0 U T L I N E S' 
OF A 
NEW SYSTEM OF PHYSIOLOGY, 
BY 
LOUIS MACKALL. M. D. 
" Non alius fare sit aditus ad regnum hominum ut fundatur in scientiis, quam ad regnum 
Ccelorum in quod, nisi sub persona infantum intrare non datur." 
" Nay, it is a point fit and necessary in the front and beginn' ig of this work, without 
hesitation or reservation to be professed, that, it is no less true in this human kingdom of 
knowledge, than in God's kingdom of heaven, that no man shall enter into it except he become 
first as a little child." 
Bacon's Works. 
WASHINGTON CITY; 
THEODORE BARNARD, PRINTER. 
1848, Entered according to Act of Congress, in the year 1848, 
By Lewis Mackall, 
In the Clerk's Office of the District Court of the District of Columbia. ADVERTISEMENT. 
The object of the following Treatise is to call attention to certain 
general laws or Laws of Nature, relating to Physiology, which have 
heretofore escaped observation. 
For this purpose a rough sketch, or outline, as it were, of human 
Physiology is given, that the application of those general laws may 
be seen ; but that the propositions in which they are stated may not 
be supposed to be conjectural, I would remark that they have been 
patiently studied out and traced up, step by step ; and are founded 
on observation and experiments, carefully conducted through a space 
of more than fifteen years. 
I propose at some future time to call attention to them separately, 
in connection with the instances, facts, and reasoning on which they 
are founded. 
Some may be curious to know how the .conclusions were arrived 
at, or what process was adopted in investigating these general laws. 
Lord Baccn professed to have discovered a rule which he termed 
the " Inductive Method," by means of which any one, of ordinary in* 
tellect, would be enabled to find out such laws or general truths ; but 
the specimens he has himself given of the application of his rule are 
not calculated to give an exalted opinion of its importance. An ac- 
count of the process adopted in our investigations, is furnished by a 
writer who was possessed of an intellect no way inferior, in my opin- 
ion, to that of Lord Bacon. Bishop Butler in his " Analogy of Reli- 
gion, Natural and Revealed, to the Constitution and Course of Nature," 
thus remarks : " How capricious and irregular a way of information, 
it would be said, is that of Invention, by means of which Nature in- 
structs us in matters of science, and in many things upon which the 
affairs of the world greatly depend ; that a man should, by this faculty, 
be made acquainted with a thing in an instant, when, perhaps, he is 
thinking of somewhat else, which he has in vain been searching after- 
it may be, for years. . . . And as it is owned the whole scheme of 
Scripture is not yet understood, so if it ever comes to be understood 4 
before the restitution of all things, it must be in the same way as 
natural knowledge is come at; by the continuance and progress of 
learning and of liberty, and by particular persons attending to, com- 
paring and pursuing, intimations scattered up and down it, which are 
overlooked and disregarded by the generality of the world. For this 
is the way in which all improvements are made ; by thoughtful men 
tracing on obscure hints, as it were, dropped by Nature accidentally, 
or which seem to come into our minds by chance. . . . For all the 
same phenomena and the same faculties of investigation, from which 
such great discoveries in natural knowledge have been made in the 
present and last age, were equally in the possession of mankind several 
thousand years before." 
August, 1848. OUTLINES 
OF A 
NEW SYSTEM OF PHYISIOLOGY. 
(1.) In considering the phenomena which are the subject of human 
physiology, the first thing that arrests the attention is this : That man is 
composed of two distinct beings-the one material and finite, the 
body; the other, the mind, or soul, which is immaterial and immortal. 
(2.) The immaterial being or mind of man is endowed by the Au- 
thor of Nature with certain faculties, and on it are impressed certain 
instincts, propensities, or dispositions, from which originate all his 
wants and desires; but those wants or desires are restrained by the 
laws of Nature, and by moral and human laws. 
(3.) One of the faculties of the human mind is called Reason; by 
means of which man is enabled to find out the laws of Nature, or 
those laws which the Author of Nature has established for the govern- 
ment of the world. 
