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'{UNIVERSITY OF NEW YORK-DEPARTMENT OF  MEDICINE.

I             LECTURE
J .
OBSTETRICS
DISEASES OF WOMEN AND CHILDREN,
         GUNNING S. BEDFORD, M. D.,
I  PROFESSOR OF OBSTKTRICS AND TUB DISEASES OF WOMEN AND CHTtDRKN IN THK UNIVERSITY OF NBVV TORE.  \
.9 :■' 
 
LECTURE
INTRODUCTORY TO A COURSE
OBSTETRICS
DISEASES OF WOMEN AND CHILDREN.
DELIVERED
OCTOBER 30th, 1846,
   GUNNING S. BEDFORD, M.D.,

PROFESSOR OF OBSTETRICS AND THK DISEASES OF WOMEN AND CHILDREN, IN THK
           UNIVERSITY OF NEW YORK.
	
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yy	/ 0 y
EW	YORK
PRESS OF THE NEW YORK UNIVERSITY.
  J H. JENNINOS. PRINTER, NO. 122 NASSAU STREET.

           1846. 
 
                                             New York, Nov. 6,1846.
  Prof. Bedford:
    Sir .-—At a meeting of the Students of the University Medical College, held
on Monday last, Robert M. O'Ferrall, of Ohio, being in the Chair, and J.
Sill, of Michigan, Acting Secretary, it was unanimously
  Resolved, That a Committee be appointed to solicit, at the hand of the several
Professors, a copy of their excellent Introductory Lectures for publication.  We
who have the honor to constitute the above Committee, take  great pleasure in
expressing the warmest desires of the Class, to which we would add  our humble
request, that a gratification so  great to us, and at the same time so honorable to
the Institution, as the publication of your eloquent and able address, delivered on
Friday last, be not withheld.
           With great respect, we are yours, &c.

       Robt. M. O'Ferrall,  Ohio.           W. N. Kins, Georgia.
       James Farrington, New York.        J. D. Holly, Alabama.
       Stephen Bronson, New Hampshire.    J. F. Dismukes, Mississippi.
       M. C. Hoyt, Vermont.                James F. Seguin, Louisiana.
       John B. Sweat, Maine.               J. P. Garvin, Tennessee.
       Wm. H. Wilber, Massachusetts.      Robert J. Bryan, Kentucky.
       Edwin Bentley, Connecticut.         John F. Conlan, Ohio.
       George D. Wilcox, Rhode Island.     Ziba Foot, Indiana-
       T. M. Franklin, New York.          James Noble, Illinois.
       Thos. E.  Hunt, New Jersey.          Leon De Alvear, S. America.
       Robert Martin, Pennsylvania.        Alex. Harvey, Canada.
       Chas. Gallagher, Delaware.         Daniel Vasbinder, Canada.
       Miles W. Palmer, Maryland.        Mathew O'Callaghan, Ireland
       Samuel Rixey, Virginia.             R. W. Fisher, Florida.
       Albert Myers, North Carolina.       Geo. A. Smith, Texas.
       Edward Sill,  Jr., South Carolina.     Thomas Frye, Arkansas.

                              By      J. SILL, Secretary of Committee.
                                            New York, Nov. 7th, 1846.
  Gentlemen:—I acknowledge, with  great pleasure, the receipt of your polite
note of yesterday, requesting,  in behalf of your fellow-students, a copy of my
Introductory Address for publication.   I cannot disguise  the satisfaction I feel
at your approval of that Lecture, and, in return  for your kindness,  I most
cheerfully accede to your request.  Be pleased to assure the Class of my devotion
to its interests, and accept for yourselves personally my warmest wishes for your
success and happiness.          Very truly, your friend,
                                                   G. S. BEDFORD.
  Messrs. Robt. M. O'Ferrall, J. Sill,
             and Committee. 
 
ADDRESS,
Gentlemen:

