from the pedicle of the umbilical vesicle, is continuous at first with the rectum representing the cloaca of birds, afterwards with the bladder, forming the Uracus, and the allantoids placental vessels. The external portion prolonged to the vitelline membrane, adheres to the uterus, and forms the umbilical cord, & the placenta. The renovation of blood is carried on by absorption or imbibition - red blood, and cardiac beating, found in some animals, before the formation of the placenta - the sheep for example. The embryo is always placed horizontally; the caudal extremity being fixed by the cord, as the pedicle contracts, the cephalic extremity is curved.The Amnios is formed by the third or accessory layer of the blastoderina which detaches itself as an epidermis of the foetus to envelope it and enclose a liquid like the Vitellius or Chorian, it has no vessels.I. Superior thyroid/Laryngeal 2. Lingual Dorsalis Sublingual Ranine 3. Facial Submental Masseteric Inferior labial Superior & Inferior Coronary Ansal. 4, Inferior Phargngeal (Posterior Meningeal 5, Occipital 6. Posterior Auricular 7. Temporal Transversalid Faciei Middle Temporal Anterior & Posterior Temporals 8, Internal Maxillary Tympanic Menninger Parva Meningea Magna Inferior Dental Deep Temporals Pterygoid Buccal Superior Alveola Infra Orbital Superior Palatine Superior Pharyngeal 13 pheno-Palatine. Internal Carotid 1. Posterior Communicating 2. Middle Cerebral 3. Anterior Cerebral 4. Ophthalmic Subclavian 1. Vertebral ( Anterior & posterior spinal Inferior Cerebella Basilar Superior cerebellar Anterior cerebral 2. Inferior Thyroid -Ascending Cervical 3. Superior Intercostal 4. Internal Mammery (Superior Diaphragmatic 5. Posterior Cervical Axcillary Artery 1. Superior Scapulavis 2. External Mammeries Thoracia Superior - - Longa - - Aeromialis - - Axillaris 3 Scapular Artery (Dorsalis Inferior Scapula) 4 Anterior Circumflex 5 Posterior bircumflex Brachialartery 1 Profunda Major 2 Profunda Minor 3 Nutritious 4. Anastomotic Radial 1 Recurrent radialis 2. Irregular Muscular branches 3 Superficialis Vole 4 Dorsilis Carpi 6 Radialis Indicis 7 Palmaris Profund Ulnar 1 Recurreus Ulnaris 2 Interossea - Anterior Posterior Recurrent 3 Irregular Muscular branches 4 Dorsalis Manus 5 Arcus sublimus (lubtalis Manus profunda) 6 Digital Arteries - Digito Ulnar Digito-Radial Thoracic Aorta 1 Bronchial 2 Esophageal 3 Posterior Mediastinal 4 Intercostal Abdominal Aorta 1 Phrenic 2 Caliac axis - Gastra Hepatic (right Gastro-Epiploie Cystic Golemia- Panereatic left Gastro-Epiploie Vaso Brevia 3 Superior Mesenterie - Colic Ileo colic Coliea Dextra Colca Media 4 Emulgent -Capsular 5 Spermatic 6 Inferior Mesenteric - Superior Left Colic Middle Left colic Inferior left Colic Superior Hemorrhoidel 7 Lumbar 8 Middle Sacral Internal Iliac 1 [?Gio]-lumbar 2 Lateral Sacral 3Absturator 4 Middle Hemorrhoidal 5 Vesical 6 Unterine 7 Gluteal 8 Ischiatic 9 Internal Pudic -Lower Hemmorrhoidal Perineal Urethio-bulbar Dorsalis Penis Lavernous External Iliac 1 Epigastric 2. Cicumplex Gii Femoral 1 Superficial Artery of the Abdomen 2 External Pudic 3 Orofunda - Perforating External Circumflex Internal 4 Anastoireosing Prolitial 1 Superior internal articulating 2 Superior external articulating 3. Middle Articulating 4. Inferior Internal articulating 5. Inferior external articulating 7. Gemellar Anterior Tibial 1. Recurrent Tibial 2. Internal Malleolar 3. External Malliolar 4. Tarsal 5. Metatersal 6. Dorsal 7. Pedal Posterior Tibial 1. Peroniel 2. Internal Plantar 3. External Planter -DigitalMedical notes VesiculaeVesicula Herpes. Groups of vesicles on a circumscrib ( epπw) ed, inflamed base,separated from each (to creep) other by healthy oRin. Eczema. (ex[?] to boil out) Crowded vesicles on irregular non-circumscribed surfaces; vesicles generally very small, & surfaces large, with or without inflammation. distinguish from miliary eruption by the coupling or crowed ^ character of it resides, & less general disturbance, for itch by its flattened, as well as crowded vesciles The chronic form may with difficulty be distinguished from lichen or psoriasis- vesicle will characterise if they can be found. Medical notes eruptions1 Efflorescent eruptions. Exanthema measles. Scarlet fever. Erysipelas. Nettle rash Erythema has several varieties, [nodosum?] intertrigo-the latter in fat persons where two skins rub. Roseola is 2 Vesicular eruptions Eczema. Herpes. Scabies. 