(4.) The material world, or all forms of matter, may be resolved 
into one simple elementary substance; this elementary substance,- 
a subtile fluid,-which, it will be found convenient to call life.* 
In using this term we may state, once for all, that we shall employ 
it in the same way as the term heat is commonly employed, that is, 
to express a variety of forms and conditions of the same thing. Our 
meaning, however, will be understood from the context. 
(5.) The great law of the material world is this; that among all 
the variety of objects in the universe, whether animate or iaanimate, 
there is a constant interchange of this subtile fluid, Life. This will 
appear as we proceed. 
(6.) The life received from surrounding objects by animals, is dis- 
posed of in various ways ; a portion of it directly, by means of the 
will, the remainder indirectly, or through the intervention of some 
other agent. 
(7.) The human body may be divided into two distinct kinds of 
structure or tissues-the Nervous tissue, and the fibrous tissue. 
(8.) Life is transmitted or circulates through the body through the 
medium of the Nervous tissue, or nerves. 
(9.) Motion is produced in the living body by the agency of the 
fibrous tissue, which comprehends the several kinds called the muscu- 
lar, tendinous, membranous, and osseous tissues. 
* See note [1] at the end. 6 
(10.) The nervous system may be regarded, in a general way, as 
being composed of a centre called the Cerebro-Spinal Centre, and 
threads, or loops passing to and from the different fibres constituting 
the fibrous tissue ; one side of the loop conducting the nervous fluid, 
or peculiar life of the animal /rom the centre to the fibre, called the 
efferent nerve, and the other side of the loop conducting this fluid from 
the fibre to the centre, and called the afferent nerve. 
(11.) The action of the living fibre is dependent for its exciting 
cause on the nervous fluid transmitted to it from the nervous centre 
through the efferent nerve ; and this action, consists in extension. The 
contraction of the living fibre is caused by having the nervous fiuid 
or its cause of action conducted away from it towards the nervous 
centre by the afferent nerve. 
(1*2.) The different kinds of fibre differ from one another in the 
extent of th"ir action, but this difference seems generally owing to the 
greater or less supply of nervous filaments. 
(13.) The organs of which the body is composed may be divided 
into the solid organs, comprising the voluntary muscles, the bones, 
&c., and into the hollow organs or tubes. 
(14.) The Functions of those organs have been divided into those 
of nutrition, of relation, and of generation. 
FUNCTIONS OF NUTRITION. 
(15.) The functions of nutrition are carried on in the tubes, or hol- 
low organs, which are composed of fibres placed about their walls- 
some longitudinally, some circularly, and others obliquely ; so that 
by the extension or elongation of those fibres their calibre is increased, 
and by the contraction of the fibres, their calibre diminished. 
(16.) There are four stages of nutrition ; in the first stage, com- 
mencing at the mouth and extending along the tube called the primae 
vise, the nutriment is converted into chyme ; in the second stage, em- 
bracing the lacteals, the receplaculum chyli and the thoracic duct, 
the chyme is converted into chyle ; in the third stage called the circu- 
lation of the blood, the chyle is converted into that fluid, and in the 
fourth stage, the vessels of the glands, the blood is converted into the 
secretions. 
(17.) Al! these changes in the form of the nutriment, as it passes 
along, are effected by means of the nervous fluid or life of the animal ; 
for throughout its whole progress this fluid is continually conveyed to 
it, and an increased supply as continually reconveyed from it to the 
nervous centre ; and this increased supply of life is the end or object 
of nutrition. 
(18.) Another function of the tube engaged in nutrition is the con- 
veying along its contents, and this act is performed in different ways 
in the several stages we have spoken pf; in the primae vise the action 
of the tube is limited to a small extent at a time; in the circulation of 
the blood, the action of the arteries takes place throughout their whole 
extent at the same moment, &c. 7 
(19.) It has been said, (11) the action of the living fibres consists 
in extension, and if we bear in mind the arrangement of the fibres 
about the walls of the tubes, it must be admitted that the action of the 
tubes consists in dilation, and, consequently, if their contents are 
conveyed along by the action of those organs, it must be by the power 
of suction and not that of propulsion, as is commonly supposed. 
