αγγείον,

inner

or evdov and xapdia, by which they mean to express the idea of the lining membrane of the heart, or an inflammation of that lining membrane. For my own part, I cannot discover any unreasonableness in Burdach's suggestion of the term endangium, from evdov and vessel, to express the idea of the lining membrane of the aorta, of the cava, of a great artery, vein, or sinus, since the Greek word ayyeLOV, and the other Greek word en or endon, express an idea of the same membrane where it is called endocardium, but only as being not confined to the cavities of the heart alone.

To repeat, or to write the long sentences, membrana vasorum communis, or membrane commune des vaisseaux sanguins, or the lining membrane of the blood vessel system, is a useless toil; wherefore, I shall beg the Student, hereafter, to allow me to speak of it by using M. Burdach's short and euphonious term, endangium.

So much I have thought it incumbent on me to say in my own defence; and now I come to the question, whether the endangium is, in fact, charged with the important offices I have supposed; and here I must invite the Student to judge for himself upon an examination of the facts, particularly the following facts, that will nowhere be denied.

A child, in its mother's womb, touches her only by its placenta, which consists of the vascular tufts into which the umbilical arteries are divided upon reaching their place of destination in the after-birth. The placenta takes out of its mother's blood the oxygen and plasma sanguinis required by the foetus.

The child in utero takes nothing but plasma, which is water, with a certain protein, probably, under the form of dissolved albumen and salts. It takes no blood, but only plasma.

But the blood, out of which the whole body of the embryon is made and maintained in its status sanitatis! Whence comes this blood, this generator of the body?

I have neither purpose nor time to enter at length into an examination of the principles of the hæmatosis. Such an essay requires not a few pages, but a volume; but, without entering at large on the subject, I may, in hopes of explaining myself, state a few particulars for that end.

1. The blood is daily renewed by means of the alible matter digested in the stomach and bowels, and absorbed by the lacteal absorbents, by which it is transferred to the blood vessels.

2. The whole of the blood is contained in the heart, the arteries, the capillaries, the erectile tissue, and the veins.

3. The only tissue that the blood touches is the endangium, which is the lining or interior membrane of all blood vessels. In the viscera

-in all the organs, indeed-it is probable that the ultimate ramuscule of a vessel consists solely of endangium, the stronger coats being unnecessary in the last distribution. The endangium, to use the idea of Prof. Burdach, separates the blood from the body, as the scarf-skin separates the body from the external world. The endangium is the delimitary membrane of the blood. The blood perishes, or changes very soon, almost immediately, after it escapes from within the endangium. It is converted-or it is coagulated, or it dissolves, or it ceases to be blood, upon leaving the cavity of the endangium.

4. Notwithstanding the chyle-particularly chyle taken from the upper end of the thoracic duct-contains vesicles or globules, or corpuscles that are of a reddish hue, and that are the results of the earliest morphological operations of the hæmatosis, it is not proper to regard these corpuscles as blood.

5. Soon after the chyle is poured into the cavity of the endangium, and becomes exposed to the influences of the oxygen in the lungs, it acquires the character of perfect blood. The foetus in utero touches the parent only by the placental tufts that it has developed at the extremity of its umbilical artery. It is only by these placental tufts that it can receive from the parent the material supplies for its hæmatosis. This material enters into its sanguiferous system only, since it comes into the vena cava by the umbilical vein. If the child has a power to make its own blood, it is clear that it makes it within the walls of its endangium. There is no other solid that the alible material of the child can come in contact with. Therefore, either the blood makes itself, or the endangium of the embryo makes it.

6. It is, therefore, not to oxygen alone that it is indebted for its morphological developments.

7. Contact with the endangium is essential to that development, since the blood loses its physical character as soon as it ceases from that contact. The endangium contains the force that makes the blood. This proposition, which I put forth in my Letters to the Class, has been denied. I reiterate it here; and I ask what violence is done to probability in this doctrine, seeing it is universally admitted that the power of a cell-a far more simple and elementary body-is so great that it can, out of the alible cytoblastem in which it exists, produce, by its metabolic and plastic energy, cartilage, ligament, skin, muscle, aciniferous viscera, nerve, and, indeed, all solids of the body? If the το μηταβωλικον και το πλαστικον really appertain to the simple tissues of cells, may we not concede a higher power to the elementary structure which we call endangium? The cell-power is a

power of presence and contact, not a power of percolation or endosmose or exosmose merely.

8. The endangium is the blood-membrane. When it is healthy, the blood is so when it is diseased, the blood becomes diseased. The health of the endangium is as essential to a normal hæmatosis as that of the gastro-intestinal mucous membrane is to the health of the digestive force. In diseases of the endocardium, the functions of the heart are modified, but the endocardium is the endangium of the beart. Similar affections of the endangium, ranging throughout extensive portions of the sanguiferous system, derange the blood vessels in which they occur, and the whole mass of the blood.

9. Simple diminution in the life-force of the endangium produces the idiopathic forms of anæmia, in which the solid constituents of the blood become lessened in quantity, while the aqueous constituent increases in quantity.

10. One thousand grains of healthy blood ought to contain seven hundred and ninety grains of water. In hydræmia, a thousand grains may contain eight hundred and fifty grains of water-or even more. Such a state of the blood is hydræmia.

11. Plethora is a contrary state, one in which the watery proportion is lessened, and the solid constituents augmented.

12. The endangium is the regulator of these proportions; when its powers are either lessened or exaggerated the crasis is changed.