3 Large vesicular eruption. Bullae Pemphigies 4 Pustular eruptions Acne. 5 Papular eruptions 6 Scally eruptions. Squamae Psoriasis or [baken?] & Groces itch.1. Marked by the rosy tint of eruption distinctly [curcumsarked?] generally a little fever.Dr. Eliz. notes on "Excretions"Copyright 194 Hickory Publishing C Printed in U.S. 25x1277 Excretions. The human body, a laboratory; the excretions are its refuse; they are both the result and the measure, of the exchanges which go on between the outside world and our own organization; they maintain the equilibrium between nutrition and decomposition. Their proportion to food, varies according to age; and is one of the essential elements, of the hygienic status. They purify the blood. Modify animal heat. And the action of the skin, corrects the effects of climate, exercise, modes of life. They lubricate the springs of the human machine; and the activity of organs; protect them in their exercise; and defend them from external forces. They reflect the changes of disease and are often curative by means of crises'. The skin, and the mucous membranes, are the two passages, by means of which we receive the materials of life, and eject refuse. It can be proved by weighing that the mass of our bodies is continually varying; there is no uniform rule in this increase or decrease, but the variations are not great, and always bring the body back to the individual mean weight.Medical Notes, Dr. Eliz. "Cholera" During Cholera season in 400 families he used sulphur as an effectual preventive --so effectual that it was said he was unlucky in never have a case of Cholera--Success of a quack who sold pill of sulphur & charcoal-- Vegetable charcoal specific in yellow fever if taken at the commencement of an attack has had patients well in six hours--If these formidable diseases have taken firm hold of the system, they lose 20 per cent--Other physicians kill their patients--all apathy invariably does harm, by its use of over dose, even if the medicine be rightly chosen--The abuse of quina in fever, many of their patients dying of quina symptoms--has cured several cancers with preparation of lime--in some, a small open sore was left which would have healed of itself in a few weeks--but the patients would not follow his directions or placed themselves with other physicians, when the sores became large again but not of cancerous character--only one lady he could now produce--Consumption in its early stages may always be cured--by mechanical & chemical means--breathing exercises indispensable but almost impossible to make patients carry out--Dyspepsia produced by a whole system of wrong living from cradle to grave--improper food --great abuse of sugar, 2 lbs per week--articles which leave a residue only, fitted for food-- Considers the high dilutions rather more efficacious, but attachs little importance to the dilution- Thinks the opinion relating to the unhealthiness of the American climate unfounded-not changes of temperature that are injurious, witness [posbboy?] & bathing, but bad living in [sating?] dressing schooling street cleaning A well grown boy of 12 above the usual size troubled with [hawt?] in the morning much headache irritation of the throat and fancies little medicine, exercise, diet,-remarked that the old school Drs would have used [?utsil] & [drinen?] it down to the stomach making him dyspeptic or the lungs consumptive- In the study of the [?] in the present race of [homopath?] have grown by exponent the Medical notes Cholera &cValuable works by Dr. Marshall Hall - Dr J Clark - Dr Gooch - The larger proportion of low childbed fevers arise from inflammation & suppuration of the uterine veins. Diseases of the Uterus. Wounds of cervix, less dangerous than of the fondus uterus kept in place more by surrounding parts than ligaments. Prolapses - causes, relaxation, parturition, violence, ascites - symptoms dragging in loins especially when standing, weight on anus, obstruction of rectum & bladder - treatment, an oiled sponge in vagina, secured by bandage; silver ring pessary supported by spiral [st?]; rest, [forucutations?] & injections astringent [astonia?] saline solutions, cold baths & applications; contraction of vagina. - [Ante?ion] may arise from violence or chronic [ ?] when the pessary must be used with caution, rest and antiphlogisties - pain in epigastrium & lumbar region, from dragging of ovarian plexuses. Retroversion. Caused by violence, relaxation, increase of bulk - signs, retention of urine, constipation, pain vomiting - distinguished from [asaite?] by difficulty of passing catheter, may be confounded with tumour or extra uterine gestation, may produce violent inflammation of surrounding parts - bleed & bathe, finger in rectum press fundus, while fingers in vagina or [?] press cervix, support when raised with pessary. Hernia ventral crural or inguinal if irreducible a suspensory bandage, or cesarean section when pregnant.-Immobility produced by adhesion from metritis or peritonitis-antiphlogistic treatment, or [mar?y] Flexion attended by Lencorrhea or irregularity hysteria, pain, compression of bladder & rectum- replass, after parturition, use pessary, tonics, & stimulants as douches on the groin- Inversion, from polyps or labour, formidable from hemorrhage, replace at once, with or without plasenta, if impossible perhaps transfixing with a needle may cause adhesion at peritoneal cavity when the [root?] may be gradually ligated or removed- Physomatra. from secretions producing gas-cleanliness bathes lotions injections of water or ablonide of [li?] Dropsy from inflammation, accumulations of water in pregnancy, or debility & distinguished from [sch?] by fluctuation, from [physometia?]