  The season for patient and laborious research has returned,
and these halls are aofain  to be devoted to the discussion of
the  numerous grave  and  complicated questions connected
with the philosophy of the healing art.  These questions will
involve issues of the deepest interest to you, because they are
directly associated with the great principles on which is erected
the fabric of Medical Science; nor will they be less important
to those for whose preservation from the ravages of disease,
and the anguish of suffering, you have consented to encoun-
ter all the sacrifices and toil, which constitute such a large
portion of the legacy  bequeathed to every  devoted student of
medicine.  The profession which you  have selected, whilst it
is enobling in its influences, is most arduous and trying in its
practical application.  You will be required to surrender your
time, and often, too, your peace of mind, to the calls of those
who look to you  for professional counsel.   Your walks will
not be amidst the gay and fascinating circles of society—they
will be limited to other scenes.   Your presence will be needed
in the chamber of sickness and sorrow—there it is that science
will proclaim its mastery over ignorance, and professional skill
its triumphs over disease and death.
  It has been said by Dr. Samuel Johnson, that the duties of
the medical practitioner are limited "  to a melancholy atten-
dance on misery;  a  mean submission to peevishness, and
a continual  interruption of pleasure."   This is, indeed, a
severe commentary on a profession, the very object of which
is to add to man's happiness, by healing him in sickness and
                             5 
6
comforting him  in affliction.   But, to carry out these objects
effectually, and to be enabled to conquer disease, in its varied
and multiplied forms, you must apply your minds to profound
and continued study.   The science of medicine is a science
of ao-es;  it bears the impress and authority of an unbroken
chain of  mighty minds—and medicine at this day is but the
superstructure raised on the principles laid down by Hippo-
crates himself. It is progressive, but yet it is stable—it is not a
thing of caprice, nor does it claim any affinity with the transcen-
dental novelties so popular in our own times.   The principles
of medical science are not so mutable  that they can be accom-
modated  to individual taste ; nor are they so complete a fiction
that they can be adapted to the current fashion with the same
facility that the tailor will alter the skirt of your coat, or the
hatter  the  shape of your  hat.  Money cannot purchase the
secrets of her temple—nor will legerdemain ever be recognized
as one of the elements, on which she lays claim to public con-
fidence.  There is nothing ephemeral in the character of her
precepts—nothing transitory  in the well deserved reputation
of her votaries.   The lessons, which  she inculcates, and the
principles which she establishes, are lessons and principles
confirmed by  the experience  of centuries, and hallowed by
the testimony and sanction of the profoundest sages of ancient
and  modern times.   We owe it to the great  dead—to those
glorious  and learned fathers from whom these precepts have
been derived, that we guard them against desecration—rather
should they be looked upon as sacred oracles, confided to our
custody,  and to be preserved with filial care and affection.  It
is a legacy rich and precious, and worthy to be transmitted
to future generations—let the  chain  of succession be perfect
so that the science of medicine may take its place among the
enduring things of this  world.   You whom I am  now
addressing will constitute in part the connecting link between
the present and future—and to you will  that future look  for
the preservation of the  trust so soon to be committed to your
charge..  The elements of knowledge, necessary to the perform-
ance of this important  trust,  you  seek  in this University— 
7
and it can scarcely be necessary to say that the lessons taught
here will be the results of the accumulated wisdom of past
ages—their great  charm will be that of attested  truth, and
they will rest upon foundations broad and impregnable.
  In return for the confidence you have manifested in selecting
the Faculty of this Institution as your  instructors, no  effort
shall  be spared to carry out your best hopes, and fulfil  the
high expectations of your friends.   We feel deeply the respon-
sibility  of our respective positions—to us has been assigned
the  duty  of inculcating on your minds  the  principles,
which are  hereafter to guide you in the treatment of dis-
ease ; and   it cannot  be disguised, that the lives and hap-
piness of those  to be  confided to your  care may  depend on
the knowledge you  receive in  these  halls.  For myself
personally, I cannot contemplate  the duties of my chair in
this University with other  than feelings  of great anxiety and
distrust—they are duties which come directly  home to  the
heart, for they involve the discussion of  the dangers and suf-
ferings  to which  woman  is  subjected  during the  various
periods  of her existence.  These periods are characterized by
distinct and important phenomena, which are justly entitled
to the serious attention of every medical  man, who cherishes
a proper  love  for his  profession;  and is  anxious, whilst
achieving a reputation for himself, to confer upon the afflicted
of his race the solid benefits of a science intended, by the God
of the universe,  to minister to the wants  of his suffering crea-
tures.   Woman, from  her infancy to  old age, is an object of
constant interest; and it is  not strange that a being so tender,
and yet so full of  endearments, should have called forth the
admiration of the philosopher, and the  fervid praises of  the
poet.  Her  history  is but the narrative of good deeds—in
health she  is our pride, in disease our solace; and, in  the
faithful discharge of her duties to  society, she is  the idol of
all hearts.   Like a ministering angel, she soothes us in afflic-
tion ;  and,  under  the depressing  influences of adversity, she
inspires hope, and incites  to renewed effort.  Who has not
felt the  cheering influence of her smiles, and  the encourage- 
8
ments  of her eloquence  in  the dark hour of despondency?
Abandoned by friends, and left to the cold charities of a selfish
and heartless world, the husband of her bosom then  knows
how to appreciate the depths of her love, and the sincerity of
her vows.
            ' There, drink my tears while yet they fall,
            Would that my bosom's blood were balm,
            And, well thou knowest, I'd shed it all
            To give thy brow one minute's calm.
            Nay, turn not from me that dear face—
            Am I not  thine—thy own loved bride—
            The one, the chosen one, whose place,
            In life or death is by thy side !'