(20.) To give a more detailed account of the first stage of nutrition 
or digestion as it is termed, a portion of food is taken into the mouth 
which we will call the first step of its progress, and being masticated 
and mixed with the saliva, undergoes a change by which it is prepared 
to enter the Pharynx, which may be regarded as the second step- 
The changes in the nutriment we have said are effected by means of 
the nervous fluid, and this is conveyed to the food in the mouth 
through the nerves of the teeth and walls of the mouth, and through 
the saliva, which we shall see contains a large amount. The nervous 
fluid having been thus intimately mixed with the food, it becomes 
changed in its nature-becomes partially vitalized-and gives off in 
its turn a fluid which goes to the nourishment of the animal. It is 
returned directly to the nervous centre by the afferent nerves of the 
teeth and walls of the mouth, and a part of it is mixed with a fluid 
which is taken up by the absorbents of the mouth. Thus it may be 
seen that digestion commences in the mouth, and in some sapid sub- 
stances it is nearly completed in this first step. 
(21.) A morsel of the food prepared, as we have seen, in the 
mouth, is presented to the Pharynx and excites it into action. This 
action, consisting in dilatation (19) the morsel is drawn along, as it 
were ; the same thing occurs along the (Esophagus. The action of 
this tube being limited to a small extent at a time, gives it the appear- 
ance as if a ball were passing along its course. The progress of the 
morsel is not entirely owing to suction, but is assisted in some mea- 
sure by the passive contraction of the tube immediately behind it. 
(22.) In the Pharynx and in each subsequent step the same thing 
occurs as in the mouth-the same changes and the same interchange 
of life-so that when digestion is completed, the residue or faeces are 
composed almost entirely of the secretions of the animal. 
(23.) The extent of the action at any one time of the tube in the 
second stage of nutrition has not been observed, but it is supposed the 
action of the Lacteals, of the Receplaculum Chyli, and the Thoracic 
duct occur at different intervals. 
(24.) Before we can explain the third stage of nutrition, called the 
Circulation of the Blood, it will be necessary to notice the structure 
of the Heart, and of the other tubes through which the blood flows. 
(25.) The Heart is a tube, or hollow organ, having thick walls 
composed mainly of muscular and tendinous fibres arranged as in the 
other tubes-so that by their extension its calibre is increased, and by 
their contraction, diminished. It is divided into four chambers or com- 
partments, two called Auricles, receiving the blood from the veins 
and two Ventricles, w'hich receiye the blood from the Auricles. At 
the entrance from the auricle to the ventricle, membranous fibres are 8 
thrown out so as to form valves, which, when extended, close up the 
passage, and thus limit the quantity of blood going into the ventricle 
at one time. In addition to this arrangement, bundles of muscular 
fibres stand out from the sides of the ventricles, and terminating in 
tendons are inserted into the tips or free edges of the valves ; and by 
their extension assist materially in closing the passage-the bundles 
of muscular fibres are called Columnse Carnese, and their tendons 
Chordae tendineae. 
(26.) The arteries have the same arrangement of fibres about 
their walls, and their entrance is guarded simply by valves. 
(27.) The Capillaries are minute vessels receiving the blood from 
the Arteries and have the same size throughout; their action is not 
understood, but it is said the flow of blood in them is constant and 
equable, and not in jets as in the arteries ; they communicate freely 
with one another and have no valves. 
(28.) The blood passes from the Capillaries into the veins, and 
flows in them also in a constant and equable course. The veins have 
valves projecting at irregular intervals from their walls, which are in- 
tended, no doubt, to prevent excessive accumulations of blood in any 
part of its course. 