13. The nervous mass, acted on by oxygen, gives out the nerveforce, the biotic force, the life-force. It does not extricate or give out that force under any other exciter or influence.

14. The arterial blood conveys oxygen, which it imparts to the nervous mass. Oken scarcely speaks metaphorically when he declares that an artery is an air-tube; it conveys vital air, oxygen. Perfect blood conveys the due amount of oxygen required to develop a perfect innervative force. Imperfect blood cannot convey a due amount of oxygen-whence the innervations produced by it are inevitably imperfect.

15. The health, activity, and power of all the organs, are but the exact expression of their innervation; under circumstances of imperfect blood in the endangium, their health, activity, and power become deranged.

In these propositions, I have set forth the opinions I have long held as to the influence of states of the endangium upon the health. I am, perhaps, imprudent, again to put them forth in this manner, and without the array and support of many facts and many arguments that I deem confirmatory of them. I prefer, however, to submit them to the

reader in all their nakedness, rather than not to present them for his examination. I hope that, in any event, they may serve me to elucidate the rationale I am about to state, as to the amenorrhoeal affections, which are still under consideration.

I have said that reproductive force is complemental, and that menstruation is a sign of the active state of that force.

The blood of an anæmical girl is incapable of developing her innervative force in sufficient amount for the regular operation of the ordinary functions. She will, therefore, scarcely produce nervous force sufficient to execute both the special and the complemental offices of her life.

The amenorrhoeal girl is generally anæmical. To cure her anæmia, is to re-establish the dominion of her life-power over both the special, and the complemental powers and offices of the system.

No attempt should be made to bring on menstruation, in order to the cure of the anæmia; but, mutatis mutandis, the anæmia should be cured, in order that her blood, fully and thoroughly oxygeniferous, may enable her nervous mass to extricate the biotic force in sum equal to the demands of the general, as well as the special, or complemental wants of the economy.

The curative indications for such ends consist in the use of drugs, frictions, baths, exercise, dress, diet, and medicines, as well as the psychiatric recommendations that may be apposite for the cases.

Drugs.-Aperients are, for the most part, indispensable, and they may well consist of a basis of aloes, or other resinous cathartics, in combination with rhubarb or extract of colocynth, and, on proper occasions, of mercury.

The celebrated Hooper's pill, which is familiarly known by every mother in the land, is composed chiefly of aloes.

The Dinner-pill, or Lady Webster's pill, is also aperient, on account of the aloes combined with it.

In some of the samples of amenorrhoea, which, while they chiefly depend upon a want of vigor in the blood, may derive a part of their rebelliousness from unhealthy states of the circulation and innervations of the pelvic viscera, a useful resource is to be found in the compound powder of jalap. Doses, consisting of twenty grains of jalap, forty grains of cream of tartar, and six drops of oil of anise-seed, may be given every alternate morning, with considerable advantage. I have sometimes directed my patients to procure half a dozen packages, each containing such a dose, and to use one of them every other day, until the whole of them should be taken.

When the idea is entertained that the hepatic secretions are impaired,

under a vicious state of the portal circulation, a very proper alterative will be obtained by the exhibition of six grains of blue-pill, fifteen grains of extract of taraxacum, and ten grains of soda, suspended with a drachm of gum Arabic, in an ounce of distilled mint or cinnamonwater. Such a dose should be followed by an aperient dose of magnesia, oil, senna, or salts.

Tonics.-The most available tonic is iron.

Iron appears to possess a peculiar power to modify the rate of the hæmatosis. Certainly, one might in vain endeavor to remove certain cases of anæmia by the aid of quinine, the various vegetable tonics, and the mineral tonics, with the same rapidity and completeness as with the ferruginous medicines. I believe that common experience teaches the truth of the above proposition.

I know not what is the rationale of the almost specific power of the martial preparations in anæmical disorders, yet I am willing to believe it true that the iron enters into direct combination with the blood, to render it more powerful and more noble by its union with it, and that it acts as a direct tonic for the solids of the economy, imparting a greater energy to the cell-life of the blood-corpuscles. Mr. Quésneville teaches us that it does combine with the blood-disks, and absorbs the oxygen which it gives out to the tissues, and that the blood takes up more or less oxygen in proportion as it contains more or less iron. I think nothing is better or more clearly established in my mind, as a therapeutical maxim, than this, namely, that an anæmical girl, who labors under no other malady, is cured of her anæmia in about sixteen days, by the proper use of iron.

The use of iron was well known so far back as the days of Louise Bourgeois, who, in her Observations diverses sur la Stérilité, perte de fruict, etc. etc. (Paris, 1627, 12 v. p. 23), says: "Pour en avoir l'heureuse yssue, il en faut user trois sepmaines, ou un mois; mais sans aucun doubte toutes les incommodités causées par le mal, cesseront avant quinze jours," that is to say, in order to reap the benefit of the medicine, it ought to be employed for three weeks, or a month; but, beyond all doubt, the whole of the inconveniences arising from the disorder will be at an end in a fortnight. Now, Louise, who speaks so positively on this point, was unacquainted with our beautiful preparation, iron-byhydrogen, and used one which, though not so good as ours, was yet capable of producing such remarkable effects as she points out.

As Louise was a celebrated practitioner, and indeed in all respects a sensible and excellent woman, I shall indulge my desire to translate the passage in which she describes her famous medicine; thinking also that, perhaps, some American practitioner might wish to subject her