  As  wife, mother,  sister—in a word, in every situation of
life, virtuous woman is the  kind and fast friend of man.   Is
it, therefore,  not due to this self-sacrificing  being,  that  we,
who know so well how  to value her excellence, should labor
assiduously to diminish  the  sufferings, and  assuage  the  sor-
rows incident to her  sex?  The duty of instructing you how
to assauge these sorrows, and rescue her from the perils by
which she is surrounded, devolves on  me;  and I need  not
say that I  will endeavor  most faithfully to perform this office.
  Parturition constitutes but a small portion of the  depart-
ment committed to  my charge.  The  difficulties and perils
of the lying-in chamber are in  themselves subjects  of vast
interest to the medical  practitioner, and  they will  receive
during the session their full measure of attention; but there
are other topics embraced  in the department of obstetric
science, which demand  the  profound investigation of every
pupil, who may desire distinction as an accoucheur.   I allude
to the  diseases peculiar to females. In  the whole circle of
medical science, there is no class of maladies which, if  pro-
perly understood, presents a more certain basis for fame  and
fortune than those,  which appertain to the  sexual organs of
the female; and it must be conceded that the attention they
have received in this country is by no means  commensurate
with  their importance.  It is, indeed, melancholy to behold
the devastation, which these affections are making among our 
9
fair country-women.   Look, for example, at the gay and appa-
rently joyful maiden as she passes you in the street, decorated
with the adornments of fashion, and loaded with all the tinsel
that wealth can purchase.  To the casual observer, she pos-
sesses that charm of life—health.   But amidst all this gayety
she is often the victim of disease which, simply from neglect,
proves the basis of early death.   Consumption, that scourge
of our race, is frequently the result of disordered action in the
womb which, in being overlooked by the practitioner, termi-
nates in disorganization of the lungs.  Thus it is that  many
an interesting creature is prematurely removed from earth,
the original cause of her disease never having been suspected!
   The  maladies peculiar to females, • from  their very na-
ture, lead  to much embarrassment  on the  part of the prac-
titioner.  It  is too  often  the  case that  his  opinion is not
requested until serious, if not fatal  progress has been made
in  the  disease.   The delicacy of the female very naturally
urges her to  a concealment of her sufferings,  until finally
bodily torture, which she is no longer able to endure in silence,
compels her to invoke professional counsel.   But alas! how
often does it  happen that, under such circumstances, the phy-
sician  is  forced  to  the  acknowledgment that the disease
is  beyond the efficacy of medicine, and his duties limited
to  the  palliation of present  suffering!  Again,  the prac-
titioner will  be sent for; the patient is unwilling to commu-
nicate freely with him in reference to her situation; she con-
tents herself with stating that her health is infirm, that she is
troubled more or less with pain  in her back, and is anxious
to  receive from  the Doctor some strengthening  medicine!
This is but  too generally the substance of the conversation
between, patient  and physician—and hence it is not surpris-
ing that public confidence should be somewhat shaken in the
efficacy of our art; and that people, sensible on all other sub-
jects, should  thoughtlessly commit  their  health and lives to
nostrum  venders,  and wreckless  empirics.  No  physician,
who is thoroughly imbued with the principles of his science,
and who places a proper value on  his reputation, will suffer 
10
 the simple declarations of his patient to guide him in either
 the diagnosis or treatment of disease.   The very foundation
 of successful treatment is diagnosis ;  or, in other words, if
 you wish effectually to combat disease, you must first ascer-
 tain not  only that it  exists, but you  must  distinguish
 the organ affected,  and  especially  discriminate  between
 organic and functional derangement;  you are  to be careful,
 too, not to confound  sympathetic influences with organic
 lesion.   If these principles be true, when applied to the treat-
 ment of disease in general, they are emphatically so in regard
 to the disorders of the  uterine system, connected as it is to
 the various portions of the economy by important and multi-
 plied sympathies.
   The ancients possessed but a  very general idea of the
 true condition of the womb ;  and their knowledge of its sym-
 pathies was vague and indefinite.  They certainly, however,
 ascribed to it extraordinary power; and although ignorant of
 its exact relations to the rest of the system, yet, if we turn to
 some of the older writers, we shall find  that a species] of
 sovereignty was claimed  for  it over  the other organs of the
 body.  Among others, Plato  observes,  " that the womb is a
 wild beast that obeys no law ; but which, when its desires
 are unsated, wanders about within the body, and excites all
 sorts of irregular  motions."  Now, it must be  admitted that
 this picture of the womb is true, not only in outline, but in
every particular, physiologically considered;  and we must
 concede that the ancients, unaided as they were by the lights
of anatomical and physiological science, and, therefore unable
to explain the phenomena of sympathy, certainly entertained
very significant notions of the controlling influence of  the
uterus over the other organs  of the  animal economy;  and
appreciated the truth of the aphorism promulged by Van Hel-
mont in the 17th  century:   " Propter solum uterum  est
mulier id quod est." With  the general ignorance, which
prevailed among the ancients in regard to the minute anato-
mical structure of  the wombr it  is, indeed, surprising that
they should have possessed such striking views of the relations 
11
of this organ to other portions of the system.  This, however,
is but another evidence of their habits of  close observation.
Galen  suspected the  existence  of  nerves  in the uterus,
and he was led to the conjecture  from the admitted properties
of the organ—sensibility and contractility.   Since the time of
this  illustrious observer,  numerous anatomists have  given
attention to the investigation of this subject; but the honor is
awarded to Dr. William Hunter  of having been the first to
examine critically  the nerves of  the  gravid uterus,  and
suggest  the interesting  fact that  they  become  enlarged
precisely like the blood-vessels  in proportion  as pregnancy
advances.   Doctor  Robert Lee, of London, has  recently made
some valuable  contributions on  the subject of the nerves of
the  uterus;  it  is  admitted  that this viscus, in  addition
to other  sources,  derives an abundant  supply  of nerves
from the great sympathetic ;  and  it is through the influence of
these nerves that the various functions of  the womb are per-
formed.  Nor is  it  difficult, with these  facts before him, for
the  practitioner to  understand how remote organs may fre-
quently exhibit the appearance of disease, when in truth the
disturbance is  merely secondary, or  the  effects of a cause
traceable to an affection of the womb itself!  It is not for me
to say how many lives have been sacrificed, and what severe
suffering entailed on the female, by the neglect of  this funda-
mental principle in the treatment of the  maladies peculiar to
her.   A patient, for example, complains of great  distress in
her  back ; she cannot exercise without an aggravation of her