(29.) A supply of blood having been collected from the veins of 
the system, generally, into the right auricle of the Heart, is received 
into the right ventricle; which is dilated for the purpose by the action 
of its fibres. Having received its due quantity, any further supply is 
cut off by the action of its valves. It is next received by the Pulmo- 
nary Artery and conveyed to the Lungs; here it undergoes a striking 
change, but similar in its nature to what has been taking place all 
along, that is, it gives off a portion of its life to, and receives a portion 
in its stead from, the Atmosphere. By this change the blood is again 
prepared to enter on its course ; it is received by the Pulmonary vein, 
and conveyed to the left auricle of the Heart. The left ventricle re- 
ceives it from the left auricle, and has its supply limited by valvesr 
Columnae Carneae, and Chordae tendineae, as in the right ventricle. 
The arteries of the general system then receive it from the left ventri- 
cle, the supply limited again by the valves at the entrance, and convey 
it to the Capillaries, which, in their turn convey it to the veins of the 
general system, whence it was first derived. 
(30.) The veins coming from some of the abdominal viscera, unite 
into one large trunk which enters the liver. This vein, called the 
Vena Portarum, takes on an action similar to that of the arteries, 
that is, it is actively dilated, and to enable it to do this, it is surrounded 
throughout its course by a loose cellular structure called the Capsule 
of Glisson. 
(31.) The Blood in its course, is continually giving off and receiv- 
ing life, as in the first stage of nutrition, and as the nutritious matter 
become vitalized and passed into another set of vessels, the Lacteals, 
so a portion of the blood in its passage through the arteries becoming 
more vitalized passes into a set of vessels peculiar to the glands and 
forms the secretions. * 9 
(32.) A large supply of the life or nervous fluid of animals is de- 
rived from the secretions, which are in some instances stored up as it 
were, for use, in bladders or receptacles. The gall-bladder, the 
urinary bladder, and vesiculae seminales are instances of such recep- 
tacles. 
(33.) A portion of the blood in its passage through the Capillaries, 
is converted by the action of the nervous fluid into the solids, and 
again the solids which have performed their office in the economy, are 
resolved into blood and pass along into the veins. 
(34.) Mechanism of Respiration.-From the position of the 
muscles-the Diaphragm, as well as the intercostal muscles-it will 
be readily understood how the chest is dilated or expanded by the ex- 
tension or active state of those muscles, and contracted by their oppo- 
site state. 
(35.) The Lungs are sacks or bladders composed of membrane 
or membranous fibres, which, by their extension expand these organs, 
and by their contraction compress them ; but these movements of the 
lungs in the higher orders of animals are assisted by the movements 
of the chest, which are synchronous. 
(36.) The view we have now taken of the proper function of the 
lungs is clearly confirmed by what is observed in the respiration of a 
lower order of animals. In the Chelonia, or terrapins, for instance, 
the parts corresponding to the ribs and sternum in the higher orders, 
are fixed and immovable ; their lungs are attached loosely to the upper 
shell or Carapax, and are expanded and contracted without the assist- 
ance of the corresponding movements of the chest. Respiration is 
carried on in these animals precisely as in the higher orders, notwith- 
standing the ridiculous notion entertained by Naturalists that their 
lungs are expanded by having the air forced into them by the action 
of the upper jaws. We would also refer to the respiration of the 
Batrachia or Frogs. 
FUNCTIONS OF RELATION. 
(37.) The Functions of Relation are performed by what we have 
called the solid organs of the body-the voluntary muscles, bones, 
tec. The bones constitute the frame-work, as it were, of the ani- 
mal ; and the muscles and tendons are bundles of straight fibres 
stretching from one point of this frame to another; and by their elon- 
gation and contraction they effect the movements of the body. 
(38.) Voluntary Motions.-The muscles, by the agency of 
which voluntary motion is effected, being attached as we have seen, 
are confined in their action to the movement of the bones upon one 
another; and for this purpose two sets of muscles are destined for each 
of those movements. 
(39.) In order to simplify our explanation, we will confine our at- 
tention to the movements of the fore arm upon the humerus, and we 
will call the set of muscles which are supposed to bend the arm the 10 
biceps muscle, and the set which are supposed to straighten the arm 
the triceps muscle. 