-by non resonance introduce catheter, or puncture with trachar- Calenls-use forceps or fingers- Retention of [catemania?] from closure of passages, simple incision- Moles-false germ, fleshy, & hydrated or vesicular, faulty products of conception: when expelled, [dangerous?] hemorrhage [Excr?] vascular cellular fibrous, osseous, tuberculens steatomatous & cancerous- Fibrous tumors mechanical evils- Fibrous [ped?lated] polypi excise, or ligate- St Bartholomew's Hospital 1850. Dr Hue Nov 22. Wilson, a laundress of London, unmarried, 21 years of age, entered Nov 22nd. She is a blonde, with high colour, large & plump. She was strong as a child, and has always enjoyed good health. Menstruation was established at 16, has been regular but very scanty painful & followed by lencorrhea. At 17, she suffered from a violent cough attended with expectoration of much blood; this cough lasted 18 months, and left her with a tendency to cough. 6 weeks previously to entrance, while hanging up a wet sheet, she felt, to use her own expression, "as if she had displaced something in the lower part of her chest." A constant pain set in which extended round the body from the infra-mammary regions- this was accompanied by nausea, and vomiting after eating, palpitation of the heart and headache. Under medical care, the symptoms diminished, she went into the country, but on her return, a fortnight before entrance, she caught a violent, cold, the former symptoms returned, attended by cough, & expectoration of a little blood. The following, is the condition of the patient, the day after her entrance into the Hospital- The pulse cannot be counted at the wrist, nor [something written backwards, from the previous page] in the temporal artery, the blood seeming to glide through frequently, without a distinct wave. The impulse of the heart is greatly increased & extended, the stoke of the apex changing its place continually. Auscultation shows a striking derangement of the heart's action - the most remarkable feature of this abnormal action, is the tumultuous and irregular nature of the contractions - the heart appears to hesitate in contracting, then several violent contractions occur in rapid succession, which are of unequal force, beats & half beats, their natural character being completely lost. At the base, the diastole cannot be distinguished, the sounds increase in the direction of the apex, and here the diastole is sometimes indistinctly heard. The number of beats is about 100 in a minute, the number however varies continually. The patient suffered from dyspnoea, lies propped up by pillows, with respiration at 40. Rhoncus & tubal respiration are heard on those parts of the lung where the respiratory sounds are not masked by the heart's action. Cough, with brownish watery mucous expectoration, speckled with crimson blood. Skin soft & cold, tongue clean, bowels regular. Great exhaustion. The catamenia occurred as usual a week ago. Milk diet prescribed, & Hst: Effervesce, e tine. Digitalis [?] 25th - Does not sleep well. Nausea somewhat diminished. Other symptoms as before. 28th - Has not slept well; was somewhat fatigued yesterday of frequent examinations; the increased pain in the chest has been relieved by a mustard plaster. Dec 3rd - The patient has continued under the same treatment. The pulse is now clearly felt at the wrist, 76, soft & moderately full, with the frequent omission of a beat. The two sounds are distinctly heard at the base. The systole a harsh murmur. She is weak, but without pain, cough or nausea, lies down at night, respiration natural, is cheerful & hopeful. 7th - Complains of exhaustion, & is low spirited, there is however no return of any bad symptom. The same treatment continued. 13th - The improvement continues - She is in good spirits, eats & sleeps well, can sew without difficulty, though a slight exertion such as rolling a bandage, produces pain in the chest, & palpitation of the heart. She feels much stronger than when she entered, and rarely suffers from exhaustion. Pulse 70 - Respiration 26 - The systole murmur extends into both carotids - The same treatment continued. 1850 notes in Dr Hue's words(Physiology gone mad) Milk, Coffee and Microbes - Coffee with Milk "Milk,--I speak of natural milk, such as is procured from the udders of the cow, and not of that unreliable liquid, a mixture of sheep's brains, plaster, and salicilic acid and water, that is sold as milk in some of the dairies in Paris--milk is one of man's most precious articles of food. But it is at the same time a form of nourishment rich in microbes, which find in it surroundings wonderfully favorable to their development. To form an idea of this, it is sufficient to quote certain statistics borrowed from a recent work of Mons. Miguel. Mons. Miguel has, by a series of experiments, calculated the number of germs to be found in a cubic centimetre of milk. Two hours after milking, the milk contained per cubic centimetre: On arrival at the laboratory 9,000 bacteria 1 hour later 31,450 " 2 hours " 36,250 " 3 " " 40,000 " 4 " 60,000 " 25 " " 5,600,000 "Originally at the moment of milking, as the milk is perfectly free from germs. The microbes which develop so rapidly, arise from the numerous processes that it undergoes in non-sterilized