suffering;  she has been  told by her  former attendants  that
she  is laboring under  rheumatism, or, as  it is termed, lum-
bago—the whole  materia  medica has been  unavailingly
exhausted in her behalf—a victim to protracted suffering, and
experiencing  no  relief,  her confidence  receives  a  severe
 shock ;  she is about to abandon regular  practice and  have
 recourse to sarsaparilla, (which at this  moment seems to be
 a specific for every species of malady,) or Mesmerism, which,
 by  converting her  into a  mirror, will enable  the  sagacious
operator to see whether the liver is not attached to the central 
12
poition of the tendoachillis ; or the anterior division of the
brain found its way into, and become a part of the adipose
matter of the  omentum!  But fortunately, before  subjecting
herself to this  most luminous yet mysterious system of thera-
peutics, she resolves to make one more effort to obtain relief;
and accordingly applies to a medical man who, in lieu of pre-
scribing for mere  symptoms, and who  does not believe that
because  there  is uneasiness or pain in a part, that, therefore,
that part must of necessity be the seat of primary disease, pro-
ceeds at once to a scientific examination of the case.  He knows
that the great secret in the successful treatment of maladies is
to trace effects to causes;  not to rest satisfied until the very
source of the trouble is reached—in a word, to know what the
matter is.  Thus, after a critical analysis of all the features of
the case, looking at it in its varied aspects, he ascertains the true
and only cause of the sufferings, which his patient has endured
for years, and which  were fast carrying her to the grave—
he finds that the pain in the back, the lumbago, are indeed,
but shadows reflected from the neck of the womb, which is,
the true seat of disease.  Having, therefore, satisfied himself
that chronic engorgement of the cervix  uteri, or some other
morbid condition of this part is really the cause, and the sen-
sations  in the back but the effects, he applies his  remedies,
reduces the engorgement of  the  uterus, restores the organ to
its normal state, and his patient to health and happiness—
" Causa sublata tollitur effectusP  I might, if it  were
deemed necessary, call your  attention to  numerous other dis-
eases, which have baffled the skill of the practitioner simply
because, in his treatment, he has violated that cardinal  prin-
ciple  of tracing effects to causes.  Why is it that hysteria,
chorea, ammenorrhea, mennorragia, dysmenorrhea, fluor
albus, leucorrhea,  6pc, which bear so heavily, and often, too,
so fatally on  suffering woman, have triumphed  over pro-
fessional effort, and brought their victims, if not to death, at
least to years of agonizing torture.  Is it because these mala-
dies  are without remedy, and bid defiance  to  professional
learning and  skill ?   Have the  splendid minds which  have 
13
been  consecrated  to the  investigation  of  these  disorders
brought forth nothing but the humiliating confession that
they are beyond relief?   Such an hypothesis cannot, for an
instant, stand before the brilliant revelations of pathological
science, which disclose  to us the important truth that the
affections  I  have just named are, for the most part, but so
many groups of symptoms indicative  of either functional or
organic disease of  the womb—and  if viewed as symptoms,
and  not as  primary diseases, they  would  readily yield to
judicious treatment.
  In order more fully to illustrate this subject, let us suppose,
for a moment, that a patient is laboring under mennorragia, or
profuse menstruation, and should apply to one of you  for
professional advice.   She informs you that, for the last  two
years, she has scarcely been free for a day from this discharge
of blood—she has  consulted numerous  physicians, and has
had administered to her every variety of medicine—she has
employed a dozen different astringent injections per vaginam,
and all without relief.   This constant drain on her system
has not failed to show its effects—her face  is blanched—her
strength  gone—her  digestive  powers  almost destroyed—
cold feet and hands—a circulation so feeble that the pulse can
scarcely be  detected—the slightest exercise producing palpi-
tation of the heart, vertigo, syncope.   In a word, she appears
before you a perfect wreck, and to the ordinary observer her
case is  without hope.  Her measure of suffering is indeed
full;  she  is surrounded by all  the'  luxury  that  wealth can
procure—but prostrated by disease, and  now brought to the
verge of the tomb by a malady that has resisted all treatment,
she  would  fervently pray for death, did  not the strong and
sacred ties  of nature tell her that she has something besides
herself to live for!  She thinks of her husband  and  chil-
dren—the former, devoted and kind—the  latter young and
helpless;  at an age, too,  when  they are most  dependent on
a mother's love and care.   These feelings touch her heart
deeply, and  she makes a last effort to regain  her health, in the
trust that she may be spared to her  family.  It is,  therefore, 
14
under circumstances like these, when all earthly hope is cut
off, and a lingering death in prospect, that you may be sum-
moned to give your professional opinion.  You investigate
most carefully the whole history of the case—the discharge
of blood which has heretofore been viewed and treated as the
disease, you regard merely as the effect or symptom of dis-
ease elsewhere.  You direct your attention to the uterus—a
vaginal examination is instituted—and you find, projecting
through the mouth of the womb,  a small tumor insensible to
the touch, with its  base downward and its pedicle upward,
attached to some portion of the internal surface of the organ—
and you at once recognize a polypus.  This is the disease—
the flooding has been occasioned  by it alone—and as long as
the polypus is suffered to remain so long precisely will the
hemorrhage or drain be kept up, until finally the patient sinks
from absolute exhaustion.  You, therefore, proceed without
delay to remove the polypus—the blood ceases to flow, the
drain is closed—and by your science and skill the patient is
not only rescued from impending danger, but she is restored
to health and the bosom of her family.   She looks upon you
as the kind friend  who, with the sanction  of  Heaven, has
arrested her  progress  to the  grave;  on  her heart are im-
pressed feelings of  abiding gratitude for the services rendered
in the hour of her need—and as  long as that heart shall con-
tinue to beat it will do so in grateful remembrance of one, who
has been the  humble instrument of prolonging the life of a
cherished wife and mother, and dispensing happiness to those
so dependent on her care.  Such a victory would, indeed, be one
of priceless value—and it is such  conquests that are truly
worthy the ambition  of  the  scientific practitioner.  Believe
not, gentlemen, that I have presented you an exaggerated pic-
ture—it is full of truth; and, when you shall have become
engaged in practice, you will have exhibited to your observa-
tion many of the same character.  If your minds be properly
imbued with  the principles  of  obstetric science, cases such as
I have just described, should they be confided to your  charge,
will prove the corner stone of your fame and fortune. 
15
  It is my duty to guard you against a prevailing error in
practice,  which  seems to have been  consecrated by almost
universal custom. If a female labor under a vaginal discharge,
whether mucous or purulent, she is supposed by her friends
and herself to be  affected  with the  ordinary  female  com-