(40.) We have said (10) the Nervous System was composed of 
loops passing from a centre to the different fibres of the body, and re- 
turning again from those fibres to the centre; that one side of the 
loop carried the nervous fluid from the centre to the fibre, and the 
other side of the loop brought the fluid from the fibre to the centre. 
We have also said (11) the action or active state of the fibre consisted 
in extension; in other words, when the nervous fluid was carried to a 
fibre it was extended, and when brought from a fibre it was contracted. 
From this view of muscular action it will be seen that the term flexor 
when applied to the biceps muscle, and that of extensor, when applied 
to the triceps muscle are misapplied, and their operation misappre- 
hended ; for the action of the biceps muscle, that is, its extension, must 
tend to straighten out the fore arm, and not to bend it on the humerus, 
and the action or extension of the triceps muscle, inserted as it is in 
the Olecranon process, must have the effect of bending the fore arm, 
and not that of straightening it out. 
(41.) The correctness of this view is best seen in strong or forcible 
actions of the muscles. Th straightening the arm out forcibly,-for 
instance in striking a hard blow with the fist,-we may be conscious 
that the biceps muscle is in action, or in drawing a resisting body 
towards us, we may be conscious that the triceps muscle is in action. 
(42.) But let me not be misunderstood ; I do not intend to as- 
sert that the bending of the arm is wholly attributable to the ex- 
tension of the triceps muscle, for it is equally attributable to the 
contraction of the biceps muscle. In all the movements of the 
body, where there are two sets of muscles engaged, the movement 
is the result of the extension of one set, and of the contraction 
of the other. Nay, in slight or gentle movements, I am willing to 
admit that they are effected by the contraction in one of the sets 
of muscles almost exclusively. But the point I insist upon is this, 
and it is a point of the greatest importance, that the contraction 
of a muscle is not its state of action, but, on the contrary, is a 
passive state ; the action, in the movements of which we are speak- 
ing, is in the afferent nerve and nervous centre, which withdraw the 
nervous fluid from the contracting muscles. 
(43.) The misapprehension of the function of muscles, which 
has existed so long, seems to me to have taken its rise from the 
fact that a muscle when contracted has its substance collected togeth- 
er, as it were, in some part of its extent, and, consequently, en- 
larged at that part; all the movements of the body being effected 
by two sets of muscles, this enlargement in one set has attracted 
attention exclusively. The condition of the other set, which are in 
an active state, and consequently have their substance diffused or 
extended by the operation of the nervous fluid, has escaped ob- 
servation. 
(44.) The account we have given of the movements of the 11 
fore arm, and of the function of the muscles engaged in those 
movements, is equally applicable to the other movements of the 
body. In explaining the phenomena observable in walking, run- 
ning, dancing and leaping, we should bear in mind that the mus- 
cles which are in action are extended, and the contraction a passive 
state of the muscles, superinduced by the withdrawal of the nervous 
fluid. 
(45.) Of the Senses.-We have said (4) that all forms of 
matter are but modifications of the subtile elementary fluid-life. 
Light, Heat, Sound, Odors and Savors are but forms of life, and 
the nerves of the senses are adapted to receive and act upon those 
forms-the nerves of each sense being suited to its peculiar form 
of life-those of the eye to light, the nerves of the ear to sound, 
&c. But the nerves of the senses cannot act unless the nervous 
fluid of the animal to which they belong is determined to them. 
(46.) Animal Heat, Sounds, Light.-As animals receive dif- 
ferent forms of life, so their peculiar life or nervous fluid is given 
off in different forms, as in animal heat, the voice and sounds of 
various animals and in the light given off by some of them, as the 
fire-fly, &c. 
FUNCTIONS OF GENERATION. 
(47.) The Male Organs of Generation.-To understand cor- 
rectly the function of the Penis, termed erection, it is best to con- 
sider it as a muscle arising from the ossa ischii, and terminating in 
the glands, with its fibres not extending from one extremity to the 
other, but divided into short sections, and so arranged that by their 
extension the organ is not only elongated, but has its diameter in- 
creased. By taking this view of it we may see that erection is not 
caused by the injection of the blood into its vessels, which is merely 
incidental, but by the determination of the nervous fluid to its fibres. 