pans, & the various chances of infection to which it is exposed during the process of milking itself; the hands of the person who milks, skins of the animals, the atmosphere of the cow house etc. The later development of these germs depends entirely on temperature. At 15 degree the increase is proportionately small during the first few hours. In 4 or 5 hours the microbes become only four times as many. But after that their multiplication is much more rapid. At the end of 15 hours one may find 1000000 per cubic centimetre, & at the end of 24 hours, several million. If the milk be exposed to a higher temperature, say 25 degrees, the number of germs is colossal. After 15 hours thous. Miguel observed 72 millions. At 35 degrees, after the same lapse of time, the number rose to 165 millions. Happily, however, the greater part of these microbes are harmless. Many probably aid digestion. For these are useful as well as harmful germs. But it is credible that the diseased microbes may be found among the others, & from that time the milk may become the source of disease the means of spreading it. [There is another, far more der.] In fact - & particularly in England such cases have been observed, a certain number of limited epidemics of scarlet fever & typhoid have been noticed which seem to have been spread by milk coming from farms where these were persons suffering from one or the other of these diseases. There is another, far more terrible disease, which may be spread by milk, consumption of the lungs (pulmonary [these] phtisics). Cows often suffer from a disease which we call "pommeliere" & which is produced by precisely the same microbe as [the] human phtisis. They [acid juices of] become phtisical.as man, ethics milk when the disease reaches the [?ea?] may contain the bacillus of the tuberculose. Wolves inoculated with cow's milk become tubeculous, & it is logical to believe that when meddled with (?) by man it introduces into his alimentary canal bacilli which may become the origin of intestinal & pulmonary phlisis. The acid juices of our stomach forms a natural obstacle which assess the progress of the bacillus, but it has not yet been proved that this obstacle is always impassable. Therefore the Academy of medicine was right in advising in a general way that milk should not be used except after it is boiled. Boiling destroys the tuberculous bacilli. It has been objected that boiled milk is indigestible, or at least less easy of digestion than unboiled I consider that there is no room for hesitation between an inconvenience and a danger. Better 2 digest boiled milk with a little more trouble, than to digest unboiled milk easily which may make you phtisical. But there is another equally unforeseen corrective. A German savant has lately shown that an infusion of coffee possesses very pure antiseptic qualities, that is to say that it arrests or hinders the development of the microbes So the typhoid fever bacillus becomes extinct in one or two days in an infusion of coffee of ?) 5 per cent. The erysiplas bacillus disappeared in 24 hours in an infusion of 10 per cent. But the most remarkable & rapid effects have been obtained with the cholera microbe, the famous "virgul-bacillus". an infusion of coffee of [?] per cent destroyed the cholera bacillus in 7 or 8 hours; an infusion of 30 per cent it withstood but half an hour. This energetic action of coffee on the cholera microbe justified scientifically the mode of treatment in vogue in Persia for cholera.This treatment consists in making the patient drink a great quantity of black coffee & obliging him to take exercise. Unfortunately the action of coffee on the tuberculous bacillus has not been experimented on. But one can believe that it will not feel more at ease than it's brethren in an infusion of coffee--- At any rate it transpired [that] from these experiments that coffee is fatal to a great many species of microbes. The mixture of coffee with ?milk must then necessarily clog the development of bacteriae which multiply so rapidly in the bitter liquid. That is, I take it, a new argument in favour of "café au lait." Those who do not appreciate this morning beverage, dear to the Parisian, contend readily that "café-au-lait" ? engenders chlorosis & makes young girls pale I do not know where they get this incongruous opinion, nor on what it is founded, but I hope that partisans of "cafe au lait" will be grateful to me for having provided them with scientific reason for defending their favorite morning beverage Fact, observed in a few experiments - in Sp. 1876. 1. Mrs Underhill felt a power which led her to move in a direction determined by my will. 2. This force did not always take her directly to the object but invariably did so at last 3. She could always resist it if she wished to do so. 4. She felt its with very varying degree of strength. 5. The exertion of it was tiring to me. 6. Mrs M could exert a similar power on my sister, but not on me 7 She thought she experiencedfatigue on exercising this power; but not on receiving it. 8 Each time Miss Cameron exerted the same force on Mrs. U. the same results followed.