plaint—the " whites," or fluor albus, as they sometimes  deno-
minate it;  and it is regarded as a simple weakness.   This is
one of the most common disorders to which the female  is lia-
ble, and is often the indication of serious disease in the womb.
It is, however, too frequently viewed with indifference by the
practitioner from the very circumstance that it is of ordinary
occurrence; and, in consequence of neglect at  the inception
of  this discharge,  especially when it depends on  organic
disease of the womb, most disastrous results  ensue  to the
unhappy patient.   She employs, for this supposed weakness,
the various remedies suggested by her friends, but experiences
no  relief.   At last she sends  for a physician, tells him she has
the fluor albus, and wishes him  to prescribe a wash.   The
physician  accordingly recommends  some  astringent lotion,
from which she derives not the slightest benefit.  Discour-
aged, and believing there is  no remedy adequate to her case,
she resolves to bear her troubles in silence, which, if they do
not ultimately produce serious disorganization, will, at least
entail on her much annoyance and suffering.  Now, I would
ask, what is meant by the " whites ? " Is it a term entitled to
consideration—or  is it a  mere vulgarism—a mantle, if you
choose, for ignorance.  The expression is employed by the
female to indicate that she is troubled with a discharge from
the vagina, not of blood, but of a mucous or purulent nature.
Every well-educated accoucheur knows that the discharges
from the vagina are four in number;—sanguineous, purulent,
mucous and watery—and he also understands that there are
various morbid conditions capable of producing each of these
evacuations.  His first duty, therefore, on being consulted is
to  ascertain the character of  the discharge.   Suppose it is
mucous, what  is next to be done ? Why promptly to discover
the specific cause.   Likewise,  he  knows,  that there  are 
16
several conditions of the female system capable of giving rise
to this particular form of discharge—for example, ascarides
in the rectum,  warty excrescences  about  the  vestibulum,
polypus and prolapsus uteri, bloody tumor of the meatus  uri-
narius, &c. &c.  He examines, therefore, with great caution;
the true  source  of the  difficulty is  ascertained; the proper
remedies applied, and he at once  relieves his patient.   But
the discharge may partake of a purulent character.  In  this
case, his attention is directed to the womb—and it is not im-
probable that, under these circumstances, he  will detect ulcers
in the neck of this organ—these ulcers  he  heals by appro-
priate treatment, and  nothing more is seen of the discharge.
I have repeatedly been called to cases of this  description, in
which the blunder consisted in mistaking the secretion for the
disease.  You see, then, how important  it is for  you to com-
prehend thoroughly the principles  on which you are to  pro-
ceed in the treatment of these maladies—and  you  cannot
fail to perceive  how  abundantly these  principles will ena-
ble you to  soothe in  their anguish, and rescue  from disease
those who,  at all times, but especially in  the hour of suffering
and peril, have a natural and earnest claim on our sympathies.
   Another  common error in practice is to impute the various
ailments of the female to falling of the womb ; and hence, if
we are to credit what is said on this subject by  certain prac-
titioners, falling of the womb is the true cause of  all female
complaints.  It would, indeed, be  much nearer  the  truth to
affirm that this affection is very commonly the result of care-
lessness on the part of the physician in not detecting, at an
early period, disease of the cervix of this organ, which, by
being suffered to progress, terminates in  chronic engorgement,
thus causing the uterus to descend, and producing a veritable
prolapsion.  It has been shown by  Lisfranc, to whom the
profession  is  under  deep obligations for the  light he has
thrown on the causes  and treatment of affections  of the womb,
that prolapsus uteri  is rarely a primary disease, but usually
consequent upon enlargement of the  cervix which, by its
increased weight, pulls  the  uterus into the vagina.  With 
17
this simple explanation, which undoubtedly is based on facts,
it must be evident that  the very means usually resorted to
for  the cure of falling of the womb, are the direct agents of
mischief—they not  only do  no  good,  but are  positively
injurious.   Every medical man,  who  possesses a  proper
knowledge of his profession, is well aware that this disease is
extremely rare among unmarried ladies.  What, therefore,
must be the character of  a practitioner^ who can  see no other
cause for the sufferings and ill-health of  a young lady, than
falling  of the womb, and consequently subjects her to  the
most cruel and unjustifiable examination.  I have heard of
several young creatures in one family, averaging from sixteen
to eighteen years of age, condemned  to this most shameful
desecration of their persons.  A physicians to be  habitually
guilty of such practices, must in all truth either be a knave,
or  labor under confirmed monomania—not, however, more
confirmed  than  the mental  delusion, which could induce
 mothers to tolerate this  unnecessary and indelicate exposure
 of their guileless daughters !
   In elucidation of the statement that females have been
 frequently treated for falling  of the womb; when in  fact it
 did  not exist,  I could call  your  attention  to numerous
 instances, which have presented themselves to my own obser-
 vation;  and  I shall take the liberty of citing the following
 case, because, in addition, it illustrates most perfectly what I
 have endeavored to impress on  your minds—if you wish to
 cure disease first ascertain its true nature.
    During the last Winter, I was requested to visit profession-
 ally a married lady from the state  of New Jersey. The history
 of her case was simple and to the following effect :-In June,
 1842 she  experienced uneasiness in the region  of the womb,
 and slight pain in passing  water.  There was more or less
 discharge of mucous from the vagina, and sexual intercourse
 occasioned at times great distress.  These were the incipient,
 and only symptoms of her malady.  A physician was  con-
 sulted  and immediately pronounced the disease to befalling
                              2 
18
of the womb.  Pessaries were introduced—abdominal sup-
porters applied, but without affording any relief to the suffer-
ing patient; whilst, on the contrary, the pessaries tended to
aggravate the pain by the pressure  they exerted on the seat
of disease.   Another practitioner was consulted, and reiterated
the opinion already advanced.   Having continued  under  his
care for more than ten months, without deriving the slightest
benefit, and experiencing a positive increase in her sufferings—
the  pain  and  difficulty in passing  water  becoming  more
aggravated—she resolved to visit the city of New York in
search of professional advice.   She arrived here in December
last, and I was requested to see her.   On hearing the history
of the case, I frankly told her that I  did not believe she
had falling of the  womb, for the simple reason that her
symptoms were not characteristic  of any such ailment.  I
proposed an examination, which was cheerfully consented to,
as the lady was most solicitous to obtain relief.  The uterus
I found in  a perfectly healthy condition and in  its natural
position.  In passing my finger along the urethra, the patient
experienced a sensation of pain, and this circumstance, together
with the difficulty of which she complained in passing water,