(48.) The tubular part of the Penis is constructed as other tubes ; 
its action in transmitting the semen is similar to that of the arteries- 
the semen is discharged in jets. 
(49.) The Testicles furnish a beautiful specimen in which to 
observe the length of °the vessels in a gland, and consequently the 
extent of surface on which the circulating fluid is subjected to the 
influence of the nervous fluid, and thus converted into a highly 
vitalized secretion. 
(50.) The Female organs of Generation may be considered as 
consisting of a tube extending from the external parts to the ex- 
tremity of the Fallopian tubes; and of the glands called the 
Ovaries. 
(51.) The male semen is deposited in this tube and conducted along 
its course, as the contents of other tubes, to its extremity, where it 
comes in contact with the product of the ovaries-the vesicles ; and 
they are prepared by the action of the semen to enter the tube and be 12 
carried back to the uterus, where the changes occur which are observed 
in the foetus in utero-gestation. 
(52.) The first portion of the abovementioned tube composed of 
the labia, nymphae, vagina, and uterus, is capable, when in a state of 
action, of a remarkable degree of expansion or dilatation, and it is a 
most astonishing circumstance that Physiologists have always regarded 
this dilitation of those organs not as the active state, but as a state opr 
posed to action, and term it a state of relaxation. 
(53.) The process of Parturition is simply this. The fundus and 
body of the uterus having continued in a state of action the allotted 
time, the nervous fluid is transferred successively to its neck, to the 
Os Tincae, to the vagina, and to the external parts ; all these parts be- 
come dilated, as their cause of action is determined to them, and the 
foetus passes along, assisted in its progress, no doubt, by the contraction 
of the abdominal muscles, and by the contraction of that portion of the 
tube from which it has passed. [2.] 
(54.) The functions of the urniary organs of both sexes, are the 
same ; the urine is discharged by means of the active dilatation of the 
urethra and the passive contraction of the bladder. 
(55.) In concluding this hasty and very imperfect sketch of Physh 
ology, I beg leave to say that, the views therein contained, have not 
been taken from books; nor were they suggested by any thing derived 
from that source. They are conclusions fairly drawn, as I conceive, 
from facts which have happened to come under my own immediate 
observation. 13 
[1.] As all forms of matter may be resolved into one elementary sub- 
stance, so the combinations simply, of this elementary substance may pro- 
duce any form of matter. For instance: 
Wheat when gr< und, assumes a new form ; it is not the mechanical division 
only which constitutes flour; for if the grain be examined, a very small part of 
it has even the appearance of flour; but in the process of grinding, the interior 
of the grain or berry, acquires a quantum of life which gives it its peculiar 
character. Again-the flour being mixed with water, and being kneaded, ac- 
quires another quantum of life, and assumes a new form-that of dough ; dough 
when baked, acquires another quantum of life, and becomes bread; if the bread 
be leavened, it undergoes an intermediate change of form. 
Another instance: Corn is given as food to a cow ; it undergoes various 
changes of form in the process of digestion, &c., and finally assumes that of 
milk ; the milk placed under favorable circumstances, acquires a quantum of 
life and assumes two different forms ; one of them, the cream, in the process of 
churning, acquires a quantum of life, and becomes butter ; butter when salted, 
assumes a new form, and becomes palatable to min, and this form, if placed in 
a condition in which its life, that is, its life of composition, is not suffered to 
pass away from it, may continue for an indefinite space of time. But if not 
placed in such condition, another series of changes takes place in consequence 
of the loss of its life of composition; it becomes rancid, &c. &c., and finally 
all its life of composition passes to the atmosphere and to surrounding objects, 
when it ceases to exist. 
[2.] Protracted Parturition.-In the foregoing short treatise, I have con- 
tented myself with pointing out some new principles of Physiology, and apply- 
ing them, in a very general way, in explaining some of the functions, of the 
animal economy. I have not applied those principles to Pathology, because 
that did not come within the scope of this paper ; but I may be allowed, here to 
point out their application to one most interesting class of cases, in the issue of 
which, perhaps more than in that of any other class, the happiness or unhappi- 
ness of mankind is involved-1 mean the cases of Protracted Parturition. Hav- 
ing taken the above simple view of the process of Parturition, I was called, in 
the Spring of the year 1835, to see a patient who had been in labor more than 
twenty-four hours. The pains, tolerably strong at first, had passed off, and the 
patient left, with the labor very slightly, if at all advanced, in that peculiarly 
anxious and excited state which we have all witnessed in such cases-the os 
uteri but partially dilated-the fundus or upper part of the uterus, distended 
and pressed high up in the abdoman. I reasoned with myself thus; "This 
condition of the uterus is owing to preternatural action in its fundus and body. 
The cessation of the pains may be accounted for in this way : The nerves of 
the organ being largely developed for the purposes of its economy, when the 
fibres, muscular, and tendinous of the uteras cease to act, they are passively 
contracted, and press on those nerves, and thus induce pain ; when these fibres 
are in a state of action, they are extended; the pressure is thus removed from 
the nervous filaments, and the pain ceases. The first indication then is, to 
subdue the preternatural action in the fundus and body of the uterus. If I can 
effect this, the passive contraction of the fibres will press the contents of the 
uterus down against its neck and mouth-this pressure will cause an action in 
the fibres, of those parts, or to speak more definitely, will cause a determination 
to them, of the nervous fluid, and the neck and os tincae will be dilated. In 
proportion as the nervous fluid is diverted from the fibres of the fundus to those 
of the neck, the former will passively contract, and the labor be promoted. 
Again-the action will naturally be transferred from the os tine®, to the vagina 
and external parts, and this transfer can be promoted by the introduction of the 
hand." 
This theory was immediately reduced to practice. As the most efficient 
means of subduing inordinate action that occured to me at the moment, I order- 
NOTES. 14 
ed a bowl of pounded ice-it was brought, and 1 stood by the patient and made 
her swallow a spoonful at a time, in rapid succession. She took it greedily ; 
the anxiety of countenance and excited state of the system, passed away, and 
when she had taken a little more than half a pint of the ice, the pains returned 
strong and efficient-the mid-wife who was present, was directed to assist her, 
and the woman was speedily delivered. The after-birth soon came away, and 
no unpleasant consequences ensued. I have frequently used the ice under 
similar circumstances, and always with the same result. 
But, that the reader may not have to depend solely on my assurances, I will 
append the testimony of three physicians of high standing in the profession, 
and who are now extensively engaged in practice. 
The following letter was addressed by me to the writers of the several an- 
swers to be found below: 
Georgetown, D. C., March 8, 1848. 
Dear Sir;-You may have observed in the National Intelligencer within 
the last few days, a circular signed by Dr. L , of Washington, as chair- 
man of a committee which had been appointed by the National Medical Con- 
vention, for the purpose of inquiring into any recent improvement in the obste- 
rical department of medicine. 
The circular referred especially to the use of Chloroform, and seemed to have 
been published, at the time it was. in consequence of a notice in the same paper 
a day or two previous, of one or two cases in which it had been used in this 
town. 
Since the publication of this circular, however, I have observed several cases 
reported, wherein the use of this remedy has been followed by instantaneous 
death-admitted by the attendants, to have been caused by the Chloroform. 
Its use being attended with so much hazard, it can probably never be introduced 
into general practice. 
Now, I think the present would be a favorable opportunity for introducing to 
the notice of the profession, a remedy in suspended labor, which I made use of 
in the Spring of 1835, and the success of which, I mentioned at the time, to my 
acquaintances-to yourself among others. 
Without reference to any theory whatever, on this subject, I propose to state 
to Dr. L , the simple fact that, in cases of suspended or protracted labor, 
pounded ice had been swallowed freely, and immediately the pains had return- 
ed, the uterus had contracted strongly, and the labor was speedily completed. 
And further, that there could be no doubt after the number of instances in 
which it had been tried, that the use of the remedy and the advancement of 
the labor stood in the relation of cause and effect. 
I think you have mentioned to me that you had used this remedy in your 
practice, and had observed its effect. Will you do me the favor to state the 
result of your observation on this subject? I do not wish you take the trouble 
to report any case in detail, but merely to state your general impression as to 
the effect of the remedy, and the extent to which it has been tried. 
Some means of producing uterine contraction without impairing or interrupt- 
ing materially the other functions, is undoubtedly a most important desidera- 
tum in medicine, and as the ice appears to have that dffect, I think it is entitled 
to a fair trial, that its merits or demerits may be fully tested. It is simply w ith 
this view that I wish to suggest it to the committee. 
Yours truly, 
LOUIS MACKALL. 
Nottingham, March 17, 1848. 
Dr. Louis Mackall, 
Dear Sir :-I take this, the first moment of leisure, to acknowledge the re- 
ceipt of yours of the Sth inst., which I hope may be in time for your purposes. 
I have, since 1835, the period referred to in your letter, been in the habit of 
using pounded ice in cases of suspended, as well as protracted labor, the conse- 15 
quence of insufficient or irregular action of the uterus, with signal success. 
There is not at this time w.ithin my recollection, a single case in which it has 
been freely used, that the uterus has not speedily responded, and safe delivery 
been effected without, in my experience, (not small) any ill consequences re- 
sulting to the mother or child. 
It may be objected that the term freely, used above, is too vague and indefi- 
nite. 1 therefore state that I am in the habit of giving a tumbler full at a time, 
and repealing as circumstances demand. I remark that, to ensure the effect 
here attributed to it, it must be liberally used. 
Very truly, your friend, 
JOHN M. S. MACCUBBIN. 
Mansfield, March 15. 1848. 
Dr. Louis Mackall, 
Dear Sir ■-In your letter of the 8th inst., which I did not get until yester- 
day, you desired me to state to you the " result of my experience with the in- 
terna] use of pounded ice in suspended or protracted labor." 
For the last ten or twelve years, I have prescribed that article in all cases of 
suspended or too feeble action, and have never been compelled to resort to any 
other means to bring about efficient uterine contraction. Indeed, I think there 
can be no doubt, it does exercise a powerful influence in shortening labor, and 
thereby materially lessening the sufferings of the patient. This fact has become 
to be so generally believed here, that all our midwives give the ice in tedious 
labors. 
Truly yours, &c., 
J. H. SKINNER. 
Calvert County, April 4, 1848. 
Dr. Louis Mackall, 
Dear Sir :-In yours of last month, you request me to give you the result of my 
observations with the use of ice as a promoter of uterine contraction. I do so 
most cheerfully. My experience, as you know, extends back over a space of 
some twelve years. During that time, I have had frequent opportunities of ob- 
serving its effects, and I can safely declare that in no single instance, have I 
been disappointed in its action. I have used it under a variety of circumstan- 
ces, and always with the most satisfactory results. In cases where labor-pains 
had been suspended for twelve or twenty-four hours, they have been renewed 
promptly and efficiently. In cases of inevitable abortion, where the uterine 
contractions are feeble and inefficient, and where hemorrhage is considerable, I 
regard it as invaluable. 
In retention of the placenta from imperfect contraction of the uterus, and in 
cases of alarming hemorrhage after delivery and expulsion of the after-birth, it 
is equally applicable. In short, wherever the firm contraction of the uterus is 
desirable, that object will most certainly be attained by the administration of 
ice. Such is the result of my experience with the use of ice as a promoter of 
uterine contraction. And allow me to add that, in no instance, have I witness- 
ed the slightest ill effect from its administration. My own experience is amply 
born out by that of several other practitioners in my neighborhood, particularly. 
Dr. B. Carr, of Friendship, who is more extensively engaged in obstetrical prac- 
tice, than almost any country practitioner of my acquaintance. In conclusion, 
allow me to acknowledge, publicly, my indebtedness to you, for what I really 
think the greatest improvement which has been made in obstetrical practice in 
the nineteenth century. 
Yours truly, 
' R. MACKALL.