attracted my attention especially to this point.  1 could detect
no disease in the uterus or vagina;  in attempting to intro-
duce an ordinary female  catheter  into the  urethra  I was
completely foiled; and, on minutely examining the condition
of this  passage, I  discovered that the lady's sufferings were
entirely due  to a stricture  of the urethra.   Stricture of the
female urethra I had never seen previously to this occasion ;
and, as far as my knowledge extends, no case  of the kind had
ever occurred  in this country;  at least, no record has been
made of it.  Velpeau, in his great work, cites but three cases of
stricture of the female urethra, and remarks  that its occur-
rence is extremely rare.   In the course  of  three months,^
succeeded in removing the stricture, and the  lady returned to
her home entirely restored to health.  It is proper for me to
observe that Doctors Detmold and  Satchwell visited this  pa- 
19
tient with me on two occasions, and heard from her own lips
the statement, which she made of what occurred previously
to my seeing her.
  I must beg your indulgence whilst I mention another case,
which  had been  mistaken for falling of the womb;  and
which, if it did not result most disastrously was certainly not
the fault  of  the  medical gentleman, who preceded me in
attendance.   On the 10th day of last July a lady, residing in
this city, sent by note a request that I should pay her a pro-
fessional visit.  She informed me that, for the last few months,
she had been under the care of a practitioner who pronounced
her to  be laboring under falling of the womb—that he had
on one occasion  introduced  an  instrument,  (a speculum  I
imagine,) which gave her so much uneasiness that, in twelve
hours  afterwards, a  miscarriage  was the consequence.   I
was also  informed by the  lady that she  had been under the
necessity of calling repeatedly at the house of this practitioner,
his engagements being  so numerous that he  could not find
time to visit her.  She had faithfully observed all his direc-
tions, but received  no benefit from  his treatment.  In my
first interview with this  patient, after hearing the above state-
ment,  I requested her to give me  a full account of her symp-
toms.   She remarked that since  the birth of her last child,
about  twelve months since, she  experienced  great irritation
about  her bladder—her nights were  much disturbed by more
or less desire to pass water—being obliged to leave her bed
more than a dozen times during the  night. The irritation of
the bladder  had entirely  disfranchised  her  from all social
intercourse—and she could not with any degree of comfort
leave her house.   This state of things had continued without
any palliation to the time of my visit, and her sufferings had
 produced an  evident inroad  on a  constitution, otherwise
vigorous.  I then asked her if her last labor had been unusu-
 ally protracted, or whether she had experienced at the  time
 any difficulty about the bladder.   To which she replied that
 her labor was natural and of  short duration—but the doctor,
 who attended her in confinement, in attempting to introduce 
20
 a catheter into the bladder for the purpose of drawing off the
 water, gave her much pain, and caused a slight discharge of
 blood, unaccompanied, however, by any flow of urine.  This
 was all the information I obtained from the patient, and I
 think you will agree with me that there was nothing in the
 case to justify the suspicion  that her difficulty was attribu-
 table to falling of the womb.  On  examination, I found the
 womb entirely free  from disease, and in its natural position.
 I detected just within the meatus  urinarius  a small  ulcer,
 which was most probably the result of injury inflicted by
 the  catheter.   This  ulcer I  regarded  as  the  only cause of
 her  suffering, and informed  the lady with great confidence
 that in a few  days  she should be  restored to health.   On
 the following  day, assisted by Doctor  Trantham, of South
 Carolina, in whose  presence the above statement was re-
 peated by  the patient, I touched the ulcer  with  the  nitrat
 Argenti—ordered mucilaginous drinks—and,  on the  fifth
 day after the operation, she took a long walk without incon-
 venience ; to the present period she has never experienced
 the slightest irritation or pain about  the bladder.   Her health
 has continued excellent, and she is at this time in the sixth
 month of gestation.
   Those  of you whose taste or preference may lead to a
 special study  of the  diseases of  women, will discover that
 they are numerous  and almost of  endless variety.  They
 produce not  only great  physical distress, but often  bring
sorrow to the  domestic hearth.  Woman, at every period of
her existence, is  liable to disease and suffering—and it would
 appear to the ordinary observer that God, for some wise yet
mysterious purpose, had imposed on her penalties and afflic-
tions far heavier than those  which  our sex are called upon
to bear.  Such may  be the belief engendered in  the vulgar
mind, after  contemplating the constant and imminent  perils
by which the female is more  or less surrounded during  the
various eras of life.  But the philosophic eye, glancing  as
 it does at the  admirable laws on which all health is based,
 sees at once that it is the violation of these laws alone which 
21
produces such disastrous effects on the female frame.   The
refinements of civilization, and the consequent departure from
those salutary influences so necessary to that harmony of
action without which a healthy condition of the system can-
not be* maintained, are making fearful inroads on the females
of the present generation ; so that, whilst on the one hand the
scholar is gladdened by the triumphs of civilization, the phi-
lanthropist on the other cannot but lament  the evils which
necessarily follow  in its  train.   It was the pride of the
ancients to impart to their children robust and vigorous con-
stitutions ;  and could a mother of those sensible times again
visit earth, look upon the present condition of society, and
examine its  effects on the females of our day, she would in-
deed think that human nature had near run its course; she
would search in vain for those who would remind her  of her
own ruddy and vigorous daughters—and, from  the fullness
of her heart,  she would drop a tear over poor degenerate hu-
manity.   Honor I  say  to the man who may succeed in
awakening parents  to a proper sense of the  serious injuries
 inflicted on  their daughters, both morally and physically, by
 subserviency to the demands of modern society!   If the dis-
eases peculiar to  women be more frequent at the present
 time than formerly—and the fact  is most satisfactorily esta-
 blished—the frequency is to be  attributed to changes in mode
 of life and education, and to the increase of nervous excite-
 ment, the  immediate  effect of  these changes.  Compare, for
 example,  if you desire to  appreciate the influences of educa-
 tion and'mode of life on the health of the female, the buxom
 lass of the country with the tender and frail  belle of this me-
 tropolis.  And  in order to obtain the full  benefit of the com-
 parison, let  it be instituted at the  period of puberty—a most
 trying and  critical period of female life—so critical, indeed,
 that it is often the index of future health, or of premature and
 painful decline.   The function of menstruation, which exerts
 such a controlling  influence over the economy, appears in
 the former  case with marked regularity, and in entire  accor-
 dance with the appointments of nature;  whilst, in the latter, 
                           22

in consequence of influences which have subjected the ner-
vous  system  to  continued  excitement,  thus  prematurely
developing the vital  forces,  menstruation  is  characterized
by  evident  aberrations, and  more  or  less  derangement  in
the various functions of the body.  This departure from the
exactions of nature is too frequently followed by the penalty
of severe suffering and disease.  The young and thoughtless
girl who, in her wayward career, so far contravenes the laws
of nature as to interfere with the menstrual function, imposes
on herself a life of sorrow, if not of irremediable ill-health. Be-
tween this function and the thoracic viscera there  is a close
alliance, which unhappily too often escapes the observation of
the practitioner.  Palpitation of the heart, asthma, hemoptysis,
are common consequences of disturbed action in the uterus ;
and, instead of being regarded as the direct effects of uterine
derangement, should they be treated without  any reference
to their legitimate cause, serious, if not  fatal results must
necessarily ensue.  Look, too, at the condition of  the entire
nervous system   in cases of either retained or suppressed
menstruation.  It is thrown into extraordinary excitement,
producing convulsions, hysteria, catalepsy, chorea, and even
mania.  Do not these facts declare, in silent yet eloquent lan-
guage, the complete subjection in which the womb holds the
general  system;  and, at the same time, point out to the prac-
titioner  the  absolute necessity, when nature is incompetent
to act for herself,  of preserving by judicious treatment the in-
tegrity of functions appertaining to this most important organ ?
  When you  shall have become engaged  in the practice of
your profession, you will discover that the maladies to which
I have  alluded will necessarily occupy much of your atten-
tion ;  your counsel and aid will  frequently be  demanded—
and the happiness, and even the lives of those who thus give
you their confidence, may rest entirely  on your judgment and
skill.   Sacred, therefore, will be the responsibilities  which are
soon to devolve on you;  and no man of conscience can con-
template them without having his mind filled with  doubt and
anxiety—and his best energies consecrated to the attainment 
23
of knowledge, which will  enable him promptly to  meet the
trying emergencies of professional life.
  You,  gentlemen, who are just on the threshold of the pro-
fession,  and have not been  engaged in the details of practical
duty, will scarcely credit the schemes resorted to in this city,
under the guise of science, for the purpose of plundering the
sick and the dying.  I  could cite several  thrilling cases in
confirmation of what I now state;  but  for the present, one
will suffice, to convey to you some idea of the monstrous prac-
tices tolerated in the very  heart of a Christian community.
Sometime  since, a lady of  great  intelligence  from one of
our  Western cities visited New  York  for the  purpose of
seeking professional advice.  Soon after her arrival in this
city I was  requested to see her; and, after listening to the
history  of her case, I became satisfied that she labored under
a formidable  disease  of  the  womb.   Without,  however,
expressing any  opinion, I  left  her  with the promise that I
would see her  on  the following day, and then  give her my
views of her case.  Accordingly, after a careful examination,
I discovered that this lady  was affected with ulcerative car-
cinoma ;  and being strenuously urged,  both by herself and
friends,  not to disguise my opinion, but to state unequivocally
whether there was any hope of recovery, I frankly  remarked
to her that her disease was  beyond permanent relief;  and all
that could  be done would be to palliate her sufferings.   This
opinion  was  received  with extraordinary firmness by the
patient; and, as I thought, with some degree of doubt both
by  herself  and friends.    After continuing  my  visits for
a week, it was very evident, from  certain manifestations,
that  some  influence  had been  at work to  destroy confi-
dence in my  judgment;   and the patient  expressed  with
great kindness,  yet with  decision, her  strong  belief that
I  was  in  error  in reference to her disease.   Under these
circumstances,  the course  for  me to  pursue  was  a  very
obvious one; and I, therefore, suggested that other counsel
should be taken in order that the opinion I had given might 
24
be  confirmed  or set  aside.   My Colleague, Dr. Mott, was
requested to see the case with me—and his examination cor-
roborated in every particular the opinion previously expressed.
I continued to  visit this unfortunate lady, and do all in my
power to assuage her anguish; her sufferings were most severe,
but she bore them with the fortitude and resignation of a Chris-
tian.  Her mind had become satisfied with the opinions that
had been given; and believing that there was  no earthly hope,
she was reconciled to die.  Just at this time, a kind friend put
into her hands a pamphlet recounting " wonderful cases  of
cure of all sorts of maladies by Mesmerism."  This poor crea-
ture, weighed down by suffering,  her form attenuated  to a
skeleton, her  mind enfeebled, and her reason rendered infirm
by protracted and agonizing disease—unable, of course, to form
a competent judgment on any subject, placed the fullest faith
in the statements set forth in the pamphlet; and, at her earnest
solicitation, the Mesmeriser was sent  for.  After the first act
of his  jugglery, he informed  her  that  the doctors  were
altogether deceived as to her disease—she had no cancer but
labored  simply, as he termed it, under a "concatenation  of
visceral deficiency //"   This "concatenation of visceral defi-
ciency," he pledged himself promptly to remove, and restore
to perfect health.  The friends of  the sufferer, passing  as
she was rapidly to the  grave, although they had no confi-
dence in  the  declarations of the heartless impostor, could
not resist the  fervent  appeals of  the dying  woman;  and
he  was, therefore, permitted  to practice his unholy  tricks.
Day after day he continued his Mesmeric operations, promis-
ing with renewed emphasis a speedy recovery. One morning,
however, on arriving at the house, and proceeding to the room
of his victim, he was  accosted by the nurse, who informed
him that the patient had expired the night before !  Unmoved
by  this disclosure, and  with perfect  indifference, lost as he
was to every feeling  of humanity, he left the house without
a word  of comment, satisfied in his own mind  that he had
obtained the  object for which he had consented  to desecrate 
25
his character—the  wages of his wretched deception.   The
God of truth and justice will assuredly deny mercy to a man
who could thus wantonly revel over the credulity of a dying
and suffering woman !  It is time to speak out on this subject—
let every  honest man  rise up in his might, and, by moral
weapons,  drive from our midst  tlic  fiends who  would thus
speculate  with human life,  and bring disgrace  on human
character.  The deeds of infamy practiced on the innocent
and unwary in this enlightened city, and the fortunes accumu-
lated by these traffickers in the happiness and lives of  their
fellow-beings, are subjects  in every way entitled to the grave
consideration  of those  who by law are the conservators of
the public weal.
   In  conclusion, gentlemen, allow me to remind you  that,
in the language of Lord Verulam, " Knoxoledge  is power ; "
and if  you wish  to succeed brilliantly in the profession of
your choice, gather knowledge—with this, associate patient
and persevering industry.  Elements like these will prepare
you for the conflict of mind with  mind—they will enable
you to enter the contest well fortified ; and, whilst you will
have  no  reason to indulge in gloomy apprehensions of the
future,  you will have around  you a shield impenetrable to
the shafts of either envy or detraction.   Detraction is the
usual penalty of success in our  profession.  Men who, from
natural  indolence or  imbecility of mind, find  themselves
unable to contend with you for the prize of public favor, are
sometimes foolish  enough to suppose that they can destroy at
will a well-earned reputation by the propagation  of base and
groundless  slanders.  Deluded  creatures! have  you not
yet learned, from  the fatal  rebound, that these  dastardly
attacks on character re-act with fearful effect  on your own
guilty heads!
   Do not, for a moment,  credit the fiction that  either  fame
or fortune can be  acquired without  laborious toil.  There  is
no royal road to professional eminence, and although money
may  be amassed  by imposing  on the credulity of the un- 
26
learned in  medicine, and substituting trick for science, yet^
to every right-thinking man, wealth so obtained is, indeed,
" filthy lucre," for it is derived at the expense of character.
But  when  I survey  this hall  and look  at  the immense
class of students before me, coming, as a large portion of you
do, from remote  sections of this country, I cannot but feel
that  the motive which induced you to  leave your  distant
homes and seek instruction here, is one honorable to your-
selves, and most  creditable to the  profession of which you
are soon to become the guardians.  It is manifest that you
place a proper appreciation  on the importance of medical
study—you have  not been seduced by the infatuations of the
day—your faith has proved too strong  and your honesty too
refined to be moved  by the  pretensions  of modern empiri-
cism.  Directing, therefore, your aspirations to a higher and
more enduring  object than the attainment of an ephemeral
reputation—and anxious as you must  be  to secure to your-
selves  an honorable distinction in the profession to which
you  are about to  dedicate  your lives,  allow me to bid you
welcome to this university—to assure you of the devoted and
sincere interest, which the faculty feel  in your behalf—and,
at the same time,  to pledge their best efforts faithfully to dis-
charge their respective duties.  It  is for you that we  shall
labor—your welfare will be  our first and cardinal object—
and if this university is to maintain her present  position, it
can  only be done through  the testimony  of  her alumni.
You now stand enrolled among her sons, and the time is not
far distant when,  having fulfilled her requirements, you will
become candidates for the highest  privileges she can confer
on worth.   These you will  receive  with her benedic-
tions, and her ardent wishes for  your success and happiness.
Remember,  gentlemen,  the seal of this university will soon
be confided to your custody—it will, I feel assured, suffer no
dishonor in your  hands. 
 
UNIVERSITY  OF  NEW YORK-DEPARTMENT  OF  MEDICINE.
The Lectures in this institution will commence on  the last Monday  of October, and
continue four months.
    Valentine Mott, M. D., Prof, of the Principles and Operations of Surgery, with
         Surgical and Pathological Anatomy.
    John Revere, M. D., Prof, of the Theory and Practice of Medicine.
    Granville Sharp Pattison,  M. D.,  Prof, of General and descriptive Anatomy.
    Mahtyn Paine, M. D., Prof, of the Institutes of Medicine and Materia Medica.
    Gunning S. Bedford, M. D., Prof, of Midwifery and the Diseases of Women and
         Children.
    John William Draper, M. D., Prof, of Chemistry.

  Wm. H. Van Buren, M. D., Prosector to Prof, of Surgery.
  Wm. Darling,  M. D ,  Demonstrator of Anatomy.

  The fees  for a full Course  of Lectures amount to  $105.   The Student can attend
one or more of the Lectures as  he may be  disposed, and pay only for those which he
attends.  The fee for the Diploma is $30.   The Matriculation fee is j$5.  The fee
for admission to the Dissecting Rooms and Demonstrations is $5.
  The most ample opportunities for Clinical Instruction will be afforded to the Students
of the University, and  the facilities for dissection will be alL that can be desired. The
materiel is abundant and cheap.   The Dissecting Rooms will be open on 1st of Oct.
  The New  York Hospital,  15 minutes walk from the  College  Building,  is  visited
daily; and  the  students have an opportunity of studying the  various Medical and '
Surgical diseases of that Institution.
  The Eye and Ear Infirmary, in which more than  1,400 patients  are prescribed for
annually, is  open to the students.
  The  University  Surgical  Clinique is attended every Saturday  at the  College
Buildings by Prof. Mott, and the University Students witness the various operations
performed by the Professor.   More  than  600 patients, affected with every variety  of
malady, are brought before the Class during the session.
  The University Lying-in Charify, under the charge  of Prof. Bedford, is ample  in
its arrangements.  During the past five  sessions' more  than  1,200 cases of Midwifery
have been attended by the Students  of the University.
  In addition to  these facilities  for Clinical observation, there are the various Dis-
pensaries and Charities of the city, containing not less than 40,000 patients, presenting
every possible aspect and  character of disease.
  Excellent Board and Lodging can be had in the vicinity of the College for $2,50  to
$3 per week.
  The number of Students in attendance the last session was 407 ;  and the Degree of
Doctor of Medicine was conferred on 135.
  N. B.—Students on arriving in the city,  by  calling at the College Building, 659
Broadway, and asking for the Janitor, will be conducted to Boarding-houses.
  Any  farther  information respecting the  institution can be had by addressing  the
Secretary, Prof. Draper, 659 Broadway.          By order,
       Nov. 16,1846.                              JOHN W. DRAPER, Sec'ry.
  P. S.—The Faculty have  resolved in future  to  deliver a Preliminary Course of
Lectures during the  month of October, commencing the first  of the  month.   Lectures
will,  therefore,  be  given daily during the  entire month of October, without extra
charge.  The Lectures will, in no way, interfere with  the integrity of the regular
 Winter-session.   The  October Course, together with the opening  of the  Dissecting
Rooms  on the  1st of the month, will, therefore, present additional facilities to those
Students,  who may be disposed to avail